Tag Archives: Dr. Bob Baker

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.

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.

What is Bloat?

Bloat; The Mother of All Emergencies

By: John Crumley DSC_0303-001

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 illustration-dog-bloat-500ximage 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 great_dane_stock_7_by_sigarnistock-d3hwnnjthe 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.

Vaccines, What are the Risks and Benefits to Your Pets.

Vaccines,What are the Risks and Benefits to Your Pets.

By: Dr. Bob Baker Dr baker with penny

As a veterinarian I am faced with questions about vaccinations every day, what are the risks? what are the benefits?  To say that vaccines are safe is true, however there are adverse effects associated with vaccination.  While extremely rare, anaphylactic allergic reactions can occur and must be dealt with immediately. Other allergic reactions, fever, vomiting, facial swelling occur on occasion, but are still rare. The old feline vaccinations were associated with development of an injection site sarcoma; this occurred more commonly in patients with a genetic predisposition to cancer. So yes there are some risks associated with vaccination.  When it comes to vaccination, we have to assess the relative risk of vaccination vs. the risk of the disease.  Rabies vaccine however is always indicated as it is state law to vaccinate dogs and cats.  Most pets however, do not have the social risk factors of humans, there  are some such as those that go to groomers, boarding kennels, and day care.  These pets have risk factors more like us, where we go to work, school, shopping; where we interact with others that may or may not be vaccinated or be incubating or spreading a contagious disease.

DSC_0854When an animal or person is vaccinated, most will form antibodies to the false infection that will protect from the real infection when the subject is exposed to the pathogen.  There are however, some individuals that are genetic non-responders, meaning they cannot form antibodies to the vaccine.  These are the individuals that get sick despite vaccination.  This happens in canine parvovirus on occasion because the dog, no matter how many times they have been vaccinated, simply cannot respond to the presented antigen.  So how do we protect these “non-responders” in the population, along with the individuals that cannot receive vaccines because of illness, immunocompromise, or allergies.  The key is a concept called herd immunity, and it derives from infectious disease management mostly in the cattle and dairy industry.  The more individuals that are vaccinated, the more protected the herd, including those that cannot be vaccinated or are non-responders.  The more individuals that do not receive the vaccine, the more likely the herd immunity will fail and an outbreak will occur.

Measles is a virus that belongs to a group of viruses  called Morbillivirus.  It evolved from a cattle virus called Rinderpest around  1100-1200 A.D.   When the measles virus first adapted to infect humans, it had a high mortality rate, killing up to 60% of those infected.  Over time, the virus (and us) have changed to be less fatal, but still is very infective.  It is interestingsierra to note that Rinderpest, the cattle morbillivirus, has been eradicated by a global vaccination protocol, similar to what we did with the Smallpox virus in humans, and almost did with the Polio virus until the Taliban in the tribal areas of Pakistan started shooting the vaccinators.  The canine morbillivirus causes a disease called distemper, which most veterinarians in practice today will never see because enough people continue to give their dogs the vaccine to keep herd immunity up and individuals protected by a highly safe and effective vaccine.

Christmas is Almost Upon us! Make Sure You Know What to Watch for Around the House !

Holiday Pet Hazards

By: Bob Baker,DVM Dr. Baker

The Holiday season brings out many potential problems for your pet.

Chocolate exposure and ingestion can cause anything from mild stomach upset to life threatening medical emergencies. If you are giving chocolate as a gift, it is best it does not get put under the tree. The nose of a dog will be able to sniff through the package and gain access to the goodies.

Sugar free treats made with an artificial sweetener called Xylitol can cause liver failure in the dog, Picture 217but is safe for humans. Grapes and raisins can cause kidney failure in dogs. Macadamia nuts are also toxic to dogs. Some dogs will like the taste of eggnog, and the optional alcohol can be a real problem.

Other dietary misadventures with bones, fatty leftovers, candy etc. can cause significant gastrointestinal upset. Bones can cause obstruction and require surgery, there can be an association of high fat foods and pancreatitis that can be life threatening.

Decorative plants such as poinsettias, holly, mistletoe and lilies can cause mild to severe gastrointestinal upset and holly mistletoe_dogand mistletoe can cause rhythm disturbances in the heart.

Tree tinsel and gift wrapping ribbon can be very entertaining to a curious cat, unfortunately cats can swallow these objects creating a linear foreign body which are incredibly dangerous. They cause a plication (accordion movement) of the intestine on itself and can saw right through multiple areas of intestine. It is very important your cat be seen as soon as possible if you suspect a linear foreign body. People will sometimes put a bow or ribbon around an animals neck which if equipped with a breakaway safety feature could result in choking

The Christmas tree itself can be a hazard, the water in the base can be a source of bacteria or can contain toxic substances to maintain freshness of the tree . We have also seen the curious pet try to climb the tree causing it to fall.

dog-christmas-lights 1Christmas lights have their associated electrical cords are another hazard. Chewing electrical cords can cause painful oral burns.

If you have any questions, just give us a call at (775) 358-6880.

Happy Holidays !

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