Memorial Day Exhaustion

Tony is so sleepy. Basil looks bored!

Liver Disease in Cats

 Liver disease is a terrible, angry disease that affects people and animals. Everyone knows the characteristic yellowing of the skin that can occur as someone progresses deeper into liver failure. Although we seem to think of liver disease as mostly affecting people, we do see it in cats and dogs as well.

The liver is an organ with many jobs, including the breakdown of fats, carbohydrates and proteins, storage of vitamins, minerals and fats, and maintaining cells that play a role in normal clot formation. The liver also helps detoxify drugs and other chemicals ingested. Although the liver is susceptible to injury, it is known for its ability to regenerate if there is damage. The liver must be greatly damaged, approximately 2/3 to 3/4 compromised before it will show signs of failure.

Most cats with liver disease will display some combination of not eating, vomiting, diarrhea or fever. Sometimes with our pets we don't identify the early signs of liver disease until they have been present for several weeks, sometimes even months. It is hard to keep track of vomiting or appetite in a cat that goes outdoors. Jaundice (yellow tint to the gums, whites of eyes), fluid accumulation in the abdomen and weight loss are signs of serious disease. 

We need to understand what is causing the damage to the liver to be able to determine the appropriate treatment. Blood tests are our main tool for diagnosing liver disease. A blood chemistry panel may show liver enzymes that are generally elevated when the liver is diseased. Inflammation, infection, toxin or drug ingestion, bile duct obstruction and cancer are a few things that can cause elevations. We can also identify decreases in the red blood cells causing an anemia or in the platelets, which can cause spontaneous bleeding.

After blood work is performed, radiographs (X-rays) are useful in determining abnormal liver size or shape and diseases of the gallbladder. Ultrasonography can further help to determine if the problem lies in the bile duct or blood vessels. Irregular densities noted on ultrasound might suggest a tumor. Using the ultrasound and a needle, we are often able to obtain a sample of cells from the liver to get a diagnosis. In some cases, an exploratory surgery with biopsies is required to be able to determine a diagnosis.

Early treatment is important for the greatest success. If no cause can be identified, supportive care is usually started. This often times includes intravenous fluid therapy, antibiotics and nutritional supplements to protect and support the liver. Diet changes also will help preserve liver function. There are a few supplement type medications that have been shown to greatly promote healing of the liver and give it a chance to regenerate. Prognosis of liver disease depends on the underlying cause and your cat's response to therapy.

Rabies Statistics in Maryland

My biggest concern as a veterinarian is the possibility of contracting rabies. While this would be highly unlikely since I am vaccinated against the virus, it is a highly fatal disease. In June of last year, a girl became only the 3rd person  in the U. S. to survive rabies. Last December a woman in South Carolina was diagnosed with rabies after being bit by a cat. She died a few days after her story was released.

 There were 305 confirmed cases of rabies in 2011 in Maryland. 17 of the cases were cats and 3 were dogs. The majority of cases were raccoons. This is the smallest number of confirmed cases of rabies since the 1980's in Maryland. Since that time there have been great efforts by health officials to prevent the spread of rabies in our state. These efforts have included vaccination clinics for domestic pets as well as treats that are dropped in forested areas that have an oral form of the rabies vaccine for raccoons to eat. The goal is that the raccoons will eat the bait and be immunized against rabies. 

 While these numbers have been improving, 3 positive dog cases is an unusually high number.  Rabies is a very serious disease. If an animal contracts the disease, they begin to show neurologic signs including excessive salivation, staggering and falling and unusually aggressive behavior.  Rabies in animals can only be diagnosed after the animal dies. If you are concerned that one of your pets or a wild animal near your home may have rabies, please contact your veterinarian or state health officials immediately.

Why Veterinarians Hate The Internet

We all love the internet. It's amazing. I can send emails to friends overseas, video chat with my grandmother and buy everything I need for Christmas gifts without leaving the house. It's a great place to share news and information. As a veterinarian, I am able to stay up-to-date on current topics in medicine and communicate with specialists across the nation. I even REFER my own clients to the internet to look at sites with more information about surgeries or diseases their pets my have.

But overall, I think most vets HATE the internet. "Dr. Google" has become one of our enemies. About 50% of my clients that come in with a sick or injured pet believe they already know what the problem is and how I should treat it before they walk in the door. Quite often I'm told, I already looked it up and I'm pretty sure that he has "X disease" and I came to you for "Y medication". Sometimes they are right, and it makes the appointment go very smoothly and I run on time. But sometimes they are wrong, so wrong. The worst cases are when they have gone to a blog written by someone who does not provide any type of credentials and posts his or her random thoughts about veterinary medicine. Or when people misdiagnose their own pets and come to me when they aren't getting better.

Here are a few examples:

Yesterday I was talking to a client about her cat's hyperthyroid condition and explained to her that there is a new diet, Hill's Y/D, that has a very low iodine content to help suppress the amount of thyroid hormone the thyroid glad releases. This diet has been shown to be an effective treatment for hyperthyroidism in cats, where the gland produces excessive amounts of thyroid hormone, causing cats to become very skinny and sick despite having a ravenous appetite. She questioned me saying, "Are you sure? Because I read online that cats with hyperthyroidism need more iodine so I gave her one of my extra strength iodoine pills. She seems to get really sick after I give it to her though." What she was doing was making the disease worse by giving the cat these pills, but she had no idea.

A client noticed their cat wasn't urinating in the litter box and was acting strange for a few days. She looked it up online and she found something that explained the same signs and thought it sounded like the cat was stressed and probably urinating somewhere else in the house. She bought another litter box and put it in a different room, thinking the internet was being helpful. After 3 days of no urine in the litter box, the cat began to cry out when trying to urinate. The owner found him in the litter box meowing loudly. This got her attention and she brought him in. When he was examined, his bladder was larger than a softball and very hard. He was blocked and unable to urinate on his own. This is a life threatening condition because the electrolyte abnormalities that develop can cause his heart to stop or his bladder could tear from the pressure. Luckily, we were able to unblock him and save his life but this could have been diagnosed a few days later if she had brought him in instead of "Googling" his symptoms.

These aren't stupid people, just misinformed people. If you want to look something up online, talk to your vet about reliable internet sites. My favorites include:

www.petplace.com
http://www.veterinarypartner.com
http://www.avma.org/

Dogs Get The Flu Too?

Everyone has heard about the swine flu and the bird flu but now there is a new flu to worry about, the dog flu. Canine Influenza is a virus that was first seen in greyhounds that mutated from the equine flu virus. It is believed that the flu virus actually jumped from the horse population in Florida to dogs. The dog  flu has been confirmed in 38 states. 

People cannot contract the flu from their dogs but they can spread the virus from one dog to another by fomites. Fomites are vehicles that allow a virus to be transmitted including clothing, water bowls, and toys. The most common way a dog becomes infected with the virus is from being around other dogs that have it. Most of our cases are seen after close contact at doggie daycares, boarding facilities and the dog parks. Because of this, more facilities are requiring the flu vaccine be given prior to admission. Pfizer Inc. has a vaccine available that will help lessen the severity of the flu but it is not 100% at preventing infection. The first time the vaccine is given, a booster must be administered 2-3 weeks later. After that, the vaccine is given every 12 months.

It's hard to ask our dog patients what they are feeling when we believe they have the flu but common signs include an ongoing cough and nasal discharge. In some severe cases we will see fever and difficulty breathing. While we usually base our diagnosis on clinical signs, confirmatory tests include a nasal swab or blood test that is submitted to a lab.

The dog flu only affects about 5-8% of the dog population. As with the human flu virus, our biggest concern when a dog contracts the flu is that secondary bacterial infections will form in the lungs and cause a serious pneumonia. The flu doesn't discriminate; all breeds and ages of dogs are susceptible.

My dogs are not vaccinated for the canine flu because they are at very low risk to contract it. I do not take them to work with me very often, we use a house sitter when I am out of town and we do not go to the dog parks. But every case is different and you should talk to your veterinarian about your dog's activities and decide if they should receive the vaccine.

Helping Cats Get Along

We were hoping you would be able to help us with our cats. We have three cats and two don't get along. We adopted Moose, a male, and Daisy, a female, within a few months of each other. While Moose became very comfortable around people, Daisy remains skittish and is nervous around people. In September we adopted another female, Zazzy. Moose and Zazzy get along without any problems, but Daisy has never accepted Zazzy. At first Zazzy would chase after Daisy and there would be hissing, growling and fur flying. Now Daisy stays in the bedroom by herself and only comes out if we carry her. Do you have any suggestions to help ease their friendship or a way to get Daisy to calm down?

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This is a great question to which many people with multi-cat households can relate. There are a couple of options for both cats, Zazzy and Daisy. It sounds like Daisy is afraid and anxious because of Zazzy, and Zazzy is a little over excited or obsessed with Daisy.

Pheromones such as Feliway can help ease stress. Feliway is a synthetic copy of the feline facial pheromone, used by cats to mark their territory as safe and secure. Using this product in the house would help both cats. Flower Essences and other natural supplements can help both cats adjust to the change and be less fearful.

Positive reinforcement, feeding and giving treats to Daisy when she is being tolerant of Zazzy, may help with repetition. Giving Zazzy other outlets for her curiosity may also help. Tall cat towers are great because they give her the opportunity to play and be able to look around rooms from multiple angles. Another good option might be window perches that allow her to look outside and become fascinated with birds and squirrels. Toys with catnip can also stimulate play and excitement in cats, which might help Zazzy be less interested in Daisy when she is roaming the house.

As a last resort, your veterinarian may prescribe a medication for one or both cats to help reduce their stress. Unfortunately, there are some multi-cat households where the cats never get along and have to be kept separated. This is more common than we would like to see, but it appears that cats are happiest this way if they cannot get along with other cats in the home.

Chickens As Backyard Pets

This was a question that was sent to our exotics veterinarian where I work.

 I have a flock of backyard chickens that are having problems. I recently introduced a new bird to the flock and soon after the egg production dropped, they have gone off their feed and their feathers are messed up. When I looked at the birds I saw lots of dark specks running around on their skin. What is the problem with them and how do I fix it so they start laying eggs again?

It sounds like your hens may have encountered a parasite problem. Those “fast-moving specks” might very well be mites. These external parasites suck the blood of their host and are common in poultry. Affected birds will often lose their appetite, look scruffy and have a drop in their egg production due to anemia from blood loss. Mites can also make the chickens more susceptible to other diseases. Your local avian veterinarian can confirm this diagnosis by examining those “specks” under a microscope as well as examining your birds for other health problems.

The key to treatment involves treating both the birds and their environment at the same time. The parasites will attack the birds to feed but often are found hiding in cool, dark areas of the hen house or in the bedding. After removing any bedding and eggs, dust both the birds and the ground with a poultry-safe insecticide powder such as ‘Sevin’ which contains 5% Carbaryl. It is important to follow the directions on the label when using insecticide powders for your safety and that of your birds. At the same time scrub all surfaces of the hen house with hot soapy water followed by a dilute 1:10 bleach solution (9 parts water to one part full-strength bleach) to eliminate the mites and their eggs. Let in as much sunlight in as you can while cleaning as this will also help kill the parasites. Replace all bedding material each time you clean. Allow the hen house to air out between applications. Since the life cycle of the parasites takes a week, you will probably need to do several weekly treatments to eradicate the pests. Don’t forget that you should not eat any eggs for a week after treating the chickens with insecticide.

Please note that you can also use an organic parasite control, diatomaceous earth, to reduce future mite problems in your chicken yard. These products are available from your farm/feed store or by consulting your agricultural extension agent. Follow the instructions on the labels for all products. Finally, your local avian veterinarian can be a very helpful source of advice for the proper husbandry of your chickens.