Disease Archives - Birnam Veterinary Clinic

Mange in cats

What is mange?

Mange is a skin condition that develops when there is an infestation of parasitic mites or an overpopulation of mites on or in a cat’s skin. The presence of these mites, some of which burrow into your cat’s skin, causes itching, redness, and other uncomfortable symptoms. As with dog mange, cats can suffer from different types of mange based on the types of mites present on their skin. In this article we explore the different types of mange that cats can get, how the different types of mange are diagnosed and what can be done to treat the mange.

Types of mange

Cats can experience a number of different types of mange, caused by different types of skin mites. These include:

Sarcoptic mange (canine scabies)
Notedric mange (feline scabies)
Demodectic mange (demodex or red mange)
Otodectic mange (ear mange)
Cheyletiellosis (walking dandruff)
Trombiculosis (chiggers)

What causes mange in cats?

The different types of cat mange are caused by tiny mites that infest the skin surface or burrow into the skin. These mites usually come from the outdoors and contact with other animals, or cats pick up the mites from the environments where other carrier animals have been. Mange is not as common in cats as it is in dogs, but its effects on cats’ health is just as serious. Here, briefly, are the causes of the various types of cat mange:

Sarcoptic mange

Sarcoptic mange is caused by an infestation of the scabies mite (Sarcoptes scabiei) that is typically found in canine scabies. The mite has a flat round body and is known for burrowing into the skin to lay its eggs. It’s this burrowing that causes an intense and insatiable itch; and the combination of burrowing and the cat’s persistent scratching causes inflammation, redness, hair loss and other skin symptoms. Cats usually contract canine scabies from infected dogs, which is why all animals in the home should be checked and treated for scabies even when only one animal is showing symptoms.

Notoedric mange

Notoedric mange is caused by an infestation of another type of scabies mite, Notoedres cati. This is also a burrowing mite and, while rarer than sarcoptic mange, notoedric mange is highly contagious among cat populations when it does occur. It is also contagious to humans, but – as with sarcoptic mange – the mites cannot burrow into human skin to complete their lifecycle, and only cause intense itching and redness for a few days. When humans are no longer around cats with notoedric mange, their own symptoms subside.

Demodectic mange

Similar to demodex in dogs, feline demodicosis is caused when the cat’s immune system is compromised by another illness or malnutrition, and is not strong enough to control natural populations of demodectic mites – Demodex cati and Demodex gatoi. These mites are a natural part of the cat’s skin microbiome, but without proper immune control, mite populations can become excessive and cause skin issues. Signs of demodex include hair loss on the legs, paws and around the eyes, which is accompanied by a severe itch.

Otodectic mange

Otodectic mange occurs in and around the cat’s ears and is characterised by itching and redness in their ear canal. These mites – Otodectes cynotis – can be found on the rest of the cat’s body, but primarily affect the ears, and can put the cat at risk of damage to their eardrums, especially when they scratch persistently. A telltale sign of ear mites is a lot of ear scratching and head shaking.

Cheyletiellosis

Unlike demodex and the scabies mites, ‘walking dandruff’ – as Cheyletiella mites are known – are visible on the cat’s fur and skin, and appear as small white flecks in motion. They live off of skin oils, dander and other skin matter; feeding and breeding on the skin’s surface. Walking dandruff is very contagious to other animals as well as people, creating a skin rash that lasts a few weeks.

Trombiculosis

Cats are also susceptible to Trombiculidae mites – more commonly known as ‘chiggers’ during their larval stage. These tiny red-orange mites cause a nasty bite through which they feed on blood before dropping off their feline host when they’re satiated. They leave red bumps, crusty skin, and severe itching even long after they’ve departed. Chiggers are also contagious to humans and are responsible for bites commonly seen around the waist and ankles.

What are the symptoms of mange?

If you’re curious as to how you would know if your cat has mange, the signs and symptoms for the different types of mange are relatively similar. Despite a specific skin mite being responsible for each type of mange, their presence on your cat’s skin will trigger the same kind of response:

severe itch – whether due to the mite burrowing into the skin, or the cat’s immune system producing an allergic response to the mite
scratching the head and ears
debris in the ear canal and on the skin
redness and inflammation
bumps and pustules
hair loss
thickened skin, where scratching and hair loss takes place
restlessness (a result of the itching)
excessive grooming

How is mange diagnosed?

Just because a cat is very itchy, scratches a lot, and has patchy hair loss doesn’t mean the vet will diagnose them with mange and send you on your way with a skin cream. Each type of mange will require a specialised treatment, so it’s crucial that the vet find out exactly which type of mite is affecting your cat.

The vet will consider all the physical signs of mange as well as take a skin scraping from your cat and identify the mite by looking at the skin scraping under a microscope. From there, they will diagnose your cat’s specific type of mange and suggest the best treatment to get rid of the mites and help your cat’s skin to heal.

How do you treat mange?

Depending on the type of mange the cat has as well as the intensity of the infestation, the vet may prescribe any number of medications – from an antibiotic to an anti-parasitic, anti-inflammatories, topical cream, a spray, shampoo and/or dip. Many tick and flea medications can also be used to combat mite infestations on your cat.

Take special note of the veterinarian’s advice on isolating your infected cat from other pets in the house, but make sure your other pets’ parasite control medication is up to date. Wash and sterilise all pet bedding, toys and socialisation areas to ensure all traces of the mites that caused the cat’s mange have been eliminated.

How to prevent mange

Many cats are roamers, so it’s not always possible to keep them out of environments where they may contract certain types of mites. It’s therefore recommended to keep your cat’s parasite control medication up to date, but to also make sure your cat is healthy and their immune system is functioning optimally. High-quality cat food, adequate exercise, fresh water and even health supplements may all work together to boost your cat’s immune health. Keep their environment clean and healthy, and also groom your cat regularly to take the opportunity to examine their skin condition.

Mange in dogs

What is mange?

Mange is a skin condition in pets caused by an overpopulation or infestation of parasitic mites. The mites burrow into an animal’s skin (sarcoptic) or over-populate the hair follicles (demodex), causing either itchiness and thickened skin, or skin changes and hair fall. There are different types of mange caused by different species of microscopic mites – the most common being demodectic mange and sarcoptic mange. In this article, we’ll explore the symptoms of mange, how the different types of mange are diagnosed and treated, and whether mange is contagious to humans.

Types of mange

Dogs can get demodectic mange or sarcoptic mange. The type of mange is determined by the type of mite infesting your dog’s skin or hair follicles. Demodectic mange is the most common type, while sarcoptic mange is the more devastating type and is highly contagious to other dogs and even to humans. Left untreated, both demodectic and sarcoptic mange can be fatal.

What causes mange in pets?

Demodectic mange

Demodectic mange is caused by an overpopulation of the skin mite Demodex canis (or other varieties Demodex injai and Demodex cornei). Dogs and humans both have a natural population of demodex mites living in their hair follicles, kept in check by a healthy immune system. If the immune system is compromised (due to illness, complications from a medical condition, or genetics), demodex mites are free to flourish and can cause mange. It’s possible for dogs with chronic conditions like cancer or diabetes to develop mange while their immune systems are weak.

Puppies can sometimes experience demodectic mange, since they acquire the skin mites from their mother. Normal, healthy puppies host demodex with no problems; sometimes experiencing bouts of overpopulation that need a simple topical treatment to bring back under control. However, puppies with a genetically weakened immune system can develop juvenile onset demodectic mange, which is very serious and needs immediate and intensive treatment.

Sarcoptic mange

Sarcoptic mange is caused by an infestation of the skin mite Sarcoptes scabiei. Sarcoptic mange is also referred to as canine scabies, and it occurs when the mite buries itself deep within the skin, causing severe itching and skin changes. Dogs with canine scabies will bite and scratch their skin incessantly, trying to get at the source of the irritation. This causes primary and secondary symptoms, which we will discuss below.

What are the symptoms of mange?

Since the different skin mites take up residence in different parts of the skin, the symptoms of scabies and demodex may differ. Let’s look at both:

Symptoms of demodectic mange

hair loss (alopecia) on the face, especially noticeable around the eyes
itchiness (though not as severe as with sarcoptic mange)
red, scaly skin patches
acne-like bumps
skin crusting
skin thickening and darkening
swelling
pain and fever if the condition has progressed
ear infections

The dog may appear lethargic and have leaky wounds if the demodectic mange is generalised (all over their body and not confined to the face) and has progressed quite far. They will need immediate treatment.

Symptoms of sarcoptic mange

intense itching and persistent scratching
hair loss as a result of the scratching
secondary bacterial and yeast infections
red, inflamed skin
skin thickening
crusting skin

In advanced canine scabies infections, the dog’s lymph nodes will be inflamed and they will become lethargic and malnourished.

How is mange diagnosed?

A veterinarian will do a skin scraping and look at it under a microscope to identify the presence of skin mites or their eggs. The demodex mite is elongated and slightly tapered, while the scabies mite is rounded.

How do you treat mange?

The treatment for both types of mange will depend on how far the infestation has progressed. There are oral medications as well as topical treatments and medical baths, both to kill the mites and promote the healing of the dog’s skin.

The sarcoptes mites may still be in the dog’s bedding and living environment, so it’s important to keep them away from these areas until they’ve been disinfected and bedding has been thoroughly cleaned. Also keep other pets away from the infected dog, to prevent the spread of canine scabies and the animals reinfecting each other.

In the case of demodectic mange, the veterinarian may also identify the systemic illness that’s weakening the dog’s immune system; be it old age, chronic disease or a genetically underdeveloped immunity. They will want to ensure the demodex is kept under control, since a compromised immune system may result in an overpopulation of demodex again in future. If the systemic illness is not being managed, demodectic mange can be fatal. Severe demodectic mange may take a long time to treat, and all dogs respond differently to treatment, but generally the prognosis is good.

Can mange in dogs spread to humans?

We have our own population of skin flora (including demodex mites) to keep our skin microbiome in balance, and cannot be infected with canine demodex mites. Demodectic mange is not contagious to humans or other dogs with healthy immune systems, but sarcoptic mange is a zoonotic disease and highly infectious. What does mange do to humans? Canine scabies mites cannot complete their life cycle in human skin, but people with canine scabies will still experience redness, itching and what appear to be inflamed welts – symptoms that will last until the mites die off. (Be aware that canine scabies is not the same as human scabies, which is caused by Sarcoptes scabiei var. hominis or the human itch mite, and needs immediate treatment to kill the mites as it is highly infectious).

How to prevent mange

Pet owners can prevent demodectic mange by ensuring their dogs are healthy and not suffering from other diseases. Regular vet check-ups give the veterinarian the opportunity to screen your dog and potentially pick up any health conditions that may compromise your dog’s immunity and lead to demodex overpopulation.

You can prevent sarcoptic mange by ensuring your dog is contained within your yard (not exposed to stray animals or unknown environments where a sarcoptes infestation may put them at risk). By keeping your pets away from dogs with known sarcoptic mange, you prevent infection.

Uveitis

Uveitis – pronounced ‘yoo-vee-i-tis’ – refers to inflammation inside the eye. The disease can occur in dogs and cats of any age and breed. Patients with uveitis will show signs of pain, redness and cloudiness of the eye. There are many potential causes and sometimes the cause is never found. Prompt treatment is necessary to avoid severe long-term consequences; even blindness. In this article we will discuss the possible causes, symptoms, diagnosis and treatment of uveitis in pets.

What causes uveitis in animals?

The causes of uveitis are classified as being ocular (as a direct result of a disease or injury to the eye) or systemic (as a result of a disease elsewhere in the body).

Ocular causes of uveitis

Corneal ulceration: Wound or an open sore on the outer surface of the eye
Necrotising scleritis: Severe inflammation of the tissues surrounding the eye
Deep keratitis: Inflammation of the surface of the cornea (the clear outermost layer of the eyeball)
Cataracts
Trauma to the eye, either penetrating injuries or blunt trauma
Lens luxation: Dislocation of the lens (clear structure within the eye that focuses incoming light on the retina)
Tumours inside the eye

Systemic causes of uveitis

Infectious diseases:
- Septicaemia or toxaemia: Blood poisoning caused by bacterial infections
- Canine ehrlichiosis (tick disease)
- Toxocariasis (worms)
- Toxoplasmosis (parasites)
- Feline immunodeficiency virus (FIV)
- Feline leukaemia virus (FeLV)
- Feline infectious peritonitis (FIP)
- Canine distemper virus (CDV)
Immune-mediated inflammatory disease
- Immune-mediated thrombocytopaenia (IMTP): The body’s immune system attacks blood platelets
Metabolic disorders
- Diabetes mellitus
- Hyperlipidaemia (high blood fat levels)
Systemic hypertension (high blood pressure)
Cancer

One of these underlying causes will trigger an inflammatory cascade that can permanently damage the structures within the eye. Unfortunately, in the majority of cases a cause cannot be identified, so the disease is considered idiopathic (with no known cause) and treated symptomatically. See below for the various forms of treatment.

Symptoms of uveitis

The symptoms of uveitis are either acute symptoms (those that are seen when it initially starts) or chronic symptoms (those that occur as the inflammation continues over a period of days to weeks). The symptoms of uveitis can be seen in one or both eyes.

Acute Symptoms	Chronic Symptoms
Redness	Deformity of the pupil
Cloudiness	Discolouration of the iris
Pain (face rubbing, squinting or keeping the eye shut)	Attachments of the pupil to other structures in the eye
Discharge	Cataracts
Photophobia (avoiding bright light)	Lens luxation
Small or constricted pupils	Swollen or shrunken eye
Blood or pus within the eye	Blindness

If your pet is showing any discomfort, redness or discharge from the eye, make an appointment with the vet immediately.

How is uveitis diagnosed?

The veterinarian will start by taking a careful history of how your pet’s condition developed, followed by a thorough physical exam. Be sure to provide as much information to the vet as possible, as this will help to determine possible causes and assist with the diagnosis. A systematic ocular exam will be performed, which may include the following:

Schirmer tear test: Determines if your pet’s tear glands are functioning adequately
Ophthalmoscopic exam: Careful examination of all structures of the eye using magnification
Fluorescein stain: Test to detect corneal ulceration
Tonometry: Test for intraocular pressure
Ocular ultrasound: To visualise internal structures of the eye

Depending on the findings, further specific tests on the eyes may need to be performed. Since uveitis can have systemic causes elsewhere in the body, it is important to do various blood and urine tests in order to identify a potential underlying cause.

If there is any indication of a specific condition that may be causing the uveitis, other tests may be necessary, such as chest X-rays, abdominal ultrasound or sample collection from other organs such as lymph nodes.

The veterinarian will be able to perform most of these tests; however, referral to an eye specialist is often recommended as some of the tests are more specialised in nature.

How do you treat uveitis in dogs?

If the underlying cause of the disease can be identified, it needs to be treated. However, often the cause is not found, so the vet offers treatment for the various symptoms.

The mainstay of treatment is the use of anti-inflammatory drugs such as corticosteroids or non-steroidal anti-inflammatory drugs. These can be given topically in the form of eye drops or systemically in the form of injections or tablets. As the disease is driven by the immune system, other immune-suppressive drugs may be needed.

If a bacterial infection is present in the eye or in other parts of the body, topical or systemic antibiotics will be given to treat the infection.

Mydriatics are drugs that are used topically to relieve the pain response (known as blepharospasm). The most commonly used mydriatic drug is atropine. Topical morphine may also be used for this purpose. Lubricant eye drops may be necessary to keep the cornea moist.

If concurrent conditions such as glaucoma (increased pressure inside the eyeball) are present, it will need to be addressed with additional treatments. Patients should be kept indoors in dark areas as they will be light sensitive. If the patient has a lens-associated uveitis due to a lens luxation or a cataract, they will need surgery to remove the lens.

Conclusion

Uveitis is a severe condition of the eye that can result in chronic glaucoma, blindness or the loss of one or both eyes. Many cases recur or relapse and will require ongoing treatment. If you see any abnormalities with your pet’s eyes, make an appointment to see the vet as soon as possible.

Adverse Food Reaction in Pets

As logic would go, feeding your dog or cat a high-quality, premium pet food would ensure their nutritional needs are met and they would thrive and live a long and healthy life. This is every pet owner’s objective for their beloved pet. However, some pets – both dogs and cats – can experience what is called an adverse food reaction. In this article, we’ll explore what adverse food reactions are, what causes them, when to take your pet to the vet, and how adverse food reactions are diagnosed and treated.

If you think your pet is experiencing an adverse food reaction, this article may offer clarity on your pet’s condition.

What is an adverse food reaction?

When your pet eats their food and it causes an abnormal response in their body, we call this adverse food reaction (AFR). One or more of the ingredients in their food causes uncomfortable symptoms indicating that something is wrong. The two most common sets of symptoms show up on their skin (dermatological symptoms) and in their tummies (gastrointestinal symptoms).

What are the symptoms of adverse food reaction?

Dogs and cats present the symptoms of AFR a little differently.

Symptoms in dogs

In dogs, their skin symptoms can include:
•   itching
•   rashes
•   skin infections
•   thickening and pigmentation of the skin
•   alopecia (hair loss)

Dogs’ gastrointestinal symptoms can include:
•   abdominal pain
•   diarrhoea
•   vomiting
•   borborygmi (tummy gurgling)

Rare symptoms may include the following:
•   head and neck swelling
•   hives (itchy, raised welts on the skin)
•   life-threatening anaphylaxis (drop in blood pressure; narrowed airways, which affect breathing)

Symptoms in cats

Cats’ skin symptoms can include:
•   itchiness (especially around the head, ears and on the neck)
•   pulling out their hair (due to itchiness)
•   bald spots
•   rashes
•   skin infections

Cats’ gastrointestinal symptoms can include:
•   abdominal pain
•   diarrhoea
•   vomiting
•   borborygmi (tummy gurgling)

Rarer symptoms in cats can include:
•   ear infections
•   eosinophilic plaques (raised wounds on the skin, nose or lips)
•   wheals
•   conjunctivitis

What causes adverse food reactions?

There are two different conditions that can cause your pet to have an adverse food reaction:
• food allergies
• food intolerance

The symptoms for both conditions are the same, but the mechanisms by which they develop are different. When your pet has a food allergy, their own immune system is triggered by an ingredient or protein (or many of them), which then reacts in a way that causes their physical symptoms. Instead of seeing the ingredient as beneficial, their immune system sees it as an invasive threat and subsequently attacks it, resulting in any of the above dermatological or gastrointestinal symptoms.

Common food allergens in dogs include beef, gluten and dairy; while cats are most commonly allergic to beef, dairy and fish. Food allergies in pets can pop up at any time in their lives – even if they’ve been healthy all along. If they’ve been diagnosed with one food allergy, they can also suddenly develop a different food allergy at any time.

If your pet has a food intolerance, it’s an abnormal reaction to a variety of ingredients or even contaminants in the food. Many dogs and especially cats are lactose intolerant, so giving them any dairy can cause mild to severe tummy trouble – this is a good example of food intolerance as an AFR. They may have food intolerances to various proteins and carbohydrates, but also to contaminants like fungi and bacteria, as well as to food preservatives, colourants and flavouring that may be added to pet food.

How are adverse food reactions identified?

Unfortunately for pets and pet owners, testing methods like blood tests, serology and intradermal skin prick tests cannot accurately detect a food allergy, so your best bet is with a food elimination trial. The vet will recommend a prescription diet consisting of one protein and one carbohydrate. Hydrolysed proteins may also be present, which are proteins that have been reduced into particles too small to cause the body to react. A prescription diet also does not contain many of the preservatives and additives in commercial pet food, known to cause a reaction.

Your pet will need to be fed exclusively on the prescription diet for eight to 12 weeks. It is critically important to the diagnosis that there be no deviation from the prescription diet – no snacks, table scraps, treats or supplements. After this time, the vet will be able to see if the symptoms have cleared up. When you reintroduce your pet’s original food and they have a flare-up of symptoms again, your vet will confirm that your pet’s symptoms are indeed from an AFR.

How are adverse food reactions treated?

When the vet has confirmed that your pet does indeed have an adverse food reaction, your pet’s best bet for living a healthy life is to avoid the food that is making them sick. Fortunately, there are many pet food options on the market that cater to pets with AFRs, such as protein diets with carefully selected ingredients that don’t contain any of the common allergens. There are also those diets that contain hydrolysed proteins, which are distilled down to a form that should not cause any adverse reactions.

A word on nutritional treatments for AFR pets

Home-cooked meals

Some pet owners are prepared to serve up home-cooked meals comprising novel proteins. While this may seem like the healthiest option and could technically not trigger an AFR, this type of diet does not offer your pet balanced, complete nutrition. Home-cooked meals – while filled with love and good intentions – are often too low in essential fatty acids, vitamins and minerals. If you want to feed your pet home-cooked meals, this must be done in consultation with a veterinary nutritionist who can determine the right levels of vitamins, minerals, omegas 3 and 6, and other nutrients required for your pet’s health and wellbeing.

Commercial prescription diets

Commercial pet food diets are designed to meet all of your pet’s nutritional needs; and for those pets with AFRs, there are scientifically developed diets containing the right blend of additional or alternative ingredients to meet their needs and avoid allergic or intolerant reactions.

Commercial pet shop diets

Some commercial over-the-counter pet diets make claims about being hypoallergenic, yet traces of allergens can still be found in their food. This happens when the pet food factories don’t have measures in place to prevent contamination from regular pet food, which is made in the same facility.

Based on your pet’s needs, the vet will recommend a prescription diet for your food-sensitive pet, and it’s in your pet’s best interest to follow the vet’s recommendation.

The long road to health

The food elimination trial can be a tricky process – just one step in the long road to correctly identifying, isolating and treating your pet’s adverse food reaction. No pet owner wants to see their pet in distress or decline, so it’s best to work closely with the vet, keep an eye on your pet’s diet, symptoms and progress, and follow the vet’s advice and guidance on your pet’s health and wellbeing.

Pancreatitis in cats

The pancreas is an organ located near the stomach and alongside the small intestine. It is responsible for producing digestive enzymes and hormones (such as insulin) that regulate blood glucose. In cats, pancreatitis is a serious condition in which the pancreas becomes inflamed leading to poor appetite, listlessness, dehydration and vomiting. It is also commonly diagnosed together with other diseases and can have life-threatening and severe long-term effects. In this article we will discuss the causes, symptoms, diagnosis, treatment and prevention of pancreatitis.

Pancreatitis has been found to be very prevalent in cats world-wide and is often not diagnosed. This may be because the symptoms are vague and there is no single test to accurately identify it.

Pancreatitis is classified as either acute or chronic, based on the changes present in the tissues of the pancreas when examined microscopically. In dogs this is important, but in cats the distinction between these two processes is very unclear and not helpful in the treatment of these patients.

What causes pancreatitis in cats?

The development of pancreatitis is considered idiopathic, which means that we do not know exactly what causes it. It is often found in association with other inflammatory diseases, most notably cholangiohepatitis (inflammation of the liver and biliary system) and IBD (inflammatory bowel disease). This disease complex is referred to as feline inflammatory disease or ‘triaditis’. Distinguishing these separate diseases is often not possible or useful, and patients suspected of having any one of these are often managed as having all three. Other diseases that are commonly associated with pancreatitis in cats are diabetes mellitus and hepatic lipidosis (fatty liver syndrome).

How does pancreatitis develop?

During acute pancreatitis the pancreas becomes inflamed when digestive enzymes are activated inside the pancreas instead of in the intestine, there is an accumulation of cellular waste products, and a decrease in blood flow. If this inflammation is very severe it can lead to multiple organ failure and death.

Chronic pancreatitis occurs as a long-standing inflammation of the pancreas that may not be detected. It can also develop after a bout of acute pancreatitis is resolved. This ongoing inflammation damages the cells leading to fibrosis and an inability of the pancreas to perform its function.

As previously mentioned, both acute and chronic pancreatitis can have complications and associated diseases that are potentially life-threatening, making distinguishing between them irrelevant in cats.

What are the symptoms of pancreatitis?

The symptoms of pancreatitis in cats are vague and include poor appetite, listlessness, dehydration and vomiting. Unlike dogs, cats do not often show signs of abdominal pain. Pancreatitis should be considered a possible cause of illness in any cat exhibiting these symptoms.

Other symptoms may be due to associated diseases rather than directly as a result of pancreatitis. Patients with IBD may have diarrhoea and weight loss. Diabetic patients will show weight loss or weight gain and typically drink large amounts of water. Patients with cholangiohepatitis and/or hepatic lipidosis may be icteric, i.e., having yellow mucus membranes (for example, of the gums and eyes).

How is pancreatitis in cats diagnosed?

Unfortunately, no single test can accurately identify pancreatitis in cats. Multiple tests will need to be performed. A full panel of blood and urine tests should be run on all cats presenting with symptoms suggestive of pancreatitis. This is important as it is often found together with other diseases. These tests will also help the vet to gauge the severity of the illness and know which treatments need to be added.

An abdominal ultrasound is a key part of the diagnostic process. Although the changes associated with this disease may not be detected on the ultrasound, it is useful for evaluating comorbidities and other possible causes for the symptoms. Referral for a specialist ultrasound may be needed in cases with subtle changes. A specific blood test called feline pancreatic lipase immunoreactivity (fPLi) is also helpful in diagnosing the disease and monitoring the cat’s response to treatment. The presence of the associated diseases (cholangiohepatitis, IBD and diabetes mellitus) will also strongly point towards a diagnosis of pancreatitis.

How is pancreatitis treated?

Aggressive in-hospital treatment is indicated for cats who are collapsed and dehydrated, as this disease can rapidly progress to full organ failure and death. The cat will need to be put on a drip, and given medications for pain and nausea. Hospital stays for this condition can range from three to 10 days or even longer if the cat is severely ill. Feeding these patients is key to their recovery, but since they will often feel too ill to eat, they will need to have a feeding tube placed. Feeding them early on in treatment is especially vital in overweight cats, as they can develop fatty liver syndrome (hepatic lipidosis), which is a life-threatening complication in itself.

Patients that are not as ill can be treated on an outpatient basis. Medications for pain and nausea will be given as necessary. Pancreatitis is often associated with cholangiohepatitis, which can occur as a result of a bacterial infection in the gallbladder and liver. Therefore, these patients may be treated with antibiotics.

Any of the associated diseases (diabetes mellitus, cholangiohepatitis, IBD and hepatic lipidosis) may also require specific treatments over and above the treatment for pancreatitis.

How is pancreatitis managed?

All patients that have pancreatitis need a permanent diet change. A hypoallergenic diet is recommended and various prescription diets are available that have been specifically formulated for this reason. It is very important that these diets be strictly adhered to, which means no additional treats or toppings to their meals. Unlike dogs, fat-restriction for cats with pancreatitis is not indicated and can lead to deficiencies in essential fatty acids.

If a diet change alone is inadequate in controlling the symptoms, most other patients will respond to an immunosuppressive drug such as cortisone.

Repeat blood tests are necessary to monitor the recovering cat’s response to treatment.

Pancreatitis in dogs

The pancreas is an organ located near the stomach and alongside the small intestine. It is responsible for producing most digestive enzymes as well as hormones (such as insulin) that regulate blood glucose. Pancreatitis in dogs is the condition we see when the pancreas becomes inflamed, leading to vomiting and abdominal pain. This disease can be life-threatening and have long-term effects. In this article we will discuss the causes, symptoms, diagnosis, treatment and prevention of pancreatitis.

Pancreatitis presents in two forms, namely acute pancreatitis and chronic pancreatitis. Acute pancreatitis has a rapid onset with severe symptoms that may be life-threatening. Chronic pancreatitis results from long-standing, low-grade inflammation in the pancreas. This can lead to irreversible changes such as fibrosis (normal tissue being replaced with scar tissue). This condition can be either subclinical (symptoms are not seen), low-grade recurrent (regular bouts of non-specific symptoms such as fussy eating) or occur as flare-ups of acute pancreatitis symptoms.

What causes pancreatitis?

The development of pancreatitis is considered idiopathic, which means that we do not always know exactly what causes it. However, certain risk factors have been identified.

Certain breeds are predisposed to pancreatitis. Miniature Schnauzers, Yorkshire and other terriers have been shown to be at increased risk for developing acute pancreatitis, while chronic pancreatitis is more common in Cavalier King Charles spaniels, English cocker spaniels, boxers and collies.

Hypertriglyceridaemia (high blood fat levels) and obesity have both been shown to be common in patients presenting with pancreatitis. Dietary indiscretion is the term used to describe dogs eating things they shouldn’t be eating, such as table scraps, large amounts of treats, or digging in the dustbin for discarded foods. This is also very common in patients with pancreatitis. Other possible risk factors include infectious diseases such as biliary, certain drugs, trauma to the abdomen (such as surgery or blunt force trauma) and various endocrine diseases such as hyperadrenocorticism, diabetes mellitus and hypothyroidism.

How does pancreatitis develop?

During acute pancreatitis, the pancreas becomes inflamed when digestive enzymes are activated inside the pancreas instead of in the intestine, there is an accumulation of cellular waste products, and a decrease in blood flow. If this inflammation is very severe it can lead to multiple organ failure and death.

Chronic pancreatitis occurs as a long-standing inflammation of the pancreas that may not be detected. It can also develop after a bout of acute pancreatitis. This ongoing inflammation damages the cells of the pancreas, which can lead to them not performing their functions properly. Dogs can develop diabetes mellitus if the cells aren’t producing enough insulin or they can develop exocrine pancreatic insufficiency (EPI) if they aren’t producing adequate digestive enzymes. These diseases are discussed in more detail in other articles.

What are the symptoms of pancreatitis?

The most common symptoms of acute pancreatitis are:

vomiting
abdominal pain
listlessness
weakness
dehydration
diarrhoea
fever

Chronic pancreatitis is more difficult to identify as the symptoms will often be mild and non-specific, such as dogs being fussy with their food, occasionally vomiting or just having an ‘off’ day. Owners may not even really notice that their dog is not well. Chronic pancreatitis can have severe consequences if left untreated, so dogs with chronic mild symptoms of illness should have a full panel of blood and urine tests done. Identifying and managing chronic pancreatitis early on may prevent the development of diabetes mellitus and EPI.

How is pancreatitis diagnosed?

Patients that present with acute pancreatitis will need various tests as no single test can accurately identify pancreatitis. X-rays of the abdomen will help the veterinarian to rule out a foreign object in the GI tract, which also commonly presents as abdominal pain and vomiting. Abdominal ultrasound can help to identify markers of pancreatitis as well as exclude other causes of the symptoms. A specific blood test called canine pancreatic lipase immunoreactivity (cPLi) is a good indicator of the presence or absence of pancreatic disease. A full blood panel can also help to identify any other organ dysfunction possibly associated with pancreatitis. The presence of other organ dysfunction indicates more severe disease with a poorer prognosis.

Chronic pancreatitis is more challenging to identify. The findings on an abdominal ultrasound are oftentimes more subtle than in cases of acute pancreatitis. The cPLi test can also be ambiguous as the levels are often not as high as with acute pancreatitis cases. Repeat blood samples may be needed to correctly identify the problem. Full blood and urine panels are also recommended to exclude other conditions that may mimic chronic pancreatitis.

How is pancreatitis treated?

Aggressive treatment of acute pancreatitis is necessary to prevent full organ failure, which is fatal. The dog will need to be put on a drip, which means they will have to stay in hospital until they have recovered. Depending on the severity of the disease, the dog can be in hospital for three to 10 days or even longer. They will be treated for nausea and pain. Feeding these patients is key to their recovery, but since they are usually unwilling to eat, they may need to be fed with a syringe or have a feeding tube inserted. An ultra-low-fat diet is recommended. Pancreatitis is seldom associated with bacterial infections, so antibiotics are not used unless specifically indicated.
Chronic pancreatitis is often not as severe and may be treated on an outpatient basis. These patients will be given a painkiller if they are experiencing abdominal pain, and an anti-nausea treatment if they are vomiting or not eating.

How is pancreatitis managed in the long term?

Risk factors such as the use of certain drugs or existing endocrine diseases need to be identified and addressed. All dogs that have pancreatitis need to be permanently put on a low-fat diet. Various prescription diets are available that have been specifically formulated for this reason. It is very important that these diets be strictly adhered to because eating fatty foods can trigger pancreatitis. These patients may only receive low-fat treats such as vegetables and fruits and most certainly no human food! If your dog has had pancreatitis, ask the vet to recommend the best low-fat treats for your dog.

Conclusion

Pancreatitis in both its acute and chronic form is a common disease. It is vital to identify and treat it early on to prevent severe consequences. If your dog has pancreatitis, the veterinarian will recommend the treatment they believe is best. It is better to treat the problem aggressively than to treat conservatively and ‘see what happens’. It is important that dog owners strictly adhere to the vet’s instructions to treat and manage their pet’s pancreatitis, and to minimise the risk of severe complications or even shortening their dog’s life.

Gastroenteritis in puppies

Gastrointestinal problems are some of the leading causes of visits to the vet. Puppies in particular are extremely prone to tummy upsets, which can have various causes. Gastroenteritis is the technical term used to describe an upset tummy and symptoms include vomiting, diarrhoea, poor appetite and, in serious cases, lethargy and collapse. Let’s look at what causes gastroenteritis in puppies.

Viral infections

The most common viruses that cause gastroenteritis in puppies are parvovirus (also called cat flu), distemper virus and canine coronavirus. Puppies pick up these viruses in the environment and from infected dogs. They are very contagious, which is why it is best to not allow your puppy out of the home or near dogs with an unknown vaccination history until they have completed their full course of puppy vaccinations.

Parvovirus causes the most severe symptoms and is often fatal if not treated aggressively in hospital. Distemper virus infections are less common in well-vaccinated communities; however, distemper can also be fatal. It is accompanied by respiratory tract infections and can progress to seizures at which stage euthanasia is recommended. Canine coronavirus (not to be confused with the human strains of coronavirus causing COVID-19) typically causes less severe illness. Puppy vaccinations are very important to prevent them from getting parvo- and distemper virus infections in particular. Crucially, puppies will only have high levels of immunity against canine parvovirus after the final vaccination at 16 weeks or older. Therefore, your puppy will remain at risk to this infection until after their last shot.

Parasitic infections

Parasites are another very common cause of gastroenteritis in puppies. The two most important microscopic parasitic infections are coccidiosis and giardiasis. Both of these are caused by single-cell organisms that live in the intestinal tract of most dogs. However, puppies do not have as effective an immune system as adult animals do, and will often become ill from these infections. Puppies get these infections from other dogs carrying the parasites and in the case of giardiasis, from an infected environment.

Intestinal worms are considered to be present in all puppies at birth as they often gain access to the puppies while in the mother’s womb as well as through her milk once they are born. The two most common worm infections in puppies are hookworms and ascariasis. These parasites can cause typical gastroenteritis symptoms, but also poor growth, pale gums and a distended abdomen.

Gastrointestinal foreign bodies

Much like human children, puppies will explore their environment by putting everything they can find into their mouths. Foreign objects that are swallowed may be small enough to pass through the entire gastrointestinal tract and out the back end without complications. However, they may also cause a partial or a complete obstruction or blockage of the intestinal tract. Foreign material that is able to move through the intestines may lead to some vomiting, diarrhoea or a poor appetite. Foreign objects stuck in the intestine create a life-threatening situation and need to speedily be surgically removed.

Food change

When puppies are adopted into their new homes, they will usually be given a different diet compared to what they are used to. All animals are prone to diarrhoea if their food is not transitioned gradually. For the first few days, we recommend feeding the puppy the food they are used to eating. Thereafter you can mix 25% of the new food with 75% of the current diet for five days. Then feed 50% of each food for five days. Thereafter feed 75% of the new diet with 25% of the previous diet for five days before changing over entirely to the new food.

Garbage disease

Garbage disease is a term we use to describe gastroenteritis that has occurred as a result of your puppy eating things they shouldn’t be eating. This need not mean just digging in the garbage. It can refer to a puppy eating insects in the garden, picking up bones and scraps of discarded food in the park or even material like grass and leaves. Therefore it is important to put precautionary measures in place to prevent your puppy from accessing rubbish bins and supervise them very closely when taking them on walks.

Dietary indiscretion

Although it may be very tempting to share your snacks with your puppy, it is important to never feed puppies foods that are not designed for them. Human food can contain ingredients that are toxic to dogs such as onion, garlic and xylitol. You should also take care not to overfeed with dog treats. Your puppy must get the majority of their nutrition from a well-balanced dog food. Treats can be given once or twice during the day. If used for training, ensure that the treats you use are as small as possible, so that they do not overeat on them. Remember that by a couple of weeks of age most puppies will have become intolerant of dairy products, so it is not a good idea to give milk to puppies.

When do I go see my vet?

When you get your puppy, take them to the vet as soon as possible for a general health check. The vet can assess your puppy for health problems and help you address them before they become serious. Vaccinations and treatments for worms, ticks and fleas can also be administered if they have not yet been given. At this visit, it is recommended to allow the veterinarian to test for the common intestinal parasites, even if your puppy is not showing symptoms. In this way parasite problems can be addressed before they make your puppy very ill.

Puppies are at higher risk than adult dogs for becoming dehydrated if they are ill. If your puppy has vomited repeatedly and is not eating, you should seek immediate veterinary care. If your puppy has vomited once or twice and has diarrhoea, but is still eating, it is potentially not as serious and emergency treatment may not be necessary. However, any puppy that is showing symptoms of gastroenteritis should be seen by a veterinarian to rule out life-threatening illnesses and give the appropriate treatments. A ‘wait-and-see’ approach is not advised, particularly not with puppies who do not yet have the appropriate defence against illness.

Gastric dilatation volvulus

It’s a scary situation when your dog looks like he has a bloated tummy, but he’s really experiencing a life-threatening medical emergency. Gastric dilatation volvulus or GDV is also called bloat, but it’s more than just a bit of air in the stomach. Its other name – gastric torsion – describes how, once inflated with air, the stomach can also twist around itself and cut off blood supply to other major organs. The body then goes into shock and the condition becomes life-threatening.

What causes GDV?

A dog does not suddenly develop gastric torsion or GDV – there are behavioural elements to this condition. It most commonly happens in dogs who eat one large meal a day or who eat or drink a large volume of food or water, gulping air as they consume it. The delayed emptying of the digestive system (potentially due to consuming oil-enriched foods) can also be a factor. Engaging in vigorous play or exercise after eating can trap air in the stomach and twist it. Add to this a dog who is prone to stress and the chances of them developing GDV increase.

After the stomach has already twisted and the contents of the stomach can’t be released, it can continue to distend, pushing up against the diaphragm and putting stress on the heart and lungs. All of this may be going on inside the dog, but what does it look like from the outside?

What are the symptoms of GDV?

A stomach filled with food and air may or may not present as a distended belly, although this is a common symptom. The following symptoms might also present, but again – not all symptoms will show in all dogs with GDV:
•   Vomiting foam or retching without vomiting
•   Restlessness
•   Drooling
•   Look anxious
•   Pacing
•   Stretching with their front legs down and their hips up

If your dog shows any of these symptoms without an obvious cause, but you suspect gastric dilatation volvulus, get him to the vet immediately. If the condition worsens, his symptoms can progress to:
•   Shortness of breath
•   Rapid heartbeat
•   Pale gums
•   Weakness
•   Collapse and death

Which dogs are more likely to develop GDV?

Veterinarians and researchers have attempted to isolate the causes of GDV in order to reduce the risk of susceptible dogs from developing the condition, but not every dog with the risk factors will end up with this syndrome. GDV is most commonly seen in large breed dogs who are also deep chested. Think of Great Danes, German shepherd dogs, Dobermans, boxers, bassets, Gordon and Irish setters, St Bernards, Irish wolfhounds, Rhodesian ridgebacks and Weimaraners. Older dogs are more prone to developing GDV, however, it’s not impossible for any breed of dog at any age to experience this dangerous condition. Males are more commonly affected than females.

Why is GDV a medical emergency?

The distension of the stomach is caused, in part, by its inability to empty its contents. Add torsion or twisting to this equation and suddenly there is increased pressure in the body, decreased blood supply to vital organs and damage to the cardiovascular system. Dehydration and systemic shock can ensue. There is no way for GDV to correct itself and it becomes life-threatening from a few minutes to a few hours. Some dogs go from having no visible symptoms to collapsing and dying, while others will show visible distress and need immediate veterinary attention.

How is GDV diagnosed and treated?

It’s important to tell the veterinarian that you suspect GDV, although in most cases, the dog’s distress will be evident. Looking at the breed, age and history of the dog can provide predetermining information that allows the vet to reach the GDV diagnosis. However, in this emergency situation, the vet’s first priority will be to relieve the pressure in the dog’s stomach to save the wall of the stomach (since there is always a risk of it bursting) and to remove pressure on other internal organs. They will attempt to insert a stomach tube, although this might be impossible due to the stomach torsion; in which case, the vet will insert a large needle through the skin to release the gas and relieve the pressure.

Treatment for shock can then begin (IV fluids and medicine to stabilise the dog’s vital signs) and as soon as the dog is stable, he can be placed under general anaesthesia so that surgical treatment can take place. The veterinarian may take X-rays to confirm the presence of gastric dilatation (distension) and volvulus (torsion) and to prepare for surgery. Some dogs will need a longer period of stabilisation before surgery, depending on how severe their condition was before treatment began.

The surgical intervention involves returning the stomach and spleen to their correct position in the body. If the spleen’s blood supply has been too compromised or if the spleen is the suspected culprit of the GDV, the whole organ may be removed. The vet may decide to perform a gastropexy to prevent GDV from happening again. This involves attaching the wall of the stomach to the wall of the dog’s body to position it permanently.

If stomach torsion has cut off blood supply to the stomach wall to the extent that necrosis (tissue death) has begun to set in, it may be necessary for the vet to remove part of the dog’s stomach – a procedure called a gastrectomy.

What is the prognosis after treatment?

Gastric dilatation volvulus is a traumatic and life-threatening event, followed by surgery. The prognosis depends on the severity of the condition before medical treatment was administered, the cardiovascular stability of the dog before surgery, and the level of aftercare received. The survival rate of GDV is around 80%, although this may be reduced by certain factors such as pre-existing heart problems, the tissue damage incurred during the ordeal, and the necessity of removing the spleen.

The dog must be hospitalised for a few days after surgery to keep a close eye on his progress and to catch any complications that may arise. There may be infections or sepsis, inflammation (peritonitis) or low blood pressure (hypotension) that could compromise his recovery and cause the dog to die.

Can GDV be prevented?

While no preventative steps can be 100% guaranteed, the following changes can be made to reduce the risk of your dog developing GDV:
•   Feed two or more smaller meals throughout the day, rather than one large meal
•   Give your dog time to rest after eating, before he engages in vigorous activity or exercise
•   Do not raise your dog’s food bowl off the ground unless instructed to do so by the vet
•   Ensure that your dog experiences a happy, relaxed environment – fearful, stressed dogs are more likely to develop GDV
•   Large dogs should eat large, high-quality kibble and not drink an excessive amount of water after eating

Address any concerns you may have over GDV with the vet and always have the emergency number for the vet on hand if your dog is susceptible to developing this condition.

Heart diseases in dogs

It is estimated that a little over 10% of all pets have some form of heart disease. There are many different reasons for the presence of heart disease – from genetics to poor diet, ageing, illness/infection and obesity – but what is common among all types of heart disease is that the condition does not simply go away on its own. It is usually progressive and, depending on how severe the symptoms are and when the dog is diagnosed with the disease, it can eventually lead to heart failure.

Types of heart disease

Heart disease can refer to any abnormality of the heart’s structure, electrical activity and function. The most common types of heart disease in dogs include those that affect the functioning of the heart valves (valvular degeneration), weaken the heart muscle (dilated cardiomyopathy), thicken the heart muscle (hypertrophic cardiomyopathy), and those in which the electrical activity of the heart is affected (arrhythmia).

Heart disease can be congenital – meaning dogs are born with a defect that results in the disease – or it can be acquired – meaning that it develops over time as a result of the side effects of infection, old age, (especially) if the dog is overweight or is not fed a complete and balanced diet.

The following are just some of the more common types of heart disease that affect dogs:

Valvular degeneration

Valvular degeneration occurs when the valves of the heart no longer function as they’re supposed to. The function of the valves is to open and close, allowing blood to flow through or stopping the flow, depending on where they are located. When they thicken, weaken and degenerate, the valves cannot open or close properly, which causes a leakage of blood and the enlargement of the heart.

Mitral valve disease or degenerative mitral valve disease is the valvular degeneration most often seen in dogs. It affects the two left heart chambers and can eventually lead to congestive heart failure. It can be diagnosed even before any symptoms show up, and will only present as a slight heart murmur. Once diagnosed, it can be managed through specific medications and the appropriate diet. It cannot be cured, which is why managing the condition is so important.

Mitral valve disease is a congenital disease for which the Cavalier King Charles spaniel is most commonly known. Almost all dogs of this breed will develop mitral valve disease and eventually succumb to heart failure.

Dilated cardiomyopathy (DCM)

If we break down the name, dilated (enlarged) cardio (heart) myo (muscle) pathy (disease) refers to a range of conditions that negatively affect the heart’s muscle, causing it to weaken and enlarge. The enlargement happens because the heart muscle (the walls of the heart) thins and weakens; the heart then cannot pump efficiently and it fails to pump all of the blood out of the heart, causing it to enlarge.

Dilated cardiomyopathy (DCM) is the most common heart disease diagnosed in large breed dogs, and second most common overall. It is progressive and often leads to congestive heart failure. If DCM is diagnosed early on, it can be managed with medication, allowing the affected dogs to live longer with fewer symptoms, but there is no cure. It is usually large and giant breed dogs who develop DCM – breeds like boxers, Great Danes, Doberman pinschers, St Bernards, Irish wolfhounds, some German shepherd dogs and some spaniels, especially those older than four years.

DCM is more common in certain breeds than others, but it is not always congenital and can be acquired due to other factors like diet and old age.

Pericardial disease

Also called pericardial effusion, this type of heart disease affects the thin sac around the heart called the pericardium. In healthy dogs, this sac contains a little fluid to assist the heart’s beating mechanism, while in pericardial effusion, the sac fills with fluid to the extent that it restricts the heart’s ability to fill with blood, which constrains its vital function.

Pericardial disease is usually a symptom or effect of hemangiosarcoma – cancer of the blood vessels near the heart – or inflammation of the heart, which causes scarring on the pericardium. When the cause of the scarring cannot be determined, the condition is called idiopathic pericardial effusion. Some dogs are even born with a pericardial sac that does not function properly, which risks normal heart function and causes heart disease.

This particular type of heart disease usually goes undetected until it causes a medical emergency. It requires the veterinarian to insert a long needle through the dog’s side and into the pericardium to drain the excess fluid that is restricting the heart’s function. The prognosis of pericardial effusion varies depending on the cause of the fluid build-up, and dogs can live for three months to three years with repeated treatments. There is no cure and the vet will encourage owners to consider the dog’s quality of life (with the possibility of sudden death) before consenting to ongoing treatments.

Heart arrhythmias

The heart’s beating function is controlled by an electrical current or pulse that stimulates the heart muscle and causes it to contract in a coordinated way. When there is an interruption in the electrical current or a disruption to the coordination, this causes arrhythmia. The different types of arrhythmias are defined by an increase or decrease of the heart rate (tachycardia or bradycardia, respectively), blockages, or a lack of coordination between the different parts of the heart (premature ventricular contractions and atrial fibrillation).

If a dog is diagnosed with an arrhythmia, there are various ways of treating or correcting it including medication or a pacemaker.

Congenital heart disease

Some heart diseases result from an abnormality in the dog’s heart development and are present at birth. Congenital heart problems account for around 4% of veterinary cardiology cases, so they are rare, but they can be devastating for the pet parents of the affected puppy. Congenital heart diseases are detected when the vet hears a heart murmur during the puppy’s checkup, but they require more extensive testing methods (such as ultrasound and electrocardiogram (ECG)) to make an accurate diagnosis.

When serious congenital heart diseases are detected in purebred puppies, it is critical that the breeders are notified so that they do not continue breeding with the parents of the sick puppies, and to provide data on the relevant bloodlines.

Congenital heart diseases include:

Patent ductus arteriosus (PDA)

An open artery that should close after birth, but doesn’t. Can be corrected with surgery.

Pulmonic stenosis

An abnormally narrow heart valve that makes the right side of the heart work harder. Can be corrected with a catheter and balloon to open up the valve.

Subaortic stenosis

An abnormally narrow channel connecting the left ventricle to the aorta, which makes the left side of the heart work harder. Surgical treatment is difficult and often unsuccessful, while medication is used to slow the development of disease and heart failure.

Ventricular septal defect

This describes an abnormal connection between the heart’s two ventricles, which can result in an enlarged heart and more blood being pumped to the lungs. Depending on the size of the problem, the dog can live with VSD, or it can be treated with medication and a carefully managed diet. Surgical intervention depends on the severity of the progression of the disease.

Symptoms of heart disease

A dog with heart problems will experience symptoms such as:

shortness of breath
rapid breathing
coughing (especially after exercise)
round belly (abdominal swelling) from fluid build-up
fatigue
fainting
rapid weight loss

Some heart disease does not present any symptoms, but may first be suspected if the vet detects a heart murmur during a routine check-up. By the time symptoms show, the dog could already be nearing heart failure, which is why it’s important to get the dog checked by a vet if any of the above symptoms are present.

How are heart diseases diagnosed?

From the stethoscope to the electrocardiogram (ECG); the chest X-ray to a simple observation; from the echocardiogram (echo) to a blood pressure monitor – there are many diagnostic tools for identifying heart diseases, depending on which type of heart disease the vet suspects.

Can heart disease be treated?

Each type of heart disease is monitored and treated for the type and severity, as well as the impact it is having on the dog’s quality of life.

Dog heart diseases range in type and severity – with some not showing symptoms until well into the dog’s life, while others show symptoms in puppyhood and need serious treatment. The vast range of heart diseases means it’s vital that dog owners take their beloved dogs for their annual check-up to allow for regular screening; and that they pay attention to potential symptoms of heart disease and act quickly if they observe any troubling symptoms in their pets.

Eosinophilic granuloma complex in dogs and cats

What is eosinophilic granuloma complex?

Eosinophilic granuloma complex (EGC) is a disease complex that presents in three main forms, namely an eosinophilic ulcer (also known as a rodent or indolent ulcer), an eosinophilic plaque or an eosinophilic granuloma. These conditions are more commonly found in cats and horses, and only occasionally in dogs.

An eosinophil is a type of white blood cell that mainly specialises in defending the body against parasites and allergies. It is a tiny cell that moves around the body in the bloodstream, moving into tissue when an intruder is detected. Inside the cell are little pink granules, which are like little chemical bombs that are released onto the intruder in order to destroy it or render it inactive.

A granuloma is a collection of immune cells that change the structure of the tissue in which they accumulate. It is a symptom of inflammation and usually shows there has been a response to a foreign invader.

What causes EGC?

The cause of EGC is believed to be a response to an allergy, usually to fleas, other biting insects, food or environmental allergens. Studies have been done that suspect a genetic component is involved as well.

When the body detects an allergen – let’s say pollen – the immune system responds by sending an army of immune cells and other responses to get rid of the foreign invader. Think of hay fever when your sinuses swell up and your nose and eyes start to run. This is an inflammatory reaction in response to the pollen.

In the case of EGC, the body responds to an allergen by sending in eosinophils, which quickly infiltrate and surround the potential danger. When they arrive, they release their little toxic bombs that attract other immune cells and start an inflammatory reaction. What you see on the outside are red, raised, round to elongated areas that are warm and angry. The toxins from the eosinophil granules actually alter and coat the structure of the collagen in the tissue where the reaction occurs, which can cause permanent scarring.

What does EGC look like?

The three forms of the condition look a little different, but can overlap.

Eosinophilic ulcer (rodent ulcer, indolent ulcer): This is a red, raised bump on the upper lip, most commonly seen in cats. Sometimes the ulcer is also seen on the tongue. This bump is not usually itchy or sore, but when irritated it can ooze and bleed.
Eosinophilic plaque: This form usually presents as hairless patches where the skin is red and thickened with well-defined borders. This area is often very itchy where pets will lick, bite and scratch the area, causing more harm and injury. These patches are often seen on the belly or thighs, sometimes on the throat or around the anus.
Eosinophilic granuloma: These granulomas range from pinkish to yellow-orange in colour. They are often complicated by bacterial infection and may or may not be itchy. They too are raised and solid and are most often seen as lines on the back legs. They can be found almost anywhere on the body such as on the belly, foot pads, head, nose, ears and bottom lip, chin and even in the mouth along the gums and palate.

In dogs EGC more commonly occurs in the mouth or on the belly. The breeds susceptible to it are huskies and cavalier King Charles spaniels, but it can occur in any breed.

There is a form of the disease seen in dogs and cats called eosinophilic furunculosis, which is caused by an allergic reaction to insect bites and stings. These look like lots of little raised areas surrounded by swelling. If left untreated, these bumps can progress to ulcers. They are most commonly seen around the eyes, nose and ears of long-nosed large breeds or curious terriers. This condition springs up quickly, usually after hunting or exposure to the outdoors when biting insects are out.

Can EGC be treated?

As the underlying cause of the condition is allergic, identifying the cause and removing the exposure to the allergy is the basis of treatment for affected animals. This often starts with flea treatment and possibly a hypoallergenic diet. Limiting exposure to the inciting allergen usually resolves the problem.

Some vets make use of allergen testing either through testing the skin or through bloodwork. The accuracy and usefulness of allergy testing, however, is somewhat controversial. While the source of the allergen is sought, your pet will likely be treated with corticosteroids in order to control the inflammatory response. In cats this is often done with a long-lasting corticosteroid injection or with tablets. Depending on the extent of the damage, the vet will assess if antibiotics will also be necessary.

Other treatments include cyclosporin, interferon alpha and even gold therapy against chronic inflammation. Cyclosporin suppresses the immune response while interferon alpha prevents the activation and release of the toxic granules in eosinophils. EGC is usually a recurrent condition and some animals may require long-term management.

I think my pet may have EGC, what should I do?

If you are concerned about a red, angry spot on your pet, it is better to have it looked at by the veterinarian. Unfortunately there are other conditions such as cancers, lymphoproliferative conditions and even viral infections such as feline herpes virus that can look similar to EGC

The vet will perform a full physical examination and usually shave and clean the affected area before taking a sample. Sometimes a simple impression smear is sufficient for a diagnosis, but many cases will require a biopsy. A biopsy is a small piece of tissue removed from the affected area and sent to a pathology lab. The lab is able to look at the tissue sample and rule out other potential causes of red, raised lesions, such as cancer. This identifies the problem directly and can guide and tailor the vet’s treatment protocol.

What is the prognosis for pets with EGC?

The majority of pets diagnosed with EGC respond very well to medical management. The condition does tend to recur, however, which may mean intermittent treatment over the lifetime of your pet. There are occasional cases that are a little more complex and that require management by a veterinary dermatologist.