HACKED BY FLYTHIAGO
Some people think it’s funny, but…well you know.
If you Google “Fecal Score” you see some great albeit somewhat graphic representations of differing dog and cat stool consistencies. Suffice to say we all likely have a pretty good idea of what diarrhea is.
Occasional diarrhea is fairly common in the dog, less common in cats. There are many causes of diarrhea: Bacterial infections, parasitic infections, liver and pancreas problems, primary small and large intestinal disease, dietary intolerance, dietary misadventures, and cancer can all be potential sources for diarrhea. Occasional diarrhea that resolves within 24 hours, that is not associated with blood in the stool, vomiting, loss of appetite, or lethargy does not generally require a trip to the veterinarian. Most over the counter medications used for diarrhea in people are not a good idea to give to our pets. Pepto Bismol, Kaopectate, and Immodium are not considered useful, and some ingredients can actually be toxic to pets. The best thing for the occasional diarrhea in an otherwise healthy dog is to withhold food initially for 12-24 hours, (never water) and the offer a bland diet (Hill’s I/D) or a homemade bland diet (boneless skinless chicken breast and white rice). In the cat, occasional diarrhea is less common and if your cat has diarrhea more than once they probably should be looked at.
Diarrhea that does not resolve in 24-48 hours or is associated with vomiting, bloods in the stool, or signs of illness should be addressed by your veterinarian. It is helpful to bring a fresh stool sample to the office if available. Tupperware or even a clean baggie will suffice if the sample can be obtained. The history of the diarrhea can be helpful in making a diagnosis. Recent changes in diet, whether the diarrhea has any blood or mucous in it, whether there is urgency associated with defecation, and also the volume and frequency will help your veterinarian determine the best course of proceeding with diagnosis and treatment.
Testing for acute onset diarrhea depends on how sick the patient is. If the pet is otherwise healthy, a fecal smear or a parasite test may be all that’s required. If the patient is notably sick, then other tests including routine blood testing may be indicated.
Chronic diarrhea is a much more involved workup that can involve more specific blood testing for pancreas function, and vitamin levels in the blood. Deeper investigation into the stool with cultures and PCR testing for infections may be indicated. Imaging tests like ultrasound can be helpful in some cases. Definitive testing for case that cannot be diagnosed by non-invasive testing would lead us to the next level which is getting a tissue biopsy of the gut. There are three ways to get tissue biopsies. Endoscopy is a procedure where a flexible tube with a camera on the end is passed into the anesthetized patient from form the mouth or the rectum. From there, the veterinarian can inspect the inside of the gut, and using special tools collect small biopsy samples from the lining. This is the least invasive way to get a biopsy, but is limited by the small sample size and the inability to inspect the entire intestinal tract. An abdominal exploratory will allow access to all levels of the gastrointestinal tract and allow for full thickness biopsy samples which are preferred by pathologists. The downside is that the procedure is quite invasive and a large incision is required to gain access to the abdomen. An in between method, called laparoscopic surgery is performed using smaller incisions with camera and surgical instruments inserted into the abdomen through small holes. In laparoscopic assisted procedures, you can still get the full thickness biopsy samples without the large incision.
Most acute onset diarrheas will resolve on their own, or with minimal intervention. Diarrhea that is chronic in nature needs a diagnosis to be managed properly. Any animal that is noticeably sick or ill should evaluated as soon as possible.
New Development in Canine Lymphoma Therapy
Lymphoma is a common type of cancer affecting both dogs and cats. It is a treatable disease, the gold standard of care being a chemotherapy
protocol called the UW-25. This is a 6 month protocol that involves sequencing the drugs vincristine, cyclophosphamide, and doxorubicin. Prednisone is often used during the initial induction of remission and another drug L-Aspraginase is used on occasion for the first treatment. This protocol has been in use for decades with usually minimal toxicity. Remission time for the more common B-cell Lymphoma generally is anticipated at 10-14 months. Recently, the pharmaceutical company Merial released a canine B-cell Lymphoma vaccine and an additional treatment option. This builds on the success of the company’s Melanoma vaccine for the treatment of malignant melanoma. The vaccine at the time of this writing does not replace the gold standard UW-25 protocol, but is used an additional measure following completion of the protocol. The initial study shows a doubling of survival time when using the vaccine vs. historical controls. This is exciting news as there have been no new treatment breakthroughs in canine lymphoma in over 30 years. The vaccine is limited to use to B-cell lymphoma and not the T-cell form of the disease. This is because the vaccine targets a membrane receptor CD-20 located on the B-cell. Fortunately, the B-cell disease is the more common form, and there are reliable special tests to determine B vs. T cell disease prior to beginning therapy. We are excited at the Baring Blvd. Veterinary Hospital Wellness Center to be able to offer this new cutting edge therapy to our cancer treatment services.
Your Dog Has a Bleeding Open Wound, What Do You Do Next?
DO NOT PANIC! It won’t help you assess the situation clearly and in a systematic manner.
Ask yourself these questions:
Is he/she breathing easily without extra effort?
- Animals in shock will pant, but breathing heavily from the belly may indicate more serious injury
Is the color of their mucous membranes (gums) pink and moist?
- If it is pale, they are likely losing a lot of blood somewhere, often times it is internally in cases of hit by cars or big dogs attacking little dogs
- If they gums are tacky it is likely a sign of shock
Approximate the size of the laceration, and what you can see
- In most places on the body, bone is fairly well covered by tissues
- You are likely to see fat, muscle, tendons and ligaments before bones
If your pet is too painful to touch, DO NOT BE PERSISTENT AND GET BITTEN. Most bleeding will stop with time if the pet is healthy and has a normal clotting system. Sometimes even placing a loose tee-shirt over the area will help from your house or car getting too bloody. If your pet allows, place a compression pad/gauze/paper towels over the area for 10-20 minutes with consistent pressure to help slow the bleeding. A covered bag of frozen peas applied to the area will also help slow the bleeding. Once the area seems to have stopped bleeding as much, you can pack the wound with Neosporin, which will help to keep hair and debris from collecting in the wound. Having a “cone of shame” in your first aid kit is also a very good idea, licking is always discouraged. A surprising amount of lacerations are not an emergency. If you can keep the wound clean and ensure the pet does not lick at it, you can see medical attention in the morning if the incident were to happen at night.
Once you have managed the situation at home, calmly call the veterinary office and alert them to the situation and that you will be on your way down. With larger lacerations your pet will be anesthetized, and the wound closed with suture and sometimes even a drain placed. Pain medication and antibiotics will always be sent home as well. Depending on your pet’s age and health status, blood work may be run prior to any procedure. In some cases of small puncture wounds, they will be cleaned, sent with medication, and there will be no additional intervention necessary. Wounds over vital structures such as lungs, or any type of penetrating wound such as a shotgun, will require radiographs to assess for internal damage as well.
My pet had an ear infection, but is doing fine now. Why do I need to come in for a recheck?
Ear infections are an incredibly common ailment of dogs. They are less common in cats, but seen from time to time. These infections are typically caused by either fungal (yeast) organisms or bacteria. These organisms are always in the environment and constantly on our pet’s skin and in their ears. During an ear infection, for some reason, those organisms break through the normal defense barrier of the skin and cause severe inflammation. This inflammation leads to a bad odor, swelling, moist discharge and itching or discomfort to our pets. For all of these reasons, catching, diagnosing, and treating the ear infection as early as possible is important.
When you come in for your initial exam for that ear, we will try to do a couple of things. We will try to look down the ear to see if we can identify any irregularities that may have predisposed the ear to the infection. These things include foreign bodies like foxtails stuck down in the canal, otic masses or polyps, or anatomic abnormalities. We will also take a sample of the ear discharge and check under the microscope to differentiate the yeast from bacterial infections. We may also recommend a culture of the ear if the inflammation is really severe.
After we know what we are treating we will work with you to find a treatment protocol that works with your budget and your schedule to medicate your pet. We have options ranging from topical products that you will place in the ears at home, to medicated gels that we place here in the clinic avoiding the need for you to medicate at home. In certain cases oral medications may be given if your pet is resistant to having their ears touched. We will tailor this therapy so that it is effective and easy for all parties.
We may ask you to come back for a recheck exam a week or two weeks later. A lot of people ask us at the time of the recheck why they needed to come back since the ears were looking so much better and they could tell that the infection was under control. It’s a really good question. There are a few reasons why we recommend that follow up. The first reason is that we would like to recheck the ear and make sure that the infection is truly cleared. Nothing frustrates owners and veterinarians more than getting 95% of an infection cleared, only to have that 5% regrow and start all over. The second reason is that we may be able to get a much better look down the ears now that the infection is cleared, the swelling is down, and your pet is more comfortable and thus more compliant with that otic exam. The third reason is that we would like the opportunity to discuss with you the techniques for preventing future infections.
Hope this answers some of your questions!
What it Means to Feed a Hypoallergenic Diet, and Why We Recommend the Hills Z/D
Usually when your veterinarian recommends feeding a hypoallergenic diet, it is because we suspect your pet may have a food allergy. The key to diagnosing a food allergy is feeding your pet a novel protein and carbohydrate which your pet hasn’t been exposed to before. This new diet must be fed for a minimum of 30-60 days before results are seen. As you can imagine the key to doing a dietary trial is making sure the diet you are feeding doesn’t contain any trace amounts of other protein or carbohydrate sources. The Hill’s diets are guaranteed to only contain 1 protein and 1 carbohydrate source, where other commercial diets very commonly have traces of other carbohydrate and/or protein sources. Hill’s also has its Z/D diet which has a hydrolyzed protein. A hydrolyzed protein is a conventional protein which is broken down into molecules so small, they don’t stimulate the immune system. The advantage of using a hydrolyzed protein is you take away the guess work of picking a protein source you think the pet won’t react to. For example, if you switch a dog to a venison and potato diet for 2 months and the dog is still itchy after the 2 months, you then wonder if the dog doesn’t have a food allergy, or you wonder if the dog is allergic to venison also. The Z/D diet takes out this variable because the protein molecule doesn’t stimulate the immune system.
The other advantage of the Hill’s diet over some other commercial diets is their diets have been tested in clinical settings where other diets may not have been. The way you can tell if a diet has been tested is to look for the Association of American Feed Control Officials (AAFCO) statement on the diet. Diets which have been tested will say under the AAFCO statement that feeding tests have been done, wheres diets which haven’t been tested will say the diet has been formulated.
In conclusion diagnosing food allergies can be frustrating for both owners and veterinarians. The key to diagnosing food allergies is trying to eliminate as many variables as possible. The Hill’s diets help us achieve this.
Bloat; The Mother of All Emergencies
I want to take this opportunity to let you know of a severe, life-threatening syndrome that affects large breed dogs and a recent advance in preventative surgery for the condition.
Since your pet is a large breed dog, you may have heard of gastric dilatation volvulus complex, also referred to as “bloat” or “GDV.” This syndrome occurs in certain breeds, specifically large “deep-chested” breeds. The stomach dilates with gas and food and then begins an abnormal rotation (illustrated on the image to the left). This can happen very rapidly, often in hours, and if untreated results in obstruction of the stomach and death. Treatment consists of aggressive fluid therapy and prompt surgical correction. The success of treatment ranges from 60 to 80%, thus unfortunately, some of the patients die despite our best efforts. Cost of the procedure, excluding the obvious emotional cost, can range from $1,500 to $5,000.
Although this syndrome is not encountered every day in predisposed breeds, the severity of the condition has incited us to explore the latest surgical techniques to both correct and prevent it.
In the past the surgical procedure to prevent this syndrome (gastropexy) had to be performed with a more traditional surgical approach with a recovery time of 7 to 10 days and a 6 to 12 inch abdominal incision. Our hospital has invested in laparoscopic equipment and advanced surgical training for our doctors to enable us to perform surgeries such as this with minimal incision size and recovery time for the patient. We often recommend preforming this procedure during the time of the spay or neuter. The surgery for the gastropexy can now be performed with two small incisions (less than 1 inch in many cases) with a recovery time of 2 to 4 days. If you have any questions on whether your pet would benefit from a preventative surgery please call us and speak with Dr. Baker, Dr Davidson, or me about the details of this surgery.
The Fun in the Sun Photo Contest is back. Please send us a picture of your pet enjoying the summer days. Whether it be outside or taking a cat nap we want to see. All the photos will be posted on our Facebook page.
We have some new rules this year about voting be sure to read the details below. This year the winner will receive a $50 dollar gift card to Baring Blvd Veterinary Hospital. Be sure to follow these steps below to register.
1. Find an adorable picture of your pet enjoying the summer season.
2. Email it to us at Baringvet@gmail.com (as a jpeg please). Subject line : FUN IN THE SUN 2015, be sure to include your first and last name, your pet’s name and your phone number.
3. Login and check out your pet’s picture on our Facebook page. (And don’t for get to like it!)Facebook-Like
4. Ask your friends and family to help by liking the picture on OUR page (if you share it ask them to click through to our page, other wise their like won’t count).
The winner will be determined by a percentage of the likes on facebook, and votes from the staff. Photos can be submitted from July 1- August 12 (to the email above). We will post all the photos at the same time on August 15. The voting will take place from August 15 through August 22. The winner will be announced after the staff vote on August 29. Good Luck !
Here are some of last years pictures: