GENERAL PET ARTICLES

Heartworm Disease

Heartworms (Dirofilaria immitis) are blood parasites that are transmitted by mosquitoes in much the same way malaria is spread in people. The adult worms can be 10 to 14 inches long and live inside the heart and pulmonary arteries. They cause a restriction in blood flow leading to lung disease and congestive heart failure. Heartworm disease is diagnosed in all 50 United States, with endemic areas ...

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Heartworms (Dirofilaria immitis) are blood parasites that are transmitted by mosquitoes in much the same way malaria is spread in people. The adult worms can be 10 to 14 inches long and live inside the heart and pulmonary arteries. They cause a restriction in blood flow leading to lung disease and congestive heart failure. Heartworm disease is diagnosed in all 50 United States, with endemic areas along the Atlantic and Gulf coast and along the Mississippi river. Treatment of infection can be relatively straightforward if the disease is caught very early, or it can be very risky if the patient has advanced symptoms. Preventive medication is the safest and easiest way to avoid heartworm infection.

Adult heartworms bear live young called microfilariae. They circulate in the bloodstream where they are picked up by mosquitoes taking a blood meal from the infected animal. Microfilariae can be seen in whole blood under the microscope; however, their numbers are dependent on the number of mating pairs of adults in the heart. A negative test for microfilariae does not mean that the animal does not have heartworms. An occult heartworm infection is one where no microfilariae are present.

Microfilariae cannot develop into adult worms without first living inside the salivary glands of the mosquito and then being transmitted back into a host animal. Once the host is infected, over the next 6 months, they will migrate through tissue to reach the pulmonary arteries and the right side of the heart. The adult worms may live up to 7 years inside the infected animal.

Dogs infected with heartworms may at first exhibit very mild and intermittent symptoms of the disease. As more adult worms invade the heart and pulmonary arteries, and as the disease progresses, coughing, exercise intolerance, inappetence, and lethargy will become more and more persistent. It is common for an infected dog to have more than 30 adult worms inside the heart. Eventually, an untreated dog will succumb to heart failure.

Cats are aberrant hosts of heartworms, meaning that the parasite does not typically infect them, but for some reason infection has occurred. Immunosuppressed cats, such as those with Feline Leukemia, may be more susceptible to heartworms. Symptoms in cats are sometimes mistaken for other feline respiratory diseases such as asthma. Coughing, gagging, rapid open-mouth breathing, and weight loss are common symptoms. In many cases, cats may have fewer than 3 adult heartworms that cause debilitating disease.

The treatment for heartworm disease is currently only approved for use in dogs. There is no protocol for the treatment of cats other than supportive care. Cats may be prescribed bronchodilators and corticosteroids to control symptoms.

Before treatment, a blood chemistry panel is performed to check for kidney and liver problems that may delay or preclude the use of an adulticide, the drug that kills adult heartworms. Also chest x-rays are taken to assess changes in the lungs, vessels, and heart. Severity of the changes and symptoms determines whether a single treatment or a split treatment will be used to kill the adult worms.

The only drug approved is called melarsomine. It is an organically bound arsenical compound that is given by injection in the lumbar muscles of the back. One injection is administered, followed by a second one 24 hours later if the patient tolerates the medication well. In a split treatment, the dog is given the first injection followed by the series of two injections 4 to 6 weeks later. In either case, the dog must be kept confined for several weeks after the injections to avoid complications from treatment.

Complications can include respiratory distress, coughing up blood, liver or kidney inflammation, lethargy, inappetence (refusal to eat), vomiting, and diarrhea.

During the treatment, the doctor may prescribe an antibiotic like doxycycline and an NSAID for pain, since the patient’s back may be sore after the deep muscle injections. Medications for other specific symptoms may also be needed.

Prevention is the best way to avoid heartworm disease and the risk involved with treatment (not to mention the expense). There are a number of safe heartworm preventive medications that your veterinarian can prescribe for your pet.

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Hematoma Of The Ear Flap

Hematoma simply means “blood filled mass”. A hematoma of the ear flap (pinna) is caused by a ruptured vessel leaking blood between the layers of skin covering the inner and outer external portion of the ear. Because the blood cannot escape the body, the ear pinna fills like a pillow or balloon. Dogs and cats can be diagnosed with an aural hematoma. Canine hematomas are usually associated with an...

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Hematoma simply means “blood filled mass”. A hematoma of the ear flap (pinna) is caused by a ruptured vessel leaking blood between the layers of skin covering the inner and outer external portion of the ear. Because the blood cannot escape the body, the ear pinna fills like a pillow or balloon. Dogs and cats can be diagnosed with an aural hematoma. Canine hematomas are usually associated with an ear infection. The pain and irritation causes the dog to shake its head violently, causing a whipping effect of the ear flap. The increased blood pressure in the vessels causes them to rupture. Another cause of a hematoma can be a trauma such as from fight wounds, and this is the more common cause of hematomas in cats. The shorter the ear pinna, the less likely that a whipping action caused the blood vessels to rupture. In any case, an ear infection should be ruled out as an underlying reason for a hematoma.

Surgical repair is usually recommended for aural hematomas. Aspirating the blood with a needle and syringe can deflate the pinna, but this treatment is seldom effective. The hematoma will probably recur, and infection can occur if the hematoma is contaminated. Left untreated, the blood will reabsorb and form scar tissue, causing the ear pinna to shrink and deform. This is sometimes called a cauliflower effect, and can occlude the ear canal leading to increased risk of ear infections.

The window of opportunity to surgically repair an aural hematoma is typically within a week of its occurrence. The pet is administered a general anesthetic after pre-surgical blood work confirms that there are no contraindications precluding surgery. If an ear infection exists, the ear canal may be swabbed to send samples to a reference laboratory for culture and susceptibility testing. This can greatly expedite a successful resolution of the infection. Also, the ear canal may be flushed with antiseptic during anesthesia to facilitate a thorough cleaning before beginning topical treatments at home.

The ear pinna is shaved and prepped before an incision is made through one layer of skin over the length of the hematoma. The blood is drained, and the blood clots that would otherwise form scar tissue are removed. There are variations in technique at this point, but all achieve the same purpose. The Variation would be to tack the two sides of the ear pinna together leaving an opening to drain any residual bleeding that may occur. This will cause the two sides of the ear to scar together so that there will be no “pocket” to fill up with blood in the future. Some veterinarians will suture a piece of plastic to the back of the ear to help hold the pinna straight while healing. Local anesthetic may be infused into the pinna to help with pain control.

An Elizabethan collar is worn during healing to prevent the pet from scratching at the sutures, and sutures are removed after 14 to 21 days. Healing times are generally longer than spay or neuter surgery to ensure that the hematoma does not recur. Oral antibiotics and pain medications are sent home after surgery. Antibacterial / antifungal ear ointments are dispensed in the case of an ear infection.

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Hernias

A hernia is defined as the protrusion of an organ through a defect in the wall of the cavity where it is normally located. The defect or opening itself is often referred to as a hernia. Hernias can be congenital or acquired traumatically. In either case, they require surgical repair to avoid strangulation of the organ and tissues that pass through them. If strangulation occurs, it can be a...

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A hernia is defined as the protrusion of an organ through a defect in the wall of the cavity where it is normally located. The defect or opening itself is often referred to as a hernia. Hernias can be congenital or acquired traumatically. In either case, they require surgical repair to avoid strangulation of the organ and tissues that pass through them. If strangulation occurs, it can be a life-threatening emergency. Blood will not be able to circulate properly through the trapped tissues, and death to the cells from lack of oxygen occurs rapidly.

Congenital hernias are common. They are a result of inappropriate breeding. Animals with congenital hernias should not be bred, but in the name of profit, unfortunately, they continue to be used as breeders. The most common type of congenital hernia is umbilical. The opening in the abdominal wall where the umbilical cord passed from the fetus to the mother’s blood supply should close rapidly after birth. But in this case, it remains open. These are usually small hernias and only allow some abdominal fat to become trapped. They may seal on their own, and being sterile they may not cause problems. The fat will form scar tissue as it is devitalized when it loses blood supply. Occasionally, the hernia is large enough to allow a loop of intestine through. The larger hernia should be repaired to prevent problems in the future. Another type of congenital hernia is the inguinal hernia. The inguinal area is where the hind limbs meet the abdomen. These are always repaired surgically as they are typically large openings that do not close on their own. They are usually bilateral, meaning on both sides of the abdomen.

Traumatic hernias occur during a violent injury to the body such as being hit by a car or attacked by a larger animal. They can occur anywhere on the body, and they too will require surgery. A diaphragmatic hernia allows abdominal organs to enter the thorax, stopping the lungs from inflating fully. The animal will be in respiratory distress or even pass out. This is a critical situation that requires immediate treatment.

There are no symptoms of a hernia per se, only symptoms of a strangulated hernia. A reducible bulge on the abdomen that suddenly becomes very hard and cannot be reduced is an indication that the hernia has strangulated. The contents of the bulge may appear dark under the skin as the blood cannot circulate properly. The animal will be in a lot of pain and should be taken to the veterinarian immediately. Tissues begin to die after a very short time without oxygen.

After hernia surgery, the pet should have restricted activity for two to four weeks to ensure complete healing.

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Hookworms

Hookworms are intestinal parasites that infect dogs, cats, and humans. They are blood-suckers that in large numbers can cause significant anemia and protein loss. In people, hookworms are the cause of cutaneous larval migrans: an itchy, blistering rash where the larvae migrate under the skin on their way to the lungs and then the intestines. Children and immuno-compromised adults are very...

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Hookworms are intestinal parasites that infect dogs, cats, and humans. They are blood-suckers that in large numbers can cause significant anemia and protein loss. In people, hookworms are the cause of cutaneous larval migrans: an itchy, blistering rash where the larvae migrate under the skin on their way to the lungs and then the intestines. Children and immuno-compromised adults are very susceptible to infection. Hookworm eggs are passed in the feces, hatch into larvae in the soil, and infect new hosts who come into contact with the soil.

Litters of puppies and kittens are exposed to hookworms during nursing and while crawling around the feces-contaminated nest. The almost microscopic larvae migrate into the lungs, where they are coughed or gagged up to the mouth, and then swallowed. Once in the small intestine, the parasites reach adulthood, the stage at which they become blood-suckers. The adult worms are about a half of an inch long and are almost never detected in the stool. The mouth of the worm has sharp hook-shaped teeth that pierce the tissue and cause bleeding. Bloody diarrhea usually accompanies hookworm infection. Anemia results which causes lethargy and decreased immune function, leading to severe illness and sometimes death.

Hookworms are diagnosed by the veterinarian who performs a fecal flotation. Eggs passed in the stool are floated in a salt solution and observed under the microscope. Deworming will usually stop the diarrhea, but anemic and very dehydrated pets may require more aggressive treatment such as IV fluids, protein and electrolyte replacement, or even blood transfusion. Deworming medications are repeated at a three week interval because of the life-cycle of hookworms, to ensure that all the parasites are killed.

The stools from an infected pet should be removed from the environment to prevent re-infection and transmission to people. Hand washing is essential, and gloves are recommended when handling contaminated bedding, etc.

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Horner’s Syndrome

Horner’s Syndrome is a collection of symptoms caused by conditions that affect the sympathetic nerves supplying the eye. Specifically, the sympathetic nervous system is responsible for controlling stress induced reactions to stimuli whereas the parasympathetic nervous system maintains the at-rest functions of the body. The sympathetic nervous system when called upon can increase heart rate and...

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Horner’s Syndrome is a collection of symptoms caused by conditions that affect the sympathetic nerves supplying the eye. Specifically, the sympathetic nervous system is responsible for controlling stress induced reactions to stimuli whereas the parasympathetic nervous system maintains the at-rest functions of the body. The sympathetic nervous system when called upon can increase heart rate and respirations, dilate pupils, raise the eyelids, and cause the release of adrenaline. In Horner’s Syndrome, the sympathetic nerve pathways to the eye have been disrupted, and only the parasympathetic system remains functional. This leads to constricted pupils, drooping eyelids, retracted eyeballs, and prolapsed third eyelids. In most cases, only one eye is affected. The causes of Horner’s Syndrome can be numerous.

Most of the time, the cause of the nerve injury leading to this set of symptoms is unknown. Diseases of unknown origin are termed idiopathic. This accounts for more than half of all cases of Horner’s Syndrome. Also for unknown reasons, Golden Retrievers seem to be at an increased risk of developing the syndrome.

Other possible causes of Horner’s Syndrome include trauma or obstruction to the sympathetic nerve pathway at any point between the brain and the eye. The sympathetic nerves that supply the eye originate in the brain, follow the spinal cord into the thorax (chest), branch back up through the neck, pass through the middle ear, and terminate at the eye. There is a separate pathway on each side of the head. Fight wounds; trauma to the head, neck, or chest; tumors of the nerves, spine, thorax, eye, or brain; middle ear infections; and intervertebral disc disease are all possible causes of Horner’s Syndrome.

Reactions to certain ear medications can also cause inflammation of the tissues surrounding the nerves, resulting in iatrogenic (disease caused by treatment) Horner’s Syndrome. The symptoms will usually resolve shortly after the medication is stopped.

Horner’s Syndrome is not a diagnosis in itself; therefore it challenges the veterinarian to find an underlying cause of the syndrome. All pathological processes that may be responsible for these symptoms must be ruled out in order to conclude that the disease is idiopathic in nature. A diagnosis as to the cause of the nerve damage will also dictate the specific treatment needed, as well as reveal the prognosis, or expected outcome of the disease. Furthermore, there is no pain associated with idiopathic Horner’s Syndrome, but if trauma or malignancy is discovered, pain medications may be warranted.

Tests that will be needed when a pet presents with symptoms will include a complete physical and neurological examination, a blood count and blood-chemistry panel, x-rays of the chest and neck, and possibly an MRI (magnetic resonance imaging) or CT scan (computed tomography). A pupil dilation test using dilute phenylephrine drops in the eyes can help to identify the location of the lesion in the nerve pathway. Dilation of the affected pupil will occur within 20 minutes in an animal with a condition such as infection or cancer that involves the middle ear. This type of testing can be helpful but results do not always contribute practical information regarding the cause or the prognosis.

If a cause of nerve injury is revealed, it will need to be addressed medically to resolve the syndrome. Spinal cord and brain lesions or tumors causing the symptoms carry a guarded to grave prognosis. Idiopathic Horner’s Syndrome has a good prognosis on the other hand, and it will usually resolve on its own after 6 months without treatment.

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Hot Spots (Pyotraumatic Dermatitis)

Hot Spots are oozing, inflamed, flat, and ulcerated areas of skin caused by self-trauma. Dogs and cats groom themselves by licking. When an irritant causes a hypersensitivity, pets may over groom to the point of destroying the top layers of the skin. Scratching can also cause a hot spot to form. Bacteria found in the mouth and on the skin will invade the broken skin causing infection. Fleas,...

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Hot Spots are oozing, inflamed, flat, and ulcerated areas of skin caused by self-trauma. Dogs and cats groom themselves by licking. When an irritant causes a hypersensitivity, pets may over groom to the point of destroying the top layers of the skin. Scratching can also cause a hot spot to form. Bacteria found in the mouth and on the skin will invade the broken skin causing infection. Fleas, allergies, matted hair, razor burn, and topical irritants like shampoos can all be factors that trigger hot spots. The hair is lost from the area but the margins are sharply defined from the surrounding normal skin and hair.

When an itch is scratched, endorphins are released in the brain, causing a sense of satisfaction. Endorphins are very powerful hormones that are associated with pleasure. So, just like a kid who won’t stop scratching a mosquito bite, the animal continues to lick or scratch because of the pleasurable sensation that is generated by the act.

Removing the irritant that started the process is essential to healing a hot spot, but this in itself will not usually stop the pet from licking. Mast cells involved in the inflammatory response that have aggregated at the wound release histamine, which causes the persistent itchiness. Antihistamines and corticosteroids like prednisone are used to provide relief. Creams and ointments that contain these drugs may be used topically. It is important to keep the animal from licking them off, so an Elizabethan collar may be placed around the neck to prevent further self trauma. If exposure to a known irritant has occurred, the pet may be bathed in an oatmeal based shampoo. Oral antibiotics are prescribed to help fight the bacterial infection in the inflamed tissue.

Hot spots can take a long time to heal; however, therapy is effective if applied promptly and vigorously.

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Hydrocephalus

Hydrocephalus means water on the brain. The brain and spinal cord are normally surrounded and supported by a cushion of fluid that serves to protect the delicate tissue from injury. It also delivers nutrients and hormones to the brain and carries toxins away. Cerebrospinal Fluid (CSF) is constantly produced, absorbed, and drained through the circulatory system at an equalized rate. In...

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Hydrocephalus means water on the brain. The brain and spinal cord are normally surrounded and supported by a cushion of fluid that serves to protect the delicate tissue from injury. It also delivers nutrients and hormones to the brain and carries toxins away. Cerebrospinal Fluid (CSF) is constantly produced, absorbed, and drained through the circulatory system at an equalized rate. In hydrocephalic animals, there is blockage at some point in the system causing abnormal fluid accumulation inside the skull and eventually increased pressures on the brain itself. This can result in brain damage and learning disabilities, blindness, seizures, coma, and ultimately death if not resolved. Hydrocephalus can occur as a result of trauma, tumor formation, or infection; but most often it is congenital or the result of maternal exposure to certain drugs and viral infections. Toy breeds with dome-shaped heads have an increased risk for developing congenital hydrocephalus.

When an animal is first born, the bones of the skull are not yet fused together. They are soft and flexible and will accommodate a significant amount of excess CSF. A hydrocephalic puppy or kitten may have an enlarged dome-shaped head with a soft spot called an open-fontanel, an altered gait, and seem disinterested or mentally dull. The eyes may be pushed downward or outward in the eye sockets, and they may be partially or completely blind. As the skull hardens and the bones fuse together, the fluid pressures will increase and symptoms will increase in severity. Seizures are common, and the untreated hydrocephalus will eventually become life-threatening.

When congenital hydrocephalus is suspected, brain imaging by MRI or CT scan may be performed to confirm the condition. An ultrasound can be performed if there is an open fontanel where the skull bones have not yet fused together. X-rays are usually not very helpful. Blood chemistry profiles are used to assess whether the animal has concurrent metabolic disease such as kidney and liver dysfunction.

Medications can be started to provide temporary improvement in swelling and symptoms. Diuretics like furosemide (Lasix) can help draw fluid away from the brain but can also cause dehydration and electrolyte loss. Corticosteroids like prednisone can reduce swelling but should not be used long term due to side effects. For unknown reasons, an antacid called omeprazole (Prilosec) can reduce CSF production by as much as 25% and may be used in combination with steroids or diuretics to control fluid pressure on the brain. Diarrhea and constipation may result from long-term use. Patients with mild symptoms can sometimes be managed with medications; however, severe hydrocephalus will require surgery.

Surgery for hydrocephalus is performed by a surgical specialist after a consultation with a neurologist. The procedure does not correct the physical obstruction in the normal CSF drainage pathways. Instead, it involves placing a shunt – a drain tube – between the one of the ventricles, or chambers in the brain where the cerebrospinal fluid is produced, and the abdomen. (The shunt can alternatively drain to the heart.) This allows the excess fluid to drain away from the skull and relieves pressure on the brain. The fluid is then re-absorbed into the circulatory system and excreted by the kidneys. For larger animals, the shunt may have to be replaced as the pet grows in size.

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Overall, the prognosis for congenital hydrocephalus is guarded at best. The severity of symptoms is directly related to the expected outcome; therefore, the disease should be treated aggressively. Symptoms are not likely to improve without treatment; they are usually progressive. Survivors of hydrocephalus should not be allowed to breed and reproduce, as their offspring will inherit the defect.

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Hypertension

Hypertension (high blood pressure) has serious consequences for both people and pets. Unlike with humans who can be diagnosed with primary hypertension, this condition is always secondary to another disease process in dogs and cats. Treatment of the underlying disease may itself control the elevated blood pressure, or additional medications specifically designed to treat hypertension may be...

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Hypertension (high blood pressure) has serious consequences for both people and pets. Unlike with humans who can be diagnosed with primary hypertension, this condition is always secondary to another disease process in dogs and cats. Treatment of the underlying disease may itself control the elevated blood pressure, or additional medications specifically designed to treat hypertension may be needed. Untreated, it may lead to acute blindness and further complicate kidney and heart disease.

Normal blood pressure measurements for dogs and cats can be influenced by the device used for measurement, breed, age, gender, reproductive status and circumstances of the measurement. Just like with people, the stress of visiting the doctor can slightly elevate these numbers. An average normal blood pressure (BP) across breeds of dog is about 133/75 mm Hg (systolic/diastolic) and an average normal BP in cats is about 124/84 mm Hg using the oscillometric (cuff) method. Treatment for hypertension in animals begins when the first number, the systolic pressure, reads consistently over 160. At measurements over 180 mmHG, the smallest vessels in the body begin to rupture. These are the vessels in the eyes and the kidneys.

Diseases that are associated with hypertension include hyperthyroidism in cats, chronic renal failure (CHF), Cushing’s disease, and Diabetes Mellitus. More than half of all pets in chronic renal failure have systemic high blood pressure, and it is almost inevitable in untreated hyperthyroid cats. Elevated blood pressure can accelerate kidney dysfunction, shortening life-expectancy. A sudden blindness caused by retinal bleeding is a serious consequence of undiscovered high blood pressure. All pets known to have these conditions should be routinely screened for hypertension. Pets over the age of seven should be screened during wellness examinations.

Treatment for hypertension always begins with addressing the underlying disease first. The blood pressure may be brought into a normal range by treating the primary illness. This is especially true for hyperthyroid cats. For persistent hypertension, several drugs are used alone and in combination to regulate blood pressure:

ACE inhibitor – (angiotensin converting enzyme is involved in producing vasoconstriction which elevates blood pressure, these drugs inhibit the process) Enalapril, Benazepril
Calcium Channel Blocker – (relaxes heart muscle contraction) Amlodipine, Diltiazem
Diuretic – (reduce edema by removing water from tissue) Furosemide, Hydrochlorathiazide
Moderate sodium (salt) restriction may also be helpful in controlling hypertension. Research goes back and forth on how beneficial this may be, but diets made specifically for heart and kidney failure have other intended purposes as well as reduced sodium.

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Hypoglycemia (Low Blood Sugar)

Hypoglycemia refers to a decrease in the amount of glucose in circulating blood that should be available to the tissues of the body as a primary source of energy. Glucose is a very basic sugar that is utilized as fuel by every cell to survive and function. All food that is consumed may eventually be broken down into glucose. Food that is not immediately required by the body for energy is...

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Hypoglycemia refers to a decrease in the amount of glucose in circulating blood that should be available to the tissues of the body as a primary source of energy. Glucose is a very basic sugar that is utilized as fuel by every cell to survive and function. All food that is consumed may eventually be broken down into glucose. Food that is not immediately required by the body for energy is converted to fat to be stored for later processing into glucose. When blood glucose levels drop significantly, cells in every system of the body including the brain, heart, vital organs, and skeletal muscles cease to function properly. A total depletion of glucose can lead to weakness, seizures, coma, and death if the condition is not corrected quickly.

There are several reasons that hypoglycemia may occur. In very young puppies and kittens, the problem may be simply a cause of inadequate food intake. If these infants are unable to nurse frequently, or if weaning onto solid foods is unsuccessful, the blood glucose will drop rapidly as energy is depleted. Young animals have not had time to develop fat stores to protect them from prolonged periods of starvation (anorexia).

Long-term anorexia may also lead to hypoglycemia in adult animals. This may occur in lost or trapped animals or in those with other diseases preventing normal food intake.

In diabetic animals, over-supplementation of insulin is the most common cause of hypoglycemia. Insulin is a hormone that carries glucose into cells. Without insulin, cells cannot utilize the sugar for fuel. Diabetes is a caused by either a deficiency in the production, or a resistance to the mechanism, of insulin. Therefore diabetics are supplemented with insulin by injection to help the body utilize glucose properly. If too much insulin is given, either because of a miscalculated volume or by accidental repeated injections, the circulating glucose will be driven into the cells rapidly leaving none to be utilized in the immediate future. Also, if a diabetic animal misses a regular meal or experiences a particularly stressful event, the blood-glucose may drop suddenly after a dose of insulin is given.

A rare cause of hypoglycemia occurs as a result of an insulinoma, a tumor that continually produces insulin regardless of the body’s energy demands. The tumor is formed by abnormal beta cells, the cells in the pancreas that are responsible for the production of insulin when stimulated by food intake and increased blood-glucose levels. Insulinomas produce the insulin hormone regardless of the presence of glucose, and hypoglycemia results if the animal cannot continually replenish the supply by eating.

Symptoms of hypoglycemia begin as lethargy, weakness, and disorientation followed by incoordination of the limbs (ataxia), stupor, seizures, coma, and death. In a very young animal with any of these symptoms, hypoglycemia should be immediately suspected and treated presumptively. Many other diseases and toxicities may lead to similar symptoms in adult animals, and diagnostics may be performed before assuming hypoglycemia as the cause.

Hypoglycemia is generally easy to reverse, yet the underlying cause of the condition is very important to realize in order to prevent recurrences. If the pet is conscious and able to swallow, oral supplementation of high-sugar foods may be given. This remedy should be applied at home assuming the pet is able to ingest food safely, followed by an examination by the veterinarian. Unconscious pets may be administered intravenous glucose by injection to quickly bring blood-glucose levels back to normal. Owners of diabetic pets should always keep an emergency supply of honey, Karo syrup, or high sugar treats on hand in case of an accidental insulin overdose.

Restoring blood-glucose levels to normal is generally an immediate cure, and long-term effects are rare if hypoglycemia is treated quickly.

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Inappropriate Elimination

There are many reasons that a pet may begin to have accidents in the house. Inappropriate elimination can have medical and behavioral causes. It should never be assumed that the accidents are spiteful. While animals do experience anxieties that can be associated with inappropriate urination or defecation, they do not hold grudges or try to get back at the owner when they are displeased. A pet...

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There are many reasons that a pet may begin to have accidents in the house. Inappropriate elimination can have medical and behavioral causes. It should never be assumed that the accidents are spiteful. While animals do experience anxieties that can be associated with inappropriate urination or defecation, they do not hold grudges or try to get back at the owner when they are displeased. A pet that continues to have accidents will have associated symptoms that can help distinguish between a medical or a behavioral cause.

Increased water consumption is always a medical symptom of an underlying pathology or disease. The increased intake of water can be a direct cause of increased urgency to urinate such as in the case of Diabetes Mellitus or Cushing’s disease, or it may be a side effect of infection and fever. A complete physical exam, urinalysis, and blood chemistry panel can give evidence of a health problem.

Bladder infections are common in dogs and cats and may be straight forward ascending bacterial infections (bacteria enters the bladder through the urethra), or they may have complicating factors such as bladder or kidney stones. A persistent urachus is a congenital deformity where the tube that connected the bladder to the umbilicus stays partially intact after birth. It can harbor bacteria making infections persistent and recurring. An x-ray can be used to diagnose stones and abnormalities in the urinary tract anatomy. Bladder infections can be secondary to metabolic disease. Diabetes causes high levels of glucose (sugar) in the urine which can feed bacteria. Any disease that causes increased water consumption and urination makes the pet more susceptible to infection.

Cats can be diagnosed with feline idiopathic lower urinary tract disease (FLUTD) wherein there is no primary infection causing inappropriate urination. It is an inflammatory process in the bladder that causes blood in the urine, straining and accidents. Bacterial infections can become established secondarily to FLUTD.

Inappropriate defecation (bowel movements) may accompany urination or may occur alone. Causes of increased frequency of defecation and straining include intestinal parasitism (giardia, worms, coccidia) and inflammatory bowel disease (IBD). In IBD, the immune system attacks the tissues of the intestinal wall and ultimately leads to diarrhea. Food allergies may contribute to IBD, especially in cats.

Behavioral disorders that cause inappropriate elimination include separation anxiety, status related stress in cats, and incomplete house training in dogs. A medical cause of the behavior should always be ruled out first. Anti-anxiety medications may be prescribed along with behavioral modification training and desensitization.

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Inflammatory Bowel Disease

Inflammatory Bowel Disease (IBD) is characterized in dogs by chronic intermittent vomiting, diarrhea and weight loss and in cats by anorexia (decreased appetite), weight loss, vomiting and/or diarrhea. Though the cause is not known, this condition appears to be immune-mediated. The presence of increased numbers of inflammatory cells within the stomach and intestinal wall may be responsible for...

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Inflammatory Bowel Disease (IBD) is characterized in dogs by chronic intermittent vomiting, diarrhea and weight loss and in cats by anorexia (decreased appetite), weight loss, vomiting and/or diarrhea. Though the cause is not known, this condition appears to be immune-mediated. The presence of increased numbers of inflammatory cells within the stomach and intestinal wall may be responsible for the interruption of normal bowel function. The cause of IBD is most likely multifactorial and involves complex interactions between genetics, immunity, and environmental (GI flora) factors.Treatments may include hypoallergenic diets, antibiotics, probiotics, and corticosteroid therapies. Blood chemistry profiles are used to rule out other disease processes that may mimic IBD, and an intestinal wall biopsy is performed to confirm inflammatory cell presence and rule out neoplasia (cancer).

The inflammatory cells associated with Inflammatory Bowel Disease include lymphocytes, plasmacytes, eosinophils, and neutrophils. These are white blood cells that produce antibodies and histamine, as well as phagocytize or consume bacteria. The predominance of one or more cell type determines the type of IBD, but this does not change the course of treatment.

On examination, an animal with IBD may appear thin due to malabsorption of nutrients and protein loss through the chronically irritated gut wall. Upon abdominal palpation, the intestines may feel “ropey” or thickened. Thickening of the intestinal wall causes a reduction in peristalsis, the normal contractions that move stool through the GI tract. Stools may contain mucous and or blood. Cats may stop grooming themselves or may over-groom the perianal area. In some patients, vomiting and diarrhea may be the only obvious symptoms.

Blood chemistry results are often within normal limits in the IBD patient. Liver and pancreatic enzymes may be slightly elevated. Plasma albumin and potassium may be decreased. There is no blood test for inflammatory bowel disease; however, ruling out other disease is necessary to make a proper diagnosis.

Fecal exams and cytologies are performed to rule out parasites and infections such as whipworms, giardia, and clostridial overgrowth.

X-rays and abdominal ultrasound may show thickened loops of intestine, but this finding in itself is not a confirmation of the disease. Radiography is instead used to help eliminate tumors as a cause of symptoms.

Biopsy by endoscopy or exploratory laparotomy is the only definitive way to confirm the presence of inflammatory cells within the stomach and intestinal wall. A general anesthetic is administered to facilitate tissue collection. An endoscope is a narrow tube with a camera and forceps attached at the end that is passed through the esophagus to obtain upper GI tissue biopsies, or through the colon to harvest lower GI tissue samples. It is not always possible to collect diagnostic samples using an endoscope. So exploratory laparotomy, though obviously more invasive, is sometimes necessary. After surgery, the tissue samples are sent to a pathologist for examination.

Some patients will improve during a food trial with a prescription hypoallergenic diet. There are two basic types of food available by prescription for IBD: novel protein, novel carbohydrate formulas and hydrolyzed protein formulas. Whichever type of food is used, the most important factor in realizing their effectiveness is to eliminate all other sources of calories. This includes treats, table scraps, rawhides, even flavor-infused chew toys as they all may contain ingredients to which the pet is allergic.

Oral medications are used to treat patients who do not respond to food trials. These include antibiotics, anti-emetics, and corticosteroids, often prescribed in combination with each other. Because there is no cure for Inflammatory Bowel Disease, long-term use of these drugs is used to control symptoms. There are possible side effects from chronic steroid use, so your veterinarian will usually prescribe a tapering dose regimen to determine the minimum dose required to alleviate symptoms. Prednisone (prednisolone) is the steroid of choice, although a safer drug called budesonide, which is less systemically bioavailable, may control some IBD patients. Steroids should only be used in patients suspected of having intestinal lymphoma (an intestinal cancer) after definitive diagnosis with intestinal biopsies. Antibiotics used include metronidazole, sulfasalazine, and tylosin. These drugs are used for their anti-inflammatory effect as well as to normalize the bacterial flora in the gut. It is important to use a therapeutic dose of antibiotic so that bacterial resistance is less likely. Sulfasalazine is used on a short term basis because of a risk of KCS (reduced tear production), and it may be toxic to cats because of its aspirin content. Anti-emetics are medications that control vomiting. Metoclopramide is an antiemetic that also increases peristaltic contractions, making it a good choice for IBD treatment.

While not considered a drug, probiotics may be useful and improve symptoms of Inflammatory Bowel Disease. Probiotics are live forms of beneficial bacteria that normally reside in the healthy intestine. In-vitro studies show that it may have anti-inflammatory effects by blocking the enzymes produced by white blood cells in the gut wall. The most common probiotics typically administered to dogs are Lactobacillus, Bifidobacterium, and Enterococcus. They are available over the counter as well as in pet products specifically made for the treatment of diarrhea.

It should also be noted that Omega 3 fatty acid supplements may be of benefit in the IBD patient.

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Jaundice or Icteric Pets

Jaundice (icterus), a yellow discoloration of tissues in the body, is caused by an increase of bilirubin in the blood-stream. Bilirubin is a breakdown product of red blood cell destruction. Jaundice is not a disease itself; rather, it is a symptom caused by a number of diseases that can be categorized as pre-hepatic (hemolytic), hepatic (liver disease), or post-hepatic (biliary stasis).

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Jaundice (icterus), a yellow discoloration of tissues in the body, is caused by an increase of bilirubin in the blood-stream. Bilirubin is a breakdown product of red blood cell destruction. Jaundice is not a disease itself; rather, it is a symptom caused by a number of diseases that can be categorized as pre-hepatic (hemolytic), hepatic (liver disease), or post-hepatic (biliary stasis).

Pre-hepatic jaundice is caused by rapid red blood cell destruction as in the case of immune-mediated hemolytic anemia (IMHA), tick-borne disease, and drug toxicity. Red blood cells are being destroyed and bilirubin is being released into the blood-stream faster than the liver can metabolize and excrete it through the bile duct. Anemia is associated with this type of jaundice, and the cause of the anemia should be addressed to correct the jaundice.

Hepatic jaundice is caused by either primary or secondary liver disease. The liver cannot metabolize the normal levels of bilirubin, and so the levels rise until the tissues become saturated with the yellow pigment. Primary liver disease can be infectious, like leptosporosis and FIP, or functional, like liver cancer. Anorexic cats are prone to hepatic lipidosis, a condition where the liver swells with fat, leading to jaundice. Secondary liver diseases include hyperthyroidism and systemic fungal diseases. Anemia is usually not present in the case of hepatic jaundice.

Post-hepatic jaundice describes a condition where bile, the metabolized bilirubin, cannot pass from the liver through the bile duct and into the intestines where it is normally excreted from the body. This is called biliary stasis, and causes can include gall stones, pancreatitis, and tumors of the bile duct. In this case, the liver is capable of metabolizing the bilirubin; however, there is no place excrete it, and so it “overflows” into the blood-stream.

The prognosis for an animal with jaundice cannot be known without discovering the underlying disease that is causing this symptom. However, jaundice should never be ignored, since the disease process causing it can be potentially life-threatening.

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Keeping Your Pet from Chewing

Sometimes pets will just not let wounds heal. Self-trauma is a very common hindrance to clearing up skin infections, healing incisions, bandaging wounds, and casting fractures. Elizabethan collars are a good solution to keep pets from chewing and licking. They may also be used to keep the pet from scratching around the head and ears. An Elizabethan collar is the lamp-shade shaped cone that goes...

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Sometimes pets will just not let wounds heal. Self-trauma is a very common hindrance to clearing up skin infections, healing incisions, bandaging wounds, and casting fractures. Elizabethan collars are a good solution to keep pets from chewing and licking. They may also be used to keep the pet from scratching around the head and ears. An Elizabethan collar is the lamp-shade shaped cone that goes around the neck.

Elizabethan Collars, or E-collars for short, should be properly sized. The pet should be able to eat, drink, and sleep comfortably with the E-collar on. It should be tight enough around the neck so that it cannot slip off, but it should not choke the pet. Ideally, the end of the cone should reach the tip of the nose when it is pushed back as far as it will go towards the shoulder blades. The E-collar should be fastened with an adjustable collar or a double-thick length of gauze.

An E-collar will keep the pet from being able to scratch an itch, but the itch still needs relief. Be sure that the pet is receiving proper treatment to alleviate symptoms.

Occasionally, a pet will not tolerate the E-collar. Tranquilizers can be given if necessary to calm the animal while using the collar. It is not a good idea to leave pets unattended while wearing an Elizabethan collar.

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Keeping Your Pet’s Teeth Clean

Besides keeping a pretty smile and fresh breath, brushing our teeth prevents periodontal disease, infection, and tooth loss. The same holds true for our pets. In fact, periodontal disease is one of the most common problems in dogs and cats despite the fact that it is easily preventable. Some statistics show as high as 85% of all pets suffer from some form of oral disease. Brushing your pet’s...

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Besides keeping a pretty smile and fresh breath, brushing our teeth prevents periodontal disease, infection, and tooth loss. The same holds true for our pets. In fact, periodontal disease is one of the most common problems in dogs and cats despite the fact that it is easily preventable. Some statistics show as high as 85% of all pets suffer from some form of oral disease. Brushing your pet’s teeth regularly can not only prevent oral health problems; it can also prevent secondary heart, liver, and kidney infections that originate from bacterial colonies in the mouth.

After an animal consumes a meal, food debris is stuck between the teeth becoming a buffet for bacteria. This mixture becomes plaque, rotting decaying material containing millions of organisms. It is so sticky that it cannot be washed or rinsed away with water. The bacteria produce waste gasses that cause halitosis – bad breath. When described that way, we all want to go brush our teeth right now! A by-product of bacterial colonization in the mouth is called calculus or tartar. It is so hard that brushing will not remove it. It can cover the gum line causing irritation, bleeding, and pockets of infection. The bacteria then have access to the blood stream and furthermore, the internal organs. Thus, the prevention of plaque is key to stopping the progression of periodontal disease.

Brushing your dog or cat’s teeth removes most of the plaque from the tooth surfaces and gums. Since pets can’t “rinse and spit”, special animal toothpaste is used that is safe to swallow. Human toothpastes contain strong detergents that irritate the stomach when swallowed. There are unique toothbrushes for pets as well that are designed to conform to smaller mouths, but a child’s soft bristle toothbrush will work fine (preferably not the same one the child is using). Angle the bristles of the toothbrush toward the gum line, and use gentle strokes. Be sure to brush all surfaces of the teeth. Just like with people, brushing after every meal is recommended. If this is not practical, remember the more often, the better. If the pet seems painful or you notice bleeding, consult the veterinarian for a dental exam.

Dental exams should be performed by the veterinarian at least twice a year. Occasionally, a professional cleaning will be required. An ultrasonic scaling of calculus and high-speed polishing of the tooth enamel is performed under anesthesia. Proper preventive care will avoid tooth extractions and infections by the time of a dental cleaning.

Some grooming salons advertise “teeth cleaning” included with grooming. While they do brush the teeth, this should not be a substitute for regular brushing, nor mistaken for a professional cleaning by a veterinarian.

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Knee Problem – Luxating Patella

A luxating patella (kneecap) is a congenital abnormality common in smaller breed dogs. This condition is a consequence of common musculoskeletal changes such as bowing or rotation of the bones in the limbs, a shallow groove where the patella is normally seated, or displacement of the quadriceps muscle group. The patella is attached to the muscles of the upper and lower leg by the patellar tendon. ...

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A luxating patella (kneecap) is a congenital abnormality common in smaller breed dogs. This condition is a consequence of common musculoskeletal changes such as bowing or rotation of the bones in the limbs, a shallow groove where the patella is normally seated, or displacement of the quadriceps muscle group. The patella is attached to the muscles of the upper and lower leg by the patellar tendon. It normally moves in a vertical path between two ridges (trochlea) on the femur. Because of the musculoskeletal changes, the patella is displaced medially (toward the inside of the knee) as the muscles stretch in a straight line. This causes instability, pain, and arthritic change in the knee. The typical gait of a dog with a luxating patella is an intermittent skip in the affected leg. When the patella pops out of place, the dog may sit and extend the leg to alleviate pain. Or he may kick out the leg behind himself as he runs three legged. This will allow the patella to move back into its normal position, and the dog will resume a normal gait. In severe cases, the patella stays luxated and rides along the medial surface of the femur. Surgery is the only way to repair a luxating patella. Severe arthritis and reduced range of motion will eventually occur if left untreated.

X-rays are taken to rule out hip dysplasia and other problems that may not allow satisfactory resolution of symptoms after surgical repair.

A general anesthetic is administered to perform x-rays, deep palpation of the knee, and then surgery on the affected knee. An incision is made along the lateral side of the knee and into the joint capsule. The patella and patellar ligament is pulled to the side. The joint is at this point inspected to assess the condition of the cruciate ligaments and menisci. A “V” shaped wedge is removed from the femur where the patella rides between the trochlea. The wedge is trimmed slightly, and then replaced to create a deeper valley to hold the patella in place. The lower patellar ligament is attached at the tibial crest, and this crest is cut free of the bone to be pinned back down in a more lateral (away from the middle) position. The objective of the surgery is to force the patella to move in a more normal vertical path along the front of the femur. The joint capsule is then sutured closed. An intra-articular local anesthetic may be injected into the joint to improve pain control during recovery.

Recovery takes about 10 to 12 weeks, with restricted activity and range of motion exercises. Pain medications and antibiotics are sent home with the pet. An Elizabethan collar is placed to prevent the dog from licking and chewing at the sutures. GAG supplements (chondroitin) are used on a long-term basis to improve joint health and prevent arthritis and pain.

d pain.

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Malassezia (Yeast) Infections

Yeast, a single-celled type of fungus, is a common opportunistic invader of the skin and mucous membranes of all animals. Malassezia pachydermatis is a species of yeast that is often cultured from skin and ear infections affecting dogs and cats. It is normally found in low numbers on healthy skin but quickly multiplies and invades inflamed, irritated, or damaged tissue. Malassezia infections are...

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Yeast, a single-celled type of fungus, is a common opportunistic invader of the skin and mucous membranes of all animals. Malassezia pachydermatis is a species of yeast that is often cultured from skin and ear infections affecting dogs and cats. It is normally found in low numbers on healthy skin but quickly multiplies and invades inflamed, irritated, or damaged tissue. Malassezia infections are particularly itchy and malodorous, and cause thickening, pigmentation (darkening), and flaking of the skin. “Elephant skin” is an often-heard description of the affected tissue in cases of Malassezia dermatitis. These types of infections may recur spontaneously when conditions are ideal.

Malassezia yeast thrives in the presence of sebum, an oily discharge from the sebaceous glands that increases in production as a result of allergies and inflammation. The parts of the body that are abundant with sebaceous glands are the most susceptible to Malassezia. These areas include the ears, face, arm pits, flanks and inner thighs, groin and perineum, and down the middle of the back; however, any part of the body can become infected with yeast. Chronic otitis and seborrhea are common precursors to Malassezia infections.

Occasionally, an animal may have an immune deficiency that makes them more susceptible to yeast infections. Certain breeds are thought to have a genetic predisposition to Malassezia. They include: Bulldogs, West Highland Terriers, Basset Hounds, Cocker Spaniels, Australian Terriers, Scottish Terriers, Dachshunds, Shelties, and Silkies. Long-haired cats such as Himalayans and Persians may also be genetically susceptible.

Symptoms of Malassezia infections of the skin and ears are usually unmistakable. There is a pungent, musty odor typical with this yeast that is reminiscent of rancid bread dough or milk. The skin will be crusty, flaky, and very itchy (human dandruff is often caused by a species of Malassezia.) Chronic infections will cause darkening and thickening of the skin, ear flaps, facial folds, and skin.

Malassezia is easy to identify and confirm in the laboratory. Swabbing the skin or ear canals for a cytology analysis under the microscope is generally diagnostic. The organisms exfoliate (shed from the skin) easily, readily take up stain and have a typical “foot print” appearance, morphologically. Other tests that may be performed include tape impression smears, skin scrapings, and full-thickness skin biopsies. A biopsy may reveal an underlying skin disorder that has become secondarily infected with Malassezia.

Malassezia infections are treated topically as well as orally. Oral anti-fungal medications can be expensive and carry significant side-effects if used indiscriminately, so they are generally reserved for deep-seated or generalized infections. Topicals must be used frequently and persistently in order to be effective. Rapid recurrence of yeast infections are usually due to poor treatment compliance or stopping the anti-fungal before the infection is completely cleared. Malassezia infections are often secondary to other underlying skin diseases, so these must be ruled out in persistent yeast infections.

For the skin, shampoos containing ketoconazole, chlorhexadine, or miconazole are specifically formulated to kill yeast. They contain degreasing agents to remove the excess oils from the skin in which Malassezia thrives. They are used at least twice a week. There are also wipes, creams, and sprays that are used to spot-treat affected areas in-between baths.

Anti-fungal ointments are specifically made for ear infections caused by Malassezia. These medications often contain broad-spectrum anti-microbials to fight co-existing bacterial infection, as well as steroids to help with tissue inflammation. Proper technique and frequency of application into the ear canal is essential to successful treatment. The ear canals are often occluded by inflamed tissue and excess exudate, or discharge, which may need to be flushed out to facilitate treatment.

Before starting oral anti-fungal drugs, a blood test for liver function and complete blood cell count (CBC) is usually performed. Drugs like ketoconazole, griseofulvin, itraconazole, and other anti-fungals may cause liver problems and bone-marrow suppression. Ketoconazole can also increase the blood-levels of certain other drugs by reducing their rate of clearance from the body. These drugs are generally safe when used judiciously, and are often necessary to achieve a complete cure.

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Malignant Melanoma

Mast cell tumors constitute about 20% of all skin tumors found on dogs. They occur less frequently on cats. Very occasionally, a mast cell tumor originates viscerally, or in the internal organs. In any case, these are malignancies that should be treated aggressively to prevent metastasis, or spreading to other parts of the body. Mast cell tumors can mimic other types of growths, benign and...

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Mast cell tumors constitute about 20% of all skin tumors found on dogs. They occur less frequently on cats. Very occasionally, a mast cell tumor originates viscerally, or in the internal organs. In any case, these are malignancies that should be treated aggressively to prevent metastasis, or spreading to other parts of the body. Mast cell tumors can mimic other types of growths, benign and malignant; any new lump or bump, no matter how innocent looking, should be checked to rule out mast cell composition.

Normal mast cells are non-circulatory, tissue-bound white blood cells that are involved in the body’s defensive response to allergens, parasites, and tissue trauma. They contain in their cytoplasm, large granules that release histamine and heparin. They are predominantly found in the skin, digestive tract, lungs, and mucous membranes of the mouth, nose, and eyes – any area that is an entry point for invaders. Mast cells play an important role in the immune system.

In any type of neoplasia (tumor), an abnormal mutation of a cell evades detection by the body’s anti-cancer mechanisms and begins rapidly dividing. There are known carcinogens that cause these mutations; however, the exact cause of a particular tumor is rarely known. This is most often the case with mast cell tumors in dogs and cats.

Cutaneous mast cell tumors, those that occur in the skin, are generally easy to diagnose. Although their gross appearance can be deceiving, resembling benign masses like fatty tumors (lipomas) and warts (papillomas), their microscopic features are distinct. A simple, relatively painless, fine-needle aspirate (FNA) will usually be adequate to reveal large numbers of mast cells under the microscope. Mast cell tumors exfoliate well; in other words, it is easy to extract representative cells from these masses in order to identify them. These cells are easy to recognize because of their large, dark staining granules.

While an FNA may be performed to determine whether a mass contains mast cells and should be removed, it is not a reliable method to grade or stage the tumor. Nor can it determine whether the mass was completely excised during surgery. Histopathology (tissue analysis by a pathologist) is a very important tool to help predict the prognosis – the likelihood of local recurrence or tumor spread. The tissue must be preserved in formalin and delivered to a pathologist for this type of laboratory testing.

There are three grades that categorize the tumor’s expected behavior after surgery. Grade I being least likely to metastasize (spread to other parts of the body), surgery is usually curative if the tumor was excised completely. This type accounts for about 50% of all canine mast cell tumors. Grade I mast cell tumors may recur locally if surgery left very narrow margins or malignant cells extend to the edge of the tissue. Grade III tumors are very aggressive, on the other hand, and are much more likely to metastasize or already have done so before surgery. Grade II tumors can be unpredictable. A consultation with an Oncologist, a cancer specialist, is highly recommended if the histopathology report returns with a grade II or grade III mast cell tumor.

Staging a tumor determines the extent to which the tumor has spread and whether metastasis has already occurred to adjacent, regional, or distant tissues. Mast cell tumors are assigned a stage 0 through IV based on a standardized system. Stage 0 means that the tumor is confined to the skin, but was not completely excised. Stage I means the tumor is confined to the skin and there is no spread to lymph nodes; whereas, stage II involves the regional lymph nodes. Stage III is assigned when there are multiple tumors or a deeply invasive tumor, and stage IV denotes metastasis to distant body tissues like the liver or lungs.

Staging the mast cell tumor helps predict how it will behave after surgery and whether further therapy is recommended. Chemo- and radiation therapies can greatly extend lifespan when surgery alone is not curative. *(The recent approval of the oral medication Palladia (toceranib phosphate) by the FDA to be released in 2010 specifically for the treatment of canine type grade II or grade III recurrent cutaneous MCTs is another advancement in the treatment of this type of cancer.)

The location of the mast cell tumor on the body can also help predict its degree of malignancy. Tumors that form on the face and extremities tend to be more aggressive than those discovered on the torso. Mast cell tumors of the internal organs carry a poor prognosis despite treatment.

Surgery to remove a cutaneous mast cell tumor is performed under a general anesthetic in most cases. Because mast cells produce and contain histamine, an H1 blocker or antihistamine drug, such as diphenhydramine (Benadryl) is given pre-operatively to patients with large tumors with significant blood supply. Allergic reactions (anaphylaxis) due to huge amounts of histamine release can cause substantial risk to anesthetized patients.

Although mast cell tumors carry the potential to be very malignant, it should be remembered that the majority of this type of tumor found as skin masses on dogs can be cured by surgical removal when detected early in their progression. A good prognosis depends heavily on early diagnosis and treatment.

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Microchipping Your Pet

Positive identification is the only way to ensure that you are reunited with your pet if it becomes lost or stolen. A secure collar with tags indicating the home address and phone numbers is a good start. The problem is that collars come off. A thief would simply remove one, and cat collars are designed to “break-away” in case the collar gets hung on a fence or tree limb. Fortunately, there has...

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Positive identification is the only way to ensure that you are reunited with your pet if it becomes lost or stolen. A secure collar with tags indicating the home address and phone numbers is a good start. The problem is that collars come off. A thief would simply remove one, and cat collars are designed to “break-away” in case the collar gets hung on a fence or tree limb. Fortunately, there has been technology developed that addresses this concern. A tiny chip contained in surgical grade glass can be implanted beneath the skin and scanned at any time to provide a unique identification number. Veterinarians, shelters, and animal control departments have the hand held scanners to check lost pets for a chip.

The microchip is not powered and never wears out. It is about the size of a large grain of rice and contains electronics that contain a unique identification code. No personal information is held on the chip, and they cannot be reprogrammed. The code on the chip is registered with the manufacturer’s recovery database along with the pet owner’s emergency contact information. They cannot be located on a GPS or other tracking device. The scanner activates the chip when it is held in close proximity to the pet. There is no problem with taking a microchipped pet on an airplane, and some countries even require a microchip as part of the disease quarantine process.

Implanting the chip can be performed without anesthesia. The procedure is relatively painless. A modified syringe and large bore needle are used to place the glass tube beneath the skin, usually between the shoulder blades. Scar tissue forms around small barbs on the microchip to keep it from migrating out of place. Some pet owners will opt to have this procedure done at the time of spaying and neutering.

There are several brands of identification chips that are FDA approved for implantation in dogs and cats. Some brands can be read by other company’s scanners, and some cannot. Pet owner’s should consult their veterinarian about which brand of microchip is most universally readable in their area.

Microchipping is the most effective method of positively identifying your pet. Each year, thousands of dogs and cats are reunited with their owners thanks to this technology.

 

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My Pet Needs Surgery

Everyone worries when their pet must undergo surgery. Whether the procedure is elective, such as a spay or neuter, or an emergency surgery to repair a life-threatening injury, it is natural to be concerned. Do not hesitate to make a list of your questions that you may have for your veterinarian. This article may help to answer some of those concerns so that you are reassured that your pet will...

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Everyone worries when their pet must undergo surgery. Whether the procedure is elective, such as a spay or neuter, or an emergency surgery to repair a life-threatening injury, it is natural to be concerned. Do not hesitate to make a list of your questions that you may have for your veterinarian. This article may help to answer some of those concerns so that you are reassured that your pet will receive the best care possible and have a safe and comfortable recovery from surgery.

Invasive surgeries will require your pet to receive a general anesthetic. Local injectable anesthetics can be used for very minor procedures which are not discussed in this topic. A general anesthetic always carries with it some degree of risk. Modern anesthetic agents are much safer than older protocols. Your veterinarian will nonetheless try to minimize any risk associated with anesthesia.

One way to ensure your pet’s safety is to evaluate a blood chemistry profile before the surgery. This can detect compromised organ function, anemia, electrolyte imbalance, and bleeding disorders. Although it is impossible to screen for every possible disease process with one blood sample, the most likely problems that would preclude or complicate surgery can be ruled out.

Monitoring equipment used during surgery has greatly improved the safety and outcome of general anesthesia. In the past, the level of anesthesia could only be measured subjectively. Heart rate and respirations were observed to indicate the depth of anesthesia. Modern monitoring of blood pressure, blood oxygen saturation (pulse oximetry), and electrocardiogram (EKG) are much more accurate at assessing the patient’s wellbeing. The depth of anesthesia can be “fine tuned” using these parameters to improve safety and speed recovery.

The drugs used to induce and maintain anesthesia have become far safer as well. Induction agents and gas anesthetics are minimally metabolized by the body and are eliminated very quickly compared to older protocols. A rapid recovery reduces the chance of anesthetic injury to the kidneys and other organs. The pet is able to return to eating and drinking shortly after the procedure which prevents dehydration and boosts the immune system during healing.

A side effect of general anesthesia is lowered blood pressure. Intravenous fluids can be administered to normalize blood pressure and ensure adequate tissue oxygen perfusion. Life-saving drugs can be administered through an IV catheter in the case of an emergency.

Analgesia (pain control) is better achieved through the drug choices that veterinarians can utilize. It is a proven fact that pain suppresses the immune response, slows healing, and increases recovery times. Your pet will receive pre- and post-operative pain medications that will ensure their comfort and improve the outcome of surgery.

The veterinary staff will give you specific instructions to follow before and after surgery. The pet will need to fast for a period of time to reduce nausea during anesthesia. Vomiting while unconscious is very dangerous, and an empty stomach will avoid this problem. Be sure that you understand the fasting instructions. Withholding water for too long before surgery can lead to dehydration which may cause problems with recovery.

After surgery, you will be given aftercare instructions. Restricted activity, physical therapy, antibiotics, pain medications, rechecks, and scheduling suture removal are common follow up procedures to a surgery. You will want to monitor your pet’s appetite and attitude afterward and call the vet if there are any problems. An Elizabethan collar may be sent home to prevent the animal from chewing and scratching at the incision.

You should understand what will be done during surgery and the expected results. Discuss the procedure with the veterinarian and the nursing staff so that you are comfortable with your part in the follow up care of your pet.

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NSAIDS–Non-Steroidal Anti-Inflammatory Drugs

NSAIDS have provided pain relief (analgesia) to pets and people for many years. It seems that there is a new NSAID on the market every time we turn around. With reports of lawsuits in the news over human deaths and serious side effects, one might wonder how safe any of these drugs are for our pets. Being an informed pet owner, we can measure the benefits and risks of these medications. We can be...

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NSAIDS have provided pain relief (analgesia) to pets and people for many years. It seems that there is a new NSAID on the market every time we turn around. With reports of lawsuits in the news over human deaths and serious side effects, one might wonder how safe any of these drugs are for our pets. Being an informed pet owner, we can measure the benefits and risks of these medications. We can be sure that we are providing comfort for our beloved animals, but at the same time, doing no unintended harm.

The term non-steroidal means that the medication does not contain any cortisone derivatives. Cortisone is a potent anti-inflammatory hormone in the body that carries its own benefits and side effects. This designation is mainly to assure that the drug can be used in patients where steroids would be contraindicated. Anti-inflammatory signifies the way that the drug acts to control pain. NSAIDS inhibit cyclooxygenase (COX) enzymes. There are at least three COX enzymes known that are responsible for numerous functions in the body including the mechanism of inflammation. Some NSAIDS target specific COX enzymes and spare others, and some inhibit all COX enzymes. Specific COX inhibitors are designed to spare the beneficial effects of certain enzymes, including protecting the mucosal lining of the stomach. NSAIDS are also non-narcotic, meaning that they do not cause sedation or euphoria, and have no dependency or withdrawal risk.

The first commercially produced NSAID was aspirin, or acetylsalicylic acid. It is a non-selective COX inhibitor. Isolated from tree bark (a folk remedy for headaches) in 1829, Aspirin was a miracle drug in treating minor pain without the risk of addiction to morphine. The side effects of aspirin include possible gastric ulceration and reduced platelet function. Because of the higher doses needed to achieve analgesia in animals, these side effects are even more pronounced in pets than in people. Aspirin was once the most commonly used NSAID in veterinary medicine, but alternative drugs have been developed that are safer for prolonged use.

A large group of NSAIDS called profens include selective and non-selective COX enzyme inhibitors. Ibuprofen (Advil, Motrin) is non-selective and carries the same risk of gastric damage as aspirin. It can be toxic to the liver; so, it is generally avoided as an analgesic for pets. Selective COX inhibiting profens include carprofen (Rimadyl), which is FDA labeled for use in dogs to treat pain. Carprofen can cause liver inflammation in some patients, and baseline liver values are measured before starting this and all NSAIDS. It should not be used in patients that have preexisting liver problems. Gastric ulceration is rare and is usually associated with over-dosage.

Other classes of COX-selective NSAIDS include the oxicams, arylalkanoic acids, and the coxib drugs. These drugs are less likely to cause stomach ulceration and bleeding than non-selective COX inhibitors in theory, however, the most common side effect seen with all of them is gastric irritation. Side effects are usually dose related. Meloxicam (Metacam), etodolac (Etogesic), deracoxib (Deramaxx), and firocoxib (Previcox) are all examples of these newer generation selective COX inhibitors.

NSAIDS are considered safe and effective for the treatment of pain when used according to directions. All of the drugs listed here, with the exception of aspirin and ibuprofen, are FDA approved for use in dogs. Cats do not tolerate most NSAIDS. There is only one drug approved for use in cats, and that is Metacam injectable. It is labeled for one time use only in cats. Other NSAIDS or the misuse of Metacam can be extremely toxic to cats. Never give a cat any pain medication that has not been prescribed by a veterinarian.

NSAIDS should never be combined with aspirin, corticosteroids, or other NSAIDS, as the risk of side effects will be greatly multiplied. Never give an extra dose or increase the dose without consulting a veterinarian. NSAIDS should not be given on an empty stomach.

All NSAIDS that are FDA labeled for use in dogs must display the following statement on their labels; “All dogs should undergo a thorough history and physical examination before initiation of NSAID therapy. Appropriate laboratory tests to establish baseline blood values prior to, and periodically during, the use of any NSAID are strongly recommended.”

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FIND US

Texas West Animal Health

16367 South FM 4,

Santo, TX 76472

Phone. 940-769-2222

Fax. 866-632-3365

Email. texaswestvet@gmail.com