Thursday, July 26, 2012

Acute Pancreatitis

This is a story about acute pancreatitis in two small dogs; one was a young male and the other an old female. They had been vomiting for several days, would not eat, their abdomens were tense and painful, and they had low-grade fevers.  The disease developed spontaneously in both dogs.  Serum lipase and amylase, two enzymes normally found in pancreatic cells, were elevated three and ten times the normal level. When pancreatic cells are injured some of the enzymes they contain leak into blood and become important for diagnosing acute pancreatitis. The pancreas is located in the abdomen alongside the small intestine and contains several enzymes that digest food when they are secreted into the intestine.  Normally, while within pancreatic cells, the enzymes are inactive.  However, enzymes can become activated inside the cells. When activated, they injure the cells by digesting them, thereby causing inflammation and the disease, pancreatitis.
            To counter the inflammation and pain from the pancreatitis both dogs were treated morning and night with minocycline, an antibiotic with cytokine-modulating anti-inflammatory properties.  Within 24 hours the dogs appeared to feel better, for they were more active and in less pain.  At 48 hours serum amylase and lipase levels had returned to normal in one dog and near normal in the other. Treatment was continued for 10 days and full recovery was uneventful.  The promptness and extent of response to treatment of pancreatitis were greater than anticipated and suggest there was modulation of inflammatory cytokine effects in the pancreas and/or suppression of intracellular enzyme activation by minocycline.

Image courtesy of Mike Barid - Flickr

Sunday, December 18, 2011

Tear Stains in Dogs

It is common to see Shih Tzu dogs, as well as Pugs and Miniature Poodles, with tear-stained faces.  This condition relates to inherited anomalies of facial structure.  The consequence is impaired drainage of tears through the tear ducts.  Instead, tears spill down the face.  Iron in tears stains the hair and the constant wetness results in infections, dermatitis and pain.
            Facial staining can be helped by restructuring the face about the eyes through two-step surgery.  Initially, a small wedge of skin is removed at the medial canthus.  As the edges are sutured together openings of the upper and lower tear ducts are repositioned closer to each other forming a tiny lake where tears collect.  The second surgery is correction of the entropion of the lower eyelid which typically has closed the opening of the ventral tear duct.  By turning the eyelid outward the duct opens and tears flow away from the eye in the tear ducts and staining of facial hair is reduced as is infection and dermatitis.

Sunday, October 2, 2011

Low back pain in a dog

The tail didn’t wag-couldn’t or wouldn’t, I wasn’t sure.  He stood there, tail drooping, looking at me with soft brown eyes that seemed to say, “please be gentle”.  He was big, a German Shepherd-cross breed dog that weighed close to 100 pounds.  His tail hadn’t swept the owner’s collectibles off the coffee table for several months.  Recently, she had spoken with me about the dog’s difficulty getting to stand on his hind feet.  I thought he might have cauda-equina compression syndrome, which would cause him pain on standing.  But now that he had come into the hospital it was clear his tail was also affected.   On rectal examination he showed pain when upward pressure was applied to the sacrum.  The spinal cord ends near the end of the lumbar spine and only nerves extend onward. The lumbosacral junction (where the spine attaches to the pelvis) had excessive flexibility and on radiographs there appeared to be new bone deposited in the spinal canal.  This was pressing the terminal spinal nerves against the roof of the spinal canal at the lumbosacral junction.  The dog could have been treated with an anti-inflammatory drug and pain would have been somewhat relieved but still he would suffer and eventually become disabled.
Instead, a dorsal laminectomy was performed.  His back muscles were separated over the lumbosacral junction and the tops of the last lumbar and first sacral vertebrae were carefully cut away with a rongeur to expose underlying nerves so that they were no longer crushed between the underlying new bone deposits and the top of the spinal canal.  The dog was placed in a recovery kennel.  When I checked on him at 10:00 that evening he still lay half asleep, but the next morning when I came in to visit him he jumped up, tail wagging gaily as he bounded out of the kennel.  His pain was gone and he can expect to live out a normal happy life.
Most dogs with cauda-equina compression syndrome require six to eight weeks to recover from surgery.  But the surgery is justified because in most cases it provides dogs prompt permanent relief from intractable back pain.

Saturday, September 17, 2011

Cats and Bats!

“Louise, you were right to be concerned when your cats killed a bat.  Fortunately, our records show Calico, Blackie, and Daisy are current on their rabies vaccinations.  If they were bitten by the bat or even if they ate it they should be protected”.
            Rabies in cats is a greater problem in the country than rabies in dogs.  More people are bitten by rapid cats than by rapid dogs perhaps because they tend to befriend and cuddle small, warm, soft animals, i.e. cats and kittens. 
            Although it has not been shown that rabies is spread among cats by biting each other it is well known they can contract rabies from bat and skunk bites.  Both bats and skunks are reservoirs for the infection in the wild.  People can also be infected with rabies by bats and skunks and for that reason should leave these animals alone, for when infected they can survive for long periods with the virus in their tissues and can infect other animals or people months after they themselves have been infected.
            I have worked with rabid animals, but not in the Imperial Valley.  Early in the disease, affected animals seem to have difficulty seeing well or may be a little uncoordinated when moving.  They behave apprehensively as if realizing something is wrong that they do not understand and not knowing what to do, they may seek human comfort and become inordinately affectionate.  As the disease progresses their alarm mounts, they become fearful and may want to hide.  Then, within hours or days affected animals become very depressed or vicious, attacking objects, humans, or animals that move.
            To avoid exposure to rabies people should be skeptical of any abrupt change of attitude in their pets.  As a rule stray animals should be left alone.  Children should be especially careful and avoid them.  If one thinks he or she has an animal with rabies, they can call their veterinarian for advice.
            Vaccination against rabies is the best prevention, although annual vaccination of dogs is required by law, vaccination of cats is even more advisable.

Tuesday, August 9, 2011

Seizures In Your Pet

This is the sad story of a seizuring Chihuahua dog that died because of brain damage.  Several weeks ago a midnight call came from a lady that said her little dog had a seizure several weeks ago and had recovered from it.  However, this day the dog had begun having seizures at noon which continued almost constantly since they started.
            My first reaction was, this is bad!  When seizuring becomes constant permanent brain damage will occur unless the seizures are promptly stopped.  It might be hopeless but I had to try to relieve the little dog’s suffering.
            Sure enough, when the dog arrived 15 minutes later it was in status epilepticus, a constant seizuring state.  It was immediately injected with two drugs that are used as anesthetics.  The dog promptly stopped seizuring and was hospitalized for observation for the remainder of the night.  The next morning it was clear the seizuring had resulted in permanent brain damage!  The dog was now blind.  It could stand and walk but when it blundered into a corner of the cage it could not get out of the corner.   It just remained standing in the corner.  It could not eat or drink but was sent home with the admonition that further care would be futile.  He died two days later.
            Seizuring can be a sign of serious brain disease.  If your pet has a seizure contact your veterinarian promptly for advice on how to proceed.  If the pet has more than one seizure in an hour it should be placed on medication to prevent further episodes.  Letting the seizures continue without control in the hope that they will stop without care creates the risk of permanent brain damage.  Also, please be aware that syncope, fainting, as occurs with some heart conditions, can be confused with seizuring but requires different treatment.  Let your veterinarian help you and your pet differentiate between the two conditions.  

Monday, July 11, 2011

Ear Mites!

Crystal, a girl of the backstreets, was a pretty cat.  Several months ago she had a liaison with Horatio.  Her owner wasn’t aware of the clandestine relationship.  Really, there was nothing to tell. Two months later Crystal started scratching her ears.  There was dark- brown, cruddy exudate in them.  When I looked there were tiny white bugs crawling around in her ears.  Ear mites!  I heard of a veterinarian that put some ear mites in his own ears just to experience what a cat goes through with these pests.  They nearly drove him nuts as they crawled around.  These mites spend much of their life crawling around on a cat’s body where ear treatment doesn’t work.  Therefore, treatment in the ears must have a prolonged effect to kill the mites when they periodically visit the ear canals.  We see a lot of cats with mites, treat them, and send home drops to be administered when the cat starts to scratching again.  This is about once a month for indoor-outdoor cats where exposure to feral cats causing re-infestation can occur.  Strictly indoor cats are usually free of mites after two treatments.  But, all cats in the house must be treated.  If not, any untreated cat will be a source of re=infestation of all the others.
Another condition in cats that is clinically similar to ear mite infestation is due to a polyp growing in the ear chambers.  This can be confused with infection or mites and requires surgery for a cure.
Ear problems are very common in dogs.  But mites are rare.  I have only seen one case of ear mites and that was in a pup.  Yeast infections in the ears of dogs are very frequently encountered.  They cause dark brown to black exudate to form in the ears that is similar to that seen with cats that have ear mites.  However, treatment is very different for mites and yeast infections.  If yeast infection of dogs is not treated properly it can result in rupture of the ear drum leading to middle ear infection which is a serious, difficult problem to treat.

Monday, June 20, 2011

Spleenic Torsion

Rosey, an 11-year-old Labrador Retriever was brought to the hospital because she was depressed and had not eaten for 3 days.  She walked slowly with her head held low and showed no interest in her surroundings at the hospital.  On examination, her heartbeat was exceptionally rapid, about 200 beats per minute.  The abdomen was slightly distended and in it I could feel a large, firm tumor that I thought might be the spleen.  The spleen is an organ that blood flows through to be cleansed of defective blood cells and infectious agents.  With a hypodermic needle I pierced the body wall and removed a small amount of the tumor’s content.  Surprise!  All I got was a syringe full of dead and degenerated blood cells.  Whatever the tumor was, it was trapping and holding blood cells, not letting them return to the body’s circulation.  A blood count showed Rosey was anemic.  She had lost 70% of her circulating blood cells, enough so that resulting anemia put her at risk of dying.  It was assumed Rosey’s health problem was related to the abdominal tumor that must be removed.  But as anemic as she was she might not survive the operation.  So, we collected 400ml of blood from Bridger, the in-house blood donor, and while it was flowing into Rosey we opened her abdomen and found the abdominal tumor was, in fact, the spleen which had rotated in the abdomen.  Its blood vessels had been twisted, thus blood could flow into the spleen but not out.  The spleen was removed.  It weighed more than 1000 grams about 10 times more than normal. Rosey recovered and again is a happy healthy dog.
 Spleenic torsion is an unusual disease in dogs.  Success in this case was related to sampling the spleen and knowing its content before surgery.  If I had corrected the torsion instead of removing the spleen the dead-cell content in the spleen would have drained into the circulatory system and killed the dog.  Administration of blood during surgery saved time allowing us to proceed without first stabilizing the dog medically.

"Photo Attributed to emildom74 via