Thursday, August 26, 2010

True or False: Is it toxic or not?

Have you ever thought about whether or not common items around the house could be dangerous to your pets? Find the truth about some of the common items here!

My dog ate Marijuana. Its ok as long as I leave lots of food out for the munchies.: False

All parts of the marijuana plant contain THC including hashish and hashish oil. Your dog will probably not die unless they eat too much but clinical signs will start at 1000 times less than the lethal dose. Signs may start as soon as 30 minutes and include disorientation, drunken gait, slow heart rate, tremors, vomiting, low blood pressure and urine dribbling. Treatment includes supportive medications and monitoring of body temperature. Most recover in 24-72 hours.

Macademia nuts are dangerous: True

When ingesting a moderate quantity (about 5 nuts per 10 pounds) you will notice vomiting, weakness and depression starting at about 6 hours after ingestion. If there is not preexisting medical condition the weakness and depression gradually improve over 24 hours.

Swifer WetJets kills dogs: False

This product is mostly water (up to 90%), some propylene glycol and a little isopropyl alcohol. The propylene glycol is not the same as toxic ethylene glycol found in antifreeze and at the concentration in this product it should not be a problem.

Febreze is dangerous for pets: False

Febreze contains water, alcohol, corn-derived odor eliminator and fragrance. Toxicity is not expected with routine use or even with exaggerated exposure!

Tea is a good antidote for sick cats and dogs: False

Tea contains caffeine which is toxic to animals. Tea is 5-10 times more toxic than semisweet chocolate!

Thursday, August 19, 2010

Feline Chronic Kidney Disease

Video Link from The Cornell University College of Veterinary Medicine: Cat owners guide to kidney disease. Includes tests used to diagnose it, what it is, medications used to manage it and instructions on giving fluids under the skin (subcutaneous fluids).

Kidney disease implies that one or both of the kidneys are not working as they should. It can go undetected until the disease is severe enough to cause clinical signs or changes in blood and urine tests. Other terms used include renal or kidney failure. Kidney disease can be acute (recently occurred and may be reversible) or chronic (has been occurring and progressing for a long time and is not reversible). Sometimes it can be a combination where a patient with stable chronic kidney disease has an acute worsening of kidney function, termed acute on chronic kidney disease.

The kidneys are important for daily function as they eliminate the waste the body produces, make sure electrolytes and water balance and they produce a variety of important hormones including one that helps prevent anemia. Luckily the kidney is made with plenty of “back-up” help. 66% of the kidneys must be damaged to lose the ability to concentrate urine and 75% of the kidneys must be damaged to see elevations in levels of wastes the body clears from the blood. This is why people and animals can donate one kidney and continue to live a normal life, as both kidneys are not necessary if they are completely healthy. One disadvantage is that the “back-up” help makes it difficult to detect kidney disease early on.

The goal of identifying kidney disease early is to attempt to slow its progression. How can you tell at home if your cat may have kidney disease? Early on, your cat will appear normal and healthy. Once 66% of the kidneys are damaged, concentration of the urine (a way the body conserves water) is not possible. A sign of this is that your cat begins to drink more water and urinate more often. You may notice that your cat is always at the water bowl or that you fill it more often than usual. You may also notice that your cat is using the litter box more often or that you are scooping the litter box more frequently.

As the disease becomes more advanced your cat will lose weight, have a poor hair coat and may not eat as well. As the kidney damage progresses body wastes are not eliminated properly and they accumulate in the blood and body. This elevation of toxins can be measured with blood work and when these levels are increased the condition is called uremia which literally means urine in the blood. Signs of uremia include loss of appetite, vomiting, ulcers in the mouth, weakness and bad breath due to the accumulation of ammonia.

Other abnormalities that can occur include anemia (the kidney produces a hormone called erythropoietin that is responsible for making red blood cells), and high blood pressure. The anemia makes the weakness and loss of appetite worse. High blood pressure can cause blindness, stroke-like signs such as changes to behavior or seizures, injury to the heart and worsening of the kidney disease itself.

So how can you identify this disease earlier rather than when your cat is sick? This is where the importance of yearly urine and blood tests during your senior cat’s annual visit comes in. A urine sample will show whether the kidneys can concentrate it appropriately (remember loss of this ability is one of the first indicators of kidney disease). If the kidney is damaged enough or there is high blood pressure proteins will also accumulate in the urine and this can be detected as well. Sometimes, urinary tract infections can affect the kidneys and a urine test can also identify if this is present. A complete blood test is important to monitor not only for two main indicators of toxin accumulation in the body (BUN and creatinine) but also to make sure that anemia is not present. A blood test can also identify electrolyte abnormalities which may require special supplements to correct.

Other tests that should be done during your senior cat’s exam should include a blood pressure. Once kidney disease is identified x-rays and ultrasound are needed to evaluate the kidneys. This evaluation is important in identifying possible kidney stones, abnormalities in size and shape of the kidneys.

Although chronic kidney disease is irreversible, for most cats treatment can “assist” the kidneys and allow a good quality of life for months or years. There is no single treatment for kidney disease. Your veterinarian will tailor make a plan for your cat based on the severity of the changes in the blood work and the signs that your cat is experiencing. Treatments include a “kidney friendly” diet, hydration therapy by giving fluids under the skin, supplements and medications to vomiting, nausea, poor appetite and high blood pressure. If your cat becomes anemic injections of the hormone erythropoietin may be recommended.

Your veterinarian will formulate a schedule for exams that will include re-checking blood work, urine tests and blood pressure. This will assist in making adjustments to the treatment plan.

In humans chronic kidney disease is sometimes managed with hemodialysis (where a machine acts like a kidney and cleanses the blood of wastes) or by kidney transplant, both of which are available for cats but usually not a realistic option for the general cat population due to limits in availability, costs and specific criteria to be an ideal candidate. It is important to remember that hemodialysis is not a cure and those receiving kidney transplants require long-term medication administration to try and avoid rejection of the donated kidney.

Remember, just because your cat seems healthy at home, it is important to see your veterinarian at least yearly for younger cats, every 6 months for senior cats (>7 years old) and that blood work and urine tests be performed in senior patients to try and spot changes before your cat is actually sick!

Wednesday, August 18, 2010

Feline Pancreatitis

Cats can be affected by inflammation of the pancreas known as pancreatitis. The pancreas is an organ in the abdomen located very close to the stomach, intestines and liver. The pancreas has multiple jobs that are very important to every day life. It produces insulin which is necessary for keeping the body’s blood sugar stable and it also produces important products necessary to properly digest food. When the pancreas becomes inflamed, the products that it makes to help digest food in the intestines are activated within the pancreas and the pancreas basically begins to “eat/dissolve” itself.

Usually the cause of pancreatitis in cats is not found. Some causes are believed to include trauma, infection and some medications. In cats chronic pancreatitis is more common in cats, where the acute form occurs more commonly in dogs. Signs of pancreatitis are very nonspecific and can be hard to notice. 80-100% of cats have decreased energy/actvity, 87-97% stop eating and 54% are dehydrated. In contrast to dogs and humans, vomiting (35%) and abdominal pain (25%) are not common signs in cats. Other conditions that occur with pancreatitis include hepatic lipidosis (fatty liver disease), inflammatory bowel disease (IBD-inflammation of the intestines), diabetes and inflammation/infection of the bile tract and liver.

Abdominal ultrasound is considered more useful that x-rays for the diagnosis of pancreatitis and should be the next test performed if x-rays of the abdomen do not provide a definitive diagnosis. A recently new blood test (fPLI-feline serum pancreatic lipase immunoreactivity) is being used to identify cats with pancreatitis. The only way to definitively diagnose pancreatitis is via biopsy, but this procedure is expensive and requires general anesthesia in patients that may be at higher risk complications. Using a combination of clinical signs, blood tests and ultrasound a strong suspicion that pancreatitis is affecting your cat can be attained.

If a cause for the pancreatitis is found, that cause must be treated. Other treatments are not directly targeted at the pancreatitis but more at helping the cat feel more comfortable and assist in balancing any secondary complications. This consists of providing intravenous fluids via a catheter to provide adequate hydration, electrolytes and blood flow to the pancreas. Medications that provide relief of nausea and vomiting as well as pain medications are given. In severe cases, protein levels drop and blood clots may form which require transfusions of plasma. Cats that have not been eating for a few days and do not begin to eat shortly after treatment is started may require a temporary feeding tube to be able to provide adequate nutrition. Cats that have inflammatory conditions of the liver/gallbladder (cholangiohepatitis) or intestines (IBD) require steroids to decrease the inflammation. If infection of the liver or gallbladder is suspected antibiotics may b administered.

The prognosis is very variable as some cases are more severe than others. Because the pancreatitis in cats is usually chronic, other bouts of pancreatitis will most likely occur at some point in time. If enough pancreatic tissues are damaged secondary complications can occur. One is diabetes as the insulin producing cells are damaged and the second is exocrine pancreatic insufficiency as the cells that make products that assist in digesting food are damaged. Sometimes the inflammation of the pancreas is so severe that the bile duct becomes obstructed.

Because cats hide disease so well, by the time they are showing signs they may already be very sick. It is important to remember that if you notice any non-specific signs such as lethargy or loss of appetite which do not improve after a day or two make sure you see your veterinarian. Pancreatitis may be only one of many possible diseases making your cat sick.

Monday, August 16, 2010

Your cat has a heart murmur, now what?

Your cat seems to be doing great at home and you realize its time for the annual trip to the vet. During the exam, everything seems to be good, except that your veterinarian mentions that a heart murmur is present. You most likely wonder what this finding means for you and your cat as well as what the next steps are in figuring out the cause of the heart murmur. In this article I will discuss the tests necessary when a heart murmur has been identified in your cat by your veterinarian when they are not showing any clinical signs of heart disease (asymptomatic).

Once a murmur has been indentified in your cat, your veterinarian will want to obtain a blood and urine sample. Anemia and hyperthyroidism may be the cause of the heart murmur and are quickly and easily identified with blood tests. A blood pressure should also be obtained, as an elevation may also have secondary effects on the heart.

X-rays (radiographs) of the chest are important as they not only reveal changes to the general size/shape of the heart, but also changes to the lungs and blood vessels. It is important to remember that normal size/shape of the heart on x-rays does not mean that there is no heart disease, it may signal that only minimal changes to the heart have occurred so far. It is also important to remember that changes on the x-rays do not tell you the type of heart disease present.
An electrocardiogram (ECG) of the heart may be obtained as well, especially if abnormal heart beats (an arrhythmia) are noted when the veterinarian is listening to the heart.

New blood tests that measure specific markers in the blood that may indicate the presence of heart disease (cardiac biomarkers) have recently become available. These tests may help strengthen the suspicion of underlying heart disease.
The gold standard (best test) for diagnosing heart disease or excluding serious disease is an ultrasound of the heart (echocardiogram). This special ultrasound is performed by a heart specialist (board certified cardiologist). The ultrasound will reveal if the heart muscles are abnormally thickened, if there is something obstructing the flow of blood, any defects within the heart and the size of the different heart chambers among other things. Of cats with heart disease, the most common form is hypertrophic cardiomyopathy (HCM). This is thickening of the heart muscle due to an abnormality in the muscle.

Your veterinarian can help you schedule an appointment with a veterinary specialist . Besides performing the special ultrasound of the heart, the veterinary specialist can also obtain any tests that your veterinarian was not able to perform. Make sure that you have any blood tests, x-rays, ECG and a copy of the medical records during your consultation. There is nothing more frustrating for the veterinary specialist (or you) than to not have all the test results needed in order to provide you with the best information as to what is affecting your cat.

Remember, just because your cat has a heart murmur it does not necessarily mean that your cat has severe heart disease. The best news the veterinary heart specialist can give you is that the murmur is not a cause for concern! If the murmur is significant, your cat can receive the proper treatments and have a follow-up plan made to try and stay ahead of any major changes. It is better to find out what is wrong before hand, than be surprised in the middle of the night and have to rush to the emergency room.

Friday, August 13, 2010

Seizures in Pets

You think your pet is having a seizure, what do you do next?

Well, the first step is to remain calm (easier said than done!), look at your watch/clock and keep track of how long the episode lasts. If the seizure is nearing 5 minutes call your veterinarian to alert them that you are on the way. A pet having a seizure for longer than 5 minutes needs immediate medical attention.

Second, take note of exactly what is occurring. Is your pet having exaggerated/violent movements of the legs while laying on its side? Is there a biting action of the mouth? Is foaming noted? Is your pet responsive to your calls? Is there any salivation, urination or defecation? Is only one part of the body moving? If a camera is easily available, recording the episode would be great so your veterinarian can see exactly what is happening.

Here is a video example of a "classic" seizure in a dog.

Here is a video of a lion having a seizure.

Third, move any objects that your pet can bump into out of the way, if they are close to stairs block off access.

Most seizures usually last less than 2 minutes. Your pet will most likely not act normal after the event, this is expected. If this is your pets first seizure call your veterinarian, depending on your pet and the history you provide to your veterinarian they may want you to come in sooner rather than later or they may decide its ok to hold-off on the emergency visit and schedule an appointment. If your pet has a second seizure within 24 hours seek medical attention.

During the visit, your veterinarian will ask you important questions about what your pet was doing before the seizures, if there were any changes in behavior or activity minutes to hours before the seizure, a description of the event, how long the seizure lasted and what occurred after the seizure.

Seizures are divided into 3 categories: diseases outside of the brain that are affecting the brain, diseases within the brain and genetic causes of seizures (idiopathic epilepsy). Dogs may be in any category. Depending on your dogs breed, young dogs usually have idiopathic epilepsy whereas puppies and older dogs usually have a disease within the brain or outside of the brain causing a problem. Idiopathic epilepsy has not been reported for cats and therefore further tests to determine the cause of the seizure is highly recommended.

In order to make sure that there are no diseases outside of the brain that can cause seizures, your veterinarian will run blood and urine tests to check the liver and kidney, ensure that electrolytes such as sodium and calcium are within normal limits, that the blood sugar is not low and that the red blood cell, white blood cell and platelet count is normal. Your veterinarian may also check a blood pressure and obtain x-rays as well.

If all of these tests checks out ok then the seizures are more likely caused by diseases within the brain. At this point your veterinarian may offer a referral for a consultation with a veterinary neurologist, a specialist that is trained to diagnose and treat neurologic problems in animals. Most likely an MRI of the brain and possibly obtaining a sample of spinal fluid to test it for infection and inflammation will be recommended.

What if you can not afford an MRI? If you can not afford an MRI, it is still OK to consult with the neurologist. They will take all the information obtained so far and attempt to deduce the most likely cause of the seizure. Based on this “best guess” certain medications may be recommended. If access to a veterinary neurologist is not available or you do not wish to consult with one, your veterinarian will also make recommendations for your pet based on their “best guess”.

Depending on the cause, it may not be realistic to expect the seizures to stop completely even with treatment. The goal with treatment is to decrease the frequency of seizure activity to what we term an acceptable rate, usually one seizure every 4-8 weeks. Some pets may seizure even less frequently. Different medications may be needed in order to find the most effective one with the least side effects for your pet. Either way, your pet will need follow-up visits and blood tests to make sure their body is handling the medication well and also to check the levels of the medications in the body. Some pets clear the medication faster than others and may need to have the dose increased. Other pets clear it slower and need the dose decreased.

A seizure medication may not be started on your pet right after the first seizure. If there is having one seizure every 4-8 weeks without medication this is as good control as we expect with some medications and your pet won’t have to deal with the side effects.

If your pet is having a seizure, remember to stay calm, watch the clock and your pet. Call your veterinarian to make an appointment or seek emergency care if advised.

Wednesday, August 11, 2010

Why do puppies and kittens need a series of vaccines?

When a puppy or kitten is born its immune system has not yet matured. Kittens and puppies remain protected from infection because of the transfer of maternal antibodies in special milk from their mother called colostrum. Colostrum is only produced a few days after giving birth and it can only be accepted during the first days after birth before their intestines “close up” and can no longer absorb the antibodies.

Sometimes antibodies are not transferred either because the puppy did not drink the colostrum or the mother did not have certain antibodies, other times those transferred only last for a short period of time. If an appropriate number of antibodies are transferred there is protection for a longer period of time. However, the maternal antibodies that are transferred do not last forever.

What does this have to do with vaccinations? Well, there is really no way to tell if maternal antibodies were transferred, which were transferred or how long they will last and therefore a vaccination given early will help protect them.

So why not just give one vaccine early and forget about it? If a vaccine is given to a pet that still has maternal antibodies present it will be inactivated and new antibodies will not be made. How long maternal antibodies last in a pet varies with each individual and for specific diseases. We do know that maternal antibodies are gone or have decreased enough to not interfere with vaccines by 16-20 weeks of age. This is why the final booster is usually given at this time when there will be no interference and protection ensured.

So why not just give one vaccine when they are older, when we are pretty sure maternal antibodies will not interfere with vaccines? Again, since there is no easy way to tell if a pet has protection from maternal antibodies at birth or if protection will last until 16-20 weeks of age, waiting to vaccinate until that time puts them at risk of developing dangerous and deadly diseases.

Therefore, vaccinations are given in series every 2-4 weeks until age 16-20 weeks. This is done to protect those that lose maternal antibodies early while ensuring that those that have longer lasting maternal antibodies are protected as well.
What if the pet is older than 16 weeks of age? In this case there is no worry about interference from maternal antibodies, but one booster 2-4 weeks after the initial vaccine is necessary to ensure a better response.

Monday, August 9, 2010

Xylitol Toxicosis In Pets

Xylitol is a commonly used sugar substitute that is as sweet as sugar with only two-thirds its calories. It is frequently found in sugar-free gum, candy, baked goods, desserts, and toothpaste. In people, xylitol is a safe compound with few associated side effects however it may have significant adverse effects in dogs. The ingestion of xylitol has been associated with a severe drop in blood sugar (hypoglycemia) and acute liver failure.

Signs of low blood sugar have been noted as soon as 30 to 60 minutes after ingestion as it is rapidly and almost completely absorbed! Why is there such a drop in blood sugar? Xylitol causes a rapid, significant increase in insulin secretion in dogs and insulin causes the blood sugar to decrease.

Acute liver failure can also become evident up to 72 hours after ingestion. Although there are two thoughts as to how this occurs it is not exactly known how this happens. It is believed that products produced by the liver when breaking down the xylitol cause severe damage. One toxic by-product depletes the liver cells of their energy source while the other reactive product damages the cell membranes, both leading to cell death.

If liver injury occurs after Xylitol ingestion the prognosis is unfortunately poor. A study revealed that 63% of dogs that ate xylitol containing products died despite aggressive medical management. Interestingly, the dose ingested does not equal whether one pet or another will develop liver failure.

If you noticed your pet eat something they weren’t supposed to, look at the ingredients. If xylitol is listed on the product bring the product packaging and your dog to the veterinarian immediately. If your dog recently ate a xylitol containing product your veterinarian can induce vomiting to try and get out as much of the product as possible. The vomiting may not be effective if ingestion was not within the past 30 to 60 minutes as xylitol is quickly absorbed by the body.

Signs of xylitol toxicosis include vomiting, diarrhea, a drunken gait, coma, and seizures. Sings of low blood sugar can occur within 30-60 minutes and if liver failure occurs signs are usually evident within 12 to 72 hours of ingestion.

Dogs have a better prognosis if improvements in blood work abnormalities related to the liver and stabilization of the blood sugar levels occur as well as lack of progression to acute liver failure within 3 days of ingestion.

It is therefore important to make sure that your xylitol containing products be kept away from your pets. It only takes a quick second for your dog to jump on the counter and eat the package of sugar free gum you just purchased. If this occurs call your vet immediately and don’t forget the package on your way out.