One of the most frustrating oral diseases seen in dogs and especially cats is one called stomatitis. Stomatitis is defined as an inflammation of the structures of the oral cavity including the gums, cheeks, palate and sometimes throat. In many patients this starts out occurring around the teeth, but eventually may spread to involve any area of the mouth.
While bacteria may be involved as instigating factors, the exact reason why stomatitis occurs is not known. It is believed that an overactive immune response of the immune system to antigens or tissues of the oral cavity may be involved. This overactive immune response will lead to symptoms of inflammation and redness, ulceration, drooling and foul odor. In severely affected pets, the ability to eat and drink may be compromised. Diagnosis is often suspected from direct visual exam; however, biopsy of the affected tissues of the mouth is necessary for a definitive diagnosis.
While ultrasonic dental cleaning and extraction of diseased teeth, as well as antibiotics may be helpful, these still do not address the underlying cause of stomatitis in most cases. In many causes immune suppressive medications with drugs such as Prednisone and gold salts may be needed. Other drugs including Azathioprine and Cyclosporine may also be needed in more serious cases. Mouth washes, including Chlorihexidine flushes, may also be helpful to soothe ulcerated and inflamed tissues. The prognosis for cure of stomatitis is certainly guarded; however with aggressive medical and sometimes surgical treatment, most pets may lead normal lives.
A common neurological condition that presents in most senior pets is a condition known as idiopathic vestibular syndrome. This condition often comes on suddenly and in most cases no known eliciting cause is determined. The most common symptoms of vestibular syndrome include head tilt, rapid involuntary motion of the eyeballs, as well as unsteadiness on the feet and often falling over. Many pets may vomit because of the likely dizzy sensation they are feeling.
This condition most commonly involves an inflammation of the nervous system involved with balance. Trauma, toxins and bacteria are usually not involved, which is why we label this condition idiopathic and of unknown origin. The condition also occurs seasonally in young to middle aged cats for unknown reasons. Treatment usually includes hospitalization and IV fluids, along with injectable anti-nausea medications and antibiotics to prevent secondary infections. Often the motion sickness drug Meclizine is used to decrease the likely motion sickness and nausea perceived by affected animals. The condition will usually self-resolve with or without supportive treatment over a period of several days. Prognosis is therefore excellent.
Pets can lose weight for a variety of health reasons. Dietary inadequacy and/or dietary allergies may be involved in some cases. Intestinal parasites are also possible. Any sort of chronic metabolic disease, including inflammation of the liver, kidney or pancreas may also cause weight loss. Hormonal conditions including Addison’s disease and diabetes also may result in weight loss. Infectious or inflammatory disease, including inflammatory bowel disease, as well as cancer anywhere in the body are other possible conditions.
Any pet with chronic weight loss should have a full medical evaluation and workup, including a CBC/chemistry blood profile, urine analysis, as well as several stool checks for parasites. X-rays and/or ultrasound also may be needed. After an extensive workup the cause of chronic weight loss can often be detected. Prognosis will vary depending upon the specific cause of the weight loss, as well as early detection through these appropriate diagnostic tests.
Toxoplasmosis is a single-celled parasite and may be found in nearly all warm blooded animals, including pets and humans. Toxoplasmosis has a complex life cycle with two types of hosts, including an intermediate host and a definitive host. Domestic and wild cats are the only definitive hosts for toxoplasmosis. This means that cats are the only species that produce eggs or oocysts when toxoplasmosis infects cats. This typically occurs when cats are exposed to the organism; however, cats shed the organism only a few days out of its whole life cycle. Therefore, the chance of human exposure from cats is very small.
Most cats show no symptoms of toxoplasmosis. In situations of stress or immune suppression, as well as infection with FelV/FIV viruses, symptoms may include fever, loss of appetite, and lethargy. In rare situations, toxoplasmosis may affect and cause symptoms in other areas of the cat’s body, including the lungs, eyes and central nervous system.
Diagnosis of toxoplasmosis is made by a combination of history, clinical signs and blood antibody tests. Treatment involves typically a 3-4 week course of antibiotics, most commonly Clindamycin or sulfonamides. Most cases of human toxoplasmosis do not come from cats, but from contact with oocyst contaminated soil, and from eating undercooked meat. Pregnant women and immune-deficient women seem most at risk. Prevention involves preventing pregnant women from handling litter boxes, as well as not eating undercooked meat, unwashed fruit or vegetables, or unpasteurized milk. Preventing cats from hunting or roaming also will help in minimizing disease.
Mammary tumors are fairly common tumors seen in dogs and cats. These tumors are most commonly seen in middle-aged and older un-spayed dogs and cats; however, they can also occur in pets who have gone through repetitive heats and/or who have been spayed at an older age.
Symptoms of mammary tumors typically include finding one or multiple breast nodules often felt associated with the teats. In advanced cases, these tumors may ulcerate and bleed to the outside. In dogs these tumors are benign 50% of the time. In cats, some report that over 90% of these tumors may be malignant. In malignant cases, mammary tumors often spread to the regional lymph nodes and lungs. Diagnosis is typically made by surgical biopsy, and surgical removal of the affected glands remains the most common form of treatment.
Prognosis will vary depending upon whether the tumor is malignant, as well as how early surgical removal is performed. In some malignant cases, palliative chemotherapy or radiation therapy may be tried; however, prognosis in these advanced cases is usually very poor.
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One of the more common chronic diseases seen in veterinary medicine is chronic renal failure. There are many possible causes of chronic renal failure including bacterial/viral infections, toxin exposure (i.e. antifreeze, non-steroidal anti inflammatory drugs, certain antibiotics), and autoimmune disease, where the pet’s immune system reacts against its own kidneys. |
Symptoms of chronic renal failure include lethargy, appetite and weight loss, increased thirst and urination, dehydration, vomiting, as well as increased foul odor of the breath. It is important to have a full medical workup including CBC/chemistry blood work, urine analysis and urine culture to differentiate chronic renal failure from other causes of these common symptoms. The finding of elevations in blood BUN and creatinine, as well as dilute urine with urinary casts seen on urine analysis is consistent with a diagnosis of chronic renal failure. Other common laboratory abnormalities include elevation in blood phosphorus, decrease in blood potassium, and anemia of chronic disease.
Treatment of chronic renal failure will need to address many of these metabolic abnormalities in order for the patient to feel better. If a patient is acutely ill with loss of appetite and/or vomiting, IV fluid therapy may be need initially in the veterinary hospital, along with systemic antibiotics, and medications to decrease nausea and vomiting. Once patients are stabilized, it is often best to continue fluid therapy at home in the form of subcutaneous treatment given by the animal guardian several times a week. This will help in decreasing dehydration, as well as flushing kidney toxins out of the blood stream.
Another important part of long term treatment at home is the feeding of a low-protein diet, preferably a home-made diet, but commercial diets are acceptable alternatives as well. Other ancillary drugs include oral medications to decrease nausea and vomiting, as well as stimulate appetite if needed. Drugs to bind phosphorus are also important in slowing down progression of chronic renal failure. With aggressive dietary and medical treatment, most pets may live many years with chronic renal failure.
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Inflammatory bowel disease is being diagnosed with increased frequency in both dogs and cats. Symptoms may include vomiting, diarrhea, changes in appetite and weight loss. It is important to have a complete medical workup for any pet with chronic digestive tract symptoms to rule out other metabolic causes from inflammatory bowel disease. |
Parasites also need to be ruled out by microscopic fecal exam. The definitive diagnosis for inflammatory bowel disease typically involves surgical or endoscopic biopsy. This is especially important in differentiating infiltrative cancer from inflammatory bowel disease. Once a diagnosis is obtained, there are several medical options for long term management of inflammatory bowel disease.
Many veterinarians will routinely worm pets with anti-parasitic medications such as Panacur C, even if stool samples are negative, as many pets may have hidden parasites contributing to the clinical symptoms. If worming is not successful in alleviating clinical signs, then dietary therapy is often instituted. The most common diets used will be novel protein diets that the pet has not been exposed to before, including rabbit, venison or buffalo. In other cases, hydrolyzed protein diets which are easy to digest may sometimes be used.
Medical therapy with antibiotics including prescription Metronidazole and/or Tylosin is also often prescribed, while dietary trials and/or worming are being tried. If there is no improvement with any of these measures, then immune suppressive medication with drugs like Prednisone and/or Atopica are next used, typically in tapering dosages over several weeks.
Through both dietary and medical interventions, most pets with inflammatory bowel disease lead normal lives and have a good prognosis.
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Cancer is one of the most common geriatric diseases affecting both dogs and cats. Cancer may involve any organ system from the skin to more interior locations, including the lymph nodes, digestive tract, liver, spleen, kidneys, lung and brain. While cancer may affect pets of any age, cancer is more likely to occur in adult and senior pets.
Symptoms of cancer are quite variable and often mimic many other chronic diseases. General signs of illness include lethargy, loss of appetite, weight loss, and changes in behavior. Other nonspecific signs may occur including vomiting, diarrhea, changes in urination, more rapid difficult respiration, and coughing. The development of sudden growths of lumps felt on the skin also may signal cancer. |
It is important that pets with any of these clinical signs be thoroughly evaluated by the veterinarian, and that a full diagnostic workup including blood, urine and radiologic testing is done so that cancer may be differentiated from other diseases. Most lumps or growths can often be routinely aspirated right in the office with a needle to find out if they are malignant, so that appropriate treatment can be instituted.
| Kennel cough is an infectious disease of the airways most commonly seen in dogs. The most common causative agents include the bacteria Bordatella bronchiceptica, but additional bacteria including Mycoplasma may be involved. In many cases viruses such as parinfluenza also contribute to clinical symptoms. |
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Kennel cough is most commonly seen in areas where there is a high concentration of dogs including dog parks, boarding facilities, grooming parlors, kennels and veterinary hospitals. Stress and poor hygiene are believed to be the biggest factors involved with the development of clinical disease. Symptoms of kennel cough include lethargy, loss of appetite, dry hacking cough, exercise intolerance and in some cases, eye and nose discharge. Any pets displaying these clinical signs should have a full veterinary exam.
It is important to differentiate kennel cough from other causes of infectious cough including influenza and canine distemper. Veterinarians also must keep in mind that cats may also develop signs of sneezing and upper respiratory symptoms on exposure to kennel cough. Treatment of kennel cough typically involves a 10-14 day course of a broad acting antibiotic such as Doxycycline, Baytril or Clavamox. Cough suppressants as well as immune stimulants such as Echinacea and goldenseal also may be used in certain cases.
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One of the most common liver disorders seen in cats is a disease known as hepatic lipidosis, a potentially fatal condition where the liver develops progressive fatty infiltration and dysfunction. Symptoms of this disease commonly include weight loss, partial or complete loss of appetite, vomiting, and often a progressive yellowing of the mucous membranes (i.e. eyes, gums and skin). |
There is often a history of obesity prior to onset of clinical symptoms. Many times an emotional and/or physical stress may also precipitate disease onset. For example, many animal guardians who are intent on getting their overweight cats to lose weight will often change diets to a low fat diet. Many finicky cats may not like the diet change and going off food for even a few days can sometimes lead to the onset of hepatic lipidosis in susceptible cats.
Diagnosis of this disease is often made by clinical history, as well as labwork suggesting fatty infiltration of the liver. Definitive diagnosis often requires ultrasound and/or needle aspiration or biopsy of the liver. Other disorders such as pancreatitis, inflammatory bowel disease, and inflammation of the liver (known as cholangiohepatitis) may also exist at the same time in affected cats. These conditions can complicate management of hepatic lipidosis, as well as also lead to secondary infections and liver failure.
Treatment of hepatic lipidosis involves getting nutrition into these often severely anorectic cats by either force feeding and/or veterinary surgical placement of a feeding tube. With aggressive nutritional support, many cats can be cured of this potentially life threatening disease. The best way of preventing this disease is through consistent and wholesome diets, and doing any dietary changes gradually with cats.
