The larynx (or voice box) is a structure located in the throat that helps direct air into the lungs and food into the esophagus. Its function is important in preventing food/water from entering the lower airways when swallowing. The larynx opening and closing is controlled by two small flaps called the arytenoids – these arytenoids close when we swallow food/water and open when we take a breath.
Laryngeal paralysis is when the nerves to one or both of the arytenoids become weakened or stop working entirely. This results in one or both of the flaps controlling the larynx to become paralyzed causing them to become slack. This causes louder raspy noise while breathing caused by the slackened arytenoids vibrating as air flows past them. Because of this weakening dogs can inadvertently swallow food or water into the lower airways resulting in coughing or even pneumonia.
The exact cause of laryngeal paralysis is yet unknown. It has been found that dogs with hypothyroidism are more prone to laryngeal paralysis. One study suggests that laryngeal paralysis may be part of a more widespread nerve degeneration; often times dogs with laryngeal paralysis also have weakness in the hind limbs.
Diagnosis of laryngeal paralysis is made by observation of the movement of the arytenoids as deep breaths are taken. This type of exam requires sedation. If one or both of the arytenoids appear slack the diagnosis is made. Occasionally chest x rays and bloodwork are also needed to better understand the situation.
Treatment of laryngeal paralysis is a surgical procedure called a laryngeal tie back or lateralization surgery. This surgery involves placing sutures to help reposition one of the arytenoids to open the airway. Unfortunately this surgery can present risks. Approximately 30% of dogs receiving this surgery will experience a complication called aspiration pneumonia in which food or water is swallowed into the lungs causing infection. Acute respiratory distress is another common complication of the surgery in which a patient will have difficulty breathing and may require an emergency tracheostomy to be placed (this is when a small hole is cut into the trachea below the surgery site to place a breathing tube).
If laryngeal paralysis is not treated the risk of respiratory crisis can occur. If a dog with laryngeal paralysis gets excited or is exposed to warm temperatures, they will begin to pant. Panting will cause the slackened arytenoids to hit each other repeatedly resulting in potentially life threatening swelling of the throat that could result in overheating, lack of oxygen to the brain, and/or death.
Helpful tips for dogs with laryngeal paralysis:
- Avoid stress to prevent excess panting
- Keep pet in a temperature controlled, cool environment avoiding extreme heat
- Use a harness instead of a collar to reduce pressure on the neck
- Ask your veterinarian if anti-inflammatory or anti-anxiety medications could be helpful
- Pursue surgical correction in a timely fashion to reduce risk of respiratory crisis
The vestibular system is a combination of sensing receptors in the middle ear which help us determine our orientation and movement. These receptors then send signals via nerves to parts of the brain that help us maintain balance and coordinate our movements. If any part of this intricate system is disrupted it can result in “vestibular disease”.
Symptoms of vestibular disease include: head tilt, ataxia or uncoordinated movements, walking in circles, falling over, motion sickness or nausea, and nystagmus (rapid eye movements side to side or rotational).
Causes of Vestibular Disease
- Middle ear infections can affect the vestibular organs which reside in the ear. Diagnosis can occasionally be made by external ear exam and microscopic evaluation of debris, but may require x rays of the bulla (bones of the inner ear). Treatment will involve topical and/or oral antibiotics. In severe cases, anesthesia for a deep ear flush may be warranted.
- Brain lesions such as cancer, bleeding or blood clots in or around the brain can be an important but less likely cause of vestibular symptoms. Diagnosis of this would require referral for CT scan or MRI.
- Idiopathic or “old dog vestibular disease” is the most common cause. Idiopathic disease has no known cause, but it occurs acutely and resolves quickly. Often dogs with this form will be back to normal in 7-14 days. Treatment involves treating for motion sickness and nausea. Physical therapy can also be helpful in assisting in recovery.
Transitional Cell Carcinoma (TCC) is a cancer of the urinary bladder. Transitional cells are the cells that line the bladder wall, TCC is a cancer that arises from these cells. The exact cause is unknown, however, an increased risk of this cancer is found in certain breeds of dogs. Shetland sheepdogs, West highland terriers, Scottish terriers and Beagles are breeds predisposed to TCC.
- Blood in the urine
- Straining to urinate
- Frequent or unexplained bladder infections
The diagnosis of TCC is often made after ruling out more common causes of the above list of symptoms (such as bladder stones, infections or other benign causes of blood in the urine and straining to urinate). Several diagnostic tests will be needed to confirm the diagnosis of TCC.
- Urinalysis – will reveal blood and sometimes abnormal cancer cells can be seen.
- Urine culture – allows for infection secondary to the tumors to be treated with appropriate antibiotics.
- Radiographs – rules out stones in the bladder
- Ultrasound – will show abnormal masses in the bladder wall, but can also show us crystals, stones or polyps in the bladder
- Cystoscopy – A tiny flexible camera that can be inserted like a catheter through the urethra into the bladder to help visualize and biopsy bladder masses
- Catheterization – in some cases a urinary catheter can be placed in male dogs that helps collect a small sample of cells for cytology
- Cytology — evaluation of cells by a pathologist
- Chemotherapy – available through veterinary oncologists.
- Surgical removal – possible only if mass is in a location favorable for surgery.
- Conservative/palliative care – piroxicam is an oral medication often used due to its anti-inflammatory properties and possible anti-tumor activity.
Your veterinarian will help formulate a diagnosis and treatment plan best suited for your pet’s needs.
Keratoconjunctivitis sicca, otherwise known as KCS or Dry Eye is a condition in which tear production is abnormally low.
Symptoms may include one or more of the following:
- Dry appearance to the eye
- Increased thick ocular discharge
- Conjunctivitis – red/inflamed eyes
- Corneal edema (hazy white appearance to outer eye)
- Corneal pigmentation (brown discoloration to the outer eye)
Corneal ulcers or damage to outer eye can occur secondary to KCS
Diagnosis is made by performing a test to measure tear production called a Schirmer Tear Test. A fluorescein stain may be performed to help rule out corneal damage or ulceration secondary to KCS.
Treatment of KCS is life long and involves using a combination of therapies to help stimulate natural tear production, provide lubrication to the eye and control secondary bacterial infections. The most common medication used is an ophthalmic ointment called Optimmune (or other cyclosporine eye medications) – this treatment can stimulate tear production as well as decrease inflammation. Prognosis is good for patients with KCS, however treatment is lifelong.
How to Look for Fleas on Your Pet
Examine your pet’s coat carefully. Using a fine-toothed comb (flea comb), look for adult fleas, or for specks that look like pepper (flea dirt). The most common areas to find fleas/flea dirt are the groin, armpits, tailhead, and the neck area. Transfer the black specks onto a white paper towel, and moisten it with water. If the specks leave a red stain, these are definatley flea droppings.
Flea Allergy Dermatitis
Many dogs and cats are allergic to flea saliva, and even a few bites cause these pets to be intensely ithcy. For these pets, flea prevention is critical. The skin irritation associated with flea bites can be treated with anti-inflammatories, and skin infections can be controlled with antibiotics.
Successful Flea Control
An effective flea control program requires treatment of all:
- Pets in the household
- Stages of fleas
- Areas of the environment
It is very important to use a flea control product that controls the larva and egg stages, as these stages comprise 95% of the flea population. Look for house treatments that contain insect growth regulators (IGRs) for effective control of all stages. Adult fleas spend a majority of their lives on a dog or cat, and are easily killed with an effective adulticide product.
Fleas complete their life cycles best in carpet/upholstry fibers, cracks or crevices on the floor, and in shady areas of yards. Concentrate control efforts in these areas. Prevention is easier and less costly than treating a flea infestation.
A. Treat the pet.
Adult fleas that are living on the pet must be killed. Effective products will not only treat an active infestation, they will prevent future infestations. It is recommended to use monthly.
These products include:
- Simparica – once monthly oral tablet for dogs only
- Comfortis – once monthly oral tablet for dogs and cats
- Parastar Plus – topical for dogs only
- Easy Spot – topical for cats only
- Revolution – topical
For pets with a significant amounts of flea dirt, we recommend administering product, waiting two (2) days, then bathe with an aloe/oatmeal shampoo. It is not recommended to use medicated shampoos or flea shampoos in conjunction with other products. These shampoos will strip, or remove, the topical products.
B. Treat the house/outdoor environment.
Remember that only 5% of the flea populations are adult fleas on the pet. The remaining 95% of the population are eggs, larvae, and pupae living in carpet and upholstery.
The recommended home treatment is a product called Knockout Spray (with IGR). One (1) can treats approximately 1200 – 1500 square feet.
- Vacuum all carpets, upholstered furniture, baseboards, and under furniture. Discard vacuum cleaner bag immediately.
- Mop floors with warm, soapy water.
- Change all linens, blankets, and replace (or wash in hot water) pet bedding.
- Follow the directions on the can. All pets and humans must be out of the treated areas as directed on the can.
- Spray all carpeted areas and upholstery with the house treatment spray. Be sure to treat under furniture, and to treat all rooms in the house.
- If you pet spends a lot of time outside or in a kennel, these areas must be treated for fleas as well. Concentrate on shady, protected areas, and dog houses. Treat the areas according to label directions.
Repeating home treatment is very important. Fleas in the pupal stage are protected by the cocoon, therefore retreat in two (2) weeks to kill fleas that emerge.
If your pet is exposed to other animals or are outside, they may become infested with fleas repeatedly. Consistent use of monthly preventatives is advised yearround to keep your pet protected from re-infestation.
- Simparica (dogs only): Give once monthly for control of fleas and ticks in dogs. Simparica has the advantage of being unaffected by swimming and bathing. Also, no residue on skin like other topical products.
- Parastar Plus (dogs only): Apply topically once a month for control of fleas and ticks in dogs. Water resistant
- Easy Spot (cats only): Apply topically once a month for flea and tick control in cats.
- Revolution: This product prevents heartworm disease, ear mites, sarcoptic mange, roundworms and hookworms, as well as fleas and ticks.
- Take a new syringe from the package (syringes are single use only, call or visit us to get refills on syringes when needed)
- Draw up 0.25ml of the red Vitamin B12 solution (measure from the top of the black plunger).
- Pull up the skin between the shoulder blades to create a skin “tent”
- Insert the whole needle into the skin (pointing downward towards the body), make sure the needle has not exited the skin on the other size of the skin “tent”.
- Inject the total volume of Vitamin B12 under the skin.
- Discard the used needle into a Sharps container, syringes are single use only. When Sharps container is full, it can be returned to Lodi Veterinary Care for proper disposal.
Physical Exam and Ear Swabs – WHY?
It is important to have an exam by the doctor and perform diagnostics (i.e. Ear Swabs) to determine the cause of the ear infection. The doctor must evaluate the ear drum to verify it is intact before prescribing ear medication, as some ear medications are toxic to the middle/inner ear. There are also different ear cleaners that are targeted to treat your pet’s specific ear condition. Once your veterinarian has prescribed the appropriate ear cleaner and medication you are ready to start.
- Restraint: Restraint, depending on your dog or cat’s temperament, may be a two-person job (one person to restrain, another to clean).
- Cats: If you have someone available to help, have them hold the cat on a table cradled next to their body. Have the person hold the front lets and chest tight so the cat can’t get away. Use a towel to restrain if the cat is too wiggly. Wrap the cat up like you would if you were wrapping a burrito/taco. Be careful not to wrap too tight.
- Dogs: If you have someone available to help, have them hold the dog in a sitting-position between their legs facing you. It is often helpful to have the dog backed-up into a corner in the sitting-position to prevent the dog from backing out from the restrainer’s legs.
Note: Cleaning can be messy, so it should be done in an easy-to-clean area such as your kitchen or bathroom or even outside.
- Lift the ear pinna (ear flap) so you can see the opening to the ear canal.
- Fill the entire ear canal with your cleaning solution until you see the solution flowing out of the ear.
- Massage the ear canal. You will hear a “swish-swish” sound (like a washing machine). This action helps loosen the debris deep down in the ear canal.
- Stand back and let your pet shake its head. The shaking will push the loosened debris up and out of the ear canal.
- Wrap a piece of paper towel or Kleenex around your finger and gently blot out the excess debris and moisture. Don’t worry about pushing your finger too far into the canal. The ear canal is “L” shaped, so there is no threat of your finger reaching the ear drum.
Use caution when using q-tips to clean your pet’s ears. The q-tip is small enough that it could cause damage to the ear drum.
There are many changes that can occur in our pets as they age. These changes may require us to care for them differently than we may have when they were younger. This guide is intended to help you recognize the signs or symptoms common in our senior pets and ways to help them stay comfortable, safe and happy.
Mobility will decrease with time due to a combination of factors. Arthritis resulting in pain or decreased range of motion of the joints may cause difficulty in rising or laying down, or difficulty getting around. Muscle and nerve weakness can also lead to difficulty lifting the legs properly to walk — this may result in dragging or scuffing of the nails on the ground, or difficulty walking on slippery floors. Decreased mobility may result in your pet laying down most of the day — this can result in bed sores and infection or possibly swollen legs from decreased circulation from lack of movement.
Addressing lack of mobility will vary case to case depending on the severity and each pet’s particular needs. The following list are things that may help our pets with decreased mobility:
- Placing non-slip rugs, bath mats or yoga mats on slippery floors to provide traction.
- Trim excess hair that may be between toes that could reduce your pets natural traction.
- Move food and water bowls to a location where they can be easily accessed. For cats this means having the food on ground level so they do not have to jump up onto a counter, or walk down stairs to get to it.
- Use a litter box with lower edges to prevent need to climb or jump into the box
- Harnesses or slings can be used to help dogs stand from a laying position, or help them walk with our assistance. The Help Em Up Harness (www.helpemup.com) is a comfortable harness worn daily that has handles over the shoulders and hips that caretakers can use to help lift dogs into a standing position, or help them walk out to potty. Even a beach towel used like a sling could be helpful if your pet isn’t amenable to wearing a harness.
- Toe Grips – (www.toegrips.com) are non-slip nail grips that fit on a dog’s toenails to provide traction on slippery floors. They can be worn continuously, but will need to be replaced every 1-3 months.
- Use ramps to minimize number of steps a pet has to maneuver to go outside or into the car
- Medications — there are many safe and effective medications to treat arthritis pain.
- Acupuncture can be helpful in supporting nerve function and strength.
- Use of baby gates to protect pets from accidentally falling down stairs
- Comfortable bedding in a variety of areas to choose from
- Keep active — take small walks if tolerated to maintain muscle mass
Pain can come from many sources: arthritis, certain disease processes, decreased mobility. Speak with your veterinarian about signs of pain to watch for such as: heavy panting, pacing, whining, laying or sitting in an abnormal posture or location, or lack of appetite. There are safe and effective medications to treat the different types of pain our geriatric pets may experience. Laser therapy and acupuncture can be combined with traditional medications to help treat and control pain.
By 8-10 years of age most of our pets will have some degree of hearing loss. This can pose safety concerns if they should become lost or if we need to call them away from a dangerous situation.
- Monitor your senior pet closely when outside, do not allow them outside alone if they are not contained in a fenced yard.
- Early on training your pets with both verbal and hand signals.
- It has been suggested that acupuncture can be helpful for age related hearing loss.
Decreased vision or blindness
Decreased vision or ability to see fine details is a common aging change. You may notice them missing treats on the floor or not being able to catch toys like they used to. Being able to see clearly at night is also a common complaint. Not all of our pets will completely lose their vision. If your pet suddenly becomes blind, a veterinary visit to evaluate vision and the eyes will be important in formulating a treatment plan. Ways to help our pets with decreased vision:
- Blocking off stairways using baby gates to prevent accidental falls
- Using night lights can help with decreased vision in poor lighting
- Not allowing pets with decreased vision outside alone to prevent accidents
- Use verbal commands or gentle touch to help guide them
- For pets who are blind the book “Living with Blind Dogs” by Caroline D. Levin can be very helpful
As muscles and nerves weaken with age, just as we see weakness in the hind legs, we can also see weakness in the muscles that control the bladder or rectum. This can result in urinary and/or fecal incontinence. Older pets may also have the urge to urinate or defecate more frequently. Hygiene can become an issue if they are urinating/defecating where they lay — this can lead to sores and infection. Depending on the severity of their incontinence, a variety of treatments are available:
- Medications can be used to help with urinary incontinence.
- Acupuncture may help improve continence
- Trimming hair near the urinary opening and anus and gently cleaning these areas with warm water on a rag to prevent sores/infection
- Use of Aquaphor ointment after cleaning near the urinary opening can reduce urine scald
- Sanitary napkins, belly bands and diapers can be used – these may increase risk of urinary tract infection.
- Covering their bedding with disposable absorbent pads (like puppy training pads or hospital chux)
- Working with your veterinarian to frequently monitor for urinary tract infections which become very common in our geriatric patients with incontinence.
- Having litter boxes with lower walls and in a variety of locations on every floor of the home for easy access
- Creating an indoor potty area for dogs to use “in an emergency” when you are away (using puppy pads, dog size litter pans, artificial turf, etc)
- Letting dogs outside to potty more frequently to reduce accidents inside
Medical conditions that our geriatric pets may have can contribute to a decreased appetite. Nutrition is important for energy and maintaining weight.
- Appetite stimulants are available in a variety of forms
- Anti-nausea medications can be used in patients with diseases that may cause nausea (kidney disease, liver disease, pancreatitis, intestinal disease, etc.)
- Vitamin B12 injections are a natural appetite stimulant that may be of benefit
- Encourage appetite by feeding foods that are both enticing, but unlikely to cause gastrointestinal upset such as: cooked white rice, cooked noodles, boiled skinless potato, lean cooked protein, protein based baby food purees. Your veterinarian may have other recommendations based on your pets specific medical needs.
Just as with food, some of our pets will become disinterested in drinking water. Hydration is very important for our pets, especially as they get older. Maintaining normal hydration can improve how our pets feel.
- Have multiple bowls of water around the house in easily accessible locations
- Use a pet water fountain — fresh running water can be more enticing
- Use low sodium chicken broth
- Try making low sodium chicken broth with gelatin added to create a “treat”
- Your veterinary team can teach you how to give fluid under the skin
Behavioral changes can be some of the more concerning changes that occur in our older pets. Signs can include: aimlessly wandering or pacing the house, altered sleep/wake cycles, acting confused, getting lost in the house, not recognising familiar people or pets, regression in potty training or personality changes. It can be natural to want to scold them for making mistakes, or waking us at night, but we need to remember that these actions are usually not on purpose. Unfortunately there is no cure for cognitive dysfunction, several modalities have been tried with variable success rates. The following have been found to be helpful in some cases.
- Feeding a diet fortified with antioxidants
- Hill’s Prescription diet B/D (canine only)
- Purina ProPlan Veterinary Diets Neurocare (canine only)
- Anipryl (selegiline HCL) is a daily oral medication that can help reduce symptoms of cognitive dysfunction (can take up to 4 weeks to see a response) (canine only)
- S-Adenylmethionine is a daily chewable tablet that contains a powerful antioxidant which can be helpful in reduction in symptoms (canine and feline)
- Environmental enrichment such as regular exercise and introduction of new toys or rotation of toys can help stimulate the brain and slow progression of cognitive dysfunction
- Studies have shown that dogs that were given both dietary and environmental enrichment had the greatest improvement in cognitive dysfunction when compared to dogs who did not have enrichment.
Of course this is the most important, but often overlooked, key to helping our geriatric pets. We love them unconditionally and because of this we, as pet owners, are the most important judge of their happiness. Keep in mind the things that make them special to you, what they love best, what gives them joy. Remember that even as the burden of caring for them increases with age we also need to keep in mind and provide them the things that bring them joy — whether it be car rides, walks (or trips outside in a wagon or stroller), a nap in the perfect sun spot, a visit with a special friend, beloved toys, favorite snacks, snuggles and cuddles with you.Caring for our pets as they age and develop medical conditions can be difficult. But we, at Lodi Veterinary Care understand the loving bond that connects us with our fur-children. If you have questions or concerns of the best ways or options to treat and help your pet, do not hesitate calling at any time.
Anaplasma phagocytophila (formerly Ehrlichia equi) is a tick-borne disease which causes Equine Granulocytic Ehrlichiosis. This non-contagious disease is transmitted by the deer tick or blacklegged tick called Ixodes scapularis. (In western states it is also transmitted by Ixodes pacificus, the western blacklegged tick.) Small rodents such as white-footed mice, chipmunks, voles, and shrews, as well as white-tailed deer and possibly birds act as intermediate hosts in the lifecycle. Dogs, humans, and horses are incidental hosts.
Image courtesy of cdc.gov
Image courtesy of the TickEncounter Resource Center
Any age or sex of horses can be affected, but horses younger than four years old seem to exhibit less severe signs.
Common signs may include:
Fever (often 103-106’F)
Lethargy, unwillingness to move
Yellowish mucous membranes (icterus); may have small hemorrhages (petecchia)
Chronic infection: poor performance, change in attitude, lethargy, depression
Secondary problems may occur in horses with preexisting or concurrent problems
There are several different testing options for anaplasmosis that involve bloodwork.
A blood smear may show inclusion bodies in white blood cells. Though very diagnostic, these are only present when the bacteria are reproducing.
A PCR is a send-out test which looks for DNA of the Anaplasma organism.
Other tests may include paired-titer levels, IFA test, or other depending on the situation.
Treatment may vary depending on the severity and other considerations, but generally would include a tetracycline antibiotic. Oxytetracycline administered intravenously once daily for about 5 days will generally result in a rapid and effective response. Doxycycline or minocycline given orally for a longer period can also be effective but typically has a much slower response rate. Horses undergoing treatment should be carefully monitored for side effects.
Non-steroidal anti-inflammatories (ex. Banamine) may also be used to help control fever.
No vaccine is currently available. At this time, the best prevention is targeted towards multifactorial tick control. Many products, such as tick leg bands and UltraBoss, can be used. In addition, environmental control is very important and may include keeping pastures mowed, trees pruned, and leaf litter to a minimum. It also helps to keep horses tails shorter than grass height and to decrease secondary hosts such as mice and shrews.
If you have any questions regarding the above information or your horse is displaying any of the signs listed above, please call us at (608)592-7755, we would be happy to discuss further.
Viral papillomas in dogs are small growths on the lips, gums, around the eyes or on the toes. They are hairless growths that have the appearance of tiny clusters of fingers or fronds. These lesions are most common in young dogs.
Papilloma lesions are caused by a papilloma virus spread from dog to dog contact or by contacting toys, food/water bowls or other objects that may have touched another dogs papilloma lesion. This virus can only be spread among dogs, it cannot be passed to other pets or humans.
Treatment in most cases is not necessary. As the immune system matures and responds; the papilloma virus lesions will regress. This process can take 1-2 months. If lesions are still present after three months, further treatments such as surgical removal or antibiotics may be warranted.
If your pet has papilloma lesions it is advised that they not participate in play groups, at the dog park or with other young dogs to prevent spread of this virus. Once the lesions have regressed, they are no longer contagious.
What are allergies?
An allergy is an abnormal reaction of the immune system. Normally, the immune system fights off foreign agents like bacteria and viruses to protect the body. In an animal with allergies, the immune system is reacting in an abnormal way to substances like pollens, dust, mold, fleas, or certain foods. An allergy to inhaled particles, like dust or pollens, is called “atopy“.
What are symptoms of allergies in dogs?
Most dogs with atopy get itchy skin. They may lick their feet, rub their faces and/or scratch their bodies. The skin may get red and irritated, and skin infections may occur because of the scratching and trauma to the skin. Eventually, the skin may be chronically irritated and be thick and leathery in certain areas. Other common symptoms include recurrent ear infections, greasy or flaky skin, or hair thinning. Dogs may less commonly have irritated eyes or nasal discharge.
Food allergies frequently have the same symptoms as atopy, but some dogs also have digestive upset such as vomiting or diarrhea.
Dogs with flea allergies usually have itchy, inflamed skin, particularly on the back near the tail.
How are allergies diagnosed?
Atopy is diagnosed by evaluation of the symptoms and response to treatment, and skin or blood tests are done to determine exactly what the dog is allergic to. These tests are necessary prior to hyposensitization treatment (see treatment section below). Food allergies can have the same symptoms as atopy but require a hypoallergenic diet trial to diagnose them (see treatment section).
How can allergies be treated?
- Dogs with allergies should be on a flea preventative, as they are frequently highly allergic to fleas. Keep allergic pets away from other biting insects as well, if possible.
- Monitor carefully for any circumstances that seem to increase your dog’s symptoms, such as swimming, warm humid weather, certain foods or treats, shampoos, medications, season of year, use of a woodstove, etc. Knowing what worsens your dog’s symptoms can allow you to avoid those situations and can help make the diagnosis.
- Keep the skin and haircoat clean and brushed– this allows you to monitor the skin condition more easily and reduces the likelihood of infection. In some situations specific shampoos, wipes or topical products may be advised.
Specific Treatment for Atopy
- Antihistamines can help reduce the symptoms. Some dogs are sleepy when first started on antihistamines, but this side effect usually goes away after a few days. These are safe for long term use. Keep in mind that antihistamines need to be given regularly, often several times a day, in order to be effective. It may take a week or longer to see improvement after starting these medications. These medications are available over-the-counter, but be sure to use products that contain only these ingredients — many multi-symptom products for humans have other ingredients that are not safe for dogs.
- Fatty Acid Supplements: Omega 3 fatty acid supplementation can reduce skin inflammation in dogs. This natural product, derived from fish oil, is very safe. It is usually easiest to feed a diet formulated to have the appropriate omega 3 ratio, rather than to supplement with fish oil capsules. Non prescription foods such as Science Diet Sensitive Skin and Stomach may be recommended for some cases of atopy. In other situations prescription diets may be advised.
- Limit exposure to allergens — many dogs have most severe symptoms in spring or fall, and keeping the air conditioner on can help filter the indoor air at these times. Change filters in air conditioning units and furnaces frequently. For dogs with allergies to dust or dust mites, removing or vacuuming carpeting frequently and washing curtains can reduce household dust.
- Cytopoint is an innovative new injectable therapy that targets itch at its source lasting 4-8 weeks per injection. This injection works by specifically neutralizing one of the main proteins that sends the itch signal to the brain. This is a very safe and effective treatment with low risk of side effects.
- Apoquel is an oral medication that stops itch at its source regardless of the type of allergy. It begins relieving itch within 4 hours and effectively controls the itch for 24 hours. Apoquel can be used long term if needed for continued itch relief. In studies, the side effects from apoquel were mild and similar to those seen with placebo (sugar pills).
- Corticosteroids — Drugs like prednisone are usually very effective in reducing itching related to atopy. A short, tapering course of prednisone (or sometimes a single injection) can be used to control severe itching. However, long term use of corticosteroids is not usually recommended, due to side effects that can occur with continual usage (elevated liver enzymes, increased risk of diabetes). Short term use is generally safe, although some animals will show side effects such as increased thirst, increased urination, and increased appetite. These side effects will go away once the dosage is reduced or discontinued.
- Hyposensitization Therapy — “Allergy shots” or a newer version of hyposensitization therapy in the form of a drop under the tongue (sublingual allergens) are used to train the immune system to respond more appropriately to the allergens in the environment. This process starts with testing to determine what the animal is allergic to, and then the owner is taught to either give injections or use allergen drops under the tongue on a regular basis at home. This treatment is usually continued for months or years or life long, depending on the animal’s response. For testing, the patient needs to be off of some of their allergy medications for 6 weeks and it is best to do the test during the time of year that symptoms are the worst. Hyposensitization therapy is the only treatment that can decrease the immune system’s response to the offending allergens leading to long term improvement in how the body responds to allergens.
- Antibiotics are frequently needed to control secondary bacterial infections of the skin, often caused by excessive chewing or licking. Medicated shampoos, wipes or topical products may also be used to help reduce or prevent secondary infections.
- Yeast infections can also occur secondary to atopy, and antifungal treatment may be necessary.
Diagnosis and Treatment of Food Allergies
- In animals that are suspected of having food allergies, a hypoallergenic diet trial is necessary to diagnose this condition. The animal is placed on a special diet that does not contain any ingredients that could be triggering allergies. Usually a minimum of eight weeks is needed for a diet trial. It is very important that the dog not be given any other foods during the trial, as even a small amount of an allergenic food could make the dog itchy. No treats, rawhides, beef flavored heartworm preventatives, etc. should be given during the trial. If the dog has food allergies, the symptoms should improve during the trial, but this may take several weeks to see improvement.
- After the diet trial, different food items are slowly introduced to see what foods the dog can tolerate, and which cause problems.
Allergies in dogs are frequently a lifelong disorder, but most dogs can lead comfortable, normal lives with treatment. It can take trial and error to find the right combination of therapies each pet will need to control their symptoms as all pets allergies are different. Working closely and openly communicating with your veterinarian is the most successful strategy in managing allergies.
Maintaining a healthy weight may be the most important element in assuring the best possible quality of life for a dog with osteoarthritis. Body weight not only increases the load on all joints, but inflammatory proteins produced by fat cells can cause the symptoms of arthritis to worsen. The goal for your pet is to have a slight “waist” when viewed from above, a “tummy tuck” when viewed from the side. You should be able to easily feel your dog’s ribs, without seeing them. To monitor your dog’s weight, please have him/her weighed periodically. A simple way to start a weight control program is to replace high calorie treats with raw vegetables (carrots/green beans) and decrease the volume of food in each meal to ¾ of the amount currently fed.
Low Impact Activity
A low impact exercise regimen is also an important factor in preventing some of the clinical signs associated with osteoarthritis. The goal of regular low impact physical activity is to maintain good muscle mass and prevent muscle atrophy while protecting the articular cartilage of the joints. The two best low impact activities include daily leash walks at a slow pace and swimming.
Remember the three “R’s” when planning your dog’s exercise regimen:
- Be Reasonable — Start with small leash walks, no long hikes or jogging.
- Be Rate-conscious — Start your dog off slowly and increase exercise time gradually.
- Be Regular — Make exercise a routine.
Joint Specific Diets
Specific “joint protective” canine diet formulations are available. These diets have a favorable ratio of omega-6 to omega-3 fatty acids which may decrease inflammation in joints. Hills Science Diet J/D is one of the prescription foods that can be beneficial in promoting joint health. If you decide to use one of these, gradually introduce your dog to this new food over 1-2 weeks by slowly adding the joint specific diet while decreasing the amount of normal food. Typically results are seen within 21-30 days of being on a therapeutic diet; benefits increase the longer your pet is on this type of diet.
Joint Supplements / Nutraceuticals
If your pet cannot go on a prescription diet for joint health due to allergies, sensitive stomach or other reasons, one might choose to supplement their current diet with nutraceuticals. Some chondroprotective (joint cartilage protective) agents are classified as “nutraceuticals” and include glucosamine, chondroitin, glycosaminoglycans, omega fatty acids, plus many others. The concern with nutraceuticals is that they are somewhere between a nutritional supplement and a pharmaceutical agent. The products are not regulated or tested by any agency; in addition, their safety and efficacy does not need to be documented prior to marketing. Despite this, many people and animals alike do seem to experience relief when taking nutraceuticals, and side effects are extremely rare. It is important to realize that you truly get what you pay for when purchasing nutraceuticals, please ask your veterinarian which brands can be trusted.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDS)
Some dogs may require prescription NSAIDS to improve their level of comfort. Examples of these medications include Rimadyl (carprofen), Metacam (meloxicam), Previcox (firocoxib), or Deramaxx (deracoxib). Not all dogs with osteoarthritis need to be on NSAIDS all the time. We will recommend the appropriate dosing schedule for your pet to keep him/her comfortable.
*Many pets will see improvements in their comfort and ease of movement with these methods. For those pets with severe osteoarthritis, other therapies may be suggested. Ask your veterinarian for more details.
Lipomas are very common, benign growths in dogs. They are seen less frequently in cats.
These growths consist of fat cells and can range in size from very tiny to ten or more inches in diameter. The most common areas to find lipomas are under the skin in the regions of the abdomen and chest. Most lipomas are fairly soft, non-painful lumps just under the skin.
We diagnose a lipoma by taking a sample with a small needle, staining it on a slide, and then looking at the cells under a microscope (a fine needle aspirate). Lipomas are characterized by fat cells with no evidence of infection or other tumor cells. We recommend a fine needle aspirate of any lump you notice on your pet, as microscopic examination is necessary for an accurate diagnosis to help us differentiate benign (non-cancerous) from malignant (cancerous) tumors.
No treatment is necessary for lipomas that remain relatively small and do not bother the animal. Some lipomas can grow large and interfere with movement of a limb, or bother the animal when he or she lies down. In that case, surgical removal is advised. Any lipomas that are growing rapidly should be re-evaluated and another fine needle aspirate performed, or the growth should be removed.
Mast cell tumors are one of the most common skin tumors in the dog. They arise from a population of inflammatory cells called mast cells. Mast cells are filled with granules of inflammatory mediators such as histamines. When manipulated these granules are released from the cell and can cause significant swelling, redness, bruising or bleeding at the tumor site. Most mast cell tumors occur either within the skin or just under the skin in the subcutaneous tissues.
The behavior of mast cell tumors is very unpredictable. Tumors can range from a single solitary mass in the skin to an aggressive form called disseminated mast cell tumor, which spreads invasively throughout the body. Mast cell tumors can be classified into three categories:
- Grade I – Well-differentiated, usually solitary nodules but may be multiple. Seldom metastasize or move to other organs in the body.
- Grade II – Moderately differentiated, higher likelihood to metastasize and cause systemic disease.
- Grade III – Poorly differentiated. Most aggressive, most likely to metastasize other parts of the body or cause systemic disease in the blood.
A MCT can usually be diagnosed from a fine needle aspirate in which a small sample of cells are stained and examined under a microscope. Mast cells typically have a very characteristic appearance with dark granules in the cells. To help stage the spread of the tumor, blood counts, aspirates of regional lymph nodes, ultrasound of abdominal organs, chest x-rays and bone marrow biopsies maybe recommended.
Once diagnosed, a mast cell tumor should be surgically removed and biopsied to determine the Grade (I-III) and to check the surgical margins. Healing can be delayed because of the inflammatory component of the mast cells. Often additional medications are advised following removal.
The grade of the tumor, the success of surgical removal, and the stage of the disease (extent of spread) determine the treatment. Surgical excision alone is often curative in a Grade I, completely excised tumor. Higher grades, incomplete excision and evidence of spread may require additional treatment.
Most mast cell tumors (Grade I) that can be completely removed have a good to excellent prognosis. The higher Grades (II + III) tend to have a guarded prognosis, and the aggressive tumors that have metastasized have a poor prognosis. Early detection and removal definitely improves the chances that this tumor can be treated. Continued monitoring of the surgical site for signs of regrowth and screening for metastatic disease is advised for all mast cell tumors.
Mast cell tumors can have a variety of appearances. A dog with a history of having a mast cell tumor removed should have all new lumps evaluated immediately. The doctors or staff at Lodi Veterinary Care will be happy to answer any questions that you may have.
Demodectic mange is caused by a microscopic Demodex mite. All dogs have demodex mites on their skin that live within the hair follicles. Most dogs live in harmony with their mites, never suffering any consequences from being parasitized. However, if the dog’s immune system becomes suppressed (or in young puppies), the Demodex mites proliferate and can cause serious skin disease. It can occur in isolated spots or affect larger areas and multiple spots on the body.
Demodex mites are host specific, therefore are not contagious to other species. Canine demodex is typically not contagious to other dogs unless infected dog is in contact with immune suppressed or very young/old dogs.
Because demodex live within the hair follicles a deep skin scraping is needed to make this diagnosis. In adult dogs with spontaneous demodex infection, further diagnostics may be warranted to determine the cause of immune suppression to result in this type of infection.
Localized demodex (those cases of demodex that only occur in few small locations on the body) in young dogs do not always require treatment. Depending on the severity of the case topical (medicated shampoos and ointments) and or oral medications (ivermectin) are used. Occasionally, dogs with demodex have secondary skin infections which require oral antibiotics.
Why do Calcium Oxalate Uroliths form?
Genetics, dietary issues and some metabolic diseases can predispose pets to the formation of calcium crystals or stones. Pets that have more acidic (low) urine pH and very concentrated urine can be factors in calcium oxalate formation. Breeds especially at high risk include: schnauzers, lhasa apsos, yorkies, poodles, shih tzus, bichons, Burmese cats and Himalayan cats.
How do you diagnose calcium oxalate stones?
Although a urinalysis can provide clues (calcium crystals and acidic/low urine pH), and an ultrasound or x ray can confirm the presence of stones, the only way to know the exact stone type is to retrieve the stone(s) surgically (cystotomy) and have a laboratory analyze it.
Do the stones have to be surgically removed?
Unfortunately there is no diet nor medication that would be able to dissolve this type of stone. Leaving the stones in place will predispose your pet to frequent irritation to the bladder wall, infections and possibly life threatening blockage of the urinary tract. Because there are many factors that lead to calcium stone formation, and no foolproof way to prevent them from reforming, studies show that 50% of all pets who have had calcium stones removed will develop new stones within 3 years.
Therapeutic plan to minimize the chance of recurrence
Diet – while specific diets cannot dissolve existing stones, they do help in preventing the development of new stones. Canned form is preferred so as to increase water consumption and thus help dilute urine.
- To be effective, prescription diets must make up >90% of the total calories consumed.
- It is especially important to avoid table scraps, however the following treats are acceptable (in very small quantities) for calcium stone forming pets: plain cooked boneless skinless chicken/turkey breast, cooked eggs, rice, peas, white potatoes, cabbage, cauliflower and bananas.
Urinalysis and Recheck– urine needs to be checked at intervals to help ensure that the concentration and pH are adequate to help reduce risk of reforming stones and check for signs of infection. If pH and concentration are not adequately controlled with diet alone, occasionally other medications will need to be prescribed.
Calcium oxalate bladder stones can be very frustrating. Not only do they tend to recur (sometimes very quickly), management will involve frequent visits to the veterinarian’s office to recheck urine. Keep in mind the trouble and expense of a stone surgery outweighs the trouble and expense of monitoring.