Pet Illnesses

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Parvovirus Outbreak - Ebola Equivalent

We all know about Ebola- one of the nastiest and most contagious viral diseases for man. Easily spread from person to person with very high death rates.

Parvovirus is the Ebola equivalent for dogs in many aspects!

Parvovirus has to be one of the nastiest and most infectious diseases of dogs causing severe suffering with a very high fatality rate despite all the best intensive care. And it is so easily prevented by vaccines.

Surprisingly, because Parvovirus has been around for so long, some pet owners have either forgotten what it does to dogs, or they were not yet born when it first arrived on the scene in a world wide epidmiec in the 1980's. Luckily for us, Parvovirus does not infect humans.

What is Parvovirus?

Parvovirus is a virus that attacks the lining of a dog’s stomach and intestines and literally strips it out. Dogs have severe shock, pain and bloody vomit and diarrhoea. Treatment involves intensive care, fluid therapy, pain relief, blood transfusions and no guarantee of success. In fact, many dogs only survive 2-3 days with this intensive care before dying, leaving pet owners with huge vet bills and no dog.

If pet owners are struggling financially, vets often have to euthanise infected dogs before starting any therapy.

How common is Parvovirus?

Where did Parvovirus come from?

It started as a mutation of the Feline Enteritis virus in the 1980’s. The virus changed its design and crossed over to infect dogs. In fact, Feline Enteritis used to be called Feline Parvovirus.

Now, that started in just one country somewhere in the world.

By 2 years, it had spread world wide! That’s why it’s the Ebola equivalent!

How did Parvovirus spread worldwide?

Parvovirus is an extremely tough virus. It can survive up to 18 months in soil or concrete and needs strong disinfectants to kill it. Infected dogs shed millions of the viruses in their diarrhoea, vomit and saliva. It did not take long before surrounding parks and streets were covered in millions of viruses.

When Parvovirus first occurred in the 1980’s, people were not aware of just how tough and contagious it was. International travellers and infected or recovering dogs being flown to other countries would infect healthy dogs upon their arrival- either by direct contact with another dog or with their clothing, bedding and foot wear.

I’m OK. Our dog lives on a farm and never goes out!

Well, the very fact that Parvovirus managed to spread across the world in just 2 years puts a few holes in this statement. It does not discriminate.

That’s why health authorities use foot/vehicle dips and whole body disinfectant showers when dealing with Ebola or Foot and Mouth outbreaks.

Un-vaccinated dogs are a ticking time bomb! Once one dog is infected, the rest will follow in very short time.

A dog can pass Parvovirus laden faeces in the park and up to 18 months later another dog can sniff that area and become infected

Due to its stability, the Parvovirus can be easily transmitted by:

A dog either brewing or in the recovery stage of a Parvovirus infection, sheds millions of the viruses into the environment. Such a dog can "seed" the paddocks, footpaths, car parks etc.

It does not take long for an epidemic of Parvovirus to occur if the general dog population has a low vaccination percentage.

How long does it take for symptoms to occur?

The incubation period (i.e. the time taken from initial infection to showing symptoms) is approx. 7-10 days. This means a dog may appear healthy, but can be excreting virus particles in its faeces and so become a source of infection to other dogs while the disease is brewing in its intestines.

Symptoms

The symptoms of parvovirus are variable, but generally presents as

Parvovirus can affect dogs of all ages; however dogs less than one year of age are particularly susceptible.

Parvovirus diarrhoea 2Parvovirus diarrhoea








Diagnosis

Diagnosis of parvovirus is not straightforward. A tentative diagnosis is often based on clinical signs. A series of faecal and blood tests is usually required to make a definite diagnosis.

Treatment

Treatment is difficult because there is no way to kill the virus once it has infected the dog.

Treatment is intensive and involves hospitalisation in an isolation ward (sometimes for many days), aggressive fluid therapy, antibiotics, pain relief and anti-vomiting drugs. Some cases require blood transfusions.

Despite all of these treatments, a high percentage of dogs die a few days later leaving the owner with no dog and a very large vet bill.

If people are struggling financially, then euthanasia at the first symptoms may be the only option

Prevention

The best method of protecting dogs against parvovirus is vaccination. It is vital all puppies and adult dogs are vaccinated against parvovirus and your vet will advise on the appropriate vaccination schedule.

Ensure your dog has its Parvovirus vaccines up to date

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Snake Bites

This article appears courtesy of:
Alpine Animal Hospital
7047 Great Alpine Road
Porepunkah, VICTORIA. 3740
Ph: (03) 5756 2444

Spring and Summer Peak Snake Periods

Spring and summer are extremely dangerous period for pets in the Shoalhaven and Illawarra region. The warm weather sees a multitude of snakes appearing in back yards, long grass and the bush.

Envenomation from toxins contained in snake venom is always a serious and life threatening incident and must be treated swiftly to save the life of a pet that has been bitten. 

If your pet is unfortunate enough to have an encounter with a snake you can help by being aware of the signs and symptoms of snake bite, and getting the affected animal to the hospital as quickly as possible. Dogs, cats and horses are all at risk, although curious dogs are the most frequently affected.

Unfortunately, we do lose the ocassional pet before we have a chance to treat them. We suspect snakes coming out of their winter rest have unusually large amounts of potent toxin to ensure they get a quick feed to fill their empty stomachs.

Types of Snakes

Around Berry and Shoalhaven Heads, we see mostly Red Bellied Black snakes. Tiger and Brown snakes are also prevalent, especially on Coolangatta Mountain and adjacent flat lands.
















Symptoms

The first clue that a pet has been bitten may just be a small amount of blood on the coat, face or limb with a some soft tissue swelling around a small puncture wound(s).

Depending on the type of snake and how much venom has been injected, an animal bitten by a snake may show any of the following symptoms:

What Type of Snake Bit Your Pet?

There are a few signs that can indicate what type of snake has envenomated your pet:

If you witness the snake biting your pet and can identify it, you should tell us. But don't waste time trying to find it as we stock a multi-snake anti-venom that covers Black, Tiger and Brown snake bites.

Most snake bites in humans occur when people try to kill snakes, often after seeing them bite a pet. It’s generally best to leave the snake alone — it’s just doing what snakes do after all — and concentrate on helping your pet.

Call First!

Phone 4448 5621 (24 Hours) immediately if suspect a snake bite

Calling ahead gives us critical extra time to make necessary preparations to ensure prompt and effective treatment.

When you call, listen very carefully to the announcements, and then call the emergency mobile number on the message (Mark sometimes has a night off with the after hours phone going to another vet).

Please do not come directly to the hospital and wander around the car park. If we are at home, have the after hours going to another vet, or are out on a house call, you will be using up what might be precious time - always call first! It could save your pet’s life. 

Emergency First Aid

Treatment

At the hospital, treatment for snake envenomation may use some or all of the following techniques/procedures:

Treatment usually involves hospitalisation for at least 24 hours. In some cases your pet may be in the hospital for several days.  After being discharged we recommend they be confined and rested for up to two weeks.

It is possible for your pet to be bitten by a snake and not become envenomated. In cases where clinical and laboratory evidence shows that the animal has not been envenomated we may only need to monitor your pet for any delayed symptoms for 12 – 24 hours.

These days the treatment of snake bite has a good success rate, and with appropriate and timely medical therapy many patients recover completely. But treating snake bite is always arduous for the affected pet, as well as for the vet and the nurses. And a very anxious time for caring pet parents.

PetPlan insuranceThe unfortunate animal will require constant monitoring, day and night, every one or two hours for the first 24 hours then every three hours for the next two days, with high rate intravenous infusions, blood clotting products and regular blood tests. Consequently, it can be expensive, although it may be covered by pet health insurance if you have it. But it’s always better to keep your pets out of likely snake habitat and avoid the risk.

Prevention

Repellants and Removal

If a snake needs removal from the property, contact WIRES to ask for theie recommended local snake handler.

See also...
CPR for pets
Pet Insurance

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Hyperthyroidism in Cats: Great News!

This is a very interesting disease of cats which we see in nearly any age group. The thyroid glands are located in the neck on either side of the windpipe. They act like the choke throttle in a car where they control the body’s metabolism. If they are inactive (hypo-thyroidism), pets are lazy, over weight, have skin problems and greasy coats.

Symptoms

Hyper-active thyroids (hyperthyroidism) make cats act like a car all revved up- ravenous appetite, hyper-active (just like my kids), under weight, often difficult to handle (again like my kids!) and may suffer from heart failure- rapid heart rate, shortness of breath, panting. The heart thickens at the expense of chamber size. This is called Hypertrophic Cardiomyopathy

Diagnosis

By performing a simple blood test, we can diagnose affected cats and institute therapy to knock-out the thyroid hormones causing all the problems.

Prognosis for Untreated Cases

Left un-treated, hyperthyroid cats run the major risk of high blood pressure and heart failure. With the rapid heart rate, the heart muscles get thicker and thicker- its a bit like a weight lifter doing extra work. This thickening happens at the expense of the chamber (ventricle) sizes, and is called Hypertrophic Cardiomyopathy (HCM).

The ventricles become smaller and smaller and as a result, can’t fill up with the same volume of blood. Less blood in means less blood out of the heart, and reduced blood supply to the body and its vital organs eg kidneys, liver, heart. Not too good!

Treatment

Unitl recently, the main treatment involved either:

NEW Treatment! Hill's y/d tin and dry food for cats

Hill's y/d Diet to the Rescue

It's taken 6 years to get to Australia after its initial launch in the UK, but finally it is here and in stock at BHVG as of Sept 2015.

Hill's y/d diet comes in tin and dry forms and is especially formulated to ensure other possible accompanying illnesses are taken care of e.g. kidney disease, urinary tract infections. It has all the essential nutrients cat require to maintain a healthy body.

Cats need to be fed Hill's y/d and nothing else for it to work. If a cat is already on medication for hyperthyroidism, this needs to stop straight away.

Cats in heart failure receive medications to slow the heart rate down (beta blockers e.g. Inderal, or calcium channel blockers e.g. Tenormin) and sometimes drugs to remove fluid from the lungs (diuretics e.g. Lasix).

Treated cases usually see an improvement in heart function and the removal of heart drugs from the treatment regime at this stage i.e. the heart pathology is reversible.

Precautions with therapy

Blood test are performed before and 24-36 hours after starting therapy to ensure the kidneys can handle having the blood pressure dropped. In some cats, the high blood pressure from hyperthyroidism is keeping their poorly functioning kidneys going. By "fixing" the hyper-thyroidism, these cats can go into kidney failure.

See also....

Downloads

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Kidney Disease

Dogs and cats can suffer from either acute or chronic renal failure caused by many different types of illnesses.

Did you know...
In humans, you can donate one kidney to a close relative and live a happy normal life. Should your remaining kidney lose up to 50% of its ability to concentrate urine, you can still appear normal although you may be drinking a bit more and making dilute urine. Kidney blood tests can be normal even at this stage.

In other words, you can loose 3/4 of your total kidney function
and still have normal kidney blood tests

What happens in kidney (renal) failure?

The same "1/4 functioning rule" applies to dogs and cats. A Senior Pet Health Check urine examination looks at the concentrating ability of the kidneys to detect early reduction in kidney function. The earlier it is detected, the easier it is to treat.

Trying to keep the remaining healthy 1/4 of kidney functioning is the name of the game in veterinary medicine. Vets are normally unable to offer dialysis and/or kidney transplants for their older patients. Dialysis is performed in people with renal failure to filter out the waste products that the kidney normally places in the urine. When a donor kidney becomes available, they don't need the dialysis any more.

Kidneys place waste products from normal day to day bodily functions in the urine e.g. waste products from protein rich meals (urea and creatinine), phosphate. When we run blood tests on renal failure cases, we see elevated levels of urea (Blood Urea Nitrogen- BUN), Creatinine and Phosphate. As mentioned before, elevation of these test results means we are already dealing with less than 1/4 of remaining healthy kidney function.

Kidneys also re-absorb a lot of water that would otherwise escape into the urine. In other words, they make the urine concentrated.

If the kidneys are failing, they are unable to concentrate urine. In other words, the pet makes more urine than normal because the kidneys can't re-absorb the water out of the urine like they did when healthy. More urine going out of the body automatically triggers a chemical release in the brain which makes the pet thirsty. So we see increased thirst and increased volume of urine in renal failure.

Kidneys have powerful protective mechanisms in place which kick into action if problems arise. One of these is a link to the brain to control blood pressure. If the kidneys are not working properly, chemicals are released which elevate the blood pressure in an attempt to improve the flow of blood through the kidney and remove waste products that are building up in the body.

Kidneys are also responsible for sending messages to the bone marrow telling it to make more red blood cells (RBC's) to replace the old ones which are "gobbled up" by the spleen and liver when they are worn out. If there is only 1/4 of normal kidney left, these messages to the bone marrow decrease and quite often, a pet in renal failure is anemic (low numbers of red blood cells). Because RBC's are responsible for carrying oxygen around the whole body, the pet is quite weak and easily fatigued.

Kidney normalKidney failure acuteKidney failure chronic

 

 




 

Causes of acute renal failure

Causes of chronic renal failure

What are the signs of renal failure?

How do you diagnose kidney failure?

As with most diseases, early detection and treatment is much more preferable especially for a vitally important organ like the kidneys. We would rather diagnose renal failure before clinical signs or blood tests indicate its presence. In other words, before the pet is down to its last 1/4 of healthy kidney tissue.

Urine Protein:Creatinine Ratio

We like to run a urine test called a Protein:Creatinine ratio which can detect kidney failure long before a pet is down to it's last 1/4 of healthy tissue. It is very accurate at detecting early kidney problems long before blood tests start to indicate a problem.

Blood Pressure

For all our renal failure cases, we use a Doppler machine to record elevations in blood pressure and measure response to blood pressure lowering medications.

What treatments are available?

Failing kidneys are not filtering waste products from meals into the urine. They build up in the body and make pet feel off colour and nauseous. That is why they sometimes vomit son after a protein rich meal. We can minimise this buildup by feeding special diets e.g. Hill's Kidney Diet (K/D) which are low in protein and high in carbohydrates and fats.

Other standard treatment for renal failure cases include:

How can success of treatment be monitored?

We like to repeat the urine Protein:Creatinine ratios and/or blood tests on a regular basis to measure response to therapy.

Conclusion

All in all, renal failure cases can be very difficult to treat, mainly because most cases are down to their last 1/4 of healthy kidneys.

For young cats in Australia with kidney failure, there is the possibility of kidney transplantation in Brisbane, but it is quite involved and the donor cat has to be taken on as a new family pet. It means life long treatment with anti-rejection drugs e.g. Cyclosporine which can mean the whole exercise is very expensive.

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Cushing’s disease

Cushing's disease is brought on by excessive amounts of cortisone circulating around the body.

Symptoms

Dogs with Cushing's disease can show a wide variety of symptoms, the most common ones being:

Affected pets may display some or all of these symptoms.

Causes

The pituitary gland is the master gland of the body. Pituitary tumours can make hormones which tell the adrenal glands to make excessive amounts of cortisone

Prognosis

Left untreated, complications can occur e.g. diabetes, poor wound healing, infections, poor skin, pot bellied, fatty liver.

Dogs with pituitary gland tumours can go on to live comfortably for some time until the tumour gets too big and starts to place pressure on adjacent parts of the brain.At this stage, we might see symptoms such as blindness and other hormone imbalances.

Unfortunately, adrenal gland tumours are often malignant and can spread to other parts of the body. Referral to a specialist may be an option if the tumour is in just one adrenal galnd and not adhered to any vital structures e.g. the major vein returning blood to the heart (caudal vena cava) which runs adjacent to the adrenal glands.

Diagnosis

Suspected cases have blood tests done to try and find out where the excess cortisone is coming from.

Skin mushy pad 4 Skin mushy pad 1










Skin mushy pad 4 Skin mushy pad 1

 

 

 

 

Treatment

Until recently, most cases were treated with a drug called Lysodren which destroys the parts of the adrenal glands that make cortisone.

A relatively new drug called Trilostane, is the current treatment of choice. It has a much higher success rate and less side effects than Lysodren. Trilostane is used in human medicine for treatment of Cushing's disease.

Trilostane is an expensive drug to supply.

Many cases on Trilostane can have the dose lowered after a few months, which helps with the budget. Regular blood tests pick up if this situation has arisen.

Unexpected Side Effects of Treament

Cortisone has powerful anti-inflammatory actions in the body. Symptoms of arthritis or itchiness (pruritis) may be hidden in dogs suffering from Cushing's disease. Once treated for Cushing's disease, these signs may become obvious to the owner and require other medications to soothe them.

Diabetes is commonly seen in Cushing's cases, probably as a result of cortisone interfering with the action of insulin. Because of this interference, the treatment dose of insulin is much higher than in a diabetic none-cushingoid dog. Once treatment for Cushing's starts, the vet has to closely monitor the diabetes to ensure there is no overdosing of insulin which now has no cortisone to interfere with its action.

Cushing's cases have to be regularly monitored to make sure the medication is working properly and also to ensure that not all the body's cortisone production has been stopped. In other words, we don't want the dogs to have the opposite problem of not enough cortisone (Addison's Disease). 

Dogs in treatment are usually given some cortisone tablets (e.g. Cortate) to have on hand just in case their dog's cortisone levels drop to zero during the course of treatment and it starts to show symptoms of Addison's disease.

Expense of Treatment

Before embarking on treatment, owners need to be very aware of the expensive nature of treament. They must be fully committed and prepared to put up with regular blood tests and expensive drug bills. In a very old patient, no treatment may be a more preferable propositon especially if the owners are on a budget.

In human medicine, pituitary gland tumous can be removed by specialist surgeons operating through the nose or roof of the mouth.

See also...
Addison's Disease

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Increased Thirst (Polydypsia)

There are a large number of causes of increased thirst (polydypsia) in pets. Besides the expected increase in thirst with hot days, exercise or change to a drier food,  any pet showing polydypsia over 2-3 days should be examined by a vet. When making the appointment, try to bring along a fresh urine sample as a lot of information can be found by examining it.

Causes

Kidney and Urine Tests

A quick examination of a urine sample can rule out the most serious and life threatening of diseases causing polydypsia, diabetes. Examining the strength of the urine (specific gravity) using a special instrument (refractometer) gives a good idea as to how well the kidneys are working. Spinning the urine down in a centrifuge, then collecting the sediment in the bottom of the tube and staining it with a special stain can show bacteria and abnormal cells.

Blood tests (biochemistry and full blood count) give an overall picture of a pet's health. An elevated kidney blood test ( BUN &/or Creatinine) suggests the pet is dehydrated and/or in kidney failure.

A pet has be down to its last 25% of normal kidney function before these blood tests rise.

Pets and humans can donate a kidney (and therefore be down to 50% total kidney function) and still lead a healthy life with no elevation of kidney blood tests or polydypsia.

If their remaining kidney becomes diseased, and loses over half of its ability to function, kidney blood test start to rise i.e. they have less than 1/4 (25%) of normal kidney tissue left in their body. In other words, we don't normally see elevated kidney tests in chronic renal failure until there is only 25% of healthy tissue left.

When there is 25-50% of healthy kidney function, kidney blood tests are often normal, but the urine may be dilute (low specific gravity). At this stage, the pet may be polydypsic as it is making too dilute a urine. The kidneys aren't doing their job of "recycling water" by sucking water out of the urine before it goes to the bladder to be voided. Their urine is dilute instead of concentrated. The brain realises it is losing more "water" than it should be from the body, so it activates the "thirst centre" in the brain which makes the pet look for water.

In summary,

It is important to check a urine sample as it can detect kidney failure long before a blood test. Regular testing of the urine specific gravity can be a great guideline as to the progression of the disease &/or response to therapy.

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Canine Pancreatitis

What is pancreatitis?

Pancreatitis means inflammation of the pancreas gland. The pancreas is a special organ that makes many different chemicals such as insulin, acids and alkalis which help digest and process foods. When a normal animal smells or swallows food, signals are sent to the pancreas telling it to start making these chemicals in preparation for the meal "on the way down"

These chemicals travel down a special tube from the pancreas into the first part of the small intestines (the Duodenum). Food on its way out of the stomach meets the chemicals and digestion gets under way.

Sometimes as pets get older and fatter, the pancreas gets inflamed or worn out from too much of a workload e.g. too many fatty meals. This small amount of inflammation results in leakage of acids and alkalis both inside and adjacent to the pancreas. Needless to say, these chemicals are very caustic. Further damage occurs to adjacent organs e.g. liver, intestines and more of the pancreas is digested by its very own chemicals. More damage to the pancreas means more leakage and it does not take long for massive inflammation and tissue destruction to occur.

Traveling through the pancreas is the bile duct- a tube connecting the gall bladder in the liver to the duodenum. Bile traveling down this tube also helps to digest food. If the pancreas is inflamed and swollen, the bile duct can become blocked. As a result, bile "backs up" in the liver and can cause a yellow staining of the blood, skin and gums (jaundice).

Pancreas normalPancreas inflammed

 













Which pets are affected?

We normally see pancreatitis in older overweight dogs or dogs being fed too many fatty meals e.g. lamb chops, marrow bones, scraps off the ham bone, cooked chicken, dairy products. Some older dogs can develop pancreatic cancer which looks just the same as normal pancreatitis.

Some breeds of dogs, e.g. Beagles, suffer from chronic low grade pancreatitis with just the occasional unexplained vomit and/or abdominal discomfort.

Diagnosis

From the history, breed, sex, age, symptoms and clinical examination, a vet usually has a pretty good idea the pet is suffering from pancreatitis. There are some specific blood tests that can confirm pancreatitis: elevated Lipase and/or Amylase and the presence of fatty and or yellow (jaundiced) serum.

A special in-house blood test ( Idexx SNAP CPL) gives an accurate positive result in pancreatitis cases (blue dot on the right is the same or darker than the dot on the left- see picture). Repeating these tests during the dog's stay in hospital gives the vet an good idea on how the dog is going.

Other blood tests may show elevated white blood cells combating inflammation and infection and elevated liver enzymes if the bile duct becomes blocked.

Symptoms

Affected dogs are suddenly extremely ill. They vomit just about anything they eat or drink. There is a lot of inflammation and pain in the abdomen. Dehydration and shock quickly follow, making the dog thirsty, however each time it drinks, more leakage of the acids and alkalis occurs. Acute secondary kidney failure can occur due to the large amount of fluid loss causing thickening of the blood and decreased blood flow to vital organs.

As mentioned above, the inflamed pancreas can block the bile duct, so jaundice is a common symptom, sometimes seen 1-2 days after the start of the condition.

Treatment

The main treatment is nothing by mouth for 12-24 hours. Even the smell of food can trigger of further release of leaking acids and alkalis. Dogs must go onto an IV drip to correct dehydration and reverse shock and damage to the kidneys.

Newer anti-vomiting drugs (e.g. Cerenia) allow early administration of food and/or fluids. This is important to provide fluid and nutrition to the cells lining the stomach and intestines.

Pain killers are an essential part of therapy as pancreatitis is very painful.

Complications

Cases failing to respond to therapy may require surgery to rule out pancreatic cancer or to gently flush the affected area to try and settle the inflammation.

Severe cases can obliterate the insulin making capability of the pancreas. Diabetes and all of its associated complications (keto-acidosis) can be a life threatening presenting sign. Cases of acute onset diabetes should have pancreatitis ruled out as an underling cause.

Repeated episodes of pancreatitis can destroy the ability of the pancreas to produce food digesting acids and alkalis, resulting in chronic diarrhoea.

In humans, there is an overall 20% fatality rate, usually due to a secondary infection developing in the affected areas of the abdomen.

Dogs with pancreatitis and diabetic keto-acidosis have a poor prognosis and despite the best of efforts, may die from complications.

Treatment can be very costly due to the length of stay in hospital with intensive care, drugs, repeat blood tests and fluid therapy.

Prevention

Normal dogs should not receive excessive amounts of fat and/or scraps in their diet especially around the festive season when trimming the fat off ham or roasts.

Make the majority of the diet a balanced dry dog food e.g. Hills VE Essentials.

Feed raw bones 2-3 times a week but try to avoid excessive marrow consumption e.g. ask the butcher to cut the large bines length ways so you can remove the marrow.

Dogs who have suffered from pancreatitis need to go on special low fat dry foods (e.g. Hills W/D dry) to prevent it re-occurring. It is vital that repeat episodes are avoided as too much damage to the pancreas can result in lack of insulin (diabetes) or the inability to digest and absorb foods (pancreatic exocrine insufficiency).

See also...
Diabetes

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Boxer Cardiomyopathy

This condition is characterised by feinting (syncope) and sudden death in Boxer dogs. It is unlike the traditional form of cardiomyopathy we see in large dog breeds (most of the time). Boxer cardiomyopathy is also known as "Boxer arrhythmogenic right ventricular cardiomyopathy".

Ventricular Premature Contractions (VPC's)

The problem is due to a run of extra heartbeats interrupting the normal flow of oxygen rich blood to the brain. No oxygen to the brain means a none functioning brain, hence the feinting( syncope).

These extra heartbeats originate in damaged heart muscle in the right ventricle (ventricular premature contractions -VPC's).

A run of 3-4 VPC's, one after the other, overtake the normal heartbeats. VPC's are ineffective contractions- i.e. they don't pump enough blood out of the heart to the brain and body. If they are very rapid, the ventricle does not have time to fill up to the top befoire it is "told" to contract. It ends up only 1/4 or less full when it contracts resulting in only 1/4 or less of the normal flow of oxygen rich blood out of the heart.

A run of several or more VPC's can cause sudden death which is a common consequence of the condition.

Diagnosis

Auscultation
By listening to the heart for several minutes with a stethoscope, a vet may detect a skip in the normal heart rhythm although this is not a sure fire way of detecting a problem as affected dogs can go for several hours without as much as one skipped VPC.

ECG
Similarly, connecting a dog to an ECG machine to record the heartbeat for a few minutes may miss a run of VPC's. If a vet sees the occasional VPC in a symptomatic dog, its pretty close to a diagnosis.









Listening to the heart or recording an ECG while the dog has a syncopal episode would be ideal way to diagnose the problem, but these events tend to happen away for vet surgeries and owners can be too stressed to  think about recording the heartbeat while their unconscious dog lies at their feet. By the time they do have a feel of the heartbeat or pulse, the rhythm may be back to normal as it may have just been a run of several VPC's taking up less than 1-2 seconds of time.

Halter ECG Recording
Specialist cardiologists can loan out 24hr ECG recording machines (Halters) which attach to the trunk of the body in special leather harnesses. A computer runs through the 24hrs of recording in seconds and prints out a report highlighting all the abnormal heartbeats.

Quite often it is astounding to see how many runs of VPC's occur while the dog is asleep. A dog that "passes away in its sleep" is a real possibility here.

Radiology
The typical boxer cardiomyopathy has normal heart and lungs on chest xrays

Ultrasound
Again, most boxer cardiomyopathy cases have normal ultrasound heart measurements.

Note:
We still see the occasional classical dilated cardiomyopathy in boxers (see images below).

Treatment

The drug of choice for suppressing runs of VPC's is Sotalol. It is usually given twice a day.

See also....

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Atrial Fibrillation

Some dogs with dilated cardiomyopathy and left A-V valve disease get a life threatening arrhythmia called atrial fibrillation.

It originates from a part of the left atrium wall which gets damaged when it enlarges. The damaged area fires off its own electrical current causing the atrium to contract very rapidly (sometimes as much as 200-300 times a minute).

Each time the damaged atrium contracts, it tries to sends an electrical signal to the ventricles below telling it to contract as "its their turn now". Not every electrical impulse gets through to the ventricle as a number of these extra charges arrive at the ventricle when it is in a "none-responsive" state (refractory period).

The refractory period may only be a split part of a second, and follows a normal ventricle contraction. Once it has passed, the extra electrical signals from the damaged atrium above can trigger off a ventricle contraction.

In effect, the atria are doing their own rapid irregular heart beat and 8 times out of 10 their extra contractions cause the ventricles to contract.

As a result, we see the ventricles pumping at a much faster and irregular rate than in a dog with no atrial fibrillation.

If a dog has either A-V valve disease or dilated cardiomyopathy, the ventricles are already having a hard time.

Cardiac output is reduced in A-V valve disease and dilated cardiomyopathy, so oxygen rich blood does not reach vital organs e.g. brain, liver, kidneys.

But don't forget the heart which is the most dynamic oxygen hungry organ (next to the brain). Any reduction in output means less oxygen for the heart muscles, so they can't pump as well as they would like.

The last thing the diseased ventricles want is atrial fibrillation causing them to contract even faster.

Atrial fibrillation can very quickly cause the ventricles to fail and lead to sudden heart failure and death.

Diagnosis

On exmination, the heart rate is very rapid and irregular- often over 200 beats a minute (nearly 3-4 beats a second). There is often evidence of left sided heart failure - coughing, weakness, pale gums, weak thready rapid pulse.

A normal ECG has one P wave (atrial contraction) followed by one QRS wave (ventricle contraction) and a normal heart rate of approx 100-140.

Atrial fibrillation shows rapid irregular spaced ventricle heartbeats (QRS waves) and no regular P waves.








Treatment of Atrial Fibrillation

The classic drug used to treat atrial fibrillation is Digoxin (Lanoxin). It increases the length of the refractory period (mentioned above). As a result, even less of the atrial contractions can get through to the ventricle to make them contract.

Digoxin blood levels need to be monitored as overdosage is common and can cause serious problems.

If the ventricles are still beating at a much too high a rate and the heart failure is under control with medications, vets may add in a second drug (Beta blocker) to slow the ventricles down.

See also....

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Feline Dilated Cardiomyopathy

Introduction

Until recently, cats presented with two types of cardiomyopathy:

Dilated cardiomyopathy was very prevalent in the UK and rest of the world in the 80's and 90's. After extensive research, it was found that a world wide deficiency of Taurine (an essential amino acid) in commercial cats foods was the cause. Food manufacturers have since added Taurine to all their products and the disease has made a marked decline in incidence. 

Symptoms

Most cats present in left sided heart failure with fluid in the lungs (pulmonary oedema) with some if not all of the following symptoms:

Embolus formation

Cats with dilated cardiomyopathy have very enlarged heart chambers with thin walls that can't pump effectively.

Cat normal heartCat dilated cadiomyopathyPulmonary oedema








With this heart enlargement, the valves between the atria and ventricles get "pulled apart" so a gap appears in the middles of the valve allowing blood to shoot up into the right and left atria (see heart valve disease)

The left atrium becomes very enlarged due to leaking of the mitral (left a-v) valve.

Cat blood clots approx. 15 times quicker than human or dog blood. Inside the dilated left atrium, blood sludges around not knowing where to go. On cardiac ultrasound, a "London fog" appearance in the left atrium can sometimes be seen. In a number of cats a solid blood clot forms in the left atrium which looks like a billiard ball bouncing around inside the left atrium.

The blood clot (embolus) leaves the left atrium into the left ventricle and out the aorta to wherever fresh blood is delivered. Small clots can go to the brain, kidneys, foreleg, parts of the intestines or elsewhere. Most clots are pretty big and tend to travel down the aorta missing the smaller outlets until they reach the end of the aorta where it splits in 2 to supply the lower part of the body.

This is called a saddle thrombus and cats have acute hindleg paralysis which very quickly get very stiff, swollen and very painful due to the lack of blood supply.

Symptoms of embolus

Cats develop a very sudden illness depending on where the embolus goes and blocks off the oxygen rich blood supply to vital organs

Diagnosis

Early cases can present with mild symptoms of general weakness, lethargy, and slight shortness of breath. Most cats have a heart murmur and a rapid heart and respiratory rate as the first detectable symptoms.

Severe cases can present in fulminate heart failure with or without a serious life threatening blood clot (embolus).

Diagnosis is based on symptoms, clinical examination, xrays and ultrasound examination.

Radiology 

Cardiac ultrasound (echocardiography)

See an ultrasound video of a human heart with an embolus in the left atrium.

Treatment

This was a very serious and frustrating disease to treat.

Conventional therapy involved treating the heart failure by using of diuretics (e.g. Frusemide) ACE inhibitors (e.g. Captopril) and anti-clotting drugs (e.g. Aspirin).

Aspirin is safe to use at low doses and only twice a week. It was thought that it would prevent embolus formation but this has recently been disproved (Mark Kittleson's work) and is no longer used.

Cats with acute saddle thrombus formation have a grave prognosis. If the cat can get to a specialist centre quickly for the clot to be dissolved by using special intravenous drugs, it stands a better chance of survival.

However once the muscles start to die off and build up a lot of waste products, dissolving the embolus results in these breakdown products entering the circulation and causing severe life threatening kidney damage. So fixing one problem leads to another.

Oral administration of Taurine resolved a number of cases with hearts sometimes returning to normal.

Preventing embolus formation has proved very difficult in cats. Many cardiac specialists have saved cats only to have another clot episode a few months later. This happens despite the use of Heparin and/or Aspirin.

See also....

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Canine Dilated Cardiomyopathy

Introduction

Cardiomyopathy is generally seen in the larger breeds of dogs. Small to medium sized dogs tend to get valve disease rather than cardiomyopathy.

The most common form in large dog breeds is called Dilated Cardiomyopathy.

Boxers have there own version called Boxer Cardiomyopathy which has recently been renamed Arrythmogenic Right Ventricular Cardiomyopathy (ARVC)

Dilated Cardiomyopathy

As in humans, this form of heart disease presents with an enlarged heart with thin walls. The walls are so thin that they are incapable of pumping blood out of the heart in an effective manner.

 

 

 


 

Pulmonary oedema






Symptoms

Radiology

Ultrasound (Echocardiography)

 

 

 

 








Treatment

The "Rolls Royce" of therapy involves:

The use of diuretics and ACE inhibitors is discussed in A-V heart valve disease.

Pimobendan is a great drug but can be expensive for large breeds. It makes the heart contract in a stronger manner without increasing the heart's demand for oxygen. It also acts as an ACE inhibitor complementing other ACE inhibitors. It has replaced the use of Digoxin (Lanoxin).

Using all three products gives the best results. 

Footnote:
Pimobendan was first released for human trials approx 20 years ago. Excellent results were obtained for people with dilated cardiomyopathy, however there were a number of sudden unexplained deaths at the time. It has since been discovered that in humans, Pimobendan cross reacts with Digoxin (Lanoxin) and that was the suspected cause of the deaths. Pimobendan is under trials again in Japan and may make its way back into human medicine.

Atrial Fibrillation

Some dogs with dilated cardiomyopathy and left A-V valve disease get a life threatening arrhythmia called atrial fibrillation which needs to be treated aggressively as it can cause sudden death.

See also....

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Heat Stress

Body regulation of heat

Heat is produced from normal daily activities such as:

Heat loss is achieved by a number of means:

Clinical signs

Causes

Nearly all cases of heat stress have a pre-existing disease present such as:

Heat stroke in a previously healthy animal occurs in the following conditions:

Effects of heat stroke on the body organs

Untreated heat stroke can cause major damage to the internal organs of the body:

Treatment

Immediate reduction in body temperature is critical to the survival of heat stroke patients.

Preferred methods include:

NB Remove the wet towel and dry the patient once the temperature reaches 39 degrees to avoid the temperature overshooting & going below normal.

Transfer to a veterinary hospital A.S.A.P. for further treatment involving:

Prevention

 

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Valve Disease

The dog heart is very similar to a human heart with 4 chambers (2 atria and 2 ventricles). Blood inside the heart flows from the atria to the ventricles below. The heart valves prevent blood going back up the way it just came from i.e. they work as a one way valve.

The 2 small thin walled chambers of the heart (atria) sit above the 2 large chambers (ventricles)










The heart has a right and left side.

 

 


 

The right side receives oxygen poor blood from the body and pumps it out to the lungs to have oxygen placed in it (a low pressure setup as the lungs are "next door").

The left side receives oxygen rich blood from the lungs (again a low pressure environment as the lungs are "next door"). It then has to pump it all around the body from the head to the tip of the tail. To be able to pump blood that far, the left ventricle has extra strong and thickened muscle walls.

The most common valve problems we see are damaged left (mitral) and/or right atrio-ventricular (AV) valves.

Right AV valve disease



 

 

 

The right AV valve lies between the right atrium and right ventricle. Oxygen poor blood from the body arrives at the heart's right atrium via the cranial and caudal vena cavas (very large internal veins). It then enters the right atrium and flows through the open right AV valve into the right ventricle.

The right AV valve closes and when the right ventricle contracts, the oxygen poor blood is pumped out to the lungs via the pulmonary arteries connected to the right ventricle.

Diseased right AV valves "leak", so some of the oxygen poor blood that normally goes to the lungs is pumped back up through the leaky right AV valve into the right atrium.

The oxygen poor blood returning to the heart is met with some resistance as the right atrium chamber already has some "leaked" blood in it. This causes a "back log" of blood in the vena cavas trying to get into the heart.

As a result, organs start to swell. The most common thing to happen is for the liver to swell up so much that free fluid starts to leak off into the abdominal cavity (ascites).

Similarly, in some , dogs and cats, fluid can leak into the chest cavity from this back pressure (hydrothorax).

When the heart contracts, blood squirting through the leaking right AV valve into the right atrium is quite turbulent and causes a lot of noise (murmur) which a vet can hear when listening to the right side of the heart with a stethoscope.

Symptoms of right AV valve disease

Left AV (mitral) valve disease

The left AV valve (also known as the mitral valve) lies between the left atrium and ventricle.









Oxygen rich blood from the lungs enters the left atrium via the pulmonary veins, and passes through the open mitral valve into the left ventricle.

All this happens under low pressure as the lungs are "next door" to the heart. Blood only has to travel a short distance to get into the empty left atria and ventricle- almost gravity fed filling up of the left side of the heart.

The mitral valve then closes, and the left ventricle starts to contract very forcefully as it has to send the oxygen rich blood all around the body. There is a huge amount of pressure generated inside the ventricle which opens up the aorta valve allowing blood to "escape" the left ventricle into the aorta and go around the body.

The mitral valve has to stand up to a lot of pressure to prevent blood trying to get through it instead of the aortic valve when the heart contracts.

Any slight damage to the mitral valve results in a high pressure jet of blood squirting back up into the thin walled left atrium when the left ventricle contracts (a bit like water going through a narrowed down hose nozzle).

Suddenly, there is a lot of high pressure "extra" blood in the left atrium obstructing blood returning under low pressure from the lungs via the pulmonary veins.

Oxygen rich blood starts to "backup" in the lungs as it meets this resistance. Eventually, the pressure gets so great that fluid leaks out of the swollen pulmonary veins and leaks into the lung tissue (pulmonary oedema).

Because there is a reduction in the amount of oxygen rich blood leaving the heart (some has gone back into the left atrium through the leaking mitral valve), there are several consequences:

Any reduction in oxygen rich blood leaving the heart means less of it going to the oxygen and energy hungry heart muscles.

The last thing the heart muscle wants to "hear" is the "greedy" brain telling it to pump harder and faster. It is already feeling the effects of a reduction in its own oxygen and energy supply.

        a) Atrial premature contractions (APC's)

        b) Ventricular premature contractions (VPC's)

If there are enough of these extra beats, they can be life threatening e.g. ventricular tachycardia or atrial fibrillation

Symptoms of left AV (mitral) valve disease

Diagnosis

A vet will hear a murmur when listening to the heart valves. The murmurs are graded 1-6; 1 being only just detectable and 6 being able to be felt by placing a hand on the lower chest wall.

The history of the cough and clinical signs will alert a vet. To distinguish the cough from a sore throat or lower airway disease e.g. bronchitis, the resting heart rate is a big clue. If its rapid, its more likely to be heart problem.

Because there is a reduction in the flow of blood out of the heart, the pulse is weak and the colour of the gums is paler than normal.

To aid in diagnosis, vets use radiology and ultrasound

Radiology

Left Heart Failure

  • Enlargement of the left atrium and left ventricle
  • The trachea is elevated upwards towards the thoracic spine
  • In severe cases one of the main branches of the trachea can be "pinched off' as it is being squeezed between the heart below and spine above
  • Fluid in the lungs (pulmonary oedema)

Right Heart Failure

  • Enlargement of the right atrium and right ventricle
  • Liver enlargement
  • Fluid in the abdomen (ascites)
  • Fluid in the chest cavity (more so in cats)



     

 

 

Ultrasound (Echocardiography)

Ultrasound is a powerful diagnostic tool in the hands of a skilled operator. A vet can see the actual damaged valves and measure heart chamber sizes and how well they are contracting. Using colour flow Doppler, the leaking blood can be seen shooting through the leaking valves into the atria. Blood pressure measurement can be made to give an indication of how severe the problem is.








Causes of heart valve disease

Treatment

1) Lower the blood pressure

Going back to the flow of blood within the left heart described above, imagine the following...

In the left ventricle just before contraction, say the aorta on the other side of the closed aortic valve has some thick honey in it.

When the ventricle contracts and tries to open up the aortic valve, there is a lot of pressure required to shift the "honey" out of the way and open the valve.

A much easier solution is to push the blood up through the leaking mitral valve into the left atrium where there is a low pressure environment i.e. very low resistance to flow of blood out of the ventricle.

A large jet of blood will shoot back up through the leaking mitral valves into the left atrium because it is much easier to send it there (being a low pressure environment) than out the aorta with the thick "honey" on the other side of the closed aortic valve.

Now, imagine we replace the honey in the aorta with water.

The ventricle now finds it much easier to open the aortic valve and send blood into the aorta.

This means much less blood shoots up through the leaking mitral valve into the left atrium which in turn means more blood can get into the left atrium from the lungs.

In other words, there is improved blood flow from the left side of the heart.

A very similar scenario happens on the right side of the heart except we are dealing with the pulmonary and right AV valves instead of the aortic and mitral (right AV) valves.

So how do we go about creating this scenario?

Vets use drugs which lower the blood pressure in the aorta and pulmonary arteries. It just like changing the "honey" to "water" - same thing.

The most common drugs are:

They work by dilating the major arteries and veins in the body, thereby allowing more blood to accumulate in these vessels and lower the overall pressure in them.

2) Remove excess fluid in the lungs and/or chest cavities

The standard drug is Frusemide (Lasix) which removes fluid via the kidneys (a diuretic).

If it fails to shift the fluid a second diuretic is added to the regime. My favourite is Hydrochlothaizide (Dithiazide) as I find another one often used by vets called Spironolactone lacks "grunt".

3) Watch for over zealous use of diuretics

In a critically ill patient with lots of fluid buildup, we sue high doses of diuretics to shift the fluid out of the lungs. Once stabilised, the vet has ot be careful not to give too high a dose and cause dehydration of loss of potassium.

If using 2 diuretics, I add in a slow release potassium supplement to avoid low levels in the blood.

Blood test should be performed regularly to check the kidneys and liver are handling the medications ok.

See also....

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Feline Hypertrophic Cardiomyopathy

Introduction

Until recently, cats presented with two types of cardiomyopathy:

Hypertrophic cardiomyopathy (HCM) is now the most common form of heart disease seen in cats. It used to be equal or second to Feline Dilated Cardiomyopathy which is now uncommon since the addition of Taurine to commercial cat foods a number of years ago.

Causes

Pathology

Basically, the heart appears normal in size on x-rays, but it is actually thicker than normal. The chambers inside the heart get smaller and smaller, meaning less room to fill up fully and therefore, less blood gets pumped out of the heart.


Cat normal heartCat hypertrophic cadiomyopathy






Symptoms

Cats are very good at disguising respiratory and cardiac illness. It’s not until they are down to their last 25% of lungs that they start to show shortness of breath or other symptoms. A panting cat sets off alarm bells in a vet’s mind.

Blood clots (thrombus) formation

Unfortunately, some cats develop blood clots inside the dilated small chambers of the heart (atria) seen with this condition. These clots may go un-noticed until they suddenly leave the heart and cause a blockage (embolus) in one of several possible locations:

Main arteries to the hind legs

Kidneys

Right forelimb arteries

Intestinal blood supply

Treatment

If a cat is in heart failure, we treat it with drugs to remove fluid from the lungs (diuretics e.g. Lasix).

Because the heart is pumping rapidly and has only a small chamber to fill up in between beats, we give drugs to slow the heart down (beta-blockers or calcium channel blockers) which gives the following advantages:

All cats should be blood tested for hyperthyroidism and high blood pressure as these conditions can cause secondary hypertrophic cardiomyopathy and occur at any age. A normal result should be repeated at a later stage as it may be just "around the corner" so to speak. If diagnosed with hyperthyroidism or high blood pressure, we treat it.

Until recently it was thought that giving Aspirin to cats would prevent blood clots from forming. However, recent evidence has shown that Aspirin does not work in cats.

A newer medicaiton, Clopidogrel (Plavix) has been shown to have anti-clotting capabilites when combined with aspirin. Due to it's bitter tatse, it is usually made up in capsules with a low dose of Apsirin and given once a day.

Prof Mark Kittleson, in a recent paper, has also suggested that because cats sleep 75% of the time, they don't really put their diseased hearts "through the paces" except for the odd trip to the vet or being chased by a dog. He believes that the use of calcium channel and beta blockers makes no difference to the long term outcome, and has since stopped recommending it as a treatment for cats not showing signs of heart failure when resting at home.

See also....

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Introduction to Pet Illnesses

Bhvg vet 2 transWelcome to the pet illnesses section of our website. There are close to 50 common pet illnesses covered here. I have written these pages over the last 15 years when I decided to be one of the very first veterinary hospitals to go onto the internet.

Believe it or not, there was only myself and 2 other Australian websites selling pet products online at that stage. Boy, have things changed! Some of the pet illnesses may not be suitable for children, so it might be a good idea to “vet” the page(s) first (lousy humour is one of my traits).

Cheers,

Mark Allison

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Canine Coronavirus (CCV)

Coronavirus (CCV) is a virus which  can cause severe illness in dogs that at first glance looks like a Parvovirus infection.

How does CCV spread?

Coronavirus can be picked up by dogs sniffing long grass where infected dogs have gone to the toilet up to one year ago. In other words, its not directly from dog to dog. Just a walk in the park and that's it!

Incidence

A recent study showed approx. 16% of dogs have come in contact with CCV in the last 12 months (that’s about one in every 6 dogs).

Coronavirus3Coronavirus1Coronavirus2








Symptoms

Coronavirus causes severe bloody watery diarrhoea, shock, abdominal pain and vomiting. There is variable mortality amongst puppies and older dogs. Signs appear very suddenly. The diarrhoea looks and smells just like Parvovirus. We see approx. 1-2 affected dogs each month.

Treatment

Treatment must be quick and aggressive to save these sick dogs. It usually involves an IV drip, anti-biotics, blood and faecal tests and intensive care. Luckily, it has a lower fatality rate and quicker recovery rate than Parvovirus

Needless to say, the costs mount up and affected dogs feel pretty ill for a few days.

Concurrent infection with Canine Parvovirus (CPV)

Concurrent infection with canine Parvovirus (CPV) is not uncommon. CCV was reportedly isolated from dogs with diarrhoea during the CPV epidemics in 1978. Dual CCV-CPV infections were identified in 15-25% of cases of severe enteritis in the USA.

Another study showed that CCV was found in 44% of fatal gastro-enteritis cases that were initially identified as only CPV disease.

A combined infection leads to a much more severe disease than occurs with either CCV or CPV alone, and is often fatal.

Group

Severity of signs

Mortality rate

Recovery rate

CCV

+

0%

100%

CPV

+++

0%

100%

CCV + CPV

+++++

89%

11%

The reason for this is that the two viruses infect different sites of the intestinal villi, leading to more extensive epithelial damage. CCV only infects the cells of the upper two-thirds of the intestinal villi. During the recovery phase of CCV infection, the crypt cells divide more rapidly replacing the lost cells.

Vaccines

Well, there is always a good side to a story and that there is a Protech Duramune C2i vaccine which has Coronavirus plus another vaccine called Leptospirosis in it.

The Protech Duramune C2i vaccine needs two shots 4 weeks apart to work. Once this has happened, then it’s an annual vaccine in combination with the either a C3 or C5 vaccine.

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Upset Stomachs

Pets may develop upset stomachs (vomiting and/or diarrhoea) due to  a change in the diet, infections, worms, stress or a combination.

Management of diarrhoea involves

1) No food for 12-24 hours.
        During this time give a re-hydration tonic e.g. Lectade and water.

2) Over the next 4- 5 days, feed a bland diet of:

3) Feed small meals often (4-5 times a day). Do not give milk as it worsens diarrhoea.

4) Allow your pet to rest.
 
5) Once the diarrhoea has resolved, re-introduce the pet’s normal food over a 3-4 day period by adding increasing amounts of its normal food to the bland diet.

When to see the vet

If your pet’s diarrhoea does not respond to this regime within 48 hours or if your kitten is:

 -contact BHVG on (02) 4448 5621

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Feline AIDS (FIV) and Vaccines

FIV (Feline Immunodeficiency Virus) is a common virus found worldwide with the number of infected cats dramatically increasing over the last 15 years.

In Australia approximately 7% to 29% of feral cats test positive to infection, many of which die from FIV related illnesses each year.

Although FIV is very similar to the human AIDS virus (destroying the immune system leaving the animal susceptible to infections), humans cannot contract Feline AIDS (FIV) from infected cats.

Special FIV Introductory Offer for Adult Cats at BHVG

We have bundled together an adult cat vaccine upgrade programme

Normal prices

Annual vaccine  $78.00
FIV Blood Test   $48.00
3 FIV vaccines   $90.00
-------------------------------

Normal price  $216.00

Cat fence

Special FIV
Upgrade Price $160.00
 

SAVE $56.00

Mention this webpage
to save $$$

1. How can my cat become infected with FIV?

Cats can become infected if they are bitten by an infected cat as the disease is transmitted in saliva. If your cat often roams outdoors they are at a higher risk for contracting the disease. The virus is also transmitted via blood and although very uncommon it is may be transmitted sexually and from queens to kitten across the placenta or in their colostrum (milk).

2. What are the symptoms of FIV?

Once the cat has been infected, FIV can then progress to feline acquired immunodeficiency syndrome (feline AIDS) suppressing the immune system similar to that seen in the human AIDS virus. As a result an infected cat may show no signs of disease for months to years after being infected.

Later it may develop a fever, enlarged lymph nodes, loss of appetite, diarrhoea, ear and skin infections, lethargy, sores in and around the mouth, slow wound healing, weight loss, upper respiratory tract infections, and eye lesions such as glaucoma. Neurological signs such as behavioural changes, weakness and inco-ordination/ wobbly gait are seen late in the course of the disease and tumours called lymphomas may occur.

Eventually the immune system becomes too weak to fight off other infections. As a result, the cat will die from one of these subsequent infections.

3. What can I do to prevent Feline AIDS/FIV?

FIV is progressive and eventually fatal with no known treatment or cure (similar to human AIDS). Vaccination of your cat is possible in Australia. Along with vaccination you can reduce your cats exposure to the virus by limiting indoor cats contact with outdoor cats, testing new cats entering the household for the virus and minimizing the chance of fights between your cats by isolating aggressive cats and close monitoring of new cats.

BHVG's Recommended FIV Vaccination Regime:

Kittens from 8 weeks

3 vaccinations against Feline AIDS/FIV are required along with the routine vaccines against Feline Enteritis, Influenza (F3 vaccine) and Chlamydia (F4 vaccine). An inter-vaccination interval of 2- 4 weeks is recommended.

Cats 6 months and over

It is recommended that a blood test prior to vaccination in cats over 6 months of age to ensure the cat has not been previously infected with the FIV virus.

Once vaccinated, a cat develops antibodies against the FIV virus and is protected. This means a positive FIV blood test later in life will probably be a false result i.e. the positive result is due to the vaccine generated antibodies being detected and is not an indication the cat is infected with FIV.

A new blood test can tell the difference between antibodies generated from a vaccine to those from an active FIV infection.

Once blood testing has confirmed that a cat is FIV negative, a series of three FIV vaccinations are required 3-4 weeks apart.

See also...
Annual Health Checks and Vaccines

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Chlamydia infection in cats

Respiratory disease in cats is a common problem for cat owners and a major concern for veterinary practitioners.

The main reason for this is that there are so many contributing factors to the disease that it can often be difficult to control.

Up until now, veterinarians have been able to vaccinate against most of the major diseases challenging cats today. These being, Feline Enteritis, Feline Flu and more recently, Leukaemia. However, one of the contributing pathogens in the feline respiratory disease complex has been Chlamydia.

Chlamydia are an unusual micro-organism. They are neither bacteria or viruses, but respond to anti-biotics, usually Tetracyclines.

Symptoms

Respiratory disease caused by Chlamydia is mainly characterised by conjunctivitis and is predominantly seen in young cats from 5–9 months of age. Once contracted, cats can be carriers for as long as 18 months post infection.

7-10 day old kittens are also vulnerable to neonatal conjunctivitis with  “sticky-eye” symptoms persisting for some time.

Whilst conjunctivitis is seen as the main clinical sign in cats, other less common conditions include, abortion, polyarthritis and pneumonitis (inflammation of the lungs). Reproductive capability has also been suggested as being impaired by cats contracting this bacterial disease.

Treatment

Chlamydia infections are traditionally treated with antibiotics. We use Vibravet paste for young cats and Tetracycline tablets for older cats. In immature cats, Tetracycline can cause colouring effects on the cat’s teeth and bone tissue. A tetracycline based eye ointment is no longer available.

Control

The disease can be controlled through vaccination with a Chlamydia vaccine. Depending on your vets preference, the Chlamydia vaccine comes as either a FeVac 4 or FeVac 5  vaccine brand. They both contain the Chlamydia antigen as well as the other Cat Flu and Feline Enteritis. The only difference between the two vaccines is the inclusion of Feline Leukaemia in Fel-O-Vax 5.

Kittens, 8 weeks of age and older and previously unvaccinated cats will require two doses 3-4 weeks apart. Annual boosting with a single dose of vaccine is recommended for adult cats.

See also...
Annual Health Checks and Vaccines
Feline AIDS (FIV)

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Spleen Tumours in Dogs

Tumours of the spleen are a relatively common type of cancer in dogs. Some breeds are more prone e.g. German Shepherds, but any breed can be affected.

As a rough rule, approximatley 50% of splenic tumours are benign (sometiomes even very big ones) and the rest malignant.

The most common type of malignant sp[lenic tumour is a haemangiosarcoma. It has a nasty habit of spreading to adjacent organs and the base of the heart.

Splenic tumours are very dangerous for dogs. They can rupture at any time with no warning, and because the spleen has a major blood supply to it, a dog can bleed to death very quickly. Affected dogs can be happy and active one minute, then suddenly dying in front of their owner’s eyes. Sometimes, the splenic tumour has a small tear, and there is only a small amount of blood loss. In these cases, the dog may suddenly collapse or go into mild shock, but appear to make a quick recovery. A collapsing dog should have its spleen examined ASAP.

Tumour spleen 3Tumour spleen 10Tumour spleen 17









A ruptured splenic tumour is a life threatening emergency requiring rapid diagnosis, surgery and intensive care. If the dog has a nasty splenic haemangiosarcoma that has spread to adjacent organs, it is more humane to opt for euthanasia as the prognosis is hopeless. If there is no evidence of spread, removal of the spleen can be successful and give the dog extra years of life.

However, we sometimes find splenic haemangiosarcoma have spread elsewhere around the body into tiny tumours (“secondaries” or “metasises”) not visible to the naked eye. The large splenic haemangiosarcoma appears to “control” the growth of the smaller “secondaries” – possibly by producing a chemical which inhibits their growth.

When the large splenic haemangiosarcoma is removed, the growth controlling chemical is removed and the secondaries start to rapidly grow. Sometimes, a dog can be brought back to the vet with advanced cancers all through the body within 1-2 weeks of the spleen being removed. Unfortunately, there is no way of predicting which case will follow this route at the time of surgery.

As part of your dog’s annual health check and vaccinations,
ask your vet to palpate the abdomen to see if there is a mass present

Medium to large sized splenic tumours are easily detected, but smaller ones may be missed.

Regular checkups are vital in the early detection of splenic tumours.

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Intervertebral Disc Disease

Humans and dogs share back problems, although the damage can be more severe in long dogs e.g. Daschunds.

The invertebral discs are positioned between each of the bones that make up the spine (vertebrae). They are soft and tough, and act a bit like "spacers" in keeping the vertebrae apart from each other. The vertebra can then bend and flex without crunching into each other.

Spine normalSpine disc disease








When discs wear out, the centre (nucleus) sometimes erupts out of its central position and travels upwards where it collides with the spinal cord and/or one of the major nerves exiting the spinal cord. This is called a "prolapsed disc".

In people, this may be to one side, and for example, it may hit the right sciatic nerve giving the person a sharp shooting pain down the back of their right leg.

In dogs, the normal sequence of events is compression on the lower half of the spinal cord as a whole. If the disc has prolapsed slowly, then the dog may just feel lower back pain, much like in people. Sometimes it goes off to one side, so only one side of the spinal cord ids affected.

If the disc prolapses with a little more force, it may cause enough pressure on the lower spinal cord to interfere with messages travelling up and down the spinal cord between the feet and brain. The messages get slowed down and by the time the brain receives information about where the hind foot is, the foot has already moved.

The result is inco-ordination (ataxia) . Affected dogs are wobbly in the hind legs and knuckle over very easily.

Sometimes, the disc prolapse can be explosive, and it can literally cut the spinal cord in half. This is quite common in dogs with long low backs e.g. Dachshunds, Basset hounds. It goes off a bit like someone squeezing an orange pip between their fingers. These dogs are paralysed and the prognosis is very poor.

Treatment

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Prostate Disease

Often middle-aged men have to become aware of a gland that they may have previously not even heard of, occasionally needing to go to the doctor to have it checked, which is an experience some would rather forget!

Well, middle aged entire male dogs (i.e. un-castrated) can also suffer from prostate problems! There are several conditions that can occur and they can all show a range of symptoms.

The prostate is a gland that is located internally in the pelvic region. It surrounds the urethra (the tube that takes urine from the bladder to the outside world) and sits below the dogs rectum.

It produces a fluid that mixes with sperm and increases the total volume of spermatic fluid.

Prostate normalProstate enlarged benign

 

 

  

 

Symptoms

Often when there is a condition affecting the prostate there will be some enlargement of the gland. This can cause any, or all, of the following symptoms:

If the problems are not addressed it can become a serious source of illness and discomfort. It is important to determine early whether it is an easily treatable condition or something more serious like prostate cancer.

So if you have an older un-desexed male dog then watch him carefully for any of the above signs. If there is anything you are unsure about then contact us.

An easy way to reduce the chances of prostate problems is desexing at a young age!

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Pemphigus

This is an uncommon condition caused by the body's immune system attacking the skin. There are many types of Pemphigus lesions ranging from pustules (pimples) to ulcers or vesicles (blister like) lesions in the skin and mucous membranes e.g. along the lip margins. Some case have thick cheesy discharge around the nail beds and can lead to the pet chewing off its own nails or toes.

It's a very hard condition to treat and once diagnosed, requires regular visits, blood tests, and continuous medication.

Pemphigus 3Pemphigus 2

 




 


Diagnosis

Diagnosis depends on ruling out other skin conditions e.g. flea allergy, food allergy, mange mites etc. Skin biopsies are the best method to diagnose Pemphigus.

Treatment

Treatment involves the use of drugs that suppress the immune system e.g. cortisone Leukaran and/or Cyclosporine. Antibiotics and regular shampoos e.g. Dermcare Malaseb may be required. Long haired animals may need to have their hair clipped short to make it easier to maintain.

Pemphigus can be fatal if not treated. It is very debilitating for affected pets (and humans who have their own version of Pemphigus).

See also...
Pemphigus Case

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Osteosarcoma

Osteosarcoma is the term for the most common type of bone cancer in pets. It usually occurs in large to giant breeds of dogs and can happen at a young age.

There is rapid destruction of bone and a lot of heat, swelling and pain associated with osteosarcoma. The tumour often spreads to other parts of the body e.g. lungs.

The most common location for osteosarcoma is just above the wrist (carpal) joint. Most cases present with a foreleg lameness and soft tissue swelling just above the carpus.

X-rays show the destructive power of the bone cancer with a typical "sunburst effect" and loss of bone detail in the lower radius and/or ulna. A vet will want to repeat these x-rays at regular short intervals to monitor its progress if the typical destructive lesions are not too obvious on x-rays at the initial consult.

Tumour elbow 1Tumour elbow 2

 


 

 


Tumour elbow 4Tumour elbow 3

 

 


 

In some dogs, there is a fungal infection of bone (see Fungal Osteomyelitis) which can look just like a bone cancer on x-rays. To differentiate it from Osteosarcoma, a bone biopsy and urine culture (looking for fungal infection in the kidneys) are performed. Aspergillus Osteomyelitis is treatable with expensive drugs but the prognosis is poor even with therapy.

Tumour radius 2Tumour radius 1







Tumour radius 4Tumour radius 3

 





Treatment

Treatment of Osteosarcoma is generally disappointing. Even with early foreleg amputation, most dogs only live a few months before it becomes noticeable that it has spread to other parts of the body. Some dogs receive anti bone cancer drugs in combination with amputation e.g. Cisplatin which can lengthen life by a few months.

Pain relief is vital and most dogs require the use of powerful pain killers.

See also...
Fungal Osteomyelitis
Osteosarcoma of the Elbow Case
Osteosarcoma of the Radius Case

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Obesity

Obesity is the most common nutritional disease of dogs and cats.

Is your pet overweight?

You may have thought to yourself that your pet is overweight or been told by a veterinary surgeon or nurse in the surgery. If your pet weighs over 15% more than it did as a young healthy adult, it is overweight. As a guide, if you have difficulty in feeling the ribs, then your pet has a problem. You should be just able to feel the ribs with a small amount of pressure. 

Why obesity is dangerous

Overweight pets suffer more physical ailments and do not live as long as animals of average weight. Obesity often reduces a pet's enjoyment of life, its performance and the owner's enjoyment of the pet.

Health risks associated with weight gain

The reason for obesity

You must admit to yourself that the animal is overweight and realise that although there are some slight aggravating causes, the only way an animal becomes and stays overweight is because it is having TOO MUCH TO EAT ! In other words, the total daily intake of calories is more than it needs.

Many owners will not face this fact and try to persuade themselves and us that the animal is not being overfed. We often hear the same answers to our suggestions that a pet is overweight:

All of these show that the owners are trying to persuade themselves that they are not over feeding the animal concerned. If your pet is fat, it is having too much to eat!

Exercise is the key to a healthy lifestyle: Exercise tips

Just the odd tidbit can add
up to a huge number of
calories for your pet

Hills slim cartoon 2 trans small

The solution

Together with the veterinarian set a specific goal for weight reduction and estimate the time required to reach that goal. Allow 8-12 weeks to reach this "target weight". We will want to see your pet at regular intervals during and after the weight-reduction program.

Management of an overweight pet should include:

Fun and games for dogs

Recommended exercises for your cat

Cats, particularly those with an indoor lifestyle, may not be getting sufficient exercise. Here are some ideas to boost the activity level of your cat.

Rewarding your pet

We all like to reward our pets. There are alternative ways to giving a reward without giving food.

Dietary management

Successful weight-reduction is rare if your pet is fed its regular diet. Decreasing the amount of regular food enough to produce weight loss may cause nutritional deficiencies and begging. Feed your pet a diet specifically formulated for weight reduction. There are two types of diet to choose from:

1) A Home Made Low Calorie Diet

This is a special high volume,low calorie diet you can cook and store in the freezer.
Feed approx. 200gm per 10 kg target weight

  • 1 cup of white rice
  • 500 gm lean meat
  • 1 or 2 beef Oxo cubes
  • 2 pints water
  • 4 tablespoons gelatine
  • Mix, then boil to cook
  • Stand to set
  • Freeze to keep

2) A Commercial Low Calorie Food

Hills r/d
diet (dry or tin) and Royal Canin Obesity are very tasty foods that can be fed in quite large amounts to cats and dogs. The dogs we have had on these diets feel satisfied by it and have certainly lost weight very quickly. It contains everything your dog or cat needs in the way of vitamins and minerals etc. Hills r/d and Royal Canin Obesity are prescription diets and are only available from Veterinary Surgeons. They can be brought either by the can or by the bag.

3) Snacks

If possible, avoid giving snacks, but if your pet is used to receiving them, use limited amounts of healthy snacks like carrots or rice cakes.

Table scraps are inappropriate for pets -especially those on a weight loss programme.

Low calorie snacks

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Mushy Pad Disease in Cats

Article appears courtesy of my colleague, Richard Malik
Post Graduate Foundation
PGF VETERINARY SCIENCE CONFERENCE CENTRE
THE UNIVERSITY OF SYDNEY NSW 2006
http://www.cve.edu.au

Feline pododermatitis is a poorly understood disorder that effects the carpal and metacarpal pads of cats. The affected pads feel soft and mushy, like marshmallows. The surface can appear wrinkled and flaky and can be ulcerated. Cats can be affected on one or all paws. Cats are usually admitted when ulcers are present as they tend to bleed intermittently.

Skin mushy pad 4Skin mushy pad 1Skin mushy pad 2

 







The condition has been seen in a number of European countries as well as USA and Australia. Veterinarians have had a variety of approaches, including surgery where the abnormal material is scooped out followed by stitches and a course of prednisolone and/or antibiotics.

Vibravet was released onto the Australian Veterinary Market a few years ago and since then several cats have been treated with doxycycline monohydrate. The majority of patients responded although it took several weeks or months for the affected pads to return to normal.

A few cats have developed “mushy pad” following a bite injury to the pad. Other cases where all pads are affected may be the result of multiple abrasions from a sharp surface.

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Megaoesophagus

This is a uncommon condition in pets. The oesophagus is the tube between the mouth and the stomach. It carries food and water by alternately contracting and relaxing the muscles that line it. This is why you can swallow water even when you stand on your head without the water rushing out your nose (a good party trick!)

Sometimes in pets, the muscles lining the oesophagus get diseased and stop functioning. When this happens, food, saliva and/or water tends to pool in a relaxed part of the oesophagus- usually in the middle of the chest. The food and/or water just sits there and is not "pushed" into the stomach. A short time later, the pet makes a gagging sound and out plops the meal, undigested and sometimes in a sausage shape. The oesophagus is very enlarged, hence the word "mega- oesophagus".

Causes

Symptoms

Diagnosis

Treatment

The most common complication that often leads to euthanasia is accidental inhalation of some of the vomit into the lungs causing severe pneumonia. To avoid this, dogs are fed small rolled up pieces of food e.g. cooked mince with rice (see photo). Food should be fed by hand with the dog in a sitting position so it slides down the dilated oesophagus into the stomach. Water should be left in an elevated position e.g. at the top of a few stairs so the dog has to drink with the tail lower than the head.

To lessen the chance of stomach acid being inhaled into the lungs and causing damage, we give ant-acids 2-3 times a day e.g. Zantac.

Antibiotics play an important role in preventing secondary infection in damaged lungs.

If the cause is Myaesthenia Gravis, we give a human tablet twice a day which helps make the muscles and nerves work. Treatment is for 3-6 months before recovery occurs. Repeat blood tests will tell the vet if the Myaesthenia Gravis has finished. X-rays will also show if the oesophagus has returned to normal function.

The use of cortisone to "knock out" the immune system is controversial as it is felt it takes a few months to work and by that time, the disease may have run its course anyway. The other problem is if you "knock out" the immune system and the dog gets an inhalation pneumonia, it will be much worse off with cortisone in the body.

See also...
A case of Megaoesophagus in a dog

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Mammary Cancer

Due to the increased awareness as a result of public education and available screening services, the mortality rate from breast cancer has dropped significantly in women. We should also apply these principles to the care of our pets.

Tumour mammary 1Tumour mammary 3









Tumour mammary 2Tumour mammary 5







This is especially the case with mammary tumours in older female pets. These tumours can affect any age pet, but mainly around the 10 year old mark.

An owner may notice a thickening or a firm lump under one or more of the nipples on the pet's belly. If you notice this you should definitely get it checked out by the vet.

About 50% of mammary tumours are malignant and will spread rapidly to the surrounding lymph nodes and even to the lungs. So it is crucial they are diagnosed early. Regularly check your pet, of any age, all over for any new lumps or bumps.
 
Interestingly pets that are desexed before their first heat are 200 times LESS likely to suffer from this type of tumour. This benefit lessens with each heat and after 2 ½ years the benefit is lost. This is another good reason to have your pet desexed early.
 
See also...
Advantages of Desexing Female Cats
Advantages of Desexing Female Dogs

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Lymphosarcoma (LSA)

Lymph nodes are found throughout the body: under the skin, in the chest and in the abdomen. These are the same "glands" that people can feel under their neck when they have a sore throat.

The tonsils form part of this network and swell up if fighting a throat or mouth infection. They are all part of the lymphatic system responsible for keeping the body protected against infections. Lymph nodes react to infections/inflammation and are the body's first line of defense.

Unfortunately, in humans and cats and dogs, we see a cancer of the lymph nodes called Lymphosarcoma (LSA) or Hodgkin's Disease. In cats, it is usually caused by a virus called Feline Leukemia Virus (FeLV) which is preventable using a vaccine. In dogs and humans, the cause of LSA is not known.

Tumour lsa 1Tumour lsa 2
 

 





Tumour lsa 3Tumour lsa 4

 

 

 


Sometimes, LSA does not just cause swelling of the lymph nodes. It can appear as a solid tumour of a body organ (e.g. kidneys, intestines, liver) and in some cases it involves the bone marrow causing a leukemia.

Other possibilities for swollen lymph nodes include a response to overwhelming infections and irritable skin problems e.g. severe flea allergy dermatitis.

Symptoms

LSA can develop in any age pet, but is generally seen in younger animals.
Symptoms vary depending on which part of the body is involved.

A cat may present for acute kidney failure or bowel obstruction due to LSA of the kidneys or intestines respectively. LSA of the eyeball can present as an "angry inflamed eye". If the bone marrow is involved, the pet can deteriorate very quickly and be very sick.

The classic LSA involves swollen lymph nodes. Initially, an owner may just notice the pet has swollen glands and is slightly off colour.

As the disease progresses rapidly, there is a quick deterioration in the pet's health with euthanasia usually performed within 3-6 weeks of initial diagnosis if no treatment is given.

Diagnosis

A diagnosis of LSA is made by removing an entire lymph node (usually the one behind the knee/stifle) under general anaesthesia and submitting it to a pathology lab for analysis. Sometimes, a meaningful result can be obtained from a needle biopsy of a swollen gland, but pathologists in general prefer a whole lymph node to look at.

LSA can be classified according to its distribution in the body and whether or not the bone marrow is involved. This system can sometimes help the vet in giving a more accurate prognosis.

Treatment

Chemotherapy using combinations of different drugs can be quite successful in getting rapid reduction in the size of the body's lymph nodes. However, the trick is in keeping the LSA from re-occurring. In veterinary medicine, we don't use the very high doses of chemotherapy used in humans so serious side effects like hair loss are not so common. None the less, regular blood tests and monitoring for other side effects is essential.

Because chemotherapy drugs can cause serious illness in people who accidentally come in contact with them (e.g. needle stick injury, squirted some in to the eye) all waste material has to go into a special waste unit for proper disposal. Staff involved in handling the drugs have to gown up , double glove, wear masks and safety eye wear. The drugs can be very expensive as well. As a result, most vet refer these cases to a specialist centre which is geared up for treating such cases.

Prognosis

All in all, treatment for LSA is very involved, expensive and requires total commitment from the owner. Life expectancy can be increased by several months and some cases go onto full remission.

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Feline Lymphoblastic Leukaemia

Leukaemia 1Leukaemia is a cancer of the cells that form into either the red or white blood cells in the blood.

There are a few types of leukaemia, and they are named according to the particular type of cell that is affected.

Therefore, lymphoblastic leukaemia is a proliferation of lymphoblasts (undifferentiated lymphocytes/cancerous white blood cells) in the circulation.

No exact cause is known for this condition, but a potential cause of this cancer is infection with Feline Leukaemia Virus (FeLV).

These cancerous white cells will interfere with normal blood cell production in the bone marrow and will cause the affected animal to be anaemic. The slide on the right shows a blood smear with very little red blood cells in it.

Leukaemia 3Leukaemia 4

 



 

 

Leukaemia 5Leukaemia 2








Diagnosis

Diagnosis depends on observing moderate to high numbers of cancerous white blood cells in the bone marrow or in other vital organs (the spleen is a common place where this cancer can originate from or be spread to)

On physical examination, the cat may have signs such as an enlarged spleen, liver, mildly enlarged lymph nodes, pale gums, and tiny spots of bleeding on the gums. The enlargement in the previously mentioned organs is caused by infiltration of the leukaemic cells and may disrupt the specific organ's normal function. The pale gums are a sign of anaemia, and the tiny bleeding spots are caused by a reduction of cells which are responsible for blood clotting in the blood.

Treatment

The only treatment for lymphoblastic leukaemia is chemotherapy. Studies have shown that prognosis with chemotherapy is poor, with an average survival time of only a few months. Results of chemotherapy would depend on the grade (severity) of the leukaemia. However, if left untreated, the estimated survival time from diagnosis is less than two weeks. Animals do not get the side effects (hair loss) of chemotherapy that humans get because they require a much lower dose of drugs in comparison to humans.

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Urinary Incontinence

Urinary incontinence is an involuntary loss of urine or the lack voluntary control of micturition (urination). The most common clinical signs are urine dribbling from a recumbent or sleeping dog. Dribbling may even occur in the standing dog when not excited.

In spayed (desexed) bitches urinary incontinence is reported to have an incidence of between 11-20%. Acquired urinary incontinence occurs in 20% of spayed dogs with a strong correlation between bodyweight and the risk of urinary incontinence. Bitches with a bodyweight of more than 20kg have a risk of 30%, while smaller dogs have a risk of 0%.

Risk Factors

Urine is contained within the bladder and is prevented from leaking out by the urethral sphincter which consists largely of muscles. The activity of the muscles is both voluntary and involuntary. The sphincter normally remains closed until the animal decides to consciously urinate. If the sphincter is lax, as occurs in incontinence, urine will leak out.

Inconvenience of Urinary Incontinence

Treatment

Stilboestrol

The traditional treatment has been Stilboestrol (1mg tablets). Dogs start on a high dose which is then stretched as far as possible eg. 1 tablet every 10-14 days. Stilboestrol can suppress the bone marrow so dogs should have a blood cell count done on a regular basis to ensure this does not happen. At 10-14 day intervals, this is less likely to occur.

Suprelorin

A slow released implant called Suprelorin has shown great promise in the management of incontinence in desexed female dogs. Suprelorin reduces elevated levels of circulating female hormones (FSH and LH), a phenomenon seen in desexed female dogs.

Reduction of FSH and LH has been shown to have high success rates in treating urinary incontinence. Duration of the response ranges from 21-365 days with an average of 159 days.

In those case where Suprelorin did not completely resolve the incontinence, the addition of Propalin to the regime was successful.

Propalin Syrup

Propalin-cartoonPropalin relaxes the bladder wall while contracting the sphincter muscle.

Prescribing and Use Information

PropalinTM Syrup

Each ml contains: Phenylpropanolamine hydrochloride 50 mg/ml

Actions

Phenylpropanolamine increases sphincter tone.

Indication

For use in bitches in the control of urinary incontinence associated with urethral sphincter incompetence.

Directions for use

To be used by or under the direction ora registered veterinary surgeon.

Dosage

Bitches- 3 mg/kg daily in divided doses with food.

Contraindications and Precautions
Side Effects

Sympathomimetics may produce a range of effects most of which mimic the results of excessive stimulation of the nervous system.

This is unlikely at the recommended dose. Treatment is symptomatic. No specific antidote is available.

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Hip Dysplasia (HD)

HD refers to an abnormally shaped hip joint which has a basic ball and socket setup.

HD usually means the ball (femoral head) is not sitting in the socket (acetabulum) as well as it should. With time, the ball and socket "bump" and "grind" into each other, leading to arthritis and joint pain.

HipsHips dysplasia

 

 

 

 

Breeds

HD can occur in any breed, but is most common in medium to large pure breeds such as:

Causes

HD is usually seen where there has been poor breeding practices e.g. mating relatives. It is carried in the genes (DNA) of the parents.

Symptoms

Signs can develop from as young as 6-8 weeks of age in severe cases. Affected dogs have a wobbly hind leg walking action when viewed form behind. They have trouble rising from rest, and as the disease progresses, pain when trying to get up. There is a reduction in exercise tolerance.

Diagnosis

Ortalani Sign in Young Pups

Young pups can have their hip joint manipulated in a certain way by a vet to determine if there is any looseness in the hip joint. This is usually done when in for their first lot of vaccines.
A positive result indicates the pup has HD and may get associated arthritis problems later in life. The good news is if the pup is less than 20 weeks of age, it can have a relatively minor operation performed to "re-shape" the hip joint while it is still growing. This is called a Juvenile Pubic Symphyodesis (JPS)

Hip Scoring and Penn Hip Evaluation

In an effort by conscientious breeders to remove HD from their breeding line, a national Hip Scoring system was set up.
An X-ray of the hips is performed under general anaesthetic and referred to a specialist veterinary radiologist for reporting.
A low score means that a pet has excellent breeding potential. Breeders then look for a breeding partner with similar low scores to ensure the litter has the best chance of being free from Hip Dysplasia. For a small additional fee, an Elbow Dysplasia X-ray can be performed at the same time.

The standard Hip Score technic has been around for some time and there are breed averages to compare the dog's score with. Its accuracy has been questioned though, and newer technics are now available which are more accurate.

If the breeder has been lucky to have a Penn Hip certified vet, a more accurate set of radiographs can be taken. The Penn Hip technic involves the use of a special device which gently pulls the hips out of their sockets (if loose), whilst taking the x-ray with the dog lying on its back.

Treatment

Juvenile Pubic Symphyodesis (JPS)

A specialist veterinary surgeon can use a cautery tool to burn a particular part of the pelvis in young pups with loose hip joints. This halts growth in this section of the pelvis whilst allowing other remaining growing parts to change the shape of the hip joint, making it much more stable.

A JPS has to be done before 20 weeks of age, ideally before 15 weeks. Success rates if performed early are as high as 90%.
This operation can save the dog from major orthopaedic operations later in life e.g. Total Hip Replacement (THR) or a Triple Pelvic Osteotomy (TPO).

Triple Pelvic Osteotomy (TPO)

This operation is performed in slightly older dogs but has some limitations.

Surgery involves cutting the pelvis into 3 sections on the affected side and re-positioning the 3 fragments so the hip socket sits move "over" the femoral head (the "ball").  Post operatively, it can take 5-6 weeks before the hip goes back into place.

Total Hip Replacement (THR)

Just like in humans, dogs with bad hips can have artificial ones installed. There are cement-based and cementless (more expensive) types of artificial hips. Surgery is performed in dogs less than 10-12 months of age with severe laxity in the hip joint and very early signs of arthritis. A cementless hip joint can last up to 10 years.

Purchasing a new pup- avoid the pitfalls

If purchasing a new pup, ask the breeder to give you copies of the hip scores (or Pen Hip reports if lucky) of both parents (as well as eye examination and elbow dysplasia scores).

If the breeder has some excuse for not having some sort of hip score, be wary of proceeding with the purchase as it could mean big veterinary bills down the track. Have the pup examined within 24 hours by your vet to check for any other problems eg heart murmurs, hernias. Ask the breeder if you can return the pup if it fails this vet examination.

These are great tips for avoiding "back yard breeders" - the scourge of organised and well run kennel clubs who have registered breeders in their ranks.

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High Blood Pressure

Just like people, dogs and cats suffer from high blood pressure.

Causes

Complications

Diagnosis

Because pets come in all shapes and sizes, traditional blood pressure machines for humans don't work too well. One of the more accurate methods is to use the Parkes Doppler blood pressure recording machine on one of the forelegs. BHVG uses this machine to monitor all of their anaesthetics to detect any drop in blood pressure during an operation. 

Treatment

Depending in the underlying cause, treatment varies. We use drugs to lower the blood pressure e.g. Norvasc while addressing the underlying cause of the hypertension.

Prevention

We perform Senior Pet Health checks on our older patients. Part of this programme involves running blood and urine tests, and measuring a pet's blood pressure.

See also...
Senior Pet Health Checks

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Heat Stress (Heat Stoke)

On Sunday, 1st Jan. 2006, I experienced the hottest day on record in Sydney and Wollongong with temperatures of 45 degrees Celsius (113 Fahrenheit) and a very strong westerly wind. We had 3 dogs presented dead on arrival. Two of these were brachycephalic breeds (a British Bulldog and a young Pug) and the other an older Chihuahua with a chest condition. It was a very upsetting experience for the owners.

Should the weather forecast issue a hot day warning, make sure your pets are kept cool, have plenty of fresh water and are not left alone at home. Dogs with thick coats should have them shaved off prior to the hot season. Watch closely for signs of heat stress.

Body heat regulation

Heat is produced from:

Heat loss is achieved by a number of means:

Symptoms

Causes

Nearly all cases of heat stress have a pre-existing disease present such as:

Heat stroke in a previously healthy animal occurs in the following conditions:

Effects of heat stroke on the body organs

Untreated heat stroke can cause major damage to the internal organs of the body:

Treatment

Immediate reduction in body temperature is critical to survival of heat stroke patients. Preferred methods include:


N.B. Remove the wet towel and dry the patient once the temperature reaches 39 degrees to avoid the temperature overshooting and going below normal.

Transfer to a veterinary hospital A.S.A.P. for further treatment involving:

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Fungal Osteomyelitis

This is a nasty infection of the long bones, often seen in German Shepherds and other large breeds. It can affect any age. Affected dogs are very ill and lame in the affected leg. Affected areas show heat and swelling. X-ray changes are very similar to those seen in bone cancer It is caused by a fungus called Aspergillus which destroys bone and spreads through the body. It can often be detected in the urine and this is used as part of the diagnosis. How it gets into the bones is not quite certain, but it may be from an injury to the leg or possibly if the fungus gets into the bloodstream e.g. through the nose.

Diagnosis

Diagnosis is based on x-ray changes, bone biopsy (to rule out Osteosarcoma), and urine analysis.

Fungal osteomyelitis shows bone destruction in the radiusFungal osteomyelitis shows bone destruction in the radiusOsteo fungal b








Treatment

Treatment is involved and is not always successful. Expensive anti-fungal drugs have to be given by a vet and repeat tests performed to ensure it is clearing up.

See also...
Osteosarcoma of the elbow
Osteosarcoma of the radius

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Gastrointestinal Foreign Bodies

Article appears courtesy of...
Richard Malik
Post Graduate Foundation
PGF VETERINARY SCIENCE CONFERENCE CENTRE
THE UNIVERSITY OF SYDNEY NSW 2006
http://www.cve.edu.au

Terry King
VETERINARY SPECIALIST SERVICES ANIMAL REFERRAL CENTRE
‘SOUTHPARK’,
2/10 COMPTON ROAD
UNDERWOOD
QLD 4119

‘New and Old’– Alimentary Foreign Bodies in Dogs and Cats

Small animal clinicians often see foreign bodies lodged in the alimentary tract (and adjacent structures) of dogs and cats. Some of these pass without any problems, some cause partial or complete obstruction, while others may cause nasty, life-threatening complications such as perforation or plication (rolling up of the intestines like a sock falling down your ankles) of the gut.

Vets need to be on the lookout for ‘new’ foreign bodies, not well described in older veterinary textbooks, when taking a history and working up cases with vomiting, abdominal pain, regurgitation etc and when instructing/educating owners during routine health checks and vaccinations of potential risks to cats and dogs.

My aim in writing this perspective is to provide a stimulus to experienced and busy clinicians to share their recent and past observations with colleagues through the C&T forum.

Oesophageal foreign bodies

These are typically associated with inability to eat and regurgitation (rather than vomiting). Usually this is a problem in dogs rather than cats, and they tend to reach the veterinarian for investigation a few days after ingestion. The commonest foreign body is an inappropriate bone gobbled up (without chewing) by a greedy dog.

Most of these require endoscopic intervention to effect a favourable outcome, typically at a centre with facilities for endoscopy and purpose designed bone retrieval forceps.

 






 

Nasopharyngeal foreign bodies

Bones, blades of grass, plant awns, berries, pills, plastic toys, bits of fish (especially fish heads) or meat can all cause problems if they become lodged in the nasopharynx (the space right at the back of the throat that joins to the back of the nose).

This usually occurs after vomiting following the initial eating and subsequently gives rise to stertor, inspiratory dyspnoea, snoring and halitosis. If the foreign body is not obvious to the human eye, then, endoscopy or a vigorous flush with saline will aid diagnosis.

Gastrointestinal foreign bodies (GIFB's)

Classic GIFB's in dogs include mango pips, peach and apricot stones, tennis ball remnants (somewhat radio-opaque) and metallic foreign bodies (washers, fish hooks, bottle tops, coins).

Bones very rarely cause problems once they reach the stomach, although excess ingestion may result in constipation if the dog is not accustomed to eating a bone rich diet.

Oes fb1Gi fb3Ball fb








Gi fb1Fb dog ball 3Stuck ball1

 






GIFB's may cause irritation of the stomach and thus vomiting, and occasionally they obstruct gastric outflow through the pylorus (the narrow exit region of the stomach). Intestinal foreign bodies give rise to signs of obstruction with or without perforation and peritonitis (initially localised, eventually generalised).

Two recent additions to the list of GIFBs in dogs are the tampon and the skewer (satay) stick.

Tampons 200KebabLinear fb

 

 

 


Tampons, for obvious reasons, are especially attractive to dogs and cause an especially nasty syndrome due to severe plication of the gut from the attached, anchored string. This problem is more apparent in these politically correct times, because flushing tampons down the toilet is actively discouraged.

Although this topic may initially appear unseemly, owners need to be made aware of this NEW danger common to many households.

Karon Hoffman has recently published an extremely elegant paper on the sonographic and clinical findings in these cases.

Hoffmann, K. L. Sonographic signs of gastro-duodenal linear foreign body in 3 dogs. [Journal article] Veterinary Radiology & Ultrasound. American College of Veterinary Radiology, Raleigh, USA: 2003. 44: 4,466-469. 10 ref.)

Satay sticks are a novel manifestation of multiculturalism in Australian society. Instead of dogs merely getting pancreatitis from eating the fatty sausages after a BBQ, or getting Heinz body haemolytic anaemia after eating the left-over onions, a new syndrome has emerged due to ingestion of wooden skewers (typically with some tasty shish kebab still attached).

These sharp linear foreign bodies usually make it to the stomach without damaging the pharynx or oesophagus, but exit the gut at points of anatomic tortuosity, such as the duodenal flexure or ileo-caecocolic junction (where the appendix are in humans), giving rise to peritonitis. They often eventually exit the body via the left para-lumbar fossa region (just behind the ribs and under the spine) where they can cause local irritation and infection.

Geoff Robbins and Geraldine Hunt have written detailed papers on the clinical syndrome that is seen with this type of foreign body (Beischer, D.A. Robins, G. M.Vertebral osteomyelitis, ataxia and paraparesis caused by a satay stick.

[Journal article] Australian Veterinary Practitioner. 1993. 23: 1, 11-15. 4 ref.; Hunt, G. B.Worth,A. Marchevsky,A. Migration of wooden skewer foreign bodies from the gastrointestinal tract in eight dogs.

[Journal article] Journal of Small Animal Practice. British Veterinary Association, London, UK: 2004. 45: 7, 362-367. 9 ref.)

Remember, however, that prevention is much more effective than a clever surgical cure!

Date palm seeds/pips seem to be an increasingly common cause of partial intestinal obstruction in certain regions of Sydney. They may lodge in the pylorus or small intestine, and being radiolucent, can be hard to detect with radiography and even utilising expert ultrasonography. Sometimes these pips pass spontaneously, having caused a few days of partial intestinal obstruction /irritation, while in other cases surgery is required to effect a cure. The value of lubricants has not been established.

Cats

In cats, cotton thread (sometimes with the needle attached), Xmas tinsel, string, fish hooks, other linear foreign bodies (e.g. dental floss) are the best known causes of intestinal obstruction. These ‘linear foreign bodies’ cause a syndrome of intestinal plication if they are lodged at a fixed site, typically the base of the tongue or the pylorus. It is therefore VITAL to always inspect the base of the tongue (by pressure in the inter-mandibular space) in every cat as a routine part of the physical examination. Cutting the string attached to the lingual frenulum can be curative in as many as 50% of cases, although some cats require surgery to unravel the intestines and remove the string.

Recently, the plastic objects used to secure plastic bags have been observed to lodge in the pylorus or intestine of cats. Darren Foster has presented a series of these ‘plastic tie’ cases at a recent feline veterinary meeting.

Plastic thingsSublingual fb







This is especially a problem in cats that like to play with these plastic bread bag ties, and can be very difficult to diagnose as the objects are not radio-dense (visible on x-rays) and can be visualised only with difficulty using ultrasonography. I understand the same thing happens in young children, and in some countries this has led to them being taken off the market and replaced by other devices. (This is why safety pins are no longer recommended for use with nappies or ‘snugglers’). While visiting Murdoch University last year I heard of a case where one of these plastic ties had snared a portion of colonic mucosa in a dog, causing exsanguination of the patient.

Hairballs remain a potential cause of gastrointestinal obstruction in cats, especially in long haired breeds and cats with skin disease associated with over-grooming. They rarely cause a problem while in the stomach (although occasionally they can get too big to be passed and cause vomiting or inappetence). If passed into the intestine, they can cause a range of symptoms from transient colic to life-threatening intestinal obstruction. They can also complicate linear foreign bodies by becoming ensnared on thread in the oesophagus or stomach.

Classic GI foreign bodies in Queensland

Add macadamia nuts (the Queensland nut), paddle pop sticks, and Kentucky Fried Chicken corn cobs (the Colonel makes them the perfect size to get caught part way along the small intestine).

Where Richard talks about Date palm seeds/pips causing partial obstruction, the Macadamia nut can do this too and its movement along the loops of the small intestine causing see-sawing symptoms of obstruction then relief with some needing surgery and some passing eventually with ‘cure'. A classic ‘zebra’ is when the nut becomes lodged around or just distal to the opening of the common bile duct, giving spectacular haematological and biochemical evidence to support clinical signs of severe cholestatic hepatopathy (vomiting, jaundice, abdominal pain, pancreatitis, etc).

Corn cob 200Gastric fb tofuQld nut
 

 

 


All of these can be difficult to see radio-graphically. We've had two cases of ‘skewer (satay) stickitis’ where the skewers have migrated anteriorly from the stomach through the left side of the liver and diaphragm to lodge in the ventral left thoracic cavity, causing symptoms of malaise, respiratory troubles, pyrexia, weight loss. After the initial GI signs abated; imaging and exploratory surgery have found the intact skewers along with a reactive pleuritis and pericarditis.

Some newer (rarer) foreign bodies that we‘ve seen- pine cone, sausage casing, netting around roasts (this one causes scrunching up of the small intestine as the linear (‘string') foreign bodies do, doll’s head, scrunchies (hair elastic), bobby pin, aquadere (wood glue), wooden sticks (2x sticks and 3x paddle pop sticks that presented with gastrocutaneous fistulas—usually swelling or wound in left caudal thoracic area).

Note: Thanks to Terry King of Veterinary Specialists for generously providing many of the photos and X-rays to accompany this article.

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Feline Infectious Peritonitis (FIP/Coronavirus)

Feline Infectious Peritonitis (FIP) is an important disease that all cat owners should be aware of. In simplest terms, it can be described as a progressive and fatal immune-mediated, systemic disease of domestic and wild cats. The infectious agents responsible for this unforgiving disease are certain strains of Feline Infectious Peritonitis Viruses (FIPV).

FIPVs are interesting in that they are formed when another type of virus, known as Feline Enteric Coronavirus (FeCV) mutates. FeCVs are very contagious between cats and many are commonly infected, especially in catteries.

In fact, studies have demonstrated that 20-30% of the general cat population have been exposed to these viruses, whilst up to 85% of cats are exposed to FeCV in catteries. Fortunately, infection with FeCV produces inapparent or only mild gastrointestinal signs. At worst, cats will have a fever, vomiting and diarrhoea lasting only a few days.

Importantly though, in small percentage of these cases (approximately 5%) the FeCV will mutate into a FIPV.

Once this occurs, the virus gains the ability to cause a systemic infection. The exact reasons why these mutations occur are unknown. In addition, the nature of these mutations varies, leading to variation in the ability of the virus to cause disease. For instance, a young healthy cat may resist a less capable FIPV, whereas an old, immuno-suppressed cat (due to stress or concurrent disease) will not stand a chance.

Furthermore, individual virus variation not only influences its ability to cause disease, but also affects the specific organs damaged by the virus. This is very important from a diagnostic perspective as it masks our ability to clearly identify the disease without invasive testing.

Symptoms

FIP cases can present with either a dry or wet form of the disease.

In the dry form, there is no fluid buildup in the abdomen and/or chest. These cases often have inflammation of the lining of the abdominal contents (e.g. white nodular lesions covering the intestines, liver, spleen)

In the wet form, there is a thick viscous yellowish fluid in the abdomen and/or chest cavity.

Depending on the virulence and form of the infectious agent, symptoms vary from case to case but can include:

Diagnosis

This is where it gets difficult:

a) In the wet form of FIP, a vet can easily collect fluid from the chest or abdomen without the need for surgery,

b) In the dry form of FIP, this may mean an anaesthetic and exploratory surgery of the abdomen to collect affected tissue. This can be risky an already very ill cat.

Treatment

Unfortunately, there is no specific treatment available at this stage for FIP.

It is a case of treating the symptoms and trying to correct dehydration, maintain organ function and prevent secondary bacterial infections complicating the picture by giving anti-biotics.

Euthanasia is eventually the best option.

See also...
Feline Infectious Peritonitis case

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Feline Urological Syndrome (FUS, FLUTD)

FLUTD is also known as Feline Urological Syndrome or Feline Cystitis. FLUTD has many causes, including infection, trauma, bladder stones, crystals, urethral obstruction or cancer.

The most frequent cause of cystitis or blood in the urine in cats is unknown- officially, this is called Idiopathic FLUTD (see below).

FLUTD can be obstructive (commonly known as `blocked’), or non-obstructive. Obstructive cases happen in male cats when a plug forms and lodges in their naturally long, thin urethra. Obstruction in female cats is rare.  Non-obstructive cases are more common, but obstructive cases are life threatening.

Obstructive cases can cause kidney failure
or death within 3-6 days of obstruction

Idiopathic FLUTD

Male and female cats prone to this are usually between 2-6 years of age. Clinical signs are usually pain on urinating, increased frequency of urinating, and blood in the urine. Urine is usually concentrated and acidic, and clinical signs usually subside in 5-7 days, unless signs lead to an obstruction. Recurrence is common, and episodes may decrease in severity and frequency over time.

A urine test is usually required to check for abnormalities, and sometimes, an additional test to see if bacteria is present in the urine is warranted. The vet will discuss what is required and what your options are. Treatment usually includes anti-inflammatories (for pain and inflammation), antibiotics (if an infection is suspected or proven by lab urinalysis) and prevention.

All cases need a thorough workup by a vet to determine the exact nature of the problem and the correct management plan to try and prevent re-occurrence.

Normal cat lowerCat fusMicroscope struvite








Symptoms

Affected cats feel the irritation in their urinary tract and have an urge to urinate (cystitis). Quite often, bacteria accompany the crystals increasing the level of discomfort. Cats suffering from FUS/FLUTD try to urinate more often than normal, often crying out whilst doing so. Owners may notice small drops of blood tinged urine in the litter tray.

The urethra in female cats is wider then in male cats. Unfortunately for male cats, their urethra is much narrower. Urinary crystals or "plugs" made of a mixture of inflammatory cells, thick mucous-like material (usually from inflammation of the bladder wall and/or crystals) can get stuck in a male cat urethra causing a blockage to the flow of urine. The male urethra is surrounded by small muscles, which sometimes spasm/cramp when there is a blockage or irritation in the urethra, thus compounding the initial blockage.

A “blocked” male cat is in a life threatening situation. The kidneys keep making urine despite the fact that the cat can not pass it. The bladder gets bigger and bigger, and the kidneys start to get a huge amount of back pressure of urine applied to them. There is a dramatic rise in the amount of potassium in the bloodstream as a result of this, which causes an irregular heartbeat. Death can occur within 24-36 hours of a complete blockage.

Causes

Although there is no single cause of FLUTD, various risk factors have been determined that predispose cats to the disease:

Factors that cause high urine levels of magnesium

Factors that contribute to an alkaline urine pH

Treatment

Female cats do not usually present with a blockage. Urine samples are examined to determine the exact nature of the crystals as not all cases are Struvite. The cat is placed on antibiotics (if bacteria are present), mid anti-inflammatories to lessen the irritation and special prescription diets e.g. Hills Feline S/D (struvite diet) or Royal Canin Urinary to dissolve the crystals by changing the urine pH. If the cat has Oxalate crystals, it usually goes onto Hills X/D diet.

Water intake has to be increased so tin foods are preferable to dry foods.

Blocked cats need surgery to relieve the pressure on the kidneys. If a cat is in serious trouble, a vet may place a large needle directly  into the bladder to suction out as much urine as possible, thus removing the back pressure on the kidneys and “buying some time” prior to surgery. Once stabilised, the cat is anaesthetised and a smooth urinary catheter passed into the tip of the penis in an attempt to flush the blocked crystal backwards into the bladder and the bladder is emptied.

Some vets like to leave the catheter in place for 1-2 days to prevent a re-occurrence of the blockage. Other vets like to remove the catheter to try and minimise trauma to the sensitive ling of the urethra. 

Occasionally, male cats can be so severely blocked that it is not possible to pass a catheter into the bladder. These cases need to have an operation to change the plumbing so they urinate through a much wider hole. This operation is called a perineal urethrostomy. This is a rare operation to perform these days with the advent of the special preventative diets from Hills.

Prevention

Tips on Transitioning Food

Generally introduce a new food over a 7 day period for dogs and 4 weeks for cats. Mix the new food with the old food, gradually increasing its proportion until only the new food is fed.

If your pet is one of the few that doesn't readily accept a new food, try...

This is important because the success of treatment depends to a large degree on strict adherence to the new food.

The Risks of Excessive Salt Intake in Your Pet

Salt can be added to products to improve their taste or to try and encourage more drinking.

Too much salt in your cat's diet could put her at an increased risk of health problems such as heart diseases and higher blood pressure.

Excess salt can stimulate the progression of kidney disease, even before it can be detected, particularly in older cats who may be in the early stages of disease but their owners are not aware of it.

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Eyes: Corneal Ulcers

Article refereed by Drs Jeff Smith and Cameron Whittaker at the Animal Referral Hospital, Homebush, Sydney

A corneal ulcer describes an injury to the cornea which may or may not be infected.

Anatomy

The cornea is the clear tough part of the eye lying directly in front of the lens and pupil. It has a convex shape and its edge is attached 360 degrees to the white (sclera) of the eye. It is fed nutrients and kept lubricated and clean by normal tear production.

There is fluid behind the cornea pushing it outwards, giving it a convex shape. The space containing this fluid is called the anterior chamber.

The cornea is made of many layers of cells which are slowly replaced by new cells growing on the bottom layer. Older cells on the top layer naturally “wear off”

The cornea has to be clear. Otherwise, one would have trouble seeing out of the eye. In order to be clear, the cornea has no blood vessels within it. This is ok unless it is injured in some way. Whenever there is an injury in the body, blood vessels deliver “healing agents e.g. white blood cells, clotting products to get things repaired ASAP.

Eye ulcer 1Normal feline eyeCorneal ulcer








Causes

Injury

If the cornea is injured e.g. by a foreign body, chemical burn, it is very difficult for healing to take place because of the lack of blood vessels. If the wound becomes infected, bacteria can have a real “field day” as the corneal cells “taste nice” and there are no defences.

Dry Eye

Some pets can develop a problem where the eye stops making tears. When this happens the cornea dries out as it has lost its source of lubrication and nutrition.

Entropion

Some pets have eyelids which roll inwards instead of maintaining a nice straight edge. The hairs on the eyelid rub against the cornea and gradually wear away the cells creating an ulcer.

Symptoms

Cornel ulcers cause pain and the whole eyeball can become very inflamed. Often the pet squints and may try to rub the eye.
There may be a small area of “blueness” visible to the naked eye at the injury site.

Left untreated, corneal ulcers can rapidly enlarge and can even perforate the full thickness of the cornea. If this happens, the fluid in the anterior chamber leaks out and unless emergency surgery is performed, the patient can lose the eye.

Treatment

Depending on how deep the corneal ulcer is, treatment will vary.

1) Third eyelid flap

The third eyelid can be placed across an ulcerated cornea to protect it whilst it heals. Blood vessels on the inside surface of the third eyelid offer healing agents to the ulcer below.

2) Conjunctival graft

Deep aggressive corneal ulcers or injuries sometimes need a flap of conjunctiva (the loose tissue on the inside edge of the eyelids) stitched to the edges. This provides a good blood supply to the injury and gets things repaired quickly. When it has healed, the flap is trimmed off at its base leaving behind a small amount of scarring.

3) Grid Keratectomy

We often place a grid pattern around the ulcer and surrounding area using a sharp instrument to allow new corneal cells to run along and stick to the underlying surface. If this is not done, the ulcer may “fill up” and appear healed, but the new cells soon “slide off” as they have no “roots” to stay attached.

See also...
Corneal ulcer case
Dry eye

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Eyes: Glaucoma

Article refereed by Drs Jeff Smith and Cameron Whittaker at the Animal Referral Hospital, Homebush, Sydney

This is a condition which occurs in both people and animals. It is a very serious problem which left untreated can lead to loss of vision. Glaucoma occurs when there is fluid build-up within the eyeball and the pressure inside the eye increases.

Normal eye processes

Eyes continuously make fluid (aqueous humor) to maintain their round shape- technically speaking, they are maintaining their Intra-Ocular Pressure (IOP). “Old” fluid is filtered off through some tiny channels in the front (anterior) chamber of the eye, just below and in front of the iris.

Normal feline eyeGlaucoma

 






Primary causes

Secondary causes

In summary, trauma to the eye is one of the most common reasons for glaucoma followed by genetic predisposition in certain breeds.

Affected Breeds

Angle abnormalities

Inherited lens luxation

Age Incidence

Symptoms

Treatment

Glaucoma is a disease where the aim of treatment is to control rather than cure the problem.

Long term conservative treatment is often unsuccessful. Surgery by a specialist ophthalmic surgeon is the long term treatment of choice.
Acute glaucoma cases require emergency therapy if one is to save the eye.

If it is due to a secondary process, treatment is aimed at fixing that particular problem e.g. removal of a luxated lens.

Prognosis

Glaucoma has a guarded to poor prognosis, especially if untreated in its early stages.
In people, ophthalmologists perform yearly eyeball pressure tests to detect early symptoms and initiate therapy as soon as possible. Glaucoma is definitely a disease where early treatment is critical.

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Eyes: Dry Eye

Causes

Dry eye results from a deficiency in the liquid portion of tears. Tears are produced by tear glands around the eye and are spread across the surface of the eye (called the cornea) by blinking. This tear film has several functions:

The most common cause of dry eye is the dog's own immune system mistaking the tear glands as foreign and attacking and destroying them, as it would an invading germ. The progressive loss of these glands results in tear production being reduced. Without the protection of tears, the eyes become dry and irritated, often develop infections and the cornea can become ulcerated. Eventually, the cornea can become permanently scarred, or develop blood vessels and pigments over its normally transparent surface, leading to blindness.

Your dog's breed and age also provide important clues. Dry eye is most common in middle aged and older dogs. The breeds of dog most prone to dry eye are: West Highland White Terrier, Cavalier King Charles Spaniel, Cocker Spaniel, Shih Tzu, Miniature Schnauzer, Pekingese, Bulldog, Pug and Lhaso Apso.

Diagnosis

A vet will have some clue as to the presence of dry eye just by the appearance of the affected eye(s). To confirm the diagnosis, the vet will perform a Schirmer Tear Test which is the diagnostic test for dry eye.

Schirmer Tear Test

This involves placing an absorbent paper strip, containing a blue coloured indicator, under the lower eyelid for one minute. Any tears produced will be absorbed by the test strip. The blue indicator is carried by the tears along the test strip, thereby showing the level of tear production. A normal eye should have tears going up to or past the 15mm mark in 1 minute.

Eye tear testEye tear test1







Symptoms

Common signs of dry eye which will alert your veterinarian to the disease include:

Treatment

Treatment of dry eye may be either medical or surgical. Medical therapy is usually effective and is commonly attempted prior to resorting to surgery. It may include:  

Eye optimmuneThe most effective registered therapy for dry eye is an eye ointment called Optimmune, which contains cyclosporin, an immune suppressant drug that is also used to prevent transplant rejection in humans.

Optimmune is the only registered product which treats the cause of the problem, not only the symptoms, by:

The concentration of cyclosporin in Optimmune is just 0.2%, so it will not affect the immune function af the rest of the dog's body. 

Optimmune is usually applied twice daily to the eyes for the remainder of the dog's life. It has been found to be effective in over 80% of dogs with initial Tear Test readings of greater than 2mm. 50% of dogs with readings of less than 2mm respond to Optimmune, therefore early diagnosis is vital.

Eye dry eye 4Eye dry eye 5
 

 

 


Eye dry eye 6Eye dry eye 7






 

Using Optimmune 

See also...
Deep corneal ulcer case due to dry eye

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Eyes: Cherry Eye

Article refereed by Drs Jeff Smith and Cameron Whittaker at the Animal Referral Hospital, Homebush, Sydney

Dogs and cats have an extra eyelid in the corner of their eyes close to their nose. It acts a bit like a windshield wiper and is normally not visible. It can stretch across the eyeball to protect it whilst a pet sleeps.

The third eyelid has a gland in its base which helps fight infection/inflammation and produces tears. Inside the third eyelid is a T-shaped piece of cartilage which helps maintain its flat shape.

In some dogs, the gland at the base of the third eyelid swells up and causes the eyelid to roll out and become prominent. This looks like a raised reddened lump in the comer of the eye.

Eye cherry eye 5Eye cherry eye 2Eye cherry eye 1







Causes

The third eyelid gland may swell up for a number of reasons including infection and/or inflammation of the eye. Some pets have a genetic defect predisposition that causes the problem.

Treatment

Normally, if an infection and or inflammation is suspected, we place local anaesthetic in the eye and by gently pulling the 3rd eyelid outwards, we can tuck the swollen gland back into the corner of the eye. We then use eye ointments containing anti-biotics and/or anti-inflammatories to try to get the gland to reduce in size. Unfortunately, this technique has a high failure rate and often the problem re-surfaces.

If the problem keeps re-occurring, then surgery becomes the best option.

See also...
Cherry eye operation

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Eyes: Cataracts

Article refereed by Drs Jeff Smith and Cameron Whittaker at the Animal Referral Hospital, Homebush. Sydney

Just like humans, pets can develop cataracts in their eyes for one of many reasons.

A cataract occurs when the lens in the eye, just like a lens in a camera, is damaged and starts to become cloudy. As a result, the amount of light hitting the retina in the back of the eyeball (just like the film in a camera) drops off. As a cataract matures and becomes more cloudy or even opaque, vision worsens.

Normal canine eyeNuclear sclerosis

 






Causes

UV Radiation

In Australia and other countries with high levels of UV radiation, the eyes receive tiny amounts of damage which over the years can result in cataract formation.

Congenital/Hereditary disease

Some breeds of pets are more prone to developing cataracts due to the make-up of their genes. This is why reputable breeders have their breeding pets tested by an eye specialist to check they are free of eye disease.

Secondary

One of the most common illnesses to cause cataracts is diabetes. If the diabetes is not controlled properly, cataracts can develop quickly. This is one of the reasons we like to see our older patients regularly for health checks to ensure we detect these type of problems early before it is too late.

Cancer

Cancer of the eyeball or lymphatic system eg leukaemia, can result in cataracts.

Prevention

We recommend a thorough health check including urine and blood testing for our senior pets at least once a year-

Early signs of diabetes include increased thirst and appetite- if you notice this in your pet, its time to see your vet with the pet and a fresh urine sample.

Treatment

Depending on what is causing the cataracts, treatment will vary. For cases that are amenable to surgery, we refer them to an eye specialist for a thorough examination and possible lens removal with or without placement of an artificial lens. Surgical results are usually excellent.

See also...
Senior Health Checks

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Epilepsy in Dogs

What is Epilepsy?

Epilepsy is a periodic disease which is characterised by seizures (convulsions) with partial or complete loss of consciousness. Idiopathic epilepsy (of unknown cause) is the most common type seen in pets.

What are the signs?

Attacks usually commence without any warning, the pet falling to the ground, then undergoing a series of muscular jerks. There is extension (stiffening) of the limbs, followed by paddling and chewing movements. The eyes are fixed and staring. Loss of control can result in salivation and passing of urine and faeces. During an attack a pet should be left alone as they cannot swallow their tongue.
Following an attack, the pet gets up, looks around in a dazed manner and may run away with no idea of where it is going.
Attacks may occur frequently or infrequently. Milder seizures, with the pet remaining conscious, may sometimes occur.

Which pets are affected?

Although it can be seen in all aged animals, idiopathic epilepsy is generally seen in pets between 1 and 5 years of age. Seizures in pets outside this age group are more commonly caused by some other disease process. Although it is seen all breeds of pets, there is an increased occurrence in certain breeds e.g. German shepherds, Beagles.

What causes Epilepsy?

The cause of idiopathic epilepsy is still unknown although it is likely to be a genetic problem in some breeds. A thorough veterinary examination including some pathology tests are required to help distinguish idiopathic epilepsy from other causes of seizures, such as nervous signs due to lead poisoning.

Can seizure episodes be prevented?

As the cause of idiopathic epilepsy is still unknown, there is no specific treatment to remove the cause of the seizure. However, medication with appropriate drugs can either prevent, or considerably reduce, the frequency and intensity of the seizures, enabling the pet to lead a normal life. Although a number of drugs have been used to prevent seizures, the initial drug of choice is Phenobarbitone. This is considered the safest and most effective preventative therapy.

Once Phenobarbitone therapy is commenced, seizures may still occur for up to 2 weeks until the required levels of the mediation are reached in the blood and brain. Also, according to the animal’s response, the dose rate may have to be adjusted during the course of the treatment. pets typically require medication for the duration of their life.

In most epileptic pets, control of seizures with Phenobarbitone is usually successful. However, some pets develop an unresponsive form in which even very high doses of phenobarbitone are ineffective. When this occurs, control may be achieved by the addition of a second drug, Potassium Bromide which can be used in conjunction with Phenobarbitone. The combination of these two medications results in effective control and prevention of seizures in most pets. As with Phenobarbitone, it can take several weeks before Potassium Bromide has an optimum effect.

How can success of treatment be monitored?

To assist in monitoring the success of treatment, the frequency of seizures should be recorded on a calendar. Because one of the most common causes of poor control is too low a dose of the medication (due to large differences in response between pets), we may suggest monitoring the levels of the medication in the blood. The dose rate of the medication can then be adjusted according to blood levels and degree of seizure control.

Are there any side effects with medication?

The main side effect with these medications used to effectively control epilepsy are sedation and unsteadiness. This is generally seen at the commencement of treatment and usually disappears after a short period as the pet adapts to the medication. In a very small percentage of cases, some effects on the liver can occur and it is therefore recommended that on occasions, blood tests to assess liver function are undertaken.

Conclusion

Although epilepsy is a frightening disorder to both to the pet and the owner, treating with Phenobarbitone (and possibly in combination with Potassium Bromide) provides effective control in most cases. This allows the pet to lead a full and active life when maintained on the medication.

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Dislocating Kneecap (Patella)

Patella is the medical term for the kneecap. The medical term "patellar luxation" refers to "dislocation of the kneecap". The kneecap is simply a small bone located on the underside of the tendon of the quadriceps muscle.

PatellasThe condition of patellar luxation is quite common, particularly the congenital form (i.e. that form present from birth) in which both hind legs are often affected (20-25% of cases).

The direction in which the kneecap slips may vary, but mostly (in 75-80% of cases) it is towards the inner (medial) side of the leg.

There is also the much less common acquired form of kneecap dislocation resulting from a direct injury to the stifle ("knee") joint.

Because the forces causing or perpetuating the kneecap dislocation vary, there is a range of surgical procedures used to correct the problem. The original deformities causing the abnormal forces may be found in the hip bone (pelvis), the thigh bone (femur) or the shin bone (tibia).

The effects of the kneecap dislocation on the knee joint of the dog may be short term and/or long term.

In the short term there may be lameness manifest as not putting the foot to the ground and with the leg locked in a flexed position. Sometimes an acute lameness is accompanied by obvious sharp pain seen as yelping or screaming.

A few dogs will carry the affected leg most of the time. Some dogs are reluctant to jump. Some dogs stretch their legs out backwards in an effort to relocate the kneecap.

In the longer term there may be arthritic soreness (manifest as weakness and a dull ache) and secondary rupture of other ligaments.

Dogs that are either born with the condition or develop it at an early age often show minimal lameness until arthritis is the major sign. These dogs may have grinding or clicking sensations in the joint but are not lame, probably because they have become desensitised. An owner may actually hear the click whilst the dog is walking, or may see the kneecap popping from side to side. But when these dogs are older the legs are typically bowed and arthritic, and the gait appears stiff and awkward. The knees are also more liable to develop a secondary rupture of the cruciate ligaments. Sometimes there can be stress on the hip joint leading to arthritis or dislocation there also.

Four grades of severity are described (number 4 being the worst), but the distinctions between grades are not always clear.

When determining the best surgical treatment, each affected knee is assessed individually according to the various deformities that are causing the kneecap to dislocate.

The most common treatment is a deepening of the groove in which the kneecap glides combined with a tightening the supportive soft tissues on one side of the joint (that which is opposite the dislocation).

Sometimes a small piece of bone, the tibial crest, needs to be rotated or moved to straighten the patellar tendon. Very rarely the femur needs to be cut and straightened. As a last resort the kneecap may need to be removed completely.

The success of surgery in preventing dislocation of the kneecap has been estimated at 60-70%. The success in reducing lameness, however, is higher. The overall success rate is improving as techniques are being better refined.

Surgery is indicated in dogs showing signs of lameness. It is also indicated in some non-lame dogs: those puppies in which severe dislocation is detected, and those dogs which belong to the large breeds. In young puppies surgery is performed early (at 3-4 months of age) so as to realign the kneecap during growth and so reduce the overall deformity of the limb and prevent irreparable contracture of the quadriceps muscle.

In large breed dogs, the early prevention of arthritis is more important than in smaller breeds. Whilst these recommendations for surgery in non-lame dogs may be quite valid, they are not often taken up by owners because there is no problem apparent to the owner at that time.

If dogs are not operated on they should at least be kept from excessive stresses on their joints by preventing them from becoming overweight.

Needless to say, dogs with the hereditary form of the condition should not be used for breeding.

See also...
Dislocating Patella Surgery 

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Diabetes: Urine Testing

Regular monitoring of urine at home is a great way for owners to help treat their pet. We recommend a twice weekly test using human urine test strips from the local pharmacy which measure both urine glucose and ketones.

Goals

Dogs

Cats

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Diabetes: Feeding

As the daily dose of insulin is adjusted to meet the daily energy (glucose) needs of your pet, regularity in feeding is essential. Your pet should, therefore, always be fed at the same time with the same amount of the same diet. Ask your vet for advice on selecting a
commercial, low carbohydrate, high fibre diet.

Dogs

Caninsulin is formulated in such a way that, after the animal is injected, there are two peaks of insulin activity. For this reason, dogs have to be fed twice daily. To ensure a uniform diet, it is preferable to use commercial diets only. However tempting, never give your pet any titbits or treats. This requires the co-operation of the whole family (and friends!).

Cats

The regime applying to dogs also applies to cats but there are a few differences. Cats sometimes simply refuse to change to another diet. If this is the case, seek advice from your vet. Some cats are used to eating small amounts throughout the entire day.
If your cat is used to this, again check with your vet.

Overweight pets

If they are overweight, both dogs and cats should be put on a diet to reduce their weight gradually.

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Diabetes: Exercise

The amount of exercise your pet takes each day should remain unchanged.

If an animal suddenly expends a lot more energy (e.g. longer walks, excitement about visitors) it burns up more glucose. This can result in an unduly low blood sugar level which may leave so little 'fuel' available for the brain that the animal could even lose consciousness.

If this happens, you must immediately administer glucose.

See also...
Hypoglycaemia

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Diabetes: Hypoglycaemia

The most serious complication seen in animals on insulin therapy is an unduly low blood glucose level. This can occur if:

Although an unusually low blood glucose level is a rare complication, it is important for you to know how to react if it happens. If the blood sugar level is too low, the brain does not receive enough 'fuel' (glucose). This can lead to a potentially fatal situation and it is important that you are able to recognise the symptoms.

Symptoms

Treatment of Hypoglycaemia

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Diabetes: Establishing a Daily Schedule

Handling Insulin

Diabetes clock2Diabetes clock3
 







The curve on the left shows a drop in blood glucose levels at 8.30am following the 8.30am insulin injection. However, by 12 hours, its effect has started to wear off and a second dose on Caninsulin is required in this case.

Feeding

Warning:
The composition of the Caninsulin solution is such that an interval of approximately 8 hours must be observed between the injection and the second meal.

IF THE ANIMAL IS NOT EATING, DO NOT GIVE INSULIN
CONSULT YOUR VET WITHIN 24 HOURS

Caninsulin lasts for approx 12 hours in most dogs.

Monitoring at Home

See also...
Hypoglycaemia

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Diabetes: Cure Rates

In general, the underlying cause of diabetes mellitus cannot be cured. However, if you can establish a regular life-style for your pet and it is treated with a good insulin preparation e.g. Caninsulin for dogs and Glargine for cats, your pet can lead a normal, contented life.

Researchers have noted that about one third of cats that are adequately treated with insulin will eventually go into remission. It is important to watch for signs of this. Remission does not occur in dogs.

Once they have been stabilised on insulin, most animals are able to lead a normal life. The life expectancy of dogs and cats on insulin is considered to be similar to that of normal, healthy animals.

Cataract formation

Most diabetic dogs will develop cataracts in later life. This is related more to the age of the dog than to control over its blood sugar.Older dogs develop cataracts much quicker than younger dogs e.g. months compared to years later.
Cataracts affect the dogs eyesight but not its overall well being.

Other complications

Unlike human diabetes, pets do not live long enough to see the long term illness associated with diabetes in humans such as...

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Diabetes: Introduction

Diabetes is a relatively common condition in cats and dogs and is on the increase, just like in humans. Most commonly it is due to a lack of insulin production by the pancreas, but sometimes it is due to other diseases or conditions interfering with the action of insulin.

Types and Causes of Diabetes

Type 1 Diabetes

Type 2 Diabetes

Pancreas normalPancreas inflammed








What is Diabetes?

During digestion, a pet's food is broken down into components that can be used by its body. Carbohydrates (starches), for example, are converted into various sugars- of which glucose is the most important. Glucose is absorbed from the intestines into the blood and provides the body cells with energy.

Glucose, however, can only penetrate most cells in the presence of a hormone called insulin. If there is a shortage of insulin, too much glucose stays in the blood and the condition known as diabetes mellitus develops. Basically diabetes is a shortage of insulin.

In some cases, however, diabetes arises from a relative insulin shortage that is brought about by overproduction of other hormones which interfere with the action of insulin e.g. cortisone in Cushing's disease.

Symptoms

Pets with diabetes can display many signs, the most common being:

Diagnosis

A vet will have some alarm bells ringing when taking a good history from the pet owner and doing a thorough clinical examination.

The symptoms may certainly indicate diabetes, but they are also seen in other diseases. The diagnosis only becomes definite when glucose is found in the urine in combination with high glucose levels in the blood.

The presence of glucose and especially ketones in the urine level gives stronger evidence that the animal is suffering from diabetes than the mere presence of elevated blood glucose levels. Cats and easily stressed dogs are notorious at having artificially elevated blood glucose levels with just the minimal amount of stress e.g. a short car ride. They will have normal urine samples so can be quickly ruled out.

Insulin

Insulin is a hormone that keeps a pet's glucose concentration at a normal level. It is produced by certain cells in a gland called the pancreas. In diabetic animals, these cells do not produce enough insulin and sometimes none at all. This disorder is most common in older bitches and castrated male cats, but it is also seen in young animals of both sexes. In some breeds there is an above average incidence of diabetes.

Treatment

Glucose Curves

A vet will start a newly diagnosed diabetic patient on a course of insulin injections. After a couple of days of therapy, bloods are collected every 2 hours following a morning dose of insulin, to measure the blood sugar levels.

Depending on how the blood glucose curve looks, adjustments are made to the dose.

Once the patient is stabilised, the vet will want to perform glucose curves on a regular basis to make sure all is well. This is very important in cats as quite a few actually start to make their own insulin once therapy starts. In these cats, it is easy to get an overdose if the dose of insulin is not lowered or stopped all together.

Insulin Overdosage

See also...
Hypoglycaemia

Owners Commitment

Fortunately, diabetes can be dealt with very successfully - but treatment requires a great deal of care and day to day consistency on the owners part. Owners must be fully committed. Treatment can not be entered into half-heartedly.

Diabetes is expensive to treat, and requires a lot of blood tests and regular check ups by the vet.

Owners have to inject their pet once or twice a day which their vet will show them how to do. It is not as hard as it sounds. There has to be a set routine in the household for timing of the insulin injections and some system where a box is ticked when it is done so there can be no chance of an accidental double dose being given.

The vet will give the owners a run down on diets and the importance of avoiding scraps and treats in between injections. Full compliance with the vet's instructions is vital for successful treatment.

If all this seems too hard, then euthanasia is the best option.

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Degenerative Myelopathy (CDRM)

This is a copy of an article sent to me by one of our clients. I don't know the author but should you know, please contact me and I will place an acknowledgement.

This disease is characterized by a slow, progressive degeneration of the fibres carrying messages up and down the spinal cord. It is commonly seen in older German Shepherds. Affected dogs gradually lose control over their back legs and have a swaying wobbly hind leg gait.  Causes

Possible causes that have been looked at but not proven include:

Incidence/Prevalence

CDRM is the most common cause of pelvic limb paresis in middle-aged, German shepherds and German shepherd mixed breeds
It is rare in other breeds of dogs and in cats.

Breed Predilections

Most commonly affected- German shepherds and German shepherd mixed breeds
Other large and medium breeds are occasionally affected.

Mean Age and Range

Mean age of onset: 9.6 years
Range: 4–14 years
German shepherds: two cases reported at 6 and 7 months old.

Predominant Sex

Males

Symptoms

Differential Diagnosis

Imaging

Treatment

Surgical considerations

No effective surgery available

It is possible for a dog to have concurrent type II disk protrusion; unless the spinal cord compression caused is extreme, surgery should not be done until a therapeutic trial of corticosteroids is completed; if marked improvement is seen, then decompressive surgery is warranted.

Drugs of choice

No proven effective treatment available

Proposed treatment—suggested by one author; combination of exercise, vitamin supplements, and epsilon aminocaproic acid (Amicar, Lederle, NY; 500 mg PO q8h mixed with a hematinic compound); apparently slows the progression in 50% of patients; 15%–20% of patients do not deteriorate further if treatment is maintained; no controlled trials have been done.

Contra-indications

Corticosteroids—do not use; not beneficial in the treatment of this disease.
Steroid myopathy—may worsen muscle atrophy and pelvic limb weakness, hastening the onset of a non-ambulatory state.

Possible complications

Pressure sores and urine scalding once a non-ambulatory state is reached.

Prognosis

CDRM is is a non-treatable disease that progresses slowly and steadily.
Euthanasia is recommended once a non-ambulatory state is reached.
Most affected dogs gradually lose function in the pelvic limbs, reaching a non-ambulatory state within 6 months to 2 years after onset.
Non-ambulatory patients eventually lose thoracic limb function and may develop urinary and faecal incontinence.

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Anterior cruciate ligament damage

The cruciate ligaments get their name from "Cross (Crus)".

They are composed of two ligaments that form a cross inside the knee (stifle) joint. They are called the cranial and caudal cruciate ligaments. By forming a cross in line with the front and back of the stifle, they prevent excessive forward and backward movement in the joint.

Active dogs, like active human sportspeople, can sometime rupture one of these ligaments, usually the cranial cruciate ligament. As a result, there is excessive forward to backward movement in the stifle. This leads to the cartilage damage as the bones crunch into each other. Before long, there is arthritis and continual pain.

Some dogs have been born with bad hind leg conformation. The plateau of bone on top of the tibia (the bone between the stifle and ankle) is sloped too far in a forward and downward direction. The average tibial plateau slope in dogs with ruptured cruciates is 24 degrees.

The tibial plateau should be roughly parallel with the ground. This places excessive strain on the anterior cruciate ligament ,and it's not long before it ruptures. These dogs need to have a special operation to repair it (see TWO below)

Ortho tpo 1After surgery, the tibial plateau is approx. 7 degrees

 





 

Normal appearance of a stifle joint viewed from the frontAppearance of a ruptured cruciate ligament

 






Treatment

Surgery is usually required before arthritis develops. The sooner it is performed , the better the outcome. There are several types of operations used.

De-Angelo's de-rotation technic

This involves placing thick nylon (something similar to fishing line used to catch marlin with) inside the joint in roughly the same position as the ruptured anterior cruciate ligament. That way, it performs similar stabilising effects in the stifle as a normal anterior cruciate ligament. This technic is used quite widely in veterinary surgery.

Four-in-one over the top technic

This is very similar to the technic used in humans. It involves taking a long strip of tough tissue from the side of the stifle, and threading it through the joint in the same direction as the ruptured ligament.

Tibial wedge osteotomy (TPO) levelling technique

This is the best approach for medium to large dogs and for dogs with malformed legs that caused the ligament to rupture in the first place.

By taking x-rays of the hind leg, a specialist surgeon can determine the size of a wedge of bone to remove from the mid shaft of the tibia (the bone between the stifle and ankle). Once the wedge is taken out, the tibia is "stuck back together" using a metal plate and screws. The effect is to make the plateau of bone on top of the tibia roughly parallel to the floor. This stabilises the joint and prevents foreword movement of the joint.

Tibial crest advancement

A new approach being used by some specialists is to loosen the tibial crest (the piece of bone which the patella/kneecap tendon attaches to) and move it forward towards the nose. A special device/spacer is placed between the tibial crest and where it used to be attached. Overall, the joint is more stable and the procedure is less invasive than other techniques.

See also...
ACL Surgery case

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Gastric Dilation (GDV/Bloat)

This condition affects mainly large deep chested breeds of dogs and is a very serious and life threatening condition. It warrants immediate veterinary attention and surgery to prevent recurrence. It is expensive to treat due to the need for intensive care and surgery. Owners have to make an early decision as to whether or not to start on treatment which can run into thousands of dollars.

Causes

Bloat appears to be caused by a combination of a number of factors:

Once a day feeding and greedy eaters

Feeding one large meal a day causes stretching of the stomach wall and damage to the nervous supply to the stomach. Research suggests that the stomach has a "pacemaker" (just like the heart) which coordinates the contractions and emptying of the stomach. If the pacemaker is damaged by stretching of the stomach wall, uncoordinated stomach contractions and emptying occur.

Breed disposition

Most of the affected breeds are large and deep chested but there is an abnormally large number of cases in the following breeds:

Feeding too close to exercise

Exercised dogs, being very thirsty and hungry, may gulp both food and water down together in a short time.

Dry dog foods

Although not proven, dry dog foods have been suggested to be a cause of bloat.
What probably happens is a combination of most of these factors e.g. continual once daily feeding of dry food to a greedy &/or thirsty dog who quickly wolfs it all down followed by a large drink of water. The food swells up and stretches the stomach wall damaging the pacemaker.

Symptoms

The following symptoms in sequence are:

What’s happening to the stomach in bloat?

The stomach ferments food which produces gas. When over- stretched, the food and gas can not empty out the normal way because the "pacemaker" has been damaged.
Dogs go into severe pain and swallow large amounts of air adding to the gas build-up.

For unknown reasons, a large percentage of these bloated stomachs then rotate 180 - 360 degrees cutting off their own blood supply as well as that of other body organs e.g. spleen.

The shear size and pressure of a bloated stomach can block off the flow of blood returning to the heart from the whole of the lower body. This blood is travelling in a large blood vessel situated just above the stomach. This means:

All this within 5-10 minutes- a catastrophe!

Unless treated immediately, the decreased blood supply leads to severe shock, abnormal heartbeats, death of parts of the stomach wall and possibly spleen as well as damage to oxygen deprived organs and muscles.

See also...
Gastric dilation case

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Arthritis in Pets

Well the cold times are here again, and maybe the poor old pet is having trouble getting going in the morning. Chances are it is not due to laziness, but it is in fact arthritis!

What is arthritis?

Arthritis is a disease condition that affects joints either individually or generally. The cartilage lining of the joints wears down and the lubricating oil in the joint is less than it should be.

What are the signs of arthritis?

Bhvg arthritis transIn pets, arthritis is particularly common in the hips and knees, especially in older dogs of the bigger breeds or cats that were very active.

The following brief questionnaire may help to assess your pet for signs of osteoarthritis:

If your answer is "yes" to any of the above questions, then ask us to examine your pet for osteoarthritis and provide advice on treatment options.

Weight control and nutrition are important factors in managing osteoarthritis. Obesity can contribute to canine osteoarthritis. If a joint is not working efficiently, carrying excess weight causes both additional pain and increased joint damage. Appropriate nutrition can help to maintain your dog’s ideal weight. Try the following tips for controlling dietary intake and body weight:

Exercise may be beneficial in the management of osteoarthritis as it can:

Exercise may take the form of walks on the leash or more varied types of recreation. Even small amounts of exercise can be beneficial. Depending on your dog’s condition, frequent gentle walks may be of more benefit than highly energetic activities.

Can arthritis be treated?

Generally speaking most people don't think there is anything that can be done for arthritis. Well, the good news is that we can help! There are a number of treatments that can be used for arthritis, some with limitations.
We routinely X-ray cases before therapy to make sure the dog is actually suffering from arthritis and not other problems e.g. infection in the bones of the lumbar spine, slipped disc or even cancer.

See also...
Obesity in Pets
Senior Pet Programme

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Addison’s disease

1. What are the symptoms of Addison's disease in dogs? How is it diagnosed? How important is early detection?

Addison's disease can present suddenly in young healthy pets, or in older pets that have been through major stress situations e.g. intensive care for road a traffic accident. Affected dogs are in severe shock with pale gums, slow heart rates, weak pulse, cool extremities and often have upset stomachs and weakness. The clinician would start to get alarm bells ringing when considering the age, history and findings at examination.

Bloods for electrolytes and biochemistries often show high potassium levels and elevation of the kidney enzymes. If the potassium is elevated, an EKG (ECG) would show a slow heart rate and depressed P waves (the part of the ECG showing the smaller heart chambers, atria, contracting).

Addison's disease is a life threatening condition that must be treated ASAP. Untreated dogs are usually dead within 24 hours from heart failure brought on by the increased potassium levels.

2. Is this disease treatable, curable, and how common is it?

If caught early enough, Addison's disease is treatable.

Addison's is an uncommon illness and seen more in pure bred small breeds of dogs. It happens when there is a lack of cortisone production by the adrenal glands located next to the kidneys. The body needs small amounts of cortisone every day to keep it "fine tuned". In stressful situations, cortisone production increases so the body can deal with the event e.g. an infection, long race, cold weather.

3. What causes Addison's disease?

The adrenal glands may stop working for a number of reasons including:

A genetic defect

Following a stressful situation

The adrenal glands have been working overtime making cortisone to deal with stress. Sometimes they work too hard e.g. a major illness, and basically run out of puff/cortisone production

Sudden removal of Cortisone therapy

Dogs on cortisone therapy for medical reasons must be weaned off very slowly. When a dog receives cortisone, the adrenal glands "go on holidays" and stop making their own supply. When its time to stop giving the dog its cortisone therapy, it should be done slowly so the adrenal gland has time to "kick start" and get production back into line. If a dog has its cortisone therapy stopped too suddenly, there is a delay of a few days before the adrenal glands "comes back from the break". These few days of no cortisone what-so-ever in the dog's body, can bring on Addison's disease.

4. If treatable, what kind of treatment method is most often used?  What is the Prognosis?

Treatment involves intensive care:

Severe cases have a guarded to poor prognosis and require more intensive care than less severe cases.

5. What are the long-term effects of the disease?

If properly treated, the vet will run tests on a regular basis to determine the status of the adrenal glands i.e. to see if they are working again. In the meantime, the dog is placed on cortisone therapy every day to keep it "fine tuned" and prevent a re-occurrence of Addison's.

Provided therapy is maintained, the dog can live a normal life. In periods of anticipated stressful events, e.g. kennelling, cold spell, the dose of cortisone is elevated to cope with the extra demands placed on the body.

6. Is Addison's disease preventable? Please explain.

Addison's is really only preventable in the scenario of dogs who are receiving cortisone therapy. As mentioned above, the dog must be taken off cortisone very slowly to prevent Addison's occurring.

7. Are certain breeds more susceptible to Addison's disease than others? If so, which ones? Is age a factor?

Any dog of any age can suffer from Addison's disease.

8. What would you most like dog owners to know about Addison's disease?

Probably the fact that if their dog is receiving cortisone therapy, it must not be stopped suddenly.

See also...
Addison's Disease case