Archive for the ‘Interesting Cases’ Category

Allergies in Pets – Scratching the surface

April 22nd, 2014

Have you noticed your pet scratching a lot lately?  Shaking their head or chewing at their paws?  If so, most likely it is due to allergies (Atopy).  We need to schedule your pet for a comprehensive exam to have several diagnostic tests done to best determine the cause(s) of their allergy problems.  The most common symptoms that owners will notice from their pet is excessive licking, scratching or chewing, odor from the ears or skin, hair loss, crusted skin lesions, greasy or oily skin, scaly, dry or red skin, stained or inflamed paws.  Recurrence of skin infections and/or ear infections is also common in allergic pets.

Depending upon the specific allergy that your pet has different recommendations and course of treatment will be made.  After a complete physical exam, complete blood panel, and fecal testing, the doctor can establish a complete history and better picture of what the issues are affecting your pet.  Allergies can be caused by various things including environmental, food, or flea allergies but all are associated with the immune system overreacting. This over-reaction by the immune system causes the body to release numerous chemicals that start an inflammatory cascade, or chain reaction effect.  The endpoint being that the skin is red, inflamed, itchy and irritated.  The skin can additionally become dry, crusty, and hot, with secondary bacterial or yeast infections.  Once the cause of the allergy is known we can maintain the best health for your pet by controlling what is causing the body to react and the discomfort that your pet is feeling.

Several diagnostic tests can be done by the Doctor in our veterinary office (many with results on the same day).  This is needed to indicate how to best treat your pet. Examples of this would be a skin cytology, skin scrapings, fungal culture, skin biopsy, urinalysis, thyroid profile along with complete labs, and allergy testing to determine the underlying allergen predominately causing the issues.

These tests are very important to indicate how we should be treating your pet and the cause of the allergy symptoms. Often, treatment is an ongoing process. And once your pet is diagnosed with allergies (depending upon which type of allergy they have, sometimes with multiple issues) it can be an ongoing lifestyle maintenance issue.

Flea allergies will go away if the source is removed and no more flea exposure occurs. Being on a monthly preventative is very important and the treatment would be to avoid the pet from being exposed to fleas.

Food allergies will work the same as with flea allergies.  Avoidance of the offending allergens is needed.  Food allergies are diagnosed by using an elimination prescription diet.  This cannot be accomplished with any over-the-counter diets, as they have cross contamination of ingredients.  This is a diet provided by the Veterinarian and is selected to restrict allergic components.  A pet must be fed this diet and this diet alone for 3-4 months to rule out food allergies.  Many pets can have combination food and environmental allergies.

Environmental allergies require more maintenance and can be a year round concern. Weekly, bi-monthly or monthly medicated baths,  using daily ear washes, Hypoallergenic prescription diet food and treats, medications (Apoquel, Atopica, antibiotics, antifungals, allergy immunotherapy, etc), routine lab work and exams are necessary to keep your pet in their best health to avoid flare ups and addressing any skin issues before they become worse.

Environmental Allergies (Atopy) is diagnosed based on the clinical signs and presenting complaints.  The specific allergen, to which the pet is allergic, is diagnosed via a blood allergy panel or skin prick test (performed by a veterinary Dermatologist).  Our hospital utilized the blood allergy panel.  Once the allergen(s) are known, specific immunotherapy is used.  Immunotherapy is the administration of very small amounts of the items to which the pet is allergic.  These can be administered via injections under the skin or via drops administered under the tongue.  The veterinarian will discuss what the best treatment option for your pet is.  Immunotherapy is designed to train the immune system to be less reactive.

Another common concern are skin issues that can be contagious to people. Certain types of mites from pets, and ringworm are contagious. Ringworm can live in the environment due to the spores for over one year and still be contagious.  Once your pet is diagnosed with ringworm the best protocol to follow would be to clean and disinfect all areas that your pet has lived on or within the home. This may include bedding, floors, countertops, carpeting, and window sills.  Any concerns should be discussed directly with your Veterinarian.  See our other articles discussing Ringworm.

Dr. Hodge is a Tampa Florida Veterinarian and owner of Harbourside Animal Hospital

Ask a vet about dog eye problems, diagnosis, and treatment

September 18th, 2012

Dog eye problems – ask a vet for online advice

From time to time, VetLive likes to publish some of their consults. Here is a question from a pet parent about her dog’s eye that is under treatment by her regular veterinarian.  Though her regular veterinarian recommended the pet be evaluated by an opthalmologist, the client did not understand the importannce of this and her appointment was for three weeks away.  The eye had worsened since the veterinarian last saw him and the pet may have lost his eye by the time three weeks passed.  He would have needed an expensive enucleation surgery at that point and been without an eye at 10 weeks old.

My 10 week old pugs eye has gone opaque. We took him into the vet and she prescribed us a pill antibiotic and two diffferent eye drops. He can now keep his eye open, but since yesterday his eye has gone red around the opaque part.

Dear Kathy,

I don’t think that this is an emergency from what you described… especially since Phineas is under therapy for an eye infection right now. But in order to give you a better and more accurate response, if you could upload a close-up picture the eye, I will be better able to evaluate it and in a few hours can give you a detailed answer. Also, I have a few more questions:

1. Was the cause of the lesion identified by the vet (i.e. a scratch, foreign body, etc.), or was the cause unknown?
2. Were the words “corneal ulcer”, or just “ulcer” ever used?
3. What medications is Phineas on (please just transcribe the names and ingredients)
4. Once again, a photo speaks a thousand words

Sorry for all the questions right back at you, but I want to help you (and Phineas), the very best I can.

Best Regards,

Dr. Jed

Best picture I can get. He’s a very ambitious 10 week old and doesn’t like to sit still!

Dog eye problems opthalmologist

Vet did a test on his eye to determine that there was no ulcer, but something did hit his eye. She described the opaqueness as bacteria behind the eye. She said she is very concerned, and referred me to a Vet Vision Dr.

Medications are:
1. Eye Drops-Gentamicin Sulfate Ophthalmic Solution 0.3% to be given every 8 hours.
2. Atropine Sulfate Ophthalmic Solution 1% to be given every 12 hours until pupil dilates, then once a day. (We can’t even see his pupil to determine that..?)
3. Pill. Antirobe Caps. Every 12 hours. 25mg.

He is acting completely normal and is having fun with his brother..we have not determined if we think he can see out of that eye yet, he doesn’t seem to run into anything.

There are a few things I am concerned about:

1. The new appearing redness at the periphery of the eye. This could be one of several things. First, it could be neovascularization which is new blood vessels that form in order to help the eye heal. It could also be irritated tissues due to worsening of the infection. Either way, magnification and an opthalmascope would be needed to evaluate the eye, in person.

2. This is a serious eye problem. Whenever the eye is insulted so much that it becomes cloudy, you have to worry about inflammation of the eye (called uveitis) and increased pressure in the eye (called glaucoma). Measuring the eye pressure regularly is something that is important. Most vets have a tono-pen that they can use to carry out tonometry to measure the intraocular pressure. There is a normal range that it should be within. Low pressure can indicate that uveitis is going on. High pressure means glaucoma. Uveitis can even lead to glaucoma (I attached a handout on glaucoma just in case you need it down the line). Either way this will likely change the regimen of medications. Therefore, if there was a change in they eye in my dog with opacity such as Phineas and new redness, I would want the eye pressure also re-evaluated. Furthermore, the fact that atropine is being given is an indication that the vet is trying to prevent these two problems. An increased eye pressure for an extended period of time will lead to blindness. If this is picked up early, there are medications to treat it.

In summary, if this were my puppy and there was a change in the eye (which is hopefully just scleritis – inflammation of the sclera), I would want the eye pressure re-evaluated and another opthalmic exam, hopefully by that Vet Vision doctor as soon as you could get in. There is just so much for Phineas to lose that it would be a shame not to. I am sorry I couldn’t tell you otherwise, but in my experience, acute changes in opaque eyes is something that warrants further investigation.

Let’s hope that I am being overly cautious and that Phineas’ exam shows that the redness is just part of the healing process. I wish you two the very best.

Regards,
Dr. Jed

Thank you very much. So in your professional opinion, do you think he can currently see out of that eye?..and do you think, with the way it looks..that it can be saved? I really hate for him to lose his eye at such a young age..and I love him to death, just looking at it makes me sad.

Our appointment is not until the 9th. Should I call and beg for an earlier appointment?

I am sure he can see light in that eye if his retina is fine, but the opacity has affected visual acuity. I have seen opaque eyes clear up and vision return to normal or near normal. Just do everything that your ophthalmologist says to the best of your ability and make sure to store the medications appropriately and that is all you can do.

One more thing- I want to be more clear… You either need to call and beg the referral hospital to get seen asap or is that doesn’t work you need to get your vet to referr you to another opthalmologist. That is what I would do if it was my puppy. At the very least, you need to check back with your vet because of the redness and for an exam.  You sound like a fantastic pet owner- so I know you will.

Best,
Dr. Jed

Thank you very much for the help! I can sleep easier now! :)

Pet Nutrition: How to read a pet food label 101 by your online vet

November 17th, 2011

pet food label, pet nutrition, ask a vetPart One: Ask the vet

Choosing proper pet nutrition is one of the most important things that you as the pet parent can do to lengthen the healthy time that you and your pet will share together. After the melamine recall of 2007, pet owners internationally are taking a more active interest in pet nutrition.


Reading a pet food label can be quite the daunting task, but with a small amount of education, you can arm yourself with the information to make an informed decision.

We’ll start at the beginning. There are a few basics required to be on pet food labels. The manufacturer’s name, brand, and product, as well as what species the food is designated for, the net weight of the product, and a pet nutrition statement indicating if the food is for a juvenile, adult, etc. Not too many companies skip this basic info, and if they do, consider yourself warned.

Do you need to ask a vet about pet nutrition?  We provide online vet nutrition consultations, and you can get started by typing your question in the box to the right.

Here’s where it gets interesting.  The next broad area of the label to make sense of is defining what the food is labeled as.

The first group is the food that is labeled as 100% something, be it 100% beef, chicken,

ask a vet, online vet, pet nutrition

buffalo, you name it. If a pet food label says this, then it means that the product must be 95% or more of that particular food product they are claiming to be.

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Why is it hard to talk about fat pets?

November 14th, 2011

angry pet owner, pet owner denying pet's obesityIt’s not just me or Dr. Jed–it’s every vet I know. As soon as we mention that Fido is getting a little thick around the middle, our pet owners who seconds ago loved us now stare at us with hatred and resentment in their eyes!

Why is it so hard to talk to pet owners about keeping their pets a reasonable weight?

From dog to hog, from rabbit to cat,
Most pets I treat are relentlessly fat.

True, I have my clients that are happy to hear this and work towards their pet’s optimum weight, but they are in the minority.  Not sure if your pet is overweight? Ask a vet!

Today, as obesity in people is unanimously recognized as being dangerous for our heart, liver, kidney, joints, why isn’t obesity in pets given that same recognition, that same warning?

fat dog, chihuahua, obese chihuahua, obese dog

This Chihuahua needs more than a StairMaster

Barring medical causes of weight gain and decreased metabolism, pet obesity is something that pet owners actually have control over.  If I had someone determining when and how much I ate, I am sure I would be much more fit than I am.  Why don’t more pet owners realize this?  Food is not love!

I once had a 42 pound dachshund as a patient.  He was so sweet, and I loved his parents, but they wouldn’t do anything about his weight.  His belly dragged the ground.  When he died, he couldn’t even walk.  In the world were we have control over very little, this is something pet owners should take charge of!

If your vet tells you that Fido is overweight, it doesn’t mean you’re doing a bad job!  We usually have at least one pet on a diet.
Is there a better way to approach the topic?  Let us know! This vet needs your input as to what the best “weigh” to talk to pet owners about when Fido the pooch develops, well, more than a pooch.

Dr. Laci

SIGNATURE DVM

Dr. Laci Nash Schaible, DVM


Just keep an eye on it? The unseen raises questions about what is fair in life.

November 14th, 2011
The following story is about one of my favorite patients ever: Jake

“My other vet told me to just keep an eye on it”

“It’s been there for a year and hasn’t changed so I have just been keeping an eye on it”

“I don’t have the money to do that microscope thing, I’ll just keep an eye on it”

Veterinarians and pet owners alike have been keeping a keen eye on lots of terrible things.  I personally have, against my will, kept an eye on torturous allergies, Cushing’s disease, probable mast cell tumors, ear infections, and a myriad of horrible and curable, illnesses, conditions, and cancers. But I can’t spend people’s money for them.  I can only educate them and hope (and often pray) that they make the move and the sacrifice.

The Egyptian Papyrus of Kahun (from approximately 1900 BCE) offered the first written record of veterinary medicine.  Ironically, The Eye of Horus (the ancient Egyptian hieroglyphic symbol) is the symbol of protection, royal power, and good health.  Maybe that’s where vets and pet owners got the expression, “keep an eye on it.”

But there are those pet owners that I really feel sorry for – the ones that wanted to do something and were told to keep an eye on it.  I have to change his name, but lets talk about the most wonderful Boxer I ever met, Jake.

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Giardia in Dogs

July 12th, 2011

Ask a Vet About Causes of Diarrhea in Dogs | Giardia

ask a vet online, dog diarrhea, giardia in dogs

Do you have a dog with sudden or relentless diarrhea? One of the common causes of diarrhea in dogs worldwide, indoor, or outdoor, big dog or teacup princess is caused by a single celled protozoan parasite called Giardia. Giardiasis is an acute or chronic gastrointestinal (GI) tract disease. It is characterized by diarrhea and weight loss in both dogs and cats.

Wondering what could be the cause of your pet’s diarrhea?  Ask a vet online now to find out what could be going on.

Giardia may infect dogs and cats. Some types of Giardia can also infect humans. Transmission is by the fecal-oral route, which means that the parasite is swallowed in food and water contaminated with feces. Note, your pet doesn’t have to eat feces to get the parasite. Usually the transmission is through contaminated water–think puddles, lakes, streams, or water that isn’t suited for drinking in some countries.

Giardia in dogs can be asymptomatic, but when signs are present, the most common one is diarrhea that results in the passage of large volumes of watery feces–think cow patty consistency. It has a distinct odor to it as well, one that I have become all too familiar with after being in veterinary medicine for over a decade. The color of the stool usually isn’t abnormal–if you are seeing grey, green, yellow, or black, you’re probably dealing with another culprit.

giardia in dogs, ask a vet, diarrhea in dogs

Giardia

Intermittent or chronic diarrhea, weight loss, decreased appetite, and vomiting occur less often. Rarely, acute or chronic large-bowel diarrhea may develop, with increased frequency and straining to defecate and the presence of mucus and red blood in the feces.

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Reviewing EPI in Cats

May 20th, 2011

diarrhea in cats, EPI in cats

Yes, it can happen
The following is an excerpts from a real answer from the pet parent of a 12-13 yr DSH cat that was been diagnosed as a diabetic 3 years ago. Her diabetes is well-regulated, but she has loose and very pungent stools. Hyperthyroidism was ruled out, and the below is a portion of the discussion about Exocine Pancreatic Insufficiency (EPI), which her vet suspected but had yet to be diagnosed.

Exocrine pancreatic insufficiency (EPI) is a disorder in which the pancreas does not produce an adequate amount of digestive enzymes. This deficiency results in maldigestion (poor digestion) and malabsorption (poor absorption). EPI is rare in cats, but it does exist.

Clinical signs include weight loss, ravenous appetite, poor haircoat, and very thin body condition.

The most common cause of EPI in a cat is chronic pancreatitis. Many cats with EPI also have concurrent IBD.

Testing is by running a serum TLI. This is the only accurate test, and there isn’t a point in spending your money on the others. The TLI test is a simple and reliable way of confirming the diagnosis of EPI; however; it is essential to use an assay specific for feline TLI since there is no cross reactivity between canine and feline TLI. Performing the test to rule it in or out of course is best. You may want to ask your vet how much it costs, as it may not be more expensive than the enzymes your vet is using, depending on the brand.

Most cats with EPI can be successfully treated by dietary supplementation with pancreatic enzymes. Dried extracts of bovine or porcine pancreas are available (e.g. Viokase or Pancrezyme). The powder is more effective than tablets or capsules. Read the rest of this entry »

Ringworm in Pets

May 10th, 2011

Dr. Jed and I have been on the hunt for a new cat or kitten for around the past six months. We have been holding out as we were waiting for “the one.” When I saw her pictures on PetFinder, I thought she was adorable, but it was the in-person visit that convinced us that she was the perfect new family member.

ringworm in pets, online vet

Almost all healed up, and tuckered out after playing in her new harness.

As luck would have it, a few days before we were supposed to adopt her, she developed ringworm. The rescue group politely gave us an out if we wanted it, and I must admit, we did consider.

I am one of those people that are particularly susceptible towards ringworm and I contract it very easily. In addition, we are adopting a second kitten (we ended up finding two that melted our hearts and we all know nothing is cuter than two kittens playing), and we had concerns that the second kitten would catch it from the first.

After much deliberation, we decided to move forward with the adoption of both kitties. We figured that two vets could treat her ringworm more effective than a rescue. That is not to say the rescue was doing a poor job, but we have the time and resources for her to be our full focus.

We have now had McKenzi for a week, and sure enough, I did get ringworm, but I treated it aggressively and it’s already resolved. McKenzi’s is greatly improved and only one tiny spot remains.

Myths about ringworm in pets

5. Let’s get the most obvious one out of the way first, but I do believe it deserves a mention as some people aren’t aware of it. Ringworm is not a worm. Ringworm is cause by one or several fungal infections that infects and survives on the top surface of the skin, called keratin.

ringworm in cats, ask the vet4. Ringworm is not just spread by direct contact. Not only can it be spread by indirect contact, such as by touching an object that is infected with it’s spores, it can even be spread by the air.

3. The type of ringworm that people naturally get is different than the type that cats and dogs naturally get. If your human family has an outbreak, that doesn’t necessarily mean that the family pet is responsible if they have no signs. A child could have picked it up at school or a playground. Either way, a culture is needed to determine the species of ringworm being passed around. Read the rest of this entry »

Sticks, stones, and other mysterious things your dog eats

April 21st, 2011

ask a vet, pica, why dogs eat rocks, why dogs eat paper

Word's most expensive dog snack

Ask the vet why your dog eats things that aren’t food

Many dog owners have this problem:  your dog eats the most bizarre things.  Guest what?  Veterinary medicine has a term for it and a diagnosis even.

The consumption of nonfood items is called pica. Although pica can be a sign that a dog’s diet is lacking in nutrition, pica often occurs in puppies and young dogs as a result of boredom.

Puppies eat all kinds of objects, and they tend to explore their world with their mouths. Although we aren’t quite sure why puppies do this, many puppies tend to chew and eat a variety of inedible objects, from rocks to plastic bags and toys, clothing, and even pieces of wood. Most puppies grow out of this behavior as the morph into adult dogs, with only the mildest of discouragement from their owners.

ask a vet why my dog eats grassMany adult dogs that eat inedible objects may do so out of destructive chewing. This is different from pica, in that destructive chewing starts off as just that, chewing. Most doggy chewing doesn’t lead to actual swallowing of the object, but inevitably your dog may swallow bits and pieces. Dogs have an ever-impressive ability to swallow something that is in the back of their mouths without second thought.

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Household Substances Can Be Dangerous Not Only to Your Pet, But Also to Your Relationship

March 23rd, 2011
The entertaining chronicles of life as a veterinarian

It was several years ago but I remember that night well.  It was 3 AM on a Saturday morning when I was handed a chart for a three-year-old snorting Bulldog name Bennie that was having problems eating and holding down his chow. The confident rascal was known to eat garbage and the owners, a young bickering couple, reported that he had been left unattended the night before and had made a mess of the apartment.Cute dog chewing slipper

The x-ray showed something large in his stomach displacing food that in all probability was not going to pass. I showed the couple the x-rays and recommended removal through the use of an endoscopic camera. They couldn’t afford that so I told them that there was a small chance that if I made him vomit, I mean, really vomit, that the object may come out the way it came in. They agreed, so I administered the drug and waited.

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