Featured Cases for 2008

January - Halitosis
February - Otitis
March - Neutering
April - Glaucoma
May - Flea Prevention
June - Leptospirosis
July - Food Allergy
August - Canine Obesity

January

HALITOSIS

IT’S MORE THAN JUST BAD BREATH

Okay, you know we’ve all smelled it before. The middle-aged to older dog comes to give you a nice wet kiss and his breath almost knocks you over. So, what does it mean? You know it can’t be a good thing, right?

The problem is plaque. Dental disease is one of the most common diseases in our pets. The bad breath comes from bacterial infection, most often inside the mouth. The bacteria can be associated with plaque, decaying tissues in the mouth, or food particles wedged between the teeth.

So, how do we get from this…...to this…

Within hours of a professional dental cleaning, a film of saliva proteins form on the teeth. In a few more hours, oral bacteria begin to stick to these proteins and start to multiply on the teeth. This is the beginning of PLAQUE, which is a mixture of saliva protein, cells from the mouth, food particles, and bacteria. At this point the plaque is like a “slime” on the teeth.

If nothing is done to remove the plaque, it becomes more firmly adhered to the teeth. It begins to evolve into a complex society of bacteria and protozoal organisms. The bacteria produce substances that help them stick better and protect them from being removed. Mature plaque is 25% bacteria and 75% matrix.

Within as little as 2 days, plaque can start to produce minerals which form CALCULUS or TARTAR. Calculus provides an environment which protects the bacteria. The bacteria produce toxins which cause inflammation of the gums or GINGIVITIS. The bacteria slowly merge up under the gums and along the tooth root. If left untreated, gingivitis can progress to PERIODONTITIS, or inflammation and destruction of the gums, surrounding bone, and tooth root attachments. In very severe cases of periodontal disease, the bacteria around the tooth roots can find access to the blood stream and then travel around the body, settling in important organs such as the kidneys, heart, and liver.

How will you know if your pet has dental disease?

1. Tartar looks like a brownish stain on the teeth, and usually starts on the back teeth.
2. Red or swollen gums, especially along the gum line where the tooth and gum meet.
3. Halitosis
4. Excessive drooling
5. Reluctance to eat or play with toys or chews
6. Pawing at the mouth
7. Swelling or draining tracts under the eye, or chronic eye discharge
8. Chronic sneezing or abnormal discharge from the nose
9. Broken teeth or masses in the mouth

If you notice any of these signs, you need to have the vet look at your pet. It’s probably time for a dental exam and cleaning.

THE DENTAL EXAM AND CLEANING

First, your pet will receive a complete exam to make sure he’s in good health. The doctor will recommend pre-anesthetic blood work to make sure there are no underlying conditions that might may anesthesia more risky. It will also help us know if your pet’s dental disease has affected his other organs such as the kidneys, liver, or heart. If abnormalities are noted, the doctor will call you with recommendations.

Next, your pet will be sedated with an IV anesthetic. This will make him very sleepy and allow a tube to be placed in his throat. The tube will be attached to a gas anesthetic to keep your pet under anesthesia during the procedure. Monitoring equipment will be attached to keep track of respirations and heart rate while your pet is asleep.

Once your pet is fully asleep, we will take pictures of the teeth so you can see the entire mouth. The technician will use a scaler to remove the tartar from all tooth surfaces. Then the doctor will “probe” around each tooth looking for evidence of pockets that tell us the infection has destroyed the tooth’s attachments. The probe measures the pockets. You can see on these pictures how deep the probe is sliding up under the gingiva of an infected tooth. The tooth itself looks okay, so you might not guess how diseased it was.

If the doctor finds pockets, loose or broken teeth, receding gums or swelling then intra-oral dental x-rays will be taken to determine if extraction is needed. Diseased teeth cause a lot of pain. And while the teeth are important to dogs and cats for eating, grooming, and social behavior, diseased teeth need to be removed for the pet’s health and well-being. Extracting teeth requires time, knowledge, and skill on the part of your doctor. If teeth can be treated with endodontics that will preserve the tooth, such as root canal therapy, we will offer you a referral to a specialist.

Sometimes, gum diseases are present which require treatment. Excessive gingival tissue that has formed in response to infection may need to be excised. Small pockets of attachment loss on a non-diseased tooth may be treated with cleaning, debridement, and packing with antibiotic gel to remove infection and promote re-attachment of the gum tissues.

Once diseased teeth and gums have been treated, the technician will polish the teeth to smooth out the surface. This helps make it more difficult for bacteria to stick to the teeth. Then the technician will apply ORAVET™ gel to the teeth. Oravet is a sealant that protects the teeth from food particles and bacteria for 1 week. You can purchase Oravet and apply it once weekly at home to keep your pet’s teeth clean and healthy!

Concerned about your pet’s pain? So are we! The medications we used to sedate your pet include some analgesia. If we know we will be extracting teeth or performing other painful procedures, your pet will also receive an injection of an anti-inflammatory pain reliever. We often administer local nerve blocks when we extract teeth as well. Post-operative analgesics are also given, as well as pain-reliever to go home with. If you feel your pet is still painful once he gets home, you should let us know immediately, since we may be able to add additional medications to keep him comfortable as he heals. You will also receive antibiotics if extractions have been performed to prevent infection. Be sure to give the whole course of medicine, and let us know if your pet is nauseous or has diarrhea.

WHAT YOU CAN DO AT HOME

1. ORAVET™ sealant gel is an amazing product. Applied weekly, it prevents food, tartar, and bacteria from sticking to the teeth and causing plaque to form.



2. DAILY BRUSHING. Believe it or not, many dogs and even a few cats will enjoy having their teeth brushed. The toothpaste used for pets is flavored so it can be like an extra little treat each day – one that the vet won’t fuss about! It takes a little time to get your pet used to having their teeth brushed, but you only have to do the outside surfaces of the teeth so if you can lift the lip, you can do it.
   
   
   
3. DENTAL DIETS. Many pet food companies are making food designed to help keep teeth clean. The kibble pieces are crunchier on the outside and softer in the middle so they actually act as a toothbrush as your pet chews it. They often have an enzymatic coating to help break up any existing plaque as well. Be sure to use one prescribed by the doctor since not all dental diets are approved by the Veterinary Oral Health Council to be effective.
   
   
   
4. ORAL RINSES. Oral rinses are mild antiseptics used to flush out the mouth and limit bacteria. They are definitely helpful for the bacteria, but since they don’t remove the matrix part of the plaque they should be used with another method.

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February

Oh! Those Itchy Ears!

Ear infections are a common nuisance seen in the veterinary clinic. Often called Otitis Externa, it is inflammation of the ear canal, and it can be caused by a variety of factors and influences. One of the most important things to understand is the structure of the dog and cat ear canal:

The Pinna is the soft, floppy part of the outside of the ear. A heavy or hairy pinna hanging over the ear canal opening keeps the ear moist, leading to infection.

Notice the “L” shape of the ear canal, and the thick cartilage lining. This makes it difficult to see the horizontal part of the canal, and even more difficult to treat deep infections.

The ear canal is lined by a modified type of skin, or epithelium. This skin has a high number of secretory glands, which normally function to clean debris from the canal. Some dogs even grow hair down in the canals. The ear drum, or tympanic membrane, lies at the bottom of the horizontal canal. It is a thin membrane that is vital for hearing. Severe infections can cause this membrane to rupture, which can allow the infection to spread to the middle ear.

Otitis externa can occur as a simple inflammatory reaction, but most commonly occurs as the result of a condition that causes inflammation in the canal. These conditions include parasite infestation (ear mites, mange mites, ear ticks), foreign bodies such as plant material, moisture (due to heavy ear pinnae, hairy ear canals, or frequent swimming), autoimmune disease, endocrine disease, and ear polyps or tumors.

But the most common condition that causes ear infections is ALLERGIES! Both food allergies and environmental allergies (atopy) result in generalized skin inflammation. This inflammation extends to the skin which lines the ears as well. The secretory glands of the ear will over-produce when they are inflamed. Bacteria and yeast love to the warm, moist secretions. Bacteria become more numerous, infecting the inflamed skin. The body tries to fight the infection by sending in inflammatory cells, resulting in pus. A vicious cycle results:

   
Normal car canal                                         Infection, debris

Animals with otitis externa show many common symptoms: Scratching at the ear, rubbing the head on furniture or the floor, shaking the head or holding it to one side, or holding the pinna at an odd angle. Sometimes the ear is hot or painful to touch. If the infection occurs in the middle ear canal the signs may be more serious.

So, how do we treat ear infections? It depends very much on the duration of the infection, whether it is a recurring infection, the type of infection, and any predisposing factors. Treating ear infections can get very complex!

First, an otoscope is used to try to evaluate the inside of the ear canal and make sure the ear drum is not ruptured. But if the canal is very swollen or painful, or if there is a lot of pus, the doctor may not be able to see very far. Next, the doctor will get swab samples from the debris in the ears to determine the type of infection, which helps us know how to treat it. We’re trying to determine if the infection is caused by yeast, cocci-type bacteria, rod-type bacteria, or a combination of these.

 
The blue ovals are yeast Tiny blue dots are cocci

Mild infections can be treated easily. A cleaner is often needed to remove the debris from the ear canal. Because the canal is “L” shaped, you should never use cotton swabs for cleaning – they push debris down deeper into the horizontal canal. A topical ointment or solution will be needed to treat the bacteria or yeast. These medications also may contain a small amount of steroid to decrease inflammation and stop the glands from secreting so much wax.

Chronic infections require much more aggressive therapy. If there is a large amount of pus and debris, it may be necessary to sedate to animal and use a video otoscope and manual flushing to clean the canal. Removing the debris will allow the medication to work much more effectively.

The video otoscope will also allow the doctor to evaluate the ear drum, and take cultures if necessary. Topical medications are used to treat the infections, but often need to be used for a much longer period of time. Oral antibiotics and steroids are often used as well, because the infection and inflammation are so deep-seated in the tissues of the ear canal. If chronic infections occur for too long, there can be serious damage to the ear canal. Surgery is sometimes necessary to remove the diseased part of the ear canal. In certain cases, the entire canal is removed, resulting in deafness.

< Swelling, severe inflammation in a chronically infected ear

When ear infections become a recurrent problem, it’s time to look for an underlying condition or disease that may be causing it. An animal with allergies or another disease will never be free from ear infections if that underlying disorder is not treated. The doctor will perform a thorough physical exam to look for signs of other diseases, such as an endocrine or autoimmune disorder. Blood testing may need to be performed to check for these problems. The doctor will also look at the rest of the skin to check for signs of allergies such as redness, dryness, rashes, and hair loss. Sometimes ear infections are the only sign of allergic skin disease. The doctor may recommend a food allergy trial or serum allergy testing to determine what the underlying allergy is that is leading to the infections.

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March

What’s the Big Deal About Neutering?

“Neuter” is a term used to describe de-sexing both male and female animals. Most people are aware that there are health benefits to having a female pet spayed, as well as preventing unwanted pregnancy. But many people are unaware that male animals, dogs in particular, also have numerous health problems that can occur in old age due to the influence of the hormone testosterone which comes from the testes. Many behavioral problems in both dogs and cats can be prevented or improved by neutering as well.

THE PROSTATE GLAND
Early castration will eliminate all prostate diseases in the dog except for cancer. The prostate gland is an important organ for reproduction because it produces fluid which buffers and protects semen. Hyperplasia of the prostate gland occurs due to the influence of testosterone in an intact dog. This hyperplasia, or gradually enlargement, is the most common reproductive disease in older male dogs. The prostate gland can become so enlarged that it blocks the colon, so owners will notice the dog straining to have a bowel movement, and the stool comes out in a flattened ribbon shape. Infection of the prostate gland is less common but can cause severe pain when it occurs. Long term antibiotics are needed to completely clear the infection. Both hyperplasia and infection are treated with neutering.

CANCER OF THE TESTICLES
Cancer of the testicles is the second most common type of cancer in old dogs, second only to skin cancers. Most testicular cancers are benign, but a biopsy is required to know if the tumor is more aggressive. Undescended, or “retained” testicles have a 13-times greater chance of becoming cancerous than normal testicles. Cancer in an undescended testicle is most commonly Sertoli Cell tumor, which is very aggressive and can cause the bone marrow to stop producing blood cells and platelets. It can also cause the dog to become “feminized” because it produces the hormone estrogen. These dogs will have development of their mammary glands and will attract other male dogs as if they were in heat.

PERIANAL ADENOMA
Tumors arising from the sebaceous glands in the perianal area occur in older intact male dogs due to the influence of testosterone. These tumors can cause severe itching and discomfort, and are often ulcerated. These tumors can be benign or malignant. If they are malignant they are often very aggressive and have usually metastasized by the time of diagnosis.

PERINEAL HERNIA
Perineal hernias occur when the muscles that support the pelvic opening become weak. This is a condition found almost exclusively in older intact male dogs. Owners will notice constipation, straining to have a bowel movement, or a swelling in the area around the anus. In severe cases, the bladder may fall into the hernia. This becomes an emergency situation because the animal can’t urinate. Reconstruction of these hernias is very difficult and the prognosis for full recovery is poor. Neutering can prevent this hernia from occurring.

BEHAVIOR
Intact male dogs have very high levels of testosterone, which can result in several hormone-related behaviors such as inappropriate mounting, urine marking, aggression towards other males, territorial aggression, and escape-oriented behavior in order to roam. It’s best to neuter dogs early (less than one year of age) because once these behaviors have started they become ingrained habits. Dogs that have not been neutered often are more difficult to train because they are more erratic and have trouble concentrating on the task at hand.

NEUTERING CATS
Cats also have many objectionable behaviors that are hormone-driven, such as urine marking, roaming and fighting. Male cats that roam and fight are at much higher risk of contracting infectious diseases such as Feline Leukemia and FIV (feline AIDS) since these diseases are spread through contact with saliva.

WHAT HAPPENS DURING THE NEUTER?
Neutering is normally a quick, simple procedure in a healthy pet. Animals can often go home the same day the surgery is performed. Pre-surgical blood screening is always recommended to ensure the animal’s liver and kidneys are healthy enough to metabolize the anesthesia, and to make sure there is no underlying infection. Laser surgery can be very helpful during the procedure. Laser is used instead of a scalpel blade to cut through tissues. The laser seals nerve endings and blood vessels so there is less bleeding and swelling both during and after surgery. This is also a great time to have your pet microchipped if he hasn’t had this done yet.
In dogs, an incision is made just forward of the scrotum. The testicles are removed through this small hole to reduce the bleeding and swelling. The stalks are tied and cut off and the incision is closed. The soft tissues under the skin are sutured, and the skin is often sealed with tissue adhesive so that no stitches are required.
In cats, the testicles can be removed through two small incisions in the scrotum. The cords are often knotted upon themselves and the testicles are then removed. The incision is left open because it will heal very quickly.
Pets are sent home with pain reliever for a few days to help them feel good during recovery. However, the most important part of the healing process is that the pet stay quiet and calm. Rambunctious dogs will sometimes have bleeding into the scrotum which can make it appear as though they weren’t neutered. This bleeding will resolve in a few days.
Some dogs experience itching of the incision as it heals and will want to lick. It can take only a few minutes for a licking dog to open up his incision, though. So dogs that lick will need to wear an Elizabethan collar or other protective device while they heal to prevent infection or opening of the incision.

 
This is a dog with one very large and one very small testicle.
The large testicle is due to a tumor, the other testicle has atrophied
because the diseased tumor was producing so much testosterone.

This is a dog with multiple perianal tumors.
Obviously, we prefer to see them before they get to this stage.

Photos borrowed from the Veterinary Information Network

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April

UNDER PRESSURE:

GLAUCOMA IN DOGS 

WHAT IS GLAUCOMA?

Glaucoma is the leading cause of blindness in dogs, and it is caused by increased fluid pressure within the eye. We call this an elevated intraocular pressure (IOP). Increased pressure inside the eye can damage the retina and optic nerve, resulting in vision impairment or blindness.

The globe of the eye is commonly referred to as the “eyeball.” It contains all of the structures needed for vision. The cornea is the clear sheet of tissue covering the front of the eye. There is fluid between the cornea and the lens which contains nutrients and waste products from the eye. This fluid is filtered at the iridocorneal angle, the site where inherited glaucoma arises. The iris is the colored part of the eye and it sits just in front of the lens. The lens is the disk used to focus light. Behind the lens is a thick, clear jelly-like substance. The back of the globe contains the retina and optic nerve, which are very sensitive structures vital for vision. Glaucoma has several different causes. It can be a primary disease of the eye, which is an inherited condition. Certain breeds appear to be predisposed to these types of glaucoma. Or it can be the result of another problem in the eye such as lens luxation, tumors, and uveitis (inflammation inside the eye).

Primary glaucoma causes an elevation of the pressure within the eye due to abnormal drainage at the iridocorneal angle. It can be classified as open-angle or closed-angle glaucoma depending upon the position of the lens. This determination requires a special piece of equipment to visualize the angle. Another type of inherited glaucoma is termed Goniodysgenesis. This is caused by an abnormal sheet of tissue in the angle, which can clog up the drainage and result in increased pressure. Pigmentary glaucoma is caused by an excessive amount of pigmented cells within the iridocorneal angle.

Primary open angle glaucoma develops slowly over weeks to months. Closed angle glaucoma is more common, and it develops much more quickly. The intraocular pressure elevates acutely, and this pressure can affect all the other structures within the eye. If the retina and optic nerve are under high pressure for long, they are irreversibly damaged, and the eye becomes blind. Glaucoma can be a very painful condition. You may notice your dog’s eye appears red, or that he is pawing at it or rubbing it on the floor, and he may be sensitive to light. The eye can actually become swollen and bulge under the increased pressure. This swelling causes damage to the inside layer of the cornea, resulting in a bluish hue. Due to pain, dogs may be lethargic or not want to eat.

GLAUCOMA IS AN EMERGENCY!

Treatment must be started as soon as possible if the eye is to remain functional. It can take just 24 hours for the damage to occur if the pressure is high enough.

The veterinarian will check for glaucoma in any red, painful eye, and in any eye with pupil abnormalities, corneal swelling or edema, or suspected visual impairment. Glaucoma is diagnosed by measuring the intraocular pressure. The cornea is anesthetized with a drop of medication. Then a tonometer pen is gently touched to the cornea to determine the level of pressure within the eye. There is a range of normal readings, but an IOP of greater than 25 is diagnostic for glaucoma.
Treatment for glaucoma depends on what type of glaucoma, the severity of the pressure, and the amount of vision loss. Primary open-angle glaucoma can sometimes be treated or at least delayed with medication. Medications will be used in glaucoma patients to try to stabilize the pressure before a patient goes to surgery. Several new surgical techniques are available to prevent high pressures from developing within the eye. However, if the eye has sustained enough damage that is it no longer visual, it is often best to remove the eye, a procedure called enucleation, so that it is not causing the animal pain. Another option is to have the contents of the eye removed, and then a prosthetic implant placed inside the globe. Although the dog is still blind in that eye, it has a more cosmetic appearance than enucleation.
Medical treatment in an emergency situation can consist of topical and/or intravenous medications to lower the pressure quickly. Long-term maintenance therapy may include topical and oral medications depending upon the severity. If one eye has suffered from glaucoma, it is common to try to prevent or delay glaucoma formation in the other eye. The most important aspect of glaucoma treatment is early detection and frequent monitoring.

BREEDS WITH INHERITED GLAUCOMA:

ALASKAN MALAMUTE

BEAGLE



BASSET HOUND

BOSTON TERRIER

BOUVIER DES FLANDRES


CAIRN TERRIER

CHIHUAHUA

COCKER SPANIEL

CHOW CHOW

FOX TERRIER

GREAT DANE

NORWEGIAN ELKHOUND

POODLE (ALL SIZES)

SCHNAUZER

SIBERIAN HUSKY


SPRINGER SPANIEL

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May

FLEA PREVENTION

HERE THEY COME: FLEAS!

If you’re like everyone else, then you had some frustration with fleas last summer! Now you’re probably wondering why they were so bad, and what can you do differently this year… First, it’s important to understand the life cycle of the flea. In order to have the most impact on your flea population this summer, you will have to attack them at multiple life stages. And prevention by starting early is going to be your best bet! One surprising fact is that the fleas you are seeing (even on your dog) are most likely Ctenocephalides felis: the cat flea.

Let’s start at the top: The adult flea. As soon as a female flea hatches from its pupa shell it needs to find a warm body to get a blood meal in order to start her ovaries producing eggs. Once she has sucked blood from your pet, she will lay her eggs in their hair coat . These eggs will fall off into the environment, especially when the dogs shakes or runs. Most of these eggs will be found where the dog spends most of its time: your carpet, the dog’s bed, or worse – your bed! A female flea will live up to 3 weeks, and can lay thousands of eggs in her lifetime. These eggs make up 50% of your flea population, and you can combat these eggs by using a product with an IGR or INSECT GROWTH REGULATOR.

The eggs will develop into larva, which crawl down to the fibers in the carpet. These little maggots will feed on the fecal matter that the adult fleas leave behind. When they are finished feeding they will spin a cocoon for pupation. Larvae can be killed with traditional insecticides and insect growth regulators. Once the larvae has spun its cocoon it is called a pupa, which will eventually develop into an adult flea. They can remain dormant in this state for almost a year, and pupae are resistant to freezing, dessication, and insecticides. They are stimulated to emerge by vibration, heat and increased carbon dioxide, which are things that occur when a living animal (or human) is near. Once a flea has emerged, it’s only goal in life is to find a blood meal. It will begin feeding within hours of finding a host. This whole life cycle, in an appropriate environment, can take as little as 16 days!

As you can see, it is important to attack fleas from many different angles. Most of our traditional products only worked on the adult fleas. As you can see from the pyramid, the adult fleas make up only 5% of the population. A product that kills adults might work for you if you don’t already have a flea population, because it is adults that will come in to start the infestation. But if you have a large infestation, or live in an environment where fleas are abundant, then a product that kills only adults will probably not get control very quickly.

That is why Insect Growth Regulators have become so important. By preventing the eggs from hatching, you can stop the whole life cycle. If you use an IGR on a regular basis, you will be PREVENTING a flea infestation from occurring. However, if you notice adult fleas, have a very allergic pet, or are planning on travelling you may want to have an adulticide product as well. Remember, too, that ticks are going to be a problem in the summer. So if your pet may be exposed to ticks, you will want to be sure your flea control program includes tick protection.

PRODUCTS WE RECOMMEND

We recommend using a product with an IGR to prevent flea infestations year round. If needed, a product for adult fleas and ticks may be added on during peak season, when traveling, or if a flea problem becomes apparent.

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June

WHAT YOUR DOG WANTS YOU TO KNOW ABOUT LEPTOSPIROSIS

You may not have even heard of Leptospirosis, but it is a disease that can affect both dogs and humans, and it is becoming more prevalent than ever. Leptospirosis is caused by a type of bacteria that has a spiral shape. There are over 200 serovars (variants) of this bacteria, but only a few which cause disease in dogs: Leptospira canicola, L. icterohemorrhagiae, L. pomona, L. grippotyphosa, and L . bratislava. Leptospires prefer warm weather, so incidence is more common in southern states, North Carolina being one of the most prominent. The disease is also more common after periods of wet weather.

Historically, most cases of Leptospirosis occurred in animals or humans living in rural areas, due to the increased exposure to wildlife. However, as communities spread outward neighborhoods are now being developed on old farmland. Wildlife areas are becoming more scarce and these animals are showing up in our backyards and garages. The latest studies are showing that urban dogs and peri-urban dogs are also at high risk. One local clinic is currently performing their own study to determine the prevalence of Leptospirosis in our area. They have found that their unvaccinated urban dogs have an infection rate as high as 14%!

Leptospira bacteria are spread mainly by rodents such as mice and rats. Transmission of the bacteria usually occurs through ingestion of infected urine or rodent-contaminated garbage, or from swimming or wading in infected water. It can also spread through broken skin, across the placenta, and through contact with infected soil, food or bedding. “Carriers” or persistently infected animals also can shed the bacteria in their urine for up to 4 years. It can take anywhere from 4-12 days for an animal to start showing signs of illness. The infection travels to the kidneys, liver, spleen, pancreas, Central nervous system, genital tract, and eyes. The disease can cause signs ranging from chronic symptoms to sudden death.

Many cases of Leptospirosis are not diagnosed, either because the animal doesn’t become ill, or because the clinical signs are vague and testing is not performed. However, some cases of Leptospirosis cause severe clinical signs and the dog becomes very ill. The difference may be related to which serovar causes the infection.

There are 3 main forms of the disease:

1. Hemorrhagic form: Often fatal, this form is characterized by small punctate hemorrhages on the mucous membranes, bloody diarrhea or vomit.
2. Icteric form: Icterus is the same as jaundice, and it occurs when the infection affects the liver. It can start out like the hemorrhagic form, but then the mucous membranes (eyes, gums, etc.) and skin will develop a yellowish hue.
3. Renal form: This form occurs when the infection attacks the kidneys and can result in kidney failure. Signs of kidney failure include lethargy, loss of appetite or vomiting, excessive drinking and urination, diarrhea, and even tongue ulcers. The damage to the kidneys may be permanent, so a dog that survives the initial insult may still require life-long treatment for kidney failure.

Diagnosis can be confusing as well. Blood samples can be sent to a laboratory for testing, but current tests look for antibodies to Leptospirosis, and thus are only able to tell if an animal has been exposed to Leptospirosis. The immune system can have antibodies to Leptospirosis if it has picked up the bacteria and successfully fought it, as well as if the animal has been vaccinated against Leptospirosis. Fortunately, the level, or amount, of antibodies can give us an idea if Leptospirosis is potentially causing the disease. And then we can repeat the blood tests in a few weeks. If the second blood test shows a large increase in the amount of antibodies, then the animal’s immune system is actively fighting the infection. Unfortunately, this means a 2-week waiting period before the disease can even be diagnosed. The good news is that treatment can be started even without a definitive diagnosis. An extended dose of antibiotics can be fairly effective if started early, although the dog may require hospitalization and intensive care until he’s more stable.

Prevention is easy. Vaccination is available and is routinely performed at Southwoods Animal Hospital. Our vaccine includes 4 of the most infectious serovars, and is boostered annually during the physical exam. Some dogs seem particularly sensitive to the Leptospirosis bacterins in the vaccine and will have allergic reactions afterwards. Signs can range from lethargy and loss of appetite, to hives and swelling of the face. Always alert the doctor right away if you think a vaccine reaction may be occurring in your dog. Treatment is needed since the swelling can spread to the upper airways and cause the animal to have difficulty breathing. Dogs that have previously had vaccine reactions may just require a “pre-treatment” injection before getting the vaccine which will help prevent the reaction from occurring. In some cases, the doctor may decide to discontinue the vaccine for certain patients if the reaction was severe.

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July

FOOD ALLERGY

Max’s Story

Max is a very sweet 5 ½ year old Lhasa Apso. He was used to getting lots of deli meats and table scraps, as well as his regular diet. Max’s life was great except when became very itchy! It all started in March 2002 when Max started shaking his head, pawing at his ears and chewing on his belly and feet. Max had classic signs of allergies. He had an ear infection with 2 types of bacteria. Because of his itching pattern and ear infection, Max’s doctor recommended trying a 3 month trial feeding only a prescription hypoallergenic diet. If there was no response to this diet, the doctor discussed allergy testing for inhalant allergies. Max’s owners diligently treated his ears with medications and flushes. Max also needed antibiotics to treat his skin infections caused by constant scratching. His parents did start the food trial, but Max was so used to his special treats that he refused to eat. His parents were discouraged and discontinued the food allergy trial.

Just a few months later, Max once again presented with itchy skin and ears. His skin now had a dark pigment from scratching so much. His skin was flakey and smelly from a secondary yeast infection which was also infecting both ears. Once again a diet trial was discussed, as well as allergy testing. Max received a steroid injection, anti-yeast medicine, medicated shampoos, ear ointment and flush for his yeast infections. His itching was relieved again, so the hypoallergenic diet was again not strictly pursued by the owners.

By August of 2003, Max was still itching so his parents decided to test him for inhalant allergies and found he is allergic to many of the plants and trees found outside during the spring and summer. Max started on “desensitization therapy” where the allergy serum is made specifically for each patient and works to decrease the immune system’s reactivity to specific allergens. However, Max was so itchy while getting the allergy injections that he never stopped scratching. His owners were understandably frustrated and stopped giving the allergy injections because Max was so miserable.

Max started on Prednisone (a steroid) to help him stop itching, and he finally found some relief, but it was only temporary. Max’s doctor warned that constant use of steroids can cause serious side effects. Max had several relapses of itching and infections. Each time the doctor recommended a food trial. But because the steroids were so effective and easy, he was treated for his symptoms only, and his liver enzymes were monitored to make sure the prednisone was not causing liver disease. Max’s doctor also recommended a newer drug called Atopica, which has the same action as steroids without the dangerous side effects. The doctor combined the Atopica with antihistamines to help control the itching and Max found relief once again.

Max’s owners tried very hard to keep Max healthy and comfortable with frequent bathing, ear flushes, special ear medications, and Atopica. When Max would have “flare-ups” his owners used small doses of Prednisone just to stop him from being miserable. Max was visiting his doctor almost every 2 months for the majority of 2004 and 2005, so his owners finally agreed to re-try the food allergy diet. The doctor did a food allergy test and Max reacted to almost every meat, as well as to dairy, eggs, potatoes, wheat, oats, corn, and even brewer’s yeast. Max’s owners were finally convinced, and although it was very hard to stop feeding Max all his special treats, they knew that if they didn’t he would never get better. Max now eats ONLY his hypoallergenic food, both canned and dry. His owners also bake him treats out of the canned food so that he can still have “cookies” – but they are hypoallergenic cookies.

About 90% of Max’s itching was due to his food allergies. Once Max’s food allergies were under control, his owners were able to go back to the allergy serum to take care of his inhalant allergies. Max’s owners have found that it is much less expensive to treat the actual allergies rather than try to stop the symptoms. His parents report that Max could never play before because he always had to stop and scratch, but now Max is now itch-free and happy. Thank you to Max’s owners for allowing us to share Max’s story. He will be so much healthier and happier because they vowed to stick to his allergy diet.

What are the costs of treating a food allergy dog when not feeding a food allergy diet?

Per Month:

Ketoconazole (anti-fungal/yeast) $ 45.50
Cephalexin (antibiotic) $ 48.80
Prednisone (steroid) $ 11.20
Malaseb Flush (ear flush for yeast/bacteria) $ 16.80
Otomax (ear medications for yeast/bacteria) $ 27.00
Atopica (anti-itch medication) $162.00

TOTAL:                             $311.30

Cost of treating a food allergy dog being fed a food allergy diet?

Per Month:

Hill’s Canine Z/D                $18.99 to $39.99
(It depends on how much the dog eats)

Cost of a happy, healthy, “itch-free” dog?

Per Month:                       Priceless.

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August

A GROWING CONCERN
CANINE OBESITY:

You’ve seen the fat old dog, huffing and puffing as his owner drags him around the neighborhood, and you probably snickered at the ridiculous sight. Or maybe that’s your dog and you understand the frustration of trying to exercise an overweight older dog that has no energy and would rather fill his days slumbering on the couch with a box of milkbones. Everyone knows obesity, even just being overweight, is bad for you. But do you understand WHY?

The more we study obesity the more we understand about fat and its role in metabolism and disease. We know a little bit of fat is okay – it cushions our organs and provides energy stores for future use. But how many of us really need to be concerned about storing energy? We know when our next meal is coming and it’s probably in just a few hours. The same holds true for our pets. So we know we don’t need to have LOTS of fat on our bodies, but what’s the harm if we do?

A dog is considered overweight if it is up to 19% over its ideal body weight, an obese if it’s 20% or more. So, if your dog was supposed to weigh 50 pounds, but actually weighs 60 pounds, then your dog is obese. How do you know if your dog is obese? First, you can ask your doctor how much your pet should weigh. We determine “Body Condition Score” by examining your pet from the top, the side, and by palpating the ribs and abdomen. At home, you may notice that your pet doesn’t seem as active, has more trouble getting up to greet you, is less likely to run and play, and may have difficulty breathing or may have started snoring.

Fat, in large amounts, can act like an endocrine organ. That is an organ which produces hormones such as your pituitary gland or your thyroid. But fat doesn’t produce helpful hormones. It produces adipokines and other hormones which result in inflammation. Adipokines decrease your metabolism and increase your appetite. So the fatter you are, the slower your metabolism and the bigger your hunger. Sounds like a vicious cycle. And that’s just the beginning because the other hormones fat produces can actually cause inflammation to occur all over your body. So it’s not just the physical difficulty of carrying around the extra weight, but ALSO the inflammation caused by the fat that causes respiratory difficulty, heart problems, arthritis, and other diseases associated with obesity.

OBESITY IS A DISEASE, AND AS SUCH, SHOULD BE TREATED IMMEDIATELY.

Now you’re getting frustrated because we’ve already admitted that it’s very difficult to get a dog to lose weight. As a matter of fact, ONLY 8% OF DOG OWNERS ARE SUCCESSFUL AT REDUCING THEIR PET’S WEIGHT WITH DIET AND EXERCISE ALONE. So what’s an owner to do? There is new hope for all those four-legged fatties out there. It’s called SLENTROL™. And it works 97.8% of the time when used correctly.

Slentrol is made for dogs only. And it doesn’t work like human weight loss medications, so there are no side effects such as oily discharges and excessive gas. It works in the small intestine and prevents some of the fat from being absorbed. It is an MTP inhibitor, so when your dog eats a meal, the Slentrol helps send the “I’M FULL” signal to his brain sooner. Your dog eats less and starts losing weight. And he’s also going to spend less time begging at your feet for treats or table scraps because he won’t be hungry all the time. The goal is to have your dog lose 3% of his weight per month. This allows him to lose fat instead of muscle, as can happen by just restricting his diet.

THE SLENTROL PROGRAM

Slentrol isn’t made to work overnight. As you know, HEALTHY weight loss takes time. But Slentrol is made to help your dog lead a healthier life by managing his weight and the side effects of obesity. Slentrol is a clear liquid that is given with a dosing syringe just once each day. You can give it directly into your dog’s mouth or on a small healthy treat. Weight Loss Phase: The first phase lasts as long as it takes for your dog to reach the ideal weight goal set by your veterinarian. Your dog will be checked monthly for weight lost and dose adjustments to make sure the weight is coming off appropriately. You will not need to change the type of food your dog is eating as long as he is on a healthy, balanced diet.

Weight Management Phase: During this phase, the medication continues and now you can focus on lifestyle changes to keep your dog at his new healthy weight. The medication dose may be adjusted, and you will continue monthly visits to monitor the changes. You will start measuring food amounts to find the ideal amount of calories your dog needs, and your dog will be more excited about exercising now.

When your dog is at his ideal weight and you are able to maintain it, you can stop giving Slentrol. By now you will know how many calories your dog needs and he will enjoy being more active with you. Slentrol is not a cure for obesity, but it will help you make lifestyle changes for your dog that are necessary to keep him healthy.

TAKE THE BARC QUIZ TO CHECK YOUR DOG’S FEEDING AND EXERCISE HABITS:

The Body Assessment Rating for Canines.

1. Is your dog of a breed that is prone to obesity such as Retrievers, Beagles, Basset hounds, Cocker spaniels, Dachshunds, Shelties, and Terriers?
2. Do you have a multi-dog household? (Dogs in multi-dog households tend to eat more and faster than those in one-dog households).
3. Is your dog over 5 years old AND still being fed the same type and amount of food as when he or she was younger?
4. Feel your dog’s ribs. Do you find it difficult to determine where one rib ends and one begins?
5. Stand at your dog’s side and look at the tuck-up – the belly area between the rib cage and hindquarters. Is the body more “square-shaped” in this area?
6. Do you regularly feed your dog table scraps and/or multiple non-meal treats each day?
7. When you feed your dog, do you just pour the food into the bowl (rather than giving a specified amount each time)?
8. Does your dog have difficulty standing up or jumping on the couch?
9. Does your dog get less than 20-30 minutes per day of outside exercise/playtime?

If you answered YES to 4-6 questions, your dog may be overweight or be at risk due to his lifestyle. If you answered YES to 7 or more questions, your dog is at very high risk for obesity. Please talk to your veterinarian. For more information, you can visit www.slentrol.com.

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