Lymphoma is the most common cancer seen in small animal veterinary medicine, and can affect the lymphoid tissue of many possible organs. By far the most common area of involvement is the peripheral lymph nodes of the body, but lymphoma may also spread and involve internal areas, as well as even the skin. Causes of lymphoma are believed be genetic in origin; however, environmental factors, including overexposure and sensitivity to chemicals, pesticides, and even over-vaccination are all believed to play roles in increased development of lymphoma.
Clinical signs will vary depending upon the location of the cancer, but with peripheral lymphoma(the most common type), symptoms include firm swellings around the body, especially under the neck, as well as nonspecific symptoms of illness such as lethargy, loss of appetite, weight loss, vomiting/diarrhea and/or coughing or difficulty breathing. While tentative diagnosis of lymphoma is often made by needle aspiration of affected lymph nodes, definitive diagnosis usually requires an excisional tissue biopsy.
Treatment of lymphoma usually involves a sequential chemotherapy protocol, which will vary depending upon severity and location of the lymphoma. Prognosis for remission is usually very good, with some animals achieving cancer free periods for 1-2 years; however, the prognosis for cure is very guarded.
Paw pad injuries in pets are fairly common. Trauma is by far the biggest cause of paw pad injuries. Because paw pads are areas quite rich in blood flow, injuries to these areas can be quite painful and may bleed easily as well. Signs of paw pad injuries include lameness of one or more limbs, as well as bleeding around the paw pads. In addition, laceration of the paw pads often occurs.
Because of the nature and location of these injuries, many times suturing is not possible, and therefore protective dressing and bandaging is often required. Paw pad injuries are especially common in the wintertime when pets often are walking on icy or salt treated roads and side walks. Depending upon the severity of the paw pad injuries, oral antibiotics may be needed. With those superficial injuries of the paw pads, I will often instruct clients to apply topical vitamin E, aloe vera or calendula gel to the areas to promote and encourage healing.
Strokes occur not only in people, but in pets as well. This will happen when there is interruption of blood flow to the brain, leading to cell damage and cell death. Symptoms often come on acutely, and may include sudden paralysis of the legs, as well as weakness of the cranial nerves resulting in facial drooping, and loss of other reflexes. Causes of a stroke include high blood pressure, toxin exposure, trauma, cancer, as well as on occasion viral and bacterial microbes. In the vast majority of cases a definitive cause is not found.
Presumptive diagnosis of a stroke is made by ruling out other causes of sudden neurologic symptoms. Definitive diagnosis of stroke, however, is only possible through neurologic testing such as an MRI test performed at a referral veterinary facility. Treatment of stroke is mostly supportive and includes IV fluids, as well as antibiotics to prevent secondary infections, as well as anti inflammatory agents. Prognosis for return to function is always guarded, and depends upon the severity of the symptoms.
Entropion is defined as an anatomic abnormality where there is inversion of either the upper or lower eyelid. In many cases the inverted eyelids will contact and rub on the underlying cornea. This genetic condition may be seen in any breed of dog, but is more common in certain breeds such as the Chinese Shar-Pei and the Akita. The severity of the entropion will determine what the presenting clinical signs are. The many clinical signs include spasm and closure of the eyelids, light sensitivity, varying amounts of eye discharge, as well as secondary scratching and irritation of the cornea. Treatment of entropion involves surgical correction of the anatomic abnormality, as well as treatment of the secondary eye inflammation with topical antibiotics and antispasmodics. The prognosis is excellent for a full recovery.
One of the more common presentations in sick puppies is when they present knuckling over, either while standing or when trying to walk. There are many possible causes of why puppies would knuckle over. Knuckling over is usually a sign of weakness, which is often secondary to metabolic factors and/or neurological factors. For example, puppies with low blood sugar are often quite weak and may knuckle over when attempting to walk. These puppies also may have little appetite, be very weak and may even present with tremors or even seizures.
Treatment of these puppies will center on slowly raising blood sugar, as well as treating the many possible underlying causes of low blood sugar. Puppies with brain and/or spinal lesions also may present with knuckling over. Certainly trauma, toxins, and various viruses all may affect the nervous system resulting in knuckling over. Developmental abnormalities of the spinal vertebrae may lead to spinal compression and secondary knuckling over may be seen. Treatment will be determined by correcting these underlying causes, and prognosis will also vary, as long as these underlying causes are treatable.
Regurgitation is defined as the passive reflux of food and/or liquids secondary to some sort of inflammation or abnormality of the esophagus. Vomiting, on the other hand, is defined as the active eructation of food and/or liquid secondary to inflammation of the stomach or intestines. In veterinary medicine, it is important to differentiate regurgitation from vomiting, as they are both treated differently, and have different underlying causes.
Most commonly, regurgitation consists of undigested food and/or liquids. Causes of regurgitation include various disorders of the esophagus, including esophagitis, foreign body ingestion, as well as a condition known as megaesophagus. Differential diagnoses of regurgitation are distinguished by history, physical exam and possibly x-rays and contrast studies. Treatment usually consists of feeding a bland, easily digested diet, as well as often antacids (i.e. Pepcid AC, Sucralfate) as well as medications to promote the forward movement of food (i.e. Metoclopramide) down the esophagus. Prognosis will vary depending upon the diagnosis.
A workup for chronic vomiting also includes the above testing, but may also include further imaging such as ultrasound or endoscopy, as well as more involved blood work. Treatment will also be based on determination of an underlying cause, as well as symptomatic medications such as the ones mentioned above, as well as newer drugs such as prescription Cerenia.
Cerebellar hypoplasia is a condition where the part of the brain known as the cerebellum is not fully mature at birth. Causes of cerebellar hypoplasia include injury, poisoning, and malnutrition. Bacterial and viral infections, including panleukopenia in cats, also may result in the birth of pets with cerebellar hypoplasia. Symptoms include jerky movements, tremors, uncoordinated motion, as well as the animal will often fall as it tries to walk. The tremors seem to increase when the animal is excited, while they typically will ease up at rest.
There is currently no treatment or cure of this condition in dogs and cats. The disease is not typically progressive, and most pets will have a normal lifespan. Living with a disabled animal requires making adjustments in the home environment to insure safety for the affected pet.
One of the hottest topics in both human and veterinary medicine is the overuse of antibiotics. While antibiotics can certainly be life-saving, the overuse of antibiotics may lead to the development of resistant bacteria that can result in severe disease. It is important for every medical doctor to look at the patient closely in deciding whether or not antibiotic use is indicated.
Fevers, for example, indicate inflammation in the body, and not necessarily infection. With eye, skin, eye or ear inflammation it is often better to perform certain tests before placing a pet on antibiotics. Evaluation of eye and ear discharges under the microscope can help sort out whether an infection is present, and whether antibiotics are indicated. Cultures of the urine and/or airway secretions also may be helpful in guiding whether antibiotics should be used. If there are symptoms of severe vomiting or diarrhea with blood, then the judicious use of antibiotics should also be considered.
Pet poisoning with common household items is, unfortunately, a fairly common situation. Among the many household items that may present a toxic risk to pets include xylitol poisoning (xylitol is found in many sugarless gums, candies and mints), human medications such as non-steroidal anti-inflammatory medications and antidepressants, flowers, chocolate, fertilizers, and various pest control products. Symptoms can range from digestive upset and neurological signs, to liver and/or kidney failure.
Appropriate pet proofing and awareness of what to do in the event of a pet poisoning situation are both important points to consider. Having the telephone numbers of local poison control centers as well as veterinary emergency hospitals is also important for ready access to sources of information about potential poisonous substances. Specific treatment will depend upon what a pet has been exposed to. Sometimes induction of vomiting is indicated, while in other cases IV fluid therapy and oral charcoal therapy may be indicated. The Pet Poison Helpline is useful for clients in those cases where poisoning is suspected. The Pet Poison Helpline at 800 213-6680 is available 24 hours a day. If you suspect your dog or cat has ingested something poisonous, call the helpline or your local veterinarian immediately.
Pancreatic insufficiency is a chronic disease in animals that can certainly affect long-term health. This disease occurs when the immune system destroys the part of the pancreas involved with digestive enzyme production. In other cases, that part of the pancreas fails to develop adequately. In either case, digestive enzymes are not produced in adequate numbers leading to symptoms of chronic often fatty diarrhea, ravenous appetite and often severe weight loss. While pancreatic insufficiency can occur in all breeds, there are certain breeds, such as the German shepherd, where the disease is more common.
Any pet that presents with the above symptoms should have a full medical workup, including CBC/chemistry blood work, urine analysis, as well as stool checks for parasites. X-rays and ultrasound may also be indicated. This workup is important to rule out other causes of chronic diarrhea in pets. The definitive diagnosis of pancreatic insufficiency is done by a TLI blood test performed by your veterinarian. Treatment of pancreatic insufficiency includes a low-residue, easily absorbed, low fat diet, as well as the supplementation with digestive tract enzymes from products such as Pancrezyme. I also find that adding probiotics is helpful in long term management of this disease. Prognosis for control of the disease is excellent, as long as pets are maintained on special diets and supplemented with the appropriate digestive enzymes.
