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Syringomyelia

by admin on August 1st, 2017

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Syringomyelia is a relatively common condition, especially in breeds like the Cavalier King Charles Spaniel and the Griffon Bruxellois, in which it is suspected to be an inherited disorder. Other names that have been used to describe this condition include syringohydromyelia, Arnold-Chiari or Chiari-like malformation, and caudal occipital malformation.

 

What is syringomyelia and what causes it?

Syringomyelia is a neurological condition where fluid filled cavities develop within the spinal cord (the bundle of nerves that run inside the spine). The most common reason for the fluid build-up is that there is an abnormality where the skull joins onto the vertebrae (the bones of the spine) in the neck, causing fluid in the brain (called cerebrospinal fluid or CSF) to be forced down the centre of the spinal cord, where it causes the tissues to become distended and cavities to form.

 

What are the most common signs of syringomyelia?

Clinical signs or symptoms can vary widely between dogs and there is no relation between the size of the syringomyelia (cavity in the spinal cord) and the severity of the signs – in other words a dog with severe fluid build-up can have relatively mild symptoms, and vice versa. The most common symptom that develops is intermittent neck pain, although back pain is also possible. Affected dogs may yelp and are often reluctant to jump and climb. They may feel sensations like ‘pins and needles’ (referred to as hyperaesthesia). Another common sign is scratching of the neck and shoulder region called ‘phantom scratching’, as there is generally no contact of the foot with the skin of the neck. Occasionally dogs become weak or wobbly if there is significant damage to nerves within the spinal cord. Cavalier King Charles Spaniels will typically show clinical signs between 6 months and 3 years of age. Not all dogs with syringomyelia will show signs of pain or other clinical symptoms, so the presence of syringomyelia can be an incidental finding on an MRI scan or specialised X-rays, when neurological investigations are being performed.

Other neurological conditions, such as slipped discs (cervical and thoracolumbar disc disease), can mimic the signs of syringomyelia and it is important for us to rule them out before concluding that your pet is suffering from syringomyelia.

 

How can syringomyelia be diagnosed?

The best method of diagnosing syringomyelia is an MRI scan of the brain and spine. It is necessary to perform this investigation under a general anaesthetic. The scan and anaesthetic are safe procedures. In the future it is possible there will be a genetic test to identify dogs with syringomyelia.

 

How can syringomyelia be treated?

Medical therapy is usually the treatment of choice in dogs suffering from syringomyelia. Several types of medication are used to manage episodes of pain, including a drug called gabapentin. This drug is safe, with few side effects apart from possible sleepiness. Other medications that may be used include anti-inflammatory drugs, corticosteroids and drugs that reduce the production of fluid in the brain and spinal cord.
Occasionally medical management is unsuccessful and surgery needs to be considered. The aim of surgery is to improve the shape of the back of the skull and reduce the flow of fluid down the centre of the spinal cord. Many dogs will improve following surgery, although some patients will have persistent signs despite surgery, whereas others may show improvement initially but then develop recurrence of their symptoms.

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Pet of the Month – August 2017 – Harry

by admin on August 1st, 2017

Category: Pet of the Month, Tags:

Pet of the Month this August is Harry, a handsome 7 year old German Shepherd Dog. We are delighted to report that he has recovered extremely well following recent surgery for Gastric Dilatation.

 

What is gastric-dilatation and volvulus (GDV)? Is my dog at risk?

Gastric dilatation and volvulus, or GDV as it is commonly abbreviated, is a relatively common clinical syndrome seen in large / giant breeds of dog. Dilatation refers to bloating of the stomach with gas, and volvulus refers to twisting of the stomach about its axis. The cause of this syndrome is not completely understood. In fact it is quite controversial which occurs first; the bloat or the volvulus (twisting). Indeed both components do not have to occur together and some patients will develop relatively simple bloat alone. GDV is a potentially life threatening condition and emergency veterinary attention should be sought immediately if it is suspected.

 

Why is GDV potentially life-threatening to dogs?

There are a number of serious and potentially fatal consequences that occur as a result of GDV. Initially the severe distension of the stomach stretches the blood vessels over its surface reducing the blood supply to the stomach walls. This is made worse by the twisting of the stomach which also twists the blood vessels, effectively shutting off blood supply to the stomach. A lack of blood flow means there is a lack of oxygen and nutrients delivered to the stomach and waste products are not removed. As with any organ this will result in parts of it dying. This process happens very quickly and in severe cases could result in part of the stomach wall rupturing and releasing its contents into the abdomen.

The large distended stomach occupies much more space inside the abdominal cavity and compresses surrounding structures. Severe distension puts pressure on the diaphragm and interferes with the patient’s ability to breath. It also applies pressure to a large blood vessel in the abdomen (the vena cava) that normally returns blood from the back half of the body to the heart. Pressure on this vessel obstructs flow therefore reducing the amount of blood returned. If blood can’t be returned to the heart, then it in turn can’t pump it out to the rest of the body. If there is insufficient blood being pumped, the blood pressure falls dramatically making the patient weak and potentially leading to collapse.

To add insult to injury, other organs in the body such as the lungs, kidneys, liver and intestines do not receive a blood supply and begin to fail. The lack of a functional circulation also means that toxic products build up in these organs that further compromise the patient. These changes can happen in a matter of hours, emphasizing the importance of early veterinary attention.

 

What are the symptoms of GDV in dogs?

The symptoms generally include obvious distension or enlargement of the abdomen with unproductive vomiting or retching. The patient may drool excessively and appear restless or agitated. As the condition progresses the patient may become increasingly weak or even develop shock and collapse.

 

What is the treatment for GDV?

The age and breed of the patient coupled with the clinical signs of a severely bloated abdomen will make your vet highly suspicious of this condition. They will immediately place one or more an intra-venous catheters to allow administration of fluids to support the circulation and dilute toxins in the blood. They may also analyse the patient’s blood to assess the severity of organ damage.

The next stage involves attempts to decompress the stomach. This is usually accomplished by passage of a specially designed tube through the mouth down into the stomach. There is a gag that can be used to assist in this process but many patients will require sedation or anaesthesia to complete the task. It can be very challenging or sometimes impossible to perform stomach tubing. This is particularly the case when the stomach is twisted 360 degrees or more. In this instance a cannula (tube) may have to be inserted through the body wall and into the stomach to allow deflation. Deflation is clearly an imperative step because it will relieve pressure on the diaphragm and help restore blood flow back to the heart through the vena cava.

Radiographs of the abdomen are often required to help distinguish between simple dilatation and dilatation with volvulus. In the latter case surgery will be required as soon as the patient is stabilised. The aim of the surgery is to de-rotate the stomach and assess it for areas of devitalisation. If there are areas of the stomach that have undergone necrosis (died), these need to be removed surgically.

It is vital that the stomach is attached to the inside of the body wall. This is called a gastropexy and it will prevent volvulus in the future. This is essential as up to three quarters of the patients that do not have this performed will have another episode in the future. This also applies to those patients suffering with bloat alone as they have the same risk.

 

What are the risk factors for GDV in dogs?

There are several factors that have been clearly demonstrated to increase an individual’s risk of developing this condition. These include:

  • Being a purebred large / giant breed
  • Having a deep and narrow chest conformation
  • Having a history of previous bloat
  • Having a history of bloat or GDV in a first degree relative (parent or sibling)
  • Increasing age
  • Having an aggressive or fearful temperament
  • Eating fewer meals per day
  • Eating rapidly
  • Being fed a food with small particle size
  • Exercising or stress after a meal

 

What breeds are predisposed to this condition?

The breeds most commonly affected are large purebred dogs that have a narrow deep chest confirmation. Those at most risk include:

  • Great Danes
  • Gordon setters
  • Irish setters
  • Weimaraners
  • St. Bernard’s
  • Standard poodles
  • Bassett hounds

Although these are the breeds we typically see GDV in, it is worthy to remember that it can happen in any patient.

What is the prognosis?

With improved understanding of the secondary consequences of GDV and excellent anaesthesia, surgical and post-operative care now available for veterinary patients a good prognosis can be achieved for this condition. Survival rates of 73-90% would be typical. There will always be a range quoted for survival because individual patient’s circumstances in terms of severity, age, general health and treatment received will have an impact on the outcome. One important factor that has been shown to decrease the survival is the presence of clinical signs for greater than six hours. This emphasizes the importance of prompt veterinary attention in all cases.

If you are in any doubt that your dog is suffering from bloat or GDV, please call your vet immediately.

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Special Offer – August – Check a lump month

by admin on August 1st, 2017

Category: Special Offers, Tags:

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Special Offer – July 2017 – Dry Eye

by admin on July 4th, 2017

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Pet of the Month – July 2017 – Henry

by admin on July 4th, 2017

Category: Pet of the Month, Tags:

Our pet of the month is Henry who we are pleased to say has recovered fully from a severe bout of pancreatitis, which necessitated a period of hospitalisation.

 

What is pancreatitis?

The pancreas is an organ in the abdomen (tummy) which is responsible for releasing enzymes (types of proteins) to digest food. The pancreas also releases important hormones (such as insulin) into the bloodstream. Pancreatitis occurs when the pancreas becomes inflamed (tender and swollen). In most cases pancreatitis occurs for no apparent underlying reason, although sometimes it can have a particular cause (such as scavenging food). Pancreatitis most commonly affects middle aged to older dogs, but in addition, dogs of certain breeds (e.g. Cocker Spaniels and Terrier breeds) are more prone to developing the condition.

 

What are the signs of pancreatitis?

Pancreatitis can cause a variety of symptoms, ranging from relatively mild signs (e.g. a reduced appetite) to very severe illness (e.g. multiple organ failure). The most common symptoms of pancreatitis include lethargy, loss of appetite, vomiting, abdominal pain (highlighted by restlessness and discomfort) and diarrhoea.

 

How is pancreatitis diagnosed?

The possibility that a dog may be suffering from pancreatitis is generally suspected on the basis of the history (e.g. loss of appetite, vomiting) and the finding of abdominal pain on examination by the veterinary surgeon. Because many other diseases can cause these symptoms, both blood tests and an ultrasound scan of the abdomen are necessary to rule out other conditions and to reach a diagnosis of pancreatitis. Although routine blood tests can lead to a suspicion of pancreatitis, a specific blood test (called ‘canine pancreatic lipase’) needs to be performed to more fully support the diagnosis. An ultrasound scan is very important in making a diagnosis of pancreatitis. In addition, an ultrasound scan can also reveal some potential complications associated with pancreatitis (e.g. blockage of the bile duct from the liver as it runs through the pancreas).

 

How is pancreatitis treated?

There is no specific cure for pancreatitis, but fortunately, most dogs recover with appropriate supportive treatment. Supportive measures include giving an intravenous drip (to provide the body with necessary fluid and salts) and the use of medications which combat nausea and pain. Most dogs with pancreatitis need to be hospitalised to provide treatment and to undertake necessary monitoring, but patients can sometimes be managed with medication at home if the signs are not particularly severe. At the other extreme, dogs that are very severely affected by pancreatitis need to be given intensive care.

One of the most important aspects of treating pancreatitis is to ensure that the patient receives sufficient appropriate nutrition while the condition is brought under control. This can be very difficult because pancreatitis causes a loss of appetite. In this situation, it may be necessary to place a feeding tube which is passed into the stomach, and through which nutrition can be provided (see Information Sheet on Feeding Tubes). If a dog with pancreatitis is not eating and will not tolerate a feeding tube (e.g. due to vomiting), intravenous feeding (using a drip to supply specially formulated nutrients straight into the bloodstream) may be necessary.

 

What is the outcome in pancreatitis?

It may be necessary for dogs with pancreatitis to be hospitalised for several days, but fortunately, most patients with the condition go on to make a complete recovery, provided that appropriate veterinary and nursing care is provided. In some instances, dogs can suffer repeated bouts of the condition (called ‘chronic pancreatitis’) and this may require long term management with dietary manipulation at the forefront.

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Disc Disease in Dogs

by admin on July 4th, 2017

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Dachshunds and similar breeds such Pekingese, Lhasa Apsos and Shih Tzus, have short legs and a relatively long back. These breeds suffer from a condition called ‘chondrodystropic dwarfism’. As a result they can be prone to back problems, more specifically disc disease.

 

What are intervertebral discs?

The intervertebral disc is a structure that sits between the bones in the back (the vertebra) and acts as a shock absorber. The structure of a disc is a little like a jam doughnut with a tough fibrous outer layer (annulus fibrosus) like the dough, and a liquid/jelly inner layer (nucleus pulposus) like the jam.

In chondrodystrophoid breeds like dachshunds, the discs undergo change where the nucleus pulposus changes from a jelly-like substance into cartilage. Sometimes the cartilage can mineralise and become more like bone and show up on an x-ray. In these breeds, this change occurs in all discs from approximately one year of age and is considered part of usual development for these dogs. This change in the discs is a degenerative process and predisposes the disc to disease.

The most common type of disc disease in dachshunds and other chondrodystrophoid breeds is ‘extrusion’. This is where the annulus fibrosus ruptures and allows the leakage of the nucleus pulposus into the spinal canal. An analogy we often use is the jam leaking from a jam doughnut when it is squeezed.

 

What are the signs of disc disease in dachshunds and other breeds?

The first evidence that there might be a problem is that your dog may be in pain. This may consist of yelping and/or a hunched back and more subtle signs such as quietness and inappetence (lack of appetite). Back pain is commonly mistaken for abdominal pain.

After pain there may be mobility problems. The first thing to occur is wobbliness of the hind limbs – termed ‘ataxia’. After this, weakness can develop with the wobbliness, which is termed paresis. Subsequently, the patient may lose control of the back legs altogether and not be able to walk. If there is no movement in the hind limbs this is ‘paralysis’.

 

Will my dog need to be referred to a specialist?

Spinal disease can sometimes be difficult to manage and your dog may be referred to a specialist. At the referral clinic, your dog will be assessed by the specialist neurologist or neurosurgeon. They will test various reflexes to decide where they think the issue may be. They will perform a clinical examination which will assess for other disease processes and look for any areas of pain. One thing that is important to assess is the presence of pain sensation. We call this ‘deep pain sensation’. To assess this, the specialist will pinch your dog’s toes, usually with fingers initially but it may need to be with forceps. This is not a pleasant test to perform but it is necessary as the presence of deep pain comes with a more favourable prognosis. The loss of deep pain sensation means the prognosis is worse and without surgery is considered very poor.

 

What investigations will be performed?

After the clinical examination, we will generally have a good idea where the problem is and the next step is to confirm the diagnosis. The best way of diagnosing disc disease is with MRI (magnetic resonance imaging) or CT (computed tomography). With MRI we get detailed information about the soft tissue such as the disc itself and the spinal cord. Computed tomography uses the same technology as x-ray and provides good information about the bone and mineral structures and can tell us where the lesion is and whether or not surgery is indicated.

 

How is disc extrusion treated?

If a disc extrusion – the ‘jam out of the doughnut’ scenario – is diagnosed then we can opt for conservative care or surgical management.

Conservative care is a non-surgical management and can be considered in dogs where the signs are mild or intermittent and when there is only mild compression of the spinal cord. It can also be considered if there are concerns regarding the cost of surgery.
Surgical treatment involves making a window through the bone structures of the vertebra, into the spinal canal, a procedure called a ‘hemilaminectomy’. Once into the spinal canal, the disc material (nucleus pulposus) is removed and the spinal cord is decompressed. Surgical treatment tends to give a speedier and more predictable recovery and is often considered the treatment of choice, where indicated.

 

What is the prognosis for a dog with disc disease?

When dealing with spinal injury, particularly from disc disease, we aim for patients to achieve a functional recovery. This means the patient is pain free, is able to get around on their own (although they may still be wobbly) and able to toilet themselves unaided. Whether a patient will return to normal or whether there will be residual deficits is down to the individual.

The prognosis for patients who have intact deep pain sensation is favourable, with most patients (80-90%) achieving a functional recovery. In patients without deep pain sensation, the prognosis is guarded, with only 50% of cases achieving a functional recovery but without surgery the prognosis for a functional recovery is approximately 5%.

Surgery tends to speed recovery and aid early pain control. We expect most patients to recover within the first 2 weeks after surgery, with a smaller number of patients taking longer (2-6 weeks). If there is no improvement after 6 weeks the prognosis becomes more uncertain and long term disability may be present. This occurs in approximately 1 in 10 patients.

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Pet of the Month – June 2017 – Louie

by admin on June 1st, 2017

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This June our Pet of the Month is Louie.

Almost 3 years ago he was discovered to have Atrioventricular Insufficiency (AVVI) during a routine investigation for an episode of acute pain, and has been managing very well since that time with appropriate medication.

 

Overview

AVVI is a degenerative disease that damages heart valve leaflets as it progresses. This damage prevents heart valves from closing properly, allowing blood to leak backward into the atrium. This leakage eventually results in a heart murmur detectable via auscultation with a stethoscope. Valve leakage impairs cardiac function and circulation, ultimately leading to congestive heart failure (CHF).

Estimates indicate that 10% of all dogs seen in primary care veterinary practices have heart disease.  As dogs age, the prevalence of heart disease reaches more than 60%.

AVVI, the most frequent cause of CHF in dogs, is a slowly progressing disease. The prevalence of this disease gradually increases with age. AVVI affects:

    • 10% of dogs 5 to 8 years of age
    • 20% to 25% of dogs 9 to 12 years of age
    • 30% to 35% of dogs over age 13 years

This increase is especially dramatic in small breeds, with up to 85% showing evidence of valvular lesions by 13 years of age.

Video: https://www.youtube.com/watch?v=7WsT-iKe5vo

AVVI occurs most often in small- to medium-sized breeds of dogs.  Breeds most susceptible to AVVI include the Boston Terrier, Cavalier King Charles Spaniel, Chihuahua, Miniature Pinscher, Miniature and Toy Poodle, Pekingese, and Pomeranian.  Ultimately, all small breed dogs are at risk for CHF due to AVVI.

 

Management

When it comes to managing canine congestive heart failure (CHF) with the goal of improving and extending life, time matters. Though the early stages of heart disease can progress slowly, once clinical signs appear, immediate treatment is needed.

In fact results of recent longterm studies show that the early administration of appropriate medication to dogs with mitral valve disease who have echocardiographic and radiographic evidence of cardiomegaly (heart enlargement) results in prolongation of the preclinical period (period before any illness is evident) by approximately 15 months, which represents substantial clinical benefit.

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Special Offer – June 2017 – Microchip Offer

by admin on May 30th, 2017

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Mycoplasma in Poultry

by admin on May 30th, 2017

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The ‘Head Cold’ of the Poultry World

As more and more pet owners are keeping poultry we felt it appropriate to look at one of the most common infections that may be seen.

The main culprit of Mycoplasma infection in backyard poultry is Mycoplasma gallisepticum. This is one of the organisms that makes up the colloquially-termed ‘chronic respiratory disease syndrome’ (potentially in association with Infectious Laryngotracheitis) in poultry worldwide. It is considered to be responsible for some of the greatest economic losses throughout commercial flocks around the globe, but can just as easily impact on smaller backyard flocks.

 

Who catches Mycoplasma, and how?

Poultry, including chickens and turkeys, are most often presented with respiratory issues involving Mycoplasma gallisepticum, but a wide range of other birds including pheasants and wildfowl can be affected.

Mycoplasma gallisepticum can be spread vertically (from hen to egg) leading to infected chicks, or, and perhaps more commonly, through horizontal transmission (bird to bird). The disease can be spread short distances through the air as an aerosol, or on shoes/water drinkers/feeders. The disease itself may remain dormant within the infected bird for potentially months before causing any overt clinical disease. It is often at this stage that rapid spread of the disease occurs throughout a flock.

 

What does Mycoplasma in poultry look like?

Focusing on the presenting signs of poultry, the degree of clinical signs can vary widely from no apparent signs up to the potential death of the bird in more aggressive, complicated disease development.

The more common presenting signs can include:

  • Rales (clicking, rattling, or crackling noises)
  • Coughing
  • Nasal discharge
  • Discharge from around the eyes
  • Swelling under the eyes

In more advanced cases, sinusitis may become apparent.

There may also be more generic signs of illness present including the birds appearing fluffed up, off food, keeping themselves away from the rest of the flock and reduction in egg production or going off lay completely.

Clinical signs are often quicker to develop and more severe in turkeys than chickens.

 

Can Mycoplasma in poultry be treated?

Mild to moderate disease can be treated successfully with appropriate antibiotics prescribed by your vet, pain relief and good nursing management (TLC!). It is important to note however that once your bird/flock has suffered from the disease, it likely to circulate and be present from thereon in. This becomes an important factor when either bringing in new birds or selling/moving your own birds.

Chickens, as well as most other birds, will suffer a much more marked immune ‘crash’ when stressed in comparison to other animals. This means that when birds are moved to a new location or mixed with other birds, the stress can induce a marked reduction in their active immunity causing a rapid onset of disease symptoms (sneezing, coughing, etc.).

Due to the risk of disease spread amongst new birds, it is absolutely vital to quarantine any incoming birds for at least 3-4 weeks to ensure that you are not putting your own birds at risk of disease.

 

Prevention is better than cure!

Vaccinations are available against certain strains, but use of a vaccine must be with caution as quarantine procedures would still always be advised, and any new birds bought in would have to have been vaccinated. The danger with vaccinating poultry is that all too often it is seen as an easily-achievable blanket cover for disease. Good biosecurity, involving washing boots, is important. Always thoroughly disinfect items that are brought in or taken off the holding containing your particular birds.

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Pet of the Month – May 2017 – Bob

by admin on May 1st, 2017

Category: Pet of the Month, Tags:

Bob is one of many cats we attend who suffers from IBD (Inflammatory Bowel Disease).

IBD is not a single disease but a group of chronic gastrointestinal disorders caused by an infiltration of inflammatory cells into the walls of a cat’s gastrointestinal tract. The infiltration of cells thickens the wall of the gastrointestinal tract and disrupts the intestine’s ability to function properly. IBD occurs most often in middle-aged and older cats.

 

How is IBD diagnosed?

Symptoms of feline IBD are not specific. They may include vomiting, weight loss, diarrhea, lethargy and variable appetite. The symptoms of IBD can vary depending on the area of the digestive tract affected.A definitive diagnosis of feline IBD can only be made based on a microscopical evaluation of tissue collected by means of an intestinal (or gastric) biopsy.

 

How is IBD treated?

The treatment of IBD usually involves a combination of change in diet and the use of various medications. There is no single best treatment for IBD in cats. Your veterinarian may need to try several different combinations to determine the best therapy for your cat.

Hypoallergenic diets are usually tried first. Corticosteroids like prednisolone may be used to reduce inflammation of the gut. Antibiotics such as metronidazole are commonly used.

 

What does the future hold for a cat with IBD?

IBD is a chronic disease. Few cats are actually cured. Symptoms of IBD may wax and wane over time. IBD can often be controlled such that affected cats are healthy and comfortable. Vigilant monitoring by the veterinarian and owner is critical.

We are very pleased to report that Bob has responded well to dietary management and is currently not requiring additional medication. Luckily he is not adept at hunting and so we have no fear that he might upset the illness through illicit snacks!

Bob

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