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Diarrhea and When to Get Concerned

Diarrhea

Some people think it’s funny, but…well you know.

Bob Baker, DVMDr. Baker

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 Kitten-using-a-litter-trayand 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.

Dog bathroomDiarrhea 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 Puppy on Fluidscamera 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.

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‘The Boss Baby’ is good film tell story about A story about how a new baby’s arrival impacts a family, told from the point of view of a delightfully unreliable narrator, a wildly imaginative 7 year old named Tim. This film have genre Animation, Comedy, Family and have 97 minutes runtime.

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Tobey Maguire as Older Tim / Narrator (voice), Alec Baldwin as Boss Baby (voice), Jimmy Kimmel as Father (voice), Miles Christopher Bakshi as Tim (voice), Lisa Kudrow as Mother (voice), Steve Buscemi as Francis E. Francis (voice).

Production
The Director of this film is Tom McGrath. The movie The Boss Baby is produced by Twentieth Century Fox Film Corporation, DreamWorks Animation and released in March 23, 2017

Similar Movie
The Boss Baby have some similar movie, Dirty Magazines, Twinkle, Sirenito, Sexual Chronicles of a French Family, Family For Rent, Forrest Gump

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New Development in Canine Lymphoma Therapy

New Development in Canine Lymphoma Therapy

By: Bob Baker, DVM 

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. DSC_0854 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.

Open Wounds FAQ

Your Dog Has a Bleeding Open Wound, What Do You Do Next?

By: Kristina Welsh, DVM DSCF6338

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

Pet_First_Aid_KitIf 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 them106906243 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.

What it Means to Feed a Hypoallergenic Diet, and Why We Recommend the Hills Z/D

What it Means to Feed a Hypoallergenic Diet, and Why We Recommend the Hills Z/D

By: Dr Tony Luchetti tl 2

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 Hills ZDand 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.Affco statement

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.