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WHAT ARE ALLERGIES?
An allergy is a state of over-reactivity or hypersensitivity
of the immune system of a pet to a particular substance
called an 'allergen'.
Most allergens are proteins. The allergen may be of
insect, plant or animal origin. Examples of common allergens
are pollens, mold spores, dust mites, shed skin cells,
insect proteins such as flea saliva, and some medications.
While an allergy may develop from a single exposure,
that is rare and usually there have been multiple exposures
to the allergen before the immune system decides to
over-react. This means that the immune response, which
normally protects the pet against infection and disease,
is acting in a harmful way.
The actual immune reactions involved
in allergies are quite complex. Most reactions involve
an antibody in the blood called Immunoglobulin E (IgE).
In an allergic reaction the allergen protein molecules
combine with IgE antibody molecules and attach to a
type of cell called mast cells. When these cells are
attached to the allergen, they break up and release
potent chemicals such as histamines, which cause local
inflammation. This inflammation causes the various signs
associated with an allergic reaction.
TYPES OF ALLERGIES
Common allergies in animals:
• Flea
• Inhalant (Atopy)
• Bacterial Hypersensitivity
• Food
• Contact (least common)
SYMPTOMS OF ALLERGIES
The most common symptom associated with
allergies in pets is itching of the skin, either
localized (one area) or generalized (all over the body).
Another group of symptoms involves the respiratory system
with coughing, sneezing, wheezing, and itchy, runny
eyes. While respiratory signs are most common in people,
itch is far more common in pets.
Less commonly, animals may have digestive system problems
such as vomiting and diarrhea.
Severe allergic reactions that cause
swelling and puffiness do occur in pets and are often
caused by stings. Fortunately they rarely progress to
respiratory distress. Anaphylaxis and shock are very
rare but can happen in pets, and are the most severe
manifestation of allergies.
HOW COMMON ARE ALLERGIES IN PETS?
Unfortunately allergies are as common in cats
and dogs as in people, and can affect all breeds including
the mixed breeds. Some allergies are inherited.
DIAGNOSIS
Definite diagnosis of allergies is difficult and involves
eliminating all other causes of skin problems, such
as mange, primary skin infections and thyroid disease.
Even when we are sure it is allergies, it can be hard
to determine which type. A flea allergic pet needs only
one flea to flare up and if they are licking they will
often eat the evidence. Food allergies require a response
to a diet trial. Bacterial hypersensitivity are usually
controlled on antibiotics. Inhalant allergies require
allergy testing to diagnose and are often seasonal in
nature.
FLEA ALLERGY
Flea allergy is an exaggerated inflammatory response
to a flea bite. Flea saliva is the allergen. It is a
common allergy of pets. Most animals experience minor
irritation from flea bites, but the flea allergic animal
will react to a single bite with severe itching. It
will bite and scratch itself and may remove large amounts
of hair. Secondary bacterial infection may occur in
the broken skin. The area most commonly involved in
dogs is the rump and the tail base region. Cats tend
to lick large areas bald or develop scabs up the midback
and neck area.
Because one flea can be a problem for
the allergic pet, strict flea control is essential.
Corticosteroids can be used temporarily, to relieve
the itch. If a secondary bacterial infection is present,
appropriate antibiotics need to be prescribed.
INHALENT ALLERGY
(ATOPY)
The main causative inhaled allergens in pets are tree
pollens (cedar, ash, oak, etc.), grass pollens, weed
pollens (ragweed, etc.), molds, mildew, and house dust
mites. Many of these allergies occur seasonally, such
as ragweed, cedar, and grass pollens. However, others
such as molds, mildew, and house dust mites are year-round.
When humans inhale these allergens,
the allergy manifests mainly with respiratory signs
- runny eyes, runny nose, and sneezing ("hay fever").
While pets occasionally have respiratory signs, most
have itchy, itchy skin. So the condition is also called
"Inhalant Allergic Dermatitis". Atopy in the
dog is usually characterized by seasonal, generalized
itching. The dog chews, licks and scratches almost the
entire body, especially the feet and face. Saliva will
often stain light colored hairs resulting in orange
or reddish brown. Most pets that have inhalant allergy
start showing signs between one and three years of age.
Affected animals will often react to several allergens.
If the offending allergens can be identified, by intradermal
skin tests or IgE allergy tests, the dog should be protected
from exposure to them as much as possible. But this
is difficult and recurrent bouts are likely. Allergy
shots can be tried to desensitize the animal. These
allergies can be treated but a permanent cure is not
usually possible.
FOOD ALLERGY
Food allergy can develop to almost any component of
food, though most commonly to a protein or carbohydrate.
Food allergy can become apparent at almost any age.
Food allergy may produce any of the clinical signs previously
discussed including itching (especially the face and
ears), digestive disorders, and respiratory distress.
Pets with food allergy often have other allergies, such
as atopy. Pets with food allergies are usually poorly
responsive to antiinflammatory medication. Response
to feeding a hypoallergenic diet is both the test to
diagnosis the allergy and the treatment. There are also
blood tests that can give an indication of what food
the pet is allergic to. The only cure for food allergy
is avoidance. Some pets will require medication during
severe episodes but most pets can be successfully treated
with a hypoallergenic diet.
BACTERIAL HYPERSENSITIVITY
Some dogs develop rashes that respond to antibiotics
but return repeatedly. These animals often have concurrent
disease such as atopy, food allergies or hypothyroidism.
But even when underlying problems are found and treated,
the skin infection will often recur spontaneously. The
underlying bacteria the pet is over-reacting to is a
normal skin inhabitant and cannot be eliminated. Most
of these pets will require antibiotic treatment throughout
their life, although bacterial hyposensitization (allergy
shots to the skin bacteria) may help.
CONTACT ALLERGY
Contact allergy is the least common type
of allergy in dogs. It results from direct contact to
an allergen such as wool bedding, pyrethrins in flea
collars or plastic food dishes. If the pet is allergic
to these substances, there will be skin irritation and
itching at the points of contact. Removal of the allergen
(once it can be identified) solves the problem.
TREATMENT
We often don't know what type
of allergy a pet has initially and diagnosis is often
made on response to treatment. The treatment chosen
depends also on the length of the pet's allergy season.
1. Anti-inflammatory.
Treatment with anti-inflammatory drugs such as corticosteroids,
sometimes given with antihistamines, will quickly block
the allergic reaction in most cases. Fatty acid supplementation
of the diet can improve the response to steroids and
antihistamines in some cases.
2. Shampoo therapy.
Frequent bathing with a hypoallergenic shampoo can be
soothing and helpful. The bathing may also rinse out
allergens in the coat that could be absorbed through
the skin.
3. Hyposensitization.
The third major form of allergy treatment is hyposensitization
with specific antigen injections or "allergy shots".
Once the specific sources of allergy are identified,
very small amounts of the antigen are injected weekly.
This repeated dosing has the objective of reprogramming
or desensitizing the immune system. Results are sometimes
good but success is variable.
4. Hypoallergenic
Diet. Treatment for food allergy requires
identifying the offending component(s) of the diet and
eliminating them. Testing for specific food allergies
requires test feeding with a special hypoallergenic
diet. Because it takes at least eight weeks for all
other food products to be removed from the body, the
dog must eat the special diet exclusively for 8-12 weeks.
If a positive response occurs, your veterinarian will
advise you on how to proceed. It must be emphasized
that if the diet is not fed exclusively, it will not
be a valid test. All table food, treats or vitamins
must be discontinued during the testing period.
5. Antibiotics.
While some pets have bacterial hypersensitivities, many
scratching animals cause secondary skin infections simply
from the trauma, and antibiotics are often required
TOP
WHAT ARE THE ANAL SACS?
The anal sacs are located
on either side of the anus at the 8 o'clock and 4 o'clock
positions; they are positioned just under the skin.
They connect to the anus by means of small canals or
ducts. Anal sacs produce and store a brownish, foul-smelling
fluid. These are the same glands that a skunk uses to
scare away its enemies. The primary purpose of these
glands in dogs was likely to impart an odor to the feces
for territorial marking purposes. They normally empty
with the bowel movements. Problems arise when the ducts
are too narrow or the fluid is too thick for the glands
to empty on their own. As the fluid builds up and solidifies,
it becomes an ideal environment in which bacteria can
grow.
COMMON PROBLEMS
WITH ANAL SACS:
1) Impaction
- occurs when the fluid becomes thick and solidified.
2) Infection - occurs
when bacteria grow in this material producing a yellow
or bloody pus.
3) Abscess - occurs
when the infection builds to create a hot, tender swelling
in the gland. Often pressure causes the skin over the
sac to break open, leaving an open sore beside the anus.
4) Glands that leak
- occurs when the canals do not close well. These
dogs constantly drain anal sac fluid and leave foul-smelling
drops wherever they have been.
SYMPTOMS OF ANAL PROBLEMS:
1) Scooting or dragging the anal area.
2) Excessive licking under the tail.
3) Pain, sometimes severe, near the tail or anus.
4) A swollen area on either side of the anus.
5) Bloody or sticky drainage on either side of the anus.
TREATMENT:
The treatment for impaction is to express the sacs
and clean out the solidified material.
With infections, the sacs must be expressed and antibiotics
administered to kill the bacteria. Sometimes the glands
are infused.
If the sacs abscess, the abscess must be drained and
antibiotics administered.
SURGERY:
For dogsor cats having recurrent problems, the
anal sacs can be removed surgically. Because these sacs
are virtually unused, there is no loss to the pet. It
is the only way to permanently cure the problem and
is the only solution for leaky glands. Surgery requires
general anesthesia which always carries some degree
of risk, whether the patient is a dog or a person. However,
modern anesthetics make this risk very minimal for dogs
that are otherwise healthy.
The most common problem after surgery is irritation
and self-trauma. It is a very sensitive area to have
an incision and stitches. Many pets require an elizabethan
collar to prevent licking. Antibiotics are usually administered
after surgery to prevent any infection - the location
is not the cleanest, so infection is possible, but uncommon.
Rarely, some pets will experience temporary lack of
good bowel control. They may drop fecal balls as they
walk. This occurs because the nerves that control the
anus are very near the anal sacs and may be damaged
during surgery. However, this is almost always a temporary
problem that will resolve itself in a few days to a
couple of weeks.
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Asthma is more common in cats then dogs
and is quite similar to that in people. Inhaled allergies
and irritants to the lungs are probably the most likely
causes:
- Inhaled debris or irritants - dust
from cat litter, cigarette smoke, perfume or hairspray,
carpet fresheners, and perfumes in laundry detergent
- Pollens or mold
- Infectious agents - viruses, bacteria
- Parasites - heartworms, lungworms
When the airway of the cat is sensitive
to certain stimuli, exposure to these agents leads to
narrowing of the airways. Regardless
of the cause, the end result is the same: muscle spasms
in the bronchi (breathing tubes), buildup of mucus and
debris. Chronic asthma will cause scarring and permanent
narrowing of the airways.
SIGNS:
Coughing and respiratory distress are the most
commonly reported signs of obstructive lung disease.
Coughing is a significant finding since there are relatively
few causes of cough in the cat. Also, many cats assume
a squatting position with the neck extending during
these coughing episodes. Wheezing is easily heard with
the stethoscope and is sometimes so loud that it can
be heard by the owners.
DIAGNOSIS:
1. Minimum data
base (complete blood count, blood chemistries, fecal
exam and urinalysis).
These tests will help to assess the general health of
the cat and may provide clues as to the underlying cause.
One particular type of white blood cell, the eosinophil,
is commonly associated with allergic events and may
provide support for a tentative diagnosis of asthma.
2. Feline leukemia
and feline immunodeficiency virus tests. These tests
are helpful in determining the overall health of the
cat.
3. Thoracic radiography
(chest x-ray). Characteristic changes in the lungs are
common on x-rays.
4. Bronchoscopy,
cytology and airway lavage (washing). Bronchoscopy is
a procedure which allows the veterinarian to look down
the airways of the anesthetized pet with a fiberoptic
scope. A small amount of sterile saline can be flushed
into the airways to retrieve samples of material from
deep in the lung. This material can be cultured for
micro-organisms and can also be carefully studied under
the microscope.
Some owners
decline the complete workup for a variety of reasons
(cost being the main one). In such cases, it may be
acceptable to treat the cat with a course of corticosteroids
(“cortisone” or “steroids”) since
most asthmatic cats respond very favorably to these
medications without side effects. Corticosteroids can
complicate the management of cats harboring secondary
bacterial infections; therefore, prophylactic antibiotics
are reasonable in cases where a workup cannot be performed.
TREATMENT
Successful management of allergic lung disease employs several therapies.
1. Any
factors known to trigger or aggravate breathing problems
should be avoided. In some cases, this may mean
trying different brands of cat litter, eliminating cigarette
smoke from the home, etc. It is important to pay close
attention to environmental factors which may aggravate
the condition.
2. Bronchodilators.
These drugs are used to open up the airway and allow
the cat to move air more freely. They should be used
faithfully and as directed to obtain maximum effect
These drugs are usually given orally as pills or capsules,
but cats can also be trained to take a puffer.
3. Corticosteroids.
Steroids have a beneficial effect on decreasing inflammation,
dilating the airway, and decreasing mucus production.
When the cat's temperament is a concern, long-acting
injections can be given as an alternative to pills.
These injections are not safe to use in dogs. Also these
drugs come as puffers, which is the safest and most
effective way to take them.
4. Emergency .
Treatment may employ bronchodilators, oxygen, rapid-acting
glucocorticoids, and epinephrine. Extreme
respiratory distress constitutes an emergency and the
pet should receive immediate attention.
TOP
DEFINITION:
A constipated animal will pass fewer than 1 stool every
other day, and will be straining and uncomfortable when
attempting to have a bowel movement. A constipated pet
may have watery diarrhea around the impacted stool.
CAUSES:
The causes are many and varied as anything that causes
prolonged retention of feces in the colon, can result
in constipation. For example;
* Dietary: bones, hair, foreign material
* Environment: lack of exercise or mobility, stress
(boarding, change of litterbox)
* Pain on Defication: trauma such as fractures or bites,
diseases of the anal area
* Obstruction: tumors, prostatic disease, matted hair
* Neurological: spinal disease, idiopathic megacolon
(common in cats)
MANAGEMENT:
1. Remove the underlying cause if possible.
2. Ensure animal is well-hydrated - if
they have not been drinking or vomiting, they should
be given intravenous or subcutaneous fluids. It is not
safe to administer laxatives and enemas to a dehydrated
animal.
3. Laxatives: Come in many, many types:
(a) Stool Softeners type laxatives:
* Emollients: These non-prescription drugs
act as detergents to soften the feces by mixing water
and fat and are most useful short term to decrease
straining. (ie. Colace;
active ingredient is docusate or DSS)
* Lubricants: These drugs soften the feces
by coating them to prevent water loss and promote
easy expulsion. They are petroleum oil products, such
as mineral oil, vaseline
and the flavoured feline hairball
remedies.
(b) Bulk Forming type laxatives: These
are most suitable for chronic use to prevent constipation
and include bran, psyllium
(metamucil) and canned
pumpkin.
(c) Stimulant Laxatives - Work on the
nerves of the bowel to stimulate pushing. Long term
use can damage the nerves of the bowel. (ie. Dulcolax,
active ingredient bisacodyl)
(d) Osmotic Agents - Work by pulling
water into the colon to soften the stools. Too much
will cause diarrhea. The sugar in milk (lactose) has
that effect on many pets, but the more effective is
the non-presciption drug lactulose.
4. Cisapride
- This drug is not a laxative. It is used in cats with
megacolon to help stimulate the nerves of the colon.
Because it is banned in humans, it requires formulation
from a compounding pharmacy.
5. Enemas
- We use enemas in clinic and have individual small
enemas for at home use if necessary.
6. Diet
- Fiber is the mainstay of prevention of constipation.
It helps to soften the stool and the increased volume
of feces stimulates better bowel movements. W/D by Hills
is one of the best diets on the market for managing
constipation. In cats with megacolon, a low fibre, low
fat diet could be tried.
7. Environment - Regular
exercise and drinking lots
of fresh water will help tremendously. Also grooming
to prevent hairballs and not feeding bones.
TOP
What and where
are the cruciate ligaments?
The knee is a relatively unstable joint
because there is no interlocking bones in the joint.
Instead, the two main bones, the femur and tibia, are
joined by ligaments. The cruciate ligaments are two
bands of fibrous tissue inside the joint that enable
the knee to work as a hinge. They are called cruciate
ligaments because they "cross over" inside
the knee joint. One ligament connects from inside to
outside the knee joint and the other outside to inside,
crossing each other in the middle.
Humans have the same anatomical structure
of the knee. Cruciate ligament rupture is a common knee
injury of athletes.
How does the injury
occur?
The knee joint is a hinged joint and
only moves in one plane, backwards and forwards. Traumatic
cruciate damage is caused by a twisting injury to the
joint. This is most often seen in running dogs that
suddenly change direction so that the majority of the
weight is taken on this single joint. The stress and
the angle causes the ligament to snap. The cranial or
anterior ligament is the most commonly affected. This
injury also occurs commonly in obese dogs, often with
very little cause.
The joint is then unstable with the bones
moving in an abnormal fashion in relation to each other,
and the result is lameness. Pain is caused initially
by the tear of the ligament. When the pet attempts to
weight bear there is a partial dislocation
of the knee which stretches the joint capsule and other
associated ligaments, causing more discomfort. This
instability will lead to arthitis and a more chronic
pain if left untreated.
A more chronic form of cruciate damage
can occur due to a gradual weakening of the ligament.
The ligament becomes stretched or partially torn and
lameness may be only slight and intermittent. With continued
use of the joint, the condition gradually gets worse
until rupture occurs.
How is it diagnosed?
With traumatic cruciate rupture, the
usual history is that the dog was running and suddenly
stopped or cried out and was then unable to bear weight
on the affected leg. Many pets will "toe touch" and place only a small amount of weight on the injured
leg.
During the examination, the veterinarian will try to
demonstrate a particular movement, called a drawer sign.
This indicates instability in the knee joint. If the
dog is in pain, has very strong leg muscles, or is uncooperative,
it is often necessary to use sedation in order to examine
the joint thoroughly. Other diagnostic tests such as
radiographs (x-rays) may also be necessary.
Treatment
Unfortunately, correction of this problem
requires surgery. Occasionally,
dogs under 10 kgs (22 lbs) may heal without surgery.
These patients are often restricted to cage rest for
two to six weeks. Dogs over 10 kg (22 lbs) require surgery
to heal. Most dogs will eventually require surgery to
correct this painful injury.
A skilled surgeon can fashion a replacement
ligament and stabilize the joint so it functions normally
or near normally. There are various techniques available
to replace the action of the cruciate ligaments. These
surgeries most often involve the placement of artificial
ligaments along the outside of the knee joint. Occasionally
the injury that causes a ruptured anterior cruciate
ligament will also result in tearing of one or both
of the menisci or "cartilages" in the joint.
At the time of surgery, these are examined and removed
if necessary. There is a newer surgical technique available
called tibial plateau leveling osteotomy (TPLO) that
is especially beneficial for larger, more athletic dogs.
Your veterinarian will discuss with you the best treatment
option for your pet.
Post-Operative
Care
It is important that your dog have limited
activity for six to eight weeks after surgery. Provided
you are able to carry out our instructions, good function
should return to the limb within three months. Unfortunately,
regardless of the technique used to stabilize the joint,
some arthritis is likely to develop. As your dog ages,
stiffness is likely to develop in the joint. Weight
control and nutritional supplements such as glucosamine
/ chondroitin may help reduce the risk of arthritis
in your pet.
Is Obesity such
a Problem?
Obesity alone can result in cruciate
ligament rupture and knee arthritis. If your dog is
overweight, the recovery time will be much longer. Obesity
also increases the risk of injury to the other knee.
We will be happy to prescribe a weight reduction diet.
Weight loss is as important as surgery in ensuring rapid
return to normal function.
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What is Cushing's Disease?
Cushing's Disease is a disease in which the adrenal glands overproduce certain hormones. Another
medical term for this disease is hyperadrenocorticism.
The adrenal glands produce several vital
substances, which regulate a variety of body functions
and are necessary to sustain life. The most widely known
of these substances is cortisol, commonly known as cortisone.
Either deficient production or excessive production
of these substances may be life-threatening
CAUSES
There are three mechanisms by which this disease
can occur. Regardless of the cause, the clinical signs
are essentially the same. It is important to identify
the cause, however, because the various forms are treated
differently and have different prognoses.
Pituitary
gland tumor:
The most common cause of Cushing's Disease (85% of
all cases) is a tumor of the pituitary gland. The
tumor may be either benign or malignant. The tumor
causes the pituitary to overproduce a hormone, which
stimulates the adrenal glands. Excessive cortisone
secretion results. The tumor may be either microscopic
or quite large. Depending on the size of the tumor,
the presence of signs other than Cushing's will be
variable. Generally, if the activity of the adrenal
gland can be controlled, many dogs with this form
of Cushing's Disease can live normal lives for many
years as long as they take their medication and stay
under close medical supervision. Growth of the pituitary
tumor would give the patient a less favorable prognosis.
Adrenal gland
tumor: Cushing's Disease may be the result
of a benign or malignant tumor of the adrenal gland.
If benign, surgical removal cures the disease. If
malignant, surgery may help for a while, but the prognosis
is less favorable than for a benign tumor.
Iatrogenic:
Iatrogenic Cushing's Disease means that the excess
of cortisone has resulted from excessive administration
of cortisone. This may occur from oral or injectable
medications. Although the injections or tablets were
given for a legitimate medical reason, their excess
is now detrimental.
CLINICAL SIGNS
The most common clinical signs associated
with Cushing's Disease are a tremendous
increase in appetite, water
consumption, and urination.
Lethargy, or lack of activity,
and a poor hair coat with
bald spots are also common. Many of these dogs develop
a bloated appearance to their abdomen due to an increase
of fat within the abdominal organs and a stretching
of the abdominal wall as the organs get heavier. The
pot-bellied appearance
also develops because the muscles of the abdominal wall
become weaker. Panting
is another common finding with this disease. Excessive
cortisol in the body can also suppress the immune system
and predispose to infections.
DIAGNOSIS
Animals with Cushings disease will often
show abnormalities on routine screening tests. A marked
elevation in a liver enzyme serum alkaline phosphatase
(ALKP) is present in over 90% of cases. Mild elevations
of other liver enzymes, cholestrol and glucose are often
present. However none of these tests are diagnostic.
A number of special tests are necessary to diagnose
and confirm Cushing's Disease. The primary one is the
ACTH Stimulation Test. If it does not confirm the diagnosis,
the Low-Dose Dexamethasone Suppression Test is performed.
Other tests are needed to decide which form of the disease
is present. Although some of these tests are somewhat
expensive, they are necessary.
TREATMENT
Iatrogenic Cushing's Disease: Treatment
of this form requires a discontinuation
of the cortisone that is being given. This
must be done in a very controlled manner so that other
consequences do not occur. Unfortunately, this usually
results in a recurrence of the disease that was being
treated by the cortisone. Because there may have been
adverse effects on the adrenal glands, treatment is
also needed to correct that problem.
Adrenal Tumor: Treatment of an adrenal
tumor requires major surgery.
Although this surgery is risky, if it is successful
and the tumor is not malignant, there is a good chance
that the dog will regain normal health. If surgery
is not an option, some of these can be well managed
with the medication Lysodren.
Lysodrenä, is the primary drug used to destroy
the abnormal adrenal tissue. Lysodrenä is also
known as mitotane or o,p'-DDD. If not enough drug
is used, the abnormal tissue persists and the disease
continues. If too much is used, most or all of the
adrenal cortex will be destroyed, which can be life-threatening.
Lysodren does have many side-effects including
anorexia, lethargy, vomiting and diarrhea. Therefore,
careful monitoring of the dog is necessary in order
to achieve good results. Because the pituitary is
not being affected by the treatment, it continues
to stimulate the adrenal gland. This means that continued
treatment is necessary. Although a cure is not achieved,
control is possible for many years.
Pituitary Tumor:
There are several options in the treatment of the
pituitary-induced form of Cushing's Disease. Besides
Lysodren, Nizoral
(Ketoconazole) and Anipryl
(L-Deprenyl) are also used. Like Lysodren,
Nizoral can have side-effects and needs persistent
monitering. While not as consistently effective as
the other two medications, Anipryl has no reported
side-effects, and monitering is not as crucial. Cost
is a consideration with all medications, and therapy
TOP
Diabetes mellitus, commonly called “sugar
diabetes” or just “diabetes,” is a disease
caused by failure of the pancreas to produce adequate
amounts of insulin. Insulin's
job is to allow the cells of the body to take in and
use glucose (sugar). Therefore, insufficient insulin
results in high blood sugar levels.
- High blood glucose levels result
in the four typical signs of diabetes: 1) weight
loss, 2) a ravenous appetite,
3) increased urination,
and 4) increased thirst.
Not all of these signs are readily seen in every diabetic
animal, but we expect that you will have seen at least
two of them.
The four clinical signs of diabetes
are also present in other diseases. Therefore, clinical
signs alone are not sufficient to make a diagnosis.
The two most important laboratory tests are the blood
glucose level and a urinalysis.
Diabetic animals have high blood glucose levels and
have glucose present in the urine.
Life With Diabetes
There are some definite financial
obligations involved in treating a diabetic pet;
however, the majority of expenditure occurs during the
regulation phase. Once the pet is stable, the costs
for insulin, syringes, and rechecks are not as bad.
However, the financial aspect is not
the only factor. This disease also requires a substantial
amount of involvement on your part to keep your pet
regulated. Most pets will require daily medications.
Usually, this is in the form of medication once or twice
daily. You will also need to monitor your pet's progress
and be aware of signs that it is not well regulated.
This takes a lot of time and commitment
on your part. If you are not dedicated to keeping
your diabetic pet regulated, you will be disappointed
with the results and the expenses associated with poor
regulation. However, most diabetic pets can be regulated
and continue to be a pleasant part of your family. But,
your commitment and involvement are critical.
Insulin
Insulin is given by
injection to replace the insulin that your pet's
pancreas cannot produce. The injections are made with
a tiny needle, so most animals do not find them unpleasant.
They are given just under the skin in areas in which
there is no chance of injuring vital organs. The technique
is much better tolerated by pets than most owners expect.
Some animals require that injections be given twice
daily, as close to a 12 hour interval as is feasible
for you to do on a consistent basis. All dogs and many
of the feline diabetics will require insulin.
Alternative Treatment
There are several oral drugs
that are effective for diabetes in humans. These drugs
improve the bodies ability to use insulin. Some of these
have been used on diabetic pets. While we sometimes
have good response to these drugs in cats, they rarely
work on dogs.
Diet and Feeding
Schedule
The ideal diet for a diabetic dog is one that
is low in sugar and high in fiber.
But, because of the importance of consistency,
it is better for your pet to eat the same quantity of
a less desirable food every day than to eat a preferred
food on an inconsistent basis.
Interestingly, most diabetic cats do best on
a diet that is low in carbohydrates
and high in protein.
In the past, specific feeding times have been strongly recommended. Most of
these schedules recommended feeding with each insulin
injection or before and four hours after each insulin
injection. Newer evidence says that specific feeding
times are not as important as we once thought. In fact,
leaving food in the bowl at all times for free-choice
feeding means that the blood glucose level is likely
to be more consistent throughout the day.
Monitoring
One of the most important aspects of controlling a diabetic
pet is monitoring that you do at home. If your pet is
monitored closely, the signs of loss of improper regulation
can be detected early and appropriate adjustments made.
Monitoring should occur in two ways: 1) Detection of
glucose in urine, and 2)
Observation of the signs
of diabetes.
Blood testing should be
performed any time the home monitoring methods reveal
abnormalities. It should also be performed every 3-4
months on a routine basis.
Emergencies
Most diabetics
have their ups and downs, but the most serious complication
of treatment is dropping the blood sugar too low. These
pets will seem weak and shaky, and may have trouble
walking. The treatment is sugar supplement, such as
syringing corn syrup or honey into the mouth, and to
offer food as they come around. If it drops low enough
can lead to a coma and death. Any diabetic who loses
consciousness needs to be hospitalized immediately.
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With disk disease the outer
shell of the disk degenerates and allows the central
part to escape. This is called a ruptured disk or slipped
disk. Since the shell is thinnest near the spinal cord,
disk material that escapes almost always goes upward,
putting pressure on the cord. Because the spinal cord
is encased within its bony canal, it cannot move away
from the pressure and it becomes pinched.
SIGNS
Pressure on the spinal cord
results in pain and/or loss of information transmission.
The dog usually experiences pain
and becomes reluctant to move.
This usually means difficulty jumping up, climbing stairs
or walking. The back is sometimes hunched and the dog
may yelp unexpectedly. A more severe rupture results
in paralysis or partial paralysis.
With this the dog is either uncoordinated or completely
unable to use the legs.
CAUSE
Disk disease is not related to injury,
although trauma can cause disks to rupture. Most owners
report that a disk rupture occurred following some
traumatic event, such as a relatively small jump or
fall. Although this act is frequently blamed for the
disk rupture, if the disk had not already been degenerating,
the rupture would not have occurred.
It is also not related to age. Most
dogs with degenerative disk disease are 3-7 years
old. It is just a spontaneous event that is most likely
controlled by genetic factors.
Certain breeds, notably the Dachshund, Poodle, Pekinese,
Lhasa Apso, and Cocker Spaniel have a high incidence
of disk disease. Other breeds, such as the German
Shepherd and Doberman Pinscher, also have disk disease
but with a lower incidence.
DIAGNOSIS
A presumptive diagnosis of disk disease
is made based on the dog's history of neck or back
pain, incoordination when walking, or paralysis when
there is no history of trauma. The physical
examination will indicate that the problem
originates from the spinal cord, giving further evidence
to disk disease. Another important factor is the breed.
If the dog is one of the high incidence breeds, the
diagnosis is even more likely.
In some cases, plain radiographs
(x-rays) may assist the diagnosis, but they
may also be normal since neither the disk nor the
spinal cord are visible. If the diagnosis is in doubt
or if surgery is to be performed, a myelogram
may be done. This procedures involves injecting a
special dye around the spinal cord while the dog is
under anesthetic. When radiographs are taken, the
dye will be seen outlining the spinal cord. A break
in the dye column means that there is pressure on
the spinal cord.
TREATMENT
-
Rest:
This is most important. A dog with disk disease
needs to stay very quiet with no running or jumping.
This is best done with cage confinement. The length
of confinement will vary among different dogs
-
Medication:
Anti-inflammatories, usually in the form of corticosteriods,
are given to reduce the swelling and inflammation
around the spinal cord and thereby help relieve
the pain. Additional pain medication is sometimes
given but only if total confinement to a crate or
cage is enforced. If the pain sensation is taken
away, the dog is more likely to progress to total
rupture of the disk. The sensation of pain is important
for limiting motion.
By far, the majority of disc problems we see are
readily treatable by rest and anti-inflammatory
medication.
-
Surgery:
Surgery may be considered if the pain or incoordination
persists after 4-7 days of treatment or if the neurological
status declines from one day to the next. The goal
of surgery is to remove pressure from the spinal
cord. Some dogs are greatly helped and return to
normal or near normal after surgery. Other dogs
do not improve at all. If walking is not regained,
most dogs will also not regain control of the bladder
and bowels. This means that urine and stool incontinence
will accompany paralysis. In this case many owners
will choose euthanasia since living with a paralyzed
dog requires very intensive nursing care at home
and quality of life for the dog is poor.
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Infections of the external ear
canal (outer ear) by bacteria
or yeast, are one of
the most common types of infections seen in dogs.
We call this otitis externa.
Some breeds, such as Cocker Spaniels and Miniature
Poodles, seem more prone to ear infections, but they
may occur in any breed.
A dog with an ear infection is uncomfortable;
its ear canals are sensitive. It shakes
its head trying to get
the debris and fluid out, and it scratches
its ears. The ears often become red
and inflamed and develop an offensive odor.
A black or yellowish discharge
commonly occurs. Head shaking and scratching can also
cause broken blood vessels in the ear flap, requiring
surgery, and chronic ear infections can penetrate
the ear drum and result
in internal ear infections and thickening and closing
of the ear canal.
EAR MITES
Ear mites can cause several of these
symptoms, including a black discharge, scratching,
and head shaking. However, ear mite infections generally
occur most commonly in cats.
Ear mites in adult dogs occur most frequently after
a cat carrying mites is introduced into the household.
Sometimes, ear mites will create an environment within
the ear canal which leads to a secondary infection
with bacteria and yeast (fungus). It is far more common
for a dog showing the above symptoms to have a bacterial
or yeast infection of the ear.
DIAGNOSIS
There are several kinds of bacteria
and at least one type of fungus
(yeast) which might cause an ear infection.
In some cases, the ear infection may be caused by
a foreign body or tumour
in the ear canal. Also, the dog must be examined
to be sure that the eardrum
is intact. Administration of certain medications can
result in loss of hearing if the eardrum is ruptured.
Not all medicines treat all types of infection. The
type of medicine is determined by the veterinarian
and must be done in the office so ear medication is
not sold over-the-counter.
First, the ear canal is examined with
an otoscope, an instrument
that provides magnification and light. This permits
a good view of the ear canal. This examination allows
us to determine whether the eardrum is intact and
if there is any foreign material in the canal.
The next step is to examine a sample
of the material from the ear canal to determine which
organism is causing the infection. This is called
cytology. Examination
of that material under the microscope is very important
in helping the veterinarian choose the right medication
to treat the inflamed ear canal. The veterinarian
can determine whether yeast or bacteria are causing
the infection and sometimes get an idea as to the
type of bacteria. A culture
may be done to determine the exact bacteria involved.
TREATMENT
If there is a foreign body or tick
lodged in the ear canal, the dog is
sedated so that it can be removed. Some dogs
have such a heavy buildup of debris that sedation
is needed to clean the canal and examine it completely.
Cytological study of debris from the
ear canal dictates which drug to use. Sometimes, it
reveals the presence of more than one type of infection
(i.e., a bacterium and a fungus, or two kinds of bacteria);
this situation usually requires the use of multiple
medications or a broad-spectrum medication. Medication
is usually in the form of ear
drops.
An important part of the evaluation
of the patient is the identification of underlying
disease. Many dogs with chronic or recurrent ear infections
have allergy problems.
If underlying disease is found, it must be diagnosed
and treated, if at all possible. If this cannot be
done, the dog is less likely to have a favorable response
to treatment or recurrence.
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Recommended tests
include a physical examination,
blood tests, and, if
heart disease is suspected, possibly x-rays
or an electrocardiogram
(EKG). If these are normal, further diagnostics may
be performed depending on the severity and frequency
of the seizures. Occasional seizures are of less concern
than when the seizures are becoming more severe and
frequent. Depending on availability, a spinal
fluid tap and fluid analysis may be performed
or specialized imaging of the head with a CAT
scan or MRI might
be performed. Fortunately, these additional tests
are usually not needed, but if they are required your
pet would be referred to a specialist.
A seizure may have all or any combination
of the following:
-
Loss or derangement
of consciousness
-
Contractions
of all the muscles in the body
-
Changes in mental
awareness from non-responsiveness to hallucinations
-
Involuntary
urination, defecation, or salivation
-
Behavioral changes,
including non-recognition of owner, viciousness,
pacing, and running in circles
Seizures consist
of three components:
1) The pre-ictal phase,
or aura, is a period of altered behavior in which the
dog may hide, appear nervous, or seek out the owner.
It may be restless, nervous, whining, shaking, or salivating.
This may last a few seconds to a few hours.
2) The ictal
phase is the seizure itself and lasts from a few seconds
to about five minutes. During this period the dog
usually falls on its side and seems paralyzed while
shaking. The above symptoms occur. If it is not over
within five minutes, the dog is said to be in status
epilepticus or prolonged seizure.
3) During the post-ictal
phase, there is confusion, disorientation, salivation,
pacing, restlessness, and/or temporary blindness.
Despite the dramatic signs of a seizure,
the dog feels no pain,
only bewilderment. Dogs do not swallow their tongues.
If you put your fingers into its mouth, you will do
no benefit to your pet and will run a high risk of
being bitten very badly. The important thing is to
keep the dog from falling and hurting itself. As long
as it is on the floor or ground, there is little chance
of harm occurring.
TREATMENT
If it is a first time seizure, we generally
just observe the dog
for further seizures. Treatment is determined by how
long it takes for another seizure to occur. That may
be days, months, or years. At some point, many dogs
have seizures frequently enough to justify continuous
anticonvulsant therapy.
Since that means that medication must be given every
12 to 24 hours for the rest of the dog's life, we
do not recommend that until seizures occur more often
than about every 2 months or unless they last more
than five minutes.
* It is important to avoid sudden
discontinuation of any anticonvulsant medication.
Even normal dogs may be induced to seizure if placed
on anticonvulsant medication and then abruptly withdrawn
from it. Your veterinarian can outline a schedule
for discontinuing the medication.
STATUS
EPILEPTICUS
-
Status epilepticus
bears special note. It is characterized by a seizure
that does not stop on its
own. When this occurs, the dog's life is
endangered. Intravenous medication is given to try
and stop the seizure. If a seizure is lasting more
than 10 minutes, you should call your veterinarian
immediately.
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What is Cardiomyopathy?
Literally, the term "cardiomyopathy"
means disease of the heart muscle. More specifically,
cardiomyopathy (CM) is a disease of the heart muscle
in which either the heart walls thicken greatly (hypertrophic
and restrictive forms) or stretch greatly (dilated
form). In either form, the heart's function is significantly
compromised and leads to an eventual state of heart
failure.
Causes
Several causes of feline cardiomyopathy have
been identified. A deficiency of taurine, an essential
amino acid, will cause dilated CM in the cat. Taurine
was deficient in many commercial cat foods until its
deficiency was identified; commercial cat foods are
now properly supplemented. Hyperthyroidism, a non-cancerous
growth of the thyroid gland, can cause a variation
of the hypertrophic form of CM. The restrictive form
is associated with an unidentified inflammatory process
within the heart muscle. However, many cases of CM
are not caused by any of these processes, and we do
not understand their origin.
Clinical Signs
Cardiomyopathy is a disease that usually takes
several weeks to months to progress to a serious stage.
During the early weeks of the disease, the cat will
probably look normal. Cats
have the ability to hide serious illness until it
reaches a crisis stage. Therefore, most cats that
develop clinical signs of cardiomyopathy will appear
to have been ill for only a few days.
A few days of inactivity and poor appetite occur first.
Just prior to the state of heart failure and death,
the cat may become very inactive
and exhibit labored breathing.
Both may be due to insufficient oxygen transport to
the body's tissues; the latter may also be due to
a collection of fluid in or around the lungs.
DIAGNOSIS
Diagnosis is generally made with a chest radiograph
(X-ray). The heart will have an abnormal shape and
fluid in or around the lungs may be detected. If a
large amount of fluid is present around the lungs,
it may be necessary to remove it and take more X-rays
because the presence of this fluid interferes with
evaluation of the heart. Many cases also require better
visualization of the heart with an echocardiogram,
or sonogram. This is a non-invasive method for looking
at the heart while it is pumping. Sound waves are
used to make this dynamic study of the heart. The
x-ray can tell us about the size and shape of the
heart but nothing about heart function. The ultrasound
can provide this information. The ultrasound will
also allow measurement of the heart muscle to determine
if it is too thick (hypertrophic CM) or too thin (dilated
CM). Finally, an electrocardiogram (EKG) is useful
to evaluate the rhythm of the heart.
Determination of the level of thyroid
hormone in the blood (T4) is often indicated in evaluating
cats with hypertrophic CM. This simple blood test
can help identify an overactive thyroid gland as the
underlying cause of heart disease.
TREATMENT
Treatment is based on the type of CM present. Different
drugs are used for the two different forms. Therefore,
if at all possible, tests necessary to define the
specific form of CM are performed before treatment
begins. Fortunately, most of these cats can be stabilized
with the correct drug; however, continual medication
will be necessary since the disease cannot be cured.
The exception to this is the cat with hyperthyroidism.
If hyperthyroidism is identified in a cat with hypertrophic
CM, the heart disease is potentially reversible if
the cat receives appropriate and timely treatment
for the thyroid disease.
COMPLICATIONS
Most of the cats with cardiomyopathy develop
signs of heart failure, as previously described. However,
cats with CM are prone to producing blood
clots within their hearts. When these clots
escape the heart, they travel through various arteries
leading from the heart. They eventually lodge in a
narrow part of the artery when their continued travel
becomes impaired by the artery's diameter. The most
common site for clots to lodge is the point at which
the aorta splits before going into the rear legs.
Thus, these cats often become paralyzed in the rear
legs very suddenly and are in significant pain. In
many cases, it is paralysis and pain that first becomes
noticeable and is the reason that medical treatment
is sought. Some owners mistake this event for an uncomplicated
lameness, or even a broken leg. When these cats are
examined, there are no pulses to one or both rear
legs, the legs are cold, and the footpads appear blue
(cyanotic) due to the lack oxygen.
Treatment of the paralyzed cat concentrates
on drugs to relieve pain and to hasten the return
of circulation to the legs. Since these cats also
have severe heart disease, they make poor surgical
candidates. Therefore, surgery to remove the clot
is not advisable due to the high incidence of death
during surgery.
The prognosis for the paralyzed cat
is variable, but is improved if the cat receives immediate
attention. Within 3-10 days, circulation may improve.
However, the heart disease must be controlled quickly
or they will die.
PROGNOSIS
The prognosis for CM is
quite variable, depending on the form of the disease
and the severity at the time of diagnosis. Some cats
can live for years if properly medicated, but the
survival rate averages about six months. Again, the
exception is when CM is caused by hyperthyroidism.
If hyperthyroidism is successfully treated, the heart
function may return to normal and the cat will no
longer require treatment.
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Feline Lower Urinary Tract Disease
(FLUTD)
FLUTD is a group of diseases that affect
the lower urinary tract (bladder and urethra) of cats.
This disease is also known as Feline Urologic Syndrome
(FUS). Both male and female cats get FLUTD.
SIGNS
Most cats with FLUTD exhibit blood
in the urine and discomfort
in urinating. The discomfort
is usually mild but can become much worse if it is
not treated. The cat often urinates much more frequently
than normal, usually with the passage of only a few
drops of urine at once. This disease will cause many
cats to urinate in places other than the litter box,
often on hard surfaces such as tile floors, countertops,
sinks, and bathtubs. They do this because it hurts
them to urinate and should not be punished.
Male cats have
a very small urethra and are susceptible to developing
an obstruction from the crystals, mucus and
blood being passed. This obstruction prevents elimination
of urine from the bladder. If the obstruction is not
relieved within 48 hours, most cats will die from
kidney failure and the retention of toxins that were
not removed by the kidneys. Even when the obstruction
is removed, swelling and scarring of the urethra and
damage to the bladder from stretching, can lead to
complications such as incontinence and recurring obstructions.
Because the urethra is relatively larger in the female
cat, the emergency posed by complete obstruction is
almost always limited to male cats.
CAUSES
There is no one cause of FLUTD in cats. One of the
most common factors is the production of tiny sand-like
crystals in the urine, although some cats actually
develop solid bladder stones. However there are more
than one type of crystal, and no one knows why some
cats develop them and others do not. Some research
has pointed to viral infections damaging the bladder,
but it has been inconclusive. Occasionally cats have
cystitis (bladder infection), while others just have
recurrent blood in the urine with no apparent cause.
This last group is the most frustrating, as they will
often have on and off urinary problems their entire
life.
More than causes, we recognize risk
factors. Cats that are overweight
and sedentary have an increased risk. This
probably relates to factors such as water intake,
urine volume and litterbox habits. For the same reasons,
a "stress"
can precipitate a urinary problem. Early neutering
of male cats has been proposed but disproved as a
risk factor. Diet can
be a significant risk factor. Cat foods with high
levels of magnesium and phosphorus can increase the
risk of developing crystals in the urine. Also dry
cat foods are more associated with urinary problems
than canned, and this is likely primarily due to the
increased volume of water consumed by cats eating
canned food.
DIAGNOSIS :
The most important test in diagnosing FLUTD is a urinalysis.
This enables us to assess for the presence and type
of crystal (there are more than one type possible)
and for infection. Getting a urine sample from cats
is a challenge, and some cats we end up keeping in
the hospital a day or two until the bladder fills
enough. Depending on the individual case, we may also
want to culture the urine or x-ray the abdomen.
TREATMENT:
If neither a bladder stone nor urethral obstruction
is present, proper medication
(antibiotics and anti-inflammatories) will
generally relieve the discomfort. A special
diet can be used to dissolve any bladder crystals
and to prevent recurrence.
If the cat has an obstruction of the urethra, a catheter
is passed into the bladder while he is under a short
acting anesthetic. The catheter is frequently left
in place for about 24 hours. The cat is discharged
from the hospital when it appears unlikely that obstruction
will reoccur, usually 1-2 days later. If he is experiencing
kidney failure and toxemia, intravenous fluids and
additional hospitalization are needed.
PREVENTION:
Although we do not believe that any one type
of commercial cat food causes FLUTD, we know that
certain things can be done to the food to minimize
a recurrence. However, dietary prevention depends
upon the type of crystal present. If struvite crystals
are present, they can be dissolved in acidic urine
with a low magnesium diet. Calcium oxalate crystals
however are more likely to occur in acidified urine.
Therefore, if at all possible, the crystals in the
urine should be analyzed for their composition. This
is the most important step in preventing future problems.
Overall, drinking enough water to keep the urine dilute
reduces the chances of any bladder problem recurring.
Perhaps the tendency of cats to NOT drink much water
is one reason urinary problems are so common. Since
canned cat food is 80% water, feeding it is the easiest
way to increase a cat's fluid intake. Changing water
dishes daily and keeping them in places the cats prefer
may also help.
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There are several conditions that
cause cats to sneeze. However, sneezing that lasts
more than two days is probably due to a viral upper
respiratory infection (URI), similar to a "cold"
that we may have. The "upper" part of
the name means that the infection is limited to
the nose, throat, trachea, and eyes. Lower respiratory
infections involve the lungs; these are relatively
uncommon in cats.
What causes an URI?
There are seven different viruses
or bacteria known to cause feline URI's.
Three of these can cause serious illness - resulting
in reduced appetite, high fever, and ulcers of the
tongue and cornea (surface of the eye). These are
the feline rhinotracheitis virus (also called feline
herpesvirus), the feline calicivirus, and Bordetella
(a bacteria which also causes "kennel cough" in dogs). The remaining viruses cause mild sneezing
for a few days but are rarely a serious problem.
How serious
is this disease?
1. Uncomplicated
viral infection
Symptoms include sneezing and clear discharge from
the nose and eyes. As a rule, the uncomplicated
forms of the viral infections are no more serious
than the common cold. An uncomplicated viral infection
will often resolve on its own. Antibiotics do not
have any effect on viruses - the
virus just has to run its course.
2. Secondary bacterial infections
or Bordetella infection
Symptoms include red, irritated eyes with yellow
or green discharge; sneezing with green or yellow
discharge from nose; lethargy; loss of appetite.
Secondary bacterial infections develop in the nose,
oral cavity, or eyes when a virus is present. Bordetella
is a bacteria that can be present on its own or
with a virus. Culture and sensitivity testing helps
to determine the type of bacteria and appropriate
medication. Antibiotics
are used to treat bacterial infections. Sometimes
these infections can be extremely
difficult to get rid of. Some cats require
long term antibiotic therapy and in others the antibiotics
are ineffective.
3. Chronic disease
Most cats with upper respiratory infection will
get better with time and/or antibiotics. A few will
have chronic problems. Chronic problems occur for
several reasons: the cat's immune system cannot
clear the virus; a bacteria is present that is resistant
to antibiotics; infection has caused scarring of
the tear ducts or nasal passages. These are things
that we simply cannot do anything about. A
cat that has runny eyes or sneezing from scarring
will have these problems for the rest of its life.
These cats will also be more prone to developing
additional bacterial and viral infections throughout
their lives. This may mean frequent trips to the
veterinarian and administering various medications.
Is prevention available?
If the cat has not been previously
infected, vaccination
is usually successful in preventing infection. For
cats that are already carriers of these viruses
or bacteria, it is still important to vaccinate.
Because immunity from vaccination lasts only about
6-18 months, annual vaccinations are necessary.
If a carrier cat should reactivate the virus and
begin shedding, periodic vaccination allows the
immune system to produce antibodies, which can be
readily available to begin fighting the infection.
Thus, the cat may still develop an URI, but the
consequences will be less severe and the recovery
will be faster. Even indoor-only cats should be
vaccinated since the viruses are air-borne.
Many cats that have infections
due to the rhinotracheitis virus or the calicivirus
will become carriers. These cats are typically well,
but they will have recurrence of sneezing. They
are contagious to other cats when they are shedding
the virus. Cats with the calicivirus constantly
shed virus and those with the rhinotracheitis only
shed when stressed.
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CAUSE
Hip dysplasia is a hereditary condition, that is
made worse by environmental factors such as overfeeding,
obesity and excessive exercise. All breeds of dogs
can be affected with hip dysplasia, although it
is predominantly seen in the larger breeds of dogs,
such as the German Shepherd, St. Bernard, Labrador
Retriever, Rottweiler, and Setters. There is equal
distribution of the disease between male and female
dogs.
SIGNS
The typical clinical signs of hip dysplasia are
a rear leg pain, incoordination,
and a reluctance to rise.
The muscles waste away
on the hind end and it becomes progressively weaker.
Most owners report that the dog has had difficulty
in rising from a lying position for a period of
weeks or months. Clinical signs can occur as early
as 4-6 months of age, but most dogs become lame
between one to two years of age. Dogs with mild
hip dysplasia and minimal arthritis may not experience
pain and lameness until they reach 6-10 years of
age.
DIAGNOSIS
Tentative diagnosis of hip dysplasia is made on
the basis of history, breed, and clinical signs.
A large breed dog that has been slow to rise for
several months and now is lame is highly suspect
for hip dysplasia. Because the clinical signs may
mimic other diseases, final diagnosis of hip dysplasia
requires x-ray. To
obtain the proper radiographs, dogs must be carefully
positioned on the radiographic table, which usually
the use of a short acting anesthetic.
TREATMENT
1. Medical
management: The crippling effects of hip
dysplasia can sometimes be controlled with moderate
exercise, strict weight
control and the use of anti-inflammatory
drugs. Many drugs which have been deemed
safe for use in humans are NOT safe for use in dogs,
and all of these drugs have serious side effects.
Please discuss the suitability and safety of any
drug with your vet before giving it to your pet.
2. Surgery:
There are 3 main procedures: femoral head ostectomy
(ball removal), triple osteotomy, and hip joint
replacement.
Femoral
head ostectomy (FHO) is when the hip joint
is a ball and socket joint. FHO is the removal
of the ball part of the joint. This is a salvage
surgery to reduce pain. This usually gives good
resullts in small dogs because a functional "false
joint" forms. However, some large dogs may
not form this "false joint" very well.
Triple
osteotomy is a procedure in which the pelvis
is cut in three places around the hip joint. The
bone is rotated to create better alignment with
the femoral head (the ball). It is reattached
so that the joint functions in a more normal fashion
without looseness and pain. This should only be
performed in a dog with no arthritic changes in
the joint. It is an expensive procedure.
Hip
joint replacement is possible. A stainless
steel ball and socket are attached to the pelvis
and femur in place of the abnormal ones. It is
another expensive procedure, but it may give many
years of pain free use of the hips. Although the
intent is for the transplant to be permanent,
the new joint may loosen after a period of time.
PREVENTION
When purchasing a puppy, look for one whose parents
have had their hips checked. OFA*certification
is ideal. Unfortunately, the genetics of hip dysplasia
are extremely complicated, and there are no guarantees.
Consider a feeding program to
slow growth. There is a growing body of evidence
that dogs who grow very rapidly are more likely to
have hip dysplasia. Feedings a large breed puppy food
or adult food will slow them down. They will still
reach their full genetic body size, but just not as
rapidly.
Avoid excessive exercise in a growing
puppy.
(*The Orthopedic Foundation for Animals
(O.F.A.) is an organization established for the
purpose of standardizing the evaluation process
of canine hip radiographs. The O.F.A. consists of
a board of certified veterinary radiologists who
are skilled in detecting hip dysplasia as well as
elbow dysplasia. The O.F.A. requires that dogs must
be a minimum of two years of age to be certified.
Many breeders require that a dog must have an O.F.A.
certificate before breeding is allowed.)
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The thyroid gland is located
in the neck and plays a very important role in regulating
the body's rate of metabolism. Hyperthyroidism is
a disorder characterized by the overproduction
of thyroid hormone and a subsequent increase
in the metabolic rate. This is a fairly common disease
of older cats. Although the thyroid gland enlarges,
it is usually a non-malignant change (benign adenoma).
Less than 2% of hyperthyroid cases involve malignancy.
Many organs are affected by this disease,
including the heart. The heart is stimulated to pump
faster and more forcefully; eventually, the heart
enlarges to meet these increased demands for blood
flow. The increased pumping pressure leads to a greater
output of blood and high blood pressure. About 25%
of cats with hyperthyroidism have high blood pressure.
CLINICAL SIGNS
The typical cat with hyperthyroidism
is middle aged or older; on the average, affected
cats are about 12 years of age.
The most consistent finding with this
disorder is weight loss
secondary to the increased rate of metabolism. The
cat tries to compensate for this with an
increased appetite. In fact, some of these
cats have a ravenous appetite and will literally eat
anything in sight! Despite the increased intake of
food, most cats lose weight. The weight loss may be
so gradual that some owners will not even realize
it has occurred or it may be quite rapid.
Affected cats often drink
a lot of water and frequently urinate. There
may be periodic vomiting or
diarrhea, and the hair coat may be unkempt.
In some cats, anorexia develops as the disease progresses.
About 30% of cats also have behavior
changes, such as nervousness or crankiness.
Two secondary complications of this
disease can be significant. These include hypertension
(high blood pressure) and a heart disease
called thyrotoxic cardiomyopathy.
Hypertension develops as a consequence of the increased
pumping pressure of the heart. In some cats, blood
pressure can become so high that retinal hemorrhage
or detachment will occur and result in blindness.
Heart problems develop because the heart must enlarge
and thicken to meet the increased metabolic demands.
Both of these problems are reversible with appropriate
treatment of the disease.
DIAGNOSIS
In most instances, diagnosis of this
disease is relatively straightforward. The fi |
