Canine Distemper

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Dr Mc Blog

June 24, 2015
There has been much dialogue and soul searching among the people of California after an outbreak of human measles occurred last Christmas. The source of contagion was traced to a child visiting Disneyland. Ultimately over 100 people were affected across many states. Part of the controversy? There is a preventative vaccine against measles, but many of these sick children had not received it. You see, there is a group of people who are opposed to vaccinations (immunization) for children. Some believed measles to have been “eradicated” in the United States since 2000. The problem is, we don’t live in a bubble. We share our earth with an ever-changing flux of people. Exposure to other people’s viruses and bacteria is as simple as going to the grocery store, sight-seeing in San Francisco, a vacation to an exotic locale. I repeat, we do not live in a tidy self-preserved bubble (gated community attempts aside).

Neither does your dog. So let’s talk about the canine distemper virus, which most of todays’ veterinarians in the big cities have never seen. Come practice in Merced County. Where, simply because of the lack of proper vaccination starting between 6 to 8 weeks of age, we do in fact see this disease. Puppies are at highest risk because of their still-developing immune system, but even older unvaccinated dogs can contract distemper. Did you know that the Canine Distemper virus is actually a relative of the human measles virus? (Your dog cannot make you sick).

The virus is passed directly from one infected dog to another, often by a cough or snotty nose sprayed into the face of another dog. Surprisingly, the virus doesn’t live long in the environment by itself, but people can transmit it accidentally if they’re handling one puppy’s sick nose and spread its mucous to another dog through petting – dogs always run up to you nose first, right?

The first signs of illness start 10 to 14 days after initial exposure to another sick dog. Your dog might have a horrible runny nose, goopy eyes and a deep cough. In the early stages the dog may run a very high fever, 105 degrees or more. It is always on our list of rule-outs for a coughing dog. If we are secure that your puppy is properly vaccinated we will place it lower on our list, but not eliminate distemper entirely. Definitive laboratory diagnosis can be difficult. When clinical signs are present, both blood tests and an oral cheek swab of saliva can aid in the diagnosis of distemper.

There are more than one strain of distemper viruses, some more virulent than others. Sometimes the virus moves quickly through its phases, sometimes an owner believes their pet has recovered, only to come down with “new” and very serious problems 2 to 3 months later. There is no cure for Distemper.

After the upper respiratory signs, the virus may affect the gastrointestinal tract. The “gastro” part or stomach responds by vomiting. The intestinal part responds with diarrhea. The dog is miserable and dehydration and weight loss are quick to follow. Many dogs die at this stage.

If the dog’s body continues to fight, the virus may attack the nervous system, creating palsies and seizures. One particular seizure is called the “chewing gum fit” – it looks as if the dog is chewing gum as its jaws work up and down. This a pathognomonic (classic, diagnostic) seizure disorder of Canine Distemper.

Once neurological signs are seen the dog is not expected to ever fully recover; though some may be partially stabilized with anti-convulsant medications, other will carry a twitching paw or be prone to seizures for the rest of their life. More than 80% of affected puppies and non-vaccinated older dogs who contract this disease will die of it. The survivors may never be wholly healthy.

And all this for lack of a vaccine. Even dogs enjoy getting together for the good times with their fellow doggie and human friends! Whether your dog is a globetrotter or a stay-at-home please protect your pets : Vaccinate your loved ones.

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

Femoral Head Ostectomy and Mercy

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Dr Mc Blog

June 3, 2015
She named her “Mercy”, a nod towards her future as an elementary school mascot. She was a cute little black and white ball of fluff, guaranteed part Border Collie. Part what else wasn’t mentioned. A bright puppy, Mercy suffered no fools. People wielding needles were not popular with her (picture a grown veterinarian trying to explain how vaccinations are lifesaving to a tiny puppy throwing a tantrum. Score : Puppy 1/ vet 0). By the time she’d been through all her puppy visits and spayed Mercy had had it! She began to stalk me when she saw me, sounding the alarm far and wide to all who’d listen. If I ignored her and walked away she’d bounce after me, stiff legged and barking in staccato yaps. If I turned to her she’d stop and lower her head to graciously allow me to pet her – but growled under her breath the entire time. Mercy is not good advertising for me.

Mercy takes her school duties seriously, snuggling up with children who need a friend and a furry hug while they find their way through problems. Mercy doesn’t choose sides on the playground. She has been known to dress up in ridiculous costumes for a rally or fundraiser. Most of all, Mercy can be depended upon to dispose of unwanted lunch items without tattling.

The dog has it made.

So I was a little surprised to find her in my office early one Monday morning. At a family picnic over the weekend she had joined in some doggie games and got rolled. She came up limping in back and hadn’t used the leg since, though bravely she didn’t cry. Her big brown eyes followed me quietly. After a gentle exam I recommended we start with a set of x-rays taken under sedation, so she wouldn’t feel further pain during the necessary manipulation to get good pictures of her bones.

We discovered that Mercy had dislocated her hip. The head or ball of the upper thigh bone is cupped inside a socket, called the acetabulum, of the hip. It swivels securely here, held in place by the depth of the socket and one very strong ligament.   This ball-and-socket joint allows tremendous range of motion and is very difficult to separate. Usually only blunt trauma, like hit-by-car can create a strong shearing force that breaks the ligament, yet not the bones. Mercy had not had a severe accident, but the clue to the underlying cause for her leg to succumb to a lesser injury was there on the x-ray : Mercy’s hip socket was flat, not deeply cupped. It had been so much easier for a quick blow to snap the ligament since the whole set-up was already relatively unstable. Once knocked out of place the strong thigh muscles kept the leg pulled forward.

Mercy was already under anesthesia for the x-rays, so after notifying the owner of her diagnosis we manipulated the head of her femur or thigh bone back into place. This is called a “closed” reduction of a dislocated leg (as opposed to an “open” or surgical reduction).The procedure went smoothly, probably for the wrong reasons : it was easier to pop back in place because it was more of a slide over the flattened edges of the acetabulum than a real “pop” into place. We bandaged her leg in an old fashioned sling and sent her home. On re-check 2 weeks later we found, not surprisingly, that her femur had slipped back out of place and we moved on to a salvage surgery called a femoral head ostectomy – translated backwards it means “to cut off the head of the femur”. It sounds awful and I’m surprised more people don’t faint when confronted with this description. The ligament cannot be repaired or replaced. Left alone, the ball part of the bone will grind into the pelvic bones, creating severe pain. However, remove the ball, leaving an unconnected “stick” of thigh bone but with all muscles attached and the leg will align where it should and a strong band of scar tissue called a “false joint” will form over time. Small dogs and cats will often have 100% recovery, larger dogs may exhibit a small sway to their gait. Mercy was walking on her injured leg before the sutures came out.

It’s been a couple of years now and I suspect most people have forgotten she ever had the injury. A testament to the benefits of orthopedic surgery, Mercy walks and trots just fine. (Mercy does not deign to run. A dog of her stature has no need to comport herself in such common fashion. My suggestion that a few too many corn dogs might be slowing her down was rejected with disbelief. Shame on me!).

Though Mercy continues to energetically terrorize me whenever we meet, I have one small revenge. As she has grown, it’s become obvious that very little of a Border Collie’s genes are included in her genetic makeup. In fact, while she was routing me one day I was reminded of a scene straight out of the Wizard of Oz, where a little dog of similar build bit the leg of a neighbor lady (soon to become the Wicked Witch of the West) and started that whole journey through the tornado…… I now call her “Toto” and darned if she doesn’t come running up to me for a long pet, growling the entire time. We have reached a mutual understanding and I am content.

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

Miliary Eczema in Cats

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Dr Mc Blog

May 27, 2015
My mother has complained of a dearth of articles about cats. Here you are, Mom. The domestic feline or house cat is believed to have appeared as a companion as early as 7,000 or more years BC. Whether part of ancient religions or welcomed as a mouse catcher, the cat was also made to be a pet. Although today many argue the value of a cat compared to a dog, statistics indicate that there are as many, or more pet cats in the world as dogs.

Cats are athletic, inquisitive, intelligent and independent.

One such special cat was Alfred. A sleek golden orange tabby, he had grown into a magnificent 12 pound, well-muscled  cat. Alfred ran his house, assuring punctual meals with scheduled outdoor exercise and afternoon naps in between.  He was about three years old when his owner noticed that his coat was looking a little patchy, and when she picked him up to pet him she felt tiny scabs over his back. Alfred seemed a little irritable when she tried to pet him, squirming away as if his skin hurt. This would not do, so off Alfred and owner went to the vet!

Close examination revealed that Alfred had scratched at himself, evidence of itchy, or pruritic skin. The fine little scabs were clustered close together over his skin, with a few slightly bald patches where he must have scratched off some fur. The working diagnosis for a cat with this kind of skin condition or dermatopathy is called “miliary eczema”. “Miliary” meaning “a rash that resembles tiny seeds” and “eczema” meaning inflamed skin, often itchy or red. This is sort of a catch-all term that describes the rash but not necessarily the underlying cause.

Most often a rash might occur in response to an allergy. But allergy to what? In Alfred’s case his owner medicated him monthly with a flea preventative and indeed, there was no evidence of flea “dirt” (blood sucked from an unlucky pet, passed through the flea’s rudimentary digestive system, and deposited in the fur as flea poop) or any live fleas on the cat. Flea allergies are the most common cause of miliary eczema in cats. Other possible sources of allergens might include contact allergens, something the cat might walk on or roll in, or airborne pollens.

Diet might be another cause of allergies.

Since “miliary eczema” defines only the appearance of the rash, other clues to its cause may be found by noting where the rash occurs on the body. For example, if a rash has broken out near the ears, your vet may look for ear mites. Both bacterial and fungal skin infections may cause similar looking rashes. After questions about your cat’s environment, in particular about any changes or recent introductions to your home or yard, your veterinarian will try to pinpoint a precise cause. Sometimes a skin biopsy is recommended for definitive diagnosis. In some instances the underlying cause is never fully understood.

In Alfred’s case the rash appeared to be a response to an unknown allergen and a trial medication with an injectable steroid was administered. This kind of steroid is a glucocorticoid, not the anabolic steroids infamously abused by some athletes. Cats are somewhat unique here, being resistant to the effects that steroids have on dogs (and people) – they suffer far fewer side effects such as hunger and thirst, as a general rule, but they also respond less well to steroid medications in general. Most cats require injectable medication rather than oral steroid medication for allergies.

Alfred was most gracious about receiving an injection in his derriere and went home to convalesce. Overnight his owner reported that he seemed more comfortable, less restless. By day three Alfred was no longer over-grooming himself (it had crept up so slowly she hadn’t noticed his frantic licking increasing) and was eating at a leisurely pace, not jumping about as if suddenly pricked by something. Within the week the little scabs began to dry up and melt away, leaving smooth skin underneath. By the second week it was clear his fur was growing back in. Alfred was once again a gorgeous golden mini panther!

Alfred was lucky. As the effects of the medication wore off around week six there was no sign of recurrence of the rash. For many cats, if the owner is diligent about flea control their cat will remain clear skinned. For others, a combination of injectable or oral medication may be necessary year round to keep their cat comfortable.

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

Merced’s Loss

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Dr Mc Blog

 

May 5, 2015
In the wake of this weeks’ horror story it has been very difficult to write about a pet disease or the function of a particular body organ. I have been in practice in this town, this community for over thirty years. I have seen incredible acts of kindness towards all manner of animals and I have witnessed cruelty and abuse towards many pets. The story of Lucious is perhaps the most violent case of pet abuse I have ever heard of in Merced.

Dogs and cats are called “companion” animals because of all that they give to humans in the way of companionship. Companion by definition being “a helpful friend”. Some say there are more pet dogs and cats in this country than children. That homes with children are very likely to own a pet dog or cat. Seniors are noted to have special bonds with their pets. The handicapped rely on service pets to assist them physically (and may be their best buds). Peace Officers and Military personnel count on them to have their backs. Dogs and cats, it seems, are everywhere, there is one to fit anybody, a pet to fill virtually every need.

Pets love you. You will never feel alone with a pet. They follow you around the house. Like kids, they wait outside the bathroom door until you’re done. Or inside, if you forget to shut the door. They’ll garden with you. When the kids have all grown up and left home they’re there, waiting to be touched and petted when maybe you don’t get the hugs you were used to. Pets are right there for the child who needs to talk to someone when no one else understands. Pets cuddle and will often sleep under the covers.  They hog the bed. They help you brave the dark. Pets coerce you to join them in outdoor outings, get some exercise. They bring you back to the simple things in life, like enjoying a nap in a sunbeam coming through the window. They are there to go on walks with you. They rarely snore when you’re talking to them. They won’t switch channels on you, either. They’re pretty much always willing to join you in the kitchen and in case your clock batteries run down they’ll keep you on time for meals. You are loved whether or not you have wrinkles, a bad hair day, or belch. They aren’t impressed by a degree nor do they care how much money you make. Their love is the closest you may get to “unconditional”. Dogs and cats do require some food, water, a few basics. Veterinary health care will fulfill most of their medical needs. Vaccinations, deworming, parasite prevention being key for all life stages. You add food and love to the recipe and it usually turns out alright.

As I write this my dog is at my feet, having followed me over to the computer. A cat sleeps nearby, having considered the situation and being somewhat put out that I won’t (cannot) make lap space at present. The rest of the household is asleep. I am not alone. According to the American Humane Society of the United States, in 2012 62% of all American households owned at least one pet.

I am not alone in the greater community of Merced that was horrified to learn of the brutal attack and ultimate death of a Merced dog last week. No need to repaint the ugly scene. I find words inadequate at such times. Animal abuse is reportable for the sake of the animals. Animal abuse is reportable for the sake of people, as pet abuse has been linked with a heightened risk of domestic violence towards children and women especially. Our lives are intertwined, all peoples, all animals on this planet.  Laws are in place to process this catastrophe in our community.

Dogs and cats serve many roles throughout our lives. We hear of the “human-animal” bond – is that just some fancy jargon for a college paper to label or define the inter-dependence we all share in this world? Looking past the analysts and academic studies of people and how we relate with pets (which most of us understand intuitively), there was a shocking reality that came to light when Hurricane Katrina devastated New Orleans in 2005. Disaster preparedness plans were in place – rescue groups swung into action – and the world watched in horror as some people chose to perish rather than leave their pets behind to die in the flood, because the plans called for saving people first – and only. Resources were limited, time of the essence. But leaving people right in front of you, to die, was unthinkable. The numbers of people who refused to abandon their pets was high enough that the Red Cross and communities have since been advised to redraw their plans so that people with pets can be accommodated without compromising the priority of rescuing all people in a disaster.

Take note : the human-animal bond is very, very strong. Respect for all life is paramount in our interactions on earth.  My sincere condolences to the community of Merced for our recent loss.

Christine B. McFadden, DVM
Valley Animal Hospital, Merced

 

The Teeth

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Dr Mc Blog

April 22, 2015
What’s a subject you can sink your teeth into? Dentistry! (oh, go ahead and smile. Ha! Your teeth are showing!). Puppies are born “gumming it” and gradually little nubs of baby teeth come in. Baby teeth are correctly called “deciduous” teeth, which I find hilarious because there are deciduous TREES that lose their leaves every fall, like an oak or a maple, and who compares losing a body part with the tree in their front yard?

By 6 weeks of age most puppy teeth, all 28, have fully erupted and are quite sharp. Teeth are valuable for ageing a young puppy. The first deciduous incisors fall out around 4 months of age, the canine or fang teeth at 6 months of age. Most dogs have all 42 of their adult teeth by 8 months of age. Whew- no wonder they teethe on shoes and garden hoses! Exceptions to this rule are every Yorkie on the planet and a few other super teensy breeds who prefer the “delayed dental eruption” plan, their personal dental plan wherein they often refuse to lose ANY baby teeth naturally. These retained or leftover baby teeth must be pulled later under anesthesia. Two sets of teeth may seem kind of crocodile-cute, but the reality is that they will entrap food and eventually rot out both baby and adult teeth. We’re talking real health issues here, so much more than a pretty smile.

Dogs use their teeth like we use our fingers – teeth are their primary tool for prehension, picking up, grabbing, testing, tasting things. Teeth keep the tongue firmly seated in the mouth, instead of hanging out. Teeth, by the simple act of chewing, keep the jawbone firm and strong – without teeth the bone will lose density and atrophy, maybe fracture. Not too long ago dentures were very common amongst our grandparents and we spoke of “gumming it” and how the dentures didn’t fit well – due to lose of bone density. Dentures aren’t an option for our pets. Teeth, of course, help our pets to eat. A service dogs’ teeth may be used to apprehend a criminal or to gently tug a handicapped person into a position of safety.

One big difference for a pet versus a person in the world of dentistry is the rather sad fact that when a puppy loses its baby teeth, it only needs care for its adult teeth for 14 or 15 years, on average – in a human, we are expected to make ours last 80 years or so. I’m not sure ours are constructed any better. But it does explain the emphasis people place on twice yearly teeth cleanings, daily brushing and flossing. Did you know that we recommend daily brushing of your dogs’ teeth? Annual cleaning would be awesome.

When your veterinarian gazes at your dogs’ mouth and politely recommends a dental cleaning, is it just to bring back a whiter smile? Probably not, though whisking away the brown moss and calculus covering those teeth would make everyone happier. All teeth start out covered in white enamel. The salivary glands empty over the back teeth, providing gentle lubrication of the gums and lips and even a small amount of enzymes to start food digestion. Anyplace that you have moisture will attract bacteria, and it is bacteria, living on the sugars from food, that leaves that soft yellow build-up on the teeth called plaque. Thousands of bacteria are piling up on your pets teeth right now! Plaque can be removed with a toothbrush. Toothpastes are formulated just for pets, in flavors they like (think chicken or salmon), fluoride added because this helps kill the bacteria that causes plaque, and without the detergents that make our toothpaste foam up (look – it must be working!) but might irritate a dogs sensitive stomach if swallowed. Brushing your dogs’ teeth daily is well worth it.

Over time plaque mineralizes and turns brown. This hard brown stuff is called “calculus” and must be scraped off – but wait a minute before you reach for your pliers or allow some unlicensed person to “clean” your dogs’ teeth. As you scrape and wrench inside your dogs’ mouth, you literally gouge the enamel, leaving deep ruts that bacteria settle into even more rapidly, and yes, you have just assured a Fast-Track pass to faster decay and damage. The ultrasonic scaler used by veterinarians and dentists alike is safe and effective at removing plaque and calculus. Any micro-abrasions created on the teeth surface are then smoothed out by the polishing afterwards (and you thought it was just foo-foo stuff to make them shine! Silly you).

I used to be more polite. I might look in a mouth and say a tooth was mobile. I’m not sure what people thought – I wanted to test drive it to see how it handled corners? I’ve dropped that approach. Now I just say their dogs’ teeth are rotting in their head. That sparks a little interest. If the dog cooperates, I like to put everything on full display. All dogs should have teeth. Their importance to the body’s over-all health is often underestimated. In just the last two weeks I have cared for several interesting, though not unusual, cases. I had an older Poodle whose upper fang tooth abscessed. The base of that tooth rests against the thin plate of bone that separates the nose from the mouth. When the root rotted so did the bone. Now there was a hole or oro-nasal fistula present. Imagine sucking bits of food and water up your nose every time you ate. Oral surgery was required to fix the problem. A Dachshund presented with a fat swelling below her left eye, not an eye problem, no sir, but an abscessed big premolar leaking into the sinus below the eyeball. A major tooth extraction and antibiotics fixed that. A 3 month old Queensland pup has a baby tooth in his lower jaw erupting inwards : when he closes his mouth the incorrectly placed tooth is literally poking a hole into the roof of his mouth. Ouch! We’re contemplating interceptive orthodontics. And these were very ordinary cases, expected in an ordinary week. Teeth are meant to last time a life time – with proper care.

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

Pretzel and the Dislocating Knee

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Dr Mc Blog

April 7, 2015
“Call me Pretzel”, the note said. I peered over the top of it to look at my patient. She was aptly named, wriggling and dancing on the exam table, tongue flashing as she air kissed in happy anticipation of meeting me. “Well, alright then! Pleased to meet you, Pretzel!” I greeted her. With a surge of energy she tried to jump towards me and instead collapsed in a heap as her back leg buckled under her. I righted her with one hand and glanced at her chart again. “Sometimes lame” it read.

I looked again at Pretzel, a little toy breed dog weighing less than 10 pounds. She was just over 1 year of age. Her owner reported that although her little dog usually ran around happily, recently she had noticed that sometimes she picked up one of her back legs when running, or might kick it out behind her then resume her pace. Pretzel didn’t like to jump as much as she used to, and occasionally gave a little cry when landing on her rear legs. As I examined her, I gently pressed on her tiny kneecaps, or patella’s, and felt the right kneecap slip out of place, bumping over the groove at the bottom of the upper thigh bone, the femur, that was supposed to hold it in place. The kneecap slid to the inside of her leg – but as soon as I straightened the leg, it popped back into place. Diagnosis : Luxating patella, also called a dislocating kneecap.

Dislocating kneecaps are very common in many toy breeds. In some breeds it is estimated that over 50% of all puppies are so afflicted, a hereditary predisposition that is evident by a year of age or sooner. Some people believe that as these toy breeds are bred for ever smaller “extreme” sizes more anatomical problems crop up. Certainly these dogs were bred for looks, as lap companions and not as “working dogs” –  attention to strong teeth, big muscles and performance were not a first priority.

The knee of a dog is an interesting joint, being very similar to that of a human in general construction. Kind of bony, it is held together by tendons and ligaments, without much muscle to cover and protect it. Hard working, it must flex and bend with every step taken, as the entire backside of the body is supported on it. So can you picture all this? The big heavy femur with this small sliding patellar bone-and-ligament-show that connects and allows bending when attached to the lower tibia/calf bone. What keeps the patella in place? It is supposed to be nestled deep in the valley of the femoral groove, and helped to stay there by being firmly attached in a straight line to the bony ridge of the tibial crest below it.

In toy breeds, the femoral groove is often formed FLAT. Imagine! With nothing to cup it, the patella is at the mercy of the inner pull of the thigh muscles and off it goes, dislocating sideways towards the inside of the knee. Because the dog was born that way, it doesn’t know that that’s not the way it should be; truthfully, although they walk a little oddly, most young dogs don’t show serious discomfort. But as the patella bobs back and forth over the rim of the distal femur, it rubs ever so slightly, just a touch of friction….and eventually arthritis. At first just a little breakdown of the cartilage covering the bone. Over time, as year pass, from an erosion of the cartilage little pits and bumps appear and the knee becomes more painful. Eventually some dogs become so crippled they can no longer use the leg at all. Surgery is too late by then.

Pretzel, happily, was young and could benefit greatly from corrective surgery. It was easy to recommend it – all the telltale signs were there, from the hard pop when her knee dislocated (painful!) to the changes in activity her owner recognized at home. After x-rays to be certain she had no other orthopedic problems that might affect the outcome and to document the flattened femoral groove, she was taken to surgery – there is no other remedy for such a knee – and her knee rebuilt. A new groove was fashioned deep into the femur and the surrounding joint capsule and ligaments were tightened to hold it in place while healing. Although Pretzel’s leg was straight, in some crooked-legged breeds the tibial crest will also be transplanted.

In case you’re wondering, large breed dogs also can develop dislocating knees, though for most it is caused by some kind of accident or trauma. Surgery is always a necessity in these cases.

During surgery we looked at her original bone, where a thin line of angry red could be seen on the inside rim where Pretzel’s patella had been rubbing as it popped back and forth. We couldn’t undo that damage, but we could stop it right there, and with no further rubbing there was a good chance she would have minimal arthritis in that joint as she aged. Once the groove was deepened, the kneecap sat firmly in place! Pretzel awakened to a fully functional knee for the first time in her life. Helped by anti-inflammatory and pain medications she was walking gingerly in the first few days; had her stitches out by the second week, and began swimming in her bathtub at home as a form of non-weight bearing physical therapy. Within 6 weeks Pretzel was flying across rooms again, taking couches in a single bound, and dispensing crazy doggie kisses to all comers.

Christine B. McFadden, DVM
Valley Animal Hospital, Merced

Heartworm

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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

 

 

Foxtails

/ Dr. Christine McFadden / Leave a comment

Dr Mc Blog

 

March 10, 2015
At home I mark the seasons by watching the ever changing flowers along our roadsides and gracing our gardens. Spring brings the first forsythia flowers of bright yellow sunshine, the pink and white magnolia blossoms. At work I am waiting for the veterinary equivalent of that first harbinger of spring, the foxtail weed sticker.

It’s coming, that moment when I look at the chart of my next patient and read “cause for visit : foxtail in ear”.

The foxtail is the seed head of several weedy grasses. Sometimes called wild barley, several different grasses produce an awn or sticker that is pointed and barbed like a miniature badminton birdie. As your dog or cat brushes through the tall grasses the foxtail will catch in their fur, working in deeper by means of the pointed base.  Foxtails burrow deeply wherever they enter, travelling in one direction, prevented from backing out or falling out by their bushy tail.

The most common sites for foxtails to lodge in a pet are the ear and between the toes. The eyes, nose and vulva are also vulnerable, though foxtails can burrow into the skin anywhere, especially in thickly furred or matted animals.

Not only are the burrowing weeds painful, they can cause serious infections and abscesses wherever they enter the body. The sticker does not break down inside. It’s pointed end can burrow through ear drums, into eyeballs and travel up legs from the toes. Unless removed, a foxtail can eventually lead to death. Foxtails breathed into the nose can lodge there and run the risk of being inhaled into the lungs if not promptly removed. Foxtails eaten may escape the stomach and tunnel through the internal organs. Foxtails can kill.

Although you can’t always prevent contact between your pet and a foxtail, you can decrease the risk by taking the following steps :

  1. Don’t let your pet run through grassy fields or empty lots filled with weeds.
  2. Brush your pet after a trip outdoors, paying special attention to the face and feet. Gently separate each toe to look for tiny tan stickers between the feet.
  3. Pets with short, slick coats are not immune to picking up a foxtail, but there’s no denying that long silky hair or “feathers”, found in dogs like the Spaniel breeds or Golden Retrievers, attract the stickers. Thick, curly coats – think Poodles or Chow Chows – can also be foxtail magnets. These breeds may do better if their lower legs, toes and underbelly are trimmed short for the summer. A dog groomer can do this safely and easily for you. A “Summer Strip” that shears a long-haired dogs’ coat to an overall length of about ½ inch helps protect heavily coated dogs from picking up the stickers, with the added bonus of cooling your pet off during our hot summers.
  4. If possible, remove all weeds from your yard in the very early, green stage. Mow the weeds down, rake up and dispose. It is the dried seed head, in its bid to reproduce and spread far and wide, that detaches from the mother plant and hitches a ride on your pet to be carried to new fields. Elimination in the green stage is far easier to control and prevents further dispersal of seed heads. Foxtails are not readily air borne, but once dry “jump” off the plant onto whatever brushes against them.

Signs that might lead you to suspect that your pet has encountered a foxtail might include the following, especially if just after a walk or run :

  1. Your pet suddenly holds an ear down, shakes or rubs his head vigorously, crying out if you touch the ear.
  2. Repeated bursts of paroxysmal sneezing, so hard it looks like her nose might hit the floor.
  3. An ugly swelling between the toes, limping on one or more feet.

Most foxtails must be probed for and removed under anesthesia. Those lodged in the ear offer the sporting chance that, moving quickly enough, one can grab the offending sticker and be done with it. It’s the closest we come to a rodeo in small animal medicine. Given that the ear is awfully close to the teeth there can be a bit of a rush as the veterinarian eyes his or her prospective patient, calculating the odds of success.

Hmmm, the moment is here.” Check ears, foxtail”. The first patient this spring? A Newfoundland, the sort of dog that ought to live at the North Pole where there are no foxtails, and pick on someone his own size, like a polar bear. This dog looks to be about 150 pounds and growing by the second. Probably eats vets like they’re cheetos. And judging by his head tilt and red ear, it hurts, BAD.

We try the calm, business-as-usual approach. Let’s take a little peek here…. Nope. Next the hold-on-to-him, person on each end approach. Uhn-uh. Three people try to restrain his head. Help! Finally, a moment of stillness and we’ve got it! Quickly a quarter inch foxtail is extracted from the ear. Everyone takes a collective breath. The ear is cleaned and medicated. The Newfie is delighted, giving us doggie high fives with his nose which knock us into the wall. We all beam at each other. Success is sweet today. We know there will be more foxtail challenges tomorrow.

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

Ear Jam / Otitis Externa

/ Dr. Christine McFadden / Leave a comment

Today we will tackle the shaky subject of ear infections in the dog. Ear infections rank right up there with some of the smelliest problems you might ever endure with your pet. And your dog feels a lot worse about it. The ear is exquisitely built in the dog – those long, silky flaps (pinnae) framing your dog’s face, so pettable, tilting to make clown faces, waving in the wind during a glorious ride peeking out the car window. Some ears stand upright at attention and a few are bald. All ears are beautiful. The inner workings of the ear contain the mysteries that lead to one of the major 5 senses in the body : Hearing. A dogs hearing ability is considered to be 4 times that of the average human being. Sound is caused by air vibrations – the more vibrations per second, the higher the sound. Humans are limited to hearing sounds that vibrate at 20,000 vibrations per second, while dogs pick them up at 50,000 vibrations per second. Another factor is that people have only 8 ear muscles to help wiggle their ears to funnel sound in and capture noises ; the dog has 18 muscles (Not to be outdone, the cat, with 30 ear muscles, enjoys the best hearing of all!).

Did you know that dogs lack most of the skin glands that a person has? One place that they DO have true skin glands is lining the inner ear canal or passageway into the ear. If you gently lift your pets ear flap, or pinnae, you’ll see a hole at the base which goes into the head: this is the ear canal. The average ear canal is 2 inches long! In the dog it travels down, with a little L-shaped jog at the end just above the ear drum (tympanic membrane). This may serve to protect the ear drum from things that fall into the ear. Just as in a person, the ear drum is exquisitely sensitive, a barrier between the outer ear and the middle and inner ear where the hearing organs are located. This fine membrane vibrates in response to the sound waves it receives, transmitting them to the middle and inner ear for complex translation. Any fluid, foreign object, mass, or swelling inside the ear may deflect the passage of air vibrations and alter hearing. Long term infections may lead to permanent thickening (hyperplasia) of the canal, blocking the travel of sound.  Loss of elasticity to the ear drum may result in deafness to varying degrees. Ear infections are serious.

So what can go wrong with an ear? How can you tell? One of the easiest things to remember is that dogs don’t really make ear wax like people do – so if you see yellow or black discharge lining the ear you know something is very wrong. This ceruminous or glandular discharge may be made up of several bacteria or yeast or both. Some people will note a bread-like odor if yeast is present, and one bacteria, pseudomonas, is quaintly referred to by its “rotten taco smell”. Because the average length of a dog’s ear canal is over 2 inches long, a veterinarian requires a specialized instrument, the otoscope, to examine deeply. An otoscope has a strong halide light and magnifying lens, coupled with a long tube sized for the individual to look deep into the canal for the cause of the problem.

Like something out of a cheap horror movie, sometimes we put our eyeball to the scope and see giant (magnified) grey legs waving at us – ear mites, Otobius megnini. These are not to be confused with the cat ear mite, Otodectes cynotis, which would be about the size of a small grain of pepper if visible at all and never waves at you. We don’t see them that often around Merced and it’s usually good for a surprised shriek. In the USA the Otobius mite is most common in the arid regions of the Southwest and has a preference for the ear, even, occasionally, in people.

Very commonly we find foxtails buried deep into ears, painfully jabbing the tender canal. Sometimes they can be removed with a long narrow instrument called an “alligator forceps” – your pet will let you know if sedation is required! The pointed, piercing end of a foxtail awn must feel like an ice pick is poking into their head! Foxtails in a deep ear hole are never good, as they may perforate the ear drum and travel into the head, adjacent jaw or lymph nodes. The ear responds vigorously to this foreign body, mounting a massive infection in an attempt to eject the invader; alas, to no avail as gravity keeps it buried deep in the canal. The best news about foxtails is that once removed the infections are usually responsive to medication and clear up quickly.

Chronic, recurring ear infections are extremely common in our Valley. Properly called “otitis externa”, these infections bear no relationship to the inner ear infections young children often suffer from. They do not respond to oral antibiotics given to toddlers. They are not similar infections at all. Hayfever, or Atopy, may be behind much of the recurring or chronic infections of dogs. The ear canal of a dog is lined with true glands. Glandular tissue may respond to an allergen, like pollens in the air (and is our Valley not King of Pollen?) by becoming inflamed. Some breeds, like the Labrador Retriever and Cocker Spaniel, are genetically born with twice as many glandular cells lining their ear canals as other breeds, making them even more susceptible to ear infections. When the ear canal is examined we can see the tiny blood vessels swollen and red and the little glands puff up, making the inner ear canal look bumpy like a cobblestone road. As the tissue swells, a thin fluid exudate oozes out, creating a warm, wet environment deep in the ear hole – perfect for breeding yeast and bacteria. And do they ever! This ear soup is stuck, since it can’t drain by itself. If unattended, blood and pus may form. These infections are very painful, and a dog may paw or shake its head so hard the blood vessels burst and the pinnae fills up like a balloon with a blood hematoma. Polyps and cancerous masses can occur. All ear infections require careful treatment plans only your veterinarian can prescribe – your pets smiling face and happy head wag is its own reward!

Christine B. McFadden, DVM

drmc@mcmenagerie.com

Snap the Cat and the Broken Jaw

/ Dr. Christine McFadden / Leave a comment

Dr Mc Blog

October 22, 2014
His name was Snap. He had some Siamese in there somewhere because he had huge blue eyes and a white body with orange fur on his ears, tail and feet, a color we call “flame point”. A stunning kitten, he was all male : big, rangy body with long legs, on the prowl to explore my exam room as soon as he was set free from his carrier. Outgoing, slightly aggressive, he was not a cat to take well to indoor confinement. Fortunately Snap’s owners had a large yard and felt their kitten could grow up there safely. No animal is bred to live a life totally indoors, never seeing the sunshine.

Snap grew quickly, losing his first kitten baby tooth as he approached 4 months of age. Most kittens gain about one pound a month as they grow, but Snap gained more – he was going to be BIG! His owners reported that Snap, who got his name when he ran to them every time someone  snapped their fingers, had added fetching to his repertoire. Green beans were a favorite for some odd reason. Snap never ate the beans himself, but his family hated to be wasteful and found themselves researching new green bean recipes as they tried to keep up with his passion. Thanksgiving was the only time of year they could look forward to without guilt (add canned mushroom soup and French fried onions for a traditional casserole).

When Snap was neutered at about 6 months of age he was just losing his baby fang (canine) teeth and looked quite adorable. Neutering helped to suppress his urge to wander and would markedly decrease the likelihood of fights with other cats, which in turn could expose him to diseases like feline leukemia, feline AIDS (FIV, the Feline immunodeficiency virus, NOT infectious to people) or problems like abscesses. “Tomcats”, an old fashioned expression for unaltered or intact male cats can also develop “stud tail” – you don’t want this folks, however manly the name may sound. It’s a greasy patch that dirties the hair of the upper tail. Yech! And the urine of an intact male cat has a unique smell that can only be called a “stench”. It’s hard to draw breath in the same room. The good news is that one surgery and the smell, the greasy tail, and all just go away and you are left to enjoy your cat.

If the average cat weighs 10 pounds, Snap was out to prove that he was anything but average. By 2 years he was 14 pounds of lean muscle, extremely athletic and he enjoyed accompanying his owners on their nightly neighborhood walks. He was a powerful hunter of toy mice. He could jump from a standstill straight up ten feet. He talked frequently, expressing his disapproval if they were a little slow serving him breakfast. Snap had scheduled petting times, also, and showed his displeasure if one was missed by turning his back to the family when they finally came home.

But one night it was Snap who didn’t come home.

The following day we received a phone call that he had been found and was being rushed down to the hospital. And oh, the look of him made our collective stomachs drop. The beautiful fur was wet from mud and blood. His jaw hung crookedly and his nostrils were plugged with clots of blood. He was able to stand and even walk, though there were long scratches abrading one side of his body. It was obvious that Snap had been hit by a car, thrown through the air, and slid hard coming down. The broken face had been the site of impact.

Animals suffer from concussion the same as people. Snap’s pupils were pinpoint (meiotic) but he was responsive and even in a daze he was able to follow visual cues to show us he could still see. We started him on IV fluids and shock therapy and under gentle sedation assessed and cleaned his wounds and took x-rays of his skull. It was pretty bad. He had fractured the center of his lower jaw, so the right side of the mandible was split from the left. Worse, his upper jaw or maxilla had broken and the pieces shifted so that part of the roof of his mouth, the hard palate, was shoved upwards on the right, crunching into his nasal passage and sinus. Oddly, the soft tissue of the hard palate, though bruised, was intact. We were able to wire the lower jaw together on the spot. There wasn’t much we could do about the roof of his mouth but wait and see. All the teeth still overlapped correctly, so he could close his mouth properly. We inserted a feeding tube down his esophagus to the stomach and threaded it out the side of his neck to facilitate eating during recovery. And what a recovery. By day 3 his pupils were normal and his attitude improving. By day 5 he was eating soft food on his own, so IV fluids and feeding tubes were removed. Snap went home, returning to have the wire in his lower jaw removed 6 weeks later. Snap lived to be 15 years old. He never liked to have his mouth examined after all that and his face was a little crooked, but we knew he’d made it when he left a green bean on his owner’s pillow one night.

Christine McFadden, DVM

Valley Animal Hospital