Wormy Wednesdays: Heartworms

Worms are so gross! (I suppose unless they are in one of these ) 

http://kidsactivitiesblog.com/wp-content/uploads/2011/03/Dirt-Cup-cropped.jpg 

 There are several different types of worms that are commonly found in our pets. Many of which are preventable and treatable. Today we are going to focus on the heartworm! As the name suggests this particular worm lives in the heart and lungs of cats and dogs. So what is the big deal with heartworms anyway?

http://www.capcvet.org/capc-recommendations/canine-heartworm

First they are transmitted by mosquitoes. This allows them to be delivered to the blood supply where they can then mature in the heart and lungs of the dog or cat. Overtime this can lead to some serious damage to these organs. In both cats and dogs, early infections may not have any symptoms. As the disease progresses in dogs you may notice a mild but continuous cough. Along with this you may notice that they just don’t have the energy they used to and may not want to exercise. Cats are a different story. Their symptoms can often be similar to other infections. You may see signs such as vomiting or rapid breathing, that can easily be confused with other respiratory diseases.

http://www.palosanimalhospital.net/sites/site-3652/images/heartworms%20in%20a%20dog.jpg

Diagnosing heartworm disease in dogs can be done with a blood test. If it comes up positive then many times we will screen a blood sample to look for the baby worms swimming around, this is done on the microscope. Cats again are a little more difficult. There is no easy test for them but rather a series of tests that may need to be done to come to a diagnosis. Yearly testing in dogs is critical to keeping the worms under control and ensuring that your preventative is still working. Early detection could be the difference between a happy healthy life for you pet and serious consequences. Even if you give the preventative every month on the same day, testing is essential to ensuring that everything is working properly.

Here’s the good news! Heartworms can be prevented! There are many products out there so sometimes we just need to find the one that will work best for us, but whatever you use it is important to use it monthly. Even in cats! Even in cats that are just inside! Prevention is much cheaper and safer than treating heartworms will ever be. The treatment process is long and can be painful as well as dangerous. It is only approved in dogs. Another benefit of many heartworm preventatives is that they also prevent against many of the intestinal parasites we will discuss in the future.

For even more information visit the heartworm society's website here!  (yes heartworms are such a big deal they have their own society!) or talk to your veterinarian. 

Introducing Dr. Marci Kirk! (That's me!)

Hello Everyone! This is Dr. Marci Kirk. I wanted to introduce myself so I can start contributing to the blog from time to time. I thought we would start with a little background about me to get things rolling!

I graduated from U of I Veterinary School in 2011. I worked in a small animal practice in Charleston/Mattoon area prior to coming to Country View Veterinary Clinic. I love getting to know clients and their pets! That’s probably my favorite part of practicing medicine. I am also very interested in nutrition and dermatology. I think both of these are important in the overall health of our pets.

Away from the office, I enjoy spending time with my husband, Michael, and our dog Charlie (a golden retriever/poodle mix). In my free time I enjoy running. I usually have a race or goal I’m training for, and typically this will be a Disney race. I absolutely love Disney and running races there is just another great way to experience it. Charlie usually comes along on several of my training runs with me. It is a great for both of us to stay active and entertained. I also enjoy reading. If I have free time I will try to read a book just for fun. I’m always open to suggestions!

My hope is to continue to make the blog informative and fun, so if you have any suggestions, comments or topics you’d like discussed just let us know! Don’t forget to check out our Facebook page for even more updates and pictures of some of our patients! 

Mammary Gland Tumors

We recently had a cat come in with a mammary gland tumor, which made me think that it would be good to discuss mammary tumors in dogs and cats.  Let's start with dogs.

Diagram of mammary glands in dogs

Of any of the domesticated animals, dogs have the highest incidence of mammary tumors.  Females who are spayed before their second heat cycle have a significant decrease in the incidence of mammary tumors compared to dogs who are left intact or spayed after their second cycle.  One of the good news for dogs with mammary tumors is that around half of the tumors act in a benign fashion.  This means that they typically grow locally in the mammary gland alone and do not spread.  Unfortunately, this means that the other half of tumors are more aggressive and have spread by the time they are diagnosed.  The smaller the tumor (<3 cm) the more likely that the tumor will be benign.  If the local lymph node is involved or the tumor has spread elsewhere (lungs), then these tumors tend to be more aggressive.

What will happen if a mass is felt on your dog.  Typically, complete staging should be performed prior to treatment.  This can involve performing labwork, taking chest x-rays (to check for lung nodules), aspirating the local lymph nodes if enlarged (to look for cancer cells), and possibly performing an abdominal ultrasound (to check for any nodules in the liver, spleen, etc).  If the tumor shows evidence of spreading, then additional therapy beyond surgery, such as chemotherapy, may be recommended.

Typically, the mainstay of treatment for the primary mass is removal of the affected mammary gland (mastectomy).  If multiple mammary glands are involved or a lymph node is involved, then all affected glands and the nodes should be removed.  After removal, the masses should be submitted to a lab where histopathology will be performed and the origin of the mass can be identified.  Although there are no definitive studies showing an added benefit of chemotherapy with mammary tumors, many veterinarians will recommend a course of chemotherapy in dogs where the tumors are thought to be more aggressive (metastasis, large size, etc).  Some vets may also recommend spaying (if not already done) the dog at the time of mass removal as some tumors may be responsive to hormones released by the ovaries.

Mammary mass form a dog

For dogs with small tumors, surgical removal may be completely curative and monitoring of the other mammary glands is the only long term recommendation.  However, tumors that are larger and more aggressive typically carry a worse prognosis of only a few months to a year.  It is important to bring your pet in for an annual exam as your veterinarian may be able to pick of a mammary mass before it becomes too large.

Cats can also develop mammary gland tumors.  Like dogs, female cats who are spayed earlier in life have a significant decrease in the incidence of mammary tumors.  Unlike dogs, most feline mammary tumors (greater than 80%) tend to be malignant.  Tumors that are smaller (<3 cm) tend to carry a better prognosis (possibly as long as 2 years), whereas prognosis for larger tumors tends to be poor (4-6 months).

Similar to dogs, staging with labwork, imaging, and evaluation of the local lymph nodes should be performed. With cats, most veterinarians recommend removal of all the glands on the affected side versus just a simple mastectomy.

Feline Conjunctivitis

We commonly see cats come into the clinic with eye problems.  Most of the time it has to do with conjunctivitis (inflammation of the conjunctiva which is the lining under the eyelid and over a portion of the eye itself).  Especially in kittens, the swelling can be quite dramatic and in cases where it is not treated can lead to problems with vision.

Severe conjunctivitis

The first thing we try to determine is the cause of the inflammation.  Although there are a number of different causes, there are three causes that occur most frequently.  These are viral infections, bacterial infections, and allergies.  In many cases we may not get the exact diagnosis, but response to treatment gives us a good idea if we are on the right track.

An eye exam can help rule out things like eyelid conformation issues, foreign bodies, or trauma.  After this, staining of the eye may be performed which can show changes consistent with a viral infection (dendritic ulcers on the cornea) or other scratches.  Conjunctiva swabs may also be taken which in some cases can show evidence of bacterial infection when looked at under a microscope.  With recurrent or non-responsive cases further testing with blood tests to evaluate for certain infections may be performed.

The most common viral infection causing conjunctivitis is a herpes virus infection.  In addition to eye problems, other upper respiratory signs like sneezing or congestion may also be seen.  This virus is the same type of virus that causes cold sores in people and can stay dormant in the body for long periods of time.  During times of stress the virus can reactivate and cause clinical signs.  In mild cases, the signs typically resolve on their own in 7-14 days.  In more severe cases, anti-viral therapy may be needed.  This can vary from using lysine, which is an amino acid that interfers in the replication of the virus to more specific anti-virals that can be given either orally (famciclovir) or topically (idoxuridine).

Applying drops to a cat's eye

The most common bacterial infections are Chlamydia or Mycoplasma.  Again, in mild causes these may improve on there own over a few weeks.  In more severe causes antibiotics may be needed.  Both bacteria typically respond to a tetracycline based antibiotic.  These can be given orally or topically as well.  We can have problems with esophagitis with tetracycline drugs, so many veterinarians substitute with azithromycin.

If an infectious problem is not suspected and an allergy is more likely (seasonality to signs, irritants like smoke in the air), then topical anti-inflammatories are usually helpful (steroids).

Please let me know if you have any questions.

Always Being Surprised

One of the nice things about being a veterinarian is that you constantly are learning and seeing new things.  Just recently, I saw a new client whose dog was having a problem after urinating.  The owner reported that after her male dog urinated he would continue to dribble urine and get it on himself.  He was four years old and the problem had probably been going on for a couple of years.  The previous veterinarian prior to the owner moving to our area had run a few diagnostic tests on the urine, but did not find anything conclusive.

After hearing the history I started out with a physical exam and pretty soon felt like I had found the possible culprit.  Male dogs have a skin fold called the prepuce (similar to foreskin in humans) that covers and protects the penis.  In this case, the opening of the prepuce was very narrow and there was a large amount of extra skin.  I thought that the narrow opening was leading to the urine pooling in the extra skin and then dribbling out after the dog was done urinating.  I suggested that we perform surgery to remove the extra skin and make the opening wider.

The owners agreed and we performed the surgery the next week.  I called for an update a couple days later and the owners reported that the problem was resolved and no more dribbling was happening.  If you would have told me in vet school that I would essentially circumcise a dog I would have laughed, but like I said earlier, I am always surprised at what I get to see and do as a veterinarian.

Cold Weather Precautions

It was -11 degrees this morning when heading to work, so I thought it would be prudent to discuss cold weather considerations for pets.  Most of the recommendations are fairly straight forward, but I thought I would review them anyway:

1.) Make sure your pet has adequate shelter.  If your pet isn't going to be indoors with you, then make sure they have an place to stay warm.  This should mean an insulated and draft free shelter.  In cases where the temperature is dangerously low (such as today) I would strongly suggest allowing your pet inside where there is heat.

2.) Have adequate water and food available.  Also, make sure that the water isn't frozen.  When temperatures are cold pets have a higher metabolic rate, so will need more calories.  Make sure that enough food is available to them.

3.) Protect pets feet.  Many people will put out salt to help with the ice on driveways.  This can be irritating to pet's paws, so make sure to wipe down pets feet after being outside.  Also make sure that pets are not running over sharp areas of ice or snow that could cut their paws.  Booties are available for dogs and many dogs are surprisingly tolerant of them.

4.) Watch for ice.  Dogs tend to have a better footing than people, but they can still take a tumble on the ice.  Especially with older pets, make sure that the walking routes you are taking are clear and ice-free.

5.) Lastly, make sure that any antifreeze is stored up and out of the way of pets.  A very small amount of antifreeze ingested by pets can put them into kidney failure.  For those do-it-yourselfers, make sure to keep this liquid away from your pets.

Hope everyone stays warm and safe during the current cold streak.  Happy New Year!!!

Some Fun Quotes

With the holidays, I thought I would do a little lighter topic.  Here are some fun pet related quotes:

“Don’t accept your dog’s admiration as conclusive evidence that you are wonderful.”-Ann Landers

“Did you ever walk into a room and forget why you walked in? I think that’s how dogs spend their lives.”

-Sue Murphy

"Dogs are not our whole life, but they make our lives whole." -Roger Caras

"A cat is a puzzle for which there is no solution." -Hazel Nicholson

"Animals are such agreeable friends - they ask no questions, they pass no criticisms." -George Elliot

“Dogs are the leaders of the planet. If you see two life forms, one of them's making a poop, the other one's carrying it for him, who would you assume is in charge.” -Jerry Seinfeld

"I like pigs. Dogs look up to us. Cats look down on us. Pigs treat us as equals." -Sir Winston Churchill

Hope everyone has a happy holiday.