Diseases #15
Giardia is an intestinal parasite cause by Giardia canis. Giardia is classified as a unicellular protozoan organism.
Giardia is transmitted by swallowing contaminated feces laced with the cyst form of the parasite. Commonly, this occurs via contaminated water. This is called an oral-fecal route. Giardia exists in two forms. The troph form is the active form. It has multiple flagella and darts across a microscope slide. The cyst form is the most dangerous as it can exist in feces for a prolonged period of time. Once ingested, the parasite causes multiple gastrointestinal signs. Giardia is most commonly seen in young puppies and animals that are housed in close quarters such as: puppy stores, shelters and boarding facilities. It can be resistant to many forms of treatment. It is very common in southern states such as Florida.
The most common clinical signs seen are vomiting and diarrhea. The diarrhea may be watery, soft and have blood in it. The diarrhea is caused by the parasite embedding itself in to the mucosal lining of the intestinal tract.
Fecal exam is the quickest way to diagnose the disease. Problem is, is that it is not passed in each bowel movement and may not be picked up. Most commonly, a small amount of stool is mixed with water and under a microscope, one may see small parasites darting about. They have a characteristic tear dropped "monkey face". To find cysts, common fecal floatation media will not work. Zinc Sulfate must be used instead. If an animal is suspected of carrying Giardia, yet can not be found on a slide, the Idexx® Snap Giardia Test is recommended.
Diagnosis is made by finding the troph or cyst version of Giardia canis or via the Idexx® ELISA test.
Treatment of Giardia often requires multiple treatments with multiple drugs. The two most commonly used drugs to treat Giardia canis in the dog and cat are: metronidazole (Flagyl®) or fenbendazole (Panacur®). Studies have been found that fenbendazole does a better job of clearing Giardia than metronidazole. The drugs are often given together in certain animals, particularly cats. Treatment is usually for about 1-2 weeks. Fecal samples are than checked periodically to make sure the animal is negative. Pets can reinfect themselves in the future.
The prognosis for Giardia canis is usually excellent once diagnosed and treated. There is a potential chance that animal Giardia can be passed to humans. Humans have their own version of Giardia caused by Giardia lamblia. This is transmitted in the same way as in pets by contaminated water supplies. In particular, swimming pools are a common source of contamination.
Gingival hyperplasia is commonly seen in older dogs and cats. It is defined as a non-inflammatory enlargement of gum tissue secondary to other dental diseases such as plaque, bacteria and other irritating agents. It can be seen in any dog but common in Labrador Retrievers in particular.
The pathophysiology of the condition is not exactly known but is tied to certain drugs (cyclosporine) plus plaque and bacterial buildup.
Common clinical signs include thickening and elevation of gum tissue. There may be pockets formed that accumulate food and debris. This will easy cause bleeding gums due to pre-existing periodontal disease.
A CBC and Chemistry profile will form a minimal database. This is also needed if a dental or other oral procedure is needed to be performed.
A diagnosis of gingival hyperplasia can only be made by biopsy and histopathological diagnosis. It must be differentiated from straight periodontal disease.
In severe cases a surgical re-contouring of the gum line is performed with elimination of existing pockets. A dental cleaning is also performed at the same time. Antibiotics are also prescribed for several weeks. Anti-Inflammatories or analgesics may be prescribed for oral pain. Rimadyl® or Tramadol® are commonly used.
The prognosis for surgically corrected gingival hyperplasia is good as long as long term dental cleanings and bacterial culture and sensitivity tests are performed routinely. Using chlorhexidine solutions in the mouth will also act as a bacteriocidal agent.
Glaucoma is defined as an increase in intraocular pressure due to poor drainage or outflow of eye fluids. It can be primary or secondary in nature although the latter is more common. There may be genetic causes also.
Glaucoma can be primary or secondary. Drainage in the filtration angles of the eyes is normal. Once this drainage is obstructed, signs of glaucoma will commence. Regardless of treatment, about a third of animals will go blind in the eye. Glaucoma cases that are not treated will cause permanent damage to the optic nerve causing blindness.
1. Primary Glacuoma: This is a sudden, acute onset of intraocular pressure. In this type, there is an increase in intraocular pressure, the vessels around the sclera (white of the eye) may be enlarged, a cloudy appearance to the front of the eye and dilitation of the pupil or no pupillary response to light. The animal suffers vision loss.
2. Secondary Glaucoma: This type of Glaucoma is secondary to other eye disease processes and is more common than primary. Clinical signs commonly seen are similar to primary and will often have an attachment of the iris to the lens or cornea plus possibly a constricted pupil.
Either condition is painful to the animal and the animal will often blink uncontrollably.
The most common test that is performed to diagnose intraocular pressures is the use of the tonometer. Readings are done in both eyes. Board certified ophthalmologists will measure the filtration angles. A complete eye exam is performed.
Diagnosis is made by obtaining a history of clinical signs and any type of injury or trauma to the eye; no matter how slight. Combined with physical findings (tonometer readings) a diagnosis of glaucoma can be made.
Glaucoma can begin in one eye or both at the same time. If one eye is affected, the best that can be done is to preserve vision and eye health in the other. All treatment is geared towards decreasing introcular pressure in the affected eye and getting it back in a normal range as soon as possible. Treatments, over a life time, can be expensive. If the vision is not lost in the eye, carbonic anydrase diuretics may be used. Specialists will often use ocular anti-oxidant therapy. The most common is Ocu-GLO®. This is a neutraceutical full of antioxidants. If vision is lost in the eye, most medical treatments are going to go nowhere and at a huge expense. Surgical drainage is performed to alleviate the intraocular pressure.
The prognosis for glaucoma is guarded at best. No matter what is done, vision is completely lost in the affected eye. Statistics show that if glaucoma starts in one eye, there is a very high probability that it will commence in the other eye. A specialist will determine that possibility and will start medical therapy to protect the vision in the other eye.
Acclimation to vision loss is easier for dogs than people or cats. Dogs are near sighted to begin with. Being able to see limited colors, they see shades of white and black and yellow. Due to immature cataracts, they may be already getting acclimated to vision loss. Keeping furniture in one place, as well as the animal's food and water bowl, will make life easier for the dog. Cats do see color and have excellent visual acuity. Loss of vision may alter the cats life. It may misjudge distances and height making jumping onto beds, tops of refrigerators or tops of door frames much more difficult.
Most people love grapes or their dehydrated cousins, raisins. They are healthy snacks for people but toxic to dogs and cats. Even small amounts of either can be toxic to pets.
Ingested grapes or raisins, even in small quantities, can cause severe illness in dogs or cats. The main clinical feature is develpment of acute renal failure.
Clinical signs associated with grape or raisin toxicity are those of acute renal failure. One to two days after ingesting raisins vomiting, diarrhea, anorexia and dehydration will occur. Animals may drink excessive amounts of water with minimal urine output. In untreated cases, animals will die of renal failure.
The most important lab tests in grape toxicity are a CBC and Chemistry Profile. The chemistry profile will show an elevation in the BUN and Creatinine. Electrolytes will also be altered.
Diagnosis of grape toxicity is made by the owner observing the ingestion of grapes or raisins or observing them in the vomit. Sometimes I wish dogs and cats could speak. Many times the owner knows nothing about any intoxication or the animal may have vomited away from its surroundings. Fortunately, signs of renal failure will be detected and a diagnosis of idiopathic renal failure will be made. That is a fancy word for unknown cause. Since dogs and cats can not speak, it really can be unknown.
Initial treatment is performed by the home owner. Making the dog or cat vomit after ingestion is crucial in the prevention of acute renal failure. The owner will be given an appropriate dose of hydrogen peroxide to give prior to leaving for the animal hospital. Hydrogen peroxide causes vomiting in animals. Activated charcoal will also be administered at the medical facility to decrease the absorption of toxins associated with grape toxicity. After lab work confirms the onset of acute renal failure, animals will have an intravenous catheter placed with saline to diurese the animal in order to jump start renal function. Symptomatic care of vomiting and diarrhea are provided as well as an easily digestible diet such as chicken and rice. It takes about 3 days for the BUN and Creatinine to drop. In other words, there is a lag time involved. As soon as those tests start to drop and the animal is drinking and eating on its own, it is on the way to recovery.
The prognosis for rapidly diagnosed and treated grape intoxifications is good. Untreated animals will go into renal failure and not survive.
The best treatment is prevention. People with pets should know from the start that grapes and raisins can make a dog or cat very ill. Keep these foods out of reach from animals. Do not leave them on coffee tables or anywhere a dog or cat can find them. Remember that dogs and cats are perpetual toddlers. You always have to keep an eye on them!
Hairballs are a constant problem in cats. A cats natural tendency to groom itself leads to hairball production. Causes are natural grooming and any other physical condition that causes hypergrooming such as flea bite dermatitis, eosinophilic complex or food allergies. Long haired cats have more severe hairball issues due to their thick long hair-coats.
During grooming, hair is swallowed and ends up in the stomach or the beginning segment of the small intestine. Hair is a natural irritant to the gastrointestinal tract. In some cases the hairball sits in the intestinal tract causing off and on vomiting. Many hairballs will pass through the cat and pass in the feces. Some may become lodged in the colon and become as hard as concrete. These are called trichobezoars and they can easily obstruct a cats lower colon.
The most commonly seen clinical sign in cats is off and on vomiting. Some days all will be right, another day the cat will vomit. The consistency of the vomit differs from that of a viral producing gastroenteritis. In hairballs, the food is vomited almost like it just was swallowed; totally undigested. It is very difficult to reproduce in writing, but the cat will make a characteristic sound during the whole exercise of vomiting the hairball. Cats will often sit for hours trying to get a hairball out of its system. Many of those than vomited will have a cigar like appearance. These are hairballs that were refluxed back into the stomach and than vomited to the outside.
Radiographs or a barium series may be performed if there is a suspect hairball obstruction. This will localize the location of the trichobezoar. Hairballs are one of the multitude of medical causes of vomiting in cats. Other tests such as a CBC and Chemistry profile may be done to rule out other issues.
Diagnosis of hairballs is by finding vomited hairballs or in many cases, hearing the characteristic heave ho sound made by a cat prior to vomiting the hairball. Radiographs are used to diagnose hairballs lodged in the lower gastrointestinal tract.
Treatment is by lubricating the gastrointestinal tract so that the hairball passes unobstructed into the feces. Many preparations are available. One of those is Laxatone®. Do not use petroleum jelly. Over time, it will bind fat soluble vitamins (D, E, K and A) causing a deficiency in them. The majority of hairball preparations available are fortified in these vitamins. The easiest way to get a cat to ingest the product is to put some on the paws of the front feet. Most cats hate anything stuck on them and will lick it off. Using a finger or tongue depressor, rub some on the roof of the cats mouth. The animal will act like it is gagging but the product will melt and the cat will swallow it. Hill's® Science Diet Adult Mature Cat Hairball Control diet is also employed to slow down the development of hairballs.
Treatment of trichobezoars in the colon are sometimes relieved by enemas. If that fails, surgical intervention takes place and the obstruction is relieved.
Prevention also plays a big part in hairball control. All cats should be brushed and combed on a regular basis. If the cat will tolerate it, shampooing will also rid the cat of loose hairs and dander.
The prognosis for hairballs is excellent for most cats. Hairballs are just a fact of life for felines. Prevention by periodic hairball remedies and daily grooming will go a long way in keeping hairballs out of your hair!