Can humans get worms from dogs and cats?

Have you ever wondered if humans can get worms from dogs and cats? You don’t have to wonder any longer, the answer is ‘yes’.  In this overview we look at which worms can be transmitted between pets and humans, what diseases they cause and how to prevent this potential health risk.

Firstly when a disease or parasite can be transmitted from animals to humans it is called a zoonosis. It is often a concern when a pet is diagnosed with intestinal worms whether the family is at risk of contracting the parasite. The concern is valid but the good news is that it is easily managed with education, proper precautions and a well organised deworming program for your pets.

There are two main categories of worms that can infect people, round worms and tapeworms. For both these worm types humans can act as either definitive (or final) hosts, intermediate hosts or paratenic hosts. The definitive host is the host when the worms are adults in the intestinal system and when they shed eggs. The intermediate host occurs when the eggs are ingested and form cysts in various organs and tissues of the body. A paratenic host is one that is not necessary for the life cycle of the worm but is similar to an intermediate host in that it is a temporary host where the worm does not develop further in its life cycle until such time it can find a suitable permanent host where it can complete its life cycle. Certain larva can also penetrate and migrate through the skin. All hosts are infected by larva which are the immature parasite that come from eggs.

Zoonotic round worms:

Ascarids: Toxocara

The way that the parasite enters the body is when a human ingests or eats the eggs of the worm. The source of these eggs can be from contaminated soil, playgrounds, geophagia (eating soil) or direct contact with dogs. Not washing hands properly after working or playing in soil and having soil stuck under the nails and then touching and eating food, can lead to humans getting the eggs in through their mouths. Proper personal hygiene therefore can prevent such infections.

Once the eggs have entered the body, the larvae hatch from it and the immature stages of these round worms cause damage by burrowing through the intestinal wall and into the internal organs of the body called visceral larva migrans. Further to this the larvae also targets the eyes of humans, which is called ocular larva migrans. Some of the burrowing larva land up in the bloodstream the blood stream and cause clumps of damaged cells called disseminated granulomas in various tissues and organs in the body including the eyes, lungs, liver, brain and heart. Most of these go clinically unnoticed but sometimes you can get loss of vision (ocular larva migrans), fever, nausea, abdominal pain, muscle pain and respiratory signs (coughing, shortness of breath, wheezing). If any of these signs occur, immediately seek the advice of a medical practitioner.

Hookworm: Ancylostoma

One of the most important and common worms in dogs and cats is hookworm. It is a frequent cause for ill thrift and diarrhoea in puppies and kittens. The infection usually occurs through the skin (percutaneous) from direct contact with contaminated ground (beaches, sand boxes, garden soil etc.).  The immature stages of this worm or larvae burrow into the skin but lack certain enzymes to break through the deeper layers of the skin resulting in an infection which is isolated to the surface of the skin. This is called cutaneous larva migrans. The larvae cause progressive skin lesions characterised by tingling initially which progresses to intense itching and redness of the skin with lines appearing in the skin. These lesions often occur in the feet, between the toes, hands, knees and on the buttocks. It is recommended to seek the advice of your medical practitioner as lack of treatment may result in the infection continuing for several weeks before your immune system is able to kill the larvae.

Hookworm infection can also happen when the larvae are ingested and localise in the intestinal tract of humans, causing inflammation of the intestines (enteritis).

Whipworms: Trichuris vulpis (rare)

Although rare, humans may become infected by whipworms originating from dogs. Humans act as definitive or final hosts in the case of this worm.

Tapeworms

Zoonotic tapeworm infections associated with dogs and cats include the flea tapeworm, Dipylidium caninum. Infection occurs when someone accidently eats or swallows a flea carrying the larva of this worm. This is more often a problem in young children. This infection can cause diarrhea and anal itching in infected humans.

Taenia species is another Typeworm. Humans act as paratenic or intermediate hosts for Taenia tapeworms. Infection by the larvae, following accidental ingestion causes wide spread cyst formation in the muscles, organs and tissues. These fluid filled cysts can range from a few millimeters in size to more than two centimeters in size. The symptoms of this kind of infection are due to the physical presence of the cyst and depend on the site of localisation. Cysts found in muscle and tissues that are not essential go unnoticed, but rarely these larva may migrate to the brain and eye causing severe symptoms. This infection is often difficult to diagnose and treat.

Echinococcus granulosus – Hydatid disease (important)

Infection with this Tapeworm is through direct contact with infected dogs (not washing hands after being in contact with the infected dog) or indirectly through contaminated water or unwashed fresh produce. Humans act as intermediate hosts. Once ingested the larvae penetrate the intestinal tract and migrate to mainly the liver and lungs forming multiple cysts (fluid filled sacks). The symptoms depend on where the cysts form. If it is in the liver you will find symptoms of liver disease which may be quite unspecific like an animal losing appetite, losing weight, and becoming sluggish. If it is in the lungs you may notice shortness of breath, or coughing. If a large cyst bursts it can cause an emergency and even lead to death.

Prevention of zoonotic worm infections

A regular and up to date deworming program is one of the best ways to prevent your pets and family from getting infected with worms. Puppies and kittens are extremely susceptible to worm infections. The mother should be dewormed prior to having a litter and all the babies should be dewormed at weaning before they are sent off to their new homes. With each puppy/kitten vaccinations they should be dewormed. From then on all animals should be dewormed every three to six months. This is dependent on their exposure to potentially contaminated areas as well as other animals. Should you walk your dogs frequently, allowing them to interact with other dogs in the park or running off the lead unattended, they should be dewormed every three months. The same applies to cats, the more cats they potentially come into contact with and the more roaming they are allowed to do, the more frequently they should be dewormed. Apart from tablets given by mouth there are also spot-ons available for deworming cats. This makes the process of deworming a cat a bit easier. If between these periods you are concerned about your pet being infected with worms, you can ask the veterinarian to check for worms by performing a stool exam called a faecal flotation and prescribing a suitable treatment.

Controlling fleas on your animals, as well as in their environment, is an important preventative measure for worm infections. There are a variety of top spot, shampoo and tablet flea treatments and with so many options one can find the one that will most suit your lifestyle and environment. The majority of the tablet and shampoo flea treatments do not have a long lasting or residual effect and only kill fleas which are on your pet at the time. It does not have any impact on the fleas in the environment or the thousands of flea eggs which are waiting to hatch. The top spots tend to last for up to four weeks.

The courteous and correct thing to do is to clean up after your pets when taking your dogs for a walk or to the park. Stools should be picked up and disposed of correctly.

All sand boxes and pits should be covered and regularly cleaned. Do not allow children to play in areas contaminated by animal waste.

It is essential that your children are taught to wash their hands after playing outside or handling animals. This promotes good hygiene and prevents the transmission of disease, including worms.

Do not feed your pets raw meat or organs as these may be a source of Tapeworms.

It is always a good idea to deworm yourself and your family on a yearly basis especially when you have young children. Should you be concerned about any risk or illness you think may be associated with worms, you should contact your medical professional for information and treatment.

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What causes back pain in dogs?

Introduction

Intervertebral disc disease is a term that describes the condition in which the softer cartilage like material in between the bones of the spine, called an intervertebral disc, pushes onto the spinal cord, causing clinical signs that varies from slight back pain and discomfort to complete paralysis of limbs. Even with the slightest clinical signs, your pet should be examined by the vet to establish how serious the condition is and be treated accordingly. The earlier this is attended to, the better the overall outcome. 

A bit of anatomy

The spinal cord is surrounded by a bony structure made up of vertebral bodies. They protect the extremely sensitive spinal cord from injury. They run from the head down to the tail tip and can be divided into cervical (neck), thoracic (chest), lumbar (mid-body) and sacral (tail) vertebra. The different vertebra all have different structures, but fulfil the same role. Between every vertebral body is an intervertebral disc that provides flexibility of the back as well as absorb shock when moving and jumping around. The intervertebral disc is composed of a soft gel centre that gives it its flexibility, and a harder fibrous outer layer, surrounding the gel centre. When the fibrous layer starts to degenerate, the gel centre follows the path of least resistance and starts to push upwards onto the spinal cord that runs directly above it. 

How does it happen?

This is a disease mainly seen in dogs, and cats are very seldom affected. Factors that increase the risk are breed or genetic predisposition, excessive weight and weak muscle development. Breeds with short legs and long backs like the Dachshund, Pekingese, Shih Tzu and Corgis are often affected. These breeds are also referred to as chondrodystrophic breeds. This term describes the condition in which the cartilage develops abnormally and tends to degenerate at an earlier age compared to other breeds. It is important to note though that disc disease is not exclusive to these breeds and can occur in many other dog breeds as well. There are two types of ‘slipped discs’, called Hansen type I, and Hansen type II. Hansen type I is the more serious one where the disc tears or ruptures and where the disc material almost “explodes” (also referred to as prolapse or herniate) up into the spinal cord, causing severe damage and subsequent paralysis. This typically happens in middle aged to older breeds mentioned above. This prolapse can happen at any point in time, and it may or may not be related to an event like a fall or a jump. As an owner of such a dog you may think that the dog was perfectly normal up to the point of the incident, but in most cases there would have already been damage or degeneration which may have started a long time ago. With Hansen type II, the onset is much slower, and the disc material only pushes up or protrudes and press onto the spinal cord -partially. This causes a variety of clinical signs ranging from low grade pain to instability in the hind quarters called ataxia or muscular weakness also known as paresis. Disc disease in non chondrodystrophic dog breeds is often a result of a specific event where the dog injures themselves by falling or jumping. A normal healthy disc only tears with severe abnormal force applied to it and is very uncommon. In most cases in other breeds where there is disc disease it is as a result of aging and or degeneration of the cartilage which make up the disc material. 

Clinical signs

The spinal cord consists of nerve tissue that conveys impulses to and from the body to the brain. It is extremely sensitive tissue that does not regenerate well after it has been damaged. When damaged, it heals by scar tissue formation and depending on the level of damage rarely regains its function. The damage done to the spinal cord when a disc pushes onto it are both due to mechanical compression, as well as secondary inflammatory changes to the nerve tissue. When the disc material presses onto the spinal cord, the pressure on the spinal nerves causes pain and it disrupts nerve impulses traveling to and from the body. The clinical signs will differ depending on where the compression happens. The disc material can prolapse anywhere from the neck down to the lumbar area. Due to the relative rigidity of the spine in the chest area and the extra support and protection provided by the ribs, disc prolapse will rarely happen in the chest area and is more likely to happen in the neck and at the lower body area. One area which is particularly vulnerable is the area behind the last rib where the chest and mid body or lumbar spine meets.  If a disc herniates in the neck, before the front limb nerves, both the front and the back limbs will be affected. If the protrusion happens in the area between the front and back limbs, only back limbs will be affected and front limbs will be normal. 

Signs usually seen are pain, weakness and instability of the back legs with the body swaying from side to side when the animal walks. In severe cases the animal may lose the ability to walk altogether and become paralysed. Dogs in pain will often yelp when picked up or moved and they may walk with an arched back and tucked in abdomen. If the neck is involved, the animal will walk with a stiff lowered neck, unwilling to move it from side to side or up and down. Ataxia can be seen as uncoordinated movements of the limbs. The back limbs will frequently cross over and affected dogs will not know where they are placing their limbs in space. In severe cases affected animals cannot use their back legs at all and might drag them along completely. 

Diagnosis

A provisional diagnosis can be made by looking at the breed and age of the dog, the presenting clinical signs, and by doing a thorough clinical exam, which will include a neurological exam. The clinical signs will provide some clues to the vet of the type of disc disease. To make a definite diagnosis, further diagnostic imaging will be required, with an X-ray being the first step. Unfortunately an X-ray cannot show up the actual degree of protrusion of the disc due to the fact X-rays do not show soft tissue as well as bone. It does however show a narrowing in the disc space between vertebrae compared to normal healthy discs. X-rays are a necessary and useful step in the diagnostic process as it rules out other potential cause of back problems like spinal cord tumors and fractures. 

After an X-ray is done, a myelogram should follow. With this procedure a dye is injected into the space surrounding the spinal cord. If there is a compression of the spinal cord, it will show up clearly on the X-rays taken afterwards. An MRI or a CT scan can be done in place of a myelogram, but these procedures are often more expensive. The reason for doing a myelogram or an MRI is not just to make a definite diagnoses of a disc herniation, but also to localise the area where the disc is herniating and assess the degree. If surgery is a possibility, the exact location of the herniated disc is of utmost importance. 

Treatment

It is important to get your pet to the vet as soon as possible if you suspect it to have a disc problem or if you see any of the symptoms described above. Keep it as quiet as possible in the meantime. There are two ways to deal with a dog presenting with disc disease, and the decision will depend on the presenting clinical signs. It can either be treated medically or surgically. In both instances the aim is to get the pressure off the spinal cord to prevent damage. It is important to realise that medical management is only reserved for patients showing very mild signs for the first time and this will be decided after a full clinical exam neurological evaluation and diagnostic procedures have been done. Medical treatment comprises of strict cage rest and anti-inflammatory medication to reduce swelling of the spinal cord. 

Probably more than 50% of cases presenting with disc disease require surgical treatment. A dog presenting with complete paralysis and with decreased sensation in the hind limbs needs to be treated as an emergency. There are different surgical techniques used, all of them taking pressure off the spinal cord to prevent further damage. Recovery can sometimes take long and adequate nursing care and physiotherapy is needed. The earlier the compression is fixed, the easier recovery will be after surgery. 

Prognosis and prevention

Prognosis after surgery depends on how severe the spinal cord has been damaged, and for how long. With rapid intervention and proper after care, prognosis is good. Unfortunately surgery cannot prevent another disc from herniating at a different location and 33% of dogs can have another slipped disc after surgery. Prevention includes regular exercise and a good diet, keeping dogs fit and slim. In dogs that are prone to disc disease, jumping on and off furniture must be restricted to a minimum. 

The importance of getting your dog to the vet if you suspect that it may have disc disease cannot be overemphasised. Sometimes even waiting and hour or two may mean the difference between life and death for your pet. If damage to the spinal cord has progressed to the point where your animal cannot feel deep pain when their toes are pinched, it is usually too late, even for surgery. 

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My young cat seems ill

Feline infectious peritonitis (FIP) is a serious and most often fatal disease affecting cats. It is most commonly seen in young cats between the ages of six months and two years. It has been found to affect male cats more commonly than females and purebred cats particularly the Asian breeds are more susceptible. It is characterised by fluid build-up in body cavities such as the chest and abdomen and neurological signs. It can affect all major organs and inevitably results in death. It may be referred to as Feline coronavirus polyserositis (wet or effusive form) or granulomatous feline infectious peritonitis (dry or non effusive form).

How is FIP transmitted?

FIP is caused by the Feline Corona Virus (FCoV). The Feline Corona Virus is commonly found in the environment and many cats may be carriers or infected with the Feline Corona Virus although only a small percentage may develop FIP. The Feline Corona Virus is more commonly found in multi cat households and catteries than in homes with less than five cats.

The Feline Corona Virus occurs in the cat’s intestinal cells. In some cases, it spontaneously mutates from a benign, and minimally pathogenic (meaning that it is hardly harmful) virus to a lethal killer. No two cats are infected with exactly the same virus as there are many different mutations and the mutation depends on the cat’s immune response. Feline Corona Virus is mainly passed on by contact with an infected cat’s stool. It may also be passed on from a queen to her kittens during pregnancy. Humans can also play a role in transmission as the virus can be carried on clothes, shoes and food bowls for a short period of time.

Stress in cats may increase the risk of contracting Feline Corona Virus.  Vaccinations, elective surgery, a new home and inadequate nutrition may all play a role. The Feline enteric Corona Virus causes self-limiting diarrhoea in cats. This means the disease usually clears by itself, without requiring treatment. FIP is the virulent mutation and is fatal.

What are the symptoms of FIP?

Feline Corona Virus has a spectrum of symptoms. It ranges from cats becoming non-carriers and completely clearing the virus to cats developing life-threatening FIP. There are two main forms of FIP that have been described. The first is the wet or effusive form, which is characterised by the build up of fluid in different body cavities. The second is a dry or non-effusive form, where cats develop granulomas or masses in organs such as the kidneys, lymph nodes, brain and eyes.

Many cats present with non-specific signs such as lethargy or weakness, poor appetite and weight loss as well as a cyclical fever (where the animal’s temperature goes up and down). There may be a history of stunted growth or the cat repeatedly being on antibiotics. Cats with the wet form of FIP may have difficulty breathing or have a swollen tummy due to the accumulation of a thick yellow fluid in the chest or abdomen. Cats with the dry form of FIP develop signs associated with the occurrence of masses in particular organs. These signs may include cloudy eyes, seisures and other neurological signs such as changes in behaviour. Watery stools are seen only occasionally and some cats may become jaundiced with a yellow discolouration of the gums, the eyes and the skin which can be seen most clearly on the inside of the ears.

How is FIP diagnosed?

FIP is a disease where the confirmation of the diagnosis is difficult and many times the disease can only be confirmed 100% if the animal has died. One of the reasons is because the initial stages of the disease looks very similar to and needs to be differentiated from the more common and usually harmless Feline Corona Virus. The diagnosis is based on a combination of non-specific and specific clinical signs as well as a compatible history, age and breed of the cat, indications of possible exposure different diagnostic tests. Seeing as there is no definitive test as for some other viral diseases, it can be quite a challenge to rule out other possibly diseases. In the wet form of the disease, the fluid can be tested which makes the diagnostic process easier.

Sometimes the only way to make a definitive diagnosis on a living animal is to surgically sample organs such as the intestines under general anaesthetic.  Blood tests, X-rays, an eye and neurological exam will help narrow down the diagnosis but unfortunately cannot confirm the diagnosis one hundred percent.

What is the prognosis once a diagnosis is made?

Sadly, FIP is a disease which cannot be cured and more often than not results in death. If a cat has been diagnosed with the wet form, one can expect a two-month survival. The dry form may have a more chronic course, but in most cases is still fatal.

Is FIP treatable?

FIP cannot be cured. Once a cat has been diagnosed, it is managed symptomatically and supportively. Euthanasia may often be the kindest option. With the wet form, the fluid may need to be drained from the chest or abdomen. The cat may need oxygen. They are often dehydrated so will need intravenous fluids. Immunosuppressive drugs such as corticosteroids and antiviral drugs may be prescribed, but the success of treatment is usually poor.  The cat may often require long courses of antibiotics to prevent the occurrence of secondary infections.

Environmental management plays an important role in supportive therapy.  This includes reducing stress and ensuring that the cat has a safe place to sleep and hide. Nutritional support is also important and includes things such as feeding soft food, warming the food and possibly hand feeding the cat.  

Once the disease becomes debilitating and weight and appetite decline, one should be prepared for the inevitable and strongly consider euthanasia as dying from FIP does appear to be painful.

Is FIP preventable?

In order to prevent FIP, one needs to try and prevent infection with Feline Corona Virus, which is nearly impossible. The good news is that not all strains of corona virus cause FIP, but reducing the transmission is still important.

There is a vaccine available but it has not been found to be very effective.  This is due to there being so many variations in the mutation of Feline Corona Virus and unfortunately these mutations are very difficult to predict.

Keeping cat numbers down in a household remains an important control method. It has been found that households with fewer than five cats are less exposed to contracting Feline Corona Virus and they tend to clear the infection quicker without being re-infected. In shelters and breeding catteries this becomes more difficult. An early weaning practice has been suggested in breeding colonies, where the queen is separated from the rest of the group one to two weeks before she gives birth. The kittens are weaned early at five to six weeks and kept isolated from the rest of the colony. In shelters, transmission is lowered where cats are kept separately but again this is not always possible as space is often limited and the virus is carried on clothes, feed bowls and cleaning equipment. The levels of Feline Corona virus may be decreased by general cleanliness, fewer cats and cleaning the litter boxes frequently. 

If a cat has been diagnosed and died, one should try and wait three months before getting a new cat as the virus can survive in the environment for a short period of time. In multi cat households, this is difficult, as most cats would have been exposed to the sick animal before it was diagnosed. FIP remains a challenging disease to manage as it is difficult to diagnose, there is no cure and it is easily transmitted between cats in the form of the non-mutated Feline Corona Virus. Keeping cat numbers down remains an important method of control as well as allowing an adequate waiting period before introducing a new cat into a household.

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My pet has red urine – what does it mean?

Bladder stones is a condition that occurs in dogs and cats of various ages, sex and breeds. Bladder stones are also called urinary calculi or uroliths. These are mineral like formations that form anywhere in the urinary tract, including kidneys, ureters, bladder and urethra. The most frequent location is the bladder. 

Clinical signs of bladder stones to look out for

Dogs with bladder stones often present like dogs with a bladder infection. Both of these conditions will show frequent urination as well as discomfort, particularly when urinating. The animal will squat to urinate frequently, often only passing small amounts of urine while straining. The owner might also see a red discoloration in the urine and in some cases the urine can be a dark red colour. Because the stones rub against the bladder wall it causes irritation and inflammation of the bladder wall that leads to bleeding. Some dogs will show discomfort and pain when walking, with the hindquarters tucked in, while cats can become very vocal when in pain. In some cases the stones may still be very small and can leave the bladder and enter the urethra. The urethra is the tube that directs urine from the bladder to the outside. If the stone is not small enough to pass, it will become lodged in the urethra, blocking urine flow completely. The pressure will build up in the bladder and the kidneys, and if this is not corrected quickly, the bladder can rupture. This will cause severe illness and if quick intervention is not done it may lead to death. 

Diagnosing bladder stones

Depending on the size and amount of stones present, the vet may be able to diagnose bladder stones on palpation of the bladder through the abdominal wall. Palpation is the process of using one’s hand to examine the body. It may feel like a bag of marbles or a bag of fine sand. A full analysis of the urine (urinalysis) must be done to make an accurate diagnosis. With this you can measure the urine pH and other parameters that provide useful information regarding the condition. Bladder infections play a big role in stone formation and a urinalysis will pick this up effectively. Diagnostic imaging like x-rays and or ultrasound needs to be considered as the next step as part of a comprehensive non-invasive workup to complete the diagnosis. X-rays can pick up radio opaque stones in the bladder, meaning the stones can be seen as white round bodies in the bladder. One has to include the whole urinary tract in these images to ensure there are no stones in the kidneys, ureters and further down in the urethra. In cases where stones have not mineralised yet or contain a lot of mucoid material, it may not show up on X-rays. A special dye or even air can be injected into the bladder to make them more visible. An abdominal ultrasound can also be very useful to pick up these stones.

Treatment of bladder stones 

To understand the treatment, we need to have a look at how these stones are formed in the first instance. Stones are formed by minerals in the urine. If the mineral concentration is high and the urine becomes super saturated, the salt will start precipitating out. The urine is normally slightly acidic, and at this pH it keeps the minerals in solution. When the pH rises the salts precipitate out easier. With bladder infections there are bacteria in the bladder that increase the pH and this will increase the likelihood of stone formation. If the bladder is infected there may be a lot debris and mucoid material floating in the urine. This debris can concentrate and form a nidus that enhances stone formation. The different types of stones most commonly encountered are struvite stones, calcium oxalate, urate, cysteine and calcium phosphate. Each type of stone will form under different conditions and different pH in the urine. Struvite stones are the most common and are also referred to as “infectioun stones”. These stones form when the pH increases, which happen with infection. It is important to send urine away for culture and antibiogram testing to make sure the infection is treated with the correct antibiotics.

The treatment for bladder stones may require surgical removal of the stones from the bladder by performing an incision into the bladder called a cystotomy. An incision is made into the bladder wall and the stones are removed by hand or with a blunt object. A catheter is passed into the urethra to make sure there are no stones blocking the urethra further down. The bladder is then flushed with saline solution and the incision closed with an inverting suture pattern. Stones must always be sent away for analysis as this will provide information on how to prevent stone formation in the future. Some stones in the early stages of formation can be dissolved medically by changing the urine pH. This may take some time and will definitely not work with all types of stones. Stones lodged in the urethra must be flushed out, or back into the bladder and be removed from the bladder.  

After the initial medical treatment of bladder or surgical removal of bladder stones, your pet may need a change of diet to prevent stones from forming again. There are specific diets on the market for specific types of stones and depending on which stones your pet had, the vet will place him or her on the correct specialised diet. Stones can easily form again after surgery if the diet and medical treatment is not done correctly and therefore regular checkups with the vet will be required after the initial diagnosis and treatment.

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Kidney Failure

The kidneys are very important organs of the animal body and play an important role in the normal day to day functioning of the Dog with kidney failure on drip receiving fluid therapybody. They act like a specialised type of filter by retaining the appropriate amount of different salts (electrolytes) to maintain fluid balance in the body. They secrete a hormone which is involved in the production of red blood cells. The kidneys are also responsible for getting rid of waste products through the urine, especially those that are produced by the breakdown of protein in food. Kidney failure starts as soon as the kidneys are damaged due to disease, damage or old age, however in animals most owners only start seeing the clinical symptoms of kidney failure once more than 70 to 75 % of the kidneys have been destroyed or damaged. This means that of two kidneys, as little as only half of one is functioning normally before the signs of kidney failure become evident.  At this stage the kidneys can no longer adapt to maintain a normal fluid and electrolyte balance in the body, and are no longer able to expel toxins as efficiently as before. The challenge with treating kidney disease is that the kidneys do not have the capacity to regenerate like other organs like the liver. This means that it is very important to look out for the symptoms of kidney failure so treatment can commence as soon as possible to preserve as much of the kidneys as possible.

Once the kidneys (the body’s filter) have become damaged, different electrolytes and nutrients are either wasted through loss in the urine, or kept in the body at levels that are too high. This leads to a variety of symptoms.

The most common sign of kidney failure is an animal which starts drinking more water than usual and urinating more often. Other signs of kidney problems in animals include weight loss and dehydration, vomiting, decreased appetite and lethargy or depression. Animals with kidney problems often have bad breath and can have ulcers in the mouth or the stomach. They may drink more or less water than usual, and urinate frequently, sometimes with discomfort. They often urinate in unusual places, and the urine may appear bloody or cloudy or have a strong smell. Animals can also develop a low red blood cell count (become anaemic) if the kidneys are no longer producing sufficient amounts of the hormone necessary for red blood cell production. Not all animals display all symptoms, but as the condition progresses the overall health of the animal will deteriorate. For this reason, monitoring your pet’s behaviour closely and visiting your vet timeously, is helpful in making an early diagnosis.

Kidney failure can be divided into two categories – acute and chronic. The acute form occurs suddenly and the affected animal deteriorates quickly. The sudden failure of kidneys can be due to consumption of toxins. These can include things like ethylene glycol (antifreeze), certain medications, raisins or grapes, lilies and raw onions amongst others. It can also occur due to shock like major trauma and compromised blood supply to the kidney; or because of a blockage or rupture in the urinary system. Acute kidney failure is seen more frequently in young animals than the chronic form.

Chronic kidney failure has a slower and more subtle progression. It is a common condition seen in older cats. Chronic kidney failure occurs due to cumulative damage to the kidneys which can include toxin exposure, infections or long-term inflammation. There is also a genetic component to the condition, with Persians and Abyssinians being very prone to kidney failure. Chronic kidney failure is irreversible, and treatment is aimed at slowing the progression of the disease and improving quality of life.

Diagnosis of kidney disease is mainly done with the help of blood tests and analysis of the urine. The blood tests screen for the accumulation of toxins in the blood. The urine tests check the concentrating ability of the kidneys as well as abnormalities in the composition of the urine; and for abnormal cells or bacteria. It is sometimes necessary to perform further tests, such as ultrasound imaging of the kidney, or taking a biopsy, to check for cancer or other abnormalities.

Animals with kidney failure need to be hospitalised for fluid therapy. This re-hydrates the animals and helps to flush out toxins that have accumulated in the blood. They also need to be fed a veterinary prescription diet. These diets contain optimal levels of protein to take pressure off the kidneys, without being so low that muscles are broken down to compensate. The diets are also low in salt, which is important because the filter action is compromised. As important as the veterinary diets are, if the animal is very reluctant to eat it is preferable to tempt it with any treat rather than trying to enforce the special diet and make the animal starve in the process. It is of paramount importance that the affected animal has access to fresh water at all times. Dehydration can dramatically worsen the condition.

Many animals with kidney failure require medication to lower blood pressure. Some animals need medication to help with nausea, and others drugs to help reduce ulceration of the gut, or to restore pH balance, or to correct low red blood cell count. There is no fixed recipe for success and your veterinarian will supply the correct medication according to the needs of the individual animal. Animals with kidney failure must return to the vet for check-ups on a regular basis. It may be necessary for intravenous fluid therapy to be repeated, or it can be carried out at home if owners are prepared to administer fluids under the skin.

As mentioned before, there is no cure for kidney failure so treatment is aimed at slowing down its progression and improving quality of life for the animal. Prognosis is worse for dogs than for cats, because in general they do not respond as well to treatment as their feline counterparts. Some cats respond very well to therapy and can be maintained on treatment for years, while others deteriorate within weeks. The earlier the condition is diagnosed, the better the prognosis, so it is important to monitor your pet for signs of ill health and make a trip to the veterinarian if you are suspicious  of kidney problems.

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Old man’s gland – Do dogs have the same problems as humans?

Prostate disease in dogsThe prostate is the only accessory sex gland in the male dog. It is a butterfly shaped structure that surrounds the urethra (the tube that connects the bladder to the outside). Due to the location of the prostate, it can affect the urinary system, the colon and the hind legs, as well as having some systemic effects. Prostatic fluid is produced continuously in the dog. Prostatic fluid makes up most of the volume of seminal fluid (the fluid that carries semen). The prostate has many nerves and blood vessels running to it but is surrounded by a thick capsule, which sometimes makes it difficult for some drugs to get deep down into the prostate. Normal prostatic function is dependent on circulating testosterone. The prostate can develop a few conditions that can result in debilitating disease in the dog.

Signs of prostatic disease

Most dogs with prostatic disease are middle aged to older intact males, as testosterone plays an important role in the function and size of the prostate. Neutered dogs are at a reduced risk but some prostatic diseases can still develop. The clinical signs that you may see at home can be divided into four different categories.

  • Urinary tract – signs may include blood in the urine, pus in the urine, difficult urination or constantly leaking urine.
  • Systemic illness – the dog may have fever episodes, weight loss, weakness and lack of appetite, drinking lots of water or vomiting.
  • Colon – the dog may appear constipated or have diarrhoea, straining or struggling to pass stool.
  • Difficult movement especially with the hindquarters – the dog may display hind limb stiffness, lameness or generalised weakness.

If any of these signs are noted in a dog, it is important to bring him to the vet where a proper clinical examination and work up can be done to diagnose the problem. A rectal exam is usually helpful in diagnosing an enlarged prostate but it is sometimes very difficult to feel, particularly in large breed dogs. X-rays will also form part of the work up as an enlarged prostate can usually be seen on X-rays. The vet may then suggest an ultrasound from the tummy’s side where the prostate can be seen and its size and shape assessed. Some animals may require further testing such as biopsies (a surgical procedure where a small part of the prostate tissue is removed and sent off to a specialist pathologist vet for microscopic examination) or even surgery to differentiate between different conditions.

Prostatitis

Prostatitis refers to inflammation, usually due to infection, of the prostate. It can affect any age or breed of dog. It can occur with or without enlargement of the prostate. Acute prostatitis is often associated with systemic illness and is more commonly seen in younger males. They may present with a very painful abdomen as well as fever and loss of appetite (anorexia). These animals may need hospitalisation and intensive treatment such as being placed on a drip, catheterisation where a special tube is inserted from outside through the penis into the bladder, and intravenous antibiotics. Chronic prostatitis has a more prolonged clinical course and is often not associated with systemic illness.  Both forms of the disease require a long course of antibiotic treatment, often four to six weeks and it is important that the choice of antibiotic is based on a culture of the urine or prostatic fluid. A culture is where a small sample of fluid is collected with a technique which is done as sterile as possible and sent off to a laboratory for tests to see exactly which bacteria or other micro-organisms may be causing the trouble. Castration, where the testicles are removed, should always be considered as it reduces testosterone which contributes to the condition and complications seen.

Prostatomegaly due to benign prostatic hyperplasia

Prostatomegaly refers to enlargement of the prostate and can be due to a number of conditions. Cysts in the prostate, cancer and infection can all lead to an enlarged prostate. Benign prostatic hyperplasia refers to an enlarged prostate without infection or cancer. Benign prostatic hyperplasia is often seen in older, intact males dogs. Castration is the treatment of choice as the benign prostatic hyperplasia is often testosterone dependent. The prostate starts to decrease in size in a few weeks following castration and the size is often back to normal in a few months.

Prostatic and paraprostatic cysts

Prostatic (within the prostatic) and paraprostatic (next to the prostate) cysts are common causes of prostate enlargement. Medical treatment is generally ineffective. Castration is recommended but surgery is usually required to reduce the cysts. It is a very specialised procedure.

Prostatic cancer

Unfortunately castration does not protect against dogs developing prostatic cancer. The signs displayed will be similar to most other prostatic diseases. A definitive diagnosis can only be made on biopsy of the prostate. There is a high rate of spread in prostate cancer and the hind legs and lungs are often affected. Surgery can be done but is difficult and has many complications. Often, supportive care is provided but unfortunately the prognosis is very poor.

In humans smart robotic surgery like the Da Vinci Surgical System have been used for removing the prostate in recent times. This surgery is less invasive than the conventional method of having to go through the abdomen. Unfortunately the cost of the equipment is prohibitive for the veterinary environment under normal circumstances. Fortunately full surgical removal of the prostate is a rare occurrence in veterinary medicine and the vet will be able to advise you which course of action would be the best, should you ever have to face this scenario.

There are many different causes of prostatic disease in dogs. It is important to be able to recognise signs of disease in your dog and further investigation is usually required. Castration remains an important control measure in prostatic enlargement but unfortunately does not completely take away the risk for the development of prostatic cancer.

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When is it more than just a tummy ache?

The pancreas is a small gland that is situated next to the stomach and first part of the small intestine in the front of the abdomen. As in humans, it performs two main functions in dogs and cats.

  1. It is responsible for producing some of the special chemicals called enzymes which aid in the digestion of food. Enzymes are usually inactive within the pancreas. They are activated when they are released into the small intestine through ducts. Enzymes break down the food into smaller particles which can then be absorbed through the intestinal wall into the blood stream.
  2. The other main function of the pancreas is to help regulate blood sugar. The pancreas produces special messengers called hormones. Insulin is one such hormone. These hormones tell the body when to release or store glucose into the cells.

Sometimes the digestive enzymes are released within the pancreas, instead of within the small intestine. When this happens, it causes severe inflammation and death of some of the pancreatic cells. This can affect surrounding abdominal organs, such as the liver. When inflammation occurs it is usually very painful and is described as pancreatitis. Pancreatitis can be acute, where the inflammation is not associated with permanent damage or it can be chronic. A chronic pancreatitis results in the pancreas becoming smaller and harder than normal and this affects the function of this important organ. Pancreatitis can become very severe very quickly and cause your pet to suffer with intense pain so it is important for your pet to receive veterinary attention as soon as you suspect there may be something wrong.

What causes pancreatitis?

One of the well-known causes for pancreatitis is when an animal eats a fatty meal. The condition normally starts fairly shortly after the animal has eaten such a high fat meal and requires urgent attention. Overweight patients have also been shown to be more at risk than those with a lean body weight. Conditions, such as shock or kidney failure that compromise the blood supply may also predispose the patient to developing pancreatitis. Certain drugs and some diseases such as tick fever or Babesia (Biliary) in dogs have been associated with causing pancreatitis. In many cases, the underlying cause cannot be found and this is described as idiopathic. Some small breeds, such as the miniature schnauzer have been found to be more prone to developing pancreatitis than other breeds.

What does pancreatitis look like?

Pancreatitis can affect any age or breed of dog or cat.

In dogs, the typical clinical signs of acute pancreatitis include:

  • Stomach cramps or abdominal pain. The pain may be so severe thatthe animal may adopt the prayer position where the head is placed on stretched front legs, the front part of the chest is on the floor and the back legs are raised
  • Vomiting
  • Loss of appetite
  • Weakness
  • Depression or listlessness
  • Diarrhoea

Dogs may not show any obvious pain until the abdomen is felt and examined. In these cases they will pull the stomach muscles together when you touch the underside of their belly or flanks and they may even groan or try and bite when you press too hard.

In cats, the most common signs include:

  • Loss of appetite
  • Dullness and being slow to move or act (Lethargy)
  • Possible vomiting and diarrhoea

Cats may also show signs of dehydration, decreased body temperature, jaundice, fever and abdominal pain in severe cases. Cats are generally more subtle at showing disease compared to dogs so clinical signs in early stages may not always be seen.

Acute pancreatitis can be very severe, causing collapse due to a drop in blood pressure. This drop in blood pressure may cause extensive damage to vital organs such as the liver, kidneys, heart and blood vessels.

How is Pancreatitis diagnosed?

Pancreatitis is not always a simple diagnosis as it may look like several other diseases and conditions affecting the abdomen. The diagnosis is usually made based on taking several things into consideration like the history, clinical signs and diagnostic tests. The history may include being fed a fatty meal or the animal being very overweight. Clinical signs would include some or all of the signs described above. The most helpful tests aiding the diagnosis, which the veterinarian may have to do include:

  • X-rays of the stomach area
  • Ultrasound of the stomach area
  • Blood tests. Apart from some general blood tests which may point to Pancreatitis there are a number of bloodtests which specifically test the pancreatic enzymes. These tests are very useful.

Some of the tests are readily available but for others the vet may need to send blood to an external lab which may delay the diagnosis. In most cases if the vet suspects pancreatitis, even before the diagnosis has been confirmed, the vet will most likely start treatment on the suspicion of pancreatitis given the clinical signs and history. The reason for this is that acute pancreatitis can deteriorate dramatically over a number of hours leading to death. Therefor no time should be wasted in starting treatment. In some cases the veterinarian may be required to do an operation and do exploratory surgery of the abdomen and take samples of the pancreas in order to confirm the diagnosis.

How is pancreatitis treated?

In cases where the cause for pancreatitis can be established, that will be removed or treated with supportive treatment provided for the organ itself. Because the cause of the pancreatitis sometime remains unknown the treatment protocol then focuses on providing supportive care. In most cases the veterinarian will advise putting the patient on a drip to provide intravenous fluid therapy. The patient will need anti-nausea medication to stop the vomiting. Often if the patient is vomiting, they will not want to eat any food for the first day or two. If the patient does want to eat, a low fat diet is recommended. In very severe cases and where available, patients may need feeding by a tube or intravenously. Pain control is very important as these patients are generally very sore. Opioids, which are drugs like morphine, provide very good pain relief. Antibiotics are not always required but if the patient is showing evidence of infection, it will be administered.

Some patients may recover quickly from pancreatitis but in most cases recovery takes five to seven days. Some severely affected patients may take several weeks to recover and some unfortunately may not survive. In some cases, the veterinarian may advise referring the patient to a specialist facility that can provide 24 hour care for critical patients because this condition can easily deteriorate to such a point.

What happens when your pet goes home?

Your pet will be released from hospital when the veterinarian is happy the vomiting has stopped and the animal appears more comfortable. Generally they will appear brighter and less depressed. Home treatment will depend on how sick your pet was, but it may include some form of pain medication and antibiotic treatment.

Dietary changes play an important role and a low fat diet is essential. There are a few commercial diets available which the veterinarian may prescribe. Feeding small meals frequently is often recommended and the low fat diet will reduce the work load on the pancreas, hopefully reducing the risk of the condition developing again. The diet will also help in weight loss with those pets that would benefit from it.

Some animals with severe pancreatitis may lose some function of the pancreas and this may need to be treated accordingly. Unfortunately, some patients may develop recurrent pancreatitis, even with appropriate diet changes and weight loss at home.

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Ear Infections in Your Pet

Ear infections are common in dogs, and to a lesser degree in cats. The anatomy of the animal predisposes them to this condition. The ear canal of the dog and cat follows the shape of an “L”, going first downwards and then horisontally. This shape makes it difficult for debris and water that go into the ear to come out, against the force of gravity.

Causes and diagnosis of ear infection

When the ear canal is wet and dirty, bacteria and yeast called Malassezia flourish. Other factors that can play a role less commonly are ear mites or even ticks which creep into the ear canal, any type of growth or foreign body, allergies, or a thyroid gland which malfunctions (hypothyroidism). With a bacterial overgrowth the discharge from the ear is usually yellowish in colour and resembles pus. With a yeast infection the discharge may have more of a dark brown or black colour, and has a distinct smell. It is also possible to have mixed infections within the ear. The vet will diagnose what type of infection is present by looking into the ear with an instrument called an otoscope, and by making a smear of the material accumulating in the ear by putting a small amount of the ear discharge onto a glass slide, staining it and then looking at what cells and organisms are present under the microscope. In more complex or recurring cases the vet will take some of this material from the ear and send it to a laboratory to establish exactly what type or bacteria or organisms is present (called a culture). This process of diagnosis is important as it affects the treatment plan for the animal.

Certain dogs are predisposed to ear infections, and for this reason the condition often recurs in these patients. The condition in these cases will never be totally cured and can only be managed. Dogs that love swimming, such as Labradors, are predisposed to ear infections because they have water entering the ear canal on a more frequent basis. Dogs that have large floppy ears, like Poodles and Cocker Spaniels are also predisposed as this conformation often prevents the ears from drying out properly. Dogs that have a lot of hair in the ear canal, like Schnauzers and Poodles, are also prone to infections, as debris and moisture can become trapped in the hair.

Ear infections are quite rare in cats but Persians are the most predisposed breed of this species. In cats itchy ears are usually because of an ear mite infection, rather than bacteria or yeast. An infection with bacteria or yeast in a cat is quite frequently associated with an underlying illness such as Feline Leukemia Virus, Feline Immunodeficiency Virus or diabetes. There is increased risk of infection in these animals because the immune system is depressed.

Signs of an infection commonly include scratching at the ears and shaking the head and may also include animals tilting their heads. There may be an unpleasant odour and you may notice a discharge. This is not always seen as other pets in the home may have licked at the infected ears to clean them. The ears may also become swollen or red, and even show crusting or scabbing of the skin. A common side effect of an ear infection is the formation of an othaematoma. This is a painful swelling of the ear that results from a collection of blood under the skin because of the vigorous shaking of the head which causes blood vessels in the ear to burst. Large othaematomas often require surgical correction.

In extreme cases animals may lose their sense of balance. Severe cases may also show disturbance of the nervous system such as walking in circles or unusual eye movements. Loss of hearing can also result from a severe infection. It is important to treat an ear infection promptly so that it does not progress to the more serious stages, and also to help relieve the discomfort that the infected animal is suffering.

Treatment of ear infections

One of the most common reasons for clients to change vets is because of the perception that the vet fails to get the ear infection under control permanently with treatment. It is important to understand that some ear infections will never be cured and can only be managed. This is as a result of other underlying reasons leading to ear infection. Animals which suffer with inhalant allergy, also known as Atopy, are very prone to itchy skin, called atopic dermatitis (derma-skin, -titis – inflammation). Because the ears form part of the skin, the ears and the inner parts of the ear canal will be affected leading to a red, warm and swollen surface (inflammation), which is a wonderful breeding ground for bacteria and yeasts to grow.

Treatment of ear infections therefore always start at trying to identify, address and alleviate underlying causes. If the underlying causes are addressed, the ear infection will in many cases not return after successful treatment. However in certain instances, it is not possible to completely eliminate the underlying cause. In these instances, it is important to reduce and manage the underlying cause as much as possible, which in turn will reduce the treatment required for ear infection. It may be a life-long problem which is incurable, but can be managed by periodic treatment.

Establishing the underlying cause may be quite difficult in itself and may require an extensive period (at least 8 weeks) of changing the dog or cat’s food to a very specific anti-allergenic diet. In certain cases of allergy, blood tests or other skin tests may need to be done to determine what exactly triggers the allergy, and vaccinations against these triggers can be formulated for the animal. Treatment of underlying causes in itself may be expensive and time consuming, and this does not even address the ear infection itself.

Once the underlying cause has been identified and addressed, treatment involves cleaning the ears and in most cases administering drops into the ears. If the infection is far advanced the ear canal will be very swollen and in most cases extremely painful, which means that the animal will have to have a general anesthetic to clean out the ears properly. In severe or recurring cases the vet may take a swab of the ear and send it to a laboratory to establish exactly what type or bacteria or organisms is present (called a culture). Further to this the vet may request a test to establish which antibiotics will work against the organisms found. In some cases severe resistance to medication has been developed by some organisms which will require special attention.

In mild cases the vet may prescribe a cleaning liquid which will need to be applied to “flush” the ears before medication is put into the ear. To clean the ears, the cleaning agent is squirted into the ear. The ear is then agitated by firmly rubbing the base of the ear. This is to help spread the cleaning agent and increase its contact with the inner surface of the ear. Remember to stand back when you have done this because most dogs will shake vigorously after this exercise. This shaking helps to loosen up material stuck in the ear canal. Once the animal has had a good shake, cotton wool or tissue paper is used to wipe up the cleaning agent and the wax from inside the ear. It is important that cotton wool buds are not used as these are small enough to penetrate too far into the ear and can damage the eardrum. There is no risk of this happening with a finger and cotton wool.

The cleaning agent will help to dissolve the wax present in the ears and create a healthier environment where the infective organisms are less likely to flourish. Once the ears have been flushed, medicated drops will have to in inserted which normally contain agents that act against the specific organisms demonstrated on the ear smear or culture as well as anti-inflammatory and soothing agents. In most cases treatment will have to be administered daily for a number of days or weeks.

In some cases systemic treatment like a course of antibiotics or anti-inflammatory medication to be taken by mouth may also be prescribed.  The vet may start off this treatment by giving some injections.

Ear infections are seen commonly in small animal practice. If you suspect that your pet is suffering from an ear infection there is no need for alarm, but attending to it promptly with a visit to the vet is advised. Some ear infections will never be cured and will require ongoing treatment and lifelong management.

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