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Pododermatitis

by admin on August 1st, 2018

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What is pododermatitis?
Pododermatitis is a term used to describe inflammation affecting the skin of the feet. It often causes dogs to have swollen, red and itchy feet, which can progress to painful sores if left untreated. In very severe cases, dogs can even become lame. This is a relatively common skin problem in dogs and can be present on its own or as part of a more widespread skin problem. There are many causes of pododermatitis and in some patients more than one cause is present at the same time. It is important to obtain an accurate diagnosis so that the right treatment can be selected.

What causes pododermatitis?

Parasites
The parasitic mite Demodex can infect the haired skin of the feet and result in pododermatitis. Demodex mites are present in very low numbers in the skin of all dogs, but in some patients, either due to a genetic susceptibility, or due to a process that lowers the immune system, these mites can populate the skin in very large numbers causing disease. Pododermatitis due to these mites tends to result in hair loss, swelling and bleeding sores in some cases. This mite is not infectious to other animals or people, but requires specific treatment to reduce mite numbers down to normal levels again. Very rarely, other parasites can also contribute to pododermatitis.

Foreign bodies
Foreign bodies like grass seeds are a very common cause of pododermatitis in dogs. Foreign bodies tend to penetrate the skin of the feet when dogs are out walking/running and then trigger inflammation when they become trapped within the feet. The body often attempts to ‘expel’ these structures resulting in painful and often discharging lumps between the toes. Affected patients often lick and chew at the affected sites. Foreign bodies are particularly likely when one lesion is present on one foot.

Allergies
Allergic diseases in dogs and cats are very common, and results in inflammation in the skin. This inflammation is very commonly seen affecting the feet, and results in redness, excessive licking and chewing at the affected sites. The most common triggers for allergic pododermatitis are food items and environmental substances such as dust mites and pollens, and skin disease usually starts in early life between the ages of 6 months and 3 years.

Deep infections
A very common feature of pododermatitis, particularly in dogs, is a deep infection of the feet. This is usually due to bacteria, but can be due to rare fungal organisms, and often results in multiple painful, swollen and discharging lumps. Affected animals usually lick and chew excessively and can become lame in severe cases. Bleeding lesions are relatively common with deep infections.

Conformation
A frustrating cause of pododermatitis is termed conformational pododermatitis. This usually occurs in heavy set dogs with excessively splayed feet. This results in weight bearing on hairy parts of the foot adjacent to the footpads and triggers inflammation of the hair follicles. Over time, this inflammation damages the hair follicles and results in chronic inflammation with the feet. Dogs with this condition tend to have large areas of pad extension, with painful and swollen lumps around the toes.

Hormonal diseases
Certain hormonal diseases can also be involved in the development of pododermatitis as the local skin immune system is reduced and the ability to fend off infections is compromised. The most commonly involved diseases include an underactive thyroid gland (hypothyroidism) or overactive adrenal glands (Cushing’s disease). However, pododermatitis is a relatively rare symptom of these diseases and dogs and cats usually show other more characteristic symptoms.

How is pododermatitis diagnosed?
Diagnosis of pododermatitis can often be achieved following a thorough evaluation of the history and clinical signs. Hair plucks and skin scrapings are performed to diagnose Demodex mite infestation and swab samples are often taken to establish if an infection is present. If lumps are discharging fluid, a sample of this fluid may also be sent to a laboratory to grow (culture) any infectious organisms. If the clinical picture is very suggestive of a foreign body, X-rays may be needed along with a surgical procedure to remove the offending item. Allergies are often only diagnosed once infections/parasites are treated and removed. If redness and inflammation remain, allergy testing may be required. Hormonal diseases are often suspected if other clinical signs are present but usually require blood testing to diagnose. Conformational pododermatitis is usually diagnosed by examining the feet and assessing the shape (conformation) of the footpads.

What are the treatments available?
Treatments for pododermatitis vary depending on the underlying cause. Parasitic infestations are usually treated with dips/rinses for the feet. Deep infections are often treated with long courses of antibiotics or antifungal medications in the rare cases due to fungal infection. Foreign bodies are best treated by identifying the foreign body and removing it in a minor surgical procedure. Hormonal diseases require treatment specific to the condition, but sometimes involve supplementing with hormone, as is the case in hypothyroidism. Allergic diseases are treated by identifying the triggers and removing them if possible.
Conformational pododermatitis is perhaps the most difficult to treat, as the defect is due to the conformation of the patient. Many of these cases can only be managed rather than cured and require modifications such as protective boots, good foot hygiene and avoidance of rough and uneven terrain. In some of the very worst cases, conformational pododermatitis can be corrected with surgery to fuse the toe webs together.

What is the prognosis?
As there are numerous causes of pododermatitis and more than one can be present at the same time, a good prognosis depends on identifying all the contributing factors and correcting them if possible. If this can be done, the vast majority of cases will have a good outcome. Cases of conformational pododermatitis are rarely cured, and require long term management.Pododermatitis

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Recurrent Corneal Ulcers (Indolent Ulcers)

by Hannah Wright on July 9th, 2018

Category: News, Tags:

What is the cornea?
The cornea is the clear window of the eye. It is a delicate structure which is less than a millimetre thick. In order to be transparent, the cornea has no blood vessels. It consists of three layers which are arranged like those of a sandwich. The three layers comprise: 1) the epithelium – this is the thin outer ‘skin’ of the cornea;  2) the stroma which is the much thicker middle layer of the ‘sandwich’;  3) the endothelium – this is the inner layer of the cornea and is very thin indeed (only one cell thick).

What is a corneal ulcer?
Any injury involving the cornea can be described as an ulcer. Generally, corneal ulcers are described as superficial or deep, depending on whether they just involve the outer skin (the epithelium), in which case they are called superficial ulcers or erosions – or whether they extend into the middle layer (the stroma), in which case they are called deep ulcers. The attached image shows the use of a dye called fluorescein which will stain ulcers and show up the defect. Most superficial ulcers heal rapidly as the cells of the surrounding outer ‘skin’ (the epithelium) slide and grow into the defect. The new skin that grows then sticks to the tissue underneath. Most superficial ulcers will have healed within a week.

How do I notice that my dog has an ulcer?
The cornea is sensitive because it has a lot of nerve endings, and ulceration is usually associated with quite marked discomfort because the nerves are exposed. Signs of eye discomfort include weeping, blinking, squinting, pawing at the eye and general depression.

What makes an ulcer indolent?
An indolent ulcer is an ulcer which fails to heal in the expected time. It then tends to cause ongoing discomfort and irritation. Eyes affected with indolent ulcers try to grow a new surface skin over the defect, but the incoming cells fail to stick down onto the layer underneath (the stroma). As a result, a thin layer of loose tissue can often be seen surrounding the ulcerated area. The reason why the cells fail to stick is not fully understood but is believed to be mainly because the epithelial cells fail to form tiny ‘feet’ that normally hold on to the tissue underneath.

Are certain breeds predisposed to develop indolent ulcers?
Certain breeds are predisposed to develop indolent ulcers – Boxers, Corgis, Staffordshire Bull Terriers and West Highland White Terriers are often affected. However, any dog can develop an indolent ulcer, and older patients are more commonly affected. Once a dog has suffered an indolent ulcer in one eye, it may develop one in the other eye, or recurrence of ulceration in the first eye. This can happen at any time after the first ulcer (sometimes years later).

What treatment options are available if my dog has an indolent ulcer?
It is not possible to achieve healing of indolent ulcers with the use of antibiotic or false tear ointments alone. In order for healing to occur, it is important that all loose tissue is removed and that the exposed stroma is treated and ‘freshened up’ to allow adhesion of new epithelial (‘skin’) cells. The process of removal of loose epithelium is called ‘debridement’ and in most patients it can be carried out with the use of local anaesthetic drops in the eye. Diamond Burr Debridement is the gold standard although other methods may be employed. Following the debridement, the exposed stroma is sometimes abraided with small dot-like scratches using a fine needle to allow the ‘feet’ of the new cells to take hold. The latter procedure is called a ‘punctate’ or ‘grid’ ‘keratotomy’.

In very fractious patients, it may be necessary to give a sedative to perform these procedures. More severe and longstanding cases require more radical treatment under a general anaesthetic. In this instance all diseased epithelium and some of the underlying stroma is removed. This procedure is carried out under the operating microscope with a sharp knife. The operation has a high success rate but is not suitable for every case.

What care will be required following debridement and cautery?
Usually, a broad spectrum antibiotic will be dispensed to be applied three times daily to help to prevent infection. In some cases, it may be necessary to give a drug (atropine) which widens the pupil and reduces pain associated with the ulcer. Often patients with an indolent ulcer will receive a painkiller which is given with food. In some patients, the pain associated with the ulcer appears more severe than in others.

How does the eye appear during healing of the ulcer?
In some patients, healing of the ulcer occurs fast and the cornea will only be slightly cloudy during treatment. However, in patients where healing of the ulcer is slow, it is common to find that blood vessels grow into the cornea and that pink granulation tissue forms to cover the defect. During this time, the eye may appear very red and odd looking. However, once the defect is fully covered, the granulation tissue will gradually clear over a period of months, leaving only minor corneal scarring in the majority of cases. Vision in most patients will return to normal or near normal after an episode of indolent ulceration.

How long does an indolent ulcer take to heal on average?
With a single treatment of debridement and cautery, approximately 80% of indolent ulcers heal within one to two weeks. The remaining 20% may require more than one treatment and, on occasions, it can take several weeks until full healing of an indolent ulcer is achieved.

The option of surgery for an indolent ulcer may have to be reconsidered if it fails to heal after several attempts at debridement  and/or keratotomy.

What complications can occur if my pet has an indolent ulcer?
The biggest concern is certainly the possibility of infection. This can occur even if a suitable broad spectrum antibiotic is used on a preventative basis. If infection occurs, indolent ulcers may become deep and may require urgent surgical intervention.

Until healing of the indolent ulcer is achieved, it is advisable that the patient returns to the surgery to ensure satisfactory progress. Once the ulcer has fully healed, patients should not require frequent veterinary attention and a return will only be necessary in selected cases or if the problem recurs in either eye.

 

Corneal ulcer

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Healthcare advice for pets travelling abroad

by admin on June 1st, 2018

Category: News, Tags:

When taking your pet abroad it is important to realise that there are potential disease risks which need to be considered. Animals from the UK will have no natural immunity to several diseases which are common in Europe and elsewhere.

The four main disease risks are Leishmaniasis, Babesiosis, Ehrlichiosis and Heartworm. All are potentially life-threatening and so must be carefully considered before travel. These diseases are all transmitted to pets when they are bitten by an infected insect (an insect which spreads a disease in this way is known as a vector). Different insects, or vectors, spread different diseases. With the exception of Heartworm, the only way to protect your pet from catching the disease is to prevent it being bitten by the vectors. Therefore, it is useful to know the feeding habits of the vectors and where they are likely to be found. The tables below give information about these diseases and their insect vectors.

The lists of geographical areas mentioned in the tables are not exhaustive. Also, high-risk times of day or year may be noted in the tables, but vectors will also feed outside these peak times. These diseases principally affect dogs, but cats may also be affected.

Whenever you are travelling abroad with your pet it is sensible to seek the advice of a local veterinary surgeon with regard to preventative health, as he or she will best know the local disease risks. If your pet falls ill while you are abroad you should seek veterinary assistance as soon as possible. It is worth finding out about local vets in the area before travelling, especially if the language is going to be a problem.

Should your pet fall ill after you have returned to the UK, do remember to mention to your veterinary surgeon that your dog or cat has travelled or lived abroad, even if it was years previously, as some of these diseases can take many years to emerge.

Leishmaniasis:

Cause of Leishmaniasis

  • Protozoal Parasite

Vector

  • Phlebotomine Sandfly

Where do Sandflies live?

  • Woods and gardens (not beaches!)
  • Mediterranean countries and islands

Feeding activity of Sandflies

  • Potentially any time of day
  • Peak activity May to October

Prevention of bites

  • Do not allow dogs to sleep outside. Sandflies enjoy similar cool resting places to dogs!
  • Allowing animals to sleep upstairs may reduce bites, as Sandflies have limited flight
  • Environmental insect repellents – e.g. coils and plug-ins
  • Scalibor repellent collar for dogs or Advantix

The speed of onset of illness

  • It may take up to 6 years for signs to develop after an animal has been bitten

Clinical signs of illness

  • Chronic or recurrent weight loss, skin and eye lesions, lameness and enlarged lymph nodes

Treatment

  • Variable success of treatment

Special considerations

  • Zoonosis (i.e. it can potentially be passed to humans)

Babesiosis:

Cause of Babesiosis

  • Protozoal parasite of the red blood cell

Vector

  • Tick

Where do Ticks live?

  • Forest and rough grazing including campsites!
  • France, Southern Europe but as far north as Belgium, Germany and the Netherlands

Feeding activity of Tick

  • Especially Spring and Autumn

Prevention of Tick bites

  • Prevent tick attachment – repellent collars (Scalibor for dogs)
  • Treatments to kill attached ticks – Frontline (cats) or Advantix (dogs)
  • Daily checking and removal of ticks using Tick Hook (see note below)

Speed of onset of illness

  • Rapid onset disease is possible

Clinical signs of illness

  • Due to haemolyticanaemia (destruction of the red blood cells). Pale mucus membranes, jaundice, weakness, fast breathing, red urine, collapse, death

Treatment

  • May not be curative

Ehrlichiosis:

Cause of Ehrlichiosis

  • A rickettsial parasite in the white blood cells

Vector

  • Tick

Where is this Tick found?

  • France, Corsica, Spain, Italy and Portugal, and further north to Germany, Belgium and Holland

Feeding activity

  • As for Babesiosis

Prevention

  • As for Babesiosis

Speed of onset of illness

  • Rapid onset disease, sub-clinical infection (i.e. the parasite is in the body but does not cause signs of illness) or chronic infection (i.e. causing a slower, long term illness) are all possible

Clinical signs

  • Fever, anorexia and enlarged lymph nodes

Treatment

  • Vets most commonly prescribe the antibiotic doxycycline to treat ehrlichiosis in dogs. It is typically given once a day for three to four weeks. Other medications can also be used when the situation warrants.

If a dog receives treatment in a timely manner, his condition will usually begin to improve rapidly, often within just a day or two, and the prognosis for complete recovery is good. In more severe cases, additional treatments (e.g., intravenous fluids, blood transfusions, immunosuppressive medications, and/or pain relievers) may also be necessary.

Heartworm (Dirofilariasis):

Cause of Heartworm

  • Nematode worm found in pulmonary arteries (those in the lungs) and heart

Vector

  • Mosquitoes

Where do the Mosquitoes live?

  • From northern France south to the Mediterranean. Much of the USA and Canada
  • Hyper-endemic in the Po Valley in Italy

Feeding activity of Mosquitoes

  • Mainly at night but some species feed during the day
  • Especially from May to September

Prevention of Mosquito bites

  • Small mesh nets or window covers
  • Environmental insect repellents – coils and plug-ins
  • Scalibor repellent collar for dogs and Advantix

Prevention of disease

  • Drug prophylaxis (preventative treatment) using Milbemax tablets – start a month before exposure, then give monthly until one month after return to the UK. Where dogs may have been previously exposed, testing is required prior to treatment. Testing comprises blood tests and chest X-rays (radiographs)

Clinical signs

  • Associated with respiratory disease and heart failure

Treatment

  • Dogs with heartworm disease will initially receive treatment needed to stabilise their condition. They will then be given medication to kill circulating microfilariae, and most will undergo a series of three injections over a month’s time to kill adult worms in the heart and lungs. Hospitalisation when these injections are given, and possibly at other times, is necessary so that your vet can watch closely for side effects. Prednisolone and doxycycline are also typically prescribed to reduce the chances that the dog will react badly to the death of the worms. Other treatments may be needed based on an individual dog’s condition.

If a dog has caval syndrome, a surgical procedure will be necessary to remove adult worms from the right heart and pulmonary artery by way of the jugular vein. Most dogs with caval syndrome die regardless of treatment.

Summary General Recommendations:

Ticks
Prevent tick attachment

  • Scalibor collars (dogs)
  • Advantix spot-on (dogs)

Kill Ticks

  • Frontline (cats)
  • Advantix spot-on (dogs)

Daily check for ticks and remove any found using a Tick Hook

Sandflies and Mosquitoes:

  • Keep your pet inside at times of peak activity
  • Use meshes/netting over windows
  • Use environmental repellents
  • Scalibor collar (dogs) or Advantix (dogs)

Heartworm prevention:

  • Monthly Milbemax tablets or fortnightly Advocate
  • Start one month before exposure and continue until one month after return

Please note:
It is important to take great care when removing ticks to ensure that the mouth parts are fully removed. Failure to do so may cause an abscess or granuloma (inflamed lump) to develop. To ensure safe removal we recommend using a specially designed Tick Hook. These come with instructions for safe tick removal.

All of the above products can be supplied by our clinic. Please note that for licensed veterinary products to be dispensed, your pet needs to be under our care which may require a clinical examination if we have not seen your pet for some time.

 

Dog & Pet travel

 

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FELINE HYPERTENSION

by admin on May 1st, 2018

Category: News, Tags:

To encourage awareness of Feline Hypertension this month we are offering the owners of all cats over 8 years of age with no previous history of hypertension a FREE Screening test with one of our nurses.

Hypertension, or high blood pressure, usually occurs in cats secondary to other diseases. The most common diseases to cause high blood pressure in cats are chronic renal failure (kidney disease), hyperthyroidism and anemia. Cushing’s disease and certain forms of cancer can also cause high blood pressure.
Hypertension is a serious problem in the cat, as it can cause blindness and strokes, just as in people. The first symptom seen is usually sudden blindness from retinal detachment – the high blood pressure literally blows out the back of the eye. If retinal detachment is caught early, with prompt and aggressive drug treatment the retina will sometimes reattach itself at least partially, and some vision will be restored. Many cats, however, will be permanently blind as a result. Owners will sometimes notice the cat’s pupils are fixed and fully dilated, or only respond very slowly and sluggishly to light. This is an emergency situation which should be treated as soon as possible.

The other common symptom of untreated high blood pressure is bleeding into the brain. Cats may suddenly show signs of disorientation, circling around and around in one spot, or otherwise acting strange. Some cats will wander the house crying as if distressed.

Ideally, high blood pressure should be diagnosed and treated before the cat becomes blind or suffers brain damage. If your cat has been diagnosed with chronic renal failure, hyperthyroidism or anemia, a blood pressure check will probably be recommended as well.

Some cats with high blood pressure will have heart murmurs or abnormal heart rhythms. If your veterinarian picks up a heart murmur or arrhythmia in a cat, especially an older cat prone to kidney or thyroid disease, a blood pressure check will be recommended. We may also pick up on high blood pressure when we draw a blood sample – if the blood gushes into the syringe without our having to pull back on the
plunger, the cat’s blood pressure is probably very high.

About 65% of cats with chronic renal failure have some degree of hypertension. This is a serious problem because hypertension in turn worsens the kidney disease. It becomes a vicious cycle in which the high blood pressure worsens the kidney disease, which increases the blood pressure even more, which then worsens the kidney disease, etc. Any cat diagnosed with chronic renal disease should have a blood pressure check on a regular basis.

In cats with hyperthyroidism the hypertension is usually temporary. Once the thyroid disease is controlled with medication or radiation treatment, the blood pressure goes back down. Treatment for high blood pressure in this disease is usually only needed for a few weeks to months. Treatment is still important, however, to prevent blindness and brain damage.

Although blood pressure measuring is important to monitor, it can also be difficult to do accurately in cats. Most cats are stressed and nervous at the veterinary clinic, and some are hostile. Blood pressure readings will probably be higher than they would be if measured when the cat was at home in its own environment. If a cat is aggressive or terrified, readings may not be possible at all. We will advise you as to whether an accurate blood pressure reading is possible in your cat.

We try to make the experience as stress free as possible, in a quiet room. The measurement itself is painless, just as it is in humans, but the cat may be frightened by the procedure. The cat needs to be held still, and a Doppler monitor is used to get the measurement. The monitor makes a noise which may frighten to some cats. The feeling of the cuff on the leg also makes some cats nervous, as does being held.

The goal of treatment is to decrease the blood pressure gradually to avoid a sudden decrease in blood flow to the kidneys, which will make kidney disease worse. In cats with chronic renal failure and high blood pressure, the pressure should be rechecked every 3-7 days, depending on how good the first reading was. Once two good readings on two successive visits are obtained, the cat is considered stable on the medication. The blood pressure is then rechecked along with kidney blood testing about every three months. Drug treatment will be necessary for the rest of the cat’s life.

There are two medications commonly used to treat hypertension. Amlodipine is usually tried first. If the response is not adequate, we may switch to benazapril. Occasionally, a cat will need both amlodipine and benazapril to control the high blood pressure.

For cats with chronic renal failure but a normal first blood pressure check, rechecks are recommended every 6-12 months. Hypertension may show up later in the course of the disease, as kidney function gradually worsens with time. In cats recently diagnosed with hyperthyroidism, the blood pressure may be high. If affirmative we will prescribe a two to three week course of blood pressure medication for the cat while the thyroid level is coming down in response to treatment. Once the thyroid level is back in the normal range, the medication can usually be stopped.

Cats that have already suffered blindness or visual impairment from hypertension usually get around well in their own home with some modifications to the environment. Your cat may not be able to find its way to the basement litter tray any more but blind cats rarely stop using the tray as long as it is accessible to them. Be sure the food and water bowls are also accessible without climbing or jumping. Dabbing some perfume or cologne on table legs and doorways once a week at first with help your pet to smell where it’s going and makes navigation easier.

Be sure to call us if you have trouble administering your cat’s medication or you notice any change. We are always glad to help!

See website: http://www.amodeus.vet for further information

Blood pressure

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HOME MONITORING OF HEART FAILURE

by admin on April 3rd, 2018

Category: News, Tags:

This article provides key aspects of monitoring your pet with heart failure at home and explains the parameters to record. These need to be monitored frequently (daily) in the few weeks after initial diagnosis and commencement of medications, or at any time when things are unstable, such as a relapse or progression in symptoms. The frequency of recording can be less (weekly) when everything is stable and your pet is happy. You can record all of these using a diary or computer database. Remember to always bring your record back with you to every visit.

Sleeping Respiratory Rate (SRR)
This should be recorded when your pet has had a period of rest and is asleep. This might be by your feet or in bed. It is best to record this when your pet falls asleep when you are in the room, as opposed to going into the room where your pet is already asleep – as they usually wake up when you enter.
Breathing is often best seen when your pet is lying on the side and the chest and flank can be seen to rise and fall. A breath in and then out is recorded as one breath. The rate is given as the number of breaths in 1 minute.

Heart rate (HR) at rest:
This is more difficult to record, but it is possible to do and it provides very useful information. The heart rate when ‘in the vets’ is always somewhat elevated because of excitement or nervousness, so does not represent the real heart rate at home.
The heartbeat can be felt by placing your hand on the chest over the heart, just inside the ‘armpits’ on the left side, but can be either side of the chest. You could purchase a cheap stethoscope and learn to listen to the heart rate. Feeling the pulse in the leg does not always represent the heart rate, as some abnormal or weak heartbeats might not produce a palpable pulse, so we prefer that you do not use this method.
You could purchase a heart rate monitor, and whilst these are a little more expensive, over the course of your pet’s life, often represent good value for money. The rate is given as the number of heartbeats in 1 minute.

Weight
One of the effects of heart failure is the accumulation of excess fluid in the lungs (oedema), chest cavity (pleural fluid) or abdomen (ascites). One litre of fluid is equivalent to 1 kg in weight. Thus monitoring your pet’s body weight is a useful means to track the loss or gain in fluid accumulation.
We recommend weighing your pet weekly. It is often best to use the scales at your own vets for consistency and accuracy.

Appetite
Your pet’s appetite may reflect his/her well-being. It is a simple scoring system, comparing appetite to when your pet was well prior to this illness and is as follows:

Appetite Scores:

1 Ate hardly anything
2 Ate much less than normal
3 Ate a little less than normal
4 Normal
5 Ate very well

Exercise
Once any congestion has resolved with treatment, a return to some exercise is good for the well-being of your pet and for the circulation. The ability to exercise also reflects the ability of the heart to function and circulate blood, so it can be a useful indication of how well your pet is doing. Again this is a simple scoring system, comparing the ability to exercise to when your pet was well prior to this illness and is as follows:

Exercise Scores:

1 Can hardly exercise at all
2 Is exercising much less than normal
3 Is exercising a little less than normal
4 Normal
5 Exercises very well

Cough
Coughing is a common symptom in dogs (it is rare in cats). This can occur for a few reasons. One is that an enlarged heart presses on the windpipe, compressing it and this triggers a cough; it probably feels like something is stuck in the throat. Another is the accumulation of fluid in the lungs (oedema), this needs to be moderately severe to trig, of course,h. Then of course a dog (or cat) can be coughing secondary to various lung conditions such as bronchitis (or asthma in cats). Monitoring the frequency and severity of a cough can therefore be useful.

Cough Scores:

1 Very often, daily
2 Often, daily
3 Often, weekly
4 Occasionally, weekly
5 None

The Happiness Factor
This is a surprisingly useful overall score of how well your pet is. It is a simple scoring system, comparing how happy your pet is compared to when your pet was well, prior to this illness and is as follows:

Happiness Scores:

1 Very unhappy
2 Much less happy than normal
3 A little less happy than normal
4 Happy, back to normal
5 Really happy

AUSCULTATE DOG HEART

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What is a Heart Murmur?

by admin on March 1st, 2018

Category: News, Tags:

Hearing your vet announce that “your pet has a heart murmur” can be very daunting. However, the significance of a murmur very much depends upon the situation. Just as a fever can be something or nothing, a murmur may be similar – it may be insignificant, but it could also be a symptom of a disease that requires treatment. So, first of all, what is a heart murmur?

Simply put, a murmur is a sound produced by a squirt of blood inside the heart when it pumps. There are many causes of a murmur.

There are three sections in this information sheet:

  • Murmurs explained
  • FAQs about murmurs
  • List of the common causes of murmurs in dogs and cats

1. Murmurs explained

Murmurs due to regurgitation
Each of the four valves in the heart act as non-return valves, permitting blood flow in one direction (forwards). If a valve becomes faulty and no longer prevents backflow, then there is a resultant backward squirt of blood through the gaps in the valve with each heartbeat. This backward squirt of flow through an incompetent valve results in an abnormal heart sound called a heart murmur. A murmur thus sounds like a ‘squirting’ or ‘gushing’ sound during each heartbeat. The most common cause of an incompetent valve in older dogs is Mitral Valve Disease, or Endocardiosis, as it is also known.

Murmurs due to narrowed valves
If a heart valve is abnormally narrowed, usually due to a congenital defect (eg. Aortic Stenosis or Pulmonic Stenosis) then blood flow pumped out through the narrowed valve is pinched, resulting in an abnormal squirt of flow, ie. a murmur. This can be likened to putting a thumb over the end of a hose pipe to make the water squirt, rather than pour.

Murmurs due to ‘holes in the heart’
A murmur can also occur through a hole in the heart – the murmur is caused by the squirt of blood going through the hole. A hole between the left ventricle and right ventricle results in a squirt of blood being pushed through the hole when the heart ventricles pump (this is called a Ventricular Septal Defect (VSD)). A hole between the aorta and pulmonary artery (the two major arteries leaving the heart) results in blood squirting through the hole (this is called a Patent Ductus Arteriosus (PDA)).

Puppy murmurs
In puppies less than 6 months of age, in addition to murmurs produced by congenital defects, puppies can have innocent or benign murmurs – often called a puppy murmur. These occur due the fast flow of blood in such a small heart. As the puppy and its heart grow and mature, then the murmur gradually disappears. It is virtually impossible for a vet to discern the difference between a puppy murmur and a congenital defect. If a murmur persists beyond 6 months of age, it is more likely to be a congenital defect.

Murmurs associated with illness
A murmur can also be produced when a dog is anaemic and the blood thin. In this situation, thinner blood (less viscous) results in a faster speed of flow and thus a murmur. A similar situation can occur when a dog is ill for other reasons, such as during a fever.

2. FAQs about heart murmurs in cats and dogs

What is the significance of a murmur?
This depends upon what the cause of the murmur is from the list above, whether the defect causing the murmur is classified as: mild, moderate or severe, and whether it is resulting in heart enlargement or not.

Is the loudness of a murmur significant?
Not always. It depends upon what the cause of the murmur is from the list above. Some murmurs are innocent and of no clinical significance, whereas others are associated with defects. Many defects can be mild and have no effect on the heart and animals can live a full and normal life with them, whereas other defects affect the heart and may need some form of treatment.

Do all these murmurs sound different for each defect?
No, in fact they virtually all sound the same. The squirt (murmur) is heard when the heart beats, so the murmur is brief. The only defect that produces a slightly different sound is a PDA – the murmur is continuous rather than intermittent or brief.
Listening with a stethoscope is not easy and many vets find this difficult. As humans, we all have differing skills and abilities, so there is a lot of variation. It is likely that a veterinary cardiologist will hear murmurs better, because they have had a lot more practice and experience, as well as additional training.

What is the best way to diagnose a murmur?
Nearly always, an ultrasound scan (echocardiography) is the best way to diagnose a murmur. But sometimes additional tests are also required, such as chest x-rays, ECG or blood tests. Echocardiography is a difficult and skilled examination that is best performed by an experienced clinician.

3. List of the common causes of murmurs in dogs and cats

Defects can be congenital, meaning an animal has been born with the defect. Or there can be changes in the heart that develop in adult life, for example due to ageing degeneration of a valve.

Murmur due to Mitral Valve Regurgitation:

  • Mitral Valve Disease (MVD) is the most common cause of a murmur in adult dogs in older age
  • Mitral Valve Dysplasia is a congenital defect of the valve
  • Mitral Valve Regurgitation can occur secondary to heart enlargement of other causes in dogs
  • Mitral Valve Regurgitation can be secondary to cardiomyopathy in cats

Murmur due to Aortic Valve Stenosis:

  • Subaortic Stenosis and Valvular Aortic Stenosis is a congenital defect of the valve
  • Hypertrophic Cardiomyopathy in cats, often causes ‘Subaortic- like Stenosis’

Murmur due to Tricuspid Valve Regurgitation:

  • Tricuspid Valve Disease occurs in adult dogs in older age, most will also have MVD
  • Tricuspid Valve Dysplasia is a congenital defect of the valve
  • Tricuspid Valve Regurgitation can occur secondary to Pulmonary Hypertension
  • Tricuspid Valve Regurgitation can be secondary to heart enlargement of other causes
  • Tricuspid Valve Regurgitation, when mild, can be seen in some normal dogs

Murmur due to Pulmonic Valve Stenosis:

  • Valvular Pulmonic Stenosis is a congenital defect of the valve

Murmurs associated with holes in the heart:

  • Patent Ductus Arteriosus is a congenital defect resulting in abnormal flow between the aorta and pulmonary artery
  • Ventricular Septal Defect is a congenital defect in which there is a hole between the two ventricles

Innocent murmurs
These are murmurs due to abnormal flow within the heart and not due to a defect in the heart, ie. there is no congenital defect or degenerative disease. There are a number of causes, these are just some examples:

  • Puppy murmurs are innocent murmurs that usually disappear by 4-6 months of age
  • Anaemic murmurs are due to the blood being thin
  • Fever murmurs are due to turbulence in blood flow
  • Flow murmurs are seen in some athletically fit dogs, ie. a murmur with no defect present

Heart Valves

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Lens Luxation

by admin on February 1st, 2018

Category: News, Tags:

What is the lens?

The lens is a large transparent structure within the eye lying just behind the black part of the eye (the pupil). The lens helps to focus light onto the back of the eye. It is normally held in place by tiny threads all around its edge.

What happens in lens luxation?
In patients suffering from lens luxation (dislocation), the lens shifts out of position and moves either into the front or into the back of the eye. If the lens becomes trapped in the front of the eye, it can cause water-logging of the window of the eye (seen as blueing of the front of the eye) and an increase in pressure within the eye (glaucoma). If it falls into the back of the eye, the lens can damage the sensitive tissue at the back of the eye (the retina) and cause it to loosen (retinal detachment). This can also lead to glaucoma. In both cases, the eye is usually painful, and blindness develops unless early appropriate treatment is given.

What causes lens luxation?
Many cases of lens luxation are hereditary and caused by a weakness in the threads holding the lens in place. This condition is called primary lens luxation and is common in the Jack Russell and other terriers. It is also occasionally seen in other breeds and crossbreeds.

Some cases of lens luxation are due to other eye diseases such as cataracts, inflammation within the eye or chronically increased intraocular pressure (glaucoma). These diseases cause damage to the threads that hold the lens in place and as a result it eventually comes loose.

What are the signs of lens luxation?
In most cases of primary lens luxation, the disease develops very rapidly. In the very early stages the eye may just look slightly red and sore. These signs may be misinterpreted as simple conjunctivitis but are in fact the beginning of a potentially blinding disease. Later the patient is often depressed and reluctant to exercise.

The eye usually appears red and painful, often with a bluish tinge over the cornea. As the pressure in the eye goes up, the optic nerve at the back of the eye (which takes messages from the back of the eye to the brain) becomes damaged and blindness results.

How is lens luxation diagnosed?
Once the lens completely dislocates it is relatively straightforward to see that it is out of position in most patients. In addition, examination by an ophthalmic specialist using specialised equipment may enable a diagnosis of lens luxation to be made well before the lens actually dislocates out of position.

Is treatment possible?
Lens luxation is a serious, blinding painful condition. Although medical management of primary lens luxation is an option, in most cases surgical removal of the lens is likely to give the best chance of preserving vision. Lens removal may also be indicated if the lens has luxated as the result of other eye conditions, but each of these cases must be assessed on their individual merits.

The surgical removal of a luxated lens is an operation that should only be carried out by an eye specialist as it requires special training and skills, the use of an operating microscope and microsurgical instrumentation. The surgery also requires the use of a special muscle-relaxant anaesthetic, as the eye must be held absolutely still in the right position during the operation. During the procedure the patient’s breathing is taken over by the anaesthetist. Again, specially trained staff are required to monitor this anaesthetic.

In surgery for lens luxation, the cornea, which forms the clear window at the front of the eye, is incised and the luxated lens is gently removed. The inside of the eye is coated with special gel during the procedure to help to protect its delicate structures. Some of the natural jelly at the back of the eye (the vitreous) also needs to be removed during the operation, and this is performed using highly specialised mechanised equipment. The wound is stitched with suture material finer than a hair. The stitches dissolve over a period of weeks after the surgery.

Following surgery, intensive medical treatment is required, and several re-examinations are necessary to give the best chance of a successful outcome.

Will my pet cope without a lens?
Most pets cope well without a lens but will need a while to adapt to the new vision. Most dogs without lenses are able to avoid bumping into objects, and many can still chase a ball.

Success chances and possible complications
The chance of a successful outcome depends in part upon the duration of the problem prior to presentation and also whether the lens is completely dislocated at the time of surgery. In early cases, the outcome of surgery can be very satisfactory, but in longstanding cases, the success chances are significantly reduced.

Unfortunately, blinding complications are seen in a significant percentage of cases – up to 30% or 40% depending upon the condition of the eye and duration of the problem by the time of surgery. These complications include persistence of glaucoma, bleeding into the eye and retinal detachment.

Even after successful surgery which has saved vision, it may be necessary to continue with long-term medication, especially to keep the pressure in the eye under control. This may in turn require patients to be returned for check-ups from time to time.

Does the condition affect both eyes?
Yes, unfortunately, primary lens luxation affects both eyes, although not necessarily at the same time. However, there will often be early signs of partial dislocation of the lens in the second eye at the time that the first eye is noticed to have a problem. Without treatment, the second lens will then usually dislocate within a few months of the first, and the natural progression of patients with this condition without surgery is to become blind in both eyes. Glaucoma then usually develops, and this not infrequently means that one or both eyes may need to be removed in order to relieve pain.

Is preventative treatment available for the second eye?
Yes, especially in cases of primary lens luxation. If the earliest signs of lens instability (subluxation) are detected at the time that the first eye is affected then the lens may be surgically removed. Early removal of unstable lenses carries the best chance of long-term success. In early cases, it may be possible to perform the surgery through a smaller incision using specialised equipment, and this, in turn, helps to give a better prognosis.

What happens if vision is irreversibly lost in an eye with a luxated lens?
Eyes that have lost vision irreversibly due to lens luxation are not suitable for lens removal. Because many eyes with lens luxation are painful, it may be necessary to consider removal of the eye under these circumstances.

What happens if an eye needs to be removed?
Eye removal is generally only recommended if the eye is painful and blind and the pain cannot be readily controlled with medication. The thought of an eye being removed may be alarming at first, but it is important to realise that this will generally make the patient feel much more comfortable and much happier very quickly. The hair is clipped at the site of the operation but soon grows back, and this then leaves hairy skin where the eye used to be. There is no hole left behind, and the result is cosmetically perfectly acceptable. And of course our patients don’t look at themselves in the mirror and worry about their appearance, they just feel more comfortable and get on with life!

Lens luxation

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Cystitis in Cats

by admin on December 6th, 2017

Category: News, Tags:

What is special about cystitis in cats?
Unlike dogs and people, cystitis in cats is frequently caused by stress rather than by an infection.

Whilst cystitis in female cats is painful and upsetting, it can actually turn into a life-threatening condition in tom cats if the urethra (the way out of the bladder) is blocked up by swelling, blood clots or crystals. Those cats are absolutely unable to pass urine, which leads to the bladder overfilling.  This in turn causes back-pressure which can ultimately lead to kidney failure and collapse. Any male cat that seems unable to pass urine should be seen by a veterinary surgeon immediately.

Why do cats get cystitis?
There are a number of possible causes of cystitis, but the majority of young cats which develop  cystitis do so as a result of stress. Sometimes an obvious reason for the underlying stress can be identified, such as the house being decorated or another cat or a dog moving in, but often it is difficult to recognise the actual cause of the stress. Once cats have developed this type of cystitis, they are very prone to having further bouts of it in the future and in some cases management of some variety is necessary to prevent further episodes.

A smaller proportion of cats, especially elderly individuals or those with chronic problems, such as kidney disease, develop cystitis due to infection, generally by bacteria.
There are several other reasons why cystitis may develop, and these include bladder stones, tumours or toxic cystitis. Such cases are uncommon, however.

What are the clinical signs of cystitis?
All types of cystitis have similar clinical signs, not all of which are necessarily observed in every case:

  • Frequent visits to the litter tray
  • Passing very small amounts of urine on the litter tray or even being unable to pass anything at all
  • Accidents in the house or urination in inappropriate places
  • Bloody urine
  • Painful urination – some cats cry when urinating
  • Some cats are restless or seem off colour

How is the disease diagnosed?
The clinical signs are very often already suggestive of cystitis. To rule out other causes and to identify which type of cystitis is affecting your cat, a general physical examination and also further tests, such as a urine analysis, are usually necessary. In some cases blood tests, radiographs/ultrasound examination or other tests may be required, too.

A male cat that is unable to urinate due to complete blockage of the bladder needs to be treated as an emergency.

How is cystitis in cats treated?
If stress-related cystitis is diagnosed, the treatment usually consists of pain relief, relaxation of the cramped bladder muscle and glucosamines, which seemed to soothe the sore inside layer of the bladder. We also strongly advise that cats which are prone to cystitis are fed only on wet food. This is an exception to the general rule, as we usually recommend feeding cats and dogs on dry food. However, we know that the overall water intake for the patient is better when wet food is given, and a slightly more dilute urine can help to prevent further episodes of cystitis. If possible, small amounts of water can be added to the wet food or the cat may be encouraged to drink by flavouring the drinking water with small amounts of something tasty e.g. salt-free chicken broth or tuna. Anything that increases the water intake in such cats is beneficial.

Male cats that are unable to pass urine often need much more intensive treatment. Usually such patients need an emergency general anaesthetic to allow us to unblock the bladder and achieve urine flow. In some cases, especially if the problem has been overlooked for a little while, intensive care may be necessary for several days and unfortunately not all cats with this condition manage to pull through.  The earlier the condition is treated, the better.

My cat has cystitis – what is the outlook?
While some cats only ever have one episode of cystitis in their life, once a cat has developed stress-related cystitis he or she is prone to develop further episodes when stressed. It is advisable always to feed such cats on wet food and encourage drinking as much as possible. It is also important to monitor such cats closely – this applies especially to tom cats as they are prone to becoming blocked.  In some cases ongoing management or medication is required.

Can dogs get this type of cystitis?
Dogs do not get the stress-related type of cystitis which we see in cats. They certainly can develop cystitis, but it is usually due to an infection or other underlying cause.  The signs of cystitis in dogs are similar to those in cats (see above), and if you become aware of such symptoms, you should seek veterinary advice at an early stage.

Cat

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Zoonoses

by admin on December 2nd, 2017

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What is a zoonosis?
A zoonosis is a disease which can be passed between animals and humans.

The following information sheet is designed to give an overview of some common or important diseases which can be passed from cats and dogs to humans, however, the list is not exhaustive.  Conditions which can be passed to humans from other domestic or exotic species are not included.  In general, these diseases are of most significance to immuno-compromised people.

What does immuno-compromised mean?
People who are immuno-compromised have immune systems which may not work very well.  This group would include the very old and very young, people recovering from severe illness or surgery, people with AIDS/HIV and people on chemotherapy drugs.

What skin diseases can be caught from cats and dogs?
Humans can be bitten by cat and dog fleas. The bites are seen as small, red, itchy lumps very often on the lower legs/ankles. It is important to keep cats and dogs regularly treated for fleas using a veterinary prescribed flea treatment. If humans are being bitten it is likely that the environment is infested, so the whole home should be treated as well. Make sure you follow any care and safety instructions when you spray your home.

Ringworm (dermatophytosis) is not a worm at all but a fungal infection of the skin. Many species of animals can carry this infection. It is often seen as patches of hair loss and scaling of the skin on cats and occasionally dogs. When humans pick up ringworm they develop red and often circular patches on their skin. This condition is treatable for both humans and pets.

Humans can also become irritated by mites that they acquire from their pets e.g. ‘fox mange’ (Sarcoptes scabei) and ‘walking dandruff’ (Cheyletiella). Infections in humans are usually self-limiting but it is advisable to visit the doctor. Cats and dogs can be treated under veterinary care after diagnosis in their owners.

Can worms affect humans?
We strongly recommend that pet cats and dogs are regularly wormed. Cat worms are currently not thought to cause problems for human health but we are not certain about this. Toxocara canis is a common round worm of dogs. If children are infected by this worm, the larva can occasionally ‘get lost’ on migration within the body and cause damage to the eyes, brain and elsewhere. Monthly worming of dogs with a good quality round wormer will prevent dogs becoming infected and spreading the worm.

Echinococcus granulosus is a dog tapeworm which also causes problems when larva ‘get lost’ on migration in the body, but this worm is thankfully only found in limited habitats (certain areas of Wales and the Hebrides). Hookworms (Ancyclostoma) which are passed occasionally in dog faeces can cause skin irritation when people have close contact with contaminated soil. Fortunately the condition is easily treated.

My pet has a tummy up-set can I catch anything from it?
Hand washing and basic hygiene should always be used when clearing up after a pet, especially when they have vomiting or diarrhoea. Giardia, Campylobacter, Salmonella and E. coli are just some of the infections which may be passed on to humans. If these bugs are suspected we will test for them but sometimes infections are not obvious, so care should always be taken in clearing up pets’ faeces.

I am pregnant, are there any specific zoonoses I should be concerned about?
Toxoplasmosis is of particular concern for pregnant women. This is a common single-cell parasite which only causes mild flu-like symptoms in most affected people – however, it can be critical to the health of both mother and fetus if a pregnant woman is infected. Many species of animal can be affected by toxoplasmosis, but only cats, the primary host, can spread the disease. When the spores pass out of the cat in its feces they are inactive. It takes about 24 hours of contact with air for the spores to become active or infective. This means that direct handling of an animal is not a great hazard, but pregnant women should not handle cat faeces or the litter tray. The greatest risk factors for Toxoplasmosis are gardening (i.e. handling soil), unwashed fruit and vegetables as well as undercooked meat. However, it is always recommended that pregnant women are especially careful to wash their hands after touching animals and before handling food. If you have any concerns about zoonoses during pregnancy you should discuss these with your midwife or doctor.

Can I catch Weil’s disease from my dog?
Weil’s disease is the severe human form of leptospirosis. This is an uncommon disease in humans and it is very rare for it to be passed by pet dogs. However, if a dog is affected its urine can be infective to humans. Both dogs and humans most commonly catch leptospirosis from stagnant or slow-moving water (specifically that which has been contaminated with rat urine). The disease causes sudden kidney and liver failure. We strongly recommend that dogs are vaccinated against leptospirosis annually. Care should be taken when handling dogs’ urine and, if leptospirosis is suspected, handlers should wash their hands and ideally wear gloves.

What should I do if I am scratched or bitten?
Cat and dog bites can be very serious. Wash all bites liberally under running water and always seek medical advice from your doctor as antibiotics are often required. There may also be legal implications if a dog has bitten a person – please see the UK Government website.

Cat scratches can also be nasty. All scratches should be thoroughly washed. Any scratch which becomes inflamed or painful should prompt a visit to a doctor. There is a bacterium which some cats have in their saliva and on their claws called Bartonella henselae which causes ‘cat scratch disease’ in humans – symptoms include swelling at the site of infection, fever, and swollen glands. Treatment may be required, especially in immuno-compromised patients.

If you have any queries concerns about your dog or cat and Zoonoses, please do not hesitate to contact us.

unnamed-1

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Lymphoma in Dogs

by admin on November 1st, 2017

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What is lymphoma?

 
Lymphoma is a cancer of the lymphatic system. The lymphatic system is, amongst other things, involved in immunity and fighting infections. Lymphoma arises from cells in the lymphatic system called lymphocytes which normally travel around the body, so this form of cancer is usually widespread. Lymph nodes (sometimes called lymph glands) are part of the lymphatic system and are located all over the body. Lymphoma can affect some or all of the lymph nodes at the same time. It may be possible to feel or see affected lymph nodes that are near the body surface (as shown in the picture) – they usually feel big and firm. Lymph nodes deeper inside the body are also often involved, as well as internal organs such as the liver, spleen, and bone marrow. This widespread involvement is not like tumour spread in other types of cancer.

 
Lymph nodes you can feel:
1 Submandibular: under the jaw
2 Prescapular: in front of the shoulder
3 Axillary: in the armpit
4 Inguinal: in the groin
5 Popliteal: behind the knee

 

What tests will my dog have?

The diagnosis of lymphoma is usually confirmed by taking a sample from a lymph node, either by fine needle aspirate or biopsy. Fine needle aspirate of a superficial lymph node is a quick, simple procedure using a needle (similar to those used for booster injections) to collect cells from the node. It causes minimal discomfort and is normally carried out while a patient is awake or under mild sedation. In some cases we need to take a biopsy, involving the removal of a larger sample of tissue – this may be carried out under a general anaesthetic. These tests allow a very accurate assessment of the tumour by a specialist looking at the samples under a microscope.

To allow evaluation of internal lymph nodes and organs, patients usually have X-rays and an ultrasound scan. Mild sedation is usually required for these procedures, as we need our patients to be very still. Blood sampling is also performed to assess a patient’s general health status.

In some cases we will recommend taking samples of bone marrow to investigate whether or not cancer cells are present in the bone marrow. This procedure is carried out under a short general anaesthetic.

All the diagnostic information we obtain allows us to give an accurate prognosis and to discuss appropriate treatment options.

 

Can lymphoma be treated?

The simple answer is yes. It is very uncommon for lymphoma to be cured, but treatment can make your dog feel well again for a period of time, with minimal side effects. This is called disease remission, when the lymphoma is not completely eliminated but is not present at detectable levels.

Without treatment, survival times for dogs with lymphoma are variable, depending on the tumour type and extent of the disease, but for the most common type of lymphoma the average survival time without treatment is 4 to 6 weeks. With current chemotherapy regimes such as the so-called Madison Wisconsin protocol, the average survival time is approximately 12 months.

Treatment options will be discussed in detail on an individual patient basis. Options include:
 
Steroid treatment (Prednisolone):
By itself, this increases average survival times to 1 to 3 months, but it does not work in all cases. It will also make subsequent treatment with chemotherapy less successful.

 
Chemotherapy:
using medications to stop or hinder cancer cells in the process of growth and division.

 

What does chemotherapy involve?

 
On each treatment day, before receiving chemotherapy, your pet’s progress is discussed, together with us performing a full physical examination and blood tests. Following this assessment, chemotherapy doses are calculated and the drugs are administered either subcutaneously (under the skin), intravenously (into a vein) via a catheter, or orally.

Chemotherapy with the Madison Wisconsin protocol involves your pet having chemotherapy treatments weekly for nine weeks (with a one week break), then fortnightly up until 6 months (i.e. 25 weeks in total). At 6 months, if your dog is in remission, therapy will be discontinued. Chemotherapy can be restarted when a patient relapses i.e. when lymphoma comes back. Patients are individuals, so the response varies from case to case, and because of this, all patients receiving chemotherapy are carefully monitored and protocols adjusted to suit the individual.

 

What are the potential side effects of chemotherapy and how can they be minimised?

Side effects can be seen because chemotherapy agents damage both cancer and normal rapidly dividing cells. Normal tissues that are typically affected include the cells of the intestine, bone marrow (which makes the red blood cells, white blood cells and cell fragments involved in blood clotting called platelets) and hair follicles. Hair loss is uncommon in dogs having chemotherapy, but it can be seen in certain breeds that have a continuously growing coat, such as Poodles and Old English Sheepdogs (cats rarely develop hair loss, but may lose their whiskers). Hair usually grows back once chemotherapy is discontinued. Damage to the cells of the intestines can result in changes in appetite or stool consistency and occasionally vomiting. Damage to the bone marrow reduces blood cell production, particularly infection fighting white blood cells (neutrophils).

Steroids are often used in combination with chemotherapy. These medications can make patients feel that they want to eat and drink more (especially during the first week of therapy when doses are usually higher and given every day). Patients should not have their access to drinking water restricted, but it is important not to increase their food intake, as excess weight gain can be problematic. The increased thirst is associated with increased urination, so patients may also need to go out to pass urine more often.

Cyclophosphamide, one of the commonly used chemotherapy agents, can cause irritation to the lining of the bladder, producing cystitis-like signs, so it’s important to bring urine samples when requested and to monitor your pet’s urination very carefully, and to promptly report any signs of problems.

Epirubicin, another chemotherapy agent, can cause damage to the heart muscle over time. The more doses your dog has, the greater the risk. For this reason, we will carry out checks on the heart before the drug is given for the first time and at various points during the treatment course. Heart complications are extremely uncommon and your dog is at much greater risk if the lymphoma is not treated.

We prescribe medications to help to prevent complications, and we will advise you on which signs to monitor. Compared to human patients who receive chemotherapy, pets experience fewer and less severe side effects, and these can usually be managed at home. This is because we use lower drug doses and do not combine as many drugs as in human medicine. Your pet’s quality of life is really important to us and to you.

 

What precautions do I need to take at home, with my pet having chemotherapy?

Chemotherapy agents can be excreted in the urine and faeces, and care must be taken when handling your pet’s waste. You will be advised of appropriate precautions, and it is important to note explicitly that pregnant women should avoid contact with the pet’s waste following chemotherapy.

 

What should I look out for?

Signs of gastrointestinal upset: if your pet has vomiting or diarrhoea for more than 24 hours please contact us or your usual vet. Also watch for any dark coloured faeces.

Signs of bone marrow suppression: Neutrophils (infection fighting white blood cells) are at their lowest point usually 5 to 7 days after treatment. If your pet is depressed, off its food, panting excessively or is hot to the touch at this time, please contact us.

Signs of bladder problems: you should alert us if your dog is urinating more frequently than he or she has been, is straining or having difficulty passing urine, or if you see blood in the urine.

 

What will happen in the future?

Unfortunately, chemotherapy for lymphoma is very unlikely to cure your pet, but will allow a good quality of life to be enjoyed for some time.

Inevitably, the cancer cells become resistant to the drugs we use, and the cancer will come back. At this stage, it is often possible to get the cancer back under control for a while with alternative agents (this is known as a ‘rescue’ treatment). Eventually, the tumour cells will become resistant again and it is likely that your pet will have to be put to sleep when his or her quality of life deteriorates.

Hopefully, this will be after many happy months of good quality life for your pet and you to enjoy together.

 

Lymphoma in Dogs

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