Case of the Month

June

Urinary Bladder Stones

Urinary bladder stones, (or calculi), can form for a variety of reasons and can be pretty uncomfortable for your pet. Stones can occur in both dogs and cats and can cause trouble urinating, squatting with little or no urine, bloody urine or increased urination and desire to go. There are several types if urinary stones, but the most common two are struvite and calcium oxalate. Calcium oxalate crystals form most commonly with the acidification of the urine. This can be caused by diet or by a secondary disease process occurring within the body. Struvite stones occur most commonly in alkaline or basic urine. They are frequently seen in combination with a urinary tract infection especially in dogs. Again diet and secondary disease plays an important role on the development of these stones. Genetics also can predispose an animal to develop stones. For example, Miniature schnauzers and cockers are prone to struvite stones.

Stones can cause significant trauma to the bladder wall leading to same pain, discomfort and blood. In severe cases, especially in cats, the calculi can enter the utretha, (the passage form the bladder to outside the body), and cause complete obstruction. This then causes urine to back up into the kidneys causing kidney damage. This becomes a medical emergency and every second of delayed treatment can worsen the condition.  In some cases, the kidney damage is irreversible even if the obstruction is relieved.

Diagnosis of urinary calculi often requires X-Rays or an ultrasound of the bladder in addition to a urinalysis. Surgical removal of the stones is the only way to remove them. Dietary management can be attempted in animals that have small stones and that do not have clinical signs, but often surgery is needed down the road. Once stones are detected, and even if surgery is performed, the animal is at risk for developing them again in the future. Once the stones are removed they are sent out for analysis to determine what they are made of. Diet recommendations are made from those results.

Case 1:
Spike is a 5-year-old, male neutered, Bichon that has had some trouble urinating over the past 2 weeks. Occasionally, his owners report drops of blood in the urine as well. Otherwise, he is happy, healthy and eating well. On examination, Spike was painful with palpation of the abdomen. A urine sample and X-Rays were obtained and there were several small stones within the bladder and the urethra. The urinalysis reveled an infection and a few struvite crystals. Surgery was scheduled for the following day because of the risk of complete obstruction with the stones in the urethra. Spike’s surgery went very well. Fifteen small stones were removed and sent to the lab for analysis. He remained in the hospital for 2 days on IV fluids and antibiotics. The stones came back as Struvite and Spike was started on a special diet to maintain an optimal pH to hopefully prevent reoccurrence. So far Spike has been clear of stones for 1 year with no further issues.

Case 2:
Ashlee is a 7-year-old, female Pug that has been peeing about 6 times daily compared to her normal 2 times a day. Over the past week she has even been noted to squat with no urine production at all. Her physical examination was completely normal so her veterinarian obtained some urine to send out to the lab. The urine came back completely normal, but her owner reported that the squatting was getting more frequent. Her vet recommended an X-Ray and it showed that Ashlee had 5 large stones and several smaller ones. The stones were pushing against the bladder wall and producing the sensation to urinate despite an empty bladder. Ashlee was taken to surgery for a cystotomy, (opening of the bladder to remove stones or masses). Her surgery went well despite one of the stones becoming lodged in her urethra. The stone had to be manually flushed back into the bladder for removal. In some instances the urethra itself must be surgically opened which results in a prolonged recovery and treatment. Ashlee ’s stones were analyzed and determined to be Calcuim Oxalate. After review of Ashlee’s history, it was determined that the diet her owner was feeding was contributing to her stone formation and she was changed to a prescription diet.

If you are at all concerned with any of these topics please do not hesitate to call one of our staff members for advice. If your pet is having urinary issues please try to bring a urine sample to your appointment to aid in diagnosis. Catch the sample in a clean container and refrigerate it if you are not coming to the office right away. Samples over a few hours old or left out of the refrigerator can falsely grow bacteria.

May

Distemper and Parvo Viruses

Canine Distemper:
Distemper is a virus that affects dogs and some wildlife and causes symptoms of respiratory, gastrointestinal and neurologic disease. The dog often breaks with a fever first and then signs of GI or respiratory disease follow. Neurologic signs appear last and are not always exhibited. Young and unvaccinated animals are more susceptible than older ones and the disease is often fatal. A vaccine is readily available and should be given to all young pups. Puppies lose their maternal antibodies at 6 to 12 weeks of age. Therefore, the first vaccine should be administered around that time frame and re-boostered every 3 weeks for a series of 3 to 4 vaccines. After this initial series the vaccine is given annually. Dogs that do recover are not contagious once fully resolved. Wildlife such as raccoons, skunks and large cats also suffer from the virus.

Distemper Case:
Baci was a five month old beagle mix purchased from a pet store one week before presentation. The breeder told the pet store that they had administered all the necessary vaccines that the pup required. Two days after having Baci at home, the owners noticed that he was very mushy and was sneezing often. He developed a thick nasal discharge and a cough. He was treated by the pet store vet for suspected Kennel Cough with antibiotics. The two diseases present very similarly, initially. Baci was not improving so the owners requested a second opinion. On presentation, Baci had a temperature of 104.8F, (normal for a puppy is 100 to 102.5F). He was very weak and lethargic. His lung sounds were raspy and he now had bad diarrhea and inappentance. X-Rays were taken and severe pneumonia was noted. Blood work revealed a low white blood cell count, which is often seen with viruses. Distemper titers were obtained and eventually came back positive for the virus. Treatment involves only supportive measures. Baci was started on aggressive antibiotic therapy, IV fluids, nebulization and force feeding. Despite all these measures, Baci’s pneumonia worsened and he became ataxia, (incoordinated). His owners regretfully elected to end his suffering and he was euthanized. The pet store, thankfully, did not have any other cases of distemper in their facility. The virus was traced back to the puppy mill where Baci was purchased. Baci would be alive and well today if he was properly immunized as the “breeder” had claimed.

Parvovirus:
Parvo is a virus that causes severe bloody diarrhea and vomiting in puppies and unvaccinated dogs. The virus is highly contagious and can be spread directly from dog to dog or from contact with the infected dog on hands, clothing, bedding, bowls, etc. The vomit and diarrhea can lead to severe and rapid dehydration and hypoglycemia, (low blood sugar). This then causes renal failure and irregular heart rates and eventually death. The dog often starts with an acute onset of vomiting and diarrhea, with no history of diet change or foreign material ingestion. Rapid weight loss and lethargy are noted. Abdominal pain and cramps are sometimes reported. A blood test is available and other causes such as parasites, foreign body and diet change should be eliminated. Treatment involves aggressive IV fluids, antibiotics and antiemetics, (anti-vomiting). The virus can be fatal, especially in very young puppies, even with immediate treatment. Again, a vaccination, often combined with distemper, is readily available and effective when given correctly.

Parvo case:
Lizzie was a four month old pit bull rescued from the shelter. She had received only 1 Distemper/Parvo vaccine while in the shelter. Initially she was playful and eating, but then developed diarrhea one day. By the following day she was inappetant and vomiting nonstop. Her owners rushed her in for an exam. Lizzie was lethargic, dehydrated and had a high heart rate on presentation. A rectal exam revealed diarrhea with blood. A blood test was sent out for Parvo and Distemper. A stool sample was negative for all parasites and XRays were clear for any foreign material. Lizzie was admitted and started on Intravenous fluids, antiemetics and anti-diarrheal medications. Her blood sugar and heart rate were closely monitored. After two days, her vomiting subsided and she began to eat on her own. After a week of hospitalization, Lizzie made a full recovery and went home with her owners. Unfortunately, the shelter reported another case in a puppy that shared a cage with Lizzie. That dog did not survive.

Both of these viruses although very serious and potentially fatal are completely preventable with vaccinations. With new puppies you MUST ensure that they are given a series of shots, just like human babies receive. After that they need vaccines Once a year or as directed by your veterinarian. Always have puppies and kittens examined immediately with any vomit, diarrhea, coughing or sneezing. They are fragile and can take a turn for the worst within a few hours! Please call our office with any concerns or questions you may have regarding any of the topics in this months case!!

April

Rat/Mouse bait ingestion

There are many over-the-counter traps and baits used to get rid of those annoying little visitors we can sometimes have in our household. The baits are meant to be ingested and then slowly cause the mouse or rat to die. This is often a slow and painful death for the little critter. Unfortuntely, the bait is made to appeal to the taste buds of animals to esure that it is eaten. Therefore, many of our dogs and cats are especially drawn to the bait as well. Once ingested the bait will cause the same slow, painful death that it would in a rat or mouse. If caught early enough there is a chance to reverse the life threatening toxins from the bait. The most common toxin used is an anticoagulant which in large amounts leads to internal hemmorhage. Other toxins used in baits can cause liver, kidney and heart failure. FOR THIS REASON YOU MUST CONTACT POISON CONTROL WITH THE NAME OF THE PRODUCT TO ALLOW PROPER TREATMENT.

The clinical signs however are often nonspecific for the bait ingestion. Typical signs from ingestion of an anticoagulant toxin may be vomiting, lethargy, bruising or excessive bleeding from a small cut or puncture. In advanced cases there may be trouble breathing, bloody diarrhea, collapse or sudden death. Often times the animal stumbles upon an old stash of bait that the owner completely forgot about and therefore ingestion has not been reported. In some cases the owner may witness their pet eat the toxin. In that case it is best to immediate make the pet vomit to prevent as much absoption of the toxin as possible Your Vet can instruct you on how best to do that. The animal should be rushed into your veternarians office for exam and more treatment. It is best to contact poison control also since there are many different types of baits and treatment depends on the active ingredient in the bait. Your vet and poison control can work hand in hand to save your pet's life.

Bloodwork should be performed to determine the extent of the damage done by the toxin. X-Rays may also be required if there are any abnormalities with breathing. Your pet may require hospitalization depending on his or her status at presentation. Intravenous fluids can help clear the drug quicker and your pet can be closely monitored. Activated charcoal may also be given by mouth to decrease absorption of the chemical. With anticoagulant toxins Vitamin K1 is used to counteract the affects of the toxin. It must be given for a period of 1 month an then bloodwork is re-evaluated at that time. Vitamin K1 will not work if the bait is composed of a different toxin however.

Prognosis is good if treatment is initiated quickly and appropriately. If left untreated or if the ingestion is not reported the prognosis is poor for survival.

Case 1:
Harry is a 10-month-old, male neutered domestic short haired cat who is very nosey. His owner was doing so spring cleaning and allowed Harry to snoop around while she cleaned out some storage closets. His owner was busy cleaning when she heard Harry chewing on something. To her shock it was rait bait she had placed in the back of the closet years ago. She immediately rushed Harry to the Vets where they induced vomiting. Her vet had her contact poison control and it was discovered that the main ingredient in the bait was an anticoagulant. Harry vomitted up most of the pellets and was given activated charcoal to prevent absorption of any of the remaining pieces. He was started on Vitamin K1 therapy for a month. After the month was up a blood panel was taken and was found to be 100% normal. Harry went on to lead a happy, healthy life!

Case 2:
Benji was a 5-year-old male mixed breed dog that presented to the Vet hospital for lethargy and inappetance. On physical exam he had multiple large bruises all over his abdomen and very labored breathing. Her lung sounds were very distant. Xrays of his chest indicated some free fluid in the chest cavity. Bloodwork revealed a prolonged clotting time as well. His owner was instructed to search the house for any sign of a toxin and sure enough she found an old box of rat bait out in the garage. Benji was left unattended out there 6 days prior to the incident. Per the recommendation of Poison control, He was hospitalized and started on Vitamin K1 therapy.His prognosis was poor given the extensive clinical signs and the amount of the toxin he ingested. Dispite aggressive treatment, Benji's therapy was started too late and he succumbed to the toxin.

****With any ingestion you should contact both your veterinarian AND Poison Control. There are many toxins out there and it is impossible for any vet to know the exact amount that causes toxicity and all of the necessary treatments. Therefore, Poison Control plays a vital role in diagnosis and treatment. Be advised that there is a charge for poison control, but it could mean the difference between the life or death of your beloved companion. The poison Control hotline is 1-888-426-4435.

March

Mange

Mange can affect dogs and cats of any age, but more commonly young animals. It is caused by a mite that lives within the skin and causes intense itchiness. There are two types that can occur, Demodex and Sarcoptic mange. Demodex is not contagious to other animals or people. Sarcoptic or Scabies is highly contagious to other animals and people.
Demodex can normally inhabit the skin of a dog, but if the number of the mites increases to an unsustainable number you can see hair loss and pruritus, (itchiness). You may notice 1 or 2 spots of hair loss intially and without treatment it can cause complete baldness and a rash. If the pet is older, a weakened immune system may trigger the outbreak. Therefore, the pet shouls be evaluated for a primary disease process. Scabies on the other hand comes from contact with an infected animal. The presentation is identical to Demodex. Diagnosis is made with a skin scrape which is viewed under a microscope as the mites are not visible to the human eye. The mites can be missed if there are low numbers or if they are dwelling deep in the skin. If you or your veterinarian are suspicious of mange it is recommended to repeat a negative scrape in 1 week.
Treatment for pets is usally a series of medicated dips and/or injections to kill the mites. Often the treatment is performed for 4 to 8 weeks. The animal is rescraped each time during the treatment until three negative scrapes are obtained and treatment can be discontinued at that point. Recently, 2 topical medication have been developed for the treatment of localized, or small lesions, of mange. The treatment regimen depends on the extensiveness of the lesions and the number of mites on the scrape. Mange, although not harmful, can be very frustrating to the owners due to the long treatment process. During treatment the pet can not receive scheduled vaccines either becuase it can affect the immune systems response to the mite. Antibiotics may be necessary if there is a secondary infection or rash from the mites.

Case 1 Demodex:
Scrappy is a 4-month-old, male intact sheltie puppy. He was due in for his last Distemper/Parvo vaccine and Rabies vaccine when his vet noted that he had bald spots on two of his legs. His owner did not report any pruritus, but the vet decided to scrape the area anyway. Sure enough he was positive for demodex, (see photo of Cigar shaped mite). He began a series of dips and was not allowed to have the remainder of his vaccines until he tested negative. After the first two treatments he developed more hair loss which can commonly occur. Seven weeks later, Scrappy received his last negative scrape and recovered fully. All of his hair regrew and he happy and healthy from then on.

Case 2 Scabies:
Brooklyn was a Boxer puppy that was purchased from a "back yard breeder" in upstate New York. The owner brought her in for a check up 5days after picking her up. He noticed that she had hair loss on the tips of her ears and a few patches on her belly. He, unfortunately, had try to clean the areas and brushed brooklyn repeatedly. Brooklyn was itchy on exam and so was her owner! A skin scrape of Brooklyn revealed a large amount of Sarcoptic mites and she was immediately admitted for treatment. Her owner was sent to his doctor at once where he was also diagnosed with Scabies and started on his own treatment regimen. Brooklyn's doggie "sister" was also treated for mange as well. Fortunately, after several weeks of treatment all three of them were negative and itch-free!

February

Feline Infectious Peritonitis (FIP)

Feline Infectious Peristonitis or FIP is a devestating virus that affectes multiple systems within the body of cats only. Currently, there is no effective treatment against this virus and many cats succumb to it at an early age. The FIP virus is believed to mutate from another virus called the Feline Corona Virus, FCoV, which is prevelant in most cat populations, but rarely produces clinical signs. Therefore, you may have a cat infected with FCoV and never see any signs of illness. The primary source of transmission is thought to be from mother cats to her offspring and introduction of a FCoV positive cat to a negative cat or colony of cats. Once infected it may take some time for the disease to mutate and progress into full blown FIP virus.

There are two forms of the FIP virus that can manifest, wet or dry. Both forms will produce weight loss, a poor coat and can cause a fever. The wet form cause fluid accumulation in the chest and/or abdominal cavities. The dry form causes granulomatous masses, basically tumors, throughout the internal organs. This results in failure of the infected organs and eventually death. Mortality reaches 100% once clinical signs appear. Diagnosis of FIP is based mostly on clinical signs and elimination of other diseases as a cause. The tests for FIP and FCoV often test positive, but this only indicates exposure and not the disease itself. A complete workup must be performed in order to rule-out other diseases. Full bloodwork, a urinalysis, Xrays and fluid analysis are needed to compile a complete data base and confirm diagnosis. Treatment, as mentioned previously, has yet to be discovered and most cats succumb to the disease within days of the start of symptoms.

Prevention of the spread of the diesase relies on routine disinfection of environment, cages, dishes and litterpans, especially in high cat populations. If you are introducing a new cat to the household you should ensure that the cat is FCoV negative or obtain the cat from a well-known breeder that states the cats are FCoV free. Always keep your cats indoors to prevent contact from outside stray cats that may carry and spread the disease or other fatal viruses. There is a vaccines against FIP, but the effectiveness of it has rated very low. For this reason many vets elect not to administer the vaccination.

Case Example:

Layla, was a 1-year-old, spayed female siamese that was purchased from a well-known breeder at the age of 4 months. She had been doing very well until her owners introduce another siamese that they purchased a pet store two months ago. The second cat was happy and healthy, but Layla began to loose weight and have a decreased appetite. Routine blood work was performed and there were not any significant changes. A week later, Layla's abdomen became very distended and she suffered from horrible diarrhea, See photo. XRays were obtained, shown below, and her entire abdomen was filled with free fluid. A sample of the fluid was submitted to the lab and found to be consistent with an FIP infection. Her condition continued to progress and eventually her owners elected to end her suffering. When speaking to Layla's breeder, they stated that they maintained an FCoV free colony and had bloodwork to support their claims. The virus must have been introduced from the petstore cat who is happy and healthy to this day.

Feel free to contact the BVG staff with anyquestions reagrding FIP, FCoV or cat adoptions.

January

Femoral head necrosis (Legg-Perthes Disease)
Common in young small breed dogs

Femoral head necrosis affects the head of the femur, the long bone in the hind leg. The head of this bone sits in the hip to form the ball and socket joint of the pelvis. Young animals do not have fully formed joints until they are aounrd 6 months of age. In some animals when the hip joint is solidifying the blood flow becomes comprimised and the head of the femur looses its blood supply. The bone then slowly begins to die off. This causes a significant amount of pain and can result in fracture of the bone. The exact cause of this is unknown, but there is an hereditary component that plays a role.

The disease is most commonly seen in small, miniature and toy breed dogs. The onset of the symptoms often are exhibited around 3 to 13 months of age. The most common presentaion is an occasional hind leg lameness. The lameness can progress to the point where the dog refuses to put the leg down and may be painful when lifted. The dog is especially painful with movement of the hip joint. There may be atrophy of the muscles associated with the affected limb as well. X-Rays are required to accurately diagnose the disease and rule out other injury. The X-Rays will show a "fuzziness" at the head and neck of the femur. The area has a "moth-eaten" appearance instead of having crisp, clean margins. Surgery is the only treatment for this condition. Without surgery the disease will progress leading to significant pain and severe arthritis. Fractures and loss of use of the limb will be inevitable.

Surgery involves a femoral head osteotomy, FHO, or surgical removal of the head and neck of the femur. Following surgery gradual increase in activity is recommended to restore lost muscle from the disease. The dog should regain full range of function within a few weeks. Occassionally, the dog may limp with damp weather or after excessive play.

Case:

Olive is a 10 month-old, female spayed Shih Tzu, who presented for a booster vaccine. The owner reported that Olive would acooassionally hold up her left hind leg when running. He really did not feel that it was a big deal becuase it only occurred from time to time and was not consistent. On examination, Olive was extremely painful with full range of motion of her hip. An X-Ray was obtained and the classic fuzziness was noted in the femoral head and neck. The following week surgery was performed and went well. At the 7 day recheck, Olive was already bearing all her weight on the affected leg. A month later she was back to her old self, running and jumping all over. Her owners are thrilled to have their playful puppy back again.

Even if your pet's lameness resolves on its own it is best to have it examined. There are several serious diseases that present as occassional lameness. Early detection and treatment will save your pet a great deal of discomfort, arthritis and pain down the road. Contact your vet today with any questions or concerns! Happy New Year!

December

Degenerative Joint Disease (Arthritis)

Degenerative Joint Disease, DJD or arthritis, is a progressive, permanent condition in animals. It is a result of the break down of the cartilage within the joints of the body. The destruction of cartilage will lead to inflammation which then triggers decreased elasticity and movement within the joint. Synovial fluid, the lubrication within the joint, becomes altered and reduced secondary to the inflammation. This allows the bones to rub together resulting in further inflammation, cartilage breakdown and pain. The process occurs in a viscious cycle leading to more wear and tear on the joint to the point of severe pain or complete lack of mobility. In some animals severe arthritis is a death sentence.
The causes of arthiritis include excessive use, prior trauma, congential disease, age-related processes, obesity and secondary disease, (i.e. cancer, lyme disease). Sporting dogs and large breed dogs are at a much greater risk than small breeds and cats due to the amount of pressure exerted on their joints. Prior trauma , such as an accident, sprain, strain, fall, etc. can weaken the cartilage and make DJD a likely problem in the future. Congenital disease, most commonly, luxating patella and hip dysplasia, will cause arthritis in the future even with surgical repair of the defect. Age and obesity just increase the wearing of the joint. Obesity causes the joint to support more weight and therefore results in faster breakdown of cartilage. Secondary disease processes such as infectious agents, (bacteria, fungi, viruses), cancers and systemic diseases, (Diabetes, Cushings and Thyroid disease) can contribute to cartilage breakdown and then arthritis.
The clinical signs of DJD range form occassional lameness, trouble getting up and down, to full blown lameness and intesnse pain. Owners often report that their pet is less active or reluctant to jump and play. Arthritis is difficult to diagnose without taking an XRay of the affected area. Xrays are a vital tool to rule out another disease process such as cancer or a fracture. A treatment for arthritis has yet to be discovered, but there are ways to keep your pet more comfortable and more active. Nonsteroidal Anti-inflammatory drugs, (NSAIDS), are the preferred treatment option. This class of drugs helps to alleviate some of the factors that contribute to pain and inflammation associated with the DJD process. Theses medications do have long term side effects and it is therefore receommended to run bloodwork prior to use and at least every six months with long-term usage. Some feel that Glucosamine can also help increase the precursors for joint fluid and allow the joint to become more lubricated. This can allow more movement and flexibility. Both NSAIDS and glucosamine can be used together for maximum relief. Physical therapy is also very beneficial to DJD animals. Massage and a combination of hot and cold therapy can help alleviate. Swimming is an excellent way to increase joint mobility.  Depending on the location and the severity of the disease, surgery may be an option to help reduce some of the discomfort your pet is experiencing. Unfortunately, any treatment is only palliative and the condition will progress with increased pain and lack of mobility.

Case 1:
Meatball was a 9-year-old, male neutered Cocker Spaniel that was massively obese. His owners brought him in for an annual check up and stated that he was having a bit of trouble getting out of bed in the morning and was reluctant to go up and down stairs. On physical examination, besides being obese, Meatball had decreased movement in both hind legs. The veterinarian recommended Xrays to evaluate the pelvis and knees, but his owner stated that he was sure it was arthritis and declined a work-up. The vet stressed the importance of Meatball losing weight, especially with his hind leg issues. Three months later, Meatball's owners returned with the same complaint, difficulty rising, but this time they said he was much less active. Again, the vet recommended Xrays, but his owners requested only medication. He was started on a short coarse of Rimadyl, a NSAID, and instructed to recheck in 1 week. At the recheck Meatball seemed much more comfortable in the owner's opinion. Bloodwork was examined in order to keep Meatball on the medication. One month passed and Meatball was again in the office with the same complaint. This time the vet required Xrays of Meatballs pelvis and knees. On Xray there was pre-existing hip dysplasia and on the right knee there was a ligament tear. The secondary arthritis was so severe that there really wasnt any option but to end Meatball's suffering. Unfortunately, both of the underlying conditions in Meatball could have been surgically corrected if addressed earlier. This would have reduced his pain and allowed for a longer and better quality life.

November

Thyroid Disease

The thyroid is a small endocrine gland that resides over the trachea or windpipe in the throat. Its most important function is to regualte metabolism in the cells of the body. Thyroid disease is a fairly common problem in animals. Dogs suffer from HypOthyroidism, or an underactive thyroid. Cats, on the other hand, develop HyPERthyroidism or an overactive thyroid. Both present very differently as we will discuss. Both are regulated, not cured, best with daily medication.

Hypothyroidism (Dogs)

This condition is an aquired disease in dogs and often cause by atrophy of the gland or from an immunemediated disease. In some cases it is congenital condition passed through the bloodline or secondary to cancer. The disease appears first in middle aged dogs of either sex. Breeds that often are affected include golden retreivers, cocker spaniels, dobermans, great danes, poodles and dachshunds. An underactive thryoid effects many other systems within the body, especially the endocrine, metabolic, skin, behavior, reproductive and cardiovascular systems. Therefore, common clinical signs include lethargy, weakness, mental dullness, poor skin and coat, weight gain and recurrent infections. Occassionally, dogs may present with neurologic signs such as, incoordination, facial paralysis, head tilt or seizures. Hypothyroidism is diagnosed by a simple blood test or blood panel. A complete blood count and chemical screen should be performed as well to rule out any secondary disease or anemia, which can occur with hypothyroidism. Once diagnosed, medication is started at a twice daily dose and blood levels are monitored every 4 weeks until regulation is achieved. The medication is often life long therapy. Thyroid levels must be monitored every 6 to 12 months to ensure that the correct dosage of medication is being administered. Proper treatment will prevent reoccurece of the symptoms.

CASE 1:
Spencer is a 4-year-old male, neutered Golden Retriever who presented to Dr. Miele for a poor, rough coat. The owner had been to two veterinarians prior to finding Dr. Miele. The other vets had treated Spencer with a variety of allergy medications and shampoos that had cost his mom a great deal of money with no success. With physical examination and thorough history, Dr. Miele learned that Spencer was also not himself lately. He was less enthusiastic, reluctant to go for walks and had gained 5 pounds in the past two months despite no change in his diet. Dr. Miele ordered up a complete blood count, chemistry panel and a thyroid level. When the results returned, Spencer's thryoid level was low as well as his red blood cell count. He was started on medication twice daily and at the 4 week recheck his coat was improving and his owner reported an excellent return to activity. His red cell count abnormalities resolved and he is doing very well today.

Hyperthyroidism (Cats):

This condition is usually caused by a nodule on the thyroid gland itself. In rare situations the nodule can be cancerous. It is often seen in older cats of both sexes. There is no breed predilection. The chief complaint is usually weight loss despite a great or even increased appetite. Other clinical signs include vomiting, diarrhea, increased drinking and urination, increased heart rate and vocalization. Diagnosis of the disease is obtained through a simple blood test. Full bloodwork must be evaluated at the same time to rule out any concurrent disease. Often times there is an increase in liver enzymes which occurs secondary to hyperthyroidism. This usually resolves once appropriate treatment has begun.
Treatment options for hyperthyroidiam include twice daily medication in either pills, liquid or topical form. Blood tests are required again in 4 weeks to ensure proper dosaging. Another option for treatment is radioiodine therapy. This procedure is only done by a handfull of veterinarians and is best reserved for younger, healthy cats. The procedure involves injection of a substance to destroy the abnormal thyroid cells. The cat must be quarantined for at least three days at the veterinary office becuase of this, but the cat will not need medication from there on if it is successful. This procedure can reverse the condition and you end up with a hypothyroid cat in rare instances. Consequences of unregualted hyperthyroidism include heart disease or failure, renal damage, chronic diarrhea or death. Therefore it is imperative to treat and monitor your hyperthyroid cat as directed by your veterinarian. A cardiac workup, Xrays, EKG and Ultrasound, should be performed if there is any evidence of heart disease at any point during your cats thyroid treatment.

CASE 2:
Queenie was a 10-year-old, female spayed domestic long hair cat that began vomiting once a week. Her owner tried to treat her for hairballs, but the vomiting persisted. She also felt that she was losing some weight despite an excellent appetite. She finally brought Queenie to the vet 6 weeks after the symptoms started. With questioning, the veterinarian learned that Queenie's owner also had to scoop the litter box to remove urine and that sometimes there was some loose stool in there. On physical examintion, Queenie was very thin and had a poor coat. She also had a very fast heart rate despite being very relaxed. A complete blood count, chemistry and Thyoid level were sent out for evalutaion. It was determined that Queenie was indeed Hyperthyroid. She was started on medication twice daily for 4 weeks and rechecked at that time. Her blood level was within the normal range so her owner was instructed to maintain that dosge for life. A recheck exam was scheduled for 4 months later. At the following recheck exam, Queenie's owner stated that the cat was not feeling very well for the past few weeks. She seemed very listless and was not as active as before. She had also lost another pound during that time. On exam this time, Queenie was very lethargic, dehydrated and thin. Her heart rate was very high and her lung sounds were decreased. Her owner confessed that she was not giving the medicaiton as directed. She would only give her a pill here and there if she remebered, sometimes not at all. An Xray was obtained and Queenie was in congested heart failure. Her prognosis was guarded and would require several medications a day to control. Her owner felt that she could not handle that and Queenie was euthanized.

October

Food Allergy Dermatitis

Food Allergy is one of the most common allergies or hypersensitivities known to affect dogs and cats. Most people know someone who is allergic to certain foods, such as strawberries or nuts. Only recently have similar allergies been recognized in companion animals. The signs are usually itchy skin, chronic ear infections, flatulence or diarrhea. Other subtler changes can also occur including hyperactivity, weight loss, lack of energy and even aggression. Food allergic animals often suffer with chronic itchiness, rashes and ear infections, which are stressful for both the pet and the owner.

Many animals will occasionally react to something that they ate. This may be sensitivity to a particular type of food. The symptoms are often not a true allergy, just a mild gastrointestinal upset. Once you associate the upset with a particular type of food you avoid it and the problem is usually solved. Food allergy, however, is different. Antibodies are produced against some part of the food, usually a protein. In a pet with food allergy, the immune system overreacts and produces antibodies to substances that it should normally tolerate. This excessive response is termed allergic reaction. Therefore, most pets with allergies exhibit itching as the primary clinical sign.

Virtually any food ingredient can trigger an allergic reaction. The most common food allergies in dogs and cats are proteins from dairy products, chicken, beef or gluten (wheat). Every time a pet eats food containing these substances, the antibodies react and symptoms such as itching, diarrhea and flatulence occur.

An elimination diet is used to determine the presence of a food allergy. This is accomplished by feeding a hypoallergenic diet, which contains none of the ingredients of the previous diet. The new diet consists of 1 protein and 1 carbohydrate source. Unique protein sources are utilized to reduce the risk of previous exposure. The elimination diet MUST BE FED FOR at least 8 to 12 weeks in order to be effective. During the trial ABSOLUTELY no treats, table scraps or flavored medications can be fed or you must begin the diet trial all over again.  For complete diagnosis, the offending food is then re-introduced and if the symptoms appear than a diagnosis is made. Reoccurrence of the original symptoms may take 6 to 8 weeks to occur. Owners, however, frequently choose not to antagonize the condition and simply maintain their pet on the new diet for life.

Once the offending substance has been identified, a diet is chosen that does not contain these particular substances. Today there are a number of commercially available, palatable, hypoallergenic diets, which your pet can be fed for the rest of his or her life. These prescription diets are an excellent choice for pets with allergies. Home-prepared diets are also highly recommended and just as effective.

The only cure is avoidance. Some pets will require medication during severe outbreaks, but most pets are successfully treated with a hypoallergenic diet.It is not uncommon for an animal that has developed an allergy to one particular food to develop other food-related allergies. Additionally, most dogs with food allergies are also allergic to fleas, pollens, etc. If you think your pet has a food allergy, or if you have any questions related to food allergy, please feel free to speak with any member of our staff at any time. We will be happy to assist you in any way. We can help both you and your pet resume a healthier, itch free life!!

Case example: Spot 1 year old, Female spayed Domestic short hair cat

Spot presented to our clinic after visiting several other veterinarians for chronic pruritus, (itchiness), that resulted in scabs and cuts from her scratching. She also suffered from horrible ear infections since the owner adopted her. Spot was examined and other causes for pruritus were ruled out, such as ear mites, mange, fleas and ringworm. Spot was fed a popular brand kitten food since day one and was occasionally given some hard treats. We decided to try spot on a hypoallergenic diet for 8 weeks. She was placed on IVD venison and pea dry formula. She was also administered antibiotics for the secondary infection and a steroid for her pruritus. At the 1 week recheck Spot was already showing great improvement. Her ear infection was almost 100% resolved, her pruritus had decreased dramatically and her scabs were drying up. At the follow-up visit a month later Spot was a whole new cat. Her hair had regrown and her itchiness had disappeared. The owners elected NOT to try her back on her regular food and she is maintained well on the hypoallergenic diet.

September

Heart Disease

Heart disease affects all animals and can creep up slowly without warning. Some owners report a mild cough or decreased activity whereas others have no signs at all. Common signs include coughing, exercise intolerance, open mouth breathing, weakness or collapse. Your veterinarian may note that your pet has a heart murmur or an arrhythmia on physical examination. A murmur is a disturbance in the blood flow within the heart and can be heard with a stethoscope. An arrhythmia is an abnormal heart rate or beat which can either be felt, if pronounced, by taking the animal’s pulse or heard with a stethoscope. Depending on the severity, your veterinarian may recommend further evaluation of the heart.

In order to determine the function of the heart an EKG should be performed to monitor the electrical impulses throughout the heart. Disturbances in flow will be evident on an EKG. X-Rays of the chest and lungs should be taken to determine if there are changes in the heart size or any secondary effects of the lungs or lymph nodes in the chest. From there an echocardiogram or ultrasound of the heart is recommended to look into the heart itself and evaluate the valve function and chamber sizes. Blood pressure should also be obtained because it is often affected by heart disease. Based on the findings of the tests medication can be prescribed to CONTROL the heart disease. Heart disease cannot be cured, but can be regulated. Bloodwork must be performed prior to the start of heart medication because any underlying disease may be detrimental with the use of heart medication.

Heart disease can progress to congestive heart failure if untreated or ignore. This results in fluids accumulation in or around the lungs and possible the abdomen. (SEE X-RAYS). In a normal x-ray the lungs are black, but in the x-ray displayed the lungs are filled with fluid (white areas). Congestive heart failure or CHF can be fatal if left untreated. Even with aggressive treatment it may not be corrected. Other complications of heart disease include increase in heart size which may put pressure on the trachea and interfere with breathing, fluid retention in the abdomen occurs with right sided heart disease, kidney failure can be a complication of heart medication and high blood pressure.

Some breeds are prone to heart disease such as Boxers, Dobermans, Cavelier King Charles and Maine Coon Cats. These breeds should be examined regularly for any changes heart sounds, pulse or EKG.

If you notice any change in your pets behavior, activity or coughing have them checked at once. A delay in treatment could cost them their lives.

August

Kennel Cough / Infectious K9 Tracheobronchitis

With the warmer months and lots of trips to the doggie park, groomer and boarding facilities many dogs are exposed to kennel cough. Kennel cough is a contagious disease of the respiratory system. In most cases it is caused by a bacterial infection. Often times the only signs is a cough. In advanced stages the dog may exhibit sneezing, watery eyes, an elevated temperature, inappetance and lethargy. Left untreated Kennel Cough has the potential to advance to pneumonia, which can be fatal especially in young pups. Kennel cough is spread through direct contact with an infected animal or it may also be air borne from a cough or sneeze. Airborne infection makes exposure more likely at places such as pet shops, grooming, boarding and training facilities. Direct exposure often occurs at dog parks. Treatment in early stages includes antibiotics, rehydration and a cough suppressant if necessary. Advanced cases can require several days of hospitalization and 2 to 3 weeks of antibiotics. Prevention includes avoiding places that do not require a kennel cough injection prior to boarding or training. A vaccine is available although not it is impossible to protect against all of the potential causes of the disease. If you come into contact with a dog that seems ill, keep your pets away from him or her and wash your hands thoroughly.

Case 1: Misty was a 5-month-old female chow that was purchased from a pet store 2 weeks prior to presentation. The owners reported that since purchasing Misty she had been sneezing, coughing and had a runny nose. Her appetite decreased with time and the owners assumed it was because they had changed his diet. On examination, Misty had a 104-degree temperature, (normal around 102), she was listless and had very harsh lung sounds. An X-ray was taken of her chest and she was diagnosed with severe pneumonia. Misty was immediately admitted to the hospital and placed on IV fluids and antibiotics. Despite aggressive treatment for 3 days, Misty continued to decline and her owners elected to end her suffering.

Case 2: Mocha was a 2-year-old female spayed mix breed dog who was boarded at a facility for 1 week. A few days after leaving the boarding facility Mocha began sneezing and coughing on occasion. Two days later her cough progressed and her appetite declined slightly. Her physical exam was rather unremarkable except for an occasional cough. She was placed on oral antibiotics and a week later she was fully recovered.

Make sure that your dogs are fully vaccinated before visiting facilities where there will be other dogs. The Kennel cough or Bordatella vaccine is NOT a routine vaccination so make sure to inform your veterinarian if your pet will be going to an area with other dogs. Also any cough should be investigated and never assume it is just a simple cold.

July

Grape and Raisin Toxicity

Grapes and raisins have proven to be severely toxic in dogs and cats if ingested in even small quantities. The fruit, due to unknown pathogenesis, causes severe kidney failure and requires rapid and aggressive treatment. If ingestion has recently occurred the animal should be forced to vomit and then receive medical attention at once. Following vomiting activated charcoal is given to reduce the amount of the toxin that is absorbed from the gastrointestinal tract. The animal should be placed on intravenous fluids as soon as possible also. Baseline bloodwork and a urinalysis must be collected and monitored every 24 hours for 3 days to evaluate kidney function and possible damage. With immediate treatment recovery is favorable with minimal long-term damage. A delay or lack of treatment will result in kidney failure and death.

Frosty is a two-year-old male neutered pit bull that loves to cause a ruckus when his owners are out. One night when Frosty’s owners returned from work they found that he had destroyed the garbage can and eaten some leftovers from the night before. They found Frosty hiding in the basement and he seemed very listless and had vomited a few times. They immediately brought him into the Brooklyn Vet Group for an examination. With questioning, we learned that there was also a large loaf of raisin bread in the garbage that was now missing. Frosty was immediately administered activated charcoal by mouth and started on intravenous fluids. Baseline bloods showed the beginnings of kidney failure and his urine contained a large amount of blood. He was admitted to the hospital for supportive treatment and continued fluids. Three days later his bloodwork was repeated and his values had come down to almost normal levels. He had stopped vomiting and his urine returned to normal color. Four weeks later a follow up visit and blood test proved Frosty was back to normal. Fortunately for Frosty and his owners, Frosty received fast and appropriate treatment and he survived his episode. Please never feed your pets any new foods without first contacting a veterinarian. As always are staff is ready and willing to assist you with any questions or concerns.

June

Summer thunderstorms and fireworks resulting in sudden behavioral changes

Many animals will suffer this summer with anxiety associated with summer storms and fireworks. Animals often become very stressed and therefore develop erratic behavior such as incessant barking, crying, urination, hiding or even become destructive. Dogs, especially, tend to suffer from this condition and have been know to cause significant damage to themselves or their owner’s property. Some dogs have gone as far as jumping threw windows or running away. This can result in severe injury or death. Owners may also punish pets for the change in behavior which magnifies the anxiety tremendously. Never place your pet outdoors during a storm or fireworks unattended!! Their first instinct will be to run.

The loud noises act as a stimuli to trigger anxiety and panic in pets. As loving owners our first response is to comfort the pet which is the absolute WORST thing to do. This reassures them that there is something to fear and reinforces the negative behavior.  Instead of speaking in a comforting tone you should speak upbeat and positive towards your pet. They will pick up on your “happy, confident” tone and become less anxious. Many pets will benefit from positive play or games during the stimuli. Only provide rewards and treats to your pet when they act calm. Playing fetch or providing a favorite toy works well. This allows them to ignore the triggers and become more comfortable when they occur in the future. If you are unable to be home with your pet during these events make sure that your pet has a safe spot to be in such as a crate or room that is comfortable and secure. Never leave them in an outdoor area. This way they feel safe during the period of anxiety. Also ensure that they are confined to a room without anything that can potentially harm them if they do become destructive, i.e. windows, wires and choking hazards. Some pets benefit from a pleasant stimulus such as a radio or television left on in the owner’s absence. Using a diffuser of pet hormones may help as well. Examples include Felioway for cats and DAP for dogs. Try to make the experience as comfortable for your pet as possible without reinforcing the behavior.

In severe cases, your pet may require a tranquilizer. Tranquilizers will only sedate your pet, however, and will not reduce the anxiety he or she is suffering from. An over the counter example is Benadryl, which will cause a sedative type effect. DO NOT USE WITHOUT FIRST CONSULTING YOUR VETERINARIAN. Your veterinarian may prescribe a tranquilizer for your pet if necessary also. We highly recommend consulting a trainer to resolve these issues without the use of tranquilizers. For any questions or concerns regarding this matter please feel free to contact the staff at the Brooklyn Vet Group. Happy Summer!!!!

May

Intestinal parasites
Why your pet needs preventative

The warmer weather has finally arrived and more pets are out running around in parks and going for walks. With that there is an increased risk of picking up an intestinal parasite which is an easy thing to do. The concern with this is that they can then bring these parasites into your home and put you and your family at risk of contracting these nasty bugs. Below are a list of the most frequently seen parasites, the signs they produce and the risks to us.

1) Roundworm: This is probably the most frequently seen intestinal parasite in dogs and cats. Many puppies and kittens can be born with parasite if their mother is infected during pregnancy. Other animals and humans can develop the parasite if they come into contact with infected environment, (dirt, sand, etc) and feces. In animals, the clinical signs range for a distended abdomen, (pot belly appearance), to diarrhea, vomiting, coughing, abdominal pain, weakness and poor coat. In young animals with large worm burdens death may occur. Infection is diagnosed by fecal flotation examination or, in severe cases, you may see the worms in feces or vomitus. The adult worms resemble spaghetti. Treatment is fairly easy and is administered by mouth for a period of 4 to 6 weeks. Zoonotic transmission, (spread of disease from animals to humans), occurs with contact from infected feces, dirt or frequently children’s sandboxes. The eggs of the parasite are released into the animals feces and will survive in the environment. If a person contacts the feces or the environment and do not wash their hands they may accidentally ingest some of the eggs. In young, elderly or immunocomprimised people the risk is greater and can cause blindness.
Case: Peekachoo is a 6-month-old  female Shih Tzu which her owners purchased from a puppy store 8 weeks prior. She was happy and playful on her first visit to the clinic. A routine fecal sample was performed and she tested positive for Roundworms. She was administered the appropriate treatment and returned for her boosters 3 weeks later. During that exam, her owners reported that their youngest daughter, who Peekachoo slept with every night, had trouble seeing recently and was taken to her doctor. Her doctor diagnosed Ocular Larva Migrans, or roundworm infection of the eye, (see photo), which resulted in permanent loss of vision in one eye. A simple test would have prevented this horrible outcome. Preventative for roundworm is also available in the form of Heartworm medication which should be administered monthly, even during the winter, to reduce the risk of this devastating disease.

2) Hookworm: A less common parasite, but can cause more serious disease such as anemia and death in young animals. Common signs include diarrhea, dark, tarry stools, poor appetite, weak, depressed and possibly a cough. Transmission from animal to animal is identical to that of Roundworm. In man, the larva enter though broken skin and cause a horrible itch and red lines on the affected area. Treatment in animals, again, is very easy. Prevention is also achieved with monthly heartworm pill preventative.
Case: Peachie was a 1-year-old male neutered jack Russell terrier that has suffered with on and off diarrhea since the owner purchased him from a breeder at 2 months of age. ON presentation he had a very dry coat, but otherwise seemed normal.  A routine fecal examination reveled a large population of Hookworm eggs. Peachie was started on treatment and a few weeks later tested negative for the parasite. His coat began to look healthier and his diarrhea subsided completely. Peachie’s owner, however, had stated that she also tested positive for hookworm infection of her feet. Peachie was allowed to roam freely in the backyard where he often relieved himself. During the warmer months his owner would walk barefoot in the yard and developed an intense itch. Her doctor diagnosed cutaneous larval migrans, see picture.

3) Whipworm: This parasite attaches to the large intestine and causes bloody, mucousy diarrhea. Transmission occurs from carrier to carrier.  The eggs of this parasite can survive for months to years in the environment. Therefore it is best to prevent this “bug” as opposed to treating it and risking re-infection. This parasite is not known to cause any effects in man.

4) Coccidia: This parasite also causes bloody, diarrhea in cats and dogs and is not known to be transmitted to man. In younger animals this parasite can be detrimental and has caused death. Transmission occurs from animal to animal. The cysts from this parasite can also remain in the environment for a long period of time leading to cycles of re-infection. Treatment, although easily, can be expensive. There is NO preventative for this parasite. Therefore it is imperative to check fecal samples routinely to rule-out an infection.
Case: Butters was an all white cat that gave birth to a litter of 5 beautiful kitties. One by one the little kittens stopped nursing and developed a thick yellow diarrhea. A fecal analysis revealed coccidian. Treatment was started on the mom and all of the babies. A few of the little ones required rehydration. Despite treatment three of the five babies died due to the severe population of coccidiosis.

***PLEASE CONTACT OUR STAFF AT THE BROOKLYN VETERINARY GROUP IF YOU HAVE ANY QUESTIONS REGARDING PARASITE CONTROL OR DIAGNOSIS. REMEMBER TO GIVE MONTHLY HEARTWORM PREVENTATIVE AND CHECK A FECAL SAMPLE ROUTINELY***

April

Lyme disease and Leptospirosis
Important vaccines to give to your dog

Lyme Disease:
Lyme disease is caused by a spirochete called Borrelia burgdorferi which is carried by deer ticks. The disease is passed to the dog through a tick bite. Tick larvae pick up the spirochete after feeding from white-footed mice. The adults often will feed and mate on other mammals such as deer. Once bitten, the spirochete spreads to the joints, lymph nodes, muscle and connective tissues. This causes signs such as shifting leg lameness, swollen joints, fever, inappetance, swollen lymph nodes, depression and in advanced cases renal, neurologic or heart disease signs. Most owners report lameness for 3 to 4 days and then resolve on its own. Recurrence is very common. Recommended treatment is a four-week course of antibiotics. The antibiotics will not cure the disease but will significantly improve the clinical signs. Symptoms of the disease will reappear throughout the rest of the dog’s life. Flare up of the disease can occur every few weeks to months at which point antibiotics are required again.
Prevention of the disease includes reduction of tick population by using yards sprays and repellents for mammals. Prevent attachment of the ticks by using products such as Frontline and by brushing dogs when they come from outside. All dogs, especially in high-risk areas, should be vaccinated for the disease as well. Once positive, owners MUST vaccinate their dogs annually. The reasoning behind this is that it is believed to reduce some of the more severe and long-term effects of the disease such as heart and kidney disease. The ticks may also feed on humans and pass the disease as well. Ticks can be carried in on pets’ fur and then jump onto humans. The disease is especially devastating in man.

Case Example:
Brutus was a 3-year-old, happy bulldog who went on long walks with his owner every Saturday. One day Brutus’ owner noticed that his front right wrist, or carpus, was very swollen and that he was limping. He decided to wait a few days and monitor his carpus. Three days later, Brutus was back to his bouncy old self. The following month, Brutus developed swellings in both of his hind legs and his owner brought him to the Brooklyn Vet Group at once. With questioning, we learned that Brutus’ owner did not use Frontline and he was never vaccinated for Lyme disease. A blood test determined that Brutus was indeed infected with Lyme. He was immediately started on a four week course of antibiotics and recovered well. Two months following the initial episode, Brutus was back in our office for swelling in all four limbs and an inability to walk. His owner also noted that Brutus was drinking a lot great deal of water, urinating more frequently and occasionally did not eat all of his food. A joint tap was performed to collect some of the fluid from the affected limbs. The lab results confirmed that the swelling was secondary to Lyme disease. Full bloodwork revealed a significant decrease in kidney function. Brutus was admitted to the hospital for aggressive treatment but never fully regained full use of his legs. His distraught owner elected to humanely end his suffering. Had he taken measures to prevent tick attachment Brutus would still be enjoying his weekly walks with his beloved owner.

Leptospirosis:
Leptospirosis is a potentially fatal bacterial infection of mammals. The bacteria particularly love to attach the kidneys and liver, but can affect all of the major internal organs. The disease is found world-wide with higher incidence in warmer climates and wet areas. Standing water and alkaline soils promote the bacteria. Transmission can occur through a variety of ways. Direct contact occurs through open wounds that contact infected urine, blood or saliva. Indirect contact can occur with exposure to contaminated bedding, soil, water or food. Wildlife are often carriers of the bacteria and deposit it in yards or water sources through urination. The organism can survive months in the appropriate environment.
There are several forms of the bacteria and clinical signs vary depending on the strain. Clinical signs range from stiffness, fever, weakness, anorexia, shivering, vomiting, dehydration and increased drinking and urination. Owners may notice a yellow tinge to the dog’s gums or eyes secondary to the bacteria attacking the liver. In advanced cases respiratory distress, difficulty walking and bleeding may occur. A blood test will confirm infection, but treatment should begin at once if suspected.
Treatment involves mostly aggressive supportive therapy to rehydrate the animal and stabilize their symptoms. Antibiotics are required to eliminate the bacteria. Liver and kidney damage may remain despite therapy. Prevention includes vaccination and reduced contact with standing water. Pets should avoid areas where wildlife is known to live. The disease is zoonotic, meaning that it can be passed from animal to man. Transmission is very easy also. Owners should avoid contact with blood and urine of known positive animals.

Case Example:
Lucy was a 5-year-old Lab mix who often went upstate with her owners during the summer. Lucy was allowed to run the owners property. The owners report that several raccoons lived on the property as well. Lucy began to drink and urinate a bit more about one week before presentation to BVG. The day of her appointment her owners noted significant weakness, inappetance and vomiting. On physical exam, Lucy was determined to be very dehydrated and icteric, yellow mucous membranes. A complete blood count and chemistry revealed significant kidney and liver disease. Lucy was admitted to the hospital and started on intravenous fluids and antibiotics while Leptospirosis titers were sent to the lab. Her results returned with a strong positive. She showed gradual improvement over a week of hospitalization and was discharged on two weeks of antibiotics. On her follow-up visit, her kidney values remained elevated. She began therapy for kidney failure which provided her with another 6 months of life. Vaccination, although not available for all strains of Lepto bacteria, may have saved Lucy’s life.

March

A sweet treat that can be deadly
The hidden toxin in your chewing gum

Several brands of sugar free chewing gum, candies and baked goods contain an artificial sweetener called Xylitol. This sugar substitute is harmless to humans but can cause life threatening blood sugar abnormalities in our furry friends. Once ingested, Xylitol causes a surge of insulin to be released into the body. Insulin drives blood sugar up into the cells of the body rapidly depleting the bloodstreams supply of sugar. This then causes a condition called hypoglycemia, low blood sugar, which results in weakness, vomiting, disorientation, ataxia, (staggered walking), and in severe cases coma or death. In addition to the hypoglycemia, the insulin surge cause potassium to be driven into the cells leading to hypokalemia or low potassium levels. Hypokalemia will further amplify the weakness and vomiting caused by the low blood sugar. Further more, Xylitol ingestion can lead to liver necrosis resulting in the patient’s death if untreated.
The dose of Xylitol required to reach toxic levels is minimal. One to two pieces of chewing gum are enough to trigger a hypoglycemic episode in a 20-pound dog! Blood level changes can occur rapidly within hours. Clinical signs vary tremendously and can range from weakness, vomiting to collapse, seizure or death. Treatment should be sought immediately if the animal is known to have ingested the product. Vomiting may be induced if within a few hours of ingestion to remove any of the remaining toxins. Activated charcoal should be administered to prevent further absorption from the intestinal tract as well. Bloodwork should be performed at once to evaluate sugar, liver and enzyme values. The animal must be placed on intravenous fluids to help flush out the offending agent. Hospitalization will be required to monitor blood sugar levels every few hours because a deadly change can rapidly occur with out any visible signs. Other medication will be necessary depending on the symptoms that your pet is exhibiting. With rapid treatment and supportive care most animals will survive this toxic insult. However, liver values should be closely monitored a few months following the incident.

CASE EXAMPLES:
1) Poochie is a 3-year-old male neuter Lhasa that decided to raid his owner’s pocketbook one night and ate at least 4 pieces of Orbitz chewing gum. The owner contacted our office and was advised to rush Poochie in at once. With examination, Poochie was found to be very weak and a bit disorientated. Vomiting was induced at once, but the owner was not sure how long ago the gum was ingested. No gum was found within the vomitus and activated charcoal was then given to coat the stomach and intestines. Bloodwork indicated a very low blood sugar and normal liver values. Intravenous fluids with dextrose, (sugar), were started at once. His blood sugar was closely monitored every 2 hours. The following day his liver values were elevated above the normal limit and Poochie began vomiting profusely. He was started on medications to control the vomiting. Within a few days all of his values stabilized and Poochie was back to 100% normal and returned home to his family. He was re-evaluated a few months after the episode and his liver values were normal.
2) Cassie was a 1-year-old yorkie who was found one morning very listless, weak and vomiting. She rushed her into the hospital and blood work indicated a life threatening low blood sugar and significantly elevated liver values. She was admitted to the hospital and started on supportive therapy at once. The owner telephoned a few hours later and reported that she found several wrappers from a sugar free candy on the ground at home and that the candy contained Xylitol. Despite therapy Cassie continued to decline rapidly. Her liver values continued to increase, her blood sugar dropped further and her neurologic condition worsened. Her owners elected to put her to sleep due to the irreversible liver damage. If Cassies’s owners had realized that she had eaten the candy a bit sooner she may have been able to be saved.

February

Dental Disease

February is pet dental awareness month

Many pets suffer silently with dental disease such as gingivitis, painful abscesses and smelly tartar and bacteria build up because they are unable to brush their teeth like we do. This allows for the accumulation of food particles leading to tartar buildup and a nice environment for bacteria to grow and flourish. Owners may not notice any signs at all that their pet has dental disease or they may notice bad breath, (halitosis), or difficulty chewing food. In severe cases an abscess can develop around the tooth root leading to pain, discomfort and odor. Without proper treatment the abscess may rupture or cause bone destruction of the tooth and surrounding jawbone. The tooth will often need to be removed to alleviate the problem.

All animals are at risk for developing dental disease. In many cases, bacteria invade the gum lining and result in dental disease. Some factors that contribute to this are age, breed, diet and genetics. Smaller dogs tend to have more issues with dental disease than larger breeds. Animals fed canned/soft food will accumulate more plaque on their teeth which creates a nice environment for bacterial growth. Other illness, for example feline immunodeficiency virus and feline leukemia virus, make the animal more susceptible to dental disease. Also young animals that have retained baby teeth should have them removed or there will be an area to accumulate debris and bacteria. The primary concerns with dental disease include bone loss, tooth loss and bone destruction which are all very painful to our pets. Secondary to the bacterial overgrowth in the mouth, the animal will swallow the bacteria which then enters the blood stream. From there the bacteria can invade any organ, but especially loves the kidneys, heart and the liver, weakening the function of these vital organs. In some cases the heart valves are so affected by bacterial growth that a disruption in blood flow can result leading to enlargement of the heart.

Dental disease is graded depending on the severity of the situation, (See photo of different levels). Stage 1 disease is described as inflammation and swelling around the gum line. Plaque and tartar are present in small amounts. Stage 2 is described as further inflammation, swelling and infection of the gum and bone around the affected tooth or teeth. During this stage the tooth will loose 25% of its attachment to the bone. Stage 3 results in further progression of the disease and pus may be noticed around the tooth causing bleeding and further destruction. The tooth attachment is damaged by up to 50% at this stage. Stage 4 is severe periodontitis and bone loss. The tooth may be mobile and there is a strong odor, blood and pus. Extraction of the tooth is inevitable at this point and the underlying jawbone destruction is irreversible. Immediate attention is required to alleviate the severe pain and bacterial overload.

Dental disease is unfortunately inevitable in our companion animals because they just cannot clean their teeth like we do. There are a few things to help reduce the severity of the disease though. It is advisable to begin brushing your pets teeth at a very young age to get them used to the procedure. There are a wide variety of pet toothbrushes and toothpastes available in your local pet store. Ideally, daily brushing is recommended, but if it can only be done a few times a week that will help a great deal. There are a wide array of dental bones, chews and treats available as well that will promote crunching and reduce tartar formation. There are dental diets on the market also that will control tartar build up. One of the most successful diets is Hills Science diet t/d. This can be feed in addition to the normal diet, as the sole diet or as a treat. Also, your pets teeth should be examined by your veterinarian at each yearly visit. As the pet ages, it may be wise to have the teeth evaluated twice a year. Your veterinarian will determine when your pet will need a professional scaling and polishing which does require general anesthesia. Prior to procedure your pet should have his or her bloodwork evaluated to determine if they are healthy enough to undergo anesthesia. Most pets will require a professional cleaning at least once in their life. Many animals require multiple dental cleanings in order to reduce the detrimental effects of untreated disease. Please contact any of our staff at the Brooklyn Veterinary Group if you have any questions regarding dental care, prevention or procedures.

Remember that February is Pet Dental Awareness Month and we will be offering 25% off all dental procedures. Please call to schedule your exam today!!

January

Feline "AIDS" and Leukemia
Why you should be testing your pets

Feline Immunodeficiency Virus, (FIV) and the Feline Leukemia Virus, (FeLV), are unfortunately very common and often detrimental viruses which affect cats. Transmission can occur relatively easily especially in the case with FeLV. Cats infected with FIV can survive a relatively normal life but suffer from a weakened immune system similar to humans with HIV. FeLV is more severe and carries a survival rate of only about 2 years past diagnosis. There is no treatment for either of these viruses and therefore prevention and testing are the only ways to decrease your pet’s risk of obtaining one of theses diseases. All cats and kittens should be tested PRIOR to exposing them to your other cats. Any cats that are allowed outside even only once in awhile should be tested annually for the disease especially if there are a lot of stray cats in your neighborhood. Cats that are positive should be kept indoors at all times to reduce the spread to other cats. Again once your cat is infected there is no treatment for the virus.

Feline Immunodeficiency Virus:
All cats are susceptible to FIV. The virus is more commonly seen in male cats that are permitted to roam outside. This is because the virus is transmitted through deep intramuscular bite wounds which occur during fighting. Cats may also obtain the virus through birth of an infected female.  Symptoms of FIV can range from nothing at all to severe debilitating disease. Most commonly gingivitis or a gum infection and poor dentition are seen. Other symptoms include upper respiratory signs such as sneezing, ocular and nasal discharge, diarrhea, fever, wasting, recurrent/resistant infections and in some cases kidney failure. Treatment in any of these situations is supportive care only. Prevention would involve testing any new addition to the household BEFORE introduction and keeping cats indoors at all times. There is a vaccine available for FIV in cats, but once vaccinated the cat will test positive for the disease making it impossible to determine vaccine induced antibodies or natural exposure.

FIV CASE EXAMPLE:
Lila was a 5 year-old female domestic long hair cat that routinely was allowed to roam outside. The owners initially presented Lila to our clinic for difficulty chewing her food. Upon physical examination, Lila was found to have severe gingivitis and several rotten teeth that would require extraction. The owners also noticed that she had lost some weight and was drinking a lot more water. Routine bloodwork was performed prior to sedating Lila for the dental work and it was discovered that her kidneys were starting to fail. This explains the weight loss and her increased thirst. Given the fact that Lila was young and kidney disease is rare at that age a FIV test was performed and returned positive. Lila was admitted to the hospital for further testing and started on intravenous fluids to support her kidney function. Initially she responded well to the therapy, but relapsed three months later. At this point her kidneys had almost completely shut down and her owners were left with no choice but to end her suffering. Lila was tested for FIV initially as a kitten and was negative at that time. Therefore, it is assumed that she contracted the virus during one of her many ventures outside.

Feline Leukemia Virus:
FeLV is a much more severe and devastating virus than FIV. Not only is the disease easily transmitted, but it also carries a grave prognosis. Once diagnosis is made it is rare for the cat to survive more than two years. Again all cats are highly susceptible to the infection. It is transmitted through direct contact such as grooming, bites, urine, shared bowls and litter pans. Similar to FIV, the virus does not have definitive clinical signs and can affect a wide range of organ systems. Most frequently, in the early stages of the disease, the cat may present with a resistant upper respiratory infection or bad gingivitis. In more severe cases lymphadenopathy, (enlarged lymph nodes), kidney failure, fluid accumulation in the chest and abdominal cavities and intestinal cancer have been seen secondary to FeLV. In most cases the animal suffers through a painful disease process.
There is also a vaccine for Feline Leukemia Virus which can be differentiated on the blood test from natural exposure. But the best way to prevent the disease is to avoid contact. Keep cats indoors at all times and test any new addition to the household BEFORE they meet pre-existing cats.

FeLV Case Example:
Stretch was an adorable little stray kitten that Mrs. Walsh found wandering around her backyard on a cold winter morning. When she called him he immediately ran over to her and started purring. Having three cats already, Mrs. Walsh had plenty of food to give the little skinny man. She brought him inside that night since the temperature was supposed to drop well below freezing. Her other cats seemed to welcome him in at once. She brought Stretch to our office later that week. He seemed relatively healthy with no obvious medical aliments, but as a part of our normal routine we sent out a FIV/FeLV test. The following day when the results returned we had the unfortunate task of informing Mrs. Walsh that Stretch was positive for FeLV and that all three of her other cats were at risk for the disease. The other three Walsh cats were tested and all three were found to be infected with the disease as well. In the past the other cats had tested negative and were always kept indoors. One of the original three fell ill with kidney failure 3 months after diagnosis and was euthanized at our office. A year later, Stretch developed a severe upper respiratory infection that progressed rapidly into pneumonia despite treatment and he too was euthanized. Currently one of the other infected cats has developed unresponsive diarrhea and severe weight loss. Mrs. Walsh will probably put her down within the next few weeks. Unfortunately, Mrs. Walsh learned a horrible lesson with taking in Stretch. If she had only brought him to the vet that day or kept him quarantined from her cats this would have never occurred.

December

Common Winter and Holiday Dangers

This time of the year can be particularly dangerous to our pets. With the hustle and bustle of the holiday season we may accidentally expose our pets to possible harmful situations or items. Below is a list of common household items that pose a potential threat to our furry friends.

1. Medications either prescription or over the counter can cause toxicity in our pets if ingested. Be careful where you leave your cold and flu medications!!
2. Household cleaners and detergents can cause anything from oral ulcerations and gastric upset to kidney failure and death. So make sure your pets are kept far away from cleaners and keep them isolated if necessary when using the products.
3. Antifreeze is severely toxic to animals and can lead to rapid kidney failure within a few hours of ingestion. It also has a very sweet taste and will attract animals to ingest it. Make sure leaks are immediately addressed. If your pet does contact antifreeze on their paws wash with water and mild soap immediately and do NOT allow them to lick their paws afterwards. Antifreeze can also be found in some glass cleaners.
4. Holiday decorations will often attract the attention of cats especially and may cause life-threatening obstructions. Households with cats are advised to avoid tinsel and other ribbon-like decorations altogether. Christmas ornaments, ornament hooks, lights and wires can also be broken or ingested so make sure they are kept out of reach. Wires are quite appetizing to cats and pockets pets!
5. Christmas tree water and needles can cause an upset stomach, diarrhea, vomiting and inappetance, if ingested.
6. Curling ribbon and bows for packages can be easily ingested and cause choking or intestinal obstruction so never leave them out in the open and unsupervised.
7. Holiday flowers, especially lilies, holly and mistletoe, are highly toxic to pets. Other common plants, such as poinsettia can cause gastric upset if eaten.
8. Holiday tables can be very enticing to our furry friends. Owners should never leave animals unattended in a room with food on the table. Several common culprits include meat bones, chocolates, candies, grapes, onions and garlic. All of these are either toxic or pose severe health hazards in our pets.
9. Rock salt used to melt ice can cause irritation to the pads and skin of the feet if animals walk on the substance. They may also lick the salt off their pads which may induce some stomach upset. There are several pet-friendly varieties available at pet stores and online.
10. Presents purchased for your pet should be carefully evaluated prior to giving them their gifts. Make sure that the toys do not have any small pieces which can be easily removed or swallowed such as bells, eyes or strings. Bones that are frayed or splintered should be taken away to avoid chocking or obstruction. Always be cautious with introducing new foods or treats as it may cause some diarrhea and stomach upset. Be careful not to over do it either as many of us are guilty of.

he staff of the Brooklyn Veterinary Group hopes that you and your families have a safe and happy holiday season! For any questions or concerns please do not hesitate to contact us at any time!!

HAPPY HOLIDAYS!

November

Turkey Bone Ingestion

Thanksgiving is right around the corner so we will have to protect our pets from potential dangers at our holiday tables. Turkey or chicken bone ingestion is an all to common problem. Animals will either be offered meat on the bone or steal bones right from the table. In the process of chewing bones they can splinter pieces off or ingest the bone in its entirety. This can result in painful irritation or possible obstruction within the throat or in the intestinal tract. Irritation from a splintered piece of bone can lead to inappetance or gagging. Obstruction in the oral cavity or throat will lead to gagging or possible choking. If the bone becomes lodged within the intestines the pet may exhibit vomiting, diarrhea and inappetance. The animal will be unable to pass any other food through its system and the area of affected intestines is at risk for rupture or tissue necrosis, (death and decay of tissue). This can then result in peritonitis, (infection within the abdominal cavity) or even death of the animal itself. It is therefore best to avoid offering your pets any bones or treats from the dining table.

Casey is a 1-year-old female puggle that was given some left over turkey scraps from the dinner table. Casey presented to our office 2 days later for vomiting and diarrhea. On physical examination, Dr. Sweeney noticed that Casey was mildly dehydrated and had a painful abdomen. She ordered some X-rays of Casey’s belly and found an entire turkey bone lodged within her small intestine. Casey was immediately placed on intravenous fluids to re-hydrate her and prepared for surgery. During surgery, the bone was found lodged within a section of the intestines. The area around the bone was severely bruised and some hemorrhaging had occurred. If her owners had delayed her examination any longer the bone would have perforated the intestinal lining causing intestinal contents to seed the abdominal cavity resulting in potentially life threatening peritonitis.

The surgery was completed by removing the bone through an incision made within the intestinal wall. The area is then sutured back together and tested for leakage. Post operatively, there is a risk for the sutures to break or for leakage to occur despite extra care. The animal is often kept in the hospital for a few days to monitor temperature and if the animal is able to eat and hold food down. In Casey’s situation she recovered fully and without any complications. Her owners have never fed her from the table again no matter how much she begs!

***Owners should also be weary of feeding their animals candy or baked goods containing chocolate, onions, garlic, grapes and raisins. All of which have potentially life threatening complications.
*** For more information on the potential dangers of human foods please contact our staff at the Brooklyn Veterinary Group at any time!

HAPPY HOLIDAYS!

October

Chocolate Toxicity

With Halloween and the other holidays fast approaching owners must be careful with their animals around all of the treats especially chocolate. Dogs and sometimes cats have a strong attraction to chocolate. Unfortunately, even in small amounts, chocolate is highly toxic to animals. Following ingestion of chocolate animals may suffer from vomiting and diarrhea. With large overdoses the nervous and cardiovascular systems are affected and the animal can suffer from muscle tremors, seizures, life threatening arrhythmias, (irregular heart rate), coma and even death. The degree of toxicity depends on the type of chocolate, the amount ingested and the size of the animal. Owners should immediately contact the ASPCA poison control, (888-426-4435), to determine if the amount ingested is toxic. This will allow your veterinarian to ensure proper treatment for the overdose as well. Treatment usually requires that vomiting be induced if the chocolate was recently eaten. Activated charcoal may be given to prevent further absorption of the toxin. The animal often requires intravenous fluids to correct electrolyte abnormalities and an EKG to monitor heart rate and rhythm. Further treatment would depend on the symptoms which the animal is suffering from. Some do require 24 hour monitoring if seizures or an arrhythmia are present.

Simba and Charlie, two six-month old male Pomeranian brothers, presented to our office because their owner found Charlie seizing when she returned home from work. Simba had vomited multiple times around her house. With further investigation, their owner discovered that they had removed a bag of dark chocolate Hershey kisses off of her kitchen table and ingested most of the bag. On presentation, Charlie was suffering from neurologic deficits and had a cardiac arrhythmia. He was immediately given activated charcoal and placed on intravenous fluids and a constant EKG monitor. Medication was administered to control his muscle tremors and irregular heart rhythm. Simba was suffering mostly from gastric upset but was also given charcoal to prevent further absorption and intravenous fluids. Despite constant treatment and close monitoring Charlie continued to seize and eventually slipped into a coma. He died several hours following presentation. Simba, however, made a complete recovery and never suffered from anything more than an upset stomach.

Chocolate is very appealing to pets so remember to keep it high up and in a cabinet if possible. If your pet has eaten any chocolate, baked goods with chocolate or hard candies please contact your veterinarian and the ASPCA poison control at once. A delay in treatment may result in severe life threatening conditions.

September

Mammary Gland Cancer and Pyometra

Spaying and neutering your pets at an early age not only helps control pet overpopulation, but may help prevent potential life threatening disease. Two major complications that intact, unspayed, female animals can suffer from are mammary gland cancer and pyometra, pus-filled uterus. Each heat cycle or period that an intact female goes through causes a surge of hormones that led to thickening of the mammary and uterine tissues. Over time the environment in these regions becomes altered and can promote growth of irregular tissues and bacteria. Tumors and infection can then arise.

Mammary gland cancer is a devastating disease that occurs commonly in dogs and cats that are left intact. Owners will often find a small mass within one of the mammary glands. Surgical removal and biopsy are encouraged to determine the type of mass and prognosis. Surgery requires that wide margins around the mass are obtained to prevent missing any of the cancerous cells. See Photos. In cats, mammary gland tumors are malignant in 90% of the cases. In dogs there is a 50% chance that the tumors are benign or non-cancerous. The cancerous form is fairly aggressive and will often spread to other mammary glands, lymph nodes and the lungs. Long-term prognosis ranges from six months to two years following biopsy. By spaying your pets at the recommended age of six months you remove the hormone stimulation that leads to tissue changes and the risk of cancer.

Pyometra or a pus filled uterus occurs also due to chronic hormone stimulation. The tissue within the uterus becomes thickened and allows for the growth of bacteria within the uterus. This condition can be potentially life threatening and is an emergency. The uterus swells with pus and can rupture resulting in death. Initially the owners may notice that the animal becomes a bit lethargic and goes off food. A bloody to pusy discharge may be noticed from the vulva also. Xrays and bloodwork will be able to determine if a pyometra is present. Emergency surgical removal of the uterus and ovaries is recommended to avoid the potential life threatening complications of this condition. See photos of the enlarged uterus. Again early spaying of your pets will remove the cause of this disease and prevent emergency surgery in the future.

Cases:

Lexi is a 7-year-old female intact domestic short hair cat that developed a large firm mass on the fourth right mammary gland that eventually ruptured. When the owners presented with Lexi she was lethargic and not eating. The mass on right mammary gland chain had ulcerated and was infected. She was in a fair amount of pain as well. Surgical removal and biopsy of the mass was performed and it was determined that the tumor was an extremely aggressive mammary gland cancer. Lexi survived two months after the surgery and then succumbed to her cancer, which had spread to her lymph nodes and lungs. If she had been spayed at six months she would probably have lived a long full life.

Suzie is a 5-year-old female intact German Shepard Dog that presented to our clinic for lethargy and inappetance. The owners also noticed a pusy discharge from her vulva over the past week. Physical examination revealed that Suzie was dehydrated with a high fever. Bloodwork showed a high white blood cell count which indicates infection. On Xray her uterus was enlarged. Lexi was immediately placed on intravenous fluids and antibiotics and prepared for surgery. During surgery an enlarged pus filled uterus was found. If Lexi’s owners had waited any longer she may not have survived. Lexi currently is doing very well. Her owners would have avoided this stressful and costly procedure by performing a spay at a young age.

If you have any questions regarding spaying and neutering your pets please do not hesitate to contact our staff at the Brooklyn Veterinary Group.

August

Heat Stroke

With the warmer months upon us owners should take extra precautions to avoid this potentially fatal condition. Heat stroke occurs when an animal’s body temperature rises well above normal, (also called hyperthermia). Owners must remember that animals cannot sweat like people and are much more affected by temperature changes than humans. Normal body temperature for a dog or a cat range from 100 to 102.5 degrees Fahrenheit. Pocket pets can run higher, normally, around 103 degrees. Some of the causes of heat stroke include high environmental temperatures and humidity, or being kept in an unventilated room or car. Over exhertion from long walks or excessive play may cause this condition as well. Underlying disease can facilitate an animal suffering from heat stroke also. Certain breeds of animals will succumb to the heat faster than others. Brachycephalic breeds, (those with non-elongated snouts such as bulldogs, boxers, pugs and Persian cats) and long-haired breeds are much more prone to overheat than others. Other risk factors include age, obesity, heart disease and dehydration.

Some of the signs that your animal may be exhibiting with heat stroke include panting, excessive salivation, fast heartbeat, reluctance to rise, diarrhea, vomiting, muscle tremors or seizures. These symptoms if left untreated can rapidly progress to multiple organ failure, coma or death within a matter of a few minutes. If you notice any of these signs do not hesitate to bring your pet directly to the vet at once. Treatment includes a complete work up to rule out any underlying disease or potential long-term effects of the hyperthermia. Intravenous fluids are administered to prevent the animal from going into shock and to aid in the cooling process. Isopropyl alcohol is placed on the animal’s pads in a means to allow an evaporative cooling process. Cool water baths may also be used depending on the degree of the hyperthermia. The cooling process must be performed slowly or you run the risk of causing hypothermia, (low body temperature) and shock. All of these treatments must be performed by a veterinary staff to ensure proper regulation of body temperature. In extreme cases, the veterinarian may require that your animal remains in the hospital for monitoring and prevention of a reoccurrence.

Ways to avoid heat stroke include regular veterinary check ups of your pets prior to the summer months or periods of prolonged exercise. If the weather becomes hot and humid owners should make sure that their pets are kept in well ventilated rooms during the day with access to fresh water at all times. Leaving animals outside in these temperatures without adequate shade can be fatal. Restrict walks and exercise during these times as well and again always bring water with you for walks. Never leave your animals in a car unattended during the warmer months. Even with the windows open a parked car can reach a temperature of over 100 degrees Fahrenheit within a few minutes.

Again if you are at all concerned with potential heat stroke bring your animal to your vet at once. Every second counts in this condition and it could be a matter of life or death.

July

Obesity

Obesity in dogs and cats is becoming a daily struggle. As in us, obesity can lead to many serious health problems in our pets. Some of the more common side effects overweight pets encounter are diabetes, heart disease and joint problems. Some animals develop horrific arthritis secondary to the excessive weight placed on their joints. This can lead to an inability to walk or go to the bathroom in which case many owners will elect to euthanize the animal. Heart, kidney or liver can also occur in obese animals and can also be life threatening.
Obesity can develop due to poor diet and lack of exercise. One of the greatest offenders of weight gain is feeding animals table scraps. In some cases there are underlying diseases that may initiate the weight gain so have your pet evaluated by his or her veterinarian prior to starting any kind of weight loss regimen. Only your veterinarian can determine if your pet is indeed obese and what will be the best plan for weight loss.  Often times an over the counter or prescription weight loss diet will be recommended. The owner will be required to measure the food to ensure that the proper amount is fed. It is best to feed pets at least TWICE daily as opposed to once to increase satiety. Also vegetables such as carrots and string beans can be added to the diet counteract the decrease in regular food fed. As always increased activity is recommended as well. For dogs you can take longer walks or play ball. Cats can be encouraged to run around after a laser pointer or dangling toys.

Case #1:

Oscar was 5-year-old Labrador retriever who presented to us for evaluation of a lameness of the right hind leg. Upon exam, Oscar was found to be severely overweight at 98 pounds, which is more than 20 pounds over average. With questioning, we learned that Oscar ate a good brand food, but was constantly offered table scraps and treats throughout the day. Oscar had a great deal of difficulty breathing with just simple activity such as short leash walks. Recently he developed a lameness of the right hind leg that made him almost 100% immobile. With examination, it was determined that Oscar had ruptured a ligament in his knee of the right leg. This type of injury will often cause lameness, but due to Oscar’s obesity it had also rendered him immobile. The owners were unable to lift Oscar to bring him outside to go to the bathroom and he was therefore covered in his own urine and feces as well. The injury most likely occurred primarily due to the excessive amount of weight the leg had to support. Surgical correction of the ligament would be required and would cost the owners approximately $2500.00. Oscar’s owners adored him and proceeded with the surgery. The surgery itself went very well, but Oscar struggled greatly with post-operative recovery again due to his obesity. His owners were unable to support him with only three good legs and he never fully regained the strength to walk again. Regretfully Oscar was put to sleep for a very routine problem that was aggravated by his weight.

Case #2:

Basil was a 10 year old, male neutered domestic short hair cat that came in for increased drinking and urination. Basil weighed 18 pounds where the average cat weighs about 9 to 12 pounds. His diet consisted of dry food all day long and one half a can of wet food. Bloodwork was performed which revealed that Basil had developed diabetes mellitus. This condition, as in humans, causes an increase in blood glucose which can be life threatening. Treatment often requires twice daily injections that the owner is taught to administer at home. Often a special diet is recommended also. Diabetes is very frustatrating and can be costly to deal with. In Basil’s case, his owner had difficulty administering the injections and he suffered a debilitating increase in his blood sugar which resulted in his death. This condition may have been completely avoided if Basil maintained a healthy weight.
Please contact our office if you have any questions regarding your pets weight or health.

June

Flea Allergy Dermatitis / Hypersensitivity

Flea allergy dermatitis or sensitivity is caused when an animal is bitten by a flea and reacts to its saliva. Small red bumps develop and lead to a severe itchiness. Many animals will suffer from hair loss and pruitis, (itchiness). In some cases the animals will scratch or chew themselves until they bleed. Regions of the body usually affected in dogs are the back, groin and tail. In cats, the areas affected are often the head and neck. Depending on the severity the entire body may be affected. Finding the fleas or flea dirt is beneficial in diagnosing the condition, but it only takes one fleabite to trigger a reaction and that flea may have moved on already. Therefore, your veterinarian may just recommend treating for fleas even though you do not visibly see them.

Your pet can contract fleas from one quick visit outside even if it only a few seconds. Even animals that never go out have been found with fleas. Either the owner carries the fleas in on their clothing or another animal in the apartment/ house has a flea infestation. Fleas will also bite humans and can lead to very itchy red bumps as well. Also fleas can carry tapeworm eggs that can be passed onto our pets through ingestion.

Treatment of flea allergy dermatitis includes removal of the fleas via a flea dip or the use of Frontline, a topical spot on treatment available for dogs and cats. Frontline kills any fleas on the animal within 24 hours and will also cause fleas eggs to become infertile and not hatch. The environment MUST be cleaned as well to completely eliminate the fleas. Fleas love to lay eggs in carpeting and crevices within floorboards. Any bedding that the animal comes into contact with should be thoroughly washed or discarded. Anything that can not be washed, couches, rugs, etc., should be sprinkled with an over the counter flea powder that is left to sit for at least one hour. Then vacuum the areas and throw the vacuum bag away because the fleas can survive in the bag. Do NOT put the flea powder on the animal itself and keep them out of that room while the powder is sitting. Some animals can have violent reactions to the flea powder that can lead to seizures or even death. Also you may consider having your house professionally bombed by an exterminator in cases of severe infestations. Flea collars are of minimal use in preventing or eliminating fleas and are not recommended. Be careful with the over the counter imitation topical preventatives. Some animals develop life-threatening illnesses and many have died as a result. Always contact your veterinarian prior to using any medication.

In very itchy animals with sores, steroids and antibiotics will be prescribed to reduce the itchiness, inflammation and secondary infection. Remember that it is easier to prevent fleas than to treat a hypersensitivity reaction and disinfect your entire home. Please pick up your Frontline at your next visit or just stop in to pick some up for your pets today. Now that the weather is warmer the fleas are out!! Frontline will also prevent your pets from getting ticks which can transmit debilitating diseases to our pets and us. As always if you have any questions or concerns regarding fleas or hypersensitivity please contact our staff at the Brooklyn Vet Group at any time.

May

Kidney (or Renal) failure

With the recent pet food recall we would like to discuss kidney disease this month.

Kidney failure can occur suddenly, (acute), or develop over time, (chronic). Potential causes of kidney disease are toxins, certain medications, heart disease, heat stroke, bacterial infections, trauma and cancer. Some of the more common toxins that may lead to kidney failure include antifreeze, grape or raisin ingestion, lily flower ingestion. In the case of the pet food recall an ingredient used in rat bait was detected in the food which causes significant renal damage in dogs and especially cats.

Some of the clinical signs associated with kidney failure include excessive drinking and urination, vomiting, lethargy, weight loss and inappetence. The kidneys help the body to filter out toxins from the blood stream therefore when they are not functioning properly the blood becomes acidic which results in nausea and anorexia. In later stages of the disease you may notice diarrhea and vomiting with blood, dehydration, halitosis, (bad breath), increased respiratory effort and DECREASED urine output. Owners should have their pets immediately examined if they notice any of the signs.

A veterinarian will most likely examine your pet and perform a complete blood count, a vetscreen and a urinalysis exam. These tests will evaluate the kidney functioning ability. If there is evidence of kidney damage than further diagnostics such as X-rays, ultrasound and urine culture may be needed to determine the extent of damage and the cause. With significant damage it is recommended that your pet is admitted to the hospital for intravenous fluids to help flush the kidneys and correct the dehydration and electrolyte abnormalities. After a few days of treatment bloodwork is re-evaluated and depending on the results a better idea of prognosis can be determined.

In cases of acute renal disease prognosis with treatment is often favorable to good. The pet may require long-term diet change to decreased the work load of the kidneys and subcutaneous fluids which an owner can be instructed to perform at home. Bloodwork should be monitored frequently following diagnosis also. Eventually the disease process will not be able to be controlled and at that point is considered chronic. Chronic renal failure on the other hand holds a survival rate of only several months.

If you pet has ingested any of the recalled pet foods we are advising an immediate physical exam, bloodwork and a urinalysis. If you are uncertain of the foods that were recalled please visit www.menufoods.com. Early diagnosis will provide a more favorable prognosis.

April

Otitis Externa (ear infection)

Otitis externa is an inflammation of the external ear canal that commonly occurs in dogs, cats and pocket pets. The inflammation occurs secondary to a change in the normal environment of the ear canal. This can be caused by a number of different factors including moisture in the ear, parasites, polyps or excessive hair or wax. Once the normal environment is altered bacteria and or yeast begin to flourish in the ear canal leading to further inflammation, discharge and discomfort. At this point the ear is infected. The skin within the ear begins to become thick and may occlude the ear canal completely. Without treatment the infection can spread through to the middle and internal canals which may result in a resistant infection or even equilibrium disturbances. Other complications include hematomas of the ear canal which occur when the blood vessels in the ear are ruptured from chronic scratching and shaking. Hematomas require surgical repair and can leave the ear permanently disfigured.

Clinical signs that owners may notice include frequent scratching of the ears or shaking of the head. There may be an odor associated with the infection as well. In advanced cases the discharge may be visible and purulent, (pus filled) or bloody. The condition occurs frequently in animals with floppy ears such as labs or cockers and small breed dogs. In some cases the infection may be due to an underlying allergy condition such as those related to food allergens. A common cause of ear infections in young and stray animals are ear mites which are a tiny parasite that live within the ear canal and cause severe itchiness. These parasites are also contagious to other animals.

If you are noticing any of these signs in your pet it is recommended to see your veterinarian as soon as possible to prevent complications. Your veterinarian may recommend culturing the ear to determine what type of bacteria or yeast is causing the infection and what medications will resolve the issue fastest. Ear infections respond best to topical treatment which requires the owner to clean and treat the ear once to twice daily. In advanced cases oral medications may be needed to control the infection and alleviate some of the discomfort your pet is experiencing. To prevent infections owners should clean their pet’s ears at least every two weeks and after bathes. If you have any questions regarding this matter please do not hesitate to contact the staff at the Brooklyn Vet Group for advice.

March

HypOglycemia (low blood sugar)

A must read for puppy owners

Hypoglycemia or low blood sugar is a condition where there is a low amount of glucose, (sugar), in the blood. This condition can occur in diabetic animals on insulin treatment, during pregnancy, overexertion, and malnutrition or more commonly in young puppies and kittens. Young and small breed animals are most susceptible to this condition. Inappetance and overexertion can rapidly use up the body's store of glucose in young animals. If these animals are not feed the levels may drop dangerously low and cause signs of hypoglycemia to develop. The signs can include weakness, collapse, depression, abnormal behavior, incoordination, vomiting or even seizures. Pepper is a 4-month-old female intact toy poodle that presented to our clinic after decreased appetite, vomiting and weakness for 1 day. On physical examination, Pepper's temperature was low at 99 degrees and she was very weak. A blood glucose was immediately obtained and it revealed that her sugar levels were dangerously low. An intravenous catheter was immediately placed and Pepper was given IV fluids with sugar in them. Pepper stayed at our hospital for the day while we monitored her sugar and had her eating again. By the end of the day, Pepper was up and playful again. Her appetite was back to normal as well. She is now closely monitored by her family for any signs of reoccurrence.

Princess was a 5-month-old female intact Maltese that suffered with similar signs as Pepper, but unfortunately her family was unable to bring her to the hospital for 2 days. By the time they arrived Princess had begun to have seizures. Her blood sugar upon arrival was very low and despite rapid treatment by our staff her seizures continued despite therapy. Princess was suffering with the constant seizures and her body temperature had risen to a deadly level. Her owners elected to euthanize her. Hypoglycemia can be an easily treated condition if