Stories

Heartworm

/ Dr. Christine McFadden / Leave a comment

Dr Mc Blog

March 24, 2015
Moonshadow gently waved his tail from side to side, tongue pink as he greeted us. The older black lab moved with a stately grace across the exam room, a gentle cough escaping from his throat. “There, did you hear that? Why is he coughing like that?”, his owner queried anxiously. I stared down at him, mind running through possibilities. Moonshadow was old, so I had to put cancer on the list. Not a happy place to start. I said nothing as I began a full exam, checking out his teeth, moving over areas where lymph nodes lurked, probing his tummy, riffling through his fur. Moonshadow cooperated with everything, seeming to enjoy it all as one big petting fest. I pulled out my stethoscope and listened carefully to his chest, timing his heart rate and listening to his lungs expand and contract with each breath. A lot of times you don’t hear much listening to healthy lungs, maybe a quiet whoosh. Today I was hearing crackles and rales, sort of like Rice Krispy cereal when you first pour the milk on. Not a good thing to hear. I stood up from the floor where I’d been kneeling at Moonshadow’s side. He side-swiped me with a lick of appreciation, then coughed gently with the extra effort. His owner, in her late twenties, shifted from foot to foot anxiously. “We’ve been through so much together. He’s travelled across the country with me.” Her voice trailed off, tears threatening. Her dog walked over to her and pushed his head up under her hand.

I asked to run a blood panel and take a set of chest x-rays. The x-rays would show me any masses in his chest that could be cancerous or might point to an odd disease like the fungal infection Valley Fever. I could evaluate his heart size and shape and find markers for other lung diseases. The bloodwork would check for signs of infection, diabetes, thyroid disorders and see if his liver and kidneys were functioning ok. Not much point in making a diagnosis of one problem and later finding out that my patient’s renal function was toast. Obtaining a complete picture up front was in the best interests of my patient so I could help him – or know that I couldn’t, should that be the case.

One of the blood tests was for Heartworm, Dirofilaria immitis, a long spaghetti-like worm that lives in the blood stream, bobbing around through little capillaries and veins as larvae until they eventually grow up and take up residence in the lungs and heart. There can a fistful of worms clogging the heart. Nothing microscopic about it – unfortunately, the patient is usually dead when you get to see it that graphically.

Heartworm goes through one of its life stages in the mosquito. It is when the mosquito bites your dog, sucking out a bit of blood (the mosquito’s meal) that it injects the microscopic larval form of Dirofilaria into your pets’ bloodstream. If you give your dog the heartworm preventative EACH MONTH it kills off all first-stage larvae encountered and the story ends there. If your dog isn’t protected by a heartworm preventative, or you forget to give it for a couple weeks (even if you re-start it and get back on track), then there is a window of opportunity for the first-stage larvae to grow on to the second stage and into the adult worms living in the chest. The whole process from mosquito bite to worms clogging the lungs and heart can take up to 2 years. The symptoms your pet shows may range from something mild like restless sleeping to wheezing to full out coughing and heart failure.

Todays’ tests are very sophisticated, requiring only a few drops of blood to detect antigen, the bodies’ response to invasion by a foreign invader, in this case the heart worm. If your dog does test positive for heartworm, a second test is done to look for actual microfilaria larvae circulating in the blood, which helps stage the disease progression and predict the prognosis for your pets chances of beating this disease.

Is there a treatment for dogs that have heartworm? Yes, an injectable form of arsenic. Can some dogs die from the treatment or get very sick from it? Yes. Does the treatment work 100% all the time? No. Once a dog has had heartworm and been successfully treated do its lungs go back to normal? It depends. Sometimes. Can cats get heartworm? Yes, statistically 5-10% as often as the dogs in a given area of California.

In February 2015 there were two (2) cases of heartworm diagnosed in local dogs : a little Yorkie in Merced and a medium sized dog that lives in Atwater. Both are house pets and neither has ever travelled outside of town. For years we have known that pets that travel to the foothills, such as Mariposa or Sonora, are at very high risk; also the Delta area of Stockton. Most of the United States is infiltrated, so ALL travelling dogs and cats should be on monthly preventative. Heartworm is HERE in Merced County. Most dogs can be protected for less than $100 a year. Talk to your veterinarian about the best choices for your pet and family.

And Moonshadow? He tolerated the arsenic treatments. His lungs were permanently damaged and he needed medicine for the rest of his life to keep the post-heartworm immune reaction under control. He was a dog that appreciated everything done for him and gave another two years of love to all he met in his journey through life.

Christine B. McFadden, DVM
drmc@mcmenagerie.com
Valley Animal Hospital, Merced

 

 

Talking Birds

/ Dr. Christine McFadden / Leave a comment

Dr Mc Blog

May 26, 2014

Now birds are an altogether different sort of animal. It goes beyond having feathers instead of fur – they are NOT mammals. And somehow “animals” and “mammals” share a bunch of “m’s” and the words start to sound the same and it all becomes very confusing. So let’s get back to the basics – birds are NOT mammals. Ignoring the occasional exception to the rule, it’s kind of interesting that birds have feathers instead of fur, have scales and claws instead of pads and paws, fly much better than they walk or run, and lay eggs instead of giving live birth to their young. Baby mammals receive nourishment from their mother’s milk. Birds regurgitate already chewed up food into their babies crops! Ewww! Science fiction come to life! The crop is a modified stomach, though birds do have a true stomach called the proventriculus, and a gizzard or ventriculus for heavy duty grinding of food. If we narrow bird-dom down to the parrot family we find a group of birds that are highly companionable, brightly colored, and can even talk human! Research with an African Grey parrot named Alex at ASU University demonstrated he could think and figure things out at the level of about a 3 year old child. If you haven’t spent time with a toddler lately, watch out! For example, Alex could differentiate not just a wooden key from a metal key, but a green, square wooden key. Parrots are noted for the use of “tools” such as sticks to obtain food, a sign of higher intelligence.

Although veterinarians traditionally receive training in a wide number of species, from companion dogs and cats to livestock cattle and horses, they are all mammals. Birds are very different. Birds don’t even have normal lungs, but do most of their breathing through cellophane-like little bags throughout their body called air sacs. Some of these air sacs invade the larger wing and leg bones (pneumatic bones), which keeps bone density lighter and helps to deliver oxygen directly where needed for long flights. Pretty amazing!

Since I have been known to say that I have a license to practice medicine and surgery on every living species on earth, with one exception (you), it’s probably obvious that it is the diversity of working with birds that makes them fascinating. Parrots in particular, large and small, are so interactive that they are a joy to study. Sylvester Stallone referred to parakeets as “flying candy” in one of his movies. Of course, working with them up close and personal brings certain features to the forefront. Like beaks. They all come with them and yes, they all bite. That little 30 gram parakeet can dig just so into your cuticle and the lumbering Macaw, a 2 to 3 pound parrot (454 grams to the pound) is capable of breaking fingers. We treat them all with respect.

Birds are adaptable. One of my staff, Amanda, recalled a little bird that had crippled legs. Her owner wrapped the bird in a little shirt with a piece of Velcro, and herself had a broad patch she had sewn onto her clothes. Sure enough, the little bird could fly around, then return to her owner via her personal landing pad.

And if you thought kids say the darnedest things, try birds. Say one bad word once (chances are you said it loudly and with energy) and the bird has it nailed forever. One client taught his Amazon to say “Let me outta here!”  I wasn’t aware of this until the bird boarded with us. This was in a small clinic where the ward rooms were very near the exam rooms. Sound carried. You can imagine the look on my clients face – and mine – when suddenly someone started to scream “Let me outta here! Let me outta here!” I actually had to show a few people that indeed it was a talking bird before I could calm them down (the bird thought he was hysterical – we began to feed him special treats about a half hour before afternoon calls to occupy his little mind).

My favorite story of all, though, centers around a woman staff member who opened the clinic early Saturdays. Pat loved her job and usually rushed down extra early to be the first one there, so she was by herself that day, walking from room to room as she checked on patients. She had just turned on the lights as she entered one ward and was crossing the room to open another when behind her she heard a soft voice say “I know what you like”. The hair rose at the back of her neck and she froze – just as the Mynah bird screeched “bananas!” Bananas indeed. Took about 5 years off Pat’s life and we had to post a sign after that warning everyone when that particular bird stayed with us.

 

Christine B. McFadden, DVM
Valley Animal Hospital, Merced
drmc@mcmenagerie.com