Diets for Pets with Kidney Disease

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In the past, most conventional veterinarians have recommended prescription low-protein diets for pets with kidney disease.

One of the most controversial issues in nutritional veterinary medicine surrounds the topic of what is the best diet to feed pets with documented kidney disease. In the past, most conventional veterinarians have simply recommended prescription low-protein diets. The theory behind using these diets is that, by using diets low in protein, we will reduce the workload that the kidneys have to do and thus slow down disease progression. In my experience and opinion however, many of these diets are made with highly inferior ingredients, including meat byproducts, excessive grains, as well as artificial colors and preservatives.

Research in recent years has also questioned whether restricting protein too early in pets with kidney disease may actually accelerate disease progression. In my practice, I much prefer to recommend natural raw meat based diets to pets of all ages. There is an excellent low-protein homemade diet recipe in the book Dr. Pitcairn’s guide to natural health for dogs and cats by Richard Pitcairn, DVM, PhD that I have found quite useful over the years.

Hypertrophic Cardiomyopathy in Pets

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Hypertrophic Cardiomyopathy is more common in cats than dogs

Hypertrophic cardiomyopathy is a form of acquired disease of the heart muscle seen most commonly in cats, and less commonly in dogs. While there can be environmental, nutritional and medical causes of some forms of cardiomyopathy, the most common cause in both dogs and cats is genetic in origin. Some cats with hyperthyroidism also can on occasion develop cardiomyopathy, which will often resolve once the overactive thyroid is addressed.

Symptoms of hypertrophic cardiomyopathy can vary, and may include sudden difficult breathing due to congestive heart failure, as well as nonspecific symptoms of loss of appetite, vomiting and changes in behavior. In some cases, blood clots may form and lead to sudden paralysis of most commonly the hind legs. Some patients with cardiomyopathy may develop abnormal heart rhythms, which may predispose some pets to a risk of sudden death without any symptoms appearing beforehand.

While it is sometimes possible to diagnose cardiomyopathy through a combination of physical exam, x-rays and an EKG, often a cardiac ultrasound is needed to document the severity and form of cardiomyopathy present. This echocardiogram is most helpful in defining long term treatment plans, as well as allowing us to determine the progression and prognosis of the heart condition.

Treatment of hypertrophic cardiomyopathy usually involves drugs such as Lasix or Furosemide to reduce fluid buildup, as well as other medications such as Enalapril to help dilate blood vessels and ease the workload on the heart. Sometimes low-dose baby aspirin is used to help lessen the likelihood of future blood clots developing. Most patients with hypertrophic cardiomyopathy will need periodic monitoring by the veterinarian through x-rays and/or echocardiogram. Prognosis will vary with earlier diagnosis and treatment having a better long term prognosis than those pets presenting with hind leg paralysis or congestive heart failure.

Canine Parvovirus

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Parvovirus is most common in unvaccinated dogs under 1 year of age

One of the most feared contagious viruses seen in small animal clinical practice is canine parvovirus. This aggressive virus is most commonly seen in unvaccinated dogs under 1 year of age. Disease incidence is highest in crowded stressful environments, including kennels and shelters; however, viral transmission may also occur through contact of infected feces at dog parks and on grass on walkways. The virus is very hardy and resistant to many common virocidal agents, and can survive for long periods in the environment. It is not uncommon for many puppies at once to come down with parvo in a crowded, stressful kennel situation.

Clinical signs of parvovirus include lethargy, loss of appetite, vomiting and often foul bloody diarrhea. Some pets may develop inflammation of the heart muscle, while in other cases sudden death without any clinical signs may occur. While diagnosis of parvovirus can be suspected based on history and clinical presentation, definitive diagnosis is usually made by viral antibody testing of the feces.

Treatment of parvovirus is best done in the veterinary hospital setting, and usually includes IV fluids and antibiotics to prevent secondary bacterial infections. Many dogs with parvovirus will also have intestinal parasites as well, which will also need to be treated. Holistic veterinarians will often report great success in treating parvovirus with herbal therapies, as well as individually prescribed constitutional homeopathic remedies.

Prognosis of parvovirus is guarded, with the cases that are treated early and aggressively having the better prognosis. Prevention of parvovirus is best through proper vaccination of susceptible puppies up to 16 weeks of age. Immunity to parvovirus vaccination lasts for years to the life of the pet, so further vaccination of adult dogs is often not needed, and I will often measure vaccination antibody titers in adult pets instead of vaccinating them, due to my concerns of over-vaccination and vaccination induced disease. I also recommend that animal guardians feed as natural a diet as possible; ideally in my opinion a species appropriate raw meat based diet is best for pets of all ages.

Anaplasmosis in Pets

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Anaplasmosis is a tick-borne bacterial infection typically carried by deer ticks

Anaplasmosis is a tick-borne bacterial infection typically carried by deer ticks and transmitted to dogs by tick bite. Clinical signs typically develop within 10-14 days after being bitten by an infected tick. However, in some cases pets may become sick months later. Typical signs include lethargy, high fever, swollen joints and a shifting lameness.  Some pets may develop vomiting and/or diarrhea, as well as neurologic signs. Rarely, seizure complications may occur, as well as liver or kidney damage. Other pets may show no clinical signs, and may clear the infection on their own, while some pets may show signs after immune stress.

While Anaplasmosis may be suspected based on history, clinical signs and initial blood work, a special in office test known as a 4DX test at the veterinary office is the way that this disease is definitively diagnosed and differentiated from other tick born diseases like Lyme disease or Rocky Mountain Spotted fever.  Treatment typically involves a 4 week course of Doxycycline, with clinical symptoms often rapidly improving within a few days of therapy. Holistic veterinarians will also work on dietary changes to preferably a home-made raw meat based diet, as well as work on strengthening the immune system with herbal and homeopathic remedies.

There is no effective vaccination for preventing Anaplasmosis, with good tick control using conventional or natural products being the cornerstone of preventing this disease.  Prognosis for a full recovery is usually excellent.

Excessive Thirst in Pets

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There are many possible causes of excessive thirst in pets.

Excessive thirst is one of the more common clinical complaints pet guardians report in pets with chronic disease. Often, when pets have excessive thirst, they will have excessive urination as well. There can be many possible causes of excessive thirst and urination. Metabolic problems of the liver and kidney, including inflammation and infection may cause excessive thirst. Hormonal problems such as diabetes and Cushing’s disease may also cause excessive thirst and urination. In older pets, various cancers may also cause excessive thirst. It is also important to recognize that various dietary factors, including high salt or processed commercial pet foods may also cause excessive thirst and urination.

Any pet with chronic excessive thirst should have a complete medical workup at the veterinarian, including blood CBC/chemistry and urine analysis as a baseline of tests. If these tests fail to reveal the underlying causes of excessive thirst or urination, additional blood work may and urine testing may be indicated, as well as x-rays and possibly ultrasound. Treatment and prognosis of excessive thirst will vary depending upon the underlying cause, but with early testing and diagnosis, most cases can be successfully managed.

What is FIP in Cats?

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FIP is most common in young or older cats over 12 or 13 years of age

Feline Infections Peritonitis (FIP) is a contagious virus seen sporadically in cats that can cause serious disease, and even death. FIP is a type of virus known as a corona virus, of which there are many types seen in our feline companions. While FIP is most commonly seen in cattery, boarding kennels and other places of crowding, it can be seen sporadically in the pet population. The incidence of FIP is highest in young cats under the age of two, as well as in older cats above 12 or 13.

FIP is usually transmitted through contact of oral and nasal secretions, as well as stools of affected cats. While many cats may become exposed to FIP virus at some point in their life, the incidence of actual clinical disease development is sporadic. FIP causes an inflammation of the blood vessels known as a vasculitis. Symptoms will vary depending upon the organs involved, but it is not uncommon for FIP to occur in the digestive tract, kidneys, lungs, eye and even brain.

FIP is usually on our list of differential diagnoses in any chronically ill cat with nonspecific vague symptoms in these various organ systems. There are two common forms of FIP, known as the dry form, as well as the wet form, with the latter often leading to buildup of fluid in the abdomen or chest. Diagnosis of FIP is sometimes made by finding the characteristic fluid in the chest or abdomen, but definitive diagnosis often involves analyzing this fluid at a lab, as well as biopsies and other laboratory and blood testing.

Treatment of FIP is palliative at best, with fluid therapy and antibiotic therapy; however, the course of the disease is usually fatal. Holistic treatment options may increase the chance at a more favorable outcome.  To learn more about homeopathy, see Canine World.

Preventing Lyme Disease in Pets

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It is far better to prevent Lyme disease in your pet than to treat it.

Lyme disease is one of the most common tick-borne diseases seen in pets today. When left untreated, Lyme disease can result in debilitating lameness and arthritis, as well as occasional neurological, cardiac and fatal kidney disease. Lyme disease is diagnosed through a combination of blood tests, history of tick exposure, as well as having clinical symptoms as part of the history and physical exam of the pet. While Lyme disease is easily treated with a 3-4 week course of Doxycycline, it is far better to prevent this severe infection, rather than treat it.

The most important aspects of prevention revolve around preventing tick bite and exposure to affected animals. Fortunately, there are many effective tick control products on the market that effectively repel and kill ticks. One of my favorite products is the Preventic Amitraz Tick Collar. When this collar is properly fitted to the pet’s neck it can detach and kill ticks for up to 3 months. The only negative issue surrounding this collar is that it cannot be submerged in water, so it must be removed in those pets when swimming or from those pets that are often out in the rain.

My other two favorite products for preventing tick infestation and Lyme disease transmission are Frontline Plus and K9 Advantix II.  I have especially found the latter product helpful in preventing tick attachment and infection transfer. When used according to the labeled recommendations, both of these products are highly effective in minimizing tick exposure. Other products like Revolution are also helpful in many cases.

While there is a vaccination for prevention of Lyme disease, I have not been impressed with either the efficacy or safety of even the newer Lyme vaccinations, and I therefore don’t recommend Lyme vaccination of dogs. Many years ago there were problems with Lyme vaccinations in people, and I have found similar problems in dogs vaccinated for Lyme disease.

There is also an excellent homeopathic remedy called Ledum, which I have occasionally found helpful when used in dogs experiencing early signs of Lyme disease.  Consultations with homeopathic veterinarians to help strengthen the pet’s immune system through diet and nutritional supplementation, in addition to homeopathic remedies and herbal supplements, can also go a long way in preventing Lyme disease in our pets.

Pyoderma in Pets

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Many pets with pyoderma will have itching of the skin

Pyoderma in pets is defined as inflammation of the hair follicles, which in most cases is due to overgrowth of bacteria on the skin. The most common bacteria involved is a staph bacteria; however, other bacteria including E coli and pseudomonas bacteria also may be involved. Pyoderma may occur in any breed or any age of pet.

The most common clinical findings in pets with pyoderma include various papules and pustules on the skin, along with secondary redness, scaling and often hair loss. Many pets with pyoderma will also have increased itching. Treatment of pyoderma most often involves prescription oral antibiotics for a minimum of 2 to 3 weeks, as well as periodic bathing with antibacterial shampoos. It is also important to address potential underlying causes of pyoderma, including inhalant/contact allergies, flea bite allergies, food allergies, and possibly hormonal disorders; otherwise, the risk of recurrence of pyoderma is increased.

Rocky Mountain Spotted Fever in Pets

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Rocky Mountain spotted fever is a tick-borne illness transmitted by the American Dog tick

Rocky Mountain spotted fever is a tick-borne disease that has been seen in increasing numbers in recent years, as veterinarians are doing more and more testing for tick-borne diseases. There are several species of ticks that may be involved, but the American Dog tick is the most common one incriminated. Depending upon the dog’s immune status, some pets will develop acute signs of Rocky Mountain spotted fever, while others may develop more chronic forms of this condition. An inflammation of the blood vessels secondary to infection is believed to be the cause of most of the clinical symptoms in infected dogs.

The clinical signs of Rocky Mountain spotted fever are quite variable, but may include lethargy, loss of appetite, lameness and stiffness, swollen joints, bleeding from the mouth, anus or urinary tract, as well as bruising on the skin. Pneumonia and cardiac arrhythmias may also be seen. Many times, neurologic complications may occur.

Diagnosis of Rocky Mountain spotted fever is best made by recognizing the clinical signs, in conjunction with blood antibody testing to document recent exposure and infection. Recently, newer PCR blood tests are now available for many tick-borne diseases. Treatment of Rocky Mountain spotted fever usually involves one month of therapy with the antibiotic Doxycycline. In rare cases, pets may need cortisone to help lessen the immune response.

Prognosis for full recovery is excellent, however occasionally pets may experience flare-ups months or years later. Because of the potential for human infection with Rocky Mountain spotted fever, it is very important to implement a good tick prevention program with products such as K9 Advantix II or Frontline Plus.

Why Does My Pet Have Pale Gums?

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Pale gums in your pet may be a sign of anemia

Pale gums in a pet can certainly be a serious clinical finding. The most common cause of pale gums in a pet is the presence of anemia. Anemia occurs when there is a lower than normal red blood cell count in the circulation. Anemia can have many causes from blood loss (secondary to external or internal parasites, cancer, etc.) to a condition where a pet’s immune system reacts against its own blood cells. Many tick born infections also may cause anemia, in addition to numerous other chronic diseases.

Pale gums  may also be seen secondary to circulatory problems, as well as allergic reactions. Because of the potential severity of many of these conditions, it is important for animal guardians to see a veterinarian as soon as possible for a complete medical workup in any pet with persistent pale gums.