Chronic diarrhoea in dogs and cats

What is chronic diarrhoea?

Chronic refers to a disease that has been ongoing, either persistently or intermittently for three weeks or more. Whereas diarrhoea, as many of us can relate, is the passing of soft or loose stool. This stool is usually soft enough that it needs to be scraped up rather than picked up. It can range from the consistency of thick porridge to watery like soup.

What causes diarrhoea?

Diarrhoea occurs when the food and liquids consumed undergo an increased rate of passage in the gut, leading to poor absorption of nutrients, electrolytes and water. This leads to the expulsion of only partially digested, watery stool

There are many causes of diarrhoea and they can be simple to complex. Infectious causes such as parasites, viruses and bacteria are often to blame. Some animals have a more sensitive digestive system that tends to revolt whenever they eat something unusual, whether it is something they have stolen out of the garbage or from your plate. Even sudden changes in diets such as changing a food brand can cause a reaction.

Autoimmune diseases due to an overactive immune system or even allergies can cause a problem too. Other causes of diarrhoea include systemic illness (liver disease or thyroid disorders) or even from medications that can have diarrhoea as a side effect.

Diarrhoea is often categorised into three groups: small bowel (affecting the small intestine), large bowel (affecting the large intestine) or mixed. The classification depends on the characteristics of the diarrhoea.

Causes of small bowel diarrhoea:

  • parasites (hookworms, roundworms and Giardia)
  • pancreatic disease
  • inflammation of the liver and biliary system, the pancreas and the intestine also known as triaditis
  • inflammatory bowel disease (IBD)
  • feline hypothyroidism
  • feline leukaemia virus and feline immunodeficiency virus (feline AIDs)
  • fungal enteritis (Histoplasmosis)
  • cancer; alimentary lymphosarcoma
  • bacterial overgrowth, dysbiosis and enterotoxicosis

Causes of large bowel diarrhoea:

  • parasites (whipworms, trichomonas and Giardia)
  • irritable bowel syndrome (IBS)
  • inflammatory bowel disease (IBD)
  • immune mediated disease  (plasmacytic lymphocytic colitis, histiocytic ulcerative colitis) and eosinophilic colitis
  • allergies and food sensitivities

When will I know if my pet’s diarrhoea is a problem?

A bout of the squirts is not usually a problem if it is short lived and resolves on its own. This occurs in most cases. However, when animals have a more serious underlying cause, or are very young, diarrhoea can turn serious pretty quickly.

Any case of diarrhoea that does not resolve on its own after a few days is considered a problem that should be addressed. This is even if your pet is still lively and eating well. Pets with chronic diarrhoea lose important nutrients and electrolytes, which leads to their own long term consequences.

The most important thing to consider with diarrhoea is dehydration, which in young and old animals can happen quickly with fatal results. If they also have other symptoms, such as vomiting, then they can lose water a lot faster.

It is important to keep an eye out for other symptoms aside from the diarrhoea, such as vomiting, poor appetite, are more tired than usual or any other changes in behaviour. Be sure to mention these to the vet.

What should I do if my pet has chronic diarrhoea?

If your pet has diarrhoea that has been ongoing for some time without resolving, or even if it waxes and wanes but never really stays away, it would be wise to consult the veterinarian. We will often ask you to bring along a fresh stool sample to your appointment.

What will the vet do if my pet has chronic diarrhoea?

The first thing the vet will do is to perform a thorough physical exam on your pet. This is to check if they have a fever, are dehydrated, see if they have any pain in their belly or show any other symptoms that can be used to build a more complete picture. The vet will gather as much information as possible to treat the cause of the problem, rather than just the symptoms.

They will require as much history on your pet’s condition as you can give.

Questions sure to be asked include:

  • How long has the condition been going on?
  • Has the problem been persistent or intermittent?
  • When did you first notice the diarrhoea?
  • Did your pet eat or do anything out of the ordinary shortly before the diarrhoea began?
  • Were there any recent changes in diet or environment, recent travels or sources of stress?
  • Are there new family members or pets at home, or has a family member or pet recently passed away?
  • Is your pet on any medication, or have they had access (intentional or not) to any medications at home, cleaning materials, chemicals, toxins or even household plants?

Characterising the diarrhoea will also be very important as this will allow the vet to narrow down where the diarrhoea is coming from, and whether it’s in the small or the large intestine. This is important as treatment will differ depending on the cause and location of the problem.

Characterising the diarrhoea will look at characteristics such as how often your pet needs to go and if there is any urgency; if they strain when they squirt; if there is any blood or mucous in the stool as well as its colour and smell.

Diarrhoea that originates from the small intestine generally shows an increased volume of faeces, but the frequency is about the same, sometimes increased. They don’t generally show a real urge to go, but additional gas and sometimes a fatty consistency is seen. If blood is included, this is usually very dark, almost black in colour, rather than bright red. Because the job of the small intestine is primarily nutrient absorption and digestion, pets with chronic small intestinal diarrhoea tend to lose weight over time. These animals may also be nauseated or vomit.

Pets with large intestinal diarrhoea tend to have small deposits more frequently, often straining, are urgent for a deposit and appear uncomfortable. These animals may have a more mucoid diarrhoea with mucosal irritation. If blood is present, it is often seen as bright red rather than dark or black.

Can the vet test for the cause of the diarrhoea?

There are many tests available depending on what the vet is looking for. They will narrow down the list of suspects based on the character of the problem as well as any other symptoms seen. Usually they will start with some simple tests in order to gather more information before testing for a specific culprit.

The best place to start is generally the stool itself. The vet will analyse a sample by checking for parasites as this is one of the most common causes of diarrhoea in pets. This may include a faecal float to look for worm eggs, a faecal wet prep to search for parasites and in some cases, a stain will be made of the sample and checked under the microscope. If there is pain in your pet’s belly or if the vet can feel a bump or mass where there shouldn’t be one, they will likely recommend an x-ray or even an ultrasound scan of your pet’s belly.

Other testing that can be done includes blood tests, which look at the level of dehydration, levels of blood proteins (which can indicate autoimmune disease) and even blood loss through the gut. In older cats with chronic diarrhoea, testing their thyroid levels may be advised. Blood tests can also be used to test the function of the pancreas and liver, which may also play a role in chronic diarrhoea. Some viruses that can cause diarrhoea in puppies such as parvo and coronavirus, as well as feline leukaemia virus or feline AIDs virus in cats, can be tested within minutes with blood or stool samples.

When something abnormal is found at this base level, the vet may recommend biopsies or cultures depending on what they are looking for. These are sent to the lab and are usually focused on specific parasites or bacteria in the case of cultures, or specific autoimmune diseases for biopsies.

How can chronic diarrhoea be treated?

The treatment will depend on the cause. In most cases the vet will recommend a dewormer, even if no parasite eggs were found. The majority of diarrhoea cases respond very well to the use of a bland diet at home. The best would be a veterinary diet, which consists of highly digestible proteins and carbohydrates with low fats. These diets include increased omega oils to reduce inflammation and special prebiotic fibres to slow the transit time in the gut and promote the growth of good bacteria. Good old boiled chicken and rice work fairly well but obviously don’t have all the extras of a prescription diet. The vet will likely include a probiotic to quickly replace the good bugs that often get knocked out with gastrointestinal disease.

Infectious conditions may require antibiotics to treat, while autoimmune diseases will require immune suppressants. Cases of significant dehydration may require a drip and hospitalisation as their best course of action.

Irrespective of the cause, treatment will be tailored to each patient individually. Everyone is different and treatment will be adjusted based on test results and individual response to treatment.

© 2020 Vetwebsites – The Code Company Trading (Pty) Ltd

Acute Abdomen

Now and again pet owners are faced with emergency situations when their pets are suddenly in severe belly pain. Unexpectedly, both the owner and the pet are in a moment of anxiety and distress. So what could possibly be going on? This sudden severe belly pain is what veterinarians call an acute abdomen.

What is acute abdomen?

Acute means to happen suddenly, while the abdomen is the lower part of the trunk of the body, often referred to as the belly. The term acute abdomen refers to sudden pain in the belly. This sudden, severe pain in an animal’s belly should be treated as an emergency and requires immediate evaluation and response by the vet.

Pet owners will often report that their dog or cat was fine yesterday or earlier in the day before showing the sudden signs of terrible belly pain. The pain could arise from any of the following:

  • gastrointestinal tract (GIT) and inner lining of the abdominal body wall
  • other organs in the abdominal cavity (liver, pancreas, spleen, kidneys, reproductive tract, lymph nodes, diaphragm)
  • muscle and skin around the abdominal cavity
  • emanating from other systems outside the abdominal area such as back pain.

Acute abdomen can be life-threatening and should be considered an emergency.

What will I see if my pet has an acute abdomen?

Since there are so many possible causes of acute abdomen, it is not surprising that its symptoms will be equally diverse. Further complicating the situation is the fact that the symptoms may be non-specific to any one particular cause. So, how can a pet owner judge from home that their pet is in a crisis situation? To help pet owners reach the decision to take their pet to the vet for examination, below is a summary of possible symptoms of acute abdomen.

Pet owners should look out for:

  • restlessness
  • unusual panting
  • arching of the back
  • body posture changes such as assuming the praying position (with their front legs on the ground and their rear end in the air)
  • retching or trying to vomit without success
  • loss of appetite
  • marked sensitivity when owners attempt to stroke their pets in the belly area
  • distention of the belly such as with advanced pregnancy, or when there is a marked accumulation of fluids in the abdominal cavity

With very painful conditions or when shock sets in, the respiratory rate and heart rate might be elevated and there may be a loss of colour in the mucous membranes.

What can cause an acute abdomen?

Acute abdomen can be caused by problems in any of the various systems located inside and/or (less frequently) outside the abdominal cavity. Potential causes of the syndrome range from injury, infection, swelling or inflammation, blockages in organ systems, to cancer.

Trauma

The pet owner may have missed potential injury or incidents of trauma. Forces from a kick, bump or a fall can lead to organs shifting to unusual positions in the body, which would normally be impossible for a pet owner to realise. These incidents can cause excruciating pain. Examples of this include diaphragmatic hernias, where internal organs punch up into the chest cavity and cannot slip back out. This is commonly seen when a pet is bumped by a car.

GIT obstruction

Pain in the belly can also originate from the GIT. Blockages in the stomach or intestines can be caused when objects such as toys or bones are swallowed whole. Pain and injury to these organs can occur when the stomach or intestines twist around themselves or even ‘telescope’. Other organs such as the spleen can also twist in association with the stomach torsion – another emergency and cause of acute abdomen in itself.

Inflammation/Disease

Life-threatening inflammatory conditions affecting the liver or pancreas are also frequently seen as causes of acute abdomen. Pancreatitis or liver disease (abscesses or cancer, as examples) are also a common cause of acute abdomen.

Examples of other possible causes of this syndrome include peritonitis, stomach ulcers, kidney disease and infections and cancer of the reproductive tract – in both male and female patients. Disc disease (back pain) is an example of pain outside the abdomen that can present as acute abdomen. 

What should I do if I suspect my pet has an acute abdomen?

Severe belly pain should be treated as a medical emergency. Take your pet to the nearest vet ASAP. Any delay can have fatal consequences.

What can I expect when I get to the vet?

Sequence of events at the veterinary hospital:

Upon arrival at the veterinary hospital, the patient will be attended to as an emergency in line with the pet owner’s complaint. The vet will then seek to confirm if the symptoms are truly suggestive of acute abdomen.

To confirm the vet’s speculation of acute abdomen, the pet owner would need to give an accurate and detailed history of the pet’s condition and lifestyle. The vet will ask many in-depth questions to get a better idea of the pet’s medical history and what might be causing their discomfort. Information will be requested regarding the names of current medications the pet is receiving, recent abdominal surgery the pet would have undergone, time estimate of when they noticed signs of pain or distress as well as the progression of the symptoms. As much as it might feel like an interrogation by the vet, this detailed information assists in speeding up the process of providing the best care for the pet.

Depending on initial findings by the vet, some pets would require stabilisation before he can do a more thorough physical examination. Once this examination is completed, a diagnostic workup plan is designed by the vet and discussed with the owner. The findings from the diagnostic tests performed will inform the staff on how best to care for the pet patient. The best care for the patient with acute abdomen can only be achieved through in-hospital care for a couple of days.

Which steps will my veterinarian take in order to find the problem?

Acute abdomen affects other body systems apart from the gut. Systems that put the patient’s life at risk that are commonly affected are the cardiovascular system, respiratory system, central nervous system, renal (kidney) system and the hepatic (liver) system. Blood tests will assist in providing an overview of the state of health of most systems. Imaging (x-ray and ultrasound scan) of the abdomen and chest areas also forms part of the diagnostic tests.

Depending on what is found on these tests, the vet may recommend surgical intervention. This may include an exploratory laparascopy where all the organs can be visualised and surgically corrected where appropriate. A host of other tests might be ordered if deemed necessary for the survival of the patient. Some tests might be repeated in the days to follow as part of monitoring the patient’s response to treatment.

How is acute abdomen treated?

A good diagnostic workup informs the decision on how to treat or manage the case. Having a diagnosis helps to categorise whether the case will be managed medically, as a surgical emergency, or as a delayed surgical case requiring the patient to be stabilised before undergoing surgery. Fluid replacement in the form of a drip is generally advocated in all cases of acute abdomen as it aids in supporting the heart and blood pressure. Medical management entails the use of appropriate drugs to relieve the patient from pain, treat infections, and addressing other possible symptoms such as stopping vomiting and diarrhoea. Surgery is reserved for cases that require surgical intervention for survival.

Conclusion

Acute abdomen is a medical and/or surgical emergency in which time is of the essence. Early intervention improves the chances of the pet’s survival. Unfortunately, due to the broad possible causes of presenting signs, proper management of each case relies heavily on a thorough diagnostic workup. Good pet owner cooperation with the veterinary teams at the hospital is of paramount importance, and dare I say, could be the difference between life and death.

© 2020 Vetwebsites – The Code Company Trading (Pty) Ltd

My pet lost a patch of fur and developed a massive sore overnight. It looks like a burn wound.

HotSpot dog

Acute moist dermatitis is a skin ailment in pets that’s caused by a trigger like an itch or pain, and exacerbated by the pet’s scratching and licking until it becomes a large bare patch of painful skin lesion. Since the lesion is an open painful wound, it’s referred to more commonly as a hotspot.

What is a hotspot?

No, we’re not talking about public wireless internet. A hotspot is a skin condition seen far more often in dogs than in cats. It is an area of very itchy, wet, unhappy, infected skin that your dog keeps licking or nibbling at. It usually develops overnight; in a matter of hours, your dog’s healthy skin can develop a massive, sore, red or yellowish bald patch. It is constantly wet and raw as some dogs tend to lick this wound almost obsessively. These spots may have started out as something small and insignificant like a bump from an insect bite, but quickly grow larger in a short time. Usually only one spot is affected rather than several around the body, but there are exceptions to this rule.

Which breeds are more likely to develop hotspots?

Retrievers and German shepherds with longer, thicker coats tend to have this problem more often than dogs with short coats. Hotspots are also more often seen in dogs who love to swim and are always in the water. This is because skin that is always wet tends to get more easily infected with bacteria and fungi that thrive in a warm, moist environment. Something triggers the itch, so when the dog begins to scratch, the bacteria is spread and the hotspot quickly develops. People with water-loving dogs often have their dogs clipped in the warm summer months to prevent this problem.

How do hotspots start?

The initial cause will vary from one pet to another. This condition often occurs as a result of the constant scratching at an itch, such as pets with fleas, allergies or even an ear infection. They can occur anywhere on the body, but usually on a spot they can reach with their paws or mouth to scratch and nibble. The typical places for hotspots to develop are the side of the face below the ears or on the upper part of the back leg. Some spots get a little more attention than others and these get infected, leading to an itchy and sore wound that your pet won’t leave alone.

Why do hotspots grow in size?

Irrespective of the cause, hotspots tend to become infected because they are always wet and the skin is licked raw. As you can imagine, your dog’s mouth is far from the most hygienic means to clean a wound. This infection then leads to swelling and pain on top of the initial itch or discomfort. In trying to alleviate the discomfort, your dog will constantly lick the area, but the more they lick, the more widespread the irritation and infection of the skin becomes.

What can I do if my dog has a hotspot?

The most important first step is to establish the underlying cause of the problem. Was your pet itchy to start with; were they shaking their head from an ear infection? Has your pet had persistent flea infestations? Take your dog to the vet, who will help to determine where the problem may have started. It’s important to not only treat the symptoms and the hotspot itself, but to find the cause in order to prevent the condition from deteriorating or returning.

How is a hotspot treated?

A hotspot involves infected skin, so it would be wise to have it treated and to get the infection under control. The vet will examine the area and determine the extent of the infection. The area around the hotspot will be shaved to make it easier to clean and treat. The area will then be cleaned and the vet will most likely treat it with antiseptic creams or even antibiotics and anti-inflammatories. Depending on the severity of the lesion, the vet may also prescribe systemic antibiotics. In severe cases this treatment may have to be continued over a number of weeks. In some instances this condition can be excruciatingly painful and may require sedation or even a full general anaesthetic to be treated properly.

While the hotspot is healing, your most important task will be to convince your dog to leave it alone. This is not always an easy task because he is probably used to licking or scratching to try to relieve the itch and pain. The most helpful tool is the Elizabethan collar (the ‘cone of shame’), which limits the access your pooch has to that spot. The cone needs to be big enough to stop your pet from reaching the hotspot, so the edge of the cone must be longer than his nose.

Most hotspots respond well to treatment, especially if the underlying cause is treated successfully, but finding the cause is usually the tricky part.

Will a hotspot getter better by itself?

The answer is no. In most cases, the condition keeps on spreading like wildfire and, if not treated sooner rather than later, your pet may end up with significant hair loss and infected skin over large areas of his body. If this happens, the treatment becomes a lot more complex and expensive. If you suspect your dog has a hotspot, the sooner you get him to the vet, the better. 

Why is my dog prone to recurring hotspots?

If the underlying condition leading to a hotspot is not successfully addressed or treated, it will most certainly lead to a recurrence of the condition. Ear infections are a common reason for dogs to scratch the side of their face. It may seem obvious that one should treat the ear condition, but an ear infection in a dog may often be a symptom of another underlying condition. Atopic dermatitis, which is skin irritation caused by the inhaling of allergens, is a common cause of ear infection. This can be a very difficult underlying cause to treat and, in many cases, may never be successfully treated; only managed. If your dog is one of the unlucky canines to have an overactive immune system that is negatively triggered by environmental allergens, it may take a lot more to address the underlying cause of a hotspot and prevent it from recurring on a regular basis. The vet will have to spend more time in such a case to work out a plan of action for future prevention.

© 2020 Vetwebsites – The Code Company Trading (Pty) Ltd

Acral lick granuloma

Canine lick granulomaWhen a pet owner brings their animal in to the vet with a firm, raised, angry red bump on the pet’s leg or ankle, complaining that the animal (a dog more often than a cat) won’t stop licking at it, the vet knows that there is a potentially long road of diagnosis and treatment ahead. The symptoms and behaviour described here are common in what’s called acral lick granuloma

What is an acral lick granuloma?

An acral lick granuloma is a medical condition whose main feature is a raised, angry red bump on the pet’s leg. This angry bump is usually the centre of the pet’s focus, where they constantly lick the area until it is raw.

If we unpack the name of the condition, it gives us a better idea of what it is and how it is caused. Acral refers to peripheral body parts, so the extremities like legs, ankles and paws. This condition usually affects the furthest end parts of the legs; more commonly the front legs, but also the back. The lick part of the name defines the cause of the condition, namely long-term licking, which aggravates the skin and leads to irritation and ulcers. A granuloma is the body’s response to long-term irritation; in this case irritation to the skin. A granuloma comprises clumps of irritated tissue, which usually appear raised like a mushroom on the surface of the skin.

So an acral lick granuloma is a condition where the body creates a granuloma on the leg/s as a result of long-term licking.

What does an acral lick granuloma look like?

Not all acral lick granulomas look identical, but they all share some basic characteristics. They usually appear as thick, firm, raised, hairless areas on the top of the front or back legs. These areas sometimes have a ring of darker coloured skin on the edges. Pets who have this problem compulsively lick the area, even if you scold them or try to distract them. It’s as if they can’t help themselves. Acral lick granulomas develop as a result of long-term licking and develop slowly over time. Long-standing cases have ulcers that develop on the topmost surface of the granuloma. These areas often have an underlying infection, so they can appear red and angry, sometimes oozing a pussy, red or straw-coloured liquid. 

Which animals can get acral lick granulomas? 

Both dogs and cats can develop an acral lick granuloma, but it’s more prevalent in older animals than in younger animals. Retrievers and high focus breeds like Dobermans, Irish setters and German shepherds tend to get this problem more commonly than others.

What causes an acral lick granuloma?

There are several theories about what leads to the development of an acral lick granuloma. Many researchers believe that this condition is mainly caused by psychological factors; that it is stress-related. There is yet other evidence that suggests that there may be an underlying medical problem that starts the licking cycle. These conditions include pain, irritation, infection and discomfort. Conditions such as arthritis, pain related to bone conditions, infections, injuries and even itchy skin-related conditions such as allergies or parasites may kick off the animal’s need to lick.

When a pet licks the area of pain or discomfort, it releases feel-good hormones, making them want to keep licking. This soothing effect is most likely how the lick cycle is maintained once it has started, which results in compulsive licking.

In cases where an initial physical cause of the problem could not be found, studies found that many of the dogs with acral lick granuloma had a psychological origin. Many of these dogs started licking as a response to stress, anxiety or boredom. Many of them started licking after a change in their environment. Examples include dogs who were crated for longer than usual, a change in their owner’s working hours, or even the loss of a friend or family member.

I think my pet may have an acral lick granuloma, what can I do?

If you suspect that your pet has an acral lick granuloma, the best would be to discuss the condition with a veterinarian. It is important to find out what started the problem in the first place. The veterinarian will examine your pet and possibly recommend x-rays or even collect samples from the area to rule out bone or joint problems, parasite infections or even cancer. The cause of the problem needs to be addressed if there is to be any hope of a solution. Each case is unique and treatment administered will depend on the cause.

Possible treatment routes

More often than not there is infection hiding deep in an acral lick granuloma, which requires long-term antibiotic treatment. This may be for weeks or months, and requires diligent effort to maintain on the owner’s part. Resolving infection in these cases is the cornerstone to successful treatment. An important component of managing an acral lick granuloma is to limit your pet’s access to this area once treatment has started. This can be done by bandaging the area or by using a cone, or Elizabethan collar.

In cases where psychological stress is a major contributor to the condition, the veterinarian may recommend a consultation with a behavioural specialist who can assist in managing the stress-related aspect of this condition. 

Keeping an eye on when your pet licks may indicate the psychological contributor to the condition. Do they lick more when they are on their own or when surrounded by people? Do they lick when locked up in their crates during the day or night or when they are alone or bored? Do they show other symptoms related to separation anxiety, like not being able to leave your side when you are at home? 

An acral lick granuloma can be a frustrating condition to treat and manage. The granuloma develops slowly over time, so you may not know there is a problem until it is well established. An important part of treating these lick granulomas is finding and treating the initial cause. Without finding the initial cause, they tend to recur. Always speak to the vet about your concerns regarding your pets.

© 2020 Vetwebsites – The Code Company Trading (Pty) Ltd

My dog is tilting his head to the side, and seems to be off balance

The vestibular system

The vestibular system is the body’s ‘balance messenger’ – giving mammals (including humans and pets) key sensory information that allows us to stay upright and properly orientated in the world. The vestibular system is made up of two main components: the inner ear and the brain.

In the inner ear, the vestibular system is made up of tiny sensitive bones, membranes and tiny hairs, all strategically positioned to send signals about balance and where your limbs are and how your body is moving also called your spatial orientation. An example of this will, for instance, be your brain sending and receiving messages about which way your head is moving. The different parts of the brain involved in the vestibular system receive the sensory information from the ear and other body structures and help them to all function together to give you a perception of balance. The eyes, the head, the body and the legs are all included, allowing for smooth, balanced and harmonised movement. The proper functioning of the vestibular system allows you to stand on one leg and touch your finger to your nose without falling over.

What is vestibular disease?

Vestibular disease shows up as the sudden onset of balance problems in your pet. The causes of vestibular disease can originate either from the inner ear (peripheral (outside)) or from the brain (central (inside)). How it is diagnosed and treated will depend on the cause (infection, trauma, structural changes or hormonal influence) and the location (inner ear or brain).

How does vestibular disease occur?

Most cases of vestibular disease occur as a result of infection and inflammation of the inner ear (peripheral vestibular disease). Long-standing outer ear infections can progress to middle and inner ear infection leading to vestibular disease in pets. Ear infections at the best of times are difficult to treat because it in itself have many different causes. The ear canal in dogs and cats is much longer than the human ear canal and consist of two parts, the vertical ear canal and the horizontal ear canal. The long ear canal can in many cases contribute to ear infections, but sometimes ear infections are not primarily related to the ears but can be as a result of general skin allergies which then causes ear infections as a secondary problem. Because severe ear infections can lead to vestibular disease, which is a really serious condition, it is important to treat ear infections as early as possible. Other causes of peripheral vestibular disease can be due to damage to the bones protecting the inner ear as caused by head trauma, abnormal growths in this area, certain medications and even hormonal abnormalities such as low thyroid levels.

Central vestibular disease, which affects the brain, is more serious and can be caused by abnormalities in the brain or the membranes protecting it. This can result from bacterial or viral infections such as meningitis, abnormal growths, toxins or even a stroke.

What symptoms will I see in vestibular disease?

The cause of the disease will determine the signs you will see. The most common sign of both peripheral and central vestibular disease is a head tilt to one side. The head tilt almost always affects only one side; with one ear up in the air and the other pointing down. The downward ear is usually the culprit for the discomfort.

The head tilt can vary in severity – from a barely noticeable tilt to tilting all the way to the side, where your pet looks like they’ll fall over. Some pets develop instability where they tend to lean to one side or even fall and roll to the same side as the head tilt. Sometimes pets will walk in tight circles, always in the same direction toward the problematic ear. In some cases, the vertigo and dizziness can cause nausea where pets drool, lick their lips or even upend their dinner. Pets with outer ear infections often scratch their ears and shake their heads with irritation. Some pets with inner ear infections can develop signs of Horner’s Syndrome, where one side of the face may droop, one eyelid hangs, the third eyelid partially covers the eye and there is a change in the size of the pupil. Sometimes one eye appears squint and looks in a different direction to the other, especially when the pet’s head is lifted up.  

If the cause is located in the brain there will be subtle signs such as poor appetite and sleeping more than usual; as well as more frightening signs such as weakness of the legs to paralysis and seizures.

Is vestibular disease treatable?

Treating vestibular disease depends on the cause of the problem. If the problem originates with an inner ear infection, the vet can usually treat it with anti-inflammatories and antibiotics. However, if the problem is more complex and affects the brain or is caused by abnormal growths, the treatment decision would depend on what is found. If your pet is nauseated or vomiting, your vet can assist with anti-nausea medication.

What do I do if I suspect my pet might be affected?

The best option would be to bring your pet to the vet for a full checkup. The vet could first determine if vestibular disease is a problem in your pet and pinpoint the source of the problem, whether it be peripheral or central. It is important to mention to the vet when you first noticed any signs and how it has progressed over time, as well as if your pet is on any medication.

The vet will do a full check on your pet. This may include examining your pet’s ears with an otoscope, test nerve and brain responses, and the vet may even recommend x-rays to have a better idea of what is going on in the inner ear. If a brain-based problem is suspected, a Computed Tomography scan (CT or CAT scan) or Magnetic Resonance Imaging scan (MRI scan) might be recommended. These procedures are highly specialised and most veterinary practices do not have the equipment to do these scans in house and you may need to be referred to a veterinary specialist.

When is vestibular disease a problem?

On the basic level, vestibular disease can be a problem if your pet is falling over and hurting themselves, or even falling into the pool and unable to get out. Ear infections are uncomfortable and often painful and will not come right by itself.

On a more serious level, a head tilt can be the tip of the iceberg and may be the first sign of a very serious problem. If your pet has vestibular disease, it is something that does require further investigation and treatment – it will not simply come right on its own.

Either way, if you see your pet persistently tilting their head to the side,  please make an appointment with the veterinary practice.

© 2020 Vetwebsites – The Code Company Trading (Pty) Ltd

Coronavirus and your pets

Now that the coronavirus has hit South Africa's shores, and several people have been confirmed to have the disease, COVID-19, there are many pet owners who are concerned about how COVID-19 will affect them and their pets.

Background

Coronavirus disease 2019 (COVID-19) is a disease caused by the coronavirus SARS-CoV-2. The source of the coronavirus is believed to be a ‘wet market’ in Wuhan, China, which sold both dead and live animals including fish and birds. Currently, there is no evidence suggesting a specific animal host as a virus reservoir, and further investigations are ongoing.

How is COVID-19 spread?

The disease is spread from person to person via respiratory droplets produced from the airways, often during coughing or sneezing. Symptoms appear between two and 14 days (with an average of five days) from the time of first exposure and contraction of the disease. As with most viral infections, some people will contract the disease while others who have been exposed to the same virus will not contract the disease. This is usually as a result of the immune status and health of the individual.

Symptoms of COVID-19 infection

The symptoms of COVID-19 are very similar to the flu we have become accustomed to in winter and include a fever, a dry cough, weakness and fatigue, and shortness of breath. Sneezing, a runny nose and a sore throat are less common. The disease usually causes only mild symptoms, but in immune compromised or older people, it can progress to pneumonia and multi organ failure.

Can pets contract Coronavirus?

Currently, there is no evidence that companion animals can be infected with or spread COVID-19.

However, there are several coronaviruses that affect our pets and that can cause disease in animals.

It is very important to understand that when we speak about ‘coronavirus’, we are actually speaking about a large family of viruses and not a single virus. To this end there are a number of coronaviruses that can affect people and animals.

Coronaviruses belong to the family Coronaviridae. Alpha- and beta-coronaviruses usually infect mammals, while gamma and delta coronaviruses usually infect birds and fish. Canine coronavirus, which can cause mild diarrhoea, and feline coronavirus, which can cause feline infectious peritonitis (FIP), are both alpha-coronaviruses. These coronaviruses are not associated with the current coronavirus outbreak. Until the appearance of SARS-CoV-2, which belongs to the beta-coronaviruses, there were only six known coronaviruses capable of infecting humans and causing respiratory disease, including the severe acute respiratory syndrome, coronavirus SARS-CoV (identified in 2002/2003) and Middle East respiratory syndrome coronavirus MERS-CoV (identified in 2012). SARS-CoV-2 is genetically more related to SARS-CoV than MERS-CoV, but both are beta-coronaviruses with their origins in bats. While it is not known whether COVID-19 will behave the same way as SARS and MERS, the information from both of these earlier coronaviruses can inform recommendations concerning COVID-19.

Can I get COVID-19 from my pets?

Recently, the Hong Kong Agriculture, Fisheries and Conservation Department (AFCD) announced that a pet dog of a COVID-19 infected patient has tested ‘weak positive’ for the virus, however, further tests are currently being carried out to determine if it is a true infection or if it is due to environmental contamination of its mouth and nose. In a statement, AFCD said that the dog had not shown any symptoms and there was no evidence to suggest that pets could contract the coronavirus or be a source of infection in people.

In the last few weeks, rapid progress had been made in the identification of viral etiology, isolation of infectious virus and the development of diagnostic tools. However, there are still many important questions that remain to be answered. For now, the information available indicates that we cannot get the coronavirus (SARS-CoV-2), which causes COVID-19, from our pets.

It is always a good idea to wash your hands with soap and water after contact with pets. This protects you against various common bacteria such as E. coli and salmonella that can pass between pets and humans.

Should I avoid contact with pets or other animals if I am sick with COVID-19?

The Centers for Disease Control and Prevention (CDC) recommends the following: “You should restrict contact with pets and other animals while you are sick with COVID-19, just like you would around other people. Although there have not been reports of pets or other animals becoming sick with COVID-19, it is still recommended that people with COVID-19 limit contact with animals until more information is known about the virus.

When possible, have another member of your household care for your animals while you are sick. If you are sick with COVID-19, avoid contact with your pet, including petting, snuggling, being kissed or licked and sharing food. If you must care for your pet or be around animals while you are sick, wash your hands before and after you interact with pets and wear a facemask.”

If my pet has been in contact with someone who is sick from COVID-19, can it spread the disease to other people?

While we do not yet know for sure, there is no evidence that companion animals can be infected with or spread SARS-CoV-2. We also do not know if they could get sick from this new coronavirus.

Additionally, there is currently no evidence that companion animals could be a source of infection to people. This is a rapidly evolving situation and this information may change.

What should I do if my pet develops an unexplained illness and was around a person with documented COVID-19 infection?

We don’t yet know if companion animals can get infected by SARS-CoV-2 or develop the COVID-19 disease. If your pet develops an unexplained illness and has been exposed to a person infected with COVID-19, talk to the public health official working with the person infected with COVID-19. If your area has a state veterinarian, the public health official can consult with them or another appropriate official. If the state veterinarian, or other public health official, advises you to take your pet to a veterinary clinic, call us before you come in to let us know that you are bringing a sick pet that has been exposed to a person infected with COVID-19. This will allow us time to prepare an isolation area. Do not bring the animal to our veterinary facility unless you are instructed to do so by a public health official.

What are the concerns regarding pets that have been in contact with people infected with this virus?

While COVID-19 seems to have emerged from an animal source, it is now spreading from person to person. Person-to-person spread is thought to occur mainly via respiratory droplets produced when an infected person coughs or sneezes. At this time, it’s unclear how easily or sustainably this virus is spreading between people.

Importantly, there is no evidence at this point in time (March 2020) that companion animals including pets such as dogs and cats, can become infected with COVID-19.

What should be done with pets in areas where the virus is active?

Currently there is no evidence that pets can be infected with this new coronavirus. Although there have not been reports of pets or other animals becoming sick with COVID-19, until we know more, pet owners should avoid contact with animals they are unfamiliar with and always wash their hands before and after they interact with animals.  As stated before in this article, if owners are sick with COVID-19, they should avoid contact with animals in their household, including petting, snuggling, being kissed or licked, and sharing food. If they need to care for their pet or be around animals while they are sick, they should wash their hands before and after they interact with them and wear a facemask.

Should my vet vaccinate my dogs against canine coronavirus because of the risk of SARS-Cov-2?

The canine coronavirus vaccines are intended to protect against enteric coronavirus infection in dogs and are NOT licensed for protection against respiratory infections. In the face of the current outbreak, some dog owners may propose that there may be some form of cross-protection against COVID-19 and may think that it will be of benefit to have their dogs vaccinated with the current coronavirus vaccine to be better protected. There is absolutely no evidence that vaccinating dogs with commercially available vaccines will provide cross-protection against the infection by SARS-CoV-2, since the enteric and respiratory viruses are distinctly different variants of coronavirus. No vaccines are currently available in any market for respiratory coronavirus infection in dogs.

What can I do to protect myself and my pets against COVID-19?

There is currently no vaccine to prevent COVID-19. The best way to prevent illness is to avoid being exposed to this virus. However, as a reminder, experts recommend everyday preventive actions to help prevent the spread of respiratory diseases, including:

  • Avoid close contact with people who are sick.
  • Avoid touching your eyes, nose and mouth.
  • Stay at home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the rubbish bin.
  • Clean and disinfect frequently touched objects and surfaces, using a regular household cleaning spray or wipe.
  • Follow CDC’s recommendations for using a facemask.
    • CDC does not recommend that people who are well wear a facemask to protect themselves from respiratory diseases, including COVID-19.
    • Facemasks should be used by people who show symptoms of COVID-19 to help prevent the spread of the disease to others. The use of facemasks is also crucial for health workers and people who are taking care of someone in close settings (at home or in a health care facility).
  • Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom, before eating, and after blowing your nose, coughing or sneezing.
  • If soap and water are not readily available, use an alcohol-based hand sanitiser with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.

Where can I find more information on COVID-19?

The most up-to-date information and advice on human infection can be found on the following websites:

• World Health Organisation (WHO) (see here)

• Centers for Disease Control and Prevention (CDC) (see here)

The most up-to-date information related to animal health can be found on the following website:

• World Organisation for Animal Health (OIE) (see here)

 

© 2020 Vetwebsites – The Code Company Trading (Pty) Ltd

 

 

 

My little dog is coughing often and sometimes seems to struggle to breathe.

What is tracheal collapse?

Tracheal collapse is a common cause of coughing and airway obstruction in dogs. The trachea, which is also known as the “windpipe”, provides the air supply from the outside to the lungs. The trachea can be thought of as resembling a vacuum cleaner pipe. It is a flexible but firm tube that is reinforced by strong cartilage rings. These rings are not complete but rather “c-shaped”, with the open end of the “c” facing to the inside of the neck with a ligament attaching from the one end of the C to the other. Sometimes these cartilage rings weaken and cannot hold their shape causing the trachea to narrow or even close, making it more difficult for air to pass through.

Which dogs are prone to tracheal collapse?

The small and toy breed dogs are most commonly affected by this condition.  Yorkshire terriers, Toy Pomeranians, Poodles and Chihuahuas are some of the most commonly affected breeds. Young dogs can be affected but the condition is more commonly seen in middle-aged to older patients. These dogs are often overweight and living in a household that has smokers often exacerbates the condition.

What are the signs of tracheal collapse?

  • The dog often has a characteristic “goose honking” cough.
  • The dog may cough when picked up or pulled on a collar.
  • Some dogs may have difficulty breathing and some turn blue when excited.
  • There is usually a degree of exercise intolerance and a wheezy noise may be heard when the animal breathes in.
  • The cough and other signs are often worsened with excitement, eating, drinking, tracheal irritants such as smoke, dust or pollution, obesity, exercise and hot and humid weather.

Diagnosing tracheal collapse

The clinical signs and breed of dog make a diagnosis of tracheal collapse highly likely. X-rays can be helpful in making a diagnosis but the collapse of the trachea is often dynamic so may not be seen all the time. Fluoroscopy is a moving x-ray and is beneficial in that the trachea can be visualised over a short period of time. Unfortunately, fluoroscopy is usually only available at veterinary teaching hospitals and some veterinary referral centres. Using a scope is the only way one can see what is happening within the trachea and may also be useful as swabs and cultures can be taken to make sure there is not a secondary infection present concurrently.

Can tracheal collapse be confused with other conditions?

Tracheal collapse can definitely be confused with other upper respiratory tract conditions of which the most common one in toy breeds is arguably reverse sneeze. Kennel cough, an infectious viral condition of the upper respiratory tract is another. Allergies are another common cause of upper respiratory tract conditions. A foreign body like a grass awn which gets stuck somewhere in the upper or lower respiratory tract is another possibility. To differentiate which condition your dog may be suffering with will most likely require a thorough clinical examination and diagnostic workup by the vet.  

Can tracheal collapse be cured?

Unfortunately, tracheal collapse cannot be cured but it can be managed relatively successfully. Medical management includes medication to suppress the cough, reduce airway inflammation and spasms, and reduce anxiety. Weight loss is probably the most important aspect of management in overweight pets as obesity greatly exacerbates the condition.

In some cases, surgery may be an option to help support the trachea. It is a specialist procedure and an animal will still need to be managed medically afterwards. Surgery does come with its own risk so it is important to speak to an experienced surgeon before travelling down this route. It is also important to remember that not all animals will be ideal candidates.

At present, there is no known way to prevent tracheal collapse but maintaining an ideal weight and reducing exposure to airway irritants such as smoke have been found to help. Patients may be managed relatively efficiently with medical management and it is estimated that more than two-thirds of dogs will show some improvement. About three-quarters of dogs will improve with surgical treatment but the surgery does also carry its own risks. Older dogs may also have laryngeal or bronchial disease. This also comes with complications and does reduce the long-term prognosis for management.  Weight management and control of the cough is vital for a good outcome and it is important to remember that medical management is still instrumental even after surgical treatment. 

There is a strong school of thought that suggests tracheal collapse may be inheritable because it is related to the shape and confirmation of the trachea. Just like you may find some dogs have longer legs and some have shorter legs, so some of the toy breeds may have narrower tracheas than others. It would certainly stand you in good stead to do some proper research before buying a highly pedigreed toy breed of dog.

If you are not sure if your dog may be suffering with tracheal collapse, visit the vet and have a proper exam done. It may just improve the quality of life of your best friend.

© 2019 Vetwebsites – The Code Company Trading (Pty) Ltd

 

My cat is eating like crazy and not picking up weight

What is hyperthyroidism?

Hyperthyroidism is a condition that arises from an excessive production and secretion of active thyroid hormones by an abnormally functioning thyroid gland. First recognised in the late 1970’s, the frequency of diagnosis has escalated dramatically – currently it is the most common endocrine (hormone system) disease in cats and also one of the more frequently diagnosed disorders in the veterinary field. The condition is estimated to affect 1 in 300 cats.

What causes hyperthyroidism?

Despite several studies, the exact cause of the disease remains unknown. Recent studies have found that there is no breed association with risk. Other studies have found cats fed mostly tinned cat food, especially fish or liver and giblet flavour, and cats using cat litter are at increased risk.

Soybeans have also been implicated as a potential culprit as it is used as a protein source in some commercial cat foods. Furthermore, the thyroid gland contains more selenium than any other tissue, which suggests this trace element may play an important role.

Which cats are affected?

The disease typically affects middle-aged to older cats, with an average age of onset at 12-13 years.  Rarely can it affect cats as young as 4 years of age. There is no breed or gender predilection.

What are the clinical signs of hyperthyroidism?

Thyroid hormones are involved in a wide variety of functions in the body, including the regulation of heat production, metabolism and interaction with the nervous system. Therefore almost any organ system can be affected and subsequently a wide variety of clinical signs are possible.

Typically the signs start out very subtle and slowly progress, causing most owners to not notice them for several months. Some owners may also put these signs down to the normal “ageing” process.

The most common clinical sign is weight loss, despite a voracious appetite. Affected cats may seem constantly hungry and “finicky eaters” stop being “finicky”, eating everything that is offered to them or that they can get to.

Affected cats often gobble down their own food before going on to eat all the other pets in the household’s food as well; they may even try to steal your food off your plate if given the chance. Remember that cats are a lot smaller than us humans – losing for example 500g is not significant weight loss for a human but for a cat it’s about 10-20% of their total body weight and definitely a cause for concern.

Affected cats also become hyperactive – they may seem restless, anxious and irritable, constantly moving or even pacing, sleeping for short periods only and wakening easily. When brought to the vet these cats typically won’t sit for the vet to examine them and become aggressive when attempts are made to restrain them.

Affected cats are also weak and tire very quickly – you may notice it can’t jump as well as it used to. They also can’t cope with stress – short car rides, bathing, boarding or vet visits may weaken them severely or even cause them to collapse.

The digestive system may also be affected, causing vomiting, soft, bulky, stinky stools and sometimes even diarrhoea.

How is hyperthyroidism diagnosed?

Hyperthyroidism can cause a wide variety of clinical signs, many of which can be caused by several other disease processes as well. Vets may perform several tests on your cat to rule out, amongst others, diabetes, kidney disease, heart disease, pancreatic disease and cancer. These tests may include blood tests, urine analysis, X-rays and even an electrocardiogram or ECG.

The diagnosis is confirmed by measuring the amount of thyroid hormone circulating in the cat’s blood.   Affected cats’ values may be up to 19 times more than the top normal value.

It is worth noting that up to 10% of affected cats may have borderline or even normal levels of thyroid hormone. These cats are either mildly affected or are suffering from another non related concurrent illness which is suppressing the thyroid levels. Therefore, the vet may decide that a single measurement is not enough to either rule in or – out thyroid disease and may recommend additional tests.

How is hyperthyroidism in cats treated?

Affected cats are generally started on anti-thyroid medication to stop the excessive secretion of thyroid hormones. The medication can be given between one and three times a day. The vet will typically start on a certain dose and repeat the thyroid hormone levels by doing a blood test after two weeks from commencing treatment.

Depending on the result, the dose may be increased or decreased and the blood tests repeated again after two weeks. This process will continue until the thyroid hormone levels return to the normal range. Once this is achieved, thyroid blood levels will need to be retested every 3 to 6 months or whenever otherwise indicated. 

The success of the therapy will mostly depend on you, the owner, as you will be the one tasked with administering the medication. It is important that you stick to the prescribed dosage and return to the vet for scheduled follow-ups or whenever your cat shows any signs of illness.

Cats are notoriously hard to pill! If you find it impossible to administer the medication, let the vet know as soon as possible – we will be happy to show you how to give the medication or help you come up with an alternative.

In some cases the vet may opt to surgically remove either one or both of the thyroid glands. Generally, the procedure cures the disease, but there is always a risk of it recurring – therefor the vet may want to monitor the progression of the disease every 6 to 12 months; if it recurs the cat will have to go onto medication again.

The vet may also recommend a diet change as there are therapeutic diets which have been specifically developed for this condition.

The last option is destruction of the thyroid gland via radioactive iodine, which is currently not readily available in South Africa.

What’s the connection between hyperthyroidism and kidney disease?

Hyperthyroid cats are predisposed to kidney disease due to the effects of the higher metabolism on the kidneys. Conversely, the higher metabolism also masks the signs of kidney failure. Consequently these cats often start showing signs of kidney failure once their thyroid condition is brought under control.

The vet may decide to monitor you cat’s kidney enzyme levels along with the thyroid levels in order to diagnose kidney failure as early as possible.

What’s the connection between hyperthyroidism and heart disease?

Hyperthyroid cats are prone to developing heart murmurs, abnormally fast heart rates and abnormal heart rhythms. The vet may notice these abnormalities when listening to the heart with a stethoscope.

The excessive amount of circulating thyroid hormone makes the heart work harder than normal, which is further worsened by having to keep up with the cat’s higher metabolic rate. Over time the heart muscle starts thickening and/or the heart chambers start dilating to increase their size in an attempt to cope with the increased workload.

Congestive heart failure sets in eventually when the heart cannot keep up anymore fluids starts building up in the lungs and/or the abdomen.

If the vet suspects heart disease, he or she may decide to investigate further with ECGs, ultrasonic heart scans and X-rays. Depending on the findings, the cat may have to go onto heart medication as well.

What is the prognosis for hyperthyroidism in my cat?

The prognosis will depend on the cat’s physical condition, age, and whether other diseases are present. When treated, the average survival rate is 2 years and the quality of life is acceptable.

© 2019 Vetwebsites – The Code Company Trading (Pty) Ltd

My dog’s nose seems to be all clogged up and hard and he is not well at all

Canine distemper

Following recent outbreaks of Distemper (Hondesiekte in Afrikaans) in Kwa Zulu Natal and Gauteng, it is important to have an understanding of this disease which is fatal in half of all cases of dogs that contract the disease.

What causes Distemper?

Distemper is a virus disease caused by the Canine Distemper Virus or CDV. This virus is a morbillivirus in the Paramyxoviridae family which is a virus group that affects humans, vertebrates and birds. This specific virus is not transmissible to humans but specifically targets dogs hence the name “Canine” Distemper Virus. The virus is closely related to measles virus in humans, and also to rinderpest virus in cattle, which at the beginning of the previous century almost killed the entire cattle population of Southern Africa. It’s a nasty virus.

What are the symptoms of Distemper?

The virus attacks mainly the respiratory system (from the nose right into the lungs), the gastro-intestinal system (from the mouth, through the stomach into the small and large intestines) and the central nervous system (mainly the brain). This means that the symptoms associated with the disease will be related to problems with these three main systems. In acute to subacute infections the dog will usually develop a fever within a day or two from being infected. The dog will go off its food and become weak and lethargic

Respiratory system symptoms may include a clogged up nose typically with mucous or slime that becomes hard, and hardening of the nose itself. This is a very telling symptom of Distemper but is by no means the only, or most typical, presentation of the disease. A dog with distemper may have a perfectly normal nose and still have the disease. Many times there will also be a discharge in the corners of the eyes. Other respiratory symptoms include coughing, sneezing and difficult breathing if the virus attacks the lungs.

If the gastrointestinal systems is affected you may see vomiting and/or diarrhoea.

If the central nervous system is involved you may have muscle tremors, a dog which seems disorientated and walks around as if they are drunk (ataxia), hind limbs which are dragged or seem lazy (paresis), a dog which cannot get up or falls down when they do get up (paralysis), and even seizures. Other symptoms which are not immediately visible and which only the vet may be able to pick up are lesions on the retina at the back of the eye, or an inflammation in the front of the eye called anterior uveitis. Hardening of the footpads  (hyperkeratosis) was previously quite common because of the strains of virus involved, but seem to be less common these days.

How is Distemper diagnosed?

There are several blood tests which can be done by the vet, but it is a difficult disease to diagnose because unlike a disease like biliary or tick fever in dogs where you can see the parasite in the blood with a bloodsmear, in Distemper, as with all other virus diseases, you cannot see the virus as it is simply too small. The trouble with the blood tests are that they are often not conclusive. The reason for this is that some of the tests, test if the dog is building up antibodies (“soldier”) against the virus. However a dog that may previously have been vaccinated may show antibodies and not have the disease. Sometimes the dog may die acutely before the body was able to produce neutralising antibodies, so in that case the test may be negative, yet the dog still had the disease.

Another type of blood test where the white and red blood cells are counted and where the white cells are less than usual, called lymphopenia,  may give an indication that the dog has a virus disease but it will not tell which virus the dog has.

If the dog has central nervous system symptoms, the fluid around the brain and spine called Cerebro Spinal Fluid (CSF) may contain antibodies but once again it may not be 100% diagnostic. There are other tests which can be run on the CSF (cell or protein content) which may be indicative, but does not conclusively confirm that the dog has Distemper.

There are a number of other diseases which can present with similar symptoms which the vet will have to rule out. On the respiratory side there is Kennel Cough or other upper respiratory tract infections. On the intestinal side there is Parvovirus and Coronavirus, parasitism like worms or Giardia, bacterial infections, toxin ingestion or inflammatory bowel disease. On the neurological side there is granulomatous meningoencephalitis, protozoal encephalitis (toxoplasmosis, neosporosis, babesia), cryptococcus or other infections (meningitis, Ehrlichiosis), pug dog encephalitis and lead or other poisoning.

Clearly Distemper is not a simple disease to diagnose and the vet will often have to rely on the age of the dog, its history, the results of the clinical tests and the appearance of the clinical symptoms, to make a diagnosis of Distemper.

How is Distemper transferred?

The virus is typically inhaled through the air from other sick dogs and also from physical contact with infected animals. The virus can survive for a period of time in the environment and if a dog which carries the virus sniffed around or spent time in a certain environment, it will leave tiny, tiny droplets (aerosol) which contain the virus in that area, which can then infect other dogs. A dog which is infected will inhale or ingest the virus and the virus will quickly spread through the mucous membranes to the local lymphnodes (these are like the remote “army bases” of the body which has to protect the body against invasions) where it will multiply and within one week the whole body will be infected.

How is Distemper treated?

Vets have over the years tried antiviral drugs of which there are very few anyway,  and none have been effective. As with almost all virus diseases one has to support the body in its own fight against the virus because it is only once the body has been successful to produce antibodies (the “soldier cells” which kill the “terrorist” or virus), that the dog will be able to overcome the disease. Often, when the body is attacked by viruses and the immune system is fighting hard to overcome the infection, bacteria will cause a secondary infection and make the whole situation worse. Therefore antibiotics are often administered even though it will do nothing against the virus, but at least it will help the body fight off opportunistic bacterial infections and help the body to overcome the disease. Other treatment depends largely on which systems are affected and to what extent. The vet will typically give symptomatic treatment, for example if the dog has seizures, the vet may administer a drug to help contain the seizures and make them less violent. Certain drugs should not be given and it is important to consult with the vet in case you think your dog may suffer from Distemper.

Can Distemper spread to humans or cats?

In the past it was suspected that the Canine Distemper Virus can cause Multiple Sclerosis in humans. However this has been proven NOT to be the case and as far as we know the disease cannot spread from dogs to humans. Similarly, as far as we know, this disease cannot be transferred to domestic cats.

What is the prognosis should my dog contract Distemper?

Unfortunately the prognosis is not good and the mortality rate is 50%. It will be very difficult for the vet to tell whether your dog will fall in the 50% that will survive or the 50% that will not make it. The vet will have to assess the extent and severity of the clinical symptoms and the progression of the disease and based on that, will advise you whether treatment has any chance of success or not. An important thing to remember is that even though the disease may not appear to be very far advanced when you first present your dog to the vet, and there seems to be early good response to treatment, like the clogging of the nose and the discharge in the eyes clearing up, the dog may still develop fatal central nervous system signs later on. It is important to understand that the vet has no control over which way the disease may go and will do his or her best with your animal’s best interest at heart, when recommending treatment or not.

Can Distemper be prevented?

A resounding yes! Vaccination has been hugely effective in almost eradicating this disease and all dogs should be vaccinated, preferably yearly at the same time as their annual health exam. Your vet will give you more specific advice related to the area you live in and the risk factors involved and should the vet think that annual vaccination is not necessary, the vet will advise you accordingly.

Puppies and old dogs are more commonly affected and all puppies should go through an initial vaccination program from 6 weeks onwards to provide protection. Puppies born from mothers who were vaccinated and had antibodies will get this protection from the initial milk or colostrum from the mother in the first few days after birth. The protection provided through the mother’s milk will start waning after six weeks and this is why vets normally start vaccinating at this time, and repeating the vaccination three or four times with booster vaccinations with monthly intervals and then yearly thereafter.

What do I do if I suspect my dog to have Distemper?

Get them to the vet as soon as you can. Home remedies or treatment is unlikely to give your dog a fighting chance. Proper supportive and secondary infection treatment remains the mainstay of treatment.

Most importantly, have your dog vaccinated. Prevention is always better than cure!

© 2019 The Code Company Vetwebsites

My older German Shepherd Dog seems to be getting weak in its hindquarters

This article outlines a genetic disorder that mainly German Shepherd dogs are prone to. There are other breeds affected by this condition too like Chesapeake Bay Retrievers, Corgis, Boxers, Wirehaired Fox Terriers and Rhodesian Ridgebacks, however, the disease is mostly seen in German Shepherds.

If one breaks down the name of the disease it describes what happens with the disease. Degeneration refers to a breaking down or deterioration of something. That “something” in this case is myelin which is the insulating sheath around neurons in the spinal cord. Neurons are the “electrical wires” of the nervous system and one can compare myelin to the insulating plastic around the wires, almost like one would find with an electrical cord. Whenever a term is followed by “pathy” it refers to a disease or disorder in a certain part of the body. In this case the spinal cord.

Degenerative Myelopathy is a debilitating condition for which there is no cure but only the potential to slow down the progress.

The occurs typically in older German Shepherd Dogs. The average age at which clinical signs start and progress is from 8 to 12 years of age. This is not a condition with rapid onset but instead is slowly progressive with clinical signs worsening with time. Degenerative myelopathy starts out as a very slowly progressive hind limb weakness and loss of function of the back legs called paresis. It is commonly confused with hip pain because the symptoms can mimic hip dysplasia, another debilitating condition with a high incidence in German Shepherds.

The condition is the result of a demyelination (loss of protective cover) and nerve degeneration of the spinal cord in the region of the mid to hind back. This degeneration is something referred to as an ascending lesion meaning that it starts at the tail end of the spinal cord and works its way towards the head. The underlying cause of the disease is thought to be a genetic mutation (change) of the SOD1 gene. This gene is responsible for the protection of cells against certain particles that damage the DNA of cells. The name given to the damaging particles are free radicles. Under normal circumstances the SOD1 gene produces a free radicle scavenger i.e. it helps to clean up the system and prevents damage to the sheath surrounding the nerves.

The way in which the defect is inherited determines whether a particular dog is at a high risk of getting the disease or if they are a carrier of the genetic mutation without showing clinical signs. An individual dog has to carry 2 copies of the mutation in the genes of the cells of their bodies for it to cause the disease. There is no sex predilection, so male or female dogs may be affected equally. What is interesting about the disease is that even if an individual dog has both copies of the mutated gene and they are at very high risk of developing the disease, there are still other factors that influence whether or not they do contract the disease and to what extent they do.  

As mentioned previously this a slowly progressive condition that has a time frame of about 3 years before severe debilitating disease sets in. The clinical signs noticed in dogs include the following:

After 6 to 12 months of contracting the disease, you will notice weakness and partial loss of function of the back legs. Your dog may seem weak and wobbly on the back legs and they may struggle to get up or be slower to get up that what they used to be. When they run, their back legs may sway abnormally.

After 9 to 18 months on contracting the disease, the back legs start to get even weaker and collapse under the dog from time to time. If one assesses the reflexes in the back legs like the patella reflex, you will find that they are abnormal and weakened.

After 12 to 24 months of contracting the disease, the front legs start to become affected and you may notice that your dog starts losing their normal co-ordination and function. By this point, the hind legs are very weak and your dog may struggle to stand and use their legs correctly. Unfortunately, the nerve degeneration also influences bladder and bowel control and they will start to urinate and defecate involuntarily. This is known as urine and faecal incontinence.

After 24 to 36 month of contracting the disease, and if the dog was able to come this far and still cope with the disease, they develop tetraplegia or quadriplegia which is a paralysis that causes partial or total loss of use of all their limbs and body. The loss is usually sensory and motor, which means that both sensation and control are lost, or put a different way, the dog does not know where its legs are and even if they did, they do not have the ability to correct it. Clearly a very unhappy situation.

The way in which this condition is diagnosed by the vet is through a number of tests as well as the typical clinical signs and also the breed of your dog. These, together with the thorough history of the condition, should provide the veterinarian with some very important clues to what is going on with your dog. The important diseases or differential diagnoses to rule out are spinal disc disease (like a slipped disc) and conditions affecting the lower part of the spine where the hips meet the spine, like hip dysplasia or joint disease. The biggest difference with degenerative myelopathy and the other conditions is that degenerative myelopathy is painless because it is the loss of sensation and function which underlies this disease. Special tests such as MRI’s may be done to visualise the damage within the spinal cord and there is also a DNA test available to check if your dog has the genetic mutation discussed earlier.

Unfortunately, there is no specific treatment available. Certain supplements can be used in an attempt to slow down the condition, such as vitamin E and aminocaproic acid. The vitamin E is an essential vitamin which helps various systems in the body to protect it from these damaging free radicles. The aminocaproic acid is an agent used to prevent the breakdown of clots in the bloodstream. The reasoning behind using this is that it is believed that the spinal cord may be indirectly attacked by the body’s own immune system. Antibodies in the bloodstream attach to the foreign material within the bloodstream forming complexes and these stimulate a response from the immune system. These complexes are usually removed by the liver and spleen. Sometimes they can stick to the walls of blood vessels, damage the walls and stimulate the formation of blood clots. The breakdown of these clots are associated with inflammation and this may result in damage to the surrounding tissues, so-called collateral damage. If this happens in the sensitive tissues of the spinal cord, the damage is devastating because the nervous tissue is not able to regenerate and repair itself. The thinking behind using aminocaproic acid is to inhibit clot breakdown in these delicate tissues.

Lastly and most importantly, the most effective treatment for this condition and the only one proven to actually slow down the progress is the use of physiotherapy and hydrotherapy. Another key factor is, the sooner the dog is diagnosed and treatment started, the better the progress of the disease can be slowed, and the more time the vet can give you with your dog. Unfortunately, the sad truth is that eventually, the disease will lead to complete paralysis and eventually, in most cases, euthanasia.

Genetic disorders like degenerative myelopathy can only be prevented by not breeding with animals where there is a family history of the disease. Make sure if you buy a puppy, that you get references on a breeder before you buy.

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