Veterinary Angels Medical Center Awards Recognitions
Awards & Recognitions
Darlene and the entire team here at Veterinary Angels Medical Center have been featured in articles and videos in and around the Agoura Hills area. We are also proud to be the recipients of multiple awards as a practice and as individual team members. Take a look at some of them below!
Links & Resources
A list of reliable resources for information on everything from Traveling with Your Pet to Pet Behavior.
Articles regarding common health conditions, their symptoms, and treatments.
A series of educational videos with how-to’s, pet care tips, and preventive health care advice.
Pet Medical Conditions
When used properly, veterinary medicine is essential and practical for many pet medical conditions. Below you will find a list of some of the most common conditions your pet may suffer from. Learn more about their causes, symptoms, treatment, and prevention. If after perusing this section you don’t find the information you were looking for, please give us a call!
Allergic dermatitis is one of the most common allergy-related health problems in dogs, though cats can be affected as well. Symptoms may start as young as a few months of age, or up to 3 years or more. Allergic dermatitis symptoms develop due to an inappropriate immune response to allergens that the pet is exposed to. These can be environmental allergens such as pollens, grasses, leaves, molds, house dust mites, or can be allergens in food or from fleas (flea allergy dermatitis).
Symptoms of Atopic Dermatitis
Atopic Dermatitis (Atopy, or inhalant allergy) is a chronic allergic skin condition that affects between 3-15% of the canine population seen by veterinarians. Atopy appears to have an inheritable component and certain breeds are predisposed. The primary clinical sign is pruritus (itching). Pruritus may be seasonal or all throughout the year. The face, ears, feet, axillae (armpits), abdomen, groin and feet may be affected, however some pets may only have one area affected or may only experience recurring bouts of otitis. Exposure to antigens may occur through inhalation or dermal contact.
Diagnosis of atopy is accomplished via ruling out other dermatologic conditions which cause pruritus, identifying concurrent/secondary infections, and either serum or intradermal skin testing. While allergy is a frequent cause of pruritus, other causes such as external parasites (fleas, mange mites), ringworm should be excluded. For most patients, a dermatologic workup including the following is recommended:
- Skin impression smear cytology – this identifies presence of secondary infections on the skin such as bacteria and yeast, which are common in patients with allergy
- Skin scraping – this test detects presence of mange mites, however is not always definitive with one test; several scrapings may need to be performed
- Woods lamp testing – A Woods Lamp is a black light which causes certain types of ringworm species to fluoresce.
- Fungal culture – culture for ringworm may be indicated dependent on history of exposure, appearance of skin lesions, or results of Woods lamp testing
- Serologic testing for inhalant/environmental allergies – allergy panels can help determine IgE antibody levels vs. many different allergens and can be helpful in formulating immunotherapy treatment
- Intradermal skin testing – intradermal skin testing involves injecting miniscule doses of antigen into the skin and observing for a “wheal” to develop corresponding to an allergic response. Intradermal testing is considered superior to serologic testing, but is less convenient and more costly.
Patients with atopic dermatitis often suffer from relapsing skin infections, and chronic inflammation of the skin leading to hyperpigmentation (increased skin pigment) and lichenification (thickening of the skin) in affected areas. Therapy is aimed at control of pruritus, reduction of skin inflammation and restoration of the skin barrier, treatment of secondary infections and long-term management of the disease to reduce flares. A variety of topical, systemic, and immunotherapeutic options may be used in the treatment of atopic patients. Topical therapies are often geared at assisting with control of secondary bacterial and yeast infections, and restoring the skin barrier function. Systemic antibiotics or antifungals may be needed for patients with severe skin bacterial or yeast infections. Systemic medications aimed at treating inflammation/itch may include antihistamines, glucocorticoids (steroids), oclacitinib (Apoquel®), or Cytopoint®. Steroids are often quite effective at treating pruritus and dermatitis in atopic cases, but may have undesirable side effects including increased thirst and urination, increased hunger, weight gain, muscle wasting, and immune suppression. Antihistamines have limited efficacy for atopy. Oclacitinib is a janus kinase inhibitor, which modulates JAK-1 cytokines involved in itch and inflammation. It is not recommended for use in patients under a year of age, or for pregnant or lactating animals. Cytopoint® is an injectable monoclonal antibody therapy directed at interleukin-31, a key cytokine involved in itch. Regardless of therapy chosen, the majority of dogs with atopy will require some form of life-long treatment to manage the disease and flare-ups.
Other Types of Allergic Dermatitis (Food & Flea Allergies)
Allergic dermatitis secondary to food allergy has a slightly better prognosis than atopy. Pets with food allergy may have primarily dermatologic symptoms (itching with or without skin lesions, ear and or skin infections), gastrointestinal symptoms (vomiting, diarrhea) or both. Symptoms are typically year round. Dermatologic evaluation as described above is advised; however unlike atopy, there are no serologic or intradermal tests which are considered highly reliable for food allergy testing. Therefore, diet trials and medical therapy are the mainstays of treatment.
Patients with Flea Allergy Dermatitis have a very good prognosis. Patients with flea allergy typically have dermatitis along the rump, rear legs and trunk. Treatment of all pets in the home and treatment of the environment to eliminate fleas, along with short term corticosteroid treatment is usually curative.
Cartilage is a slippery substance which acts as a buffer or “cushion” between the bones in a joint. It allows the bones to move over or around each other without pain. Arthritis occurs when the cartilage within a joint becomes damaged. Eventually an arthritic joint becomes inflamed and painful. There are over 100 different types of arthritis recognised in humans. In pets, the most common form is osteoarthritis, sometimes called degenerative joint disease. Other types include rheumatoid arthritis and septic arthritis which is caused by joint infection. Arthritis commonly affects older and middle-aged pets. However, the condition is not limited to these age groups and younger animals can also suffer from the disease. When arthritis eventually causes changes in the joint which result in pain, this often becomes apparent by changes in the animal’s behavior – the primary symptoms of the disease. Because arthritis commonly develops with age, pet owners sometimes confuse changes in their animal’s behavior as normal age-related changes (such as a decrease in play), whereas in fact, the animal might be suffering quite severe arthritic pain.
Osteoarthritis is the most common form of arthritis. It is essentially caused by daily wear-and-tear of the joint, but can also occur as a result of injury. Osteoarthritis begins as a disruption of the cartilage; ultimately, this causes the bones in the joint to erode into each other. The condition may start with minor pain during your pet’s activity, but can develop into continuous chronic pain which might even occur when the animal is resting. Osteoarthritis typically affects the weight-bearing joints but can affect both large and small joints of the body. Unlike rheumatoid arthritis, osteoarthritis is most commonly a disease of elderly pets. Osteoarthritis, like rheumatoid arthritis, cannot be cured, but the condition can be prevented from worsening. Physiotherapy to strengthen muscles and joints can be helpful. Pain medications may be required. For some pets, weight-loss can reduce the stress on the joints thereby reducing the development of osteoarthritis.
Rheumatoid arthritis occurs when the body’s own immune system starts to attack body tissues. The attack is quite general and affects not only the joint but also many other parts of the body. This condition causes damage to the joint lining and cartilage. Eventually, this results in erosion of the opposing bones of the joint. Drugs used to treat rheumatoid arthritis include corticosteroids.
Symptoms of arthritis may not be particularly obvious in the early stages of the disease, but become apparent as pain in the joint increases. Symptoms may be particularly difficult to notice in cats as they tend to hide signs of injury or weakness. Limping An animal with arthritis may favor one or more of their limbs, or have a distinct limp. The severity and type of limp will depend on the joint/s that are affected. Limping is often more pronounced immediately after the animal wakes up from sleeping, and then becomes less pronounced as the animal begins moving about.
Because of the pain caused by arthritis, affected animals may become reluctant to move in ways with which they previously had no difficulty. For instance, arthritic cats might stop jumping up to high areas for sleeping, or may stop using litter trays with high sides. Dogs may not be able to sit so easily, jump in and out of cars, or get up and down stairs.
Arthritis can also affect various parts of the spine. This often results in an abnormal posture with a hunched back, a sore neck, or lameness in one or both hind legs.
Animals with arthritis become tired more easily. For dogs, walks may become shorter and your pet may spend more time sleeping or resting.
Pets with arthritis often lick, chew or bite the painful body areas. If this becomes severe, it may cause baldness over the affected area, or inflamed skin. Conversely, your pet may reduce its grooming because the movements are painful.
Changes in temperament
As with any condition that causes pain, your pet may become irritable if arthritis develops – they may bite, snap or vocalize when handled. It may be necessary to revise your petting or handling so that it does not cause pain.
Muscle atrophy is a decrease in the mass of muscles. This decrease can be partial or a complete wasting away. Arthritic pets can develop muscle atrophy due to inactivity. Atrophied muscles in the legs will give your pet the appearance of having legs thinner than usual.
Some cat breeds are more susceptible to arthritis than others. Hip dysplasia (abnormal development of the hip joints) is seen especially in Maine Coon, Persians, Siamese and other breeds. Patella luxation (dislocation of the knee cap) is more common in Abyssinian and Devon Rex breeds. In dogs, the larger breeds such as Labrador, Retriever, German Shepard and Alaskan Malamute are all more susceptible to hip dysplasia than other breeds.
Injury or trauma
Fractures, dislocations and other joint injuries can cause abnormal joint conformation and irregular future development. This can result in secondary osteoarthritis.
There is no evidence that obesity causes arthritis, however, it can make an existing condition worse.
Arthritis affects one in every five adult dogs in the U.S. It is one of the most common sources of chronic pain that veterinarians treat. In dogs, the joints most commonly affected by arthritis are:
spine (inter-vertebral joints)
A study in 2002 concluded that 90% of cats over 12 years of age had evidence of degenerative joint disease. In cats, the joints most commonly affected by arthritis are:
A veterinarian will be able to diagnose whether your pet has arthritis. They will perform a physical examination on your pet and may take x-rays. Occasionally, it might be necessary to take blood or joint-fluid samples to investigate possible joint infections.
Although arthritis cannot be cured, there are treatments available that can ease the pain for your pet. The solution to keeping arthritic pets comfortable is not to limit their activity but to manage their pain. Initially, treatment for pain may need to be aggressive, especially if the pet has been inactive for a long time. As the benefits of exercise develop, the need for pain relievers often decreases.
Exercise is important for treating arthritis as it keeps strength in the muscles, tendons and ligaments surrounding the joints. If these supportive tissues become weak or loose, they can worsen arthritis. Exercise stimulates the production of joint-fluid which lubricates the joint and nourishes the cartilage. Exercise also keeps pets from becoming obese; extra weight increases the loading on joints making movement even more painful.
Nonsteroidal anti-inflammatories (NSAIDs) and opioid derivatives can be used in the treatment of arthritis.
Several diets or dietary supplements are available for pets with arthritis. These contain essential fatty acids to reduce inflammation, and glycosaminoglycans, the ‘building blocks’ of cartilage.
Acupuncture and low-level laser therapy have also been used in the treatment of arthritis in pets.
Neoplasia describes a process involved in several different diseases. It is therefore difficult to give an all-encompassing definition. However, it is generally recognized that neoplasia is the uncontrolled, abnormal growth of cells or tissues in the body, prior to a lump or abnormal growth developing. Once developed, the abnormal growth is called a neoplasm or tumor. Tumors can be benign or malignant.
Benign and Malignant Tumors
A benign tumor is a mass of cells that lacks the ability to invade neighboring tissue or spread throughout the body. Benign tumors typically have an outer fibrous sheath of connective tissue and grow more slowly than malignant tumors. Malignant tumors usually grow more aggressively, they invade the tissues surrounding them and can metastasize (spread throughout the body). The actual swelling or appearance of a neoplasm is often described as a “tumor” or “mass”. The word “cancer” is often used instead of neoplasia, but only malignant neoplasms are true cancers.
INCIDENCE OF NEOPLASIA AND CANCER
Neoplasia is common in pets and the incidence increases with age.
Approximately 32% of all cats over 10 years of age will die from some type of cancer. Most feline cancers occur in cats 10 to 15 years of age – although lymphoma is an exception as this occurs most often in young cats. Cats commonly develop skin tumors; 25% of all feline cancers are skin cancers, with 50% to 65% of them being malignant. The next most common type of feline cancer is breast cancer (17%) and approximately 10% of all feline tumors are found in the mouth.
It has been estimated that almost 50% of deaths in dogs over 10 years of age are cancer-related and approximately 25% of all dogs will die from cancer. Overall, the incidence of cancer is 3 times greater in female dogs compared to males. This difference is due to the much high rate of mammary cancer in bitches. The incidence of cancer in pure-bred dogs is substantially higher. For example, one in five Golden Retrievers is diagnosed with hemangiosarcoma and is likely to die from it. Other breeds in which cancer is more common include the Boxer, Bernese Mountain dogs and Greyhound.
Physical examination and a pet’s medical history may lead a veterinarian to suspect neoplasia. Additional tests, such as x-rays, ultrasound examination and blood-tests may be necessary to confirm the diagnosis. In some cases, taking a tissue sample (biopsy) from the neoplasm for microscopic examination may also be necessary. This examination can help determine whether the neoplasm is benign or malignant. Additional tissue samples from other organs such as the lymph nodes may be necessary to determine the rate and extent of spread of a malignant neoplasm.
The causes of most neoplastic diseases are not known. Prevention is therefore difficult and early detection is the best way to manage neoplasia. Cancer is a “multi-factorial” disease. This means it has no known single cause. Hereditary and environmental factors have been identified as risk factors contributing to the development of cancer in pets.
COMMON TYPES OF NEOPLASIA IN PETS
Skin neoplasia is common in older dogs, although developing tumors are usually benign. Cats also develop skin neoplasms, most of which are malignant. If you find a lump on your pet, your veterinarian should be consulted to determine whether it is malignant.
Mammary Gland (Breast)
Both cats and dogs can develop mammary neoplasms. In dogs, mammary cancer is the most frequently diagnosed cancer, accounting for 70% of all cancer cases. In dogs, 50% of all breast neoplasms are malignant, whereas in cats, more than 85% of breast neoplasms are malignant. Spaying your female pet before she is 12 months old will greatly reduce the risk of this type of neoplasia.
Head and Neck
Neoplasia of the mouth is common in dogs but less common in cats. Symptoms include tumors on the gums, bleeding, bad breath, or difficulty in eating. Because many swellings in these areas are malignant, early, aggressive treatment is essential. Neoplasms may also develop inside the nose. These can cause bleeding from the nose, breathing difficulty, or facial swelling. These symptoms should be checked by your veterinarian.
Lymphoma is a common form of neoplasia in dogs and cats, characterized by swelling of one or several lymph nodes in the body. In cats, one cause of lymphoma can be the contagious feline leukemia virus.
Testicular neoplasia is rare in cats. It is more common in dogs, especially those with retained testicles, i.e. testicles that did not descend correctly during maturation and may remain located in the abdomen or between the abdomen and scrotum.
Neoplasms inside the abdomen are common. Because of their location, they can be difficult to detect and an early diagnosis is unlikely. Symptoms of abdominal neoplasia are weight loss or abdominal swelling.
Bone neoplasms are seen most often in large-breed dogs or dogs older than 7 years; they are rarely seen in cats. The most common sites are the leg bones, near the joints. Symptoms include persistent pain, lameness, and swelling in the affected area.
Many symptoms of neoplasia are also seen in non-neoplastic conditions, however, they still need prompt attention by a veterinarian for diagnosis. Neoplasia is often treatable; early detection and diagnosis will assist in getting the best possible treatment.
The various types of neoplasia require different individual treatment. This may include one, or a combination, of therapies such as surgery, chemotherapy, immunotherapy, radiation, hyperthermia (heating) or cryosurgery (freezing). Your pet’s overall health is, of course, important. Veterinarians may recommend dietary changes or other alterations to your pet’s life to help your pet respond better to the proposed treatment. Discuss with your veterinarian, the best treatment options for your pet and especially the risks and side-effects associated with these options Pain management is an extremely important aspect of treatment. In some cases, depending on the recommended course of treatment, your veterinarian may refer you to a cancer specialist, or specialty clinic. Some types of neoplasia can be cured, but other types can only be managed to decrease their spread to other organs and tissues of the body. This will prolong your pet’s comfort and quality of life as much as possible. Early detection of a neoplasm and the type of neoplasm are often the greatest factors which determine the success of treatment.
Depending on the severity, development and type of cancer, euthanasia may be considered. Before making your decision for treatment or euthanasia, discuss with your veterinarian the options available so that you can make the best choice for your pet and your family.
The success rate of any treatment is highly dependent on the type and severity of the neoplasia, as well as the aggressiveness of any treatment being undertaken. Benign neoplasms are usually easier to treat. Although some neoplasms, especially the more aggressive cancers, cannot be cured, treatment can both prolong and improve your pet’s quality of life.
Research means we are learning more and more about neoplasia. Animals today have a considerably better chance of being successfully treated for neoplasia and cancer than they did just a few years ago. New diagnostic methods, such as improved imaging techniques, can help detect neoplasia earlier. These will improve your pet’s chances of an early diagnosis and receiving early treatment. New treatments are being developed which will provide better success rates with less risk of side-effects.
Oral hygiene is a very important issue for dogs and cats. The bad breath that is so common in pets is also often the first sign of dental disease. By 2 years of age, 85 percent of dogs and cats have periodontal disease. Periodontal disease begins with the accumulation of plaque on the teeth which, if not removed, then hardens into tartar. Tartar accumulation causes sensitive, sore, and swollen gums as well as gingivitis. At this point your pet is suffering from advanced dental disease. As well as the visible cosmetic problems, advanced dental disease also has an effect on many internal organs. Bad teeth in dogs and cats has been scientifically linked to heart, lung, and kidney problems, which can shorten the life of your pet.
The progression of dental disease is affected by breed and diet. In dogs, smaller breeds tend to experience dental problems at a younger age than their larger counterparts. In cats, mixed breeds do not suffer from dental disease as much as purebreds do. Many years ago, it was believed that animals should always be fed dry food to help keep tartar at bay and prevent dental issues. That way of thinking has been replaced, and the Veterinary Dental Society does not consider dry food or canned food to make a difference.
It is recommended that you always try to prevent dental disease, but if your pet already shows signs of dental issues such as loose teeth, swelling gums or oral infection, a deep cleaning performed by your veterinarian under general anesthesia may be necessary.
There are many basic steps that can be taken to prevent dental disease at home. To further eliminate plaque and improve the health of your pets’ mouths, you should brush their teeth daily, beginning when they are young. While there are rinses available to combat bad breath, be cautious of anything containing alcohol. Chinese herbal remedies have proven helpful in some situations, but diet and daily brushing are the best ways to prevent dental disease in dogs and cats.
Diabetes - Canine
Diabetes mellitus is a disease caused either by a lack of insulin, or an inadequate response of the body to this hormone. After your dog has eaten, the digestive system breaks-down the food into various parts. One of these is carbohydrates which are further converted into simple sugars such as glucose. Glucose is absorbed from the gut into the blood where it is transported around the body. Insulin, which is produced by “beta cells” in the pancreas, helps in the process of moving glucose into the cells of the body where it is converted into fuel. If there is insufficient insulin available, or the body responds inadequately to insulin, glucose is unable to enter cells and can build up to high concentrations in the bloodstream. The resulting condition is called hyperglycemia. As a result, an animal may behave as if it is constantly hungry (the cells are not producing fuel), but may also appear malnourished, again because the cells are unable absorb glucose.
Damage to the beta cells in the pancreas can be either temporary or permanent. The damage may be caused by a virus, infection, trauma, some medications (steroids), or even from over-work after too much sugar or carbohydrate consumption.
Diabetes mellitus is often divided into two types, depending on the origin of the condition:
Diabetes mellitus Type 1, sometimes called “juvenile diabetes” or “insulin-dependent diabetes”, is caused by the destruction of beta cells in the pancreas. Because the destruction of the cells is not reversible, the animal must be treated with an exogenous (external) source of insulin. Both dogs and cats can suffer from Type 1 diabetes.
Diabetes mellitus Type 2, sometimes called “”adult-onset diabetes” or “non-insulin-dependent diabetes”, is characterized by high blood sugar due to the body being resistant to insulin and a relative lack of insulin. Type 2 diabetes is not found in dogs but it is found in cats.
RISK FACTORS AND INCIDENCE
There is evidence that canine diabetes has a seasonal connection (similar to that in human Type 1 diabetes). The primary cause of canine diabetes is unknown, however, the major risk factors are thought to include
Other insulin-resistant disorders, e.g. Pancreatitis
Between 0.2% to 1.0% of dogs develop Type 1 diabetes. This incidence is expected to increase in the future. The disease typically affects middle-aged (6 to 9 years) and older dogs, especially females that have not been spayed.
Some breeds are at greater risk of developing the disease. These include Australian Terriers, Poodles, Dachshunds, Standard and Miniature Schnauzers, Samoyeds and Keeshonds. Other breeds show a lower risk than normal. These include Boxer, English Springer Spaniel, German Shepherd, Golden Retriever, Staffordshire Bull Terrier and Weimaraner.
Juvenile diabetes can also occur; Golden Retrievers and Keeshonds are particularly susceptible.
Diabetes is one of many conditions that cause visible changes in behavior which the owner can detect. Usually, there is a gradual onset of the disease over a few weeks. By knowing the signs of diabetes, you will be able to detect the disease earlier and thereby seek an early diagnosis and treatment. The following are indications your dog may have diabetes. If your dog shows any of these, speak with your veterinarian about the possibility of diabetes:
Excessive thirst/drinks more water than usual (polydipsia)
Urinates more frequently or in greater volumes (polyuria) or perhaps loses urinary control
Consistently acts hungry (polyphagia) but maintains or loses weight
Unusually sweet-smelling or fruity breath (from ketone production)
Urinary tract infections
Chronic skin infections
Cloudy or misty eyes
To diagnose diabetes, your veterinarian will initially conduct a test for the presence of glucose and ketones in the urine. If necessary, a blood test will then measure your dog’s blood glucose concentration. A diagnosis of diabetes is confirmed if glucose is present in the urine and its also at a persistently high concentration in the blood.
The objective in managing diabetes is to regulate glucose concentrations by avoiding peaks and troughs, and to reduce or eliminate the symptoms of diabetes, such as excessive thirst and urination. With daily insulin injections, changes in diet and lifestyle, the disease can be successfully managed. Currently, dogs diagnosed with diabetes and receiving appropriate treatment, have the same, or similar, life expectancy as non-diabetic dogs of the same gender and age.
Managing canine diabetes often requires daily insulin injections to restore your dog’s insulin level and control blood glucose concentrations. Each individual diabetic dog’s requirements are different, so you and your veterinarian will need to find the appropriate dose and treatment regimen. Your dog may need to stay at the veterinary clinic for several days so that your dog’s response to treatment can be closely monitored. The prescribed insulin product may be specifically for diabetic dogs, or a human insulin product. The size of insulin dose will depend on several factors, including the weight of the dog.
If your dog needs daily injections, you will have to learn how to do this. It can be a daunting task and at first you may feel nervous about this. This is common, but, it is easier than you probably think. After a while, you will learn how to administer daily injections without stress for your pet or you.
It is an important part of diabetes management to monitor your dog’s blood glucose concentrations. The method of monitoring will depend on you and your diabetic dog. Methods include urine glucose (and ketone) test strips, or, blood glucose meters.
Diet is vitally important in helping to regulate your dog’s diabetes. If your dog is more stable when first diagnosed, the first treatment might be a high-fiber diet to normalize blood glucose levels. Once the levels are stabilized you should aim to feed your dog exactly the same diet every day and at the same time(s) of day.
The diet is likely to have a low fat content, a good-quality protein, complex carbohydrates and dietary fiber to help slow absorption of glucose from the gut. Your diabetic dog’s insulin injection should be given in conjunction with the regular meals – usually just afterwards. This allows increased nutrients in the blood to coincide with peak insulin levels. This will reduce the tendency for your pet’s blood sugar levels to swing either too high or too low. Overall, the diet should be palatable, nutritious, and minimize fluctuations in blood glucose. In addition, it should help maintain a healthy weight for your dog. Avoid feeding diabetic dogs treats that are high in glucose.
For diabetic dogs, exercise should be regulated because activity affects blood glucose concentrations. Create a consistent exercise routine to avoid any sudden requirement for energy or glucose.
It is important to get regular veterinary checkups to identify possible changes in your pet’s diabetic condition. Diabetes affects dogs differently over time. Changes may even occur after a long period of stabilization. If diabetes progresses, dogs can develop secondary health concerns such as cataracts and severe urinary tract problems. Ultimately, untreated diabetes can cause coma and death.
Although it is often stated that canine diabetes can not be cured, in February 2013, Type 1 diabetes in dogs was successfully cured using pioneering gene therapy.
Distemper - Feline
Diabetes mellitus is a disease caused either by a lack of insulin, or an inadequate response of the body to this hormone. After your cat has eaten, the digestive system breaks down the food into various parts. One of these is carbohydrates which are further converted into simple sugars such as glucose. Glucose is absorbed from the gut into the blood where it is transported around the body. Insulin, which is produced by “beta cells” in the pancreas, helps in the process of moving glucose into the cells of the body where it is converted into fuel. If there is insufficient insulin available, or the body responds inadequately to insulin, glucose is unable to enter cells and can build up to high concentrations in the bloodstream. The resulting condition is called hyperglycemia. As a result, an animal may behave as if it is constantly hungry (the cells are not producing fuel), but may also appear malnourished, again because the cells are unable to absorb glucose.
Damage to the beta cells in the pancreas can be either temporary or permanent. The damage may be caused by a virus, infection, trauma, some medications (steroids), or even from over-work after too much sugar or carbohydrate consumption.
Diabetes mellitus is often divided into two types, depending on the origin of the condition:
Diabetes mellitus Type 1, sometimes called “juvenile diabetes” or “insulin-dependent diabetes”, is caused by the destruction of beta cells in the pancreas. Because the destruction of the cells is not reversible, the animal must be treated with an exogenous (external) source of insulin. Both cats and dogs can suffer from Type 1 diabetes.
Diabetes mellitus Type 2, sometimes called “”adult-onset diabetes” or “non-insulin-dependent diabetes”, is characterized by high blood sugar due to the body being resistant to insulin and a relative lack of insulin. Type 2 diabetes is found in cats, but not in dogs.
RISK FACTORS AND INCIDENCE
Diabetes has been diagnosed in cats of all ages, both sexes, both intact and neutered individuals and all breeds. Older cats, especially neutered males, are more susceptible to the disease. It has been reported that in the UK, Australia, and New Zealand, Burmese cats have a higher incidence of diabetes mellitus but this has not been found in North America.
Key risk factors for diabetes in cats include
Other metabolic diseases (e.g., hyperthyroidism, Cushing’s disease, acromegaly)
Predominant indoor lifestyle
Between 0.2% to 1.0% of cats develop Type 1 diabetes. This incidence is expected to increase in the future.
Diabetes is one of many conditions that cause visible changes in behavior which the owner can detect. Usually, there is a gradual onset of the disease over a few weeks. By knowing the signs of diabetes, you will be able to detect the disease earlier and thereby seek an early diagnosis and treatment. The following are indications your cat may have diabetes. If your cat shows any of these, speak with your veterinarian about the possibility of diabetes:
Excessive thirst/drinks more water than usual (polydipsia)
Urinates more frequently, in greater volumes (polyuria) or perhaps loses urinary control
Consistently acts as if it is hungry (polyphagia), but maintains or loses weight
Unusually sweet-smelling or fruity breath (due to ketone production)
Thinning, dry and dull hair
To diagnose diabetes, your veterinarian will initially conduct a urine test for the presence of glucose, ketones and/or urinary tract infection. If necessary, a blood test will then measure your cat’s blood glucose concentration. If glucose is present in your cat’s urine, a blood test will determine blood glucose concentration and fructosamine concentration. A consistently raised blood glucose concentration could indicate that your cat’s pancreas is not secreting sufficient insulin, or, your cat’s body is behaving as if it is “resistant” to the insulin being produced. Regardless of the underlying cause for the increased blood sugar, your cat is suffering from diabetes mellitus. The diagnosis is considered as confirmed when glucose is found at consistently high concentrations in blood and in urine.
Because cats can suffer from either Type 1 or Type 2 diabetes (dogs only suffer from Type 1) some cats can be treated (at least initially) with oral medications, while others require immediate insulin injections.
The objective in managing diabetes is to regulate glucose concentrations by avoiding peaks and troughs, and to reduce or eliminate the symptoms, such as excessive thirst and urination. Although diabetes can not yet be cured in cats, the condition can be successfully managed with daily insulin injections, changes in diet and/or medication. The serious chronic complications that afflict humans with diabetes mellitus are uncommon in diabetic cats. Once stabilized with proper treatment and home care, diabetic cats can live many healthy years.
Managing feline diabetes often requires daily insulin injections to restore your cat’s insulin level and control blood glucose concentrations. Each individual diabetic cat’s requirements are different, so you and your veterinarian will need to find the appropriate dose and treatment regimen. Your cat may need to stay at the veterinary clinic for several days so your cat’s response to treatment can be closely monitored. The prescribed insulin product may be specifically for diabetic cats, a human insulin product, or a human oral hypoglycemic medication. The size of the insulin dose will depend on several factors, including the weight of the cat.
Some diabetic cats may show clinical remission after a few weeks or months of treatment, i.e. they will cease requiring insulin. However, clinical remission does not mean that the diabetes has been cured; the cat’s diet and lifestyle must still be taken care of and insulin may be required again in the future.
If your cat does need daily insulin injections, you will have to learn how to do this. It can be a daunting task and at first you may feel nervous about this. This is common, but, it is easier than you probably think. After a while you will learn how to administer daily injections without stress for your cat or you.
Oral Hypoglycemic Medications
Healthy diabetic cats can sometimes be successfully treated with glipizide. This is an orally administered medication that lowers blood glucose. Although glipizide is suitable for controlling the disease in some cats, most require insulin injections to fully control their diabetes.
It is an important part of diabetes management to monitor your cat’s blood glucose concentrations. The method of monitoring will depend on you and your diabetic cat. Methods include urine glucose (and ketone) test strips, or blood glucose meters.
Diet is vitally important in helping to regulate your cat’s diabetes. Once the blood glucose levels are stabilized, you should aim to feed your cat exactly the same diet every day and at the same times of day. Many cats prefer eating small amounts throughout the day and your veterinarian will probably not try to change this. Cats require high levels of good-quality protein in their diet. A high-protein, low-carbohydrate food is ideal for a diabetic cat. Overall, the diet should be palatable, nutritious and minimize fluctuations in blood glucose. In addition, it should help maintain a healthy weight for your cat.
It is important to get regular veterinary checkups to identify possible changes in your pet’s diabetic condition. Diabetes affects cats differently over time. Changes may occur even after a long period of stabilization.
Although it often stated that diabetes can not be cured, in February 2013, Type 1 diabetes in dogs (not cats) was successfully cured using pioneering gene therapy. It seems only a matter of time before this is applied to cats.
“Ear mites” is a term used to describe an infestation of an animal’s ears by the mite Otodectes cynotis. This is a common parasitic infestation, but it is generally mild in severity. Complications can occur if the animal’s immune system is in some way compromised. In such cases, the mites can cause hypersensitivity and subsequent irritation of the external and middle ear.
Animals that have an infestation typically scratch excessively at the ears, shake their heads and even create bald patches by removing their hair from scratching. A serious consequence of prolonged and vigorous shaking of the head is that some ears will form a hematoma. This is a collection of blood within the tissues of the external ear – usually because the head shaking and scratching has ruptured a blood vessel. Excessive scratching at the ears can also cause damage to the ear canals or ear drums.
Ear mites can occur in animals of any age, although it is particularly common in young cats and dogs. It is highly contagious and is often transmitted from the mother to the newborn soon after birth. It is also transmitted between animals of different species, although it does not affect humans. The mite can often spread from the ear to other parts of the body.
Itching and scratching – usually the ears, head and neck
Frequent shaking of the head
Thick red-brown or black crusts on the inside of the ear
Bumps in the ear canal which look like coffee grounds
Scratches and abrasions on the external ear
Crusting and scaly tissue on various body areas including the neck, rump and tail
Diagnosis will require a detailed history of your pet’s health, when the symptoms started, and details of the regular contact your pet has with other animals. Your veterinarian will perform a complete physical exam and then, if needed, standard laboratory tests such as a blood count and blood profile, urinalysis and electrolyte tests to screen for other diseases.
Skin scrapings will be taken for dermatological analysis. Identification of the mites may require ear swabs to be placed in mineral oil. Your veterinarian will use an otoscope to inspect your pet’s ear canals to assess the severity of the infestation. If your pet is hypersensitive to the mites, a deep examination of the ears can be difficult. In such cases, a diagnosis can be made by observing the animal’s response to medical treatment.
If your pet has ear mites, it is likely he will be treated as an outpatient and you will be provided with medication to eradicate the mites. This infestation is extremely contagious; all pets in the household should be treated and their environment thoroughly cleaned. The mites can not survive for long periods away from the host, so cleaning the environment thoroughly and treating the pets is usually sufficient.
A commercial cleaner should be used to generally clean the insides of ears to remove any debris before beginning topical treatment. The parasiticide should be used for between 7 to 10 days to eradicate mites and eggs, and then a repeat treatment approximately 2 weeks later. Flea treatments should also be applied to eliminate mites on other sites of the body. Some animals, especially cats, sleep in a curled-up position. This means their tail can come into contact with their ears and there is risk of spreading the mite infestation. Therefore, the tail should also be thoroughly cleaned.
LIVING AND MANAGEMENT
Most patients will have a good prognosis. Your veterinarian will schedule a follow up appointment for approximately 30 days after therapy begins. They will swab your pet’s ears and also perform a physical exam to assess the effectiveness of the treatment.
Epilepsy - Canine
Epilepsy is a neurological condition which occurs in many animals, including dogs. It is caused by sporadic electrical storms in the brain which result in seizures or fitting. Seizures are a sudden involuntary increase in muscle tone and/or movement. They vary from being brief and nearly undetectable episodes, to long periods of vigorous shaking. Epilepsy is often an inherited condition and is the most common brain disorder in dogs. The incidence is much higher in some breeds, e.g. the English Springer Spaniel.
TYPES OF SEIZURE
A life-threatening condition in which there is one continuous seizure lasting longer than 10 minutes, or recurrent seizures with no period of normal consciousness.
Multiple seizures within a 24-hour period which may also be life threatening.
Seizures are further classified as focal, generalized, and focal with secondary generalization. Focal seizures affect only a small part of the brain, whereas generalized seizures tend to affect both sides of the brain.
As the frequency of seizures increases, the probability of damage to the brain neurons also increases. This in turn increases the likelihood that the dog will seize again.
STAGES OF A SEIZURE
The Prodome – This stage precedes the seizure by hours or days and is characterized by changes in the dog’s mood or behaviour.
The Aura – This signals the start of a seizure. The dog may show nervousness, whining, trembling, salivation, restlessness, hiding and apprehension.
The Ictus – the actual seizure. This is a period of intense physical activity usually lasting 45 seconds to 3 minutes. The dog may lose consciousness and show teeth gnashing, uncontrolled thrashing of limbs, drooling, whining, foot paddling, urination and defecation.
The Post Ictus/Ictal – This is the stage after the seizure. The dog may eat or drink excessively, continuously pace, or appear blind and deaf.
TYPES OF EPILEPSY
There are three types of epilepsy that can affect dogs; reactive, secondary and primary. Symptomatic (secondary) means that a cause has been identified, whereas idiopathic (primary) means there is no apparent cause.
Reactive seizures are caused by metabolic problems, such as low blood sugar. or kidney or liver failure. Secondary epilepsy seizures are caused by problems such as a brain tumours, strokes, or other trauma. In primary epilepsy, there is no known cause – this is usually diagnosed by eliminating other possible causes for the seizures.
Low blood pressure
Trembling, shaking or twitching
Difficulty with breathing
Swelling in the brain
Obsessive and compulsive behaviors
As with most dog diseases, diagnosing the condition early and getting appropriate treatment are vital to overall health and wellness. With epilepsy, younger dogs are more at risk from severe forms of epilepsy, including primary epilepsy. Diagnosis will require laboratory and biochemical tests. These may reveal the following –
Low blood sugar
Infectious blood diseases
DEVELOPMENT OF THE DISEASE
Effectively, anything that disrupts brain circuitry can affect the development of epilepsy. This includes the current pattern of seizures because they influence future development of the seizures. Other factors include how old a dog is when it first seizes, and the frequency and outcome of re-occurring seizures.
Drugs that can be used when treating epilepsy in dogs include corticosteroids, anti-epileptic and anti-convulsant medications. These can help reduce the frequency or intensity of seizures. The medication will depend on the type of epilepsy the animal is suffering and will also take into account any other underlying health concerns.
For some animals, surgery may be required to remove tumors contributing to the seizures.
Epilepsy - Feline
Epilepsy is a disorder of the brain causing physical attacks that come on suddenly and without control. The cat may be conscious or unconscious during these recurring attacks. When there is no known cause for these seizures, it is called Idiopathic Epilepsy.
When cats are having a seizure, they tend to have focal onset beforehand (this is when the brain’s cells are firing abnormally in one area or multiple areas of the brain). During this time, your feline friend may look confused and scared. They may even seek out your help or hide from you. When the cat begins to have their seizure, which can last up to 90 seconds, he/she will fall to their side.
During this time, your cat may do any of the following:
Paddle with his/her four limbs
Chomp their jaw
Produce an excessive amount of drool
Seizures generally happen in a patient’s resting state; usually at night or during the early morning hours. Most of the reverberations seen with seizures will disappear before you get your feline friend to the veterinarian.
Most cases of epileptic seizures occur in cats between the ages of one and four. There are several changes in the cat after a seizure occurs (called postictal behavior), which may include:
Loss of sight
Increase of appetite (or polyphagia)
Increase in thirst (or polydipsia)
Seizure recovery can be instantaneous or take a full-day.
WHAT IS THE CAUSE OF FELINE EPILEPSY?
For the most part, the cause of feline epilepsy is not known. However, some idiopathic epilepsy is tied to genetics.
There are two key factors in determining if a cat has idiopathic epilepsy:
Age of first occurrence
Frequency and type of seizure (pattern)
If your feline friend suffers two or more seizures in its first week of having a seizure, the veterinarian will often disregard idiopathic epilepsy and find another diagnosis. If the seizures happen in a cat younger than one and older than four years of age, it could be metabolic or intracranial epilepsy (in the skull). When a feline is suffering with focal seizures, it means there are some neurologic deficits (or structural intracranial disease).
The veterinarian will begin diagnosing the type of epilepsy your cat has during a routine blood test. This test will include the following things:
Complete blood cell count
Blood chemistry profile
He/she will also test for viruses like feline AIDS and feline leukemia. A urinalysis may be conducted as well. Further testing may be done – MRI, CT scan, spinal tap, etc.
The majority of the treatment for feline epilepsy is outpatient. The cat may be given anticonvulsant medications based on how often and severe the seizures are.
HOW TO MANAGE YOUR CAT’S SEIZURES
It’s very important to keep an eye on the feline’s blood when taking medications. Cats that are given phenobarbital will need to have periodic serum and blood chemistry profile monitoring. How your feline reacts to the treatment and the drug serum levels will dictate if medication dosages will need adjustments.
Older felines using a potassium bromide treatment must be closely watched for problems with their kidneys. If your older feline suffers with epileptic seizures, the veterinarian must suggest changing his/her diet.
It’s recommended that felines suffering with genetic or idiopathic epilepsy be neutered or spayed to avoid passing on the trait.
You should never give over-the-counter medication to a feline suffering with epilepsy until you speak to the veterinarian. Over-the-counter medications can often interfere with anticonvulsant medications or reduce the seizure threshold, increasing the possibility of more seizures.
Never miss a dose of your feline’s anticonvulsant medication and keep them inside to ensure they don’t miss a dose.
When a feline suffers with genetic abnormalities epilepsy, there’s not much you can do to avoid it. If you suddenly stop giving your feline their anticonvulsant medication, you could exacerbate the condition, leading to more seizure episodes.
Hyperthyroidism is a common disease of older cats. The disease results from development of an active thyroid nodule (typically an adenoma) which produces excessive amounts of T4, the primary thyroid hormone.
The primary role of thyroid hormones is to regulate metabolism, however thyroid hormones also affect digestion, neurologic functions, and muscle function. Symptoms of hyperthyroidism may include:
- weight loss despite good appetite
- rapid heart rate
- heart murmur
- hair coat changes
However, in some cats the only symptom may be gradual weight loss.
Diagnosis of hyperthyroidism is accomplished via laboratory testing. Total T4 hormone levels may be determined via in-clinic testing or through reference laboratories. Generally speaking, T4 hormone levels higher than 4.0 mg/dL, along with compatible history and symptoms, support the diagnosis of hyperthyroidism. Complete blood count (CBC), comprehensive chemistry testing, and urinalysis should also be done in conjunction with T4 testing, to evaluate for other concurrent diseases. Some hyperthyroid cats may have normal T4; evaluation of FT4 and T3 may be necessary to establish the diagnosis. For hyperthyroid cats with cardiac symptoms (murmur, tachycardia), thoracic radiographs and echocardiography are useful in evaluating thyroid-related cardiac disease.
There are four options for treatment of hyperthyroidism in cats, including radioactive iodine administration, long term oral medication, surgery, and dietary management with Hill’s y/d®. Radioactive iodine therapy is the treatment of choice.
Radioactive iodine therapy (I131) involves the administration of radioactive iodine, which selectively targets and destroys overactive thyroid tissue. I131 therapy is highly effective, having a high cure rate; few cats relapse.
Surgical treatment (unilateral or bilateral thyroidectomy) involves removal of one or both thyroid glands. Potential adverse events include inadvertent removal of parathyroid glands, resulting in need for calcium and vitamin D supplementation, and hypothyroidism, resulting in the need for thyroid supplementation.
Most pet owners with hyperthyroid cats elect long term medical management with methimazole, which suppresses thyroid hormone production. If treatment with methimazole is elected, oral administration is preferred over transdermal. After initiation of treatment, laboratory testing is ideally done 2-3 weeks to assess blood counts, renal parameters and T4. Adjustments in dosage are made as indicated until desired endpoints are reached with laboratory parameters and patient response to therapy. Primary side effects of oral methimazole therapy are gastrointestinal: vomiting and diarrhea, or drug hypersensitivity reaction.
If oral methimazole therapy is not tolerated, transdermal therapy, dietary management, or radioactive iodine therapy may be considered.
Flea Control & Flea Bite Allergies
Flea bite hypersensitivity and flea allergic dermatitis (FAD) is a skin disease that affects many animals, including cats and dogs. It is often considered to be the most common skin disease in pets. The allergy is an immune response to the saliva (or components of the saliva – including antigens, amino acids, aromatic compounds, polypeptides, and phosphorus) injected by fleas when they bite your cat or dog. The bitten animal’s body begins an exaggerated antigen-antibody reaction to the saliva, inflammation results from scratching by the pet and secondary bacterial infections (principally Staphylococcus intermedius and Malassezia pachydermatis) can begin if the skin is traumatized by the scratching. Flea allergy can develop in your pet at any age, although, 61% of flea-allergic dogs develop FAD between 1 and 3 years of age. It is uncommon for hypersensitivity to develop in very young animals (less than 6 months of age) because they do not yet have a fully developed immune system to react to the flea bite.
The flea life-cycle is the typical 4-stage process of the adult flea, egg, larvae and pupa. Adult fleas must feed on blood (from your pet) before they can reproduce. Once the adult flea lays her eggs on the host (usually in batches of approximately 20), these fall to the ground and frequently into the animal’s bedding. The adult flea may also jump off the host after laying the eggs, however, adults cannot survive long once they are off your pet. Both the egg and larval stages live in the environment rather than on the animal, therefore, it is essential to treat both the animal (for the adults) and its environment.
SYMPTOMS AND TYPES
The most obvious symptom of flea bite hypersensitivity and FAD is severe itching of the skin, which your pet attempts to cope with by scratching and biting. At this stage, the condition is referred to as pruritis, which in hypersensitive animals can be caused by as few as one or two flea bites a week. Because of the low numbers of fleas which can cause the condition, symptoms often persist, even after flea control methods have been used. Symptoms will often occur in episodes, and in general, symptoms worsen with age. Scratching can become habitual and develop into a condition called neurodermatitis in which affected skin become thick and leathery. After frequent scratching has been occurring for a while, the most notable symptoms are the patchy loss of hair, erythema (redness of the skin), pustules (pus-filled bumps) and crusts or scabs on the skin. Although any part of the body can be affected by flea bite hypersensitivity, the hind end is often affected more than the front or head of your pet’s body.
One problem with diagnosis of FAD is that it may be difficult to see fleas or flea dirt (flea feces). This is partly because the pet’s scratching has likely removed them. Carefully inspect your pet’s skin by using a flea comb to part the fur. This will enable you to inspect for fleas or flea dirt more readily. There are skin tests available for mites or bacterial skin diseases, and these may be recommended by your veterinarian if fleas cannot be seen directly. The distribution of scratching or lesions on the pet’s body can assist in diagnosis. Sometimes, the best diagnostic method is to simply treat for fleas and observe for changes in the symptoms.
For animals with flea bite hypersensitivity, it is essential to control the flea population on the animal, in its environment, and prevent any re-occurrence. There are numerous commercial applications for killing adult fleas, however, these only act for a period of time and all should be repeated as indicated on the product for effective and continuous flea control. Spot-on insecticides are often used. These are a topical treatment, usually applied to a small area, (e.g. the back of the neck) where the animal is unable to lick it. Oral products are also available, but some of these can be difficult to administer, especially to cats. Shampoos can be especially beneficial for young animals or for a severe and acute flea infestation, however, it is essential that a more long-term product is also used to ensure continuous flea management. There are also many commercial products available that can be used to treat for flea eggs and larvae. If the treatment causes fleas to leave the host pet, the fleas may bite humans during the process of searching for another host. It is virtually impossible to successfully control fleas in the long-term if your pet is kept outdoors. There are some products that may be effective for short-term control, but this is dependent on the kennel or other housing not becoming infested. If your pet is allergic to flea bites, they may require steroids or anti-histamines to reduce their sensitivity. Similarly, if a bacterial infection develops from any lesions, your pet may require antibiotics. Your veterinarian may request follow-up examinations to assess the progression and success of treatment they have recommended.
LIVING AND MANAGEMENT
The most essential factor in successfully controlling or treating fleas is the application of regular doses of flea treatment. This should be done at the frequency recommended by the manufacturer, or as advised by your veterinarian. It takes only one or two bites for an animal that is allergic to fleas to start itching. Therefore, it is best to be consistent with flea control products and the timing of their application. You should also consider other factors such as how frequently your pet is bathed or swims, and whether you are using topical or spot-on treatments. This will determine the time between applications.
Gastric dilatation-volvulus syndrome (GDV) is commonly called “gastric torsion” or “bloat”. The first part of the syndrome’s name refers to the expansion of the animal’s stomach due to excessive gas accumulation (Dilation). This condition can then be complicated by the stomach twisting around its short axis (Volvulus). Viewed from behind the animal, the stomach can rotate 90-360° in a clockwise direction around the esophagus, which may block the esophagus and prevent the animal from belching or vomiting to release the excess gasses.
The condition is common in domestic animals, particularly dogs. As a consequence of the gastric twisting, a number of emergency conditions can result. These include increasing distension of the stomach, heightened pressure within the abdomen, and damage to the cardiovascular system. Another consequence can be decreased perfusion – the process of moving nutrients around the body via blood in the arteries. Reduced perfusion can result in organ death. In dogs, mortality rates from GDV range from 10 to 60 percent, even with treatment.
Dilation of the stomach and volvulus cause increased pressure on both surrounding organs and blood vessels. The symptoms of GDV therefore include:
Rapid heart beat (tachycardia)
Labored breathing (dyspnea)
Pale mucus membranes (nose, gums and mouth)
General symptoms of shock
Abdominal pain and distension
Vomiting (to the point of unproductive dry retching)
CAUSES and RISK FACTORS
The exact causes of GDV are unknown, although several risk factors have been identified.
Genetics and Anatomy
Large breeds of dog are at higher risk of GDV, especially deep-chested breeds. The five breeds at greatest risk are Great Danes, St. Bernards, Weimaraners, Gordon Setters, and Irish Setters. The lifetime risk for a Great Dane developing bloat has been estimated to be 37 percent. Other breeds at increased risk include German Shepherds and Standard Poodles.
Dogs having a parent or sibling with a history of GDV are at higher risk and the risk of GDV increases with age, although it has been reported in puppies.
Environmental factors believed to contribute to GDV include ingestion of large amounts of food or water by the dog, ingesting food too quickly, too much activity after eating, or delays in emptying the gastrointestinal system.
Clinical tests for GDV include urine analysis and blood testing for concentrations of lactate in the plasma. Diagnosis may also include imaging techniques such as x-rays of the abdomen.
Other conditions have symptoms similar to those of GDV. These include bacterial infections, gastroenteritis (inflammation of the gastrointestinal tract), or overeating by the dog (sometimes called “food bloat”).
GDV is an emergency condition. Dog’s suffering the condition usually need to be hospitalized to receive aggressive treatment, especially if secondary cardiovascular problems are apparent. After the cardiovascular system has been stabilized, the gastric system can be decompressed. The preferred method is oro-gastric intubation, i.e. insertion of a tube through the dog’s mouth and into the stomach. Surgery can then return internal organs (particularly the stomach and spleen) to their normal positions. To prevent recurrence of GDV, a permanent gastropexy may be required. In this procedure, the dog’s stomach is secured to prevent future twisting.
LIVING AND MANAGEMENT
After an attack of GDV, further treatment is likely to include analgesics and other necessary medications. The dog’s activity should be restricted for approximately 2 weeks, particularly if surgery has been required.
Recurrence of GDV attacks is common, occurring in up to 80 percent of dogs treated medically only, i.e. without surgery. Several steps can be taken to prevent GDV or its recurrence, including:
Avoiding strenuous exercise by the dog after eating and drinking
Slowing the dog’s rate of food consumption
Feeding frequent small portions to the dog rather than infrequent larger portions
Glaucoma is a disease of the eye caused by increased pressure within the eye. In the normal eye, fluid (aqueous humor) is continuously produced by a structure called the ciliary body, which lies behind the iris. The fluid then flows through the pupil into the front chamber (anterior chamber) of the eye. Fluid drains through a series of canals around the outer edge of the iris. In glaucoma, the drainage of fluid is inhibited, leading to increased pressure within the eye, eventually causing damage to the optic nerve and blindness.
Glaucoma in dogs may be primary or secondary. Primary glaucoma results from a hereditary abnormality of the drainage system. Secondary glaucoma occurs as a result of trauma to the eye, inflammation in the eye, lens luxation (dislocation), or intra-ocular tumors. Breeds known to have hereditary glaucoma include Samoyeds and Huskies, Cocker Spaniels, Poodles, and Chow Chows. Secondary glaucoma is more common in dogs vs. primary.
Symptoms of glaucoma may include:
- vision loss
- bulging appearance of the eye (chronic glaucoma)
- appetite loss
- behavior change
Often the primary presentation of acute glaucoma is a red eye.
Diagnostic evaluation of the eye typically includes Schirmer tear testing to assess for Dry Eye, Fluorescein stain for assessment of corneal lesions, and intra-ocular pressure measurement via tonometry. Tonometry is most often accomplished via use of a device that measures the intraocular pressure via touching the tip lightly against the cornea, after application of topical anesthetic. Normal intraocular pressures in the dog are typically 15-20 mmHg. In breeds predisposed to primary glaucoma, evaluation by an ophthalmologist to include gonioscopy (evaluation of the drainage apparatus), along with ERG, are used to determine if glaucoma is primary or secondary. This evaluation will also determine if the eye may be blind, when there is anterior eye inflammation or cataract of the lens is present. The importance of determining if glaucoma is primary or secondary lies in the formulation of a treatment plan.
Primary glaucoma is often treated with topical medications with the intention of reduction in intraocular pressure. In acute glaucoma where pressures may exceed 50-60 mmHg, aqueous centesis may be necessary as well to acutely drop IOP, while treatment is instituted. Dorzolamide, a CAI (carbonic anhydrase inhibitor) works by inhibiting the production of aqueous humor. Timolol, a beta-blocker, also works by reducing production of aqueous humor. Latanoprost is a prostaglandin analog, which works by improving drainage of aqueous humor.
When medical management fails at maintaining reduced IOP, alternative options may be considered, including laser ablation of the ciliary body, cryotherapy of the ciliary body, drainage implant, chemical ablation of the ciliary body via intraocular injection of gentamycin, removal of the eye or evisceration (removal of the structures inside the eye) with intra-ocular prosthesis. All options have potential complications.
Ultimately, roughly 50% of pets with glaucoma in one eye may go on to develop glaucoma in the other eye, therefore frequent monitoring is important in prevention of blindness in both eyes.
Heartworm is a parasitic roundworm (Dirofilaria immitis). It primarily infects dogs, cats and ferrets, although it can also infect a wide variety of wildlife. It is a potentially fatal parasite, however, it is preventable. Humans have become infected, although this is rare and does not usually cause illness.
LIFE-CYCLE, TRANSMISSION AND EFFECTS
Mosquitoes are the only way that heartworms can be transmitted from animal to animal. When mosquitoes bite an infected animal and ingest their blood, young heartworms (microfilariae) enter the mosquito’s digestive system. Within 2 to 6 weeks, the microfilariae inside the mosquito develop into infective larvae. They then migrate to the mosquito’s salivary glands. These infective larvae can then be transmitted to another animal when the mosquito bites to get its next meal of blood.
The period between the initial infection when the dog or cat is bitten by an infected mosquito and the development of the microfilariae into adults living in the tissues of your pet usually takes 6 to 7 months. This is known as the “prepatent period”.
In cats, the microfilariae live for only a month in the vascular system and are seen in only 20% of infected cats (compared to 80 to 90% in dogs). This means that infected cats are unlikely to transfer the heartworm to another mosquito – in stark contrast to infected dogs.
The larvae introduced by the mosquito grow for 1 to 2 weeks under the skin at the site of the mosquito bite. Then, they migrate to muscles in the chest and abdomen, and 45 to 60 days after infection, molt to the next larval stage. Between 10 to 15 weeks after infection, the larvae enter the blood system where they are transported through the heart to reside in the pulmonary artery of the lungs.
During the next 3 months, the larvae (or immature worms), continue their development to become adults. Adult female worms can grow up to 14 inches in length and males about 2 inches shorter. The growing and feeding worms damage the blood vessels which causes a decrease in the efficiency of the heart and moving blood around the body. Occasionally, adult heartworms migrate to the right side of the heart and even to the large cardiac veins in severe infections. This can result in severe lung and heart disease. Animals showing signs of illness from adult heartworm infection are said to be suffering from heartworm disease. Death can occur as the result of congestive heart failure. Adult heartworms can have a long lifespan; they may survive for 5 to 7 years in dogs and 2 to 3 years in cats.
At approximately 5 to 7 months post-infection, if both adult females and males are present, they will mate and produce new microfilariae. The host’s immune system raises a strong response to these microfilariae, which unfortunately, can cause damage to other organs. The life-cycle then continues when a mosquito bites an infected pet and itself becomes infected by the microfilariae.
At one time, heartworm in the U.S. was confined to the southern states, but has now spread to nearly all locations where mosquitoes are found. It is also found in many other countries. All dogs are susceptible to heartworm infection and both indoor and outdoor cats are at risk of the disease. If you plan to visit different areas of the country with your dog or cat, or another country, consult your veterinarian about the risk of heartworm in the area you intend to visit.
Because mosquitoes are the vector of this disease, any animal which comes into contact with mosquitoes should be tested. This also includes pets that might go outside only occasionally.
SYMPTOMS AND DIAGNOSIS
Dogs with recent or mild heartworm infections may show no signs of illness. However, once the adult worms have developed in the lungs, your dog may cough, have difficulty breathing, become lethargic or lose its appetite; he may also tire rapidly after only light or moderate exercise.
Your veterinarian will have available to them, numerous diagnostic tests to detect the presence of adult heartworms. These are infections that have occurred at least 6 months previously. The presence of adult female heartworms can be detected with an antigen test which is very accurate in dogs. Exposure to heartworms can be detected by antibody tests. To confirm the diagnosis and evaluate the severity of the disease, your veterinarian may conduct other tests such as chest radiographs (x-rays), a blood profile, or an ultrasound of the heart (echocardiogram). These will also help determine the best treatment plan for your dog.
Symptoms of heartworm disease in cats include those often associated with other diseases. These include respiratory distress, gagging, coughing and vomiting. Symptoms associated with the first stage of heartworm disease, when the heartworms are carried to the pulmonary arteries, are often mistaken for feline asthma or allergic bronchitis, when in fact, they are actually due to a syndrome newly defined as Heartworm Associated Respiratory Disease (HARD). Cats may die suddenly from heartworms, although this happens rarely.
The diagnosis of heartworm infection in cats is more difficult than it is with dogs. Several tests may be required to assess the likelihood of heartworm infection. Even then, the results may be inconclusive. Usually, both antigen and antibody tests are conducted for cats to increase the probability of detecting heartworms.
As usual with most medical problems, prevention is better than cure. However, if your dog does contract a heartworm infection, treatment is available. Treating dogs for heartworms carries with it a substantial risk, but, if your dog is in good health and the instructions of your veterinarian are followed, this will considerably reduce the possibility of serious complications.
The aim of treating heartworm is to kill both the adult worms and microfilariae, as safely as possible. Successful treatment means there will be heartworms dying inside your dog’s lungs. Therefore, during treatment, hospitalization may be required initially. Upon going home, the dog should be rested (limited to leash walking) for a period, to decrease the risk of partial or complete blockage of blood flow through the lungs by dead worms. Other medications may be required to reduce the body’s inflammatory reaction to the worms being broken down in the lungs.
At present, there is no effective and safe treatment for heartworm infection in cats. If your veterinarian diagnoses heartworms in your cat, they may also recommend medications to reduce the inflammatory response and the resulting disease. Another course of action may be surgery to remove the heartworms. Cats are more resistant hosts to heartworm than dogs and are often able to rid themselves of infections. Unfortunately, many cats react severely to the dead worms as they are cleared by the body which can result in a physiological shock reaction, a life-threatening condition.
Removing heartworms by surgery is a high-risk procedure for both dogs and cats. It is typically reserved for only severe cases, however, this approach may be necessary to give your pet the best chances of survival.
Heartworm infection is almost 100% preventable in dogs and cats. There are several heartworm medications available which can be obtained in a variety of formulations. Based on your pet’s risk factors and life-style, your veterinarian will recommend the best preventative, but of course, you will have to remember to administer the medication for it to work!
The preventatives do not kill adult heartworms. They also do not eliminate heartworm infection or prevent signs of heartworm disease if heartworms are already present in the animal’s body. Therefore, it is recommended that a blood test for existing heartworm infection is conducted to assess the pet’s current heartworm status, before beginning a prevention program. It is more difficult to detect heartworms in cats, therefore, additional testing may be necessary to make sure there is no infection during any course of prevention.
Once treatment has finished, testing must then be repeated at the correct intervals. Six months after starting the preventative treatment, a test should be performed to confirm that your pet was not infected prior to starting the prevention – it should be remembered that tests only detect adult worms. From then, heartworm tests should be conducted on an annual basis to ensure your pet does not subsequently become infected. This will also check the appropriate amount of medication is being administered. Some pets develop a heartworm infection despite year-round treatment with a preventive; having regular tests is the most effective way to keep your pets protected.
Hip dysplasia is a hereditary condition resulting in malformation of the hip joint. The hip joint is a “ball and socket” joint; in dogs with hip dysplasia, the acetabulum (socket) is typically too shallow to accommodate the femoral head (ball) and the femoral head is malformed. Poor congruity of the femoral head and acetabulum result in joint laxity, wear on articular cartilage, and eventual osteoarthritis.
Large breeds are affected more commonly than small breeds. Early symptoms of hip dysplasia can include a “bunny hopping” rear limb gait, rear limb lameness, narrow rear limb stance, difficulty going up stairs, laxity in the hip joints, and reduced hip and thigh muscle mass. Over time with the development of progressive osteoarthritis, the disease can be quite debilitating resulting in severe lameness and difficulty rising, rear limb weakness, marked thigh muscle atrophy, pain and reduced mobility.
Diagnosis of hip dysplasia involves a comprehensive history, physical examination with gait assessment, palpation of hips for laxity under sedation, and performing radiographs of the hips while the pet is sedated, using either the OFA (Orthopedic Foundation of America) or Penn Hip methods. Because hip dysplasia is a hereditary condition, breeds with increased risk should have hip certification prior to breeding. Dogs which have confirmed hip dysplasia should not be bred.
Treatment & Management
Treatment options for hip dysplasia include medical or surgical management. The choice of treatment will depend on age at onset of symptoms, the severity of symptoms and response to medical management.
Medical management options include joint supplements, and pain medications including NSAID (non-steroidal anti-inflammatory drugs), Tramadol, and Gabapentin; weight management, physical therapy and laser therapy.
For symptomatic puppies diagnosed at a very young age (less than 4 months), Juvenile Pubic Symphysiodesis (JPS) is a feasible treatment option. For these patients, Penn Hip studies are recommended for initial diagnosis. The JPS procedure involves cauterizing the area where the left and right halves of the pubis join. This affects the growth of the entire pelvis, resulting in better congruity of the hip joint.
For symptomatic dogs less than one year of age, triple pelvic osteotomy (TPO) is another surgical option. TPO surgery involves cutting three pelvic bones (ileum, ischium, pubis) in order to rotate the hip socket to provide better coverage of the femoral head. After performing the cuts (osteotomies) a bone plate is used to secure the new position of the pelvic bones. For most dogs, one hip is operated rather than both at the same time, allowing for adequate recovery time (2 months) between procedures.
For older dogs with pain and reduced mobility, either FHO (Femoral Head Ostectomy) or THR (total hip replacement) surgery are options to consider if medical management fails. FHO involves removal of the femoral head (ball component of the ball and socket joint); a “false joint” is formed during the healing phase and early return to function and physiotherapy is important for these patients. FHO is not recommended for dogs over 50 lbs. Total hip replacement is preferred for larger dogs. THR surgery is similar to hip replacement for humans; a prosthetic implant is placed in the hip socket and femur, forming a synthetic hip joint. Patients undergoing THR may return to full function very quickly after surgery. In summary, hip dysplasia is a hereditary condition that can be debilitating but can be managed with medical or surgical options to improve the quality of life of your pet.
Hookworm - Canine
If you are a dog owner, you need to be on the lookout for hookworms. These can be fatal for your dog, especially puppies. The hookworm parasites make their way into the small intestines, sucking blood and causing pain as they go. The problems get worse as the larvae reach the fourth stage, causing anemia and inflammation in the intestine of your dog. Blood will continually seep from the areas where the worms have been active and biting.
The first thing you will notice in your dog is that he loses his appetite and appears unhealthy. Also, the ears, lips and nostril linings will look pale. Hookworms will often make their way into the lungs, which will result in your dog developing a cough. Other symptoms to look for include tarry, dark stool, diarrhea, and constipation. Failure to treat these symptoms can mean a quick death for your pet.
It is mother’s milk that often leads to puppies getting hookworms. The worms often come from contaminated water sources and enter via larval penetration of the skin or ingestion.
You will not be able to see the hookworms with the naked eye, which means a veterinarian will have to diagnose them microscopically via a stool sample. Once the diagnosis has been made, the vet can then decide the best course of treatment. If you find that one or more puppies in the litter have already died, it may be hookworms that were the cause.
Vets will prescribe medication that will either kill or expel the worms. Oftentimes that is enough to take care of the issue, but iron and nutritional supplements may also need to be added to the treatment process. Worm medication should be administered to puppies when they are two weeks old and should continue until they have been weaned. Even then, monthly treatments should continue until all the larvae have been expelled.
Pregnant dogs should be administered treatment two weeks after breeding, with treatment continuing for 2-4 weeks after the puppies are born. This is usually enough to protect the puppies and get rid of any larvae in the intestine.
Depending on the condition of the dog and the severity of the issue, they may have to be hospitalized to receive further treatment. That could be anything from fluid therapy to a blood transfusion and/or supplemental oxygen. Even with the best treatment, sudden death can still occur.
Keeping all areas clean that your dog inhabits is essential. Pay special attention to their drinking bowls and other areas where water accumulates. If you notice any of the aforementioned symptoms in your dog, make sure that he sees a vet ASAP.
Inoculations for hookworms are not available, which means you really need to be vigilant at all times and act quickly when you spot potential symptoms. While hookworm cases in humans are rare, the parasites can get in through the skin, which means you need to be careful when treating your pet.
Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) is a chronic gastrointestinal disease in dogs and cats. Onset of symptoms may begin in young adulthood up to geriatric years, however, median onset age is around 6 years. IBD can occur in pets of any breed, however certain breeds are predisposed to particular forms of IBD including Soft Coated Wheaton Terriers (protein losing enteropathy and nephropathy) and Boxers (histiocytic ulcerative colitis). The exact cause of IBD is unknown, however, several factors may play a role, including mucosal permeability defects, infectious causes, dietary allergens, and the immune system.
Symptoms may include:
- intermittent vomiting
- appetite loss
- weight loss
- intermittent diarrhea
- edema or ascites in more severe instances such as protein-losing enteropathy
Diagnosis of inflammatory bowel disease is ultimately achieved by biopsy. However, this is not recommended as the first diagnostic step in evaluation of patients with gastrointestinal symptoms so several other diagnostic tests are often done prior to biopsy in order to rule out other diseases.
Comprehensive labwork including complete blood count, biochemistry analysis, electrolyte levels and serum T4 levels, along with serial fecal testing are important in initial evaluation of patients with chronic gastrointestinal symptoms. Atypical Addison’s disease should also be ruled out prior to biopsy of the gastrointestinal tract. Atypical Addisonian patients may have completely normal lab test results, however may have waxing/waning gastrointestinal symptoms and weight loss. ACTH stimulation testing is necessary to rule out this disease. Serum trypsin-like immunoreactivity (TLI), folate and cobalamin levels may also be useful in evaluating patients with chronic gastrointestinal disease. Low TLI level concurrent with chronic diarrhea is diagnostic for exocrine pancreatic insufficiency. Serum folate and cobalamin are useful in assessing for small intestinal bacterial overgrowth; and patients with low cobalamin levels benefit from parenteral B12 supplementation in the treatment of diarrhea associated with malabsorptive forms of inflammatory bowel disease.
Fecal α-1 proteinase inhibitor testing is helpful in confirming intestinal protein losses in patients with hypoalbuminemia. Other potential causes of hypoproteinemia include renal protein loss and reduced hepatic synthesis. Radiographs of the abdomen are not particularly helpful in diagnosis of IBD, however ultrasonography may show changes such as increased thickness of the gastric and intestinal walls.
Biopsy of the gastrointestinal tract may be obtained via surgery or endoscopy. Surgical biopsy offers the advantage of obtaining full thickness biopsies, however has increased risks due to potential for infection or leakage from surgical sites. Endoscopic biopsies are partial thickness and associated with less risk than surgical biopsies, however if disease is not present in superficial layers of bowel, then biopsies may not yield an accurate diagnosis. Whether surgical biopsies or endoscopic biopsies are elected, it is important to obtain multiple biopsies from several regions of the gastrointestinal tract, including the ilium. Lymph node biopsies (mesenteric lymph node) should also be collected when surgical biopsies are performed.
Treatment of patients with inflammatory bowel disease may vary depending on severity of symptoms. Generally, it is recommended for all patients to do empiric deworming with febendazole, and to use metronidazole or tylosin and dietary management initially for patients with diarrhea. Dietary management typically involves feeding a restricted novel protein diet, hydrolyzed protein diet, or high fiber diet for 4-6 weeks and evaluating for efficacy. Dietary therapy may need to be continued indefinitely or altered depending on response. Patients with vomiting may benefit from periodic or chronic administration of maropitant (Cerenia®). In patients with primarily large bowel signs, sulfasalazine may help control symptoms.
When symptomatic therapy and diet therapy fail to resolve symptoms, immunosuppressive therapy is added. Prednisolone or budesonide may be used in these instances. For patients that do not respond well to prednisolone, combination therapy with chlorambucil (cats) or azathioprine (dogs) may result in improved control of clinical signs.
Ultimately, IBD is a disease that is not cured but managed. Flares often occur and are usually the result of dietary indiscretion.
Kennel cough, also called Infectious Tracheobronchitis (ITB) or canine infectious respiratory disease complex, is a multi-factorial illness in dogs. Kennel environments provide the ideal location for the disease to flourish due to increased presence of a variety of respiratory pathogens, increased stress, and increased contact between dogs.
Symptoms of kennel cough may include cough, ocular discharge, and nasal discharge.
There are several viral and bacterial pathogens involved in Canine Kennel Cough. In the past, it was believed that the primary causes were the virus Canine Parainfluenza, and the bacteria Bordetella bronchiseptica. However, research has now shown that there are several other pathogens that may be involved, including adenovirus, canine respiratory coronavirus, herpesvirus, distemper, influenza, mycoplasma, and streptococcus zooepidemicus, to name a few.
The severity of respiratory symptoms that develop in exposed dogs varies relative to pathogens involved, vaccination status of the population, contact rate and increased stress amongst the animals in the kennel setting. Bordetella infection generally results in mild upper respiratory symptoms. Vaccinated adult dogs are less likely to develop disease from exposure to Bordetella and distemper, whereas exposed unvaccinated pups are most at risk. The development of neurologic signs along with respiratory signs may indicate that distemper is a causative agent. Influenza may affect dogs of all ages and vaccination status, as influenza vaccines are not widely used in the general population.
Diagnostic testing is most useful when several dogs are affected. Respiratory PCR panels are now widely available and can be used easily as a non-invasive method of testing, using nasal, oropharyngeal and conjunctival swabs. PCR tests, while convenient, may yield both false positive and false negative results; therefore it is important to interpret results amongst several patients when a large number of dogs are affected.
Other means of diagnosis include tracheal washing, and post-mortem testing of tissues from deceased or euthanized animals. Tracheal wash with cytology and culture is most beneficial if symptoms are primarily lower airway in nature, however this method of testing is not practical on a large scale.
Prevention is the key to reducing morbidity associated with kennel cough. Vaccination alone is insufficient to significantly reduce disease, as there are several pathogens for which no vaccine has been developed. However, vaccination is nonetheless important and an immunization series should be completed at least two weeks prior to boarding. Distemper, adenovirus, parainfluenza, Bordetella, and ideally influenza immunizations should be included for best protection.
Maintaining good sanitation, establishing required vaccination protocols for dogs in kennel settings, reducing stress in the kennel setting, optimizing kennel airflow design, and isolating symptomatic patients are additional factors which can all help reduce the severity of outbreaks. Many of the pathogens involved in kennel cough are easily transmitted via both aerosolization and fomites (inert carriers such as clothing), therefore, careful attention to cleaning procedures and working with symptomatic patients is important.
There is no single all-encompassing effective treatment for kennel cough. Dependent on the pathogens involved, some milder cases may not need antibiotic therapy, however for moderate to severely affected animals, systemic antibiotics can help reduce symptoms. Nebulization therapy may also be helpful in patients with more severe lower respiratory signs.
Leptospirosis is a bacterial disease caused by several serovars of the bacteria Leptospira. Leptospires can cause illness in dogs as well as several other species of domestic and wild animals, including cows, horses, pigs, sheep, skunk, opossum, raccoons, rats and mice, deer and others. Leptospirosis is also contagious to humans and is therefore considered a zoonotic disease.
Leptospira bacteria are shed in the urine of infected animals, contaminating water and soil. Some animals serve as hosts, and do not become ill but rather serve as reservoirs for the bacteria and shed the bacteria intermittently over long periods of time. The organisms can survive in soil or water for months. Increased rainfall, higher temperatures, and seasonal movement of animals correlate with the increased prevalence of the disease. Exposure to and consumption of infected water is the primary method of infection. The bacteria may enter the body via ingestion, contact with mucous membranes, or cuts in the skin. Once in the body, the Leptospires migrate to kidneys, liver, spleen, nervous system, and eyes. The preferred site for colonization of the bacteria is in the kidneys. Clinical signs appear typically within 7 days of infection.
Dogs are the primary companion animal affected by Leptospirosis. Male, middle-aged, mixed breed dogs are most at-risk. Cats may become infected but generally remain asymptomatic. Most infected dogs are asymptomatic, however dogs that develop clinical signs may become severely ill; symptoms may range from mild lethargy to fever, inappetence, vomiting, diarrhea, increased thirst and urination, weight loss, icterus (jaundice). Kidney failure can ensue in some dogs, as well as liver failure and complications such as hepatic encephalopathy and DIC (disseminated intravascular coagulation). Peracute Leptospirosis infections can rapidly cause death.
Diagnosis of Leptospirosis is accomplished via laboratory testing on blood and urine, including blood counts, chemistry tests, urinalysis, and either paired antibody titers or PCR testing. Blood tests will often show increased renal (kidney) parameters (creatinine, BUN) and/or increased liver enzymes (ALT, ALP, Total Bilirubin) as well as thrombocytopenia (low platelets), dilute urine, white blood cells and red blood cells in the urine, and proteinuria (protein in the urine). Antibody titers may initially be negative, therefore repeat testing may be needed at 2-week intervals; however, a single initial high titer may be diagnostic, if vaccination has not been recently done. PCR testing (for bacterial DNA) is now widely available, however, false negatives can occur as the organism may be only intermittently present in urine or blood. PCR testing is not accurate after antibiotic therapy has been started.
Inpatient treatment is often necessary for dogs with impaired kidney or liver function, including intravenous fluids, antibiotics, anti-nausea medications, and nutritional support. Initial therapy with ampicillin or penicillin antibiotic is followed by treatment with oral doxycycline antibiotic to clear the carrier state of the organism.
Prevention of Leptospirosis is accomplished through routine vaccination, boosted annually. Puppies can begin Leptospirosis vaccination series as early as 12 months of age. Talk with your veterinarian about the risk of Leptospirosis in your area and if vaccination might be a good choice for your dog.
Mange is a term used for a range of skin diseases characterized by poor coat and skin condition. Mange is caused by a range of common exoparasites called mites, found mainly in companion dogs. Some species of these mites are normal residents of your pet whereas others are not. Their favorite place to reside is in the skin and hair follicles. If they are allowed to proliferate out of control, all mites can cause skin infections which can become severe if not treated. Because mites belong to the Acari (a subclass of arachnids) another term sometimes used for mite infestation is “acariasis”.
There are two major groups of mites that can infest your pet. These are Sarcoptes species, which burrow into skin, and Demodex species, which live in skin follicles.
Sarcoptic mange, also known as “canine scabies”, is caused by the Sarcoptes scabiei mite This is a microscopic mite that is oval-shaped and light-colored. They are easily transferred between hosts. The canine sarcoptic mite can also infest cats, pigs, horses, sheep, and various other species. They cause itching due to their movement while burrowing through the skin. Hair loss and crusting usually occur, often seen first on the elbows and ears. Intense scratching and biting can cause skin damage, and secondary skin infections are common.
Demodectic mange is also called “demodicosis”, “demodex” or the “red mange”. It is indirectly caused by the Demodex canis mite. This is a species of mite that is naturally present on almost all dogs. They are transferred from the mother to her pups during suckling and close contact in the first few days of life. Normally, the immune system and scratching/biting behavior of your pet are able to cope with the natural population of mites and many dogs never suffer any consequences. However, if the animal has a compromised immune system and develops hypersensitivity to the mite, mange can begin.
Demodex canis is not the actual cause of mange, rather, it is due to a bacterium called Staphylococcus epidermidis. The demodex mite dilates the follicles and sweat-glands on your pet’s skin allowing the bacterium to enter the body. Demodex canis possibly also carries and introduces the bacterium.
Three types of demodectic mange are recognized:
Localized mange – occurs when the mites proliferate in only 1 or 2 (some say up to 4) small, confined areas, usually on the animal’s face. The resulting isolated, scaly, bald patches look like a polka-dot pattern. Localized demodicosis is common in puppies and approximately 90% of cases disappear without any treatment.
Generalized demodectic mange – affects larger areas of skin, sometimes the entire body. This becomes extremely itchy if there are secondary bacterial infections. The skin may also become foul-smelling. This form of mange can indicate underlying health problems or risk factors such as a compromised immune system, hereditary predisposition, or an endocrine problem. The course of treatment for the dog depends on the age at which the disease develops.
Demodectic pododermatitis – is a type of mange confined to the foot and is often accompanied by bacterial infections. It is one of the most resistant forms of mange. To make an effective diagnosis, deep biopsies are often required.
Transmission of sarcoptic mange mites usually requires direct host-to-host contact. Although mites can live off a host and in the environment for several weeks, they are infective for only 36 hours.
Although demodex mites are relatively easily transferred from one dog to another, it requires direct physical contact. In healthy animals, transmission of the mites simply adds to the dog’s natural population and there is no resulting skin disease. Even for severe cases, isolation of dogs is usually considered to be unnecessary. It is very rare for demodex mites to be transmitted to humans or cats.
The symptoms of mange vary, depending on the type of mite causing the disease.
Sarcoptic mange can cause extremely intense itching. It can result in listlessness and frantic scratching, gradually increasing over several days. It also can result in hair loss (alopecia), reddened skin, sores and crusty scabs. In dogs, the most commonly affected areas are the ears, elbows, face and legs. In severe cases, it can spread rapidly over the entire body. Sarcoptic mange in humans causes a rash of red bumps, similar to mosquito bites.
Demodectic mange causes hair loss, bald spots, scabbing and dry sores. Secondary bacterial infections can make the dog extremely itchy and uncomfortable. Demodectic mange is not transmitted from dogs to humans. Demodex in pets can be detected by:
Itching, bald patches, particularly around the mouth and eyes
Itching, bald patches on the body and legs – spreading to cover the entire body
Thick discharge from the ears, particularly in cats
Leathery or wrinkly skin
A veterinarian will perform a physical exam of your pet and if necessary, take skin scrapings and examine these with a microscope to confirm the presence of mites. If the mites are buried deep in the skin, they can be difficult to identify. In such cases, the veterinarian may rely on your pet’s history and clinical signs to make a final diagnosis.
Localized demodectic mange: Puppies and dogs less than 18 months old are especially prone.
Generalized demodectic mange: Can be hereditary in dogs. Some breeds, such as the Dalmatian, American Bulldog and American Pit Bull Terrier appear to be more susceptible. Older dogs with an underlying illness are also more prone.
Demodectic pododermatitis: The Old English Sheepdog and Shar Pei are particularly prone.
The medication given to your dog will depend on various factors such as the type of mange and the breed of dog. Medication may be given orally, by injection, by shampoo or dip, or applied topically (locally). It is important to realize that many skin treatments can be toxic to dogs. They should not be repeated frequently. Check with your vet before beginning any mange treatment program.
When treating sarcoptic mange, the first step is to isolate your dog to prevent the disease spreading to other pets (and humans). It is likely your vet will prescribe antiparasitic medications to eradicate the mites, as well as separate medications for easing itching, reducing inflammation and treating secondary skin infections. The results of such treatment are usually seen after 4 weeks
Demodectic mange is treated not only by medications but also by managing physiological stress to improve your pet’s immune system. To prevent secondary skin infections, some dogs may also require additional treatments, for example, medicated shampoos.
Younger dogs often fully recover from mange. In contrast, adult dogs often require long-term treatment and therapy to control the disease. It has been suggested that because demodectic mange is thought to be hereditary, dogs with the disease should not be bred.
Whichever treatment option is used, this should be accompanied by skin scrapes every 2 weeks. Usually, medication is discontinued after 2 consecutive scrapes are negative. A final scrape should be performed 4 weeks after treatment to check there has not been a recurrence.
Sarcoptic mange: Thoroughly clean or replace the bedding and collar. Treat all animals in contact with your pet. Keep your pet away from animals you suspect might have the disease. Get periodic skin scrapes to ensure the mites have been eradicated.
Mitral Valve Disease
Mitral valve disease (MVD) is the most common cardiac problem encountered in small breeds of dogs; with increased prevalence in certain breeds such as Cavalier King Charles Cocker Spaniels, Boston Terriers, Miniature Poodles, Chihuahuas and Pomeranians. Males are affected more than females.
The mitral valve is located between the left atrium and left ventricle, and it regulates the flow of blood from the atrium to the ventricle during the cardiac cycle. The valve leaflets are tethered via structures called chordae tendinae to the papillary muscles, located in the left ventricle. During systole (contraction) the ventricles contract and push blood into the aorta and pulmonary artery; during this phase of the cardiac cycle, the mitral valve (and tricuspid valve) are closed. In mitral valve disease (also referred to as A-V valve insufficiency), the mitral valve leaflets develop degenerative changes, and do not close properly during systole. This leads to regurgitation of blood backward from the left ventricle into the left atrium, causing circulatory overload of the left side of the heart. Over time, dilation of the chambers (eccentric hypertrophy) ensues, and decline in contractile function results in congestive heart failure.
Many pets with MVD are asymptomatic. Early signs of disease may include heart murmur, cough, and reduced exercise tolerance. In late stages of disease with congestive heart failure, patients develop respiratory distress due to pulmonary edema, weakness due to hypoxia, and weight loss. Untreated, congestive heart failure leads to death.
Diagnosis of MVD is accomplished through correlating physical exam findings (left sided heart murmur, with or without other symptoms such as cough, exercise intolerance, etc.), thoracic radiographs, and echocardiography. Care must be taken to differentiate concurrent primary pulmonary disease in patients with cough, vs. cough secondary to MVD, as medical management will depend on the reason for the cough. Coughing in patients with MVD, without evidence of left atrial enlargement, and without radiographic evidence of pulmonary edema, is indicative of a concurrent independent respiratory disease.
Classification of Disease
Treatment of patients with MVD is stratified based on classification of disease. The current recommended classification system for canine MVD was developed in 2009 and is referred to as the ACVIM Consensus Classification System.
Class A patients are those who have high risk of MVD but no cardiac changes or symptoms.
Class B patients include those who have structural disease but do not have clinical signs. Class B patients are further differentiated into Class B1 (no left sided heart enlargement) and Class B2 (left sided heart enlargement present).
Class C patients have had, or currently have, symptoms of congestive heart failure.
Class D patients have end stage disease and have failed standard treatment protocols.
Controversy exists as to whether treatment of Class B patients is of benefit. For Class C patients, treatment with furosemide and/or spironolactone, angiotensin converting enzyme inhibitor drugs, and pimobendan can significantly improve symptoms and aid in control of disease. Patients presenting in acute congestive heart failure with marked dyspnea should be hospitalized for intensive care which may include oxygen therapy, injectable furosemide, and additional supportive care as warranted. Average survival time after diagnosis of congestive heart failure is typically 6-14 months dependent on severity of heart disease.
Pet Obesity is a growing epidemic in the United States and worldwide. According to the Association for Pet Obesity Prevention, over half of all pets in the U.S. were obese in 2015. The data were obtained through statistics collected from over 100 veterinary clinics on over 1200 pets, via body condition scoring at the time of routine wellness exams.
Repercussions of Obesity in Pets
Being overweight has health repercussions in pets just as it does in people. Arthritis, heart disease/failure, urinary tract disease, diabetes, asthma, and other health conditions are secondary issues that affect overweight and obese animals more commonly. Additionally, the lifespan of obese or overweight dogs is reduced by nearly 2 years compared to healthy-weight dogs. The Purina Lifespan study evaluated the longevity of dogs fed the exact same diet over 14 years; the lean-fed dogs were fed 25% less and lived an average of 1.8 years longer than their overweight counterparts.
Assessing Your Pet’s Body Condition
There are several helpful tools to assess your pet’s body condition. The 9-point Purina Body condition Scoring Chart is a great visual tool to reference. Another simple, but effective tool is to palpate your pet’s rib cage and compare to your hand:
- Top of the knuckles – there is too little fat; your pet is underweight
- Fleshy part of the base of the thumb – there is too much fat; your pet is overweight
- Palm-side of the base of each knuckle – there is just the right amount of fat, your pet is at ideal, or near ideal body weight
When your pet is overweight or obese, developing a plan of action together with your veterinarian, and the entire family, is the best thing to do. Fortunately, it’s a lot easier to control what your pet eats, than to control what you eat! There are several measures you can take to start getting your pet back to a healthier weight:
- Make a list of what you feed your pet including type(s) of food, treats, feeding portions, and feeding schedule (free feeding, meal feeding, etc.). Review this with your veterinarian. Meal feeding (set portions and set times) is often a more effective way of weight management vs. free choice feeding.
- Determine the current body weight, and target body weight, for your pet with the assistance of your veterinarian.
- For weight loss, most veterinarians advise a 20 – 25% reduction in caloric intake. This includes any dry food or wet food, treats and human food. The easiest thing to do is to greatly reduce or eliminate all treats and substitute healthy alternatives. Many dogs do enjoy vegetables and certain fruits as well, but consult with your veterinarian about what is safe to give your pet. Your veterinarian can help calculate the amount of calories your pet should get daily for maintaining current weight, vs. weight loss.
- For pets that will not eat a commercial diet, or if your pet has special nutritional needs due to a health condition – consult your veterinarian on the best course of action. They may recommend a consultation with a veterinary nutritionist, or other sources to make sure your pet receives proper nutrition in their diet.
- Discuss the weight loss plan with the family and make sure everyone is on board.
- Develop a regular exercise routine with your pet, working with your veterinarian to assess what is most appropriate for your pet’s age and health status.
Canine Parvovirus (CPV), sometimes simply called “Parvo”, is a viral illness that exists in 2 forms. Intestinal CPV is the more common form. This is characterized by vomiting, diarrhea, weight loss and anorexia (lack of appetite). The second less common form is cardiac CPV. This affects the hearts of puppies in the uterus or up to 8 weeks of age and is often fatal. CPV is highly contagious, although the incidence of infections has been considerably reduced by early vaccination of puppies.
SYMPTOMS AND TYPES
The first sign of CPV is usually lethargy. The next symptoms are generally a loss of appetite or diarrhea, followed by vomiting.
The intestinal form of CPV drastically reduces the dog’s ability to absorb nutrients. This means that infected animals quickly become dehydrated and weak from a lack of protein absorption. The major symptoms of CPV are severe bloody diarrhea, fever, vomiting, lethargy, anorexia and eventually, severe weight loss. The mucous membranes of the eyes and mouth often become redder and the animal may have tachycardia (rapid heart rate). Infected dogs may respond with pain or discomfort when the abdomen is touched. Another symptom of CPV can be hypothermia (low body temperature) rather than fever.
The cardiac form attacks the heart muscle and the puppy often dies suddenly or after a brief period of breathing difficulty due to the collection of fluids in the pulmonary system. This disease may or may not be seen in conjunction with the signs and symptoms of the intestinal form. However, the cardiac form is now rarely seen due to vaccination of breeding dogs.
CAUSES AND RISK FACTORS
There are several risk factors that can increase susceptibility to CPV.
The virus is usually transmitted either indirectly from the feces of an infected dog, or directly by contact with an infected dog. The feces of an infected dog have high concentrations of the virus, so when a healthy dog sniffs or ingests infected feces, it may contract the disease. The virus can also reside in the soil and on small items within the environment (fomites); it will be transmitted if these are ingested. Transmission of the virus to a dog’s environment can also occur from shoes that have contacted infected feces or fomites. This is an important route of transmission as the virus can live in the ground for up to 1 year. It is also resistant to most cleaning products and weather changes. If there is a possibility that infected feces have been contacted, the suspected areas should be washed with household bleach, the only disinfectant known to kill the CPV virus.
CPV infections can also be caused by improper vaccination protocols or vaccination failure. Establishments that house a large number of inadequately vaccinated puppies (e.g. some breeding kennels, dog shelters) are particularly hazardous places with respect to transmission. Dog breeds that have a high susceptibility to the virus include German Shepherds, Rottweilers, Pit Bulls, Doberman Pinschers, English Springer Spaniels, Labrador Retrievers and Alaskan Sled Dogs. A poor immune system from immuno-suppressive diseases or drug therapies can also increase the possibility of infection.
Diagnosis of CPV requires a range of techniques. This will usually start with a physical examination of the dog. If required, biochemical tests and urine analysis will reveal any elevated liver enzymes, lymphopenia (low lymphocyte levels) or electrolyte imbalances. The blood tests will give a chemical blood profile and a blood cell count. Radiograph imaging will show any obstruction of the intestine while ultrasound imaging can reveal enlarged lymph nodes within the body and any fluid-filled sections of the intestine.
The veterinarian will require a thorough history of the dog’s health, recent activities and when the onset of symptoms occurred. Samples of feces or vomit can be examined and used microscopically for detection of the virus.
Because CPV is a viral infection, there is no cure for it. Treatment is aimed at controlling the symptoms and preventing secondary infections. The dog will require intensive therapy for its bodily systems to recover. Severe diarrhea and dehydration will be treated by intravenous fluids to re-establish and maintain normal body fluid levels. Nutrition therapy is critical in re-establishing protein and electrolyte levels which will then need to be monitored and regulated.
Several medications may be given to your dog to treat symptoms or prevent further complications. These include antiemetics to reduce vomiting, H2 blockers to reduce nausea, antibiotics to prevent secondary infections and anthelmintics to prevent parasitic infections.
Untreated cases of CPV have a mortality rate of 91%. With aggressive therapy, mortality rates are reduced to 5-20%. When death occurs, this is usually due to severe dehydration, secondary bacterial infections, toxins in the blood from bacteria, or severe bleeding from the intestines. Because puppies have a less developed immune system, their prognosis is usually poorer. Puppies that are infected with CPV commonly suffer from shock and sudden death.
LIVING AND MANAGEMENT
During recovery, it is best to feed your dog a form of diet that is easily digested. After the initial recovery, your dog will be a contagion risk to other dogs for possibly 2 months. Therefore, you should isolate your dog from others. In addition, you should consider telling your neighbors that they may need to have their own pets tested. Wash all objects that your dog uses (e.g., toys, kennel, sleeping box, dishes) with a very dilute bleach solution (1:30 ratio) to disinfect and kill the parvovirus.
Having suffered and recovered from a CPV infection, it is likely your dog will have a weakened immune system making it more susceptible to other illnesses. Talk to your veterinarian about how the dog’s immune system can be made as normal as possible and ways in which you can protect your dog from unhealthy situations. Complete recovery means your dog will have long-term immunity against the virus, however, it is still possible that your dog can again be infected with the virus.
To prevent CPV infection, the best course of action is to follow the correct vaccination protocol. Puppies should be vaccinated at 6, 9 and 12 weeks of age, and should not be allowed contact with outside dogs until at least 2 weeks after the last vaccination. Breeds with a high susceptibility to CPV may require a longer initial vaccination period, possibly up to 22 weeks.
Rabies is caused by a group of viruses (lyssaviruses) which can infect all warm-blooded animals. Rabies can also infect humans, which is probably why it is one of the most well known viruses; Worldwide, 1 person dies from rabies every 10 minutes. The virus has its devastating effects by causing inflammation of the brain. The delay between contracting the disease and the first symptoms is usually 1 to 3 months, however, it can vary from less than 7 days to more than one year. The delay is dependent on the distance the virus must travel through the body to reach the central nervous system of the newly infected animal.
The transmission of rabies is almost exclusively the result of an infected animal biting a non-infected animal. Rarely, it can also be transmitted by scratches or infected saliva falling on the mucous membranes of the non-infected animal. Amongst wildlife, foxes, coyotes, skunks, raccoons and bats are most likely to transmit the virus. It has been reported that in caves containing many infected bats, transmission of the virus has resulted from aerosolization. The rabies virus does not live for long outside the host. For example, it remains viable for less than 24 hours in the carcass of an infected animal. The saliva of an infected animal contains high concentrations of the virus, however, being bitten by an infected animal does not necessarily mean that the bitten animal, or human, will become infected.
After infection by the rabies virus, the bitten animal may go through one or all of several stages. Initial symptoms include itchiness at the site of infection and fever. Usually, the virus spreads along the peripheral nerves of the animal towards the brain. The virus is relatively slow moving. The average time between exposure to brain involvement is between 3 to 8 weeks in dogs, 2 to 6 weeks in cats, and 3 to 6 weeks in humans. However, incubation periods as long as 6 months in dogs and 12 months in humans have been reported. Once the virus reaches the brain, it then moves to the salivary glands where it can be transmitted to another animal through a bite. After the virus reaches the brain, the animal will show one or more of 3 distinct phases.
The first phase is known as the “prodromal phase”. In dogs, this usually lasts for 2 to 3 days. Behavioral changes such as apprehension, nervousness, anxiety and solitude may become noticeable, and a fever may develop. Animals that are normally friendly may become shy, irritable and may even snap or nip. On the other hand, normally aggressive animals may become very affectionate and docile. The site of the bite will receive much attention from the animal with constant licking and perhaps rubbing. In cats, the prodromal phase is a little shorter than for dogs as it lasts for only 1 to 2 days. Cats also usually experience more fever spikes and changes in behavior than dogs.
After the prodromal phase, infected animals may enter what is called the “furious stage”. Cats are particularly susceptible to developing this phase. In dogs, the furious stage usually lasts for 1 to 7 days. Animals are restless, irritable and become hyper-responsive to auditory or visual stimuli. As the restlessness increases, the animal begins to wander, progressively becoming more irritable and vicious. If caged, rabid animals may bite and attack their enclosure or its contents. Animals become progressively more disoriented, begin to have seizures and eventually, they will die.
Some animals may develop a third phase, the “paralytic phase”. This occurs either after the prodromal or furious stage. The paralysis is produced when the virus attacks motor neurons. This phase usually develops within 2 to 4 days after the first symptoms of rabies are observed. The nerves affecting functions of the head and throat are usually the first to be involved. Animals may become unable to swallow and as a result begin salivating. As the muscles of the diaphragm and face become increasingly paralyzed, the animal may show deep labored breathing and a dropped jaw. The animals may make a choking sound, as if there is something lodged in the throat. By progressively losing muscular control, the animal gets weaker, eventually going into respiratory failure and subsequently, it dies.
The current method of diagnosing rabies is a microscopic examination of the brain. There are new techniques being developed which use skin or blood samples as a method of testing potentially exposed animals (and humans), although they are not yet being used routinely.
As a precaution, if your pet is bitten or scratched by any carnivorous wildlife (including bats) that is not available for testing, your pet should be considered as having been exposed to rabies. The bitten pet should be placed into complete isolation for 6 months. One month before being released, your pet should be vaccinated. If your pet’s vaccination has expired, it will need to be to be evaluated on a case-by-case basis. Dogs and cats with current vaccinations are kept under observation for 45 days if they are bitten.
If an animal bites a human and it is suspected that the animal may have rabies, the animal will either be quarantined, or observed for at least 10 days to monitor for symptoms that indicate it has rabies. Other factors will affect the requirements of the quarantine such as whether or not the biting animal was currently vaccinated, and the legalities and local concerns of the community in which you live.
Humans that have been bitten by a potentially rabid animal are usually given post-exposure vaccinations and a globulin (antibody) injection to protect them from becoming infected. If you are bitten by any animal that might have rabies, you should immediately wash the wound thoroughly for 15 minutes with soap and water and then seek medical attention.
Currently, there is no treatment for rabies. Only a small number of people have survived rabies and this required extremely intensive medical care; if the disease develops in humans, death is almost certain. Similarly, although there are reported cases of dogs surviving rabies infection, these are extremely rare.
VACCINATION AND PREVENTION
To prevent infection by the rabies virus, animals must be vaccinated. If done correctly, this provides a very high level of protection. Although vaccination for rabies is mandatory for dogs in all states, it is estimated that 50% are not vaccinated. Some communities also require cats to be vaccinated. This is very important because currently, there are a greater number of cats being infected by rabies than dogs. It has been estimated that less than 10% of cats are vaccinated and this is causing the high incidence of cat rabies.
The standard protocol to vaccinate cats and dogs is a first injection at 3 to 4 months of age and then again at one year of age. A year later, your pet can be given a 3-year vaccination which has proven to be very effective. The veterinarian can explain their recommendations for your pet.
Roundworms, also called ascarids, are one of the most common intestinal parasites of companion animals. Toxocara Canis, Toxascaris leonina, and Bayliascaris procyonis are the three species recognized as causing infections in companion animals. Roundworms are easily distinguished from other intestinal parasites by their appearance; adults are often elongated and tan in color, with 3 lips at the anterior end. Roundworms are capable of infecting dogs and cats, as well as numerous other mammalian hosts.
Ingestion of non-embryonated eggs, ingestion of paratenic hosts infected with larvae, or transplacental infection from dam to fetus, are the methods by which infection is spread. Eggs of Toxocara shed in feces become infective within 2-4 weeks, by which time fecal material is degraded and no longer apparent. Ascarid eggs are quite hardy and capable of surviving long periods of time in the environment. When larvated eggs or hosts with somatic larvae are ingested, the larvae migrate through the liver and lungs, eventually to be coughed up and swallowed, where they complete development in the intestinal tract. The entire life cycle can be completed in 2-4 weeks depending on whether eggs or larvae are ingested. In the case of transplacental infection, larvae migrate to the lungs and liver of the fetus, where they wait until after birth to complete migration and development in the intestinal tract of newborn pups.
Symptoms are most commonly observed in young pups with heavy worm burdens, and include poor thrift, poor haircoat, pot belly appearance, diarrhea, and in some cases vomiting of adult worms. Adult dogs often remain asymptomatic but continue to shed eggs into the environment. For Balyascaris, symptoms may also include neurologic signs, as the larvae tend to migrate to the central nervous system.
Roundworms are considered a zoonotic parasite, and can result in several health problems when humans are infected. Infection rate appears highest in areas of poverty with larger populations of free-roaming dogs. Larvated eggs can be commonly found in soil at playgrounds and parks. When infective eggs are ingested, children can develop a variety of health problems including visceral larval migrans, ocular larval migrans, and neural larval migrans.
Diagnosis of roundworm infection in companion animals is usually accomplished via fecal centrifugation testing. The Companion Animal Parasite Council recommends that pups and kittens be tested two to four times during their first year of life, and once to twice annually depending on lifestyle and risk factors.
Several drugs are approved for the treatment of roundworms in cats and dogs, including pyrantel, febendazole, milbemycin and moxidectin. The Companion Animal Parasite Council recommends that all pups have a deworming series, starting at 2 weeks of age and twice weekly for a minimum of two and up to four treatments, and then beginning a monthly preventive product.
Prevention of roundworm infections involves measures such as routine deworming of pups and kittens, and monthly preventive for adults, as well as decontamination of the environment by removal of feces. Regular screening for parasites is also conducive to detection of occult infections. Enforcement of leash laws, and restricting predation also reduce roundworm incidence by decreasing contamination of soils at public areas and reducing ingestion of infected paratenic hosts. For more information about roundworms, please visit www.capcvet.org/guidelines/ascarid/.
Systemic Fungal Diseases
Blastomycosis, Histoplasmosis, Coccidiomycosis and Cryptococcosis are systemic fungal diseases which can cause serious illness and death, in both animals and people. Collectively these are known as dimorphic fungi, meaning they have two physical forms – spores and yeast. Spores are the infective form and reside in the environment; infection occurs when spores are inhaled. Once in the body, the spores develop into yeast.
Blastomyces spores are found in decaying organic matter, soil and leaf litter. Histoplasma spores are most frequently found in bat droppings. Coccidiomyces spores are found in dust and soil, and Cryptococcus spores in bird droppings and soil.
Each of these fungal infections can cause various symptoms. The respiratory tree is the initial site of infection. Inhaled spores transform to yeast; which are taken up by macrophages. Infection can then disseminate via lymphatics and blood to other locations such as lymph nodes, eyes, nervous system, skin, and abdominal organs. Granulomatous inflammation ensues at the sites of yeast dissemination.
Symptoms of these fungal infections are quite variable and may include:
- weight loss
- appetite loss
- and draining skin lesions
Histoplasmosis may cause chronic gastrointestinal symptoms in dogs. Respiratory disease is common in patients with Blastomycosis, and prognosis is poor in patients with severe respiratory infection and hypoxemia. Ophthalmic infections may result in permanent blindness resulting from uveitis, secondary glaucoma, and retinal detachment. Cryptococcus most frequently causes chronic nasal disease in cats.
Diagnosis of these fungal infections may be accomplished via cytology of affected tissues (enlarged lymph nodes or draining skin lesions may contain yeast organisms) and antigen testing of blood or urine. In patients showing symptoms consistent with these systemic fungal infections, laboratory testing including complete blood cell counts, blood chemistries, urinalysis and thoracic radiographs are helpful in assessing extent of disease.
Treatment of affected animals usually requires prolonged treatment with systemic antifungal drugs. Historically itraconazole had been the treatment of choice, however cost of treatment is often prohibitive and therefore other azoles such as fluconazole are utilized. For pets with severe respiratory compromise, hospitalization and treatment with intravenous amphotericin in conjunction with azole therapy is needed. Fungal infections may relapse after treatment and apparent resolution. Repeated antigen testing is helpful in assessing response to treatment and when therapy can be discontinued, as antigen levels should decline with successful treatment.
Tapeworms are a common parasite of cats and dogs, as well as other mammals, birds, fish, amphibians, reptiles and humans.
Tapeworms are a common parasite of cats and dogs, as well as other mammals, birds, fish, amphibians, reptiles and humans. Tapeworms are comprised of proglottids (segments) forming a strobili (length of multiple proglottids). The head, or scolex, of the tapeworm has hooks or suckers which attach to the lining of the intestine, where they feed on nutrients of their host. New proglottids are formed sequentially, with the oldest proglottids at the tail end of the strobila (length of the joined proglottids). The oldest proglottids are essentially egg packets, which pass through the feces of the host. Tapeworm species typically have a life cycle involving an intermediate host, in which ingests the eggs, which in turn develop into larvae or cysts. Larvae or cysts are then ingested by the definitive host, in which they undergo development and attach to the lining of the intestine.
Species of tapeworms most commonly found in dogs and cats include:
- Dipyllidium caninum – fleas are the intermediate host for this tapeworm; cats and dogs become infected by ingesting fleas on their own coat, or by ingesting fleas on other animals including prey animals like mice and other rodents.
- Taenia taeniaeformis – mice, rats and other rodents are the intermediate host for this tapeworm, which most often infects cats.
- Taenia pisiformis – rabbits are the intermediate host; dogs are usually the definitive host
- Echinococcus multilocularis – rodents are the intermediate host; cats and dogs are the definitive hosts; this tapeworm is most often identified in the Midwest
- Echinococcus granulosus – sheep, goats, cattle and other ungulates are the intermediate hosts; wild dogs are often the definitive host
- Diphyllobothrium caninum – fish are the intermediate host; dogs and cats are the definitive host
- Spirometra mansonoides – frogs, rodents and snakes are intermediate hosts; dogs and cats are the definitive hosts. This tapeworm is most often identified in the Eastern states/Gulf Coast region.
Some species of tapeworms can infect humans. Infants and young children are most at risk.
In pet cats and dogs, tapeworms rarely cause signs of illness. Occasionally, pet owners notice the proglottids around the pet’s anus or in fresh stool samples. In cases of heavy worm burdens, weight loss or poor hair coat quality may be present.
Diagnosis of tapeworm infections is done through finding proglottids passed in stool samples, and by performing fecal centrifugation testing. However, tapeworm eggs may not be shed consistently, therefore false positive fecal tests may occur.
Treatment of tapeworm infections is most commonly done with praziquantel administered as a single dose, however, Spirometra and a few other tapeworm species require off-label dosing of the drug.
Prevention of tapeworms is best accomplished by controlling and preventing flea infestations, keeping pets from eating rodents, dead animals or garbage, and use of regular heartworm preventives containing praziquantel.
Ticks are a type of parasite belonging to the class Arachnida, which differ in many regards from insects in that they have eight legs rather than 6, and two body segments rather than three. Ticks are obligate parasites in that they cannot survive or complete their life cycle without a host to feed on. There are two major groups of ticks – hard-shelled ticks (Ixodidae), and soft-shelled ticks (Argasidae). There are several anatomic differences between the two groups, however, the most notable difference is that the hard-shelled ticks tend to remain attached to their hosts for hours or days, whereas the soft shelled ticks take a short blood meal and drop off.
Ticks are found in general where their hosts are found and prefer more humid climates. They feed on a variety of species of mammals, birds, and reptiles and some amphibians. They are obligate blood-feeders. Ticks cannot fly or jump but instead crawl toward their prey. They are able to detect odors, chemicals, temperature, and airflow changes via “Haller’s organs” on their legs. Ticks waiting for hosts to attach to climb on grass or other vegetation and outstretch their front legs to help sense when a potential host is approaching; this is called “questing.”
Contrary to popular belief, ticks can survive through the winter by becoming dormant and hiding in leaf litter, or by attaching to a host. Some tick species can survive over a year without a blood meal.
Ixodidae (hard shell) ticks bite by making a cut in the skin, injecting a secretion with an anticoagulant or anti-platelet factor, and then sucking blood via their hypostome. Blood feeding is required in order for the completion of the life cycle stages. In hard-shell ticks, there are four life stages: egg, larva, nymph, and adult. The larva can be distinguished from adults in that they have six legs rather than eight. In soft shell ticks, there are seven nymph stages (instars). Each stage is completed on a different host.
RISK OF DISEASE
Ticks are carriers of several infectious diseases, including viruses, bacteria, and protozoa. Many of these can cause serious illness in animals and humans. Lyme disease is perhaps the most well known, however, others include rickettsial diseases such as typhus and Rocky Mountain Spotted Fever, and also Q Fever, Ehrlichia, Anaplasmosis, Babesia, Tularemia, and others. Tick paralysis is another disease caused by ticks, which is not due to any viral or bacterial cause, but rather neurotoxins secreted by the tick.
The primary tick species affecting dogs and cats are the Deer Tick (Ixodes Scapularis), the Brown Dog Tick (Rhipicephalus Sanguineus), the Lone Star Tick (Amblyomma Americanum), and the American Dog Tick (Dermacentor variabilis). Of these, the Brown Dog tick has the unique ability to complete its entire life cycle indoors.
REMOVAL AND PREVENTION
Removing a tick is best done with a removal tool or tweezer. If pieces of the mouthparts or head are left behind, they can be removed similar to how a splinter would be removed.
Preventing ticks is best accomplished through the use of permethrin products on clothing during outdoor activities, and for pets, using a product recommended by your veterinarian, at the specified dosage, frequency, and duration.
Urinary incontinence is the involuntary leakage of urine, or inability to control urination. It occurs in dogs and cats of any life stage for various reasons.
Pet owners may notice urinary accidents in the home as the primary symptom. Since incontinence is only one potential reason for urinary accidents, it is important to carefully document when urine accidents are happening, whether the pet is cognizant of the urine leakage, if there is a pattern, and if there are any lower urinary signs such as urgency to urinate, frequent urination of small amounts, or blood in the urine.
Incontinence in Young Animals
In young animals, urinary accidents can be the result of incomplete house training vs. a variety of medical problems, including congenital abnormalities of the urinary tract, urinary infections, estrogen-associated urinary incontinence in dogs spayed at a young age, and trauma to the spine/pelvis.
Incontinence in Cats
In cats, incontinence is rare and usually associated with retroviral infection (Feline Leukemia/FIV). However, in cats, urinary accidents or inappropriate urination are a common symptom of feline lower urinary tract disease, and inappropriate elimination must be distinguished from incontinence.
Incontinence in Adult & Senior Animals
In adult or senior dogs and cats with recent onset of symptoms, leakage may result from sphincter-mechanism incompetence (most common in older female dogs, due to reduced tone of the urinary sphincter), diseases causing increased thirst and urination (diabetes, Cushing’s disease), trauma, or disorders affecting neurologic components of the control of micturition (voiding).
Voluntary control of urination is a complex reflex pathway involving the brain, spinal cord, autonomic nervous system, nerves innervating the bladder and urethra, and muscles of the bladder and urethra. Disorders affecting control of urination can originate in any part of the pathway. These may be congenital or developmental, degenerative, cancerous, inflammatory or infectious, or trauma induced.
Diagnostic evaluation of pets with urinary incontinence may include the following:
- Serial urinalysis evaluation and urine culture
- Laboratory testing to assess for underlying issues such as kidney disease, diabetes, and Cushing’s disease; FeLV (feline Leukemia virus) and FIV (feline immunodeficiency virus) in cats
- Diagnostic imaging such as radiology, ultrasound, contrast studies, CT or MRI
- Urethroscopy and urethral pressure profiles
Treatment of urinary incontinence is ultimately dependent upon the underlying disorder. Congenital/developmental abnormalities such as ectopic ureter (abnormality of anatomy in which ureter(s) terminate in the urethra rather than the urinary bladder) require surgical correction.
“Pelvic bladder” is another anomaly which may be treated with a combination of drug therapy and surgical options such as colposuspension and injection of collagen into the urethral sphincter. Estrogen associated urinary incontinence in young females spayed at an early age is responsive to treatment with diethylstilbesterol, an estrogen analog. Pets with spinal or pelvic trauma may recover some ability to control urination given time and physical therapy. In patients with urine leakage secondary to diabetes or Cushing’s disease, therapy aimed at treating the underlying disorder (trilostane for Cushing’s disease, insulin for diabetes) often resolves urine leakage. In adult or senior pets with reduced urethral sphincter function, drug therapy with phenylpropanolamine is often helpful.
Ultimately, though there are many potential reasons for urinary incontinence, your pet can benefit from thorough diagnostic evaluation and treatment under the care of your veterinarian.
Vestibular Disease is also known as “Old Dog” Syndrome. Most mammals gain their sense of balance and spatial orientation from organs in the inner ear and parts of the brain, collectively called the “vestibular system”. If the vestibular system becomes diseased, this affects the ability of the animal to balance itself. There are two forms of vestibular disease. The most common form is peripheral vestibular disease which arises from disorders affecting the inner ear and nerves (i.e. not the central nervous system). The second form, called central vestibular disease, is a much less common condition although it is considerably more serious as it originates within the central nervous system. Both forms result in the animal experiencing a loss of balance and other symptoms of vertigo and dizziness. This disease can appear extremely dramatic to dog owners, particularly the first time the symptoms are observed. However, most cases improve quickly with appropriate care, treatment and addressing the causes of the condition.
Peripheral Vestibular Disease
Peripheral vestibular disease results from irritation of the nerves connecting the inner ear to the brain. This irritation can arise from several causes:
Chronic and recurrent infections of the inner and middle ear
Overzealous cleaning of the ears
Trauma from head injury
Drugs like the aminoglycoside antibiotics, including amikacin, gentamicin, neomycin and tobramycin.
Ear cleaners that should not be used with ruptured eardrums
Congenital defect (present from birth)
Peripheral vestibular disease can also be idiopathic, meaning the cause has not been identified. Infection of the middle ear is the most common cause of the disease in younger dogs; in older dogs, brain tumors may be the cause of the disease.
Central Vestibular Disease
Causes of central vestibular disease include:
Bleeding in the brain
Loss of blood flow
SIGNS AND SYMPTOMS
Signs of vestibular disease include:
Abnormal posture, e.g. leaning or head tilt (towards the side of the problem)
Asymmetric ataxia, i.e. “drunken” gait (worse on the side of the problem)
Circling/deviating (towards the side of the problem)
Nystagmus–involuntary, rhythmic, jerking eye flicks–the slower flick is towards the side with problem)
Vomiting (motion sickness)
Dizziness and loss of balance can cause excessive drooling, sometimes with nausea and vomiting. If only one ear is affected, circling and head-tilting is usually in the direction of that ear and only the eye on that side may develop nystagmus.
Congenital vestibular disease is usually apparent before 3 months of age. Breeds that are predisposed to this condition include the Akita, Beagle, Doberman pinscher, German shepherd, English cocker spaniel, Smooth fox terrier and the Tibetan terrier.
Vestibular disease in old dogs is often mistaken for the animal having a stroke. The signs of vertigo caused by the disease can be more intense in older dogs which may show a complete inability to stand, nausea and circling. The disease in old dogs can make eating and drinking, or even going outside to urinate or defecate, very difficult, if not impossible. Therapy is likely to be needed in the form of intra-venous fluids and supplemental nutrition.
A physical examination and neurological assessment will ascertain if the vestibular disease is of the peripheral or central form. If the peripheral form of the condition is identified, your veterinarian will likely use an otoscope to look deep into your pet’s ears. Sometimes, x-rays are needed to assist the diagnosis. Other screening methods such as blood tests, culture and sensitivity, and cytology will help eliminate other potential causes of specific symptoms. Your veterinarian may also recommend a biopsy of any polyps or tumors that are found. If central vestibular disease is diagnosed, MRI or CT scans are likely to be recommended. Additional tests include cerebrospinal fluid analysis in which the fluid that bathes the brain and spinal cord is analyzed for abnormalities in protein concentration, cell counts and other parameters. This test is most useful to determine if there is an inflammatory and/or infectious disease.
The aims of treating vestibular disease are two-fold. The first aim is to deal with the underlying cause while the second aim is to provide supportive care.
The symptoms of nausea and vomiting can be mitigated by motion sickness medications. If the middle or inner ear is infected, antibiotics are likely to improve the condition. Ear infections should be identified and treated as quickly as possible. Inflammation may respond to treatment initially, but without good treatment, it can progress to a point where it may be untreatable. If the vestibular disease is caused by an under-active thyroid, the condition will resolve once the metabolic condition is managed correctly. If a medication is the cause, stopping the medication can bring complete resolution, however, there can sometimes be some residual hearing loss. Surgical removal of polyps can result in a complete cure, however, if there are cancerous tumors, the prognosis is usually less positive. The central vestibular form of the disease generally has a poorer prognosis than the peripheral form, primarily due to the potential for devastating damage to the brain stem. Fortunately, most cases of the peripheral form improve quickly once the underlying cause is diagnosed, addressed and the vertigo symptoms are treated with appropriate care.
Rehabilitation therapy can help your dog learn better awareness of his body position and thereby improve his stability. Symptoms of dizziness can prevent, or even totally stop, normal walking. This means food and water sometimes need to be close to your pet, or even brought to him to eat or drink. Some dogs may need to be hand-fed for a while. Many dogs need help getting to a place for urination or defecation.
There is no treatment that consistently manages either congenital vestibular disease or the geriatric condition. These pets require nursing care and confinement. Puppies born with the congenital disease often adapt and are less affected as they get older. In old dogs, the condition usually resolves in 7 to 14 days, however, the head-tilt can be life-long.
Talk to the veterinarian if you are concerned your pet is showing signs of vestibular disease.