Diseases #14
Everybody knows that fish hooks are used for fishing. Bait is applied to the hook and people catch fish! This is great but not so when an animal gets caught in one or all of its nasty barbs.
Most cases of animals getting entangled in fish hooks are at camping sites, lakes, oceans or anywhere people go fishing. Many of the fish hooks have a fishy/meaty smell that attracts both cats and dogs. Fish hooks also have other shiny components that also make them irresistible to cats. Felines love any and I mean any shiny object. Fish hooks can be embedded anywhere on the body. Fish hooks may also be swallowed. This can be quite dangerous.
Fish hooks are many times found embedded: in the paws of the animal, the tongue, the cheeks of the mouth and the nostrils most frequently.
Many times owners do not notice anything wrong until they see fish line hanging off of a dog or cats body. Because of this, veterinarians will run a CBC to mainly check the white cell count for signs of infection (a left shift neutrophilia).
Diagnosis is made by finding a fish hook embedded anywhere on the animal's body.
Treatment is effective removal of the fish hook. This is always done under light sedation. Usually the barb is pushed threw the tissue, the sharp barb is cut off and the remainder of the hook is pulled out the way it went in. Forcing it out without cutting the barb will do more harm than good. Animals may also swallow the fish hook. If this is in the oral cavity, it is easily removed. If it is in the esophagus or stomach it may need to be removed with an endoscope or surgery. If the hook is in the intestinal tract surgery may be necessary. Antibiotics are always prescribed for infections and pain killers may be prescribed for a short period.
Prognosis for fish hook altercations is excellent. Prevention of the problem is best. Keep all tackle boxes and bait supplies closed and away from prying dogs and cats. If warranted, keep animals away from the fishing site. This is complete avoidance of anything bad happening.
Fleas cause total discomfort in dogs and cats. Most of that discomfort revolves around the severe allergy developed to the flea bite. Rarely do people ever think that an animal can become anemic over time to fleas. A flea is a little blood sucker and drains your pet of blood one drop at a time. If the animal is extremely small and young plus severely infested with fleas, anemia can happen.
A small dog or cat has a very low blood volume. If it is covered from head to toe with fleas, blood depletion will soon happen. Making matters worse, fleas transmit tapeworms to dogs and cats. Those parasites can further drain an animal of any blood or nutrition. Flea anemia can easily cause the death of a small, young puppy or kitten.
Pale mucous membranes and pale pads of the paws are noticed. More systemic clinical signs may be seen due to the anemia. The respiratory and heart rate will be elevated and the animal may tire often. Seeing this in active puppies and kittens is abnormal. Young animals are very active. Pets parasitized with tapeworms may also pass those tape segments or other intestinal parasites.
A CBC is the lab test of choice to check for anemia. Levels of hemoglobin and red cells will be lower. The hematocrit will also be lower. Smears will be made to determine the type of anemia. Fecal samples will be checked for intestinal parasites.
Diagnosis is made by the presence of large flea populations on the dog or cat plus the clinical signs of anemia.
In severe cases of anemia, a pet may require a blood transfusion. In most cases hematinics are administered to the animal. Nutrical® contains extra iron and other nutrients to help an animal. Most dogs have a regenerative anemia so will respond to this treatment. Pet-Tinic® is also extremely effective.
Perhaps just as important, flea control is mandatory. Fleas must be controlled on the animal as well as well in the pets environment. There are many topical pet products available such as Frontline® and Revolution®. Foggers and flea sprays are excellent for home and outdoor control. Many professional companies provide environmental flea control.
Until the pets hematocrit and other red cell indices turn around, the prognosis for flea anemia is guarded. Once the animal and its environment are treated for fleas plus the red cell indices start to climb, the prognosis is favorable.
Fungal diseases are very common in dogs and cats. There are two general types of fungal organisms:
1. Cutaneous: Cutaneous fungal infections are caused by numerous dermatophytes. One of those is Ringworm. It is extremely contagious and difficult to clear in the environment.
2. Systemic: Systemic fungal diseases are those that cause internal, generalized disease in dogs and cats. The most commonly seen diseases are: Blastomycosis, Aspergillosis, Cryptococcosis, Coccidymycosis and Histoplasmosis. These are much more serious and difficult to treat than the cutaneous types.
Cutaneous fungal organisms cause their problems at the level of the hair follicle. They live and reproduce there causing the clinical signs seen of alopecia that normally appears in a circular pattern. Systemic fungal disorders play havoc in the animal's body. Aspergillosis usually reproduces in the nasal passages of animals. Cryptococcosis invades the central nervous system, eyes, skin and other organs. Blastomycosis invades the respiratory tree causing pneumonia. Coccidiomycosis is a dangerous disease capable of causing clinical signs in the lungs, central nervous system, liver amongst others. Histoplasmosis often does not cause symptoms or disease but in severely infected animals, multiple organ systems can be effected.
Cutaneous fungal organisms produce circular, white colored areas of alopecia over the body surface. It often produces a moth eaten appearance on the skin. Most of them are not pruritic but animals may lick at the lesions.
Systemic fungal infections cause clinical signs in the organs they reproduce in.
1. Blastomycosis: Most animals develop signs of respiratory disease that can lead to pneumonia. Other organs may be associated with the disease hence other clinical signs.
2. Aspergillosis: Aspergillosis is a yeast organism that causes nasal respiratory disease in animals. A muco-purulent discharge, bloody nose and sneezing are very common in most animals.
3. Cryptococcosis: The majority of dogs will show clinical signs of respiratory disease including pneumonia and coughing. Neurological signs such as seizures, head pressing plus ataxia are common.
4. Coccidiomycosis: Minor respiratory signs and pneumonia may be seen or nothing at all. In severe systemic infections clinical signs involving the bone, liver, spleen and others are noted.
5. Histoplasmosis: The majority of individuals do not show any clinical signs but will have an antibody titer to the disease. Some animals will demonstrate signs of weight loss, vomiting and diarrhea.
A CBC and Chemistry profile are performed to obtain a medical database on the animal. The systemic fungal organisms can be cultured in respiratory secretions and other organs. The cutaneous dermatophytes can easily be diagnosed by growing in a fungal media culture. Noticing the typical white circular growth and color change in the media or looking at some of the growth on a microscope slide is helpful.
The diagnosis of cutaneous fungal diseases is made by the presence of associated lesions on the animal's body plus identifying the organism on a fungal culture. Systemic fungal infections can be difficult to diagnose because many of these animals are treated for respiratory signs, amongst others. Only than, when therapy goes no where when veterinarians will dig deeper to get to a cause and diagnosis. Diagnosis is made by identifying the organism. Just as important is obtaining a medical history that shows where the dog or cat may have traveled recently. Many of the systemic fungal organisms are seen in particular parts of the country. Knowing where they have traveled will give clues on a particular diagnosis.
Treatment of cutaneous fungal organisms is by topical application of anti-fungal medications containing miconazole. Tresaderm® is also used. Treatment should continue for at least six weeks. The treatment for systemic fungal disorders includes: ketoconazole, Itraconazole or fluconazole. To be effective these drugs must be administered early in the disease process.
The prognosis for cutaneous fungal diseases is excellent once it is diagnosed and treated. Care must be taken to rid the home environment of spores (particularly with ringworm). This can be accomplished by cleaning and disinfecting beddings, vacuuming rugs plus frequently changing air handler filters. The prognosis for systemic fungal diseases is guarded until the clinical path of the disease is known. When neurological signs and severe pneumonia are present, the prognosis is not favorable. Cryptococcosis is the worst of the group and rarely carries a good prognosis.
Fungal Diseases This is an excellent article written by Dr. Michael Dym.
Feline Lower Urinary Tract Disease used to be called Feline Urologic Syndrome (FUS) for years! FLUTN produces a myriad of clinical signs depending upon the actual cause of the disorder. The three most common causes are:
1. Idiopathic Cystitis
2. Urethral Obstruction
3. Urolithiasis (Urinary Stones)
4. Urinary Bladder Diverticulum
1. Feline Idiopathic Cystitis: This form of the disease is usually diagnosed after all other possible causes of the disease have been ruled out. Cellular changes in the bladder mucosa and stress are associated with this type.
2. Feline Urolithiasis: Urinary bladder stones are common in cats. pH changes of the urine from an acidic environment to a more alkaline one favors the formation of struvite (magnesium phospate) crystals and oxalate crystals. Individual crystals coalesce together and form grit or stones.
3. Urethral Obstruction: This is the most dangerous of the three. If any stone or a combination of crystals and cellular debris plug the urethra, urination is impossible and the animal becomes obstructed. This is a medical emergency. Urethral obstruction is most commonly seen in males. I have never treated an obstructed female cat. In the male the urethra is narrower and a bit longer in the male compared to the female cat.
4. Bladder Abnormalities: In addition to the above, cats may present with clinical signs of lower urinary tract infection but on a pneumocystogram or Hypaque® dye study a small pouch or diverticulum may be found at the cranial point of the urinary bladder. Urine and other debris accumulate and form a nidus of infection in cats.
There are three types of feline lower urinary tract disease causes but the clinical signs overlap one another. It is just a matter of rule outs trying to figure the cause of the clinical signs presented in a particular cat. The most common sign initially seen in cats is straining to urinate in the litter box. Many owners attribute this to constipation but that is farthest from the truth. Cats will often try to urinate frequently and blood is often seen in the urine. Cats will often urinate outside of the litter box. If the cat is almost or completely obstructed it will cry out in pain while it attempts to urinate. They are very uncomfortable and will lick their perineal area trying to relieve the discomfort. Cats hate stress and are creatures of habit. Behavioral changes seen in the cat due to the disease often throw the cat off of its normal diet and this also includes fluid intake. This makes the condition worse.
Any cat presented with signs of lower urinary tract disease requires a complete workup. A CBC and Chemistry profile are performed. If the cat is obstructed, the BUN and Creatinine will be elevated. A urinalysis is performed. Urinary crystals may be seen plus the pH of the urine noted. If stones are palpated a radiograph will visualize them. Urine cultures may also be sent out to a lab for culture & sensitivity.
Diagnosis can be confusing at time since most of the symptoms presented can be associated with all causes of the disease. The medical history is important plus physical findings. It is very easy to palpate a cat that is obstructed. The bladder is large and firm. At the same time the bladder is palpated one can see the animals external urethral orifice spasm trying to urinate. Nothing comes out. Urinary uroliths can be visualized via radiographs or ultrasound. Crystals will be found in the urine. Once everything has been ruled out and the only clinical signs noted are straining to urinate with blood in the urine and THAT IS IT....than you are dealing with Feline Idiopathic Cystitis.
1. Feline Idiopathic Cystitis: This condition often clears up by itself as long as there is no obstructive diseases. Cats are placed on Hill's® Prescription Feline c/d or Royal Canin Feline SO. Both diets have low levels of magnesium and encourage the cat to drink water. One nutritional supplement that does help cats with idiopathic cystitis is feline glucosamine/chondroitin. This substance is used to help maintain cartilage in dogs and cats with signs of arthritis but it has a protective effect on the urinary bladder and helps alleviate clinical signs in the cat. A popular formulation is Cosequin® for cats.
2. Urolithiasis: This condition in cats is treated medically or surgically. If radiographs or ultrasound indicates the presence of relatively large stones, surgery (cystotomy) is recommended. If there is the typical gritty stone found in the bladder, dietary resolution is recommended by putting the cat on Hill's® Prescription Feline s/d. This will dissolve small struvite stones but does nothing for oxalate stones. This is a short term diet and usually than switched to the products mentioned above. If the stone does not dissolve, a cystotomy is performed.
3. Urethral Obstruction: This is a medical emergency and the pressure on the bladder has to be relieved otherwise the bladder can rupture and or the animal will go into acute renal failure secondary to the urethral obstruction. Under a general anesthetic the obstruction is relieved with a 3.5 tom cat catheter or via (my favorite) a lacrimal canula attached to a 12cc syringe filled with saline. In severe cases, an emergency cystocentesis (bladder tap) is performed drawing off as much urine as possible to relieve the pressure. Once the obstruction is relieved the animal is catheterized and urine input and output are measured. Complications of urethral obstruction are loss of detrusor muscle tone resulting in urinary incontinence or a rupture of the urinary bladder. Most cats do well and are put on one of the prescription diets for life. Again, nothing will dissolve an oxalate stone but the diets will encourage drinking plus will maintain an acidic urine pH.
4. Urinary Bladder Diverticulum: This is repaired surgically. The diverticulum is excised and the animal is put on one of the prescription diets and or feline glucosamine/chondroitin.
Overall, the prognosis for most cases of feline lower urinary tract disease is very good. Animals that are in renal failure are guarded until clinical signs are reversed. A handful of cats with loss of detrusor tone will gradually begin to urinate on their own. For those cats that do not regain detrusor tone, most owners are taught how to compress the bladder to remove urine without it dribbling out all the time. The key to future success is to maintain appropriate diets and nutritional supplements plus multiple urinalysis' throughout the year making sure the pH is acidic and a negative presence of crystals. The best product on the market to collect urine from a cat is Kit4Cat®. This is a litter that is hydrophobic and collects on the surface so an eyedropper can collect the urine to be put into a clean container. If the owner does not want to fiddle with urine collection the veterinarian can perform cystocentesis and get the sample in the medical office.
Gastric Torsion goes under several names. Gastric Dilitation-Volvulus or the common name, bloat. The cause of Gastric Torsion is unknown however it is most commonly seen in large deep chested dogs such as Great Danes, Labrador Retrievers, Doberman Pinschers and the like.
The stomach fills up excessively with food, water or air and gets exceedingly larger. This causes several problems. The return flow of blood to the heart is impaired, the stomach may actually rupture plus the expanded stomach puts pressure on the diaphragm which makes it harder for the lungs to expand to take in oxygen. In many situations, the stomach will twist along with or without the spleen in the same longitudinal axis as the esophagus. This cuts off blood supply to both organs. This entire process causes oxygen starvation and subsequent clinical signs. In the final stages, the blood supply to the organs is gone and the stomach cells start to die. Bacteria than start to reproduce and sepsis soon follows with complete organ shut down.
Prior to clinical signs, the majority of dogs are fed a large meal with or without water. They than go out and exercise. The viscera start moving around and signs of bloat can ensue. Dogs will be presented with a distended abdomen on the left side of the body. In volvulus, animals will try to vomit but can not. Animals are distressed and will often just stand there doing nothing. Animals than may show signs of shock associated with elevated heart and respiratory rates. Some may be presented totally collapsed.
A CBC and Chemistry profile are done for a medical database. Many animals may have heart arrhythmias so an electrocardiogram will be run. Commonly, radiographs are taken to assess the size of the stomach. Blood gases are helpful to determine oxygen and carbon dioxide leves. Electrolyte abnormalities will be picked up in the Chemistry profile.
Diagnosis of gastric torsion/volvulus is made by obtaining a solid history and physical exam. The history combined with the presence of a huge distended abdomen and associated clinical and laboratory signs makes GDV a straight forward diagnosis.
The first thing to do is relieve the stomach pressure. This is done by using a trocar to pass into the stomach allowing air pressure to escape through the opening in the skin. Most dogs are in shock and require an intravenous line and saline pushed at a rapid rate appropriate for the size of the dog. Corticosteroids such as dexamethasone phosphate are administered intravenously. A stomach tube is inserted to attempt to relieve the pressure on the stomach. Most of this is all done at the same time by the medical team. Oxygen is always administered. At an appropriate time, the dog is anesthetized and a laparotomy is performed. The stomach is derotated and fixed (tacked) to the peritoneum called gastropexy. The organs are checked for viability. Sometimes it is necessary to do a splenectomy (spleen removal) and or remove part of the necrotic (rotten) stomach. Animals that do survive are hospitalized for several days with intravenous feeding and watched for post surgical arrhythmias.
Even after corrective surgery, about a quarter of animals do not survive. The survival rate and prognosis go way down when an animal has suffered through the majority of clinical signs. Cell, and later organ death, cause multiple cascading effects that are difficult to stop. General anesthetics are an extreme risk in these cases but must be done.