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Hip dysplasia

by admin on March 3rd, 2020

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What is hip dysplasia?

Hip dysplasia means abnormal development of the hip joint. It inevitably leads to the development of arthritis (osteoarthritis). Either the hip dysplasia or the secondary arthritis may cause hip pain.

Hip dysplasia is a genetic disorder caused by the combination of genes from the parents (dam and sire). During the first few months of life, as the hips are developing, they become unstable. As a result the ball (femoral head) and socket (acetabulum) move apart during weight bearing. This causes abnormal forces on the soft bones which leads to the ball becoming flattened and the socket becoming shallow.  The process is self-perpetuating and causes damage to the covering of the bones (the articular cartilage). Cartilage damage is a key feature of the secondary osteoarthritis.

What are the signs of hip dysplasia?
Hip dysplasia is a common condition, especially in large breed dogs. The key signs are hind limb lameness and stiffness. The latter is generally most evident after rest following exercise. Difficulty rising and reluctance to jump or exercise are also common features. A rolling hind limb action may be seen in young dogs. More subtle signs include restlessness, moaning and licking the skin over the hip.

Signs tend to develop when the dog is immature and growing (five to 10 months of age) or when adult (perhaps a few years of age). When immature, it is the instability of the hip that causes the pain whereas in adult dogs it is the osteoarthritis which results in discomfort.

How is hip dysplasia diagnosed?
Examination may reveal muscle wastage (atrophy), especially over the hips. Manipulation of the joints may cause increased pain and instability may be palpable.

X-rays (radiographs) are necessary to diagnose hip dysplasia. They enable the severity of the abnormal joint development and presence of secondary osteoarthritis to be assessed.

How can hip dysplasia be treated?
The majority of dogs with hip dysplasia can be managed satisfactorily without the need for surgery. Exercise often needs to be controlled to some degree. Each dog will have its own threshold of duration and type of activity beyond which hip pain may increase. Hydrotherapy is often beneficial. Dogs that are overweight benefit from being placed on a diet. Tit-bits may need to be withdrawn and food portions reduced in size. Regular monitoring of weight may be necessary. Painkillers (anti-inflammatory drugs) may be indicated to make the dog more comfortable. Long-term drug therapy should be avoided if at all possible in view of potential side effects.

Some dogs with hip dysplasia fail to respond satisfactorily to conservative treatment and in these cases surgery may be indicated. The two key types of surgery are (1) reconstructive and (2) salvage.

Reconstructive surgery
In some young dogs (usually less than a year of age) the abnormal hip joint may be reconstructed to make it more stable. This involves cutting the pelvis and rotating the cup (acetabulum) over the ball (femoral head). The rotated section is secured in the new position with a specially designed plate. Either a triple pelvic osteotomy (TPO) or a double pelvic osteotomy (DPO) can be performed. Reconstructive surgery has the advantage of maintaining the dog’s own joint tissues and hopefully reducing the development of osteoarthritis. Unfortunately many young dogs with hip dysplasia are not good candidates for reconstructive surgery.

The aftercare following DPO or TPO surgery is very important. Exercise has to be restricted for eight weeks until the cut bones heal. Long-term hip function is generally good. Further surgery or long-term medication is generally not necessary.

Salvage surgery
Adult dogs with hip dysplasia and secondary osteoarthritis that fail to respond to medical management may require salvage hip surgery. The principle options are to replace the hip with an artificial one (total hip replacement) or to remove the ball (femoral head removal or excisional arthroplasty).

Total hip replacement generally results in significantly better limb function compared to femoral head removal and the recovery is much quicker. However, although uncommon, there are potential complications with total hip replacement surgery that need to be carefully considered prior to making a decision. With modern systems total hip replacement can be performed successfully in all sizes of patients.

Femoral head removal provides a ‘false joint’ where the limb is supported on the pelvis by scar tissue and the surrounding muscles. Recovery following surgery is slow and the limb ends up slightly shorter. Aftercare, especially physiotherapy and hydrotherapy, is very important.

Total hip replacement
Total hip replacement surgery involves replacing the painful joint with a plastic cup and a metal ball (acetabular and femoral prostheses). Care following surgery is critical to reduce the possibility of complications, such as dislocation of the prostheses. A rapid reduction in joint pain and improvement in limb function are to be expected.

What is the outlook with hip dysplasia?
The outlook or prognosis with hip dysplasia and the associated osteoarthritis is generally good. As mentioned above many dogs can be managed successfully with conservative treatment involving modification of exercise and weight, with or without the need for anti-inflammatory painkiller drugs. Those that fail to respond satisfactorily may necessitate reconstructive procedures (DPO or TPO) or salvage surgery such as total hip replacement. The outcome of these procedures is generally very good, albeit that there are potential complications.

 

HIPS NORMAL

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Pet of the month – March 2020

by admin on March 3rd, 2020

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Pet of the month for March is Boots, a delightful one year old Whippet who was recently hit by a car.

Boots presented with severe difficulty breathing and respiratory distress. Radiography showed he had a pneumothorax, which is an accumulation of air outside the lungs, but inside the chest wall. The air outside the lung prevents the lungs from inflating normally, and as happened with Boots can lead to lung collapse.

Treatment involved draining the air from inside the chest cavity to allow the lungs to expand, and oxygen therapy was provided until Boots was stable. Additonally strong pain relief was provided.

Boots required intensive care and repeated chest drainage until the damage repaired.

We are delighted to report that Boots is now back to good health!

 

BOOTS

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Special Offer – March 2020

by admin on March 3rd, 2020

Category: Special Offers, Tags:

March Wellness Offer

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Special Offer – February 2020

by admin on February 3rd, 2020

Category: Special Offers, Tags:

Feb Neutering Offer

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Pet of the month – February 2020

by admin on February 3rd, 2020

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Our Pet of the Month for February is lovely Frida, a beautiful two year old Sphynx.

She is seen here recovering from surgery to take skin biopsies, required during the investigation of her ongoing dermatitis, an issue which started when she was just 5 months old.

The recurring scabs and spots on Frida’s head and neck proved unresponsive to treatment so she was referred to a skin specialist who came to our clinic especially to see Frida. We hope the results will provide clarity on the cause of Frida’s condition and the best way of managing and or curing it.

Frida

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Asthma and Bronchitis in Cats

by admin on February 3rd, 2020

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What is asthma and feline bronchitis?

Asthma is a common respiratory condition in cats. The disease is caused by activation of inflammation in the lungs in response to irritants or allergens in the environment. The cells in the lungs respond by increased production of mucus and reversible narrowing (spasm) of the small airways. The condition is similar to the well described human form of the disease. In most cases the exact cause or trigger is unknown. A similar condition exists called chronic bronchitis. This shares many similarities with asthma. In cats with chronic bronchitis inflammation of the small airways is present however the reversible spasm is not.

What are the signs?

The signs of both conditions are similar and can vary in severity and frequency. The most common include:

  • Coughing
  • Rapid breathing/open-mouth breathing
  • Increased noise or wheezing sounds when breathing
  • Breathing difficulties/increased effort whilst breathing

Some cats can have a sudden life-threatening asthma attack. The signs of this would include breathing difficulties, open mouth breathing and weakness/collapse. This can happen in cats with previously diagnosed asthma or can be the first sign in some cases. Immediate veterinary attention is required in any cat with these signs at home.

How are the conditions diagnosed?

A diagnosis of asthma or chronic bronchitis is normally reached after a series of diagnostic tests. Often these are performed to exclude other causes of coughing/breathing difficulties in cats. Firstly a thorough history is taken. A physical examination is then performed. Harsh or wheezy sounds can be heard when the chest is auscultated.

In addition a combination of some or all of the following tests can be performed:

  • Blood tests to assess general health and to evaluate white blood cell number and type.
  • Faecal tests to check for feline lungworm infection may be performed.
  • X-rays or a CT scan of the chest. In some asthmatic cats X-rays and/or CT scan can be normal. In others thickened airway walls are seen or signs of ‘over-inflation’ of the lungs. These tests are also important to rule out other causes of coughing/breathing abnormalities in cats.
  • Bronchoscopy or video camera into the lungs to examine the inner lining of the airways.
  • An airway wash may be performed. The fluid is then examined under the microscope to check inflammatory cell type and number and whether there is any evidence of bacteria or parasites. In addition the fluid is often cultured and a test for bacterial and/or parasitic DNA performed.

What is the treatment?

Both conditions are treated with anti-inflammatories (normally corticosteroids). Generally the medication is administered in one of three ways

  • By injection: in cats which are hospitalised short-acting injectable forms of steroids may be administered, especially in patients that are experiencing breathing difficulties. Rarely long-acting injectable forms that can last between 3-6 weeks can be used in patients who cannot be given medication by mouth or inhaled medication.
  • By mouth (tablet or occasionally liquid form): to begin with a higher dose is used before gradually reducing to the minimum effective dose.
  • By inhalation: metered dose inhalers (MDIs) can be used as an alternative to oral medication. These are administered using a spacer device attached to a specially designed face mask for cats. Once a cat has become accustomed to the device it is normally well tolerated.

The advantage of this method of administration is that the steroids are delivered directly to the lungs and absorption to the rest of the body is minimised. This can reduce systemic side effects associated with oral steroid therapy. Further information regarding the Aerokat™ spacer device including a video demonstrating how it is used can be found on the following website: https://www.trudellmed.com/trudell-animal-health

In addition some cats require bronchodilators which are drugs that can help to relax (or dilate) the small airways. This medication can be given by injection in patients that are hospitalised or by mouth (tablets) at home. Inhaled bronchodilators are also available.

What is the prognosis for feline asthma?

With appropriate treatment the prognosis is normally good. Many cats will require life-long therapy. Unfortunately some cats can have progressive signs despite treatment. Uncommonly in some asthmatic cats a severe attack can be fatal.

If you have any questions about your cat’s condition, or his or her treatment, please do not hesitate to contact us.

Cat

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Addison’s Disease (Hypoadrenocorticism)

by admin on January 3rd, 2020

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What is Addison’s Disease?
Addison’s Disease is also called ‘hypoadrenocorticism’. This is a potentially life-threatening disorder caused by inadequate levels of hormones produced by small glands which are located in the abdomen (the tummy) near the kidneys. The adrenal glands produce two types of hormone that are critical for life:

  • Glucocorticoids
  • Mineralocorticoids

These hormones circulate through the blood stream and have effects on cells and tissues throughout the body. Dogs or cats with insufficient levels of these hormones can become very unwell.

Glucocorticoids are a natural form of cortisone (steroid). Cortisone is essential for life and must be at the right levels in the body for animals (and humans) to feel well. Steroids improve appetite and have effects on the function of the immune system that fights off infections.
Glucocorticoids can also be used as a drug for the treatment of some diseases.

Too little natural circulating cortisone is one of the components of Addison’s Disease (too much circulating glucocorticoid also causes a problem called Cushing’s Syndrome). Mineralocorticoids are also hormones produced by the adrenal glands.

Mineralocorticoids help to control the body’s ‘salt’ concentrations of both sodium and potassium. As with glucocorticoids, too much or too little mineralocorticoid in the body generally results in serious medical problems.

Addison’s Disease occurs when the body has insufficient circulating levels of both glucocorticoids and mineralocorticoids.

What causes Addison’s Disease?
Addison’s Disease results when both of the adrenal glands are damaged. This most commonly occurs when the affected animal’s own immune system, which normally fights off infections, becomes overactive and damages the adrenal glands (so called ‘immune mediated’ disease). Less common causes of Addison’s Disease are cancers or infections that can invade and kill the adrenal gland tissues.

Which animals are predisposed to Addison’s Disease?
Although Addison’s Disease is not very common, it occurs most frequently in young to middle-aged female dogs. Addison’s Disease is considered rare in cats, but the condition has been diagnosed in dogs and cats of all ages and of either sex (including neutered animals of both sexes).

Breeds that appear to be predisposed to Addison’s Disease include Portuguese Water Dogs, Standard Poodles and Bearded Collies, although it can affect any breed and crossbred dogs.

What are the symptoms (signs) of Addison’s Disease?
The signs of Addison’s Disease come on quickly, usually over a few days, although they can also appear over a period of months. Most owners notice that their pet develops several problems at about the same time including;

  • Reduced appetite
  • Lethargy and weakness
  • Vomiting
  • Diarrhoea
  • Weight loss
  • Tremors

In severe cases some dogs will suddenly collapse and develop shock-like symptoms.

What tests are needed to diagnose Addison’s Disease?
The signs of vomiting, diarrhoea, loss of appetite, and weight loss are extremely non-specific – many other conditions such as stomach and intestinal disease, kidney disease and pancreatic disease can cause these symptoms. Further tests are therefore needed to determine the cause of these problems.

Changes that may be noted on blood tests include changes in the salt levels in the blood – an increase in potassium and a decrease in sodium are major findings. However, these changes can also be seen with other disease processes, and if Addison’s Disease is suspected, a specific test is then recommended for confirming the diagnosis – this is called an ‘ACTH stimulation test’.

What treatment is needed if Addison’s Disease is diagnosed?
Initially, most patients with Addison’s Disease have severe dehydration and electrolyte (salt) loss, meaning that they need to be hospitalised for initial treatment and stabilisation.

Once stabilised, patients with Addison’s Disease require long term (lifelong) treatment with hormone replacement, to substitute for the missing mineralocorticoids and glucocorticoids. These drugs can be given at home in the form of tablets or injections.

The amount of medication may need to be changed over time, and frequent blood tests are recommended to monitor the condition and improve the chances of good control of the disease.

If dogs are stressed (for example due to going to boarding kennels, or because of other illness) your vet may guide you to administer some additional steroid therapy.

What’s the prognosis (outlook)?
Once dogs and cats with Addison’s Disease are correctly diagnosed and properly treated, they can live long and happy lives. Treatment is almost always successful and rewarding.

Dog

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Special Offer – January 2020

by admin on January 3rd, 2020

Category: Special Offers, Tags:

Dental Offer January

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Pet of the month – January 2020

by admin on January 3rd, 2020

Category: Pet of the Month, Tags:

Pet of the month for January is Red who is a registered Hearing Dog. Unfortunately on a recent walk he found something appealing to devour that came with a fish hook attached.

Red is seen here post surgery to remove the hook that was found on radiography to be located in his stomach. We are delgihted to report that he is recovering very well.

 

Red

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Chronic liver failure

by admin on December 2nd, 2019

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The liver is a vital organ – animals and people cannot survive without their livers. The liver performs many complex functions that are essential to life and good health. Its main functions are:

  • To convert food into useful substances such as proteins for repair and growth of the body
  • To maintain normal functions such as blood clotting, fighting infection and secretion of substances to the bloodstream
  • Bile production, which assists with the absorption of fat and certain vitamins
  • To store the body’s primary sugar (glucose) as glycogen and be able to release it into the bloodstream when it is needed
  • To neutralise and break down toxic substances such as chemicals and some medications, for later elimination in bile or through the kidneys

What is chronic liver failure?
Chronic liver failure occurs due to long-term damage to the liver, resulting in a liver that fails to work. Chronic liver failure can be caused by chronic exposure to toxins, heavy metals (copper, iron and zinc), chronic infections, chronic inflammation/irritation, cancer, blood vessel abnormalities (congenital portosystemic shunt – an abnormal blood vessel that a pet is born with that bypasses the liver), immune disease and fatty liver syndrome in cats.

The liver is very good at regenerating itself (unlike other organs such as the kidneys), but serious ongoing damage to the liver can cause long-term failure of its function – this is known as chronic liver failure. Over 75% of the liver is usually damaged before liver failure occurs.

What are the signs of chronic liver failure?

  • Reduced appetite
  • Lethargy
  • Increased thirst
  • Strange behaviours
  • Vomiting
  • Diarrhoea – occasionally blood in the stools, or dark, tarry stools
  • Bloated tummy due to fluid accumulation
  • Yellow skin, urine, gums (jaundice)
  • Weight loss

How is chronic liver failure diagnosed?
Liver failure is diagnosed by blood tests which indicate dysfunction of the liver. Further investigations, such as ultrasound scans, urine cultures, blood cultures or other tests for infections, may be required in individual cases. Samples of the liver may be required to diagnose the cause of liver failure in many cases – these may be obtained through a needle placed in the liver under guidance on an ultrasound scan; alternatively the liver may be visualised by using keyhole surgery (laparoscopy) or by a full surgical procedure. The technique that is chosen will depend on a number of factors, and these will be discussed with you in the event that biopsies are required. In some cases of chronic liver disease the initial cause of the problem may no longer be present at the time of investigation, but the disease itself may still cause symptoms, and the damage to the liver may also continue.

How is chronic liver failure treated?
Chronic liver failure requires multiple treatments. It is important to try to remove the initiating cause (e.g. toxins, infections, cancer etc). Sometimes, this is not possible and it is best to support liver function and make the patient as comfortable as possible. Some diseases e.g. blood vessel abnormalities such as congenital portosystemic shunts (abnormal blood vessels that bypass the liver) can be corrected by Specialist surgical procedures.

Treatments which may be required in chronic liver failure include:

  • removing fluid from the abdomen that accumulates due to scarring of the liver
  • antibiotics to prevent infections
  • antacids to reduce gastrointestinal ulceration
  • drugs to support the liver including anti-oxidants, anti-scarring drugs and drugs that bind to heavy metals i.e. copper and zinc
  • dietary modification to reduce protein and copper levels in some patients
  • nutritional support – an adequate intake of vital nutrients including calories is very important in cases of chronic liver failure.

What is the long term outlook?
Considering the severity of this disease process, this is a challenging condition to treat. Early intervention and aggressive treatment can be successful in some cases where the extent of damage is not too severe. At the present time, liver transplants are not available in veterinary medicine.
If your pet develops chronic liver failure, we will discuss the treatment options in detail with you and give you the help you need in making decisions about what you wish us to do to help your pet.

Dog Jaundiced

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