Pet Education Center

Allergic Dermatitis

Arthritis

Cartilage is a slippery substance which acts as a buffer or “cushion” between the bones in a joint. It allows the bones to move over or around each other without pain. Arthritis occurs when the cartilage within a joint becomes damaged. Eventually an arthritic joint becomes inflamed and painful. There are over 100 different types of arthritis recognised in humans. In pets, the most common form is osteoarthritis, sometimes called degenerative joint disease. Other types include rheumatoid arthritis and septic arthritis which is caused by joint infection. Arthritis commonly affects older and middle-aged pets. However, the condition is not limited to these age groups and younger animals can also suffer from the disease. When arthritis eventually causes changes in the joint which result in pain, this often becomes apparent by changes in the animal’s behavior – the primary symptoms of the disease. Because arthritis commonly develops with age, pet owners sometimes confuse changes in their animal’s behavior as normal age-related changes (such as a decrease in play), whereas in fact, the animal might be suffering quite severe arthritic pain.

TYPES

Osteoarthritis
Osteoarthritis is the most common form of arthritis. It is essentially caused by daily wear-and-tear of the joint, but can also occur as a result of injury. Osteoarthritis begins as a disruption of the cartilage; ultimately, this causes the bones in the joint to erode into each other. The condition may start with minor pain during your pet’s activity, but can develop into continuous chronic pain which might even occur when the animal is resting. Osteoarthritis typically affects the weight-bearing joints but can affect both large and small joints of the body. Unlike rheumatoid arthritis, osteoarthritis is most commonly a disease of elderly pets. Osteoarthritis, like rheumatoid arthritis, cannot be cured, but the condition can be prevented from worsening. Physiotherapy to strengthen muscles and joints can be helpful. Pain medications may be required. For some pets, weight-loss can reduce the stress on the joints thereby reducing the development of osteoarthritis.

Rheumatoid arthritis
Rheumatoid arthritis occurs when the body’s own immune system starts to attack body tissues. The attack is quite general and affects not only the joint but also many other parts of the body. This condition causes damage to the joint lining and cartilage. Eventually, this results in erosion of the opposing bones of the joint. Drugs used to treat rheumatoid arthritis include corticosteroids.

SYMPTOMS

Symptoms of arthritis may not be particularly obvious in the early stages of the disease, but become apparent as pain in the joint increases. Symptoms may be particularly difficult to notice in cats as they tend to hide signs of injury or weakness. Limping An animal with arthritis may favor one or more of their limbs, or have a distinct limp. The severity and type of limp will depend on the joint/s that are affected. Limping is often more pronounced immediately after the animal wakes up from sleeping, and then becomes less pronounced as the animal begins moving about.

Reduced mobility
Because of the pain caused by arthritis, affected animals may become reluctant to move in ways with which they previously had no difficulty. For instance, arthritic cats might stop jumping up to high areas for sleeping, or may stop using litter trays with high sides. Dogs may not be able to sit so easily, jump in and out of cars, or get up and down stairs.

Abnormal posture
Arthritis can also affect various parts of the spine. This often results in an abnormal posture with a hunched back, a sore neck, or lameness in one or both hind legs.

Reduced activity
Animals with arthritis become tired more easily. For dogs, walks may become shorter and your pet may spend more time sleeping or resting.

Abnormal grooming
Pets with arthritis often lick, chew or bite the painful body areas. If this becomes severe, it may cause baldness over the affected area, or inflamed skin. Conversely, your pet may reduce its grooming because the movements are painful.

Changes in temperament
As with any condition that causes pain, your pet may become irritable if arthritis develops – they may bite, snap or vocalize when handled. It may be necessary to revise your petting or handling so that it does not cause pain.

Muscle atrophy
Muscle atrophy is a decrease in the mass of muscles. This decrease can be partial or a complete wasting away. Arthritic pets can develop muscle atrophy due to inactivity. Atrophied muscles in the legs will give your pet the appearance of having legs thinner than usual.

RISK FACTORS

Genetics
Some cat breeds are more susceptible to arthritis than others. Hip dysplasia (abnormal development of the hip joints) is seen especially in Maine Coon, Persians, Siamese and other breeds. Patella luxation (dislocation of the knee cap) is more common in Abyssinian and Devon Rex breeds. In dogs, the larger breeds such as Labrador, Retriever, German Shepard and Alaskan Malamute are all more susceptible to hip dysplasia than other breeds.

Injury or trauma
Fractures, dislocations and other joint injuries can cause abnormal joint conformation and irregular future development. This can result in secondary osteoarthritis.

Obesity
There is no evidence that obesity causes arthritis, however, it can make an existing condition worse.

INCIDENCE

Arthritis affects one in every five adult dogs in the U.S. It is one of the most common sources of chronic pain that veterinarians treat. In dogs, the joints most commonly affected by arthritis are:

 hips
 elbow
 shoulder
 knee (stifle)
 wrist (carpus)
 ankle (hock)
 spine (inter-vertebral joints)

A study in 2002 concluded that 90% of cats over 12 years of age had evidence of degenerative joint disease. In cats, the joints most commonly affected by arthritis are:

 shoulder
 hips
 elbow
 knee
 ankle (tarsi)

DIAGNOSIS

A veterinarian will be able to diagnose whether your pet has arthritis. They will perform a physical examination on your pet and may take x-rays. Occasionally, it might be necessary to take blood or joint-fluid samples to investigate possible joint infections.

TREATMENT

Although arthritis cannot be cured, there are treatments available that can ease the pain for your pet. The solution to keeping arthritic pets comfortable is not to limit their activity but to manage their pain. Initially, treatment for pain may need to be aggressive, especially if the pet has been inactive for a long time. As the benefits of exercise develop, the need for pain relievers often decreases.

Exercise
Exercise is important for treating arthritis as it keeps strength in the muscles, tendons and ligaments surrounding the joints. If these supportive tissues become weak or loose, they can worsen arthritis. Exercise stimulates the production of joint-fluid which lubricates the joint and nourishes the cartilage. Exercise also keeps pets from becoming obese; extra weight increases the loading on joints making movement even more painful.

Pharmaceuticals
Nonsteroidal anti-inflammatories (NSAIDs) and opioid derivatives can be used in the treatment of arthritis.

Diet
Several diets or dietary supplements are available for pets with arthritis. These contain essential fatty acids to reduce inflammation, and glycosaminoglycans, the ‘building blocks’ of cartilage.

Additional treatments
Acupuncture and low-level laser therapy have also been used in the treatment of arthritis in pets.

Cancer

Neoplasia describes a process involved in several different diseases. It is therefore difficult to give an all-encompassing definition. However, it is generally recognized that neoplasia is the uncontrolled, abnormal growth of cells or tissues in the body, prior to a lump or abnormal growth developing. Once developed, the abnormal growth is called a neoplasm or tumor. Tumors can be benign or malignant.

Benign and Malignant Tumors

A benign tumor is a mass of cells that lacks the ability to invade neighboring tissue or spread throughout the body. Benign tumors typically have an outer fibrous sheath of connective tissue and grow more slowly than malignant tumors. Malignant tumors usually grow more aggressively, they invade the tissues surrounding them and can metastasize (spread throughout the body). The actual swelling or appearance of a neoplasm is often described as a “tumor” or “mass”. The word “cancer” is often used instead of neoplasia, but only malignant neoplasms are true cancers.

INCIDENCE OF NEOPLASIA AND CANCER

Neoplasia is common in pets and the incidence increases with age.

Cats
Approximately 32% of all cats over 10 years of age will die from some type of cancer. Most feline cancers occur in cats 10 to 15 years of age – although lymphoma is an exception as this occurs most often in young cats. Cats commonly develop skin tumors; 25% of all feline cancers are skin cancers, with 50% to 65% of them being malignant. The next most common type of feline cancer is breast cancer (17%) and approximately 10% of all feline tumors are found in the mouth.

Dogs
It has been estimated that almost 50% of deaths in dogs over 10 years of age are cancer-related and approximately 25% of all dogs will die from cancer. Overall, the incidence of cancer is 3 times greater in female dogs compared to males. This difference is due to the much high rate of mammary cancer in bitches. The incidence of cancer in pure-bred dogs is substantially higher. For example, one in five Golden Retrievers is diagnosed with hemangiosarcoma and is likely to die from it. Other breeds in which cancer is more common include the Boxer, Bernese Mountain dogs and Greyhound.

DIAGNOSIS

Physical examination and a pet’s medical history may lead a veterinarian to suspect neoplasia. Additional tests, such as x-rays, ultrasound examination and blood-tests may be necessary to confirm the diagnosis. In some cases, taking a tissue sample (biopsy) from the neoplasm for microscopic examination may also be necessary. This examination can help determine whether the neoplasm is benign or malignant. Additional tissue samples from other organs such as the lymph nodes may be necessary to determine the rate and extent of spread of a malignant neoplasm.

CAUSES

The causes of most neoplastic diseases are not known. Prevention is therefore difficult and early detection is the best way to manage neoplasia. Cancer is a “multi-factorial” disease. This means it has no known single cause. Hereditary and environmental factors have been identified as risk factors contributing to the development of cancer in pets.

COMMON TYPES OF NEOPLASIA IN PETS

Skin
Skin neoplasia is common in older dogs, although developing tumors are usually benign. Cats also develop skin neoplasms, most of which are malignant. If you find a lump on your pet, your veterinarian should be consulted to determine whether it is malignant.

Mammary Gland (Breast)
Both cats and dogs can develop mammary neoplasms. In dogs, mammary cancer is the most frequently diagnosed cancer, accounting for 70% of all cancer cases. In dogs, 50% of all breast neoplasms are malignant, whereas in cats, more than 85% of breast neoplasms are malignant. Spaying your female pet before she is 12 months old will greatly reduce the risk of this type of neoplasia.

Head and Neck
Neoplasia of the mouth is common in dogs but less common in cats. Symptoms include tumors on the gums, bleeding, bad breath, or difficulty in eating. Because many swellings in these areas are malignant, early, aggressive treatment is essential. Neoplasms may also develop inside the nose. These can cause bleeding from the nose, breathing difficulty, or facial swelling. These symptoms should be checked by your veterinarian.

Lymphoma
Lymphoma is a common form of neoplasia in dogs and cats, characterized by swelling of one or several lymph nodes in the body. In cats, one cause of lymphoma can be the contagious feline leukemia virus.

Testicles
Testicular neoplasia is rare in cats. It is more common in dogs, especially those with retained testicles, i.e. testicles that did not descend correctly during maturation and may remain located in the abdomen or between the abdomen and scrotum.

Abdomen
Neoplasms inside the abdomen are common. Because of their location, they can be difficult to detect and an early diagnosis is unlikely. Symptoms of abdominal neoplasia are weight loss or abdominal swelling.

Bone
Bone neoplasms are seen most often in large-breed dogs or dogs older than 7 years; they are rarely seen in cats. The most common sites are the leg bones, near the joints. Symptoms include persistent pain, lameness, and swelling in the affected area.

Non-neoplastic conditions
Many symptoms of neoplasia are also seen in non-neoplastic conditions, however, they still need prompt attention by a veterinarian for diagnosis. Neoplasia is often treatable; early detection and diagnosis will assist in getting the best possible treatment.

TREATMENT

The various types of neoplasia require different individual treatment. This may include one, or a combination, of therapies such as surgery, chemotherapy, immunotherapy, radiation, hyperthermia (heating) or cryosurgery (freezing). Your pet’s overall health is, of course, important. Veterinarians may recommend dietary changes or other alterations to your pet’s life to help your pet respond better to the proposed treatment. Discuss with your veterinarian, the best treatment options for your pet and especially the risks and side-effects associated with these options Pain management is an extremely important aspect of treatment. In some cases, depending on the recommended course of treatment, your veterinarian may refer you to a cancer specialist, or specialty clinic. Some types of neoplasia can be cured, but other types can only be managed to decrease their spread to other organs and tissues of the body. This will prolong your pet’s comfort and quality of life as much as possible. Early detection of a neoplasm and the type of neoplasm are often the greatest factors which determine the success of treatment.

EUTHANASIA

Depending on the severity, development and type of cancer, euthanasia may be considered. Before making your decision for treatment or euthanasia, discuss with your veterinarian the options available so that you can make the best choice for your pet and your family.

SUCCESS RATE

The success rate of any treatment is highly dependent on the type and severity of the neoplasia, as well as the aggressiveness of any treatment being undertaken. Benign neoplasms are usually easier to treat. Although some neoplasms, especially the more aggressive cancers, cannot be cured, treatment can both prolong and improve your pet’s quality of life.

THE FUTURE

Research means we are learning more and more about neoplasia. Animals today have a considerably better chance of being successfully treated for neoplasia and cancer than they did just a few years ago. New diagnostic methods, such as improved imaging techniques, can help detect neoplasia earlier. These will improve your pet’s chances of an early diagnosis and receiving early treatment. New treatments are being developed which will provide better success rates with less risk of side-effects.

Dental Disease

Oral hygiene is a very important issue for dogs and cats. The bad breath that is so common in pets is also often the first sign of dental disease. By 2 years of age, 85 percent of dogs and cats have periodontal disease. Periodontal disease begins with the accumulation of plaque on the teeth which, if not removed, then hardens into tartar. Tartar accumulation causes sensitive, sore, and swollen gums as well as gingivitis. At this point your pet is suffering from advanced dental disease. As well as the visible cosmetic problems, advanced dental disease also has an effect on many internal organs. Bad teeth in dogs and cats has been scientifically linked to heart, lung, and kidney problems, which can shorten the life of your pet.

The progression of dental disease is affected by breed and diet. In dogs, smaller breeds tend to experience dental problems at a younger age than their larger counterparts. In cats, mixed breeds do not suffer from dental disease as much as purebreds do. Many years ago, it was believed that animals should always be fed dry food to help keep tartar at bay and prevent dental issues. That way of thinking has been replaced, and the Veterinary Dental Society does not consider dry food or canned food to make a difference.

It is recommended that you always try to prevent dental disease, but if your pet already shows signs of dental issues such as loose teeth, swelling gums or oral infection, a deep cleaning performed by your veterinarian under general anesthesia may be necessary.

There are many basic steps that can be taken to prevent dental disease at home. To further eliminate plaque and improve the health of your pets’ mouths, you should brush their teeth daily, beginning when they are young. While there are rinses available to combat bad breath, be cautious of anything containing alcohol. Chinese herbal remedies have proven helpful in some situations, but diet and daily brushing are the best ways to prevent dental disease in dogs and cats.

Diabetes- Canine

Diabetes mellitus is a disease caused either by a lack of insulin, or an inadequate response of the body to this hormone. After your dog has eaten, the digestive system breaks-down the food into various parts. One of these is carbohydrates which are further converted into simple sugars such as glucose. Glucose is absorbed from the gut into the blood where it is transported around the body. Insulin, which is produced by “beta cells” in the pancreas, helps in the process of moving glucose into the cells of the body where it is converted into fuel. If there is insufficient insulin available, or the body responds inadequately to insulin, glucose is unable to enter cells and can build up to high concentrations in the bloodstream. The resulting condition is called hyperglycemia. As a result, an animal may behave as if it is constantly hungry (the cells are not producing fuel), but may also appear malnourished, again because the cells are unable absorb glucose.

Damage to the beta cells in the pancreas can be either temporary or permanent. The damage may be caused by a virus, infection, trauma, some medications (steroids), or even from over-work after too much sugar or carbohydrate consumption.

Diabetes mellitus is often divided into two types, depending on the origin of the condition:

Type 1
Diabetes mellitus Type 1, sometimes called “juvenile diabetes” or “insulin-dependent diabetes”, is caused by the destruction of beta cells in the pancreas. Because the destruction of the cells is not reversible, the animal must be treated with an exogenous (external) source of insulin. Both dogs and cats can suffer from Type 1 diabetes.

Type 2
Diabetes mellitus Type 2, sometimes called “”adult-onset diabetes” or “non-insulin-dependent diabetes”, is characterized by high blood sugar due to the body being resistant to insulin and a relative lack of insulin. Type 2 diabetes is not found in dogs but it is found in cats.

RISK FACTORS AND INCIDENCE

There is evidence that canine diabetes has a seasonal connection (similar to that in human Type 1 diabetes). The primary cause of canine diabetes is unknown, however, the major risk factors are thought to include
 Genetics
 Autoimmune disease
 Other insulin-resistant disorders, e.g. Pancreatitis
 Obesity
 Certain medications

Between 0.2% to 1.0% of dogs develop Type 1 diabetes. This incidence is expected to increase in the future. The disease typically affects middle-aged (6 to 9 years) and older dogs, especially females that have not been spayed.

Some breeds are at greater risk of developing the disease. These include Australian Terriers, Poodles, Dachshunds, Standard and Miniature Schnauzers, Samoyeds and Keeshonds. Other breeds show a lower risk than normal. These include Boxer, English Springer Spaniel, German Shepherd, Golden Retriever, Staffordshire Bull Terrier and Weimaraner.

Juvenile diabetes can also occur; Golden Retrievers and Keeshonds are particularly susceptible.

DETECTION

Diabetes is one of many conditions that cause visible changes in behavior which the owner can detect. Usually, there is a gradual onset of the disease over a few weeks. By knowing the signs of diabetes, you will be able to detect the disease earlier and thereby seek an early diagnosis and treatment. The following are indications your dog may have diabetes. If your dog shows any of these, speak with your veterinarian about the possibility of diabetes:
 Excessive thirst/drinks more water than usual (polydipsia)
 Urinates more frequently or in greater volumes (polyuria) or perhaps loses urinary control
 Consistently acts hungry (polyphagia) but maintains or loses weight
 Unusually sweet-smelling or fruity breath (from ketone production)
 Lethargy
 Dehydration
 Urinary tract infections
 Vomiting
 Chronic skin infections
 Cloudy or misty eyes

DIAGNOSIS

To diagnose diabetes, your veterinarian will initially conduct a test for the presence of glucose and ketones in the urine. If necessary, a blood test will then measure your dog’s blood glucose concentration. A diagnosis of diabetes is confirmed if glucose is present in the urine and its also at a persistently high concentration in the blood.

MANAGEMENT

The objective in managing diabetes is to regulate glucose concentrations by avoiding peaks and troughs, and to reduce or eliminate the symptoms of diabetes, such as excessive thirst and urination. With daily insulin injections, changes in diet and lifestyle, the disease can be successfully managed. Currently, dogs diagnosed with diabetes and receiving appropriate treatment, have the same, or similar, life expectancy as non-diabetic dogs of the same gender and age.

Insulin
Managing canine diabetes often requires daily insulin injections to restore your dog’s insulin level and control blood glucose concentrations. Each individual diabetic dog’s requirements are different, so you and your veterinarian will need to find the appropriate dose and treatment regimen. Your dog may need to stay at the veterinary clinic for several days so that your dog’s response to treatment can be closely monitored. The prescribed insulin product may be specifically for diabetic dogs, or a human insulin product. The size of insulin dose will depend on several factors, including the weight of the dog.

If your dog needs daily injections, you will have to learn how to do this. It can be a daunting task and at first you may feel nervous about this. This is common, but, it is easier than you probably think. After a while, you will learn how to administer daily injections without stress for your pet or you.

Monitoring
It is an important part of diabetes management to monitor your dog’s blood glucose concentrations. The method of monitoring will depend on you and your diabetic dog. Methods include urine glucose (and ketone) test strips, or, blood glucose meters.

Diet
Diet is vitally important in helping to regulate your dog’s diabetes. If your dog is more stable when first diagnosed, the first treatment might be a high-fiber diet to normalize blood glucose levels. Once the levels are stabilized you should aim to feed your dog exactly the same diet every day and at the same time(s) of day.

The diet is likely to have a low fat content, a good-quality protein, complex carbohydrates and dietary fiber to help slow absorption of glucose from the gut. Your diabetic dog’s insulin injection should be given in conjunction with the regular meals – usually just afterwards. This allows increased nutrients in the blood to coincide with peak insulin levels. This will reduce the tendency for your pet’s blood sugar levels to swing either too high or too low. Overall, the diet should be palatable, nutritious, and minimize fluctuations in blood glucose. In addition, it should help maintain a healthy weight for your dog. Avoid feeding diabetic dogs treats that are high in glucose.

Exercise
For diabetic dogs, exercise should be regulated because activity affects blood glucose concentrations. Create a consistent exercise routine to avoid any sudden requirement for energy or glucose.

Checkups
It is important to get regular veterinary checkups to identify possible changes in your pet’s diabetic condition. Diabetes affects dogs differently over time. Changes may even occur after a long period of stabilization. If diabetes progresses, dogs can develop secondary health concerns such as cataracts and severe urinary tract problems. Ultimately, untreated diabetes can cause coma and death.

THE FUTURE

Although it is often stated that canine diabetes can not be cured, in February 2013, Type 1 diabetes in dogs was successfully cured using pioneering gene therapy.

Diabetes- Feline

Diabetes mellitus is a disease caused either by a lack of insulin, or an inadequate response of the body to this hormone. After your cat has eaten, the digestive system breaks down the food into various parts. One of these is carbohydrates which are further converted into simple sugars such as glucose. Glucose is absorbed from the gut into the blood where it is transported around the body. Insulin, which is produced by “beta cells” in the pancreas, helps in the process of moving glucose into the cells of the body where it is converted into fuel. If there is insufficient insulin available, or the body responds inadequately to insulin, glucose is unable to enter cells and can build up to high concentrations in the bloodstream. The resulting condition is called hyperglycemia. As a result, an animal may behave as if it is constantly hungry (the cells are not producing fuel), but may also appear malnourished, again because the cells are unable to absorb glucose.

Damage to the beta cells in the pancreas can be either temporary or permanent. The damage may be caused by a virus, infection, trauma, some medications (steroids), or even from over-work after too much sugar or carbohydrate consumption.

Diabetes mellitus is often divided into two types, depending on the origin of the condition:

Type 1
Diabetes mellitus Type 1, sometimes called “juvenile diabetes” or “insulin-dependent diabetes”, is caused by the destruction of beta cells in the pancreas. Because the destruction of the cells is not reversible, the animal must be treated with an exogenous (external) source of insulin. Both cats and dogs can suffer from Type 1 diabetes.

Type 2
Diabetes mellitus Type 2, sometimes called “”adult-onset diabetes” or “non-insulin-dependent diabetes”, is characterized by high blood sugar due to the body being resistant to insulin and a relative lack of insulin. Type 2 diabetes is found in cats, but not in dogs.

RISK FACTORS AND INCIDENCE

Diabetes has been diagnosed in cats of all ages, both sexes, both intact and neutered individuals and all breeds. Older cats, especially neutered males, are more susceptible to the disease. It has been reported that in the UK, Australia, and New Zealand, Burmese cats have a higher incidence of diabetes mellitus but this has not been found in North America.

Key risk factors for diabetes in cats include
 Genetics
 Chronic pancreatitis
 Other metabolic diseases (e.g., hyperthyroidism, Cushing’s disease, acromegaly)
 Physical inactivity
 Predominant indoor lifestyle
 Obesity

Between 0.2% to 1.0% of cats develop Type 1 diabetes. This incidence is expected to increase in the future.

DETECTION

Diabetes is one of many conditions that cause visible changes in behavior which the owner can detect. Usually, there is a gradual onset of the disease over a few weeks. By knowing the signs of diabetes, you will be able to detect the disease earlier and thereby seek an early diagnosis and treatment. The following are indications your cat may have diabetes. If your cat shows any of these, speak with your veterinarian about the possibility of diabetes:
 Excessive thirst/drinks more water than usual (polydipsia)
 Urinates more frequently, in greater volumes (polyuria) or perhaps loses urinary control
 Consistently acts as if it is hungry (polyphagia), but maintains or loses weight
 Unusually sweet-smelling or fruity breath (due to ketone production)
 Lethargy
 Thinning, dry and dull hair

DIAGNOSIS

To diagnose diabetes, your veterinarian will initially conduct a urine test for the presence of glucose, ketones and/or urinary tract infection. If necessary, a blood test will then measure your cat’s blood glucose concentration. If glucose is present in your cat’s urine, a blood test will determine blood glucose concentration and fructosamine concentration. A consistently raised blood glucose concentration could indicate that your cat’s pancreas is not secreting sufficient insulin, or, your cat’s body is behaving as if it is “resistant” to the insulin being produced. Regardless of the underlying cause for the increased blood sugar, your cat is suffering from diabetes mellitus. The diagnosis is considered as confirmed when glucose is found at consistently high concentrations in blood and in urine.

MANAGEMENT

Because cats can suffer from either Type 1 or Type 2 diabetes (dogs only suffer from Type 1) some cats can be treated (at least initially) with oral medications, while others require immediate insulin injections.

The objective in managing diabetes is to regulate glucose concentrations by avoiding peaks and troughs, and to reduce or eliminate the symptoms, such as excessive thirst and urination. Although diabetes can not yet be cured in cats, the condition can be successfully managed with daily insulin injections, changes in diet and/or medication. The serious chronic complications that afflict humans with diabetes mellitus are uncommon in diabetic cats. Once stabilized with proper treatment and home care, diabetic cats can live many healthy years.

Insulin
Managing feline diabetes often requires daily insulin injections to restore your cat’s insulin level and control blood glucose concentrations. Each individual diabetic cat’s requirements are different, so you and your veterinarian will need to find the appropriate dose and treatment regimen. Your cat may need to stay at the veterinary clinic for several days so your cat’s response to treatment can be closely monitored. The prescribed insulin product may be specifically for diabetic cats, a human insulin product, or a human oral hypoglycemic medication. The size of the insulin dose will depend on several factors, including the weight of the cat.

Some diabetic cats may show clinical remission after a few weeks or months of treatment, i.e. they will cease requiring insulin. However, clinical remission does not mean that the diabetes has been cured; the cat’s diet and lifestyle must still be taken care of and insulin may be required again in the future.

If your cat does need daily insulin injections, you will have to learn how to do this. It can be a daunting task and at first you may feel nervous about this. This is common, but, it is easier than you probably think. After a while you will learn how to administer daily injections without stress for your cat or you.

Oral Hypoglycemic Medications
Healthy diabetic cats can sometimes be successfully treated with glipizide. This is an orally administered medication that lowers blood glucose. Although glipizide is suitable for controlling the disease in some cats, most require insulin injections to fully control their diabetes.

Monitoring
It is an important part of diabetes management to monitor your cat’s blood glucose concentrations. The method of monitoring will depend on you and your diabetic cat. Methods include urine glucose (and ketone) test strips, or blood glucose meters.

Diet
Diet is vitally important in helping to regulate your cat’s diabetes. Once the blood glucose levels are stabilized, you should aim to feed your cat exactly the same diet every day and at the same times of day. Many cats prefer eating small amounts throughout the day and your veterinarian will probably not try to change this. Cats require high levels of good-quality protein in their diet. A high-protein, low-carbohydrate food is ideal for a diabetic cat. Overall, the diet should be palatable, nutritious and minimize fluctuations in blood glucose. In addition, it should help maintain a healthy weight for your cat.

Checkups
It is important to get regular veterinary checkups to identify possible changes in your pet’s diabetic condition. Diabetes affects cats differently over time. Changes may occur even after a long period of stabilization.

THE FUTURE

Although it often stated that diabetes can not be cured, in February 2013, Type 1 diabetes in dogs (not cats) was successfully cured using pioneering gene therapy. It seems only a matter of time before this is applied to cats.

Distemper- Canine

Canine distemper is a viral disease. It affects domestic dogs and several species of wildlife such as raccoons, wolves, foxes and skunks. Canine distemper is contagious and has no known cure. In domestic dogs, young, non-vaccinated puppies are most susceptible to the disease. The virus belongs to the Morbillivirus class of viruses. This means it is a relative of the human measles virus.

SYMPTOMS AND TYPES

The infective virus can be found in secretions from the eyes and nose, and in urine and feces. It can therefore be spread in several ways – through the air during indirect contact (e.g. utensils, bedding), or direct contact with an infected animal. The time between infection and disease is 14 to 18 days, however, a fever may occur from 3 to 6 days after infection. Initially, the virus attacks the dog’s tonsils and lymph nodes. It replicates itself in these tissues for approximately 7 days and then attacks the nervous, respiratory, urogenital and gastrointestinal systems.

Initial symptoms of canine distemper include an elevated body temperature (above 103.5°F or 39.7°C), reddened eyes and a watery discharge from the nose and eyes. More developed symptoms include lethargy, tiredness and eventually anorexia. At this stage, coughing, vomiting and diarrhea may also occur. In the extreme stages of the disease, the virus affects the other bodily systems, particularly the central nervous system (CNS); the dog may begin having seizures, fits and paralysis.

Some strains of the virus can cause an abnormal enlargement or thickening (hyperkeratosis) of the foot pads and sometimes the nose. This symptom gives canine distemper its colloquial name of “hard pad disease”.

In animals with weak or compromised immune systems, death can result 2 to 5 weeks after the initial infection.

CAUSES

If live vaccines are not properly attenuated, or the incorrect type of vaccine is administered, this can
inadvertently transmit the disease to the animal, however, this is a rare route of transmission. If your dog’s respiratory or gastrointestinal systems have a bacterial infection, this can increase his vulnerability to distemper. In particular, non-immunized dogs that have contact with an infected animal or its environment (e.g. bedding, bowls, toys) are at great risk of contracting the disease.

DIAGNOSIS

Diagnosis of canine distemper requires biochemical tests and urine analysis. These may reveal a reduced number of lymphocytes (white blood cells that function in the immune system), a disease called “lymphopenia”.

Blood serology tests may identify positive antibodies produced by the immune system to combat the virus, however, this test cannot distinguish between antibodies that have occurred due to vaccination or exposure to a virulent virus. Viral antigens (proteins produced by the virus) may be detected in urine or vaginal tests.

Skin associated with hair, mucous (from the nose) and the epithelium of the foot-pad may also be tested for antibodies.

If it is suspected that the infected animal has developed pneumonia, radiographs may be used. Brain lesions can be detected by computerized axial tomography (CAT) and magnetic resonance imaging (MRI) scans.

TREATMENT

There is no cure for canine distemper and there are no antiviral drugs effective in treating the disease. Treatment of the disease is therefore directed toward alleviating the symptoms. For example, intravenous fluids may be used to support an animal that has become anorexic, dehydrated or has diarrhea. Regular clearing of discharge from the eyes and nose may be required. Antibiotics should control the symptoms caused by secondary bacterial infections, and phenobarbitals and potassium bromide may be required to control convulsions and seizures. The CNS should also be monitored for seizures and related neural disturbances.

LIVING AND MANAGEMENT

A dog’s prognosis for surviving canine distemper is dependent on several factors such as the strain of the virus and the capability of the dog’s immune system. Recovery is possible, although seizures and other fatal CNS events can occur 2 to 3 months after recovery. Fully recovered dogs are not infective – they do not spread or carry the virus.

PREVENTION

To prevent canine distemper, ensure your dog is routinely vaccinated and immediately isolated from any infected animals. New-born pups have under-developed immune systems and therefore particular care must be taken not to expose them to the virus. The virus does not survive in the environment for more than a few hours at room temperature. It is destroyed by routine cleaning with disinfectants, detergents, or drying. However, it can survive for several weeks in shady environments at temperatures slightly above freezing. It can also persist longer in serum and tissue debris.

Distemper- Feline

Feline Panleukopenia Virus (FPV) is a viral disease of cats. It is also known as “Feline Infectious Enteritis”, “Feline Distemper”, “Feline Ataxia”, or “Cat Plague”. It is highly contagious and life-threatening. The name, panleukopenia, is derived from the low count (leucopenia) of white blood cells (leucocytes in the immune system) characteristic of affected animals. The virus attacks primarily the intestinal tract, bone marrow and stem cells of the developing fetus. Specifically, it attacks the rapidly dividing blood cells in these tissues, meaning infection often leads to anemia and the animal becoming highly susceptible to secondary viral or bacterial infections.

FPV is one of the most significant feline diseases in the non-vaccinated population. The virus is highly resistant and can survive for years in contaminated environments. This means that vaccination is the best prevention measure for your cat. Kittens between 2 to 6 months of age, pregnant cats and immune compromised cats are at the highest risk of developing severe symptoms. In adults cats, FPV generally occurs in only mild form and may not show any symptoms. Cats which survive an FPV infection develop immunity to any further infection with the virus.

The virus causing FPV is related to the canine parvovirus as they are both in the genus Parvoviridae, however, the feline parvovirus can not be transmitted from cats to dogs, or vice versa.

SYMPTOMS

Behavioral
 Depression
 Complete loss of interest in food or water (may hang head over bowl but not drink or eat)
 Hiding for several days
 Tucking feet under the body for extended periods
 Resting chin on the floor for extended periods

Physiological
 Vomiting
 Diarrhea (often contains blood)
 Dehydration
 Anorexia (weight loss)
 Fever
 Anemia
 Poor coat condition
 Ataxia (other neurological symptoms if the virus attacks the brain)

Causes
FPV is caused by the feline parvovirus which is transmitted by contact with infected blood, feces or urine. The virus can also be transmitted by fleas that have been feeding from an infected cat, or by humans who have not washed their hands between handling cats, or by equipment that has been used by other cat such as bedding or bowls. Proper human hygiene, e.g. using soap and water during hand-washing after handling each animal, minimizes the possibility of transmitting the infection to healthy animals.

The feline parvovirus can survive and persist on many surfaces. It is therefore important to practice safe methods to effectively clean the cat’s environment, including its handlers, to reduce the possibility of transmission. Even with these precautions, the virus may persist in environments where an infected cat has been. Establishments which house large numbers of cats (e.g. shelters and kennels) may harbor the virus.

Kittens can acquire FPV while in the uterus if the pregnant mother is infected, or, through her breast milk during nursing. The prognosis is generally poor for kittens which have contracted the disease whilst in the uterus.

Because cats tend to go outdoors more during summer, the disease is more likely to be transmitted during this season.

Diagnosis
If you suspect your cat has FPV, your veterinarian will require a thorough history of her health and recent activities. This will include whether your cat has recently been in contact with other cats, or if she is allowed access to the outdoors.

FPV symptoms can be similar to several other diseases including poisoning, pancreatitis, feline leukemia, feline immunodeficiency virus and others. It is therefore important to give as much detail as possible to your veterinarian so that appropriate treatment can start quickly.

The veterinarian will initially perform a physical examination. If necessary, blood tests will be taken for a complete blood count and biochemistry profile, and possibly a urine test for urinalysis. The feline parvovirus attacks and kills cells that divide rapidly, such as those in the intestine and those produced in the bone marrow. An infected animal will typically have a blood count that is low in white and red blood cells. Microscopic examination of feces may reveal remnants of the virus.

Treatment
Cats infected with FPV are likely to require immediate treatment. Because dehydration is one of the primary symptoms, the major aim is to restore body fluid levels to normal values and maintain these, along with appropriate electrolyte balance. It is critical this is done quickly as the dehydration can quickly become life endangering. Because the virus compromises the immune system, your cat may have to take antibiotics to reduce the possibility of opportunistic bacterial infections.

Your cat will need to be rested during her recovery. Provide a warm and quiet space away from other animals and children. Avoid her exerting herself by placing food, water and the litter tray close to her recovery bed. Isolate the infected cat from others, however, maintain your own physical contact with the cat as the probability of your cat’s recovery are increased by receiving affection from you; this infection has an extremely depressing effect on both the mental and physical health of your cat and your cat ‘s recovery will benefit considerably from your affection and comfort. Strict hygiene is essential. Remember that the virus can remain infective on surfaces and people which handle an infected cat should stay especially clean to avoid transmitting the virus to other cats.

If your infected cat is treated effectively and quickly, and survives the first 2 days, it is likely she will make a full recovery. It may take several weeks for your cat to return to complete normality, but once she has, she will have a life-time immunity to FPV and will not transmit the virus after the initial infection.

Living and Management
Follow your veterinarian’s advice with regards medication, isolation of your cat and household disinfection. Closely observe your other cats for signs of illness and discuss with your vet, the possibility of vaccinating other cats in the home.

Although household bleach is an effective disinfectant against the FPV virus, replacing all items associated with an infected cat is the best way to ensure any traces of the virus have been removed. Remember that although your infected cat will not be susceptible to re-infection, other cats can easily be infected by contaminants that remain.

The most important action in the prevention of FPV is vaccination. Ensure you ask your veterinarian to include the FPV vaccine in any vaccination program for your cat. Non-vaccinated, pregnant cats have a compromised immune system and are therefore highly susceptible to fatal complications. If the developing fetuses become infected with FPV, they are very likely to have severe developmental dysfunctions at birth.

Ear Mites

“Ear mites” is a term used to describe an infestation of an animal’s ears by the mite Otodectes cynotis. This is a common parasitic infestation, but it is generally mild in severity. Complications can occur if the animal’s immune system is in some way compromised. In such cases, the mites can cause hypersensitivity and subsequent irritation of the external and middle ear.

Animals that have an infestation typically scratch excessively at the ears, shake their heads and even create bald patches by removing their hair from scratching. A serious consequence of prolonged and vigorous shaking of the head is that some ears will form a hematoma. This is a collection of blood within the tissues of the external ear – usually because the head shaking and scratching has ruptured a blood vessel. Excessive scratching at the ears can also cause damage to the ear canals or ear drums.

Ear mites can occur in animals of any age, although it is particularly common in young cats and dogs. It is highly contagious and is often transmitted from the mother to the newborn soon after birth. It is also transmitted between animals of different species, although it does not affect humans. The mite can often spread from the ear to other parts of the body.

SYMPTOMS

Behavioral
 Itching and scratching – usually the ears, head and neck
 Generalized itching
 Frequent shaking of the head

Physical
 Thick red-brown or black crusts on the inside of the ear
 Bumps in the ear canal which look like coffee grounds
 Scratches and abrasions on the external ear
 Crusting and scaly tissue on various body areas including the neck, rump and tail

DIAGNOSIS

Diagnosis will require a detailed history of your pet’s health, when the symptoms started, and details of the regular contact your pet has with other animals. Your veterinarian will perform a complete physical exam and then, if needed, standard laboratory tests such as a blood count and blood profile, urinalysis and electrolyte tests to screen for other diseases.

Skin scrapings will be taken for dermatological analysis. Identification of the mites may require ear swabs to be placed in mineral oil. Your veterinarian will use an otoscope to inspect your pet’s ear canals to assess the severity of the infestation. If your pet is hypersensitive to the mites, a deep examination of the ears can be difficult. In such cases, a diagnosis can be made by observing the animal’s response to medical treatment.

TREATMENT

If your pet has ear mites, it is likely he will be treated as an outpatient and you will be provided with medication to eradicate the mites. This infestation is extremely contagious; all pets in the household should be treated and their environment thoroughly cleaned. The mites can not survive for long periods away from the host, so cleaning the environment thoroughly and treating the pets is usually sufficient.

A commercial cleaner should be used to generally clean the insides of ears to remove any debris before beginning topical treatment. The parasiticide should be used for between 7 to 10 days to eradicate mites and eggs, and then a repeat treatment approximately 2 weeks later. Flea treatments should also be applied to eliminate mites on other sites of the body. Some animals, especially cats, sleep in a curled-up position. This means their tail can come into contact with their ears and there is risk of spreading the mite infestation. Therefore, the tail should also be thoroughly cleaned.

LIVING AND MANAGEMENT

Most patients will have a good prognosis. Your veterinarian will schedule a follow up appointment for approximately 30 days after therapy begins. They will swab your pet’s ears and also perform a physical exam to assess the effectiveness of the treatment.

Epilepsy- Canine

Epilepsy is a neurological condition which occurs in many animals, including dogs. It is caused by sporadic electrical storms in the brain which result in seizures or fitting. Seizures are a sudden involuntary increase in muscle tone and/or movement. They vary from being brief and nearly undetectable episodes, to long periods of vigorous shaking. Epilepsy is often an inherited condition and is the most common brain disorder in dogs. The incidence is much higher in some breeds, e.g. the English Springer Spaniel.

TYPES OF SEIZURE

Status epilepticus
A life-threatening condition in which there is one continuous seizure lasting longer than 10 minutes, or recurrent seizures with no period of normal consciousness.

Cluster seizure
Multiple seizures within a 24-hour period which may also be life threatening.

Seizures are further classified as focal, generalized, and focal with secondary generalization. Focal seizures affect only a small part of the brain, whereas generalized seizures tend to affect both sides of the brain.

As the frequency of seizures increases, the probability of damage to the brain neurons also increases. This in turn increases the likelihood that the dog will seize again.

STAGES OF A SEIZURE

 The Prodome – This stage precedes the seizure by hours or days and is characterized by changes in the dog’s mood or behaviour.
 The Aura – This signals the start of a seizure. The dog may show nervousness, whining, trembling, salivation, restlessness, hiding and apprehension.
 The Ictus – the actual seizure. This is a period of intense physical activity usually lasting 45 seconds to 3 minutes. The dog may lose consciousness and show teeth gnashing, uncontrolled thrashing of limbs, drooling, whining, foot paddling, urination and defecation.
 The Post Ictus/Ictal – This is the stage after the seizure. The dog may eat or drink excessively, continuously pace, or appear blind and deaf.

TYPES OF EPILEPSY

There are three types of epilepsy that can affect dogs; reactive, secondary and primary. Symptomatic (secondary) means that a cause has been identified, whereas idiopathic (primary) means there is no apparent cause.

Reactive seizures are caused by metabolic problems, such as low blood sugar. or kidney or liver failure. Secondary epilepsy seizures are caused by problems such as a brain tumours, strokes, or other trauma. In primary epilepsy, there is no known cause – this is usually diagnosed by eliminating other possible causes for the seizures.

SYMPTOMS

Physical
 Tachycardia
 Weak pulse
 Low blood pressure
 Muscle contractions
 Trembling, shaking or twitching
 Difficulty with breathing
 Obvious seizures
 Fainting
 Swelling in the brain
 Obsessive and compulsive behaviors

DIAGNOSIS

As with most dog diseases, diagnosing the condition early and getting appropriate treatment are vital to overall health and wellness. With epilepsy, younger dogs are more at risk from severe forms of epilepsy, including primary epilepsy. Diagnosis will require laboratory and biochemical tests. These may reveal the following –
 Low blood sugar
 Kidney failure
 Liver failure
 Fatty liver
 Systemic diseases
 Infectious blood diseases
 Viral diseases
 Fungal diseases

DEVELOPMENT OF THE DISEASE

Effectively, anything that disrupts brain circuitry can affect the development of epilepsy. This includes the current pattern of seizures because they influence future development of the seizures. Other factors include how old a dog is when it first seizes, and the frequency and outcome of re-occurring seizures.

Treatment
Drugs that can be used when treating epilepsy in dogs include corticosteroids, anti-epileptic and anti-convulsant medications. These can help reduce the frequency or intensity of seizures. The medication will depend on the type of epilepsy the animal is suffering and will also take into account any other underlying health concerns.

Medications include:
 Phenobarbital
 Potassium Bromide
 Phenobarbital
 Primidone (Mysoline)
 Valium (Diazepam)
 Dilantin
 Gabapentin
 Keppra (Levetiracetam)

For some animals, surgery may be required to remove tumors contributing to the seizures.

Epilepsy- Feline

Epilepsy is a disorder of the brain causing physical attacks that come on suddenly and without control. The cat may be conscious or unconscious during these recurring attacks. When there is no known cause for these seizures, it is called Idiopathic Epilepsy.

SYMPTOMS

When cats are having a seizure, they tend to have focal onset beforehand (this is when the brain’s cells are firing abnormally in one area or multiple areas of the brain). During this time, your feline friend may look confused and scared. They may even seek out your help or hide from you. When the cat begins to have their seizure, which can last up to 90 seconds, he/she will fall to their side.

During this time, your cat may do any of the following:

 Urinate
 Defecate
 Paddle with his/her four limbs
 Chomp their jaw
 Stiffen
 Vocalize
 Produce an excessive amount of drool

Seizures generally happen in a patient’s resting state; usually at night or during the early morning hours. Most of the reverberations seen with seizures will disappear before you get your feline friend to the veterinarian.

Most cases of epileptic seizures occur in cats between the ages of one and four. There are several changes in the cat after a seizure occurs (called postictal behavior), which may include:

 Awkwardness/Confusion
 Obsessive behavior
 Pacing
 Directionless wandering
 Loss of sight
 Increase of appetite (or polyphagia)
 Increase in thirst (or polydipsia)

Seizure recovery can be instantaneous or take a full-day.

WHAT IS THE CAUSE OF FELINE EPILEPSY?

For the most part, the cause of feline epilepsy is not known. However, some idiopathic epilepsy is tied to genetics.

DIAGNOSIS

There are two key factors in determining if a cat has idiopathic epilepsy:

 Age of first occurrence
 Frequency and type of seizure (pattern)

If your feline friend suffers two or more seizures in its first week of having a seizure, the veterinarian will often disregard idiopathic epilepsy and find another diagnosis. If the seizures happen in a cat younger than one and older than four years of age, it could be metabolic or intracranial epilepsy (in the skull). When a feline is suffering with focal seizures, it means there are some neurologic deficits (or structural intracranial disease).

The veterinarian will begin diagnosing the type of epilepsy your cat has during a routine blood test. This test will include the following things:

 Complete blood cell count
 Thyroid screen
 Blood chemistry profile

He/she will also test for viruses like feline AIDS and feline leukemia. A urinalysis may be conducted as well. Further testing may be done – MRI, CT scan, spinal tap, etc.

TREATMENT

The majority of the treatment for feline epilepsy is outpatient. The cat may be given anticonvulsant medications based on how often and severe the seizures are.

HOW TO MANAGE YOUR CAT’S SEIZURES

It’s very important to keep an eye on the feline’s blood when taking medications. Cats that are given phenobarbital will need to have periodic serum and blood chemistry profile monitoring. How your feline reacts to the treatment and the drug serum levels will dictate if medication dosages will need adjustments.

Older felines using a potassium bromide treatment must be closely watched for problems with their kidneys. If your older feline suffers with epileptic seizures, the veterinarian must suggest changing his/her diet.

It’s recommended that felines suffering with genetic or idiopathic epilepsy be neutered or spayed to avoid passing on the trait.

You should never give over-the-counter medication to a feline suffering with epilepsy until you speak to the veterinarian. Over-the-counter medications can often interfere with anticonvulsant medications or reduce the seizure threshold, increasing the possibility of more seizures.

Never miss a dose of your feline’s anticonvulsant medication and keep them inside to ensure they don’t miss a dose.

PREVENTION

When a feline suffers with genetic abnormalities epilepsy, there’s not much you can do to avoid it. If you suddenly stop giving your feline their anticonvulsant medication, you could exacerbate the condition, leading to more seizure episodes.

Feline Hyperthyroidism

Hyperthyroidism is a common disease of older cats. The disease results from development of an active thyroid nodule (typically an adenoma) which produces excessive amounts of T4, the primary thyroid hormone.

Symptoms

The primary role of thyroid hormones is to regulate metabolism, however thyroid hormones also affect digestion, neurologic functions, and muscle function. Symptoms of hyperthyroidism may include:

• weight loss despite good appetite
• vomiting
• diarrhea
• rapid heart rate
• heart murmur
• hair coat changes
• overgrooming
• hyperactivity

However, in some cats the only symptom may be gradual weight loss.

Diagnosis

Diagnosis of hyperthyroidism is accomplished via laboratory testing. Total T4 hormone levels may be determined via in-clinic testing or through reference laboratories. Generally speaking, T4 hormone levels higher than 4.0 mg/dL, along with compatible history and symptoms, support the diagnosis of hyperthyroidism. Complete blood count (CBC), comprehensive chemistry testing, and urinalysis should also be done in conjunction with T4 testing, to evaluate for other concurrent diseases. Some hyperthyroid cats may have normal T4; evaluation of FT4 and T3 may be necessary to establish the diagnosis. For hyperthyroid cats with cardiac symptoms (murmur, tachycardia), thoracic radiographs and echocardiography are useful in evaluating thyroid-related cardiac disease.

Treatment

There are four options for treatment of hyperthyroidism in cats, including radioactive iodine administration, long term oral medication, surgery, and dietary management with Hill’s y/d®.  Radioactive iodine therapy is the treatment of choice.

Radioactive iodine therapy (I131) involves the administration of radioactive iodine, which selectively targets and destroys overactive thyroid tissue. I131 therapy is highly effective, having a high cure rate; few cats relapse.

Surgical treatment (unilateral or bilateral thyroidectomy) involves removal of one or both thyroid glands. Potential adverse events include inadvertent removal of parathyroid glands, resulting in need for calcium and vitamin D supplementation, and hypothyroidism, resulting in the need for thyroid supplementation.

Most pet owners with hyperthyroid cats elect long term medical management with methimazole, which suppresses thyroid hormone production. If treatment with methimazole is elected, oral administration is preferred over transdermal. After initiation of treatment, laboratory testing is ideally done 2-3 weeks to assess blood counts, renal parameters and T4. Adjustments in dosage are made as indicated until desired endpoints are reached with laboratory parameters and patient response to therapy. Primary side effects of oral methimazole therapy are gastrointestinal: vomiting and diarrhea, or drug hypersensitivity reaction.

If oral methimazole therapy is not tolerated, transdermal therapy, dietary management, or radioactive iodine therapy may be considered.

Flea Control & Flea Bite Allergies

Gastric Torsion/Bloat

Glaucoma

Glaucoma is a disease of the eye caused by increased pressure within the eye. In the normal eye, fluid (aqueous humor) is continuously produced by a structure called the ciliary body, which lies behind the iris. The fluid then flows through the pupil into the front chamber (anterior chamber) of the eye. Fluid drains through a series of canals around the outer edge of the iris. In glaucoma, the drainage of fluid is inhibited, leading to increased pressure within the eye, eventually causing damage to the optic nerve and blindness.

Glaucoma in dogs may be primary or secondary. Primary glaucoma results from a hereditary abnormality of the drainage system. Secondary glaucoma occurs as a result of trauma to the eye, inflammation in the eye, lens luxation (dislocation), or intra-ocular tumors. Breeds known to have hereditary glaucoma include Samoyeds and Huskies, Cocker Spaniels, Poodles, and Chow Chows. Secondary glaucoma is more common in dogs vs. primary.

Symptoms

Symptoms of glaucoma may include:

• Redness
• Cloudiness
• Pain
• squinting/blinking
• vision loss
• bulging appearance of the eye (chronic glaucoma)
• appetite loss
• behavior change

Often the primary presentation of acute glaucoma is a red eye.

Diagnosis

Diagnostic evaluation of the eye typically includes Schirmer tear testing to assess for Dry Eye, Fluorescein stain for assessment of corneal lesions, and intra-ocular pressure measurement via tonometry. Tonometry is most often accomplished via use of a device that measures the intraocular pressure via touching the tip lightly against the cornea, after application of topical anesthetic. Normal intraocular pressures in the dog are typically 15-20 mmHg. In breeds predisposed to primary glaucoma, evaluation by an ophthalmologist to include gonioscopy (evaluation of the drainage apparatus), along with ERG, are used to determine if glaucoma is primary or secondary. This evaluation will also determine if the eye may be blind, when there is anterior eye inflammation or cataract of the lens is present. The importance of determining if glaucoma is primary or secondary lies in the formulation of a treatment plan.

Treatment

Primary glaucoma is often treated with topical medications with the intention of reduction in intraocular pressure. In acute glaucoma where pressures may exceed 50-60 mmHg, aqueous centesis may be necessary as well to acutely drop IOP, while treatment is instituted. Dorzolamide, a CAI (carbonic anhydrase inhibitor) works by inhibiting the production of aqueous humor. Timolol, a beta-blocker, also works by reducing production of aqueous humor. Latanoprost is a prostaglandin analog, which works by improving drainage of aqueous humor.

When medical management fails at maintaining reduced IOP, alternative options may be considered, including laser ablation of the ciliary body, cryotherapy of the ciliary body, drainage implant, chemical ablation of the ciliary body via intraocular injection of gentamycin, removal of the eye or evisceration (removal of the structures inside the eye) with intra-ocular prosthesis. All options have potential complications.

Ultimately, roughly 50% of pets with glaucoma in one eye may go on to develop glaucoma in the other eye, therefore frequent monitoring is important in prevention of blindness in both eyes.

Heartworm

Heartworm is a parasitic roundworm (Dirofilaria immitis). It primarily infects dogs, cats and ferrets, although it can also infect a wide variety of wildlife. It is a potentially fatal parasite, however, it is preventable. Humans have become infected, although this is rare and does not usually cause illness.

LIFE-CYCLE, TRANSMISSION AND EFFECTS

Mosquitoes are the only way that heartworms can be transmitted from animal to animal. When mosquitoes bite an infected animal and ingest their blood, young heartworms (microfilariae) enter the mosquito’s digestive system. Within 2 to 6 weeks, the microfilariae inside the mosquito develop into infective larvae. They then migrate to the mosquito’s salivary glands. These infective larvae can then be transmitted to another animal when the mosquito bites to get its next meal of blood.

The period between the initial infection when the dog or cat is bitten by an infected mosquito and the development of the microfilariae into adults living in the tissues of your pet usually takes 6 to 7 months. This is known as the “prepatent period”.

In cats, the microfilariae live for only a month in the vascular system and are seen in only 20% of infected cats (compared to 80 to 90% in dogs). This means that infected cats are unlikely to transfer the heartworm to another mosquito – in stark contrast to infected dogs.

The larvae introduced by the mosquito grow for 1 to 2 weeks under the skin at the site of the mosquito bite. Then, they migrate to muscles in the chest and abdomen, and 45 to 60 days after infection, molt to the next larval stage. Between 10 to 15 weeks after infection, the larvae enter the blood system where they are transported through the heart to reside in the pulmonary artery of the lungs.

During the next 3 months, the larvae (or immature worms), continue their development to become adults. Adult female worms can grow up to 14 inches in length and males about 2 inches shorter. The growing and feeding worms damage the blood vessels which causes a decrease in the efficiency of the heart and moving blood around the body. Occasionally, adult heartworms migrate to the right side of the heart and even to the large cardiac veins in severe infections. This can result in severe lung and heart disease. Animals showing signs of illness from adult heartworm infection are said to be suffering from heartworm disease. Death can occur as the result of congestive heart failure. Adult heartworms can have a long lifespan; they may survive for 5 to 7 years in dogs and 2 to 3 years in cats.

At approximately 5 to 7 months post-infection, if both adult females and males are present, they will mate and produce new microfilariae. The host’s immune system raises a strong response to these microfilariae, which unfortunately, can cause damage to other organs. The life-cycle then continues when a mosquito bites an infected pet and itself becomes infected by the microfilariae.

GEOGRAPHICAL DISTRIBUTION

At one time, heartworm in the U.S. was confined to the southern states, but has now spread to nearly all locations where mosquitoes are found. It is also found in many other countries. All dogs are susceptible to heartworm infection and both indoor and outdoor cats are at risk of the disease. If you plan to visit different areas of the country with your dog or cat, or another country, consult your veterinarian about the risk of heartworm in the area you intend to visit.

Because mosquitoes are the vector of this disease, any animal which comes into contact with mosquitoes should be tested. This also includes pets that might go outside only occasionally.

SYMPTOMS AND DIAGNOSIS

Dogs
Dogs with recent or mild heartworm infections may show no signs of illness. However, once the adult worms have developed in the lungs, your dog may cough, have difficulty breathing, become lethargic or lose its appetite; he may also tire rapidly after only light or moderate exercise.

Your veterinarian will have available to them, numerous diagnostic tests to detect the presence of adult heartworms. These are infections that have occurred at least 6 months previously. The presence of adult female heartworms can be detected with an antigen test which is very accurate in dogs. Exposure to heartworms can be detected by antibody tests. To confirm the diagnosis and evaluate the severity of the disease, your veterinarian may conduct other tests such as chest radiographs (x-rays), a blood profile, or an ultrasound of the heart (echocardiogram). These will also help determine the best treatment plan for your dog.

Cats
Symptoms of heartworm disease in cats include those often associated with other diseases. These include respiratory distress, gagging, coughing and vomiting. Symptoms associated with the first stage of heartworm disease, when the heartworms are carried to the pulmonary arteries, are often mistaken for feline asthma or allergic bronchitis, when in fact, they are actually due to a syndrome newly defined as Heartworm Associated Respiratory Disease (HARD). Cats may die suddenly from heartworms, although this happens rarely.

The diagnosis of heartworm infection in cats is more difficult than it is with dogs. Several tests may be required to assess the likelihood of heartworm infection. Even then, the results may be inconclusive. Usually, both antigen and antibody tests are conducted for cats to increase the probability of detecting heartworms.

TREATMENT

Dogs
As usual with most medical problems, prevention is better than cure. However, if your dog does contract a heartworm infection, treatment is available. Treating dogs for heartworms carries with it a substantial risk, but, if your dog is in good health and the instructions of your veterinarian are followed, this will considerably reduce the possibility of serious complications.

The aim of treating heartworm is to kill both the adult worms and microfilariae, as safely as possible. Successful treatment means there will be heartworms dying inside your dog’s lungs. Therefore, during treatment, hospitalization may be required initially. Upon going home, the dog should be rested (limited to leash walking) for a period, to decrease the risk of partial or complete blockage of blood flow through the lungs by dead worms. Other medications may be required to reduce the body’s inflammatory reaction to the worms being broken down in the lungs.

Cats
At present, there is no effective and safe treatment for heartworm infection in cats. If your veterinarian diagnoses heartworms in your cat, they may also recommend medications to reduce the inflammatory response and the resulting disease. Another course of action may be surgery to remove the heartworms. Cats are more resistant hosts to heartworm than dogs and are often able to rid themselves of infections. Unfortunately, many cats react severely to the dead worms as they are cleared by the body which can result in a physiological shock reaction, a life-threatening condition.

SURGICAL REMOVAL

Removing heartworms by surgery is a high-risk procedure for both dogs and cats. It is typically reserved for only severe cases, however, this approach may be necessary to give your pet the best chances of survival.

PREVENTION

Heartworm infection is almost 100% preventable in dogs and cats. There are several heartworm medications available which can be obtained in a variety of formulations. Based on your pet’s risk factors and life-style, your veterinarian will recommend the best preventative, but of course, you will have to remember to administer the medication for it to work!

The preventatives do not kill adult heartworms. They also do not eliminate heartworm infection or prevent signs of heartworm disease if heartworms are already present in the animal’s body. Therefore, it is recommended that a blood test for existing heartworm infection is conducted to assess the pet’s current heartworm status, before beginning a prevention program. It is more difficult to detect heartworms in cats, therefore, additional testing may be necessary to make sure there is no infection during any course of prevention.

Once treatment has finished, testing must then be repeated at the correct intervals. Six months after starting the preventative treatment, a test should be performed to confirm that your pet was not infected prior to starting the prevention – it should be remembered that tests only detect adult worms. From then, heartworm tests should be conducted on an annual basis to ensure your pet does not subsequently become infected. This will also check the appropriate amount of medication is being administered. Some pets develop a heartworm infection despite year-round treatment with a preventive; having regular tests is the most effective way to keep your pets protected.

Hip Dysplasia

Hip dysplasia is a hereditary condition resulting in malformation of the hip joint. The hip joint is a “ball and socket” joint; in dogs with hip dysplasia, the acetabulum (socket) is typically too shallow to accommodate the femoral head (ball) and the femoral head is malformed. Poor congruity of the femoral head and acetabulum result in joint laxity, wear on articular cartilage, and eventual osteoarthritis.

Symptoms

Large breeds are affected more commonly than small breeds. Early symptoms of hip dysplasia can include a “bunny hopping” rear limb gait, rear limb lameness, narrow rear limb stance, difficulty going up stairs, laxity in the hip joints, and reduced hip and thigh muscle mass. Over time with the development of progressive osteoarthritis, the disease can be quite debilitating resulting in severe lameness and difficulty rising, rear limb weakness, marked thigh muscle atrophy, pain and reduced mobility.

Diagnosis

Diagnosis of hip dysplasia involves a comprehensive history, physical examination with gait assessment, palpation of hips for laxity under sedation, and performing radiographs of the hips while the pet is sedated, using either the OFA (Orthopedic Foundation of America) or Penn Hip methods. Because hip dysplasia is a hereditary condition, breeds with increased risk should have hip certification prior to breeding. Dogs which have confirmed hip dysplasia should not be bred.

Treatment & Management

Treatment options for hip dysplasia include medical or surgical management. The choice of treatment will depend on age at onset of symptoms, the severity of symptoms and response to medical management.

Medical management options include joint supplements, and pain medications including NSAID (non-steroidal anti-inflammatory drugs), Tramadol, and Gabapentin; weight management, physical therapy and laser therapy.

For symptomatic puppies diagnosed at a very young age (less than 4 months), Juvenile Pubic Symphysiodesis (JPS) is a feasible treatment option. For these patients, Penn Hip studies are recommended for initial diagnosis. The JPS procedure involves cauterizing the area where the left and right halves of the pubis join. This affects the growth of the entire pelvis, resulting in better congruity of the hip joint.

For symptomatic dogs less than one year of age, triple pelvic osteotomy (TPO) is another surgical option. TPO surgery involves cutting three pelvic bones (ileum, ischium, pubis) in order to rotate the hip socket to provide better coverage of the femoral head. After performing the cuts (osteotomies) a bone plate is used to secure the new position of the pelvic bones. For most dogs, one hip is operated rather than both at the same time, allowing for adequate recovery time (2 months) between procedures.

For older dogs with pain and reduced mobility, either FHO (Femoral Head Ostectomy) or THR (total hip replacement) surgery are options to consider if medical management fails. FHO involves removal of the femoral head (ball component of the ball and socket joint); a “false joint” is formed during the healing phase and early return to function and physiotherapy is important for these patients. FHO is not recommended for dogs over 50 lbs. Total hip replacement is preferred for larger dogs. THR surgery is similar to hip replacement for humans; a prosthetic implant is placed in the hip socket and femur, forming a synthetic hip joint. Patients undergoing THR may return to full function very quickly after surgery. In summary, hip dysplasia is a hereditary condition that can be debilitating but can be managed with medical or surgical options to improve the quality of life of your pet.

Hookworm- Canine

Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is a chronic gastrointestinal disease in dogs and cats. Onset of symptoms may begin in young adulthood up to geriatric years, however, median onset age is around 6 years. IBD can occur in pets of any breed, however certain breeds are predisposed to particular forms of IBD including Soft Coated Wheaton Terriers (protein losing enteropathy and nephropathy) and Boxers (histiocytic ulcerative colitis). The exact cause of IBD is unknown, however, several factors may play a role, including mucosal permeability defects, infectious causes, dietary allergens, and the immune system.

Symptoms

Symptoms may include:

• intermittent vomiting
• appetite loss
• weight loss
• intermittent diarrhea
• edema or ascites in more severe instances such as protein-losing enteropathy

Diagnostic Testing

Diagnosis of inflammatory bowel disease is ultimately achieved by biopsy. However, this is not recommended as the first diagnostic step in evaluation of patients with gastrointestinal symptoms so several other diagnostic tests are often done prior to biopsy in order to rule out other diseases.

Comprehensive labwork including complete blood count, biochemistry analysis, electrolyte levels and serum T4 levels, along with serial fecal testing are important in initial evaluation of patients with chronic gastrointestinal symptoms. Atypical Addison’s disease should also be ruled out prior to biopsy of the gastrointestinal tract. Atypical Addisonian patients may have completely normal lab test results, however may have waxing/waning gastrointestinal symptoms and weight loss. ACTH stimulation testing is necessary to rule out this disease. Serum trypsin-like immunoreactivity (TLI), folate and cobalamin levels may also be useful in evaluating patients with chronic gastrointestinal disease. Low TLI level concurrent with chronic diarrhea is diagnostic for exocrine pancreatic insufficiency. Serum folate and cobalamin are useful in assessing for small intestinal bacterial overgrowth; and patients with low cobalamin levels benefit from parenteral B12 supplementation in the treatment of diarrhea associated with malabsorptive forms of inflammatory bowel disease.

Fecal α-1 proteinase inhibitor testing is helpful in confirming intestinal protein losses in patients with hypoalbuminemia. Other potential causes of hypoproteinemia include renal protein loss and reduced hepatic synthesis. Radiographs of the abdomen are not particularly helpful in diagnosis of IBD, however ultrasonography may show changes such as increased thickness of the gastric and intestinal walls.

Diagnostic Biopsy

Biopsy of the gastrointestinal tract may be obtained via surgery or endoscopy. Surgical biopsy offers the advantage of obtaining full thickness biopsies, however has increased risks due to potential for infection or leakage from surgical sites. Endoscopic biopsies are partial thickness and associated with less risk than surgical biopsies, however if disease is not present in superficial layers of bowel, then biopsies may not yield an accurate diagnosis. Whether surgical biopsies or endoscopic biopsies are elected, it is important to obtain multiple biopsies from several regions of the gastrointestinal tract, including the ilium. Lymph node biopsies (mesenteric lymph node) should also be collected when surgical biopsies are performed.

Treatment

Treatment of patients with inflammatory bowel disease may vary depending on severity of symptoms. Generally, it is recommended for all patients to do empiric deworming with febendazole, and to use metronidazole or tylosin and dietary management initially for patients with diarrhea. Dietary management typically involves feeding a restricted novel protein diet, hydrolyzed protein diet, or high fiber diet for 4-6 weeks and evaluating for efficacy. Dietary therapy may need to be continued indefinitely or altered depending on response. Patients with vomiting may benefit from periodic or chronic administration of maropitant (Cerenia®). In patients with primarily large bowel signs, sulfasalazine may help control symptoms.

When symptomatic therapy and diet therapy fail to resolve symptoms, immunosuppressive therapy is added. Prednisolone or budesonide may be used in these instances. For patients that do not respond well to prednisolone, combination therapy with chlorambucil (cats) or azathioprine (dogs) may result in improved control of clinical signs.

Ultimately, IBD is a disease that is not cured but managed. Flares often occur and are usually the result of dietary indiscretion.

Kennel Cough

Kennel cough, also called Infectious Tracheobronchitis (ITB) or canine infectious respiratory disease complex, is a multi-factorial illness in dogs. Kennel environments provide the ideal location for the disease to flourish due to increased presence of a variety of respiratory pathogens, increased stress, and increased contact between dogs.

Symptoms

Symptoms of kennel cough may include cough, ocular discharge, and nasal discharge.

There are several viral and bacterial pathogens involved in Canine Kennel Cough. In the past, it was believed that the primary causes were the virus Canine Parainfluenza, and the bacteria Bordetella bronchiseptica. However, research has now shown that there are several other pathogens that may be involved, including adenovirus, canine respiratory coronavirus, herpesvirus, distemper, influenza, mycoplasma, and streptococcus zooepidemicus, to name a few.

The severity of respiratory symptoms that develop in exposed dogs varies relative to pathogens involved, vaccination status of the population, contact rate and increased stress amongst the animals in the kennel setting. Bordetella infection generally results in mild upper respiratory symptoms. Vaccinated adult dogs are less likely to develop disease from exposure to Bordetella and distemper, whereas exposed unvaccinated pups are most at risk. The development of neurologic signs along with respiratory signs may indicate that distemper is a causative agent. Influenza may affect dogs of all ages and vaccination status, as influenza vaccines are not widely used in the general population.

Diagnosis

Diagnostic testing is most useful when several dogs are affected. Respiratory PCR panels are now widely available and can be used easily as a non-invasive method of testing, using nasal, oropharyngeal and conjunctival swabs. PCR tests, while convenient, may yield both false positive and false negative results; therefore it is important to interpret results amongst several patients when a large number of dogs are affected.

Other means of diagnosis include tracheal washing, and post-mortem testing of tissues from deceased or euthanized animals. Tracheal wash with cytology and culture is most beneficial if symptoms are primarily lower airway in nature, however this method of testing is not practical on a large scale.

Prevention

Prevention is the key to reducing morbidity associated with kennel cough. Vaccination alone is insufficient to significantly reduce disease, as there are several pathogens for which no vaccine has been developed. However, vaccination is nonetheless important and an immunization series should be completed at least two weeks prior to boarding. Distemper, adenovirus, parainfluenza, Bordetella, and ideally influenza immunizations should be included for best protection.

Maintaining good sanitation, establishing required vaccination protocols for dogs in kennel settings, reducing stress in the kennel setting, optimizing kennel airflow design, and isolating symptomatic patients are additional factors which can all help reduce the severity of outbreaks. Many of the pathogens involved in kennel cough are easily transmitted via both aerosolization and fomites (inert carriers such as clothing), therefore, careful attention to cleaning procedures and working with symptomatic patients is important.

Treatment

There is no single all-encompassing effective treatment for kennel cough. Dependent on the pathogens involved, some milder cases may not need antibiotic therapy, however for moderate to severely affected animals, systemic antibiotics can help reduce symptoms. Nebulization therapy may also be helpful in patients with more severe lower respiratory signs.

Leptospirosis

CAUSES

Leptospirosis is a bacterial disease caused by several serovars of the bacteria Leptospira. Leptospires can cause illness in dogs as well as several other species of domestic and wild animals, including cows, horses, pigs, sheep, skunk, opossum, raccoons, rats and mice, deer and others. Leptospirosis is also contagious to humans and is therefore considered a zoonotic disease.

Leptospira bacteria are shed in the urine of infected animals, contaminating water and soil. Some animals serve as hosts, and do not become ill but rather serve as reservoirs for the bacteria and shed the bacteria intermittently over long periods of time. The organisms can survive in soil or water for months. Increased rainfall, higher temperatures, and seasonal movement of animals correlate with the increased prevalence of the disease. Exposure to and consumption of infected water is the primary method of infection. The bacteria may enter the body via ingestion, contact with mucous membranes, or cuts in the skin. Once in the body, the Leptospires migrate to kidneys, liver, spleen, nervous system, and eyes. The preferred site for colonization of the bacteria is in the kidneys. Clinical signs appear typically within 7 days of infection.

SYMPTOMS

Dogs are the primary companion animal affected by Leptospirosis. Male, middle-aged, mixed breed dogs are most at-risk. Cats may become infected but generally remain asymptomatic. Most infected dogs are asymptomatic, however dogs that develop clinical signs may become severely ill; symptoms may range from mild lethargy to fever, inappetence, vomiting, diarrhea, increased thirst and urination, weight loss, icterus (jaundice). Kidney failure can ensue in some dogs, as well as liver failure and complications such as hepatic encephalopathy and DIC (disseminated intravascular coagulation). Peracute Leptospirosis infections can rapidly cause death.

Diagnosis of Leptospirosis is accomplished via laboratory testing on blood and urine, including blood counts, chemistry tests, urinalysis, and either paired antibody titers or PCR testing. Blood tests will often show increased renal (kidney) parameters (creatinine, BUN) and/or increased liver enzymes (ALT, ALP, Total Bilirubin) as well as thrombocytopenia (low platelets), dilute urine, white blood cells and red blood cells in the urine, and proteinuria (protein in the urine). Antibody titers may initially be negative, therefore repeat testing may be needed at 2-week intervals; however, a single initial high titer may be diagnostic, if vaccination has not been recently done. PCR testing (for bacterial DNA) is now widely available, however, false negatives can occur as the organism may be only intermittently present in urine or blood. PCR testing is not accurate after antibiotic therapy has been started.

Inpatient treatment is often necessary for dogs with impaired kidney or liver function, including intravenous fluids, antibiotics, anti-nausea medications, and nutritional support. Initial therapy with ampicillin or penicillin antibiotic is followed by treatment with oral doxycycline antibiotic to clear the carrier state of the organism.

Prevention of Leptospirosis is accomplished through routine vaccination, boosted annually. Puppies can begin Leptospirosis vaccination series as early as 12 months of age. Talk with your veterinarian about the risk of Leptospirosis in your area and if vaccination might be a good choice for your dog.

Mange

Mange is a term used for a range of skin diseases characterized by poor coat and skin condition. Mange is caused by a range of common exoparasites called mites, found mainly in companion dogs. Some species of these mites are normal residents of your pet whereas others are not. Their favorite place to reside is in the skin and hair follicles. If they are allowed to proliferate out of control, all mites can cause skin infections which can become severe if not treated. Because mites belong to the Acari (a subclass of arachnids) another term sometimes used for mite infestation is “acariasis”.

CAUSES

There are two major groups of mites that can infest your pet. These are Sarcoptes species, which burrow into skin, and Demodex species, which live in skin follicles.

Sarcoptic mange
Sarcoptic mange, also known as “canine scabies”, is caused by the Sarcoptes scabiei mite This is a microscopic mite that is oval-shaped and light-colored. They are easily transferred between hosts. The canine sarcoptic mite can also infest cats, pigs, horses, sheep, and various other species. They cause itching due to their movement while burrowing through the skin. Hair loss and crusting usually occur, often seen first on the elbows and ears. Intense scratching and biting can cause skin damage, and secondary skin infections are common.

Demodectic mange
Demodectic mange is also called “demodicosis”, “demodex” or the “red mange”. It is indirectly caused by the Demodex canis mite. This is a species of mite that is naturally present on almost all dogs. They are transferred from the mother to her pups during suckling and close contact in the first few days of life. Normally, the immune system and scratching/biting behavior of your pet are able to cope with the natural population of mites and many dogs never suffer any consequences. However, if the animal has a compromised immune system and develops hypersensitivity to the mite, mange can begin.

Demodex canis is not the actual cause of mange, rather, it is due to a bacterium called Staphylococcus epidermidis. The demodex mite dilates the follicles and sweat-glands on your pet’s skin allowing the bacterium to enter the body. Demodex canis possibly also carries and introduces the bacterium.

Three types of demodectic mange are recognized:

 Localized mange – occurs when the mites proliferate in only 1 or 2 (some say up to 4) small, confined areas, usually on the animal’s face. The resulting isolated, scaly, bald patches look like a polka-dot pattern. Localized demodicosis is common in puppies and approximately 90% of cases disappear without any treatment.

 Generalized demodectic mange – affects larger areas of skin, sometimes the entire body. This becomes extremely itchy if there are secondary bacterial infections. The skin may also become foul-smelling. This form of mange can indicate underlying health problems or risk factors such as a compromised immune system, hereditary predisposition, or an endocrine problem. The course of treatment for the dog depends on the age at which the disease develops.

 Demodectic pododermatitis – is a type of mange confined to the foot and is often accompanied by bacterial infections. It is one of the most resistant forms of mange. To make an effective diagnosis, deep biopsies are often required.

TRANSMISSION

Sarcoptic mange
Transmission of sarcoptic mange mites usually requires direct host-to-host contact. Although mites can live off a host and in the environment for several weeks, they are infective for only 36 hours.

Demodectic mange
Although demodex mites are relatively easily transferred from one dog to another, it requires direct physical contact. In healthy animals, transmission of the mites simply adds to the dog’s natural population and there is no resulting skin disease. Even for severe cases, isolation of dogs is usually considered to be unnecessary. It is very rare for demodex mites to be transmitted to humans or cats.

SYMPTOMS

The symptoms of mange vary, depending on the type of mite causing the disease.

Sarcoptic mange
Sarcoptic mange can cause extremely intense itching. It can result in listlessness and frantic scratching, gradually increasing over several days. It also can result in hair loss (alopecia), reddened skin, sores and crusty scabs. In dogs, the most commonly affected areas are the ears, elbows, face and legs. In severe cases, it can spread rapidly over the entire body. Sarcoptic mange in humans causes a rash of red bumps, similar to mosquito bites.

Demodectic mange
Demodectic mange causes hair loss, bald spots, scabbing and dry sores. Secondary bacterial infections can make the dog extremely itchy and uncomfortable. Demodectic mange is not transmitted from dogs to humans. Demodex in pets can be detected by:

 Itching, bald patches, particularly around the mouth and eyes
 Itching, bald patches on the body and legs – spreading to cover the entire body
 Thick discharge from the ears, particularly in cats
 Leathery or wrinkly skin

DIAGNOSIS

A veterinarian will perform a physical exam of your pet and if necessary, take skin scrapings and examine these with a microscope to confirm the presence of mites. If the mites are buried deep in the skin, they can be difficult to identify. In such cases, the veterinarian may rely on your pet’s history and clinical signs to make a final diagnosis.

RISK FACTORS

Localized demodectic mange: Puppies and dogs less than 18 months old are especially prone.
Generalized demodectic mange: Can be hereditary in dogs. Some breeds, such as the Dalmatian, American Bulldog and American Pit Bull Terrier appear to be more susceptible. Older dogs with an underlying illness are also more prone.
Demodectic pododermatitis: The Old English Sheepdog and Shar Pei are particularly prone.

TREATMENT

The medication given to your dog will depend on various factors such as the type of mange and the breed of dog. Medication may be given orally, by injection, by shampoo or dip, or applied topically (locally). It is important to realize that many skin treatments can be toxic to dogs. They should not be repeated frequently. Check with your vet before beginning any mange treatment program.

Sarcoptic mange
When treating sarcoptic mange, the first step is to isolate your dog to prevent the disease spreading to other pets (and humans). It is likely your vet will prescribe antiparasitic medications to eradicate the mites, as well as separate medications for easing itching, reducing inflammation and treating secondary skin infections. The results of such treatment are usually seen after 4 weeks

Demodectic mange
Demodectic mange is treated not only by medications but also by managing physiological stress to improve your pet’s immune system. To prevent secondary skin infections, some dogs may also require additional treatments, for example, medicated shampoos.

CURES

Younger dogs often fully recover from mange. In contrast, adult dogs often require long-term treatment and therapy to control the disease. It has been suggested that because demodectic mange is thought to be hereditary, dogs with the disease should not be bred.

Whichever treatment option is used, this should be accompanied by skin scrapes every 2 weeks. Usually, medication is discontinued after 2 consecutive scrapes are negative. A final scrape should be performed 4 weeks after treatment to check there has not been a recurrence.

PREVENTING RECURRENCE

Sarcoptic mange: Thoroughly clean or replace the bedding and collar. Treat all animals in contact with your pet. Keep your pet away from animals you suspect might have the disease. Get periodic skin scrapes to ensure the mites have been eradicated.

Mitral Valve Disease

Mitral valve disease (MVD) is the most common cardiac problem encountered in small breeds of dogs; with increased prevalence in certain breeds such as Cavalier King Charles Cocker Spaniels, Boston Terriers, Miniature Poodles, Chihuahuas and Pomeranians. Males are affected more than females.

The mitral valve is located between the left atrium and left ventricle, and it regulates the flow of blood from the atrium to the ventricle during the cardiac cycle. The valve leaflets are tethered via structures called chordae tendinae to the papillary muscles, located in the left ventricle. During systole (contraction) the ventricles contract and push blood into the aorta and pulmonary artery; during this phase of the cardiac cycle, the mitral valve (and tricuspid valve) are closed. In mitral valve disease (also referred to as A-V valve insufficiency), the mitral valve leaflets develop degenerative changes, and do not close properly during systole. This leads to regurgitation of blood backward from the left ventricle into the left atrium, causing circulatory overload of the left side of the heart. Over time, dilation of the chambers (eccentric hypertrophy) ensues, and decline in contractile function results in congestive heart failure.

Symptoms

Many pets with MVD are asymptomatic. Early signs of disease may include heart murmur, cough, and reduced exercise tolerance. In late stages of disease with congestive heart failure, patients develop respiratory distress due to pulmonary edema, weakness due to hypoxia, and weight loss. Untreated, congestive heart failure leads to death.

Diagnosis

Diagnosis of MVD is accomplished through correlating physical exam findings (left sided heart murmur, with or without other symptoms such as cough, exercise intolerance, etc.), thoracic radiographs, and echocardiography. Care must be taken to differentiate concurrent primary pulmonary disease in patients with cough, vs. cough secondary to MVD, as medical management will depend on the reason for the cough. Coughing in patients with MVD, without evidence of left atrial enlargement, and without radiographic evidence of pulmonary edema, is indicative of a concurrent independent respiratory disease.

Classification of Disease

Treatment of patients with MVD is stratified based on classification of disease. The current recommended classification system for canine MVD was developed in 2009 and is referred to as the ACVIM Consensus Classification System.

Class A patients are those who have high risk of MVD but no cardiac changes or symptoms.

Class B patients include those who have structural disease but do not have clinical signs. Class B patients are further differentiated into Class B1 (no left sided heart enlargement) and Class B2 (left sided heart enlargement present).

Class C patients have had, or currently have, symptoms of congestive heart failure.

Class D patients have end stage disease and have failed standard treatment protocols.

Treatment

Controversy exists as to whether treatment of Class B patients is of benefit. For Class C patients, treatment with furosemide and/or spironolactone, angiotensin converting enzyme inhibitor drugs, and pimobendan can significantly improve symptoms and aid in control of disease. Patients presenting in acute congestive heart failure with marked dyspnea should be hospitalized for intensive care which may include oxygen therapy, injectable furosemide, and additional supportive care as warranted. Average survival time after diagnosis of congestive heart failure is typically 6-14 months dependent on severity of heart disease.

Obesity