Resources

Arthritis is an inflammation of any joint in the body.  The inflammation can have many causes. 

The most common type of arthritis is osteoarthritis which can be due to wear and tear on joints from over use, aging, injury, or from an unstable joint such as which occurs with a ruptured ACL (anterior cruciate ligament) in the knee. 

The chronic form of this disease is called degenerative joint disease (DJD). It is estimated that 20% of dogs older than one year of age have some form of DJD. One study showed that 90% of cats over 12 years of age had evidence of DJD on x-rays.

Other causes of the inflammation can be infectious.  Septic arthritis is caused by a bacterial or fungal infection.  Lyme disease or Ehrlichia infection can also cause arthritis.  Auto-immune diseases, or what is now called immune- mediated diseases, such as Lupus can cause swollen, painful, inflamed joints.  More rarely, tumors can cause arthritis.

Treatment for arthritis should be directed to the inciting cause if possible. Surgery may be needed to stabilize a joint. DJD may be treated with NSAID's, pain medication such as Tramadol, cartilage protective agents such as glucosamine or Adequan, acupuncture, or as a last resort, steroids.   NSAID's (non-steroidal anti-inflammatory drugs) have many types.  In general, it is recommended to use NSAID's developed for pets, and not ones made for use in people as those are highly likely to cause ulcers in dogs, and most NSAID's can't be used in cats.

Bloat or gastric dilation and volvulus is a life threatening emergency that happens in dogs and rarely in cats.  It consists of the rotation of the stomach around its ligaments and a severe distention with gas.  Bloat needs to be treated within a couple of hours of its occurrence or the dog will not survive.  Treatment involves decompression and surgical untwisting and tacking of the stomach. 

Top risk factors of GDV are:

1. Deep chested dogs: Great Danes, Standard Poodles, St. Bernard, Weimaraner, Doberman, Shepherds, Setters, and Pointers.
2. Age: dogs older than 7 are twice as likely to develop GDV.
3. Gender: male dogs are twice as likely to develop GDV.
4. Feeding frequency: dogs who eat once per day are twice as likely to develop GDV.
5. Speed of eating: Dogs who eat quickly or exercise right after eating are at increased risk of GDV.
6. Temperament: Dogs who are nervous, anxious, or fearful are at increased risk.

Signs of GDV: The most obvious signs are abdominal distention (swollen belly) and nonproductive vomiting (animal appears to be vomiting, but nothing comes up) and retching. Other signs include restlessness, abdominal pain, and rapid shallow breathing. Profuse salivation may indicate severe pain. If the dog's condition continues to deteriorate, especially if volvulus has occurred, the dog may go into shock and become pale, have a weak pulse, a rapid heart rate, and eventually collapse. A dog with gastric dilatation without volvulus can show all of these signs, but the more severe signs are likely to occur in dogs with both dilatation and volvulus.

Prevention:

1. A gastropexy surgery tacks the stomach in place so the dog is less likely to develop a GDV. This is highly encouraged in at-risk breeds and can be done at the time of spay/neuter.  Or any time!
2. Large dogs should be fed two or three times daily, rather than once a day.
3. Water should be available at all times, but should be limited immediately after feeding.
4. Vigorous exercise, excitement, and stress should be avoided one hour before and two hours after meals.
5. Diet changes should be made gradually over a period of three to five days.
6. Susceptible dogs should be fed individually and, if possible in a quiet location.
7. Dogs that have survived bloat are at an increased risk for future episodes; therefore prevention in the form of preventive surgery or medical management should be discussed with the veterinarian.

Canine distemper is caused by a virus that is shed in bodily fluids of infected animals. The virus affects primarily the lungs, intestines, and nervous system.

Symptoms of the infection can include coughing, diarrhea, vomiting, inappetance, dehydration, weight loss, seizures, and encephalitis. Secondary infections can present as discharge from the eyes and/or nose, and pneumonia.  Distemper is highly contagious to unvaccinated dogs.  Puppies, especially those from shelters, are at the highest risk.

Currently there are no antiviral medications to treat canine distemper. Treatment is aimed at controlling secondary bacterial infections with antibiotics and supportive care as needed. Vaccination against Canine Distemper Virus is highly effective and is part of the DAPP combo vaccine.  Puppies should be isolated from other dogs until they have completed their series of vaccinations.

What is cancer:  Cancer, by definition, is the uncontrolled growth of cells.  Any type of cells in the body can become cancerous.  Cancer can be benign or malignant.  Benign cancer refers to a group of cancer cells that grow in their spot, do not spread, usually do not grow “quick” and generally do not cause many problems.  Common benign cancers include: lipomas, papillomas, and histiocytomas.  Malignant cancers typically spread to other sites of the body, tend to grow quick, and affect the animal’s ability to survive.  Examples of malignant cancers are: sarcomas, carcinomas, melanomas, and hemangiosarcomas.  There are a number of factors that influence how fast a cancer may grow or spread: type of cancer cell, location, genetics, as well as any concurrent illness or debilitating condition the patient may have.

Why cancer happens:  While there are many research studies devoted to determining the causes of cancer, a lot about this disease is still unknown.  It is evident that factors like genetics; exposure to harmful substances, injury, and advanced age can predispose certain patients to this disease.

Diagnosis:  Regular physical examinations and thorough medical history review are often key components to detecting cancer.  Samples of any abnormal tissue should be evaluated by a pathologist to determine the type of tumor and degree of aggressiveness of the disease.  A pathologist's report, along with other imaging such as X-rays, ultrasound, and lab work help establish the patient's health status and determine the optimal treatment plan.

Treatment:  There are many different type of cancer treatment: surgery, chemotherapy, radiation or any combination of these treatments.  The important thing is to destroy the abnormal cells without damaging the normal cells.  Veterinary oncologists, veterinarians that specialize in the study and treatment of cancer, can be consulted to help determine what treatment would be best for the patient.

Prognosis:  Cancer is not always a terminal disease.  Early detection and appropriate treatments are important in achieving the best outcome.  New advancements in diagnostics and more effective treatments are being discovered all the time.

Canine parvovirus is a highly contagious virus that attacks the villus of the intestine and the bone marrow.  Most dogs with parvo have symptoms of lethargy; loss of appetite; fever; vomiting and severe, often bloody, diarrhea. Dehydration develops rapidly and can be fatal. Early detection and treatment by your veterinarian are essential to improve the chances of survival. This usually involves several days of hospitalization in the intensive care unit at your veterinarian's facility. Many factors are in play but even with the proper care, the puppy may not survive.

The virus is released into the environment from infected puppies when they have a bowel movement. When unprotected dogs come into contact with the feces (stool), infection occurs when the virus is ingested. All dogs are at risk, but unvaccinated puppies are particularly susceptible to infection.  Unfortunately, the virus is very resistant to environmental conditions and difficult to destroy; it can remain infective for years.  Routine household disinfectants will not kill the virus, and a 1 to 30 dilution of bleach should be used to clean any appropriate surfaces.

Canine parvovirus is easily diagnosed with a rapid in house test that detects the virus in the feces.  It can be confirmed with a low white blood cell count on CBC.  Although in a dog with no vaccine history and clinical signs is often diagnostic enough.

Vaccination and cleanliness are critical to preventing Parvovirus infection. Your Veterinarian will design a vaccination schedule tailored to your pet's particular needs. 

The Importance of Dentistry

What is periodontal disease?
Over 85% of dogs and cats have some type of periodontal disease.  Periodontal disease simply means that the gums and bone that hold the teeth in place are being destroyed by oral bacteria.  This preventable disease is the number one diagnosed disease in our pets, yet many animals suffer needlessly.  Periodontal disease begins with gingivitis, or inflammation of the gum tissue, which is caused by plaque.  Plaque is a mixture of saliva, bacteria, glycoproteins and sugars that adhere to the tooth surface.  Within about 48 hours after a cleaning, a thin layer of plaque has adhered to the teeth.  Eventually this hardens to become calculus or tartar, which pushes the gums away from the teeth and increases surface area for more plaque to adhere.  Eventually, the supporting structures of the tooth (bone, tissue, periodontal ligament) are destroyed and the tooth becomes mobile and will either fall out on its own or need to be extracted.  Signs of periodontal disease are bad breath (halitosis), reluctance to eat, chewing on one side of the mouth, dropping food, pawing at the face or rubbing the face on the floor, drooling, becoming head shy, and painful mouth/face.

Veterinarians recommend the following care for pets:

STEP 1:  Bring your pet in for a dental exam.  Don't wait for his annual checkup if you suspect a problem.

STEP 2:  Begin a dental care regimen at home.  Brushing your pet's teeth at least every other day is very important.  We also recommend using a specially formulated dental rinse, and dental chews and food.  Please ask us if you need instructions on brushing your pet's teeth, or if you have any other questions.  

STEP 3:  Schedule your pets for an annual teeth cleaning.  This is also very important and ensures we are catching any disease early enough to treat.  

Periodontal disease and oral bacteria actually affects other organ systems including the heart, liver, kidneys, lungs and brain.  This makes it essential to treat and prevent!

Diabetes Mellitus (DM) is a life long disorder of dogs and cats that results when the pancreas fails to produce enough insulin to meet the animal's needs. Insulin is a hormone needed to transport glucose (blood sugar) into the body's cells. When there is a lack of insulin in the body, blood glucose rises to abnormally high levels. Over time, this causes damage to body tissues and produces the symptoms commonly seen in animals with DM.

Early symptoms, such as weakness, weight loss, change in appetite and depression can be mild and may go unnoticed by the owner. Increased thirst and frequent urination more commonly results in a visit to your Veterinarian where tests can be done to identify what may be affecting the family pet. Urinary tract infections are more common in diabetic pets than in normal animals due to the high concentration of sugars in the urine.

 
Once a diagnosis has been made, a treatment plan will be designed to meet the individual needs of your pet and you. The plan will address the type and amount of insulin, how it is to be administered, dietary restrictions and exercise for your pet.  Dogs are Type I diabetics in that they require insulin injections.  Cats are usually Type II diabetics. Insulin injections are usually used initially, but when fed a special diet, as much as 70% of cats can eventually be maintained without the insulin.

There is no cure for DM, but through your commitment of time and management of their life style, your pet can lead a happy comfortable life.

Epilepsy (often referred to as a seizure disorder) is a chronic neurological condition characterized by recurrent unprovoked seizures.  It is commonly controlled with medication, although surgical methods are used as well. Epileptic seizures are classified both by their patterns of activity in the brain and their effects on behavior.

In terms of their pattern of activity, seizures may be described as either partial or generalized. Partial seizures only involve a localized part of the brain, whereas generalized seizures involve the entire cortex. The cause of epilepsy is not known, but many predisposing factors have been identified, including brain damage from congenital defects, head trauma, penetrating wounds of the brain, brain tumor, high fever, bacterial or viral encephalitis, stroke, intoxication, or acute or congenital metabolic disorders. Hereditary or genetic factors also play a role.

Feline parvo, feline distemper or feline panleukopenia are all names for a highly contagious viral disease of kittens and adult cats caused by the feline parvovirus. Like canine parvovirus, it affects the bone marrow and causes low white blood cell counts. It is relatively common in unvaccinated cats and is often fatal, especially in young kittens. It has been referred to as Feline Distemper, but in fact, it is a different virus than canine distemper and causes different symptoms.

Early symptoms of panleukopenia are lethargy and loss of appetite then rapid progression to severe, sometimes bloody diarrhea and vomiting.  These signs are very similar to other diseases, some serious, some not so serious. Therefore, if any abnormal behaviors or signs of illness are observed, it is important to have your veterinarian examine your pet as soon as possible.  A diagnosis of panleukopenia is presumed if vomiting and diarrhea are present along with a low white blood cell count.  A diagnosis is confirmed when the virus is detected in feces using an in house snap test.

Another syndrome associated with the feline distemper virus occurs when a susceptible pregnant cat or a newborn kitten is exposed.  The kittens will have permanent damage to the cerebellum part of the brain and walk with an uncoordinated gait and an elevated tail.  It may also affect the retinas of their eyes.  They are otherwise alert and act normal.

Infection occurs when unvaccinated cats come in contact with the virus, which may be by contact with blood, urine, feces, nasal secretions, or even the fleas from an infected cat.  The hands and clothing of people who handle infected cats can also spread the disease. Unfortunately, the virus is very resistant to environmental conditions and difficult to destroy; it can remain infective for years.  Routine household disinfectants will not kill the virus, and a 1 to 30 dilution of bleach should be used to clean any appropriate surfaces.

There is no medication to kill the virus. Hospitalization with IV fluid therapy and antibiotics to prevent secondary infection are necessary to support the cat's health while its own body is fighting the infection. Not all will survive.

Preventing the infection through vaccination is better rather than treating an infected cat. Today's vaccines are very effective in helping your pet protect itself from infection. A series of kitten vaccinations followed by adult boosters stimulate the cat's immune system to produce protective antibodies. Should the cat come into contact with the virus, these same antibodies will help your cat successfully fight off the infection.

Consult with your veterinarian for advice on a vaccination schedule appropriate for your pet.

A common parasite, fleas are found in almost every area of the world and can be found on dogs, cats, and many other mammals. They survive year to year even in cold climates because they live on pets, in buildings, and on wild animals.

There are four stages to the flea life cycle. Eggs are laid by an adult female flea which is on a host.  The eggs roll off into the environment and after a few days they mature into larvae.  Larvae survive by eating flea feces, flea egg shells, organic debris, and other flea larvae.  They can crawl and move as far as six inches per day.  After a few days, and once conditions are conducive, larvae mature into pupae.  Pupae have very thick shells and are very resistant to environmental conditions.  After a few days, and once the pupae detect a host is present, they mature into adult fleas that hop on another host.  However, the pupae can remain dormant up to 6 months.  Which makes fighting flea infestations very difficult and frustrating.

There are many types of flea treatments.  Unfortunately, there is no one drug or chemical that can kill all four stages of the flea.  There are several types of good products to kill adult fleas:  Activyl, Frontline, Advantage, Comfortis, Capstar, Revolution, and others. Older products of various formulations of synthetic pyrethrins are also available, some of which are highly toxic to cats.  Lufenuron and methoprene are chemicals that work on immature stages of the flea, although there is no chemical that will kill the pupal stage.

Fleas are the number one allergen of dogs and cats and can cause severe skin disease and itching. Another reason fleas should be treated is due to the fact that they can carry and spread several serious diseases, such as tapeworms, Cat scratch disease (Bartonella), murine typhus, and the bubonic plague.

Your veterinarian can help you with a flea control program depending on what kind of pets you have and the level of flea infestation. Control may involve treating the environment as well as the pets. Contact your veterinarian today for more information about the treatment options available for your pet!

Heartworms have been diagnosed in dogs in all parts of the world and is actually very common. This may be due to the fact that heartworm has a virtual 100% prevalence rate in unprotected dogs living in highly endemic areas. Heartworm, also known as Dirofilaria immitis, is transmitted by mosquitoes. The mosquito injects a microscopic larvae which grows into an adult worm six to eighteen inches long inside the heart of the affected dog.

The worms can cause mild symptoms, such as coughing, but with time, more severe symptoms such as congestive heart failure, weight loss, fluid build-up in the abdomen, fainting spells, anemia, collapse, and death usually occur.

Luckily we have several excellent medications which can prevent heartworm if given as directed. There are oral and topical medications which need to be given monthly, and which also help protect against some intestinal parasites.  There is also an injectable medication, ProHeart, which is administered every six months.

Even if a dog has been given preventatives, it is still important to have annual checkups for heartworms by doing a blood test. Many people are not totally compliant about giving the preventive medication on time, and no medication works perfectly. If a dog has heartworms and it is given a dose of preventative, there can be a reaction that is detrimental to the dog, even deadly.

Heartworms were once thought to be rare in cats. Now we know the incidence is anywhere from 10% to 50% of the canine rate. Heartworm disease in cats is different than in dogs. Cats usually test negative on the routine blood test done in the hospital, the worms are smaller and usually do not produce microfilaria which are like baby heartworms that circulate in the bloodstream. Veterinarians have to do different tests, sometimes more than one, to diagnose heartworms in cats.

The symptoms in cats are different also. Cats usually have asthma signs or cough, even vomit. Cats can die acutely. The treatment for adult heartworms in dogs is expensive and potentially harmful to the dog. This is why it is much better to just prevent them in the first place. There is not a treatment for adult heartworms in cats. Many veterinarians recommend monthly heartworms preventative for cats in addition to dogs, since heartworm can be such a serious problem. 

Hip dysplasia is a congenital disease that, in its more severe form, can eventually cause lameness and painful arthritis of the joints. It is caused by a combination of genetic and environmental factors. It can be found in many animals and, rarely, humans, but is common in many dog breeds, particularly the larger breeds. In the normal anatomy of the hip joint, the thigh bone (femur) joins the hip in the hip joint, specifically the caput ossis femoris. The almost spherical end of the femur articulates with the hip bone acetabulum, a partly cartilaginous mold into which the caput neatly fits. It is important that the weight of the body is carried on the bony part of the acetabulum, not on the cartilage part, because otherwise the caput can glide out of the acetabulum, which is very painful. Such a condition may lead to poor articulation of the joint.  In dogs, the problem almost always appears by the time the dog is 18 months old. The defect can be anywhere from mild to severely crippling. It can cause severe osteoarthritis eventually.

Hip dysplasia can be diagnosed as a puppy with a simple radiograph of the hips.  The radiograph looks specifically for how much of the acetabulum covers the head of the femur.  If the puppy is still growing, hip dysplasia can be prevented by a surgery that alters the growth of the hips, allowing for the hips to cover the femoral head more as the puppy grows. 

In its late stages if hip dysplasia is severe, the dog may benefit from a total hip replacement, or a procedure called a FHO (femoral head ostectomy) where the head of the femur is removed to prevent it from painfully grinding against the acetabulum.  This is a procedure that is only done in severe cases. 

Hookworms are small, thread- like parasites of the small intestine where they attach and suck large amounts of blood.  These parasites are found in almost all parts of the world, being common in dogs, and occasionally seen in cats.

Symptoms are usually diarrhea and weight loss.  The parasites can actually suck so much blood that they cause pale gums from anemia, and black and tarry stools.  Young puppies can be so severely affected that they die.  Infection can be by ingestion of breast milk from an infected mother, by ingestion of infective eggs, or by skin penetration of infective larvae.

Since the adult parasites are so small, they are rarely seen in the stool.  Diagnosis of these parasites is by the veterinarian or laboratory finding the microscopic eggs in the stool.

There are a variety of medications that can kill hookworms.  The important point to know is that there is no one medicine that will kill all the types of intestinal parasites that exist.  Some of the monthly "heartworm preventatives" will also work to treat hookworms.

People exposed to hookworms can develop “cutaneous larval migrans” where infective larvae, usually from contaminated yards, can penetrate human skin and cause red tracts.

Hypothyroidism is the deficiency of thyroid hormone and is the most common hormone imbalance of dogs. This deficiency is produced by several different mechanisms. The most common cause (at least 95% of cases) is immune destruction of the thyroid gland.  It can also be caused by natural atrophy of the gland, by dietary iodine deficiency, cancer (primary or metastatic) of the thyroid gland or (rarely) as a congenital problem. Hypothyroidism is most common in medium to large breeds of dogs that are middle aged (4 to 10 years) but can occur in any dog. 

Hypothyroidism is extremely rare in cats and is most commonly seen in cats following bilateral thyroid removal or radioactive iodine therapy for hyperthyroidism.  This is often transient and usually does not require therapy.  Rarely cats can have congenital hypothyroidism.

Thyroid hormone serves as a sort of volume dial for metabolism.  Since virtually every cell in the body can be affected by thyroid hormone it is not surprising that reduced levels of thyroid hormone can lead to symptoms in multiple body systems.  A recent published survey of hypothyroid dogs showed the following percentages of symptoms:

• 88% had some kind of skin abnormality
• 40% had hair loss (often on the tail or on both sides of the trunk and flanks ).
• 22% had skin infections
• 14 % had dry brittle coats with hair that could easily be pulled out
• 49% were obese
• 48% were described as lethargic or listless at home
• 36% were anemic
• 80% had an increase in blood cholesterol 

Hypothyroidism is treated with the oral administration of thyroid hormone, usually given twice daily for the life of the dog. Periodic blood testing is recommended; it is important to know if the medication dose is too low or too high.  Thyroid supplement is a safe medication but if it is not given in sufficient doses the patient will not be adequately treated. If the dose is too high excessive water consumption, weight loss, and restlessness can result.  Once a pet is started on thyroid supplementation, it is recommended to check a T4 level in two to three weeks, with the blood draw between 4 to 6 hours after the morning dose.  Once the correct dose is found, it is recommended to perform a T4 every six to twelve months.

This is a very common disease of the middle aged to older cat.  A tumor (97% are benign) on the thyroid gland starts producing too much thyroid hormone.  Symptoms are usually weight loss in spite of eating well and vomiting.  Other signs you might see are diarrhea, a dull and flaky hair coat, and personality changes.  This disease usually can be easily diagnosed with a blood test, although occasionally we need a special test called a technesium scan to diagnose the early, borderline cases.

There are three basic methods of treatment:  radioactive iodine, surgery, or an oral medication called methimazole (Tapazole).  For most cats, the best treatment is radioactive iodine.  In 97% of the cases, it is a one -time treatment.  The biggest disadvantage is that the treatment needs to be done at a special facility, and the cat needs to be hospitalized for usually 5 to 10 days.  In the past, surgery was a common treatment, but it is performed less frequently as the problem seems to recur on the other gland.  Treating with Tapazole is also common, but has the disadvantage that it is life long and the cat needs blood tests to monitor the thyroid level and to check for adverse effects.

The disease of hyperthyroidism can actually help the kidneys.  If the cat has both kidney disease and hyperthyroidism, it is not a candidate for radioactive iodine and the dose of Tapazole may need to be adjusted.  Kidney tests are also monitored when a cat is being treated for hyperthyroidism.

Leptospirosis is a serious, life-threatening disease caused by a spiral shaped bacteria.  Dogs, cats, other animals and even people can be infected through exposure to urine, bite wounds, ingestion of infected flesh, or contact with contaminated soil, water and even bedding.  Certain environmental conditions can favor the bacteria: standing water, rain, floods and warm moist weather. Pets living under these conditions, especially those who live primarily outdoors or are used for activities like hunting or herding are at a higher risk of being infected. The bacteria can quickly spread through the body causing symptoms like fever, joint pain, excessive drinking and general malaise. Eventually the bacteria settle in the kidneys or liver where it rapidly multiplies leading to organ inflammation, organ failure and possibly death.

People infected with Leptospirosis show the same symptoms as pets: fever, joint pain, excessive drinking and general malaise.  Most often people contract the disease when their mucous membranes or open wounds come into contact with the urine or other bodily fluids of an infected animal.

Repeated blood tests 2 to 4 weeks apart are recommended for diagnosis.  This test detects the presence of antibodies the body produces after being exposed to the disease.  Recent vaccination against leptospirosis can make diagnosis difficult as vaccines stimulate the body to create similar antibodies. New technology has made rapid tests available and sometimes urine can be used although this test is less sensitive.

Fortunately, leptospirosis can be treated with a combination of antibiotics. If kidney function becomes seriously impaired, patients may need kidney dialysis; some patients need this only temporarily while others will need it for life.

Supportive care is crucial for pets that become extremely debilitated by the disease.  Intravenous fluids help maintain blood flow through the damaged organs.  Special precautions should be observed when cleaning up any urine or bodily fluids from an infected patient.

Vaccinations are available and effective.  This vaccine has historically been one of the more reactive vaccines.  Often resulting in pain at the injection site, lethargy, and low grade fever, or more severe hives, facial swelling, and anaphylaxis.  Your veterinarian can discuss the benefits vs. the risks of the vaccine for your pet. 

A liver shunt is also named a PSS, portosystemic shunt, portacaval shunt or portosystemic vascular anomaly. This abnormality occurs when a pet's venous blood from the intestine bypasses the liver. In the normal pet, blood vessels pick up nutrients from ingested material in the intestine and carry it to the liver to be processed. In the case of a shunt, an abnormal blood vessel carries this blood around the liver and dumps the nutrients directly into the general circulation. Toxins build up in the bloodstream as a result. The pet can be born with the shunt (congenital) or can develop it later (acquired).

Breeds at increased risk for congenital shunts include Cairn Terriers, Yorkshire Terriers, Maltese, Irish Wolfhounds, Himalayans and Persians. An acquired shunt can develop in any breed and is usually caused by liver problems due to toxins, hepatitis, infections, inflammation, etc.

Symptoms of a liver shunt include stunted growth, weight loss, vomiting, diarrhea, lethargy, unresponsiveness, seizures, disorientation, poor skin and coat, excessive drinking and urination. Some pets will have a single sign and some with have several.

The diagnosis is made with blood tests, urinalysis and imaging tests (radiographs and/or ultrasounds). A liver function test called bile acids is usually very suggestive for a liver shunt when the values are very high. Another diagnostic test that can be performed is nuclear scintigraphy, which must be done at a referral specialty facility. Yet another possible diagnostic test that can be performed is a CT scan. 

The treatment and how well the pet responds are dependent on many things including the location and severity of the shunt. Some pets will do well for long periods of time with medical management only. Medical management includes a low protein diet, antibiotics and lactulose. Surgical repair is commonly done for congenital shunts and again the success is dependent on the location and severity of the shunt.

Luxating patella is a condition where the kneecap (patella) moves out of its normal position.  Luxating patella is one of the most common knee joint abnormalities of dogs, but it is only occasionally seen in cats.  It may affect one or both of the knees.   In some cases it moves (luxates) towards the inside of the knee, and in other cases it luxates towards the outside of the knee.  Luxation to the inside of the knee is the most common form seen; it is most commonly seen in the small or miniature breeds of dogs such as Poodles, Maltese, Yorkies, and Chihuahuas.  Luxations towards the outside of the knee are seen less frequently.  It can be present in many breeds, but is seen especially in Newfoundlands. 

There are four grades of patellar luxation:

• Grade I- the kneecap can be manually luxated but the kneecap returns to its normal position when the pressure is released.
• Grade II- the kneecap can spontaneously luxate out of position with just normal movement of the knee.
• Grade III- the kneecap remains luxated most of the time but can be manually reduced into the normal position.
• Grade IV- the patella is permanently luxated and cannot be manually repositioned

Dogs frequently start with a Grade I or Grade II and worsen over time to a Grade III or IV. Many people are not aware their pet is affected, but a luxating patella can cause pain.  Owners may see the pet limp on a rear leg, or they may see them shake a rear leg to try to snap the kneecap back into place.

A serious consequence of patellar luxation is that it predisposes the dog to a rupture of a ligament inside the knee called the anterior cruciate ligament (ACL).  ACL ruptures are very painful, and usually the dog doesn't bear weight on the affected leg. Surgery is indicated for any case that is causing lameness or pain. 

Luxating patellas are surgically repaired by deepening the groove the patella sits in. This makes it more difficult for the patella to luxate.

There are many types of mites that infect dogs, cats, and other animals.  Mites are microscopic arthropod parasites that, for the most part, infect the skin or mucous membranes.  Mites can even be present on birds and reptiles.  The most common mites that infect dogs and cats are ear mites, Demodex, scabies, and Cheyletiella.

Ear mites are very common on cats and are occasionally seen on dogs.  They live primarily in the ear canals and can cause severe itching.  They are easily transmitted between pets, so if they are found in one pet, all pets in contact should be treated.  A different species of ear mite can infect rabbits.

Demodex is a mite that all dogs are exposed to, but only a small percentage of dogs develop skin problems. In young puppies, it usually causes small areas of hair loss especially on the head and front legs.   Adult dogs tend to show more generalized symptoms, and usually have more red, itchy skin lesions.  Adult dogs that develop Demodex usually have another disease such as hypothyroidism, Cushings, or cancer that suppresses the immune system and allows the Demodex to increase in numbers and cause lesions.  It is now recognized that cats have their own species of Demodex, but the disease is much more rare in cats.

Scabies is a skin disease in dogs or people caused by the mite Sarcoptes.  Most dogs with this disease are intensely itchy.  Scabies is highly contagious, but not all dogs in contact are as itchy.  People also have their own species of Sarcoptes; most of their cases are due to the human scabies mite, but it is possible for people to develop lesions from the dog scabies mite.

Cheyletiella species of mites can be seen in rabbits and dogs.  It is especially seen in puppies as large flakes of scale and is sometimes called "walking dandruff". There is no one treatment that will kill all the types of mites discussed here.  Your veterinarian can advise you on the various treatments for each problem.

Did you know an estimated 54% of pets in the US are considered overweight? 

Excess weight is a serious health problem for dogs and cats. The two main causes of obesity are too much food and too little exercise. Other contributing factors can be due to hormonal influences, certain genetic factors, and other disease processes.

If you pet is carrying extra weight, it can:

1. Increase the risk of heart disease by forcing the heart to work harder.
2. Increase the risk of arthritis as extra weight can stress the joints, cause joint pain, and make it harder for your pet to move around comfortably.
3. Obesity can cause breathing problems, skin and hair coat problems.
4. Especially in cats, obesity frequently leads to diabetes.

All of these problems can make your pet uncomfortable and limit the way they interact with you and other family members.

Treatment is to rule out and treat any medical causes, such as hypothyroidism. Reducing caloric intake and increasing exercise can help your pet successfully lose weight. Lifestyle changes and a weight loss program are essential. Your veterinarian can help determine if your pet is too heavy and provide guidelines for achieving their ideal weight.

Rabies is a fatal viral infection that is transmitted primarily through bite wounds. Skunks, bats, raccoons, and foxes are the primary carriers. Rabies is also fatal to humans, there has been only one case of a person surviving rabies when treatment was started after clinical signs were present. Puppies are vaccinated when three to four months of age and then one year later.

Each state varies in its rabies law, most states require rabies vaccine every three years for adult pets, but some states still require them annually. If a person or a pet is bitten by an unknown or unvaccinated animal (dog, cat, or wild animal), the local health department or your veterinarian should be consulted.

The animal that bit should be apprehended, if possible, and your veterinarian or local health official should be contacted immediately. A test can be done to see if rabies is present, but it does require the animal be euthanized because the test can be done only on the brain tissue. Rabies is preventable through regular vaccination of dogs and cats.

There are many types of roundworms, but some of the most common are intestinal parasites of dogs, cats, and raccoons.  Puppies are frequently born with roundworms, and kittens can be infected via the mother's milk or feces. Adult roundworms are ivory colored, four to six inches long, and round (not flat) in shape.  These parasites can cause diarrhea, vomiting, weight loss, and even coughing in these young patients. In the usual case, the owner will not see the adult roundworms passed in the stool.  This is why it is important for the veterinarian to do a laboratory test to check for any parasites that might be present. We check for parasite eggs with a microscope.  You should bring a fresh stool sample (one that was produced that day) to your puppy or kitten's appointment.

It is important to know that animal roundworms can be transmitted to people, and in some cases can cause serious disease. In a recent study from the Center for Disease Control (CDC), it was reported that almost 14 % of all Americans are infected with Toxocara, the most common roundworm of pets.  Although most people infected have no symptoms, the parasite is capable of causing blindness (especially in children) and other systemic illness.  The infective agent is the microscopic egg in the animal's stool.  It is known that these eggs are very resistant to environmental conditions.  They have been shown to live in yards, playgrounds, and fields for up to 10 years.

The most dangerous roundworm is Baylisascaris, a parasite of raccoons that has an affinity for brain tissue. Children infected with this parasite have suffered severe, permanent mental retardation.  The majority of raccoons carry this parasite.  If wildlife is present on your property, you should patrol the grounds and any raccoon stools should be treated as hazardous waste.  Wear disposable gloves to double bag and dispose of the feces.  The only thing that will kill the remaining eggs in the soil is fire.

The CDC recommends regular deworming of all puppies and kittens to try to reduce the exposure to people. A medication will be dispensed when your puppy or kitten is first seen.  Another important measure is monthly parasite preventative, or what we sometimes call "heartworm preventative".  Many of these drugs are also effective for roundworms, and are an important part of a wellness program.

The CDC prevention measures include:

• Keep dogs and cats under a veterinarian's care for early and regular deworming
• Clean up after the pet and dispose of stool
• Keep animals' play area clean
• Wash hands after playing with dogs or cats
• Keep children from playing in areas where animals have soiled
• Cover sandboxes to keep animals out
• Don't let children eat dirt 

The rupture of the cruciate ligament is the most common knee injury in the dog.

This injury has two common presentations. One is the young athletic dog playing roughly who acutely ruptures the ligament and is non-weight bearing on the affected hind leg. The second presentation is the older, overweight dog with weakened or partially torn ligaments that rupture with a slight misstep. In this patient the lameness may be acute or there may be more subtle chronic lameness related to prolonged joint instability.

Your veterinarian will perform an orthopedic exam and take radiographs (x-rays) in order to diagnose this injury. The orthopedic exam involves an analysis of the gait, examination of the joint for swelling and/or pain and the presence of "drawer movement" (the presence of forward instability of the knee joint). Sedation is often required to do an adequate evaluation of the knee, especially in large dogs. Sedation prevents the pet from tensing the muscles and temporarily stabilizing the joint and preventing the demonstration of the drawer sign. Radiographs confirm inflammatory changes in the joint and establish the level of osteoarthritic changes present.

Surgical repair is recommended in most cases to stabilize the joint and prevent further osteoarthritic changes secondary to the joint instability. There are three primary types of surgical repair: extracapsular, tibial tuberosity advancement (TTA) and tibial plateau leveling osteotomy (TPLO). The type of surgical repair will be determined by the size, age and activity level of the pet as well as the degree of osteoarthritis already present in the joint. The recovery time and recommendation for physical therapy will depend on the type of surgical repair performed.

Seizures are common in dogs, but more unusual in cats.  Seizures are just symptoms which can occur with many kinds of diseases.  They can happen because of diseases outside the brain or inside the brain.  Low blood sugar that can happen with an overdose of insulin or with a tumor of the pancreas can cause seizures.  Hypoglycemia can also happen in puppies and kittens that aren’t eating well or haven’t eaten in a while.  They can happen with diseases of the liver or kidneys.  Ingestion of toxins such as snail bait can cause seizures.  Lesions of the brain such as tumors, abscesses, granulomas, infections, or inflammatory diseases can cause seizures.  Epilepsy may cause seizures.

Seizures most commonly last for a few seconds to a couple minutes.  Grand mal seizures cause the head to go back and the legs stiffen with rhythmic jerking.  The pet is usually unconscious.  Smaller partial seizures may be more difficult to recognize, but you should be suspicious of any repetitive rhythmic movements.  After the seizure, the pet usually enters the post ictal phase where it is dazed, lethargic, and not able to walk normally.  This phase may last for minutes, hours, or days.  A pet may have one seizure, and never have another, but most commonly they do recur.

Testing should be done to try to determine the cause of the seizures.  Blood testing, urinalysis, and liver function tests are commonly done.  An MRI of the brain or a spinal tap may also be needed.

Intravenous medication can be given by a veterinarian to stop a seizure.  If the seizures become too frequent, usually any more than every four to six weeks, anti-convulsant medication can be given to try to reduce future seizures.  Anti-convulsant medicine does not guarantee a pet will never have another seizure, but it tends to make the seizures shorter in duration and less frequent. Phenobarbitol is the most common anti-convulsant medicine prescribed.  When a dog first starts on this medicine, it will act like it is drunk for the first week or so, until it becomes accustomed to the drug.  Phenobarbitol is given twice daily, and once it is started, it is usually given for the life of the pet.

Potassium bromide is the second most common anti-convulsant prescribed.   It is available only at special compounding pharmacies.  It is usually formulated into a liquid.  It can be administered to the dog by squirting it onto a piece of bread that is fed to the dog once daily.  Potassium bromide can be toxic to people, therefore, it is advised to wear gloves when handling this drug.

Tapeworms live in the digestive tracts of vertebrates as adults and often in the bodies of various animals as juveniles. In a tapeworm infection, adults absorb food predigested by the host, so the worms have no need for a digestive tract or a mouth. Large tapeworms are made almost entirely of reproductive structures with a small "head" for attachment. Tapeworms are not contagious between cats or dogs.  They are only transmitted by eating an intermediate host.  The most common tapeworm in cats and dogs (dipylidium caninum) is transmitted by the pet eating a flea.  A less common tapeworm, but still frequently seen (Spirometra) is transmitted when a cat eats a frog or a lizard.  Tapeworms are usually seen as little pieces of rice in the stool.  It is easily treated with dewormer prescribed by your veterinarian.

Ticks are the small wingless external parasites, living by hematophagy on the blood of mammals, birds, and occasionally reptiles and amphibians. Ticks are blood-sucking parasites that are often found in freshly mown grass, where they will rest themselves at the tip of a blade so as to attach themselves to a passing animal. It is a common misconception that the tick can jump from the plant onto the host. Physical contact is the only method of transportation for ticks. They will generally drop off the animal when full, but this may take several days. Ticks have a harpoon-like structure in their mouth area, known as a hypostome, which allows them to anchor themselves firmly in place while sucking blood. This mechanism is normally so strong that removal of a lodged tick requires two actions: One to remove the tick, and one to remove the remaining head section of the tick.
Ticks are important vectors of a number of diseases. Ticks are second only to mosquitoes as vectors of human disease, both infectious and toxic.  Hard ticks can transmit human diseases such as relapsing fever, Lyme disease, Rocky Mountain spotted fever, tularemia, equine encephalitis, Colorado tick fever, and several forms of ehrlichiosis. Additionally, they are responsible for transmitting livestock and pet diseases, including lyme disease, babesiosis, ehrlichia, anaplasmosis and cytauxzoonosis.

4DX Snap tests are often used for heartworm testing.  They also detect Ehrlichia, Lyme disease, and Anaplasma.

Vertigo is a syndrome in the elderly dog, which can be very frightening to the owners. The dog is suddenly afflicted with a balance problem, usually staggering, but occasionally unable to stand, and more rarely actually rolling over and over. There is a tilting of the head to one side and nystagmus, a rhythmic flicking movement of the eyes. Nausea and vomiting may also in present. It is not due to a stroke, as most people assume. It is thought to be due to an abnormal flow of fluid in the semi-circular canals of the inner ear. It is more common in older medium to large breeds of dogs. It is rarely seen in cats. Although the symptoms are alarming and often incapacitating to the dog, the prognosis is good. Improvement of clinical signs usually starts within 48-72 hours and most patients are normal within two to three weeks, even with no treatment. A mild head tilt may persist. Veterinarians should be consulted as the symptoms can also be caused by ear infections, foreign bodies in the ear, or tumors. The vestibular system may need treatment, with motion sickness drugs, or intravenous fluids if the nausea is severe or the dog is unable to eat or drink for a few days.