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Posts Tagged ‘Veterinary medicine’

Impaction colic is most commonly found in the pelvic flexure of the colon. It usually consists of poorly digested food lodged where the colon turns back on itself and narrows (the pelvic flexure). This condition is easily diagnoses via rectal examination, an indispensable part of the physical exam when called on a colic case. This condition is most commonly seen when the horse is confined in a small space, not receiving enough exercise and is being fed a large volume of concentrated feed, pellets and/or grain. It can also occur if the animal’s teeth need floating or if there are other dental issues preventing normal chewing (mastication). It can also occur if the animal cannot take in adequate water.

Colonic impaction will almost always respond to medical treatment. Sometimes high enemas will resolve the issue when mineral oil pumped into the stomach is not sufficient to move the blockage.

In the Southeastern U.S. coastal Bermuda hay is commonly available and used to feed horses. This type of hay can result in an impaction of the terminal ilium, the portion of the small intestine where it joins with the cecum (a large blind sac where fermentation aids digestion of roughage) and the entrance into the colon (large intestine). Obstruction of the ilium can also be the result of ascarids (intestinal parasites) after the horse has been treated for the infestation and is passing large numbers of the dead parasites. It is most commonly seen in young horses following their first deworming. When equine tapeworms are an issue treatment can result from a blockage of these dead or stunned parasites in the small intestine. When this condition occurs, the animal will usually exhibit intermittent moderate to severe abdominal pain. Distended loops of small intestine can sometimes be found on rectal exam. Ultrasound diagnosis may be necessary to identify this type of colic. Severe cases may result in gastric reflux. This usually responds to nasogastric intubation and the release of the accumulated gases from the stomach. Cases that are non-responsive to routine treatment may respond to warm soapy water or carboxymethylcellulose enemas providing the site of impaction can be located and reached rectally.

Less commonly encountered is hypertrophy of the longitudinal and/or circumferential smooth muscle layers of the small intestine (ilium or jejunum). The condition may be idiopathic (of unknown cause), or neuronal dysfunction usually associated with parasitic migration, particularly of the larval stage of ascarids. It may also be the result of increased tone of the ileocecal valve. This leads to hypertrophy of the smooth muscle of the ilium because it has to push ingesta through a smaller orifice. This diagnosis is usually made during surgery and can occur following the removal of a portion of intestine and the anastomosis (rejoining of the bowel) resulting in stricture.

Sand colic can occur when horses are pastured on sandy or heavily over-grazed pastures or fed on the ground. When I practiced in Arizona (back in the 1960’s) it was relatively common for backyard horses kept in small corrals to be fed on the ground on loose dirt. The ingested dirt or sand mostly accumulates in the pelvic flexure but may also be found in the right dorsal colon or in the cecum. The sand or dirt will irritate the mucosa (lining) and can result in diarrhea. Examination of the manure will often reveal the presence of sand and/or dirt. Accumulation and the resulting weight and abrasion on the mucosa can also result in a lack of colonic motility rather than hypermotility and diarrhea and in severe cases, rupture and peritonitis.

The diagnosis is the result of careful observation of the conditions in which the animal is kept and fed, abdominal auscultation for the sounds of hyper or hypo motility (too much or too little) and gas accumulation. Radiographs or ultrasound may be required to make the diagnosis. Medical treatment with laxatives is often effective especially with the addition of psylliumhusk. Psylliumis the common name for several members of the plant genus Plantago. Commonly marketed products of this include; Metamucil, Pinch, Fybogel, Kansyl and Luelax. Mineral oil treatment alone is less effective since it will usually float on the surface of the accumulation without penetrating. Psylliumbinds to the sand and helps to remove it. Animals with this condition may also suffer from rapid overgrowth of Salmonellaor other bacteria so antibiotic added to the treatment may be indicated. If signs of severe colic do not respond to medical treatment within a few hours surgery is indicated. Where grazing or feeding on the ground cannot be avoided prophylactic treatment feeding a pelleted psylliumproduct may be recommended by your veterinarian.

Impactions of the cecum are uncommon. They can occur when horses ingest bedding or as a result of post-operative or other pain therapy involving the use of opioids resulting in GI stasis and constipation. Because of its function as a fermentation vat gas and fluid accumulation is rapid and can lead to rupture within a day or two, if not corrected surgically. The condition can usually be diagnosed on rectal exam but rupture can occur early in the progression of the condition.

Gastric impactions are rare. It can occur following ingestion of foods that swell after eating, ingestion of bedding or poor-quality roughage, dental problems, ingestion of a foreign object or disease that interferes with normal gastric function. Ingestion of persimmons form a sticky gel in the stomach and feeding haylage can be problematic. When I practiced in Arizona ingestion or feeding of mesquite beans was a problem. Feeding sugar beet pulp can also be problematic. Diagnosis using gastroscopy or ultrasound may be necessary. Gastric impactions will often respond to treatment with water or other fluids via nasogastric intubation.

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The mitral or left atrioventricular valve is one of four one-way valves in the heart. It controls blood flow from the left atrium, where oxygenated blood coming from the lungs collects, to the left ventricle where arterial blood is pumped out into the body. When the left ventricle contracts the mitral valve closes thus preventing blood from going back into the atrium. With a slight delay the aortic valve, the outlet valve from the left ventricle, opens and blood is pumped out into the arterial system.

Two kinds of mitral valve disease occur. Stenosis or narrowing of the valve results in interference with the blood’s ability to flow into the left ventricle. Insufficiency is the inability for the valve to close properly, and allows blood to be pumped back through the valve into the left atrium. Either condition can result in the valve not closing properly resulting in blood leaking, regurgitating, or flowing back into the left atrium. When this happens a murmur can usually be detected.

Mitral valve disease can be the result of a birth defect, or acquired as the result of bacterial or viral infections, some types of cancer that affect the heart muscle or just as a result of the aging process, particularly in smaller breeds of dogs. When the mitral valve does not function properly the ability of the left atrium to empty is compromised and the larger than normal volume of blood in the left atrium causes the pressure in that chamber to increase. As a result blood flow out of the lungs is compromised. Depending upon the severity of the lesion the outcome can be congestive heart failure characterized by pulmonary edema, the collection of fluid in the lungs.

Congenital mitral valve stenosis is more commonly found in Newfoundland and bull terrier breeds but can occur in any breed including mixed-breeds. Acquired mitral valve disease, particularly age associated degenerative valve disease, can occur in any breed of dog but appears to happen more frequently in the smaller breeds and is endemic in King Charles spaniels. Mitral valve disease in the King Charles spaniel has been shown to be a polygenetic disease that can afflict over fifty percent of all individuals of this breed by the time they are five years old. By age ten any of these dogs that survive almost always demonstrate signs of the condition.

Depending upon the severity and progression of the valve disease many dogs will have no clinical signs in the early stages. We usually notice that as the dog gets older it seems to lose energy. Your veterinarian will usually detect a murmur, the result of the blood regurgitating through the diseased valve. This results in turbulent flow and can be detected before any clinical signs are noticed. The loudness of the murmur is not always associated with the severity of disease. A small area of leaking can result in a very turbulent and noisy jet while a large area might not create enough turbulence to create a loud murmur. If the disease progresses the dog may exhibit exercise intolerance, coughing, trouble breathing, increased rate of respiration, weakness and collapse with exercise.

The diagnosis is usually made by auscultation, use of the stethoscope. If the dog is showing clinical signs of congestive heart failure your veterinarian, or the veterinary cardiologist to whom you have been referred, may need to take X-rays, an electrocardiogram, an ultra-sound exam or even catheterize the animal to determine the severity of the disease, the prognosis and the level of treatment required.

Treatment for this condition is palliative, designed to control the symptoms and delay the progression of the disease. Medical treatment cannot cure the problem. Because the valve usually degenerates slowly the treatment can change over time. A variety of drugs are used depending on the stage and progression of disease. These include diuretics, vasodilators, positive inotropic drugs (drugs that increase the force of contraction of the heart muscle) like digitalis, and other agents that may prove beneficial in certain individuals. In humans if the patient is showing signs of heart failure as a result of mitral valve disease the treatment of choice is open-heart surgery and heart valve replacement with a prosthetic valve. This is possible to do in dogs, and available in some very specialized institutions, but it is expensive and usually not an option to be considered.

This disease can also occur in cats and almost any other species of animals but is most commonly identified in dogs. The problem is reasonably easy for your veterinarian to detect and another good reason for regular physical exams.

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I am running this post again because too many people seem to be searching for a way to kill their neighbor’s dog or cat. Since it was originally posted on Jan. 31, 2012 this post receives the most hits almost every day and many reach it by searching, “how to kill an animal with antifreeze” or similar queries. Find information here about how to save your pet if it drinks antifreeze.

This is one of the most common forms of poisoning seen in dogs and cats. It usually happens when the antifreeze drips from your vehicle’s radiator forming a puddle on the garage floor or driveway. The active ingredient in antifreeze is ethylene glycol a syrupy liquid that seems almost addictive to some pets. You must take special care if you change your antifreeze yourself, since pets can get into containers left open or spilled. It is possible for a cat to poison itself by walking through a puddle then licking its paws. As little as five tablespoons of commercial antifreeze is enough to kill a medium sized dog. If you see or suspect your pet has ingested antifreeze you should make it vomit, by giving it a teaspoonful of hydrogen peroxide per five pounds of body weight, but not more than three teaspoonfuls at a time. If it vomits or not, take it to your veterinarian as quickly as possible and explain what you think has happened. If your pet has already vomited, do not try to make it vomit more. Do not try to induce vomiting if the pet is showing signs of distress, shock, difficult breathing or is unconscious.

Ethylene glycol is also an ingredient in some liquid rust-inhibitors, incorporated in solar collectors, used in many chemical manufacturing processes and can be found in a variety of household products. Check the labels! To be most effective, your veterinarian must administer treatment within three to eight hours. Ethylene glycol is actually an alcohol converted, by enzymes in the liver, particularly alcohol dehydrogenase, into oxalic acid. The oxalic acid combines with calcium in the blood to form calcium oxalate crystals that block the nephrons in the kidneys and result in kidney failure.

Since ethylene glycol is an alcohol, the early signs of poisoning resemble drunkenness; euphoria and/or delirium, wobbly gait, uncoordinated movements, nausea as evidenced by excessive salivation, lip smacking, dry heaving, and vomiting. This phase can persist for about six hours and the animal may appear to be better, not so! If untreated the signs progress to excessive urination, diarrhea, rapid heart rate, depression, weakness and eventually into fainting, tremors, convulsive seizures, and coma, all signs of kidney failure.

If you arrive at the animal hospital in time and give a history of your pet ingesting antifreeze, or your veterinarian runs appropriate tests and makes the diagnosis, before signs of kidney failure occur, there is a good chance your pet will be saved. Treatment involves the induction of vomiting. Using activated charcoal to bind any ethylene glycol still in the digestive tract is not effective, but may be indicated when other toxins are suspected. Since 1996, your veterinarian has had access to fomepizole (Antizol-Vet). This drug is an effective antidote, if administered intravenously before kidney damage occurs. Back in the olden days, we used grain alcohol as an antidote, significantly less expensive than fomepizole. Alcohol dehydrogenase has about 100 times the affinity for grain alcohol than it does for ethylene glycol. When used as an antidote the liver metabolizes less ethylene glycol and fewer oxalate crystals form. Depending upon the severity of kidney damage it still might be possible to save your pet with aggressive fluid therapy to flush the kidneys, and other supportive treatment. Some specialty practices may be equipped to provide kidney (renal) dialysis. You do not want to know how much a kidney transplant will cost, but it is possible, in both dogs and cats, in specialized centers with the necessary equipment and experience.

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As a Pre-Thanksgiving offer Travels With Chalize will be available on Kindle for free downloads starting Sat. Nov. 21 and ending Tues. Nov. 24. It is available now and will continue to be available for KDP Select downloads. Don’t miss this opportunity.TWC-front cover

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Official Apex Reviews Rating:

Animals Don’t Blush takes the reader on an enjoyable, eye-opening journey through the ups and downs of a first-year veterinarian in Montana. In accessible, often hilarious language, author David Gross shares a variety of different anecdotes highlighting his rather entertaining experiences as the primary caregiver for a wide cross section of four-legged patients. Throughout the pages of Animals Don’t Blush, Gross’ considerable expertise shines through, as well as the deep-rooted compassion he has for both animals and their owners. Informative without being pedantic, and amusing without being pandering, this page-turning tome is sure to please more than just the animal lovers amongst us.

A highly satisfying literary treat from a truly gifted storyteller.

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Charlize and I just returned from the Pacific Northwest Book Sellers Association annual meeting in Portland, OR. While there Charlize made a host of new human friends and I had the opportunity to meet and greet owners and employees of independent bookstores. It was great fund to talk about my books and to autograph and give books to them. I hope they will read the books and like them. If so they are likely to recommend them to their customers. Giving those books away makes sense to me.

When one of my books is purchased used at least three things happen:

1) Sellers of the new book, especially independent bookstores, lose out. I hate that and so do they.

2) The author and the publisher receive nothing and it competes with the a sale of the book new.

3) It actually costs the publisher and/or author out of pocket. They must pay a “set up fee” plus a monthly fee to warehouse new copies of the book with a distributor.

I’ve had people tell me that they really enjoyed one of my books. When I inquired I found they had purchased it used online or from a used bookstore. I was happy they liked my work but I had no idea one of my books had been sold in this manner and most certainly received no remuneration for the sale.

I hope that when folks are done reading one of my books they will give them as gifts. That will build an audience for my work. Every used book sold competes against a new copy for which I might be paid.

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The Animal Poison Control Center was started prior to my arrival as Head of the then named Veterinary Biosciences department in the College of veterinary medicine at the University of Illinois, Champaign-Urbana. After I took office the Center was taken over by the ASPCA and has grown and become more effective as a result. The service answered more than 167,000 calls in 2014 all involving exposure of animals to possible toxicants. Nearly 16% of those calls were about pets getting into medicines intended for human use, the seventh year in a row that this type of exposure was the most common.

Here are the most common pet toxins of 2014 as reported by the ASPCA:

  1. Human prescription medications. Especially dangerous are ADD/ADHD drugs.
  2. Over-the-counter medications including herbal and natural supplements as well as cough, cold and allergy medications. Many of these contain acetaminophen and/or pseudoephedrine or phenylephrine. All are highly toxic to pets. Glucosamine joint supplements are often flavored and will appeal to some animals, particularly dogs. Overdose can result in diarrhea and occasionally in liver failure.
  3. Insecticides particularly insect bait stations can result in bowel obstructions from ingesting the plastic shell containing the bait.
  4. Household items including paints and cleaning products.
  5. Human foods. Dogs were usually the culprits getting into serious trouble by ingesting large quantities of onions, garlic, grapes, raisins and particularly a sugar substitute xylitol found in sugar-free gum and other products.
  6. Veterinary medications, particularly chewable medications are particularly attractive to some pets.
  7. Chocolate, discussed in a previous blog.
  8. Plants, a long list of plant poisons have been covered in this blog.
  9. Rodenticides, haven’t discussed these but toxicity is obvious.
  10. Lawn and garden products, these include fertilizers as well as weed killers, etc.

Other potential hazards include:

  1. Oxygen absorbers and silica gel packs often found in packages of pet treats, jerky and other edibles. These can result in iron poisoning.
  2. Toxic lily plants including the Tiger, Asiatic, Stargazer, Casablanca, Rubrum, Day, Japanese Show and Easter lilies. Some cats are attracted to these plants and a small amount can result in kidney failure. The Calla, Peace and Peruvian lilies are relatively non-toxic but can result in GI inflammation and upset. These were also described in a previous blog.
  3. For reasons unknown some cats are attracted to antidepressants such as Cymbalta and Effexor. Ingestion can result in severe neurological and cardiac toxicities.
  4. Cats are also more sensitive to non-steroidal anti-inflammatory drugs like ibuprofen and naproxen. Don’t be tempted to treat your cat or dog with these agents.
  5. Glow sticks and glow jewelry contain dibutyl phthalate. If your cat’s mouth and/or skin are exposed from chewing on these objects it can result in a chemical burn.
  6. The leaves, fruit, seeds and bark of avocado trees, particularly those from Guatemala, commonly found in our supermarkets, can be toxic to birds, rabbits and horses resulting in respiratory distress, pulmonary congestion, pericarditis (inflammation of the sac surrounding the heart) and death from large doses. Dogs and cats seem to be much less sensitive to avocado toxicity.
  7. Raw bread dough made with live yeast when ingested, usually by dogs, can expand in the stomach resulting in gastric dilatation that can be life threatening.
  8. Ethanol poisoning, inebriation, was recently discussed along with hops poisoning.
  9. Grape and raisin poisoning has also been covered previously.
  10. Macadamia nuts are attractive to some dogs but are not usually fatal. After ingesting a sufficient quantity dogs may show weakness of the hind legs, demonstrate pain behavior, may show muscle tremors and/or develop a low-grade fever.
  11. Moldy foods can produce tremor genic mycotoxins. Since it’s not possible to determine whether a particular mold is producing these toxins the safest thing is not to empty that container from the back of the refrigerator into your dog’s dish. Cats will just turn up their nose and walk away. Also be on the lookout for garbage, road-kill, fallen fruit or nuts that could be moldy. Don’t let your dog get to them.

As always if your pet is showing any kind of suspected toxicosis get it to your veterinarian as soon as possible.

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