Periodontal Disease

She was brought to the hospital because she had been sneezing for a week and the owner wanted it stopped.  This was the first time I had seen Trixy, an old, overweight Miniature Poodle. At first I thought she might have a chronic infection somewhere in the nasal cavity that was causing her to sneeze or maybe cancer in the back part of the nasal cavity.  With these problems one often sees intermittent bleeding from the nostrils and there may be reverse sneezing as if there was exudate draining backward into the throat, but this hadn’t happened.  Then, when Trixy was put on the floor, she did a forward sneeze trying to clear something from the front of the nasal cavity.  That was different, not what I expected. The teeth were the cause of the problem!  I could see they were massively caked with a greenish-gray scale that had accumulated over years.  It was accompanied by periodontal disease and that infection had progressed down the teeth causing them to become loose and painful.  In Trixy’s case, infection around the roots of the large canine teeth had eroded into the nasal cavity creating fistulas (holes) so that pus drained into the nasal cavity, causing poor Trixy to sneeze.  To treat this condition one can administer antibiotics which may control the infection temporarily only to have it resume when the antibiotic treatment ceases.  Another way veterinarians solve Trixy’s problem is to stop the flow of pus by cleaning the teeth with ultrasound (brushing won’t do), extracting teeth that are loose or infected and then, surgically close the fistulas between the mouth and the nasal cavity. 

Prevention by routine tooth cleaning is the preferred management of this disease.  Twenty years ago many dogs had fistulas between the mouth and the nasal cavity that developed when canine teeth with severe periodontal disease fell out.  This condition was especially common in small lap dogs that lived indoors and ate human table food.  But over time owners of these small dogs have eliminated table food diets and fed nutritionally balanced commercial dog food which has prevented bone degeneration around the teeth from developing.  They also have had their pet’s teeth cleaned routinely by a veterinarian.

Treating Puppies with Parvo virus Infection; A Study

Start of the parvo virus season is just around the corner. It extends through fall, winter and spring and is most prevalent in low desert areas such as the Imperial Valley. Affected puppies vomit, and suffer from diarrhea. If neglected, pups can become very dehydrated and death is a common outcome. Some owners treat sick puppies themselves using over-the-counter remedies too often with disastrous results.  Years ago I learned that the drugs used to treat sick puppies were critical. Sometimes when one of the penicillin drugs was used for treatment the puppy would develop a severe Clostridium difficile diarrhea, a very undesirable consequence.

 I did some studies to see what might or might not work. During the 2016 parvo season 61 pups that had tested positive for parvo were treated. They all got the same regimen: a liquid oral prescription for the gastro-intestinal bacteria, a small injection of a broad spectrum-antibiotic for other bacteria in their bodies and an oral antivirus medicine used in people. Puppies were sent home with instructions to return the following day for further treatment. Most of the sick puppies were treated only once, and only one of them died. Perhaps the antivirus medicine was most helpful I am not certain that it was but I continue to rely on it.

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

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.

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.

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.

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.