My pet injured its eye!

Just like in people, the eye of a dog or cat is a delicate structure that can be affected by a huge number of different conditions. This article will cover trauma to the eyelids, third eyelid and cornea.

Anatomy of dogs and cats eyes

The eye of the dog and cat is very similar in structure to the human eye but there are one or two differences. Both a cat and dog’s eye is globoid (round) in shape. The part of the eye exposed to the outside is protected by the eyelids and eyelashes, just as in people. The cornea is the see-through part of the eye. It is a thin layer, allowing light to pass through the pupil and lens to the back of the eye.  The white of the eye is known as the sclera. The conjunctiva is the pink part of the eye that can be seen between the eyelids and the eyeball. Dogs and cats both have an extra membrane, known as the third eyelid or nictitating membrane.  This membrane can be seen in the inner angle of the eye and sometimes it can cover most of the eye, particularly following trauma. 

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Trauma to the eyelids

The eyelids are the first structures protecting the delicate eyeball from the outside and potentially trauma. Due to being more active, getting into fights and exploring, cats and dogs are more prone to traumatizing their eyelids. Lacerations or cuts to the eyelids are a fairly common injury seen in most veterinary practices.  If there is any trauma to the eye, it is important to take your pet to the vet. Some injuries may be superficial and cleaning the wound with disinfectant may be all that is required. In other cases, the eyelid may need to be stitched back together. The sooner the eyelid is stitched, the better the chances of it staying together. It is very important that the eyelid margin (that is the part that the eyelashes attach to) remains smooth. If there is a kink in the eyelid margin, this can lead to further trauma to the eye and it can damage to the sensitive cornea.  Once the eyelid has been stitched, your pet may require eye drops for a few days to assist with the healing and prevent any infection.

Trauma to the third eyelid

Sometimes the third eyelid can be lacerated. This is commonly seen in cats that have been involved in a fight and have been scratched in the eye.  If the third eyelid is badly traumatized, it may need to be sutured.

Trauma to the cornea

Corneal ulcers

The most common injury seen to the cornea is corneal ulceration. This is where the first outer layer of the cornea (the epithelium) is damaged, exposing the more sensitive inner stroma of the cornea. This can be very painful. A scratch to the eye or a splash of shampoo or other caustic substances can cause an ulcer.  There are some viruses, such as herpes virus in cats that can also cause ulcers in the cornea. Often we do not know what has caused the ulcer. If you notice your dog or cat squinting, or the eye is closed and seems painful, then it is important to take them to the vet immediately. Often the conjunctiva will also be inflamed. This is known as conjunctivitis. The eye may also have some discharge.

The vet will examine the eye with an ophthalmoscope. This will allow the inside of the eye to be seen and ensure that there is nothing else going on. The vet will then perform a fluorescein test. This is where an orange stain is placed on the cornea. The eye is then looked at with a UV light (blue coloured light). If there is any defect in the cornea, this will show up as bright green. The corneal epithelium does not take up any stain but if the stroma is exposed it will take up the stain. 

Corneal ulcers can vary in size and severity. It is important to start treatment as soon as possible as the quicker it is treated, the more likely it is to heal. If the injury is superficial and small topical treatment with eye drops remains the most effective treatment. It is important that eye drops containing corticosteroids are not used as this delays the healing of the cornea and can, in fact, make the ulcer worse. Other drops and medications may be needed for pain control or to maintain the eye’s lubrication. The eye will need to be assessed daily to ensure that it is healing. In some cases, further treatment will be needed. In severe cases, the ulcer may need to be covered with either the third eyelid or some conjunctiva. This procedure will need to be done under general anaesthetic. The flap is placed over the cornea and sutured in place to give the cornea time to heal. The vet may even give you a referral to a specialist veterinary ophthalmologist which is a vet who would have done between four and six years of extra study over and above their veterinary degree, to become an eye specialist.

There is no set time to how long the cornea will take to heal but daily checkups are required initially to ensure that the condition is not deteriorating. In very severe or long-standing cases, the eye may even need to be removed. 

Foreign bodies within the eye

Penetration of the cornea by foreign bodies such as thorns, glass and sand can be seen in dogs and cats. This is normally very painful and can quickly lead to infection within the eye. If the foreign body is just penetrating the surface of the cornea, it may be removed with the aid of local anaesthetic. In severe cases, where the foreign body has penetrated deeper into the cornea and eye, it will need to be surgically removed. Fine instruments are often required in order not to damage the eye further and this procedure may need to be performed by a specialist ophthalmologist. If your pet is showing any signs of pain or discharge to their eye, it is important to seek immediate veterinary attention.

What is the prognosis with eyelid and corneal trauma?

The prognosis of injuries to the eyelids and cornea will depend on the severity of the trauma. If treated quickly, then permanent damage to the eye is minimized but this does depend on how extensive the injury is. The cornea scars white and so if the ulcer is very deep or long-standing this can affect the eyesight, particularly if the scar forms over the part of the cornea that is in front of the pupil. It is important to remember that the quicker it is treated, the more successful the treatment is likely to be. If you notice any pain, discharge or redness to your pet’s eye, it is important to take them to vet for an assessment. You may ask how do you determine that your pet experiences pain in their eyes? Apart from you visibly seeing damage to the eye or noticing an eye which is excessively teary, you will most likely notice your pet scratching at the injures eye with their front paw or alternative scratching the eye or face on furniture or the carpet, in an effort to relieve the discomfort and pain. If you are in doubt, err on the conservative side and get your pet to the vet as soon as you can. The loss of eyesight through the loss of an eye is simply not worth risking seeing whether the animal will get better by themselves.

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The vet could not cure my pet!

First things first, there are always 3 parties to any veterinary consultation: The vet, the pet and the one often overlooked, the owner. For any veterinary treatment to be successful at least two of the three parties, namely the vet and the owner, are pivotal to the success of any intervention. As an owner, you are the eyes and ears of the vet in the home environment and most importantly no one knows your pet the way you do. The truth is we the vet cannot do their job without you. I am sure many have heard the saying that vets have it harder because their patients don’t talk, they can’t tell the vet what is wrong, or where it hurts. It is for this reason that a vet will require every bit of additional information they can get from you, the owner. Animals are as biologically complicated as people, in fact, most medical ailments affecting people can affect animals.

When any consultation starts the first thing a vet starts doing is asking you questions about your pet, this is what we call history taking. It is the first step to working out the puzzle and coming to a diagnosis in order to treat.  These question can include activity levels, appetite, urination, defecation, history of limping or pain, what is in the environment at home, has anything changed etc. Vets are many things, but they are certainly not mind readers and these are pertinent questions which help the vet identify the problem. So as an owner it is your responsibility to be aware of what is going on in your pet’s life. You are the closest thing they have to being able to speak. Always remember that you know your pet better than anyone else and you will be able to notice changes much sooner. So don’t hesitate to bring your pet to the vet if you suspect something to be wrong with your pet. Sooner is always better.

Now that the consultation has started your vet will be doing the clinical examination and this involves some uncomfortable things like having their temperature taken via the rectum. The better part of the physical clinical examination is an invasion of your pet’s personal space in an environment where they are already scared, nervous and anxious. If you know your dog or cat is nervous and may potentially bite, it is always a good idea to inform the vet in advance. Although most vets have “spiderman reflexes” they don’t particularly like getting bitten when they may just not be fast enough to escape a hurting or nervous animal’s defence mechanism. Most dogs will never bite their owners, so you are essentially the safety net for your vet. You need to hold your pet and if they become aggressive, don’t let go. If you are at all concerned they may harm you or feel you will be unable to restrain your pet adequately, let the vet know. Vets have contingency plans such as muzzles and most of the time, wonderful, experienced handlers that can assist. When everyone feels safe, then everyone is relaxed and tension subsides and often the animals will calm down in response to this.

Luckily most of the diagnostic procedures and some in-hospital treatments (surgeries, drip, injections etc.) don’t involve you as an owner to a large degree. However, when your pet goes home on medication and home treatments, it’s all about you. Unfortunately, treatments and medications don’t work if they aren’t given. If the vet prescribes a course of medication, dose as instructed and always finish the course, especially if it is antibiotics. If wounds need to be cleaned, or ear/eye drops applied, they must be done as instructed. Always remember the vet knows better than anyone else how difficult animals patients can be when it comes time for giving medications. A useful tip when dosing medication for dogs: Hide them in something tasty like a Vienna sausage, cheese, peanut butter (check no xylitol in sugar-free alternatives), ham or anything tempting enough for your dog. A good idea is to offer a few pieces of your treat of choice without any medication in, then once your unsuspecting dog is sure there is nothing unsavoury in the treat, sneak the tablet laden one in, with the next clean one following in quick succession, and they often gobble it up without even tasting it. If you have one of those stubborn, clever dogs who delicately eats the treat and leaves the tablet untouched, you will have to learn to dose your pet properly. This involves placing the table in the back of the throat behind the tongue.  Ask the vet for a demonstration.  Cats, on the other hand, are a whole different kettle of fish. Most cats will not willingly eat medication whether or not it’s disguised in something tasty. They will generally require direct oral dosing of medication. The technique for pilling a cat can be demonstrated by the vet, and a few practice rounds in the consulting room is always a good idea. Once you have the knack pilling them comes the trouble of catching them to actually give the medication. After day three they will normally have learnt to avoid you when it comes to tablet time. Something that often works to reduce the negative association of dosing medication is giving them a treat afterwards, something tasty and very tempting.

Monitoring the response to treatment and recovery from treatment is essential for the owner. If your pet is not getting better or not responding as expected, they must be brought back into the vet. Complicated cases may require several diagnostic steps and treatment options to get it right. If the vet has scheduled a follow up to monitor the response to treatment, then your pet should be brought back for their check-ups. This helps the vet keep on top of treatment and progress. Vets, in general, are very busy, they see consultations, monitor and treat in-hospital patients, perform surgeries, research cases and manage practices. Although vets try to stay on top of everything they are human and sometimes things can slip their minds. It is important for you as an owner to take responsibility and contact the vet if you have any concerns, queries, you are looking for updates, or are looking for results for anything if the vet hasn’t come back to you timeously.

Vets rely heavily on you, the owner, for treating their animals successfully. Without the owner’s care, commitment and involvement in the treatment and care of their pets after they have been to the vet, the vet has almost no chance of achieving the successful outcome they desire for your pet’s treatment.

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My dog is really getting old

Taking your elderly dog to the vet for an annual check-up can sometimes feel like a waste of time and a big inconvenience to the pet involved. The stress involved and the difficulty of transporting a big elderly dog, which is not so mobile anymore, may make you wonder if it is really necessary. The answer is a very big YES!

At what age exactly are dogs considered geriatric? You may find different views on the internet and as with humans, it does depend to a large degree on the individual animal. Some humans are sprightly and active at age 75 and others are tired and sickly at age 60. The same applies to dogs but there is a general consensus that small breed dogs generally have a longer life span than medium and large breed dogs. Giant Breeds are considered geriatric at the early age of 6 to 7 years, whereas breeds are only regarded as geriatric when approaching ten to twelve years of age.  The aim of an annual check-up for an adult dog is not just to update the vaccinations, but to give the veterinarian an opportunity to evaluate the dog’s general health and pick up any problems that might have gone unnoticed by the owner. The broad generalisation is that for each one year a human ages, a dog will age the equivalent of 7 years. If you look at it in this light, it will make sense that in older dogs, regular check-ups, as in humans, are vital. The vet will also ask the owner a series of questions to establish how the animal is doing at home. Things to start looking out for when an animal gets older is a loss of appetite, losing weight, struggling to get up and move around, as usual, drinking and urinating more than usual, and general signs like vomiting and diarrhoea.

As the animal’s body ages, it goes through normal changes and often it is an accumulation of these changes that result in health problems. The most common problem that old dogs deal with is arthritis, and as older animals become less active they tend to become overweight. Extra weight places extra stress on already painful and inflamed joints. These patients might need to be X-rayed to rule out any other causes of limping and stiffness. Once a diagnosis of arthritis is made, the vet may advise a change in exercise regimen, a change in bedding, potentially a change of diet or adding joint supplementation products on to, or into the animals' food, and often anti-inflammatory medication depending on the severity. The most important method of pain relief remains weight loss.

The organ function of old dogs often decreases as well. A common problem is decreased kidney function turning into chronic renal failure. As the kidney function decreases, it loses the ability to clear the animal’s blood of toxins. Some medications need to be excreted through the kidneys, and if the kidney function is already compromised, it can cause serious side effects. A good example of this is the anti-inflammatory medication mentioned for pain control in arthritic dogs. This group of drugs is excreted by the kidneys and will cause side effects if the kidneys are not functioning well. For this reason, vets will often test the liver and kidney function of old animals before placing them on chronic medication. It is also important to re-test every six months. Animals that suffer from kidney problems will show signs like weight loss and decreased appetite, as well as drinking and urinating more than previously. It is important to take your dog to see a vet as soon as these signs are noted.  These days there are blood tests which can pick up kidney disease much sooner than the blood tests that were available only a few years ago. Yet, sadly, even though these tests are a lot more sensitive, they only pick up kidney disease once 40 % of kidneys are damaged vs the old blood tests which picked it up after 75% of the kidneys were damaged. Veterinary research will keep on evolving to find means of detecting organ failure sooner, but a test with normal results does not necessarily mean that there is not kidney failure. The other important aspect with regards to kidney failure is that the kidneys do not have the ability to regenerate or repair themselves. So, once the cells are damaged, that is it for the kidney. The only way to support the kidneys once damage has taken place is to try and prevent further damage and lighten the load of the kidneys. This can be done by changing the diet and there are specific veterinary therapeutic and prescription diets available for this which the vet can advise you on. Heart failure, as well as liver failure, can also occur showing a various range of clinical symptoms. With heart failure, your pet might be exercise intolerant, start with a cough (especially at night), and breathe faster in general.

Another common problem in geriatric animals is cancer or neoplasia. As the immune system defence mechanism decrease, the ability to recognise cancer cells decreases, and together with oxidative damage in old animals, cancer can occur more commonly. Organ enlargement and organ failure are often an indication of cancer and the vet may recommend an abdominal ultrasound as well as x-rays to pick up cancer. Even the slightest signs in an old animal can indicate a bigger problem. Owners will often complain that the pet has become fussy, and eats less. But this can be the first signs to indicate that a bigger problem exists. It is important to remember that it’s not normal when an animal that has always eaten well, become fussy out of the blue. In most cases old age, as in humans go hand in hand with less active and a lower appetite, but a major reduction in appetite is usually a sign of disease.

So how do you take care of geriatric animals?

  1. Feed a good quality diet: Old dogs cannot digest food as easily as young animals and they need all the nutrients and antioxidants they can get. There are various maintenance, therapeutic, prescription diets specifically formulated for older animals as well as animals with diseases like kidney failure, heart problems, and arthritis. These good quality foods help the animal cope better with their life stage or specific health problem. If there are no particular health problems, a good quality senior diet is preferred. Please speak to the vet to advise you and the best diet to feed your dog.   
  2. Keep their weight stable: With decreased metabolism and decreased mobility, older dogs tend to pick up weight quickly if they don’t have a chronic medical condition. Research has shown time and time again that obese animals have a decreased lifespan. Problems like diabetes and heart conditions are very common in obese animals.
  3. Encourage activity and moderate exercise: It is important to keep them active, but do not overdo this. Regular short walks are more than adequate and only do it if the animal is not in pain.  Swimming in most cases is a really good form of exercise for dogs but not all dogs love water so go with the flow in terms of your dog’s preference.
  4. Good dental care: Dental hygiene is essential in animals of any age. If the teeth are rotten and the gums are inflamed, they may suffer from pain when they eat. The plaque build-up supplies the body with a continuous source of bacteria to the bloodstream. These bacteria can lodge on the heart valves or in the kidney tubules leading to chronic heart and renal failure.
  5. Provide adequate bedding and shelter: Older animals are stiff and sore and will sleep much better with a softer surface to lie on. They also lose the ability to regulate their body temperature adequately and may need extra shelter against heat, cold and other weather conditions.
  6. The most important thing to remember with geriatric animals is to bring them to the vet for annual check-ups. If the vet can help to pick up a disease in the early stages, they might not be able to cure it, but they can definitely make your pet more comfortable and even add a couple of years to your pet’s life by recommending the right geriatric care for your specific dog.

 Old age is not a disease! So if your animal is not eating too well and slowing down, do not just blame old age. Rather seek veterinary advice, you may just save your old dog’s life for a couple more years.

© 2018 Vetwebsites – The Code Company Trading (Pty) Ltd.

My cat is really getting old

Due to improvements in nutrition, veterinary and home care, cats are living a lot longer than they did twenty to thirty years ago. In the past when a cat reached the age of 13 years old, we believed them to be really old. This is definitely no longer the case. We see several cats that are now reaching ages in excess of twenty years. Cats also tend to age a lot more gracefully than dogs and so it is not always easy to tell when they are starting to struggle or are showing signs of illness.  

Cats are considered elderly once they reach 11 years, with senior cats being between the ages of 11 and 14 years and geriatric cats being over 15 years.  As cats age,  they go through many behavioural and physiological changes and are more prone to developing certain illnesses in their last few years of life.  
 

What physiological and behavioural changes can you expect with your ageing cat?

As cats age, their sense of smell and taste becomes less sensitive. This means that food may need to smell a little stronger in order to appear more palatable to the cat. They also have a decreased ability to digest fat and protein so food needs to provide adequate nutrition but not be too rich. As well as sight, their hearing also diminishes and so extra care is needed to ensure they are out of the way of vehicles or they may need to be brought to their food. 

When considering their behaviour, they become less adaptable to changes in their environment and can become stressed more easily. Older cats tend to spend less time outside and more time sleeping inside.  Their appetite often decreases and they can become fussier due to their diminished sense of smell and taste. Other changes related to particular diseases may be noted. They may start to drink more water with kidney failure, or show pain and aggression due to pain and arthritis.
 

Are there any changes in routine care for your older cat?

As your cat ages, you may need to start doing a few things that weren’t necessary when they were younger and more active. Cat’s are naturally very clean animals and as they get older, grooming does become more difficult. Regularly checking your cat is advisable as problems can be picked up sooner and dealt with more efficiently.  
  • Pedicures – elderly cats are less able to retract their claws and they can become stuck on furniture and bedding. The claws also thicken with age. It is important to check them weekly to ensure that the nails are not growing into the paw pads. Some cat may need regular trimming. With advice and some training from the vet, this can be done at home and may help reduce the stress of a journey to the vet or parlour.
  • Grooming – Ageing cats may struggle to groom themselves due to athritits. Long haired cats, in particular, may need to be brushed several times a week to avoid matted fur. Their eyes may need to be cleaned occasionally with moist cotton wool. It is important to check around their “bottom” (perineum – the area around the anus and rectum) to ensure that there are no faeces stuck and there isn’t matted fur. Some cats may need to be trimmed.
  • Hairballs – The digestive system in older cats can be a little sluggish and so problems like hairballs can become more common. There are several different options when it comes to hair ball control such as food or supplements. If you are unsure if your cat is vomiting or bringing up hairballs then it is important to consult the veterinarian. 
  • Toilet habits – It is advisable to provide an indoor litter box, even if your cat normally urinates and defecates outside. As older cats are more slow and sedentary, they may not want to go very far and they are also more sensitive to the cold and wet. An indoor litter box also makes monitoring the frequency of urination and consistency of stool easier. An increase in urination may be a sign of an underlying condition such as diabetes or kidney failure. Older cats may also struggle with constipation and may need supplements or a change in food. In severe cases, the veterinarian may need to perform an enema.
  • Dental disease – As cats age, dental issues such as gingivitis (inflamed gums),  plaque build-up and loose teeth may become more of a problem. This may affect their appetite, their ability to eat, and may cause them pain. Bad breath (halitosis), drooling, loss of appetite, tooth chattering and pawing at the mouth may all be an indication that there is an underlying dental issue that may need attention. If you are in any doubt then consult the veterinarian.

How often should you take your ageing cat to the vet?

The frequency of veterinary visits will depend on the general health of your cat and any particular illnesses that they may have. Older cats that have not had any issues, are eating and drinking well and do not appear to have any signs of weight loss or other health problems should be seen at least once a year. This gives your veterinarian a chance to assess them and decide whether any procedures or tests are needed. As your cat ages, blood and urine tests are an indispensable tool in detecting problems early, before the onset of clinical signs and severe disease. In the past few years, newer generation blood tests like SDMA, have become available which can pick up kidney disease months, to even years, before it is clinically visible. The levels of these biomarkers start increasing in the blood when there is 40% loss of kidney function compared to the older type of tests where 75% of the kidney function had to be destroyed before the levels of blood markers would increase in the blood tests available to vets. Even with these new and wonderful tests, it is still quite scary to think that we can only start picking up kidney disease by the time that almost half of the kidney function is irreparably damaged. 

Unlike the liver, the kidneys do not have the capacity to regenerate, and therefore once a certain percentage of the kidneys have been damaged, there is no way of repairing it. Therefore it is so critically important that these tests be done at an earlier age, or stage of kidney disease, in order to help protect the functional part of the kidneys. 

If your cat has been diagnosed with a particular condition, visits to the vet may be required more frequently to refill medication, follow up on weight checks or do blood tests.

The following sigs are an indication that your cat should be seen by the vet:

  • Any loss of or change in appetite
  • Weight loss
  • Change in water intake- usually drinking more than normal
  • Struggling to jump, lameness or stiffness
  • Any lumps or bumps
  • Decreased energy levels
  • Balance problems
  • Difficulty in passing urine or faeces or messing in abnormal areas
  • Disorientation or distress or any change in normal behaviour
  • A coat which becomes dull
  • Any other signs of disease like vomiting or diarrhoea, change in vision, bad breath, weakness or anything else which is out of the ordinary

Detecting certain diseases early often helps improve the success of treatment so it is important to be on the lookout for any changes in your cat. Older cats will need more time and attention but with advances in veterinary medicine and care, they should be able to live their last few years in comfort and relatively free from stress.

Just like in humans, the life expectancy of animals are increasing and just as we care for the elderly in our human communities, we can show the same love and care for our geriatric pets and ensure a good quality life for them right up until the end. 

© 2018 Vetwebsites – The Code Company Trading (Pty) Ltd

My pet is vomiting

Vomiting is one of the most common symptoms of disease seen in pets. It can be quite alarming to see your pet vomit up all his or her food or alternatively continuously wretch and only bring slime or bile. So should you rush your dog or cat to the vet immediately when you see them vomit, or is it safe to wait and see? Because there are so many causes of vomiting, we recommend that if you are ever in doubt, it is always better to visit the vet and have it seen to, even if it is just to put your mind at ease and prevent it from progressing to something more serious.

It is important to realise that vomiting is not a disease or medical condition in and of itself, but rather a symptom of many different underlying causes. Healthy animals should not vomit, so there will usually be some underlying disease process which causes your animal to vomit. This could be as diverse as a brain condition, kidney disease, liver disease, gastrointestinal tract problems or endocrine conditions. It may have an infectious origin, but the cause may not be infectious at all and may vary from a physical obstruction such as a lodged bone to something as sinister as cancer. Distinguishing between vomiting and regurgitation is important. While vomiting is an active process which involves contraction of the abdominal muscles to expel the gastric content, regurgitation is a completely passive process where food is expelled from the stomach or from the oesophagus without any abdominal muscle contractions. Regurgitation usually points to a problem in the upper gastrointestinal tract, like the oesophagus. Nauseous dogs will often lick their lips and start salivating. This “overproduction” of saliva is there to protect the oesophagus against the acidic vomit moving up from the stomach by neutralising it. 

During the clinical exam, the vet will try to establish why your pet is vomiting and will decide after the clinical exam to either carry on with further diagnostic tests if he or she finds anything out of the ordinary, or send your pet home with the appropriate treatment. A full history from a vomiting animal’s owner is often the most useful diagnostic tool, so try and answer any questions the vet may have to the best of your ability. Common questions your vet may ask are: 

  • How many times has your dog or cat vomited?
  • How long has the vomiting been going on for?
  • What did your dog or cat vomit up?
  • Has your dog or cat lost any weight?
  • Is your dog or cat still eating?
  • Has their diet changed in any way?
  • What does the vomit look like?

It is important to know if there is a runny tummy (diarrhoea) associated with the vomiting and if so, to establish your pet’s hydrations status. An animal that is not keeping any fluids down, and vomits throughout the day together with losing fluids through diarrhoea can dehydrate quickly. The vet will most likely feel (palpate) your animal’s abdomen to establish if there is any pain, or perhaps a foreign body stuck somewhere which may be palpable. Depending on the size or the location of a foreign body, it may not always be possible for the vet to feel it. Severe pain in the abdomen will alert the vet to a more serious problem like pancreatitis. Dogs and cats can swallow the strangest things which may cause a blockage in the narrower parts of the digestive tract. This can become a life-threatening condition depending on the type of blockage and the length of time the foreign body is entrapped. Some foreign bodies can perforate the gut which can cause the animal to go into septic shock.

The majority of pets presenting with vomiting is due to dietary indiscretions and will recover within 24 – 48 hours. In these cases, the animal will show minimal abdominal pain, and hydration status will be normal, and temperature will be within normal limits. They are usually not severely depressed, but stay bright and alert. If the animal is bright and alert and healthy in all other respects, the vet may recommend skipping a meal or providing a liquid critical care diet together with access to fresh water. Food can then be introduced slowly over the next 12 hours. A bland diet of chicken and rice can be fed, or a veterinary therapeutic diet that is easily digestible and which has a low-fat content. 

In some cases of animals vomiting, there will be certain things that indicate to the vet that there is a more severe problem than a simple dietary indiscretion. If the vomiting has been carrying on for more than a couple of days, continuous or intermittent, further investigation is always required. Severe weight loss, dry coat and general weakness are some of the danger signs. Raised or decreased body temperature, severe abdominal pain, and accompanying bloody diarrhoea should also raise concern. These animals should ideally be admitted at the veterinary practice and rehydrated with a drip. Animals that are losing fluids by vomiting and diarrhoea often also develop electrolyte imbalances. Glucose may be low due to anorexia lasting a couple of days, and the vet will need to assess what kind of electrolyte supplementation is required with the fluid therapy. While the animal is being treated symptomatically, the vet will start with further diagnostic tests. After a basic blood smear and microscopic examination, the vet may recommend a urinalysis and faecal analysis as part of a minimum database. If the diagnosis cannot be made with these basics diagnostic tests, more comprehensive blood tests may be required which will include a full blood count, biochemistry and electrolytes. If a definitive diagnosis cannot be made with these tests, further investigation with the help of diagnostic imaging which may include X-rays and or ultrasound may be recommended. Even with extensive testing and diagnostic aids, it may not be possible to make a definitive diagnosis immediately, and in these cases, the vet will discuss the merits of further diagnostic tests or procedures, or referral to a specialist vet, with you. 

Some of the more common conditions that can present with vomiting are:

  • “Garbage disease” – where the animal eats leftover food or other items from a knocked over garbage bin 
  • Foreign bodies varying from stones to clothing garments, to anything other than pet food which the animal may have chewed and accidentally swallowed part or all of. Depending on the size and the type of foreign body it may either cause a partial obstruction or alternatively could cause a complete obstruction of the intestinal tract, which may only be rectified with surgery. 
  • Hairballs in cats
  • Pancreatitis or pancreatic tumours
  • Chronic or acute kidney disease
  • Chronic or acute liver disease including liver tumours
  • Inflammation of any part of the intestine including the mouth, oesophagus, stomach, small intestine or large intestine 
  • Megaoesophagus which may be due to auto-immune disease or other causes
  • Any tumours pressing on to, or causing an obstruction in the digestive tract
  • Gastric ulcers

The most important thing to remember is that vomiting is merely a symptom of an underlying problem which may or may not have anything to do with the intestinal tract. If your animal is vomiting and does not stop after a single episode, it is worth a visit to the vet to have it checked out.  

©2018 Vetwebsites The Code Company (Pty) Ltd

 

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.

©2018 Vetwebsites The Code Company (Pty) Ltd

My dog is ravenously hungry all the time and eats like a beast but is as thin as a rake.

Why is the pancreas important?

The pancreas is a small, light pink, glandular organ that is situated between the stomach and the duodenum (part of the small intestines). It has many important functions, all of which can be classified into two main categories namely endocrine and exocrine.

The endocrine function of the pancreas refers to its hormone-producing cells. Hormones are small chemical messengers that are released into the bloodstream. Two important hormones produced by the pancreas are glucose and glucagon, both of which are important in maintaining blood sugar levels.

The exocrine function of the pancreas refers to its ability to produce enzymes. These enzymes are important in digestion and breaking down larger substances into smaller particles or molecules that the body can absorb and use. The digestive enzymes include amylase to digest starch, protease to digest proteins and lipase to digest fats. These digestive enzymes are stored in the pancreas in the inactive form (called zymogens). They are released through a small duct into the duodenum and break the food down into small molecules as it moves through the small intestine. If these enzymes are not present, food is not broken down and the nutrients in the food cannot be absorbed and utilised.

If the pancreas is unable to produce the enzymes in sufficient quantities we get the condition referred to as exocrine pancreatic insufficiency. This can also be referred to as maldigestion, which means that the food is not being processed and absorbed properly. The most common signs associated with the lack of digestive enzymes include a runny tummy or diarrhoea, which can sometimes be greasy and foul smelling and weight loss, despite an increased appetite. Other signs may include a poor coat, abdominal discomfort and increased borborygmi, which are the noises that can be heard when we say our tummy is grumbling.

What causes decreased digestive enzyme production?

There are three main causes of exocrine pancreatic insufficiency, namely acinar atrophy, chronic pancreatitis and neoplasia. These are big terms and we will take the time to explain each.

Acinar atrophy refers to the condition where the glandular cells that produce the enzymes become shrivelled or small and are unable to function properly. This process is thought to have a genetic component and German Shepherds are the most common breed to suffer from this condition. They are not born with the condition but it develops later on in their lives, commonly around four years of age. Rough Coated Collies are another breed that may be affected by atrophy of the acinar cells.

Chronic pancreatitis refers to a long-standing inflammation of the pancreas. The pancreas scars (this is referred to as fibrosis) and loses a lot of its function. 90% of the pancreas has to be damaged before signs of the disease are seen.

Neoplasia or cancer is the third cause of exocrine pancreatic insufficiency and this is where abnormal, fast-growing cells overtake the pancreas.

In cats, chronic pancreatitis is the most common cause of the decreased production of digestive enzymes.

How is this condition diagnosed?

There are several different tests available to diagnose exocrine pancreatic insufficiency. The most accurate test available measures levels of trypsin-like enzymes in the bloodstream. This test is known as the serum trypsin-like immunoreactivity test. A blood sample needs to be taken after the dog has been fasted or starved for a certain period of time for it to be accurate. Only a single blood sample is required. There is a similar test for cats but it is not as freely available. There are tests available to measure enzyme levels in the stool but these are not as accurate as the blood tests.

How is exocrine pancreatic insufficiency treated?

Treatment of this condition requires supplementation of the digestive enzymes. If available, feeding fresh or frozen pancreas from cows or pigs is the first treatment employed. This works very well but fresh pancreas may be difficult to get hold of and not everyone likes the idea of handling uncooked animal products. There are commercial formulations available, some of which may be very expensive. Most of the supplements given are digested in the stomach but the little that is not is enough to help with digestion in the small intestine. Powdered enzymes appear to work the best. There are tablets available but their absorption and efficacy seem to be a little unpredictable. It will be important to discuss the best option for your pet with the vet at the time of diagnosis.

The supplementation of pancreatic enzymes will decrease the clinical signs of the disease but not completely control the diarrhoea. Vitamin B12 (Cobalamin) may need to be supplemented. The intestinal bacteria in dogs and cats produce this vitamin. Often there is an overgrowth of bacteria and instead of producing more Cobalamin, they end up consuming what is made. This leads to a deficiency in the dog or cat. Cobalamin is supplemented by initially weekly and then monthly injections. Patients may also suffer from inflammatory bowel disease and may need treatment for this.

Can exocrine pancreatic insufficiency be cured?

Exocrine pancreatic insufficiency is a result of the loss of functional cells within the pancreas. It is rarely cured but can be managed with appropriate therapy. Treatment is for life. With appropriate management and monitoring, the animal often gains weight, the stools improve and they can often live a normal life with a normal lifespan.

If your pet is losing weight even though it seems to be hungry all the time, it will be a good idea to bring him or her to the vet for a checkup.

© 2018 Vetwebsites – The Code Company Trading (Pty.) Ltd.

Help! My pet has just drank some Anti-Freeze

Winter has arrived and many people, as a precautionary measure, are putting antifreeze into their cars’ radiators, to prevent the water from freezing.

Ethylene glycol is the main ingredient found in antifreeze. Antifreeze is not as commonly used in South Africa as on other very cold parts of the world, as we do not get the very cold temperatures found in some parts of the Northern hemisphere. It is however found in many other products, which are found in South Africa. It is found in lower, less harmful concentrations in hydraulic brake fluid, solvents, motor oils, paints, film-processing solutions, wood stains, inks and printer cartridges.

Ethylene glycol is a sweet, odourless liquid that dogs and cats may find quite tasty. Ethylene glycol has a very narrow margin of safety. This means that only a very small amount needs to be ingested in order for it to be toxic and very often fatal.

As little as a tablespoon may cause severe acute kidney failure in dogs and as little as one teaspoon may be fatal to cats. Animals are often attracted to ethylene glycol due to its sweet taste. It has a repulsive aftertaste but often the animal has ingested enough of the fluid by the time the aftertaste kicks in, to cause disastrous effects.

What are the signs that your animal may have been ingested ethylene glycol?

Early signs of intoxication may be seen from 30 minutes to 12 hours after ingestion and may include any combination of the following signs:

  • Drunkenness
  • Excessive thirst or urination
  • Nausea or vomiting
  • Panting
  • Sedation
  • Halitosis (bad breath)
  • Muscle twitching
  • Fatigue
  • Coma

Ethylene glycol poisoning can be divided into three stages:

  • Stage 1: occurs up to 30 minutes after ingestion and includes fatigue, vomiting, incoordination, excessive urination, excessive thirst, low body temperature (hypothermia), seizures and coma.
  • Stage 2: occurs 12 to 24 hours after ingestion. Some of the clinical signs seen in the first 30 minutes may improve but during this stage, the animal may become very dehydrated and develop an increased heart rate and breathing rate.
  • Stage 3: occurs 36 to 72 hours after ingestions. There is generally severe kidney dysfunction at this stage. The dog or cat is generally in much pain and they do not produce urine (this is referred to as anuria). The patient may become more depressed and tired. They may lose their appetite and vomit. They may have a seizure or fall into a coma, which eventually leads to death.

How is ethylene glycol toxicity diagnosed?

If you suspect that your dog or cat may have ingested antifreeze or any other product containing ethylene glycol, it is important to seek immediate veterinary attention. If your animal is showing any of the clinical signs described, it is important to bring your pet to the vet immediately to be looked at. If there is any possibility that your pet may have been exposed to ethylene glycol but not showing any signs, they should still be brought to the vet.

If your pet has vomited or had diarrhoea, collecting a sample to bring to the vet may be beneficial in making a diagnosis. If a diagnosis can be made quickly and supportive treatment is given sooner, the prognosis, although still very poor, is that much better.

It is important to provide the veterinarian with a good history with as much detail as possible. The onset of symptoms may give a very important clue as to the potential cause. In some countries, there is a specific test for ethylene glycol toxicity but this is not widely available. The ethylene glycol concentration in the blood also decreases very rapidly so it is important to test as soon as possible after suspected ingestion. Diagnosis is usually made from history, clinical signs and laboratory data.

Ethylene glycol is processed or metabolised by the liver into toxic by-products that are damaging to the kidneys. Kidney function is measured by two main products in the blood, namely Creatinine and Blood Urea Nitrogen, both of which are nitrogenous waste products. If the kidneys are not functioning properly, these two products build up in the blood. These levels can be tested relatively easily. They are not a specific test for ethylene glycol poisoning, but they do indicate kidney damage. By the time these levels increase, it is unfortunately very often too late.

Looking at the urine may also assist in confirming exposure to ethylene glycol and subsequent kidney damage. The urine is often very dilute and contains blood, proteins and specific crystals. The urine is often acidic.

Is there a treatment?

Quick action and treatment are essential if there is any chance of survival. There is an antidote for ethylene glycol toxicity but it is very expensive and unfortunately not readily available in this country. The antidote also needs to be given within five hours of ingestion. Alternative treatment such as ethanol are available but animals need to be monitored closely as the drugs used for treatment have side effects. Sodium bicarbonate administered in the drip will assist with the metabolic acidosis.

In suspected cases, supportive treatment is essential and this will include intensive monitoring, fluid therapy to correct dehydration and correction of any pH imbalances in the body. Despite treatment, the prognosis is often grave to poor and many animals do not survive antifreeze poisoning.

The old saying, “Prevention is better than cure”, stands true here. It is important to be aware of any household products that contain ethylene glycol and store them safely, away from animals. Clean up any potential spills immediately and if you are unsure of potential exposure seek veterinary care immediately. There are many potential threats within a home of which the drinking of antifreeze is only one, and so it is important to be aware of them and take the necessary precautions to safeguard your animals.

© 2018 Vetwebsites – The Code Company Trading (Pty.) Ltd.

When should I be worried about my cat’s coughing?

A cough can be described as a sudden, forceful expiration of air through the glottis (part of the throat). It is usually accompanied by an audible sound (something that can be heard), which is often preceded by an exaggerated inspiratory effort (a big breath in). Cats, just like humans, may cough occasionally to clear their throat or because they have an irritation but coughing can be a clinical sign for a varying number of serious conditions in cats.

History, as well as the breed of the cat, plays an important role in determining what is causing the cough. The type of cough is also important. A cough can be moist and productive, meaning that the cat brings up a lot of phlegm and mucous or it can be dry and non-productive. This means that the cat is coughing but isn’t bringing anything up. Despite what many people may think, cats are not just little dogs. Like dogs, there are many reasons why a cat may cough but the cause of the cough may be very different from dogs. It is important to take your cat to the vet if they have a persistent cough.

Upper respiratory infections or snuffles and asthma are two common causes of coughing in cats.

Upper respiratory infections or “Snuffles”

The respiratory tract consists of the nose, throat, sinuses, windpipe (trachea) and lungs. A cat’s nose, throat and sinuses are susceptible to a number of different viral and bacterial infections. Feline calicivirus and herpes virus are two of the most common viruses causing upper respiratory infections in cats. Both viruses are transmitted through sneezing, coughing, grooming or sharing food and water bowls. The viral infections can be complicated by secondary bacterial infections.

The symptoms of snuffles in cats are varied and may include sneezing, upper respiratory congestion, runny noses and teary eyes, coughing, gagging, drooling, fever, a loss of, or decreased appetite, rapid breathing, and ulcers in the mouth. Cats with sniffles may develop conjunctivitis in their eyes; have open-mouthed breathing and they may be depressed. Age, vaccination status and physical condition all play a role in a cat’s susceptibility, but multi-cat households and shelters are most at risk. Cats who have recovered from the viruses may become life-long carriers.

Taking your cat to the vet when you suspect snuffles is important. In severe cases, cats may become dehydrated and require intravenous fluids and antibiotics. Some cats may recover by themselves but some may require antibiotics and other medications. Cats should be isolated from others as the viruses are very contagious.

Feline asthma

Asthma in cats is very similar to asthma in humans and is basically a chronic inflammation of the small passageways in the lungs. These passages become thickened and constrict, making it very difficult for the cat to breathe. The cat may become very distressed, worsening the condition and in severe cases, an asthma attack may result in death. The lungs may release mucus into the airways and this often leads to coughing and wheezing. The most common symptoms of a cat suffering from asthma include coughing, wheezing, difficulty in breathing, open mouth breathing and overall weakness and lethargy. In some cases, cats may develop blue lips, gums and tongue due to a lack of oxygen.

It is thought that asthma develops as a result of chronic allergic bronchitis. Allergic bronchitis may be caused by different allergens such as pollens, moulds, dust and cigarette smoke. Parasites, stress and obesity may also be contributing factors. Asthma is most commonly noted in cats between the ages of two and eight years old and it appears to be more common in females than males. Oriental breeds such as Siamese and Burmese cats seem to be more frequently affected.

Asthma is diagnosed on a combination of history, a clinical exam and certain diagnostics tests. It is important to rule out other possible causes of coughing. There is no cure for asthma but it can be successfully managed.

Other causes of coughing

Other causes of coughing in cats may include a cat which accidentally inhaled dust particles, respiratory parasites, heartworm (which is a disease not currently found in South Africa), tumours in the chest and pneumonia. It is rare that cats with heart failure cough.

If it something as trivial as inhaling dust particles, for instance when someone cleans their house and have a curious cat around them when they dust off a very dusty shelf, the coughing should stop shortly after commencing, once the particles have been removed by the coughing bout. Persistent coughing in cats is something completely different and can be an indication of some serious conditions and diseases and so it is very important that a vet examines them. An accurate history and clinical exam are vital in making a diagnosis but often further testing such as X-rays and lung fluid samples may be required.

Any coughing that persists for longer than a few hours is a cause for concern and worry and is enough reason to have your cat checked out by the vet.

© 2018 Vetwebsites – The Code Company Trading (Pty.) Ltd.

My dog seems sore in its front leg

What is elbow dysplasia?

Elbow dysplasia is the collective term that describes a number of conditions that affect the growth and development of a dog’s elbow. It is most commonly seen in large and giant breed dogs. Labradors, Golden Retrievers, German Shepherds and Rottweilers are the most common breeds but it can occur in any breed. There are a number of different theories as to why elbow dysplasia occurs but it is often a combination of factors, which leads to the abnormal development of the joint. Defects in cartilage growth, trauma to the joint, genetics, exercise and diet may all play a role in the development and progression of elbow dysplasia.

The elbow is made up of three bones. The humerus is the top bone. It forms the connection between the shoulder and the elbow. The ulna and radius from the bottom part of the joint and connect the elbow to the metacarpals or wrist.  When there is an abnormal development between these three bones, they do not sit together as they should and there are abnormal pressures within the joint. This mismatch of growth and abnormal pressure can lead to a number of different conditions. The different conditions can occur alone or in combination and may include the following:

  • Fragmented medial coronoid process (FMCP)
  • Ununited anconeal process (UAP)
  • Osteochondritis dessicans (OCD)
  • Elbow incongruity

Some conditions are more common in certain breeds but any condition may occur in any breed.

Figure1: Normal flexed (bent) elbow of a dog

The above X-ray shows a normal elbow of a dog to illustrate the different bones and parts of the bone that make up the elbow. If the radius grows more slowly than the elbow it becomes shorter and this puts increased pressure on the medial coronoid process of the ulna. “Process” in this context means a pointy piece of bone protruding from the main bone. Directly translated the medial coronoid process is the “inside crown pointy bone”. With the ulna being longer than the radius this can cause cartilage damage in the joint and sometimes the tip of the coronoid process may fracture or break. This is referred to as the fragmented medial coronoid process. Labradors, Rottweilers and Boerboels are the most commonly affected breeds but it can occur in any breed.

If the ulna grows too slowly then the radius pushes the humerus (upper arm bone) against the anconeal process of the ulna. The anconeal process looks almost like the beak of a bird. If the radius grows too long, it puts pressure on this section of bone or “beak”, which prevents it from growing and maturing properly and may lead to the anconeal process being unable to unite or attach properly to the rest of the upper part of the ulna bone (called the olecranon). This ends up being like a “bird with a loose beak”, and needless to say is very uncomfortable and painful for the dog. The ununited anconeal process occurs commonly in German Shepherds and Boerboels.

If the radius and ulna do not grow at the same rate of speed, a condition called elbow incongruity can occur. This causes wear and tear on the cartilage, as the humerus does not meet the appropriate surfaces on the radius and ulna. Thus, some points of contact are overloaded and this can lead to fragmentation of the medial coronoid process and other abnormalities.

Cartilage is the protective layer that is formed over the bone within joints. Cartilage helps lubricate the joint and reduces friction within the joint. Osteochondrosis is a condition where there is an abnormality of the cartilage and the bone underneath it. Osteochondrosis most commonly occurs in the inside part of the upper arm bone or the medial condyle of the humerus of the elbow joint. Osteochondrosis dissecans (OCD) describes the condition where a flap of cartilage forms. This flap may stay attached or break off and float around in the joint. It is usually very painful. It is commonly seen in Labrador Retrievers suffering from elbow dysplasia.

What are the signs of elbow dysplasia?

Elbow dysplasia can affect one or both elbows. No matter which condition is present, the clinical signs are generally the same. Most commonly, dogs show lameness on one or both elbows, particularly after resting and lying down. They may be reluctant to exercise and may struggle walking up and down stairs. Elbow dysplasia can present as early as five months, but signs are commonly seen in large and giant breed dogs between six to ten months. In some cases, elbow dysplasia may only be diagnosed when the dog is much older and the joint has become arthritic. The lameness is often worse after exercise and often will not resolve completely.

An orthopaedic examination in most cases reveals pain and occasionally swelling of the elbow with a restricted range of movement of the joint. Movement is reduced due to arthritis developing in the abnormal joint.

How is elbow dysplasia diagnosed?

Elbow dysplasia is diagnosed by a combination of a thorough clinical exam and diagnostic imaging. X-rays are generally the first diagnostic step in diagnosing elbow dysplasia. Certain conditions such as an ununited anconeal process are generally quite easy to visualise but other conditions may need further diagnostics such as a CT (X-ray computed tomography or CAT scan) or arthroscopy. Arthroscopy is keyhole surgery where a small camera is placed within the joint to visualise it. It is minimally invasive and, in some conditions, the joint is operated on at the same time.

What are the different treatment options?

The treatment undertaken depends on a number of factors. Age, clinical signs and degree of arthritis in the joint are all deciding factors. It is not possible to reverse the damage that has already been done to the joint, but the progression of the disease can be slowed. All dogs with elbow dysplasia will develop a certain degree of arthritis, even if they undergo surgery and so this should be taken into consideration beforehand. 

Surgery by a specialist surgeon vet may be recommended to help correct a step in the joint (elbow incongruity), remove any fragments of bone or cartilage, or to surgically alter the joint (arthrotomy).

Many dogs may be managed medically or conservatively, particularly if the changes within the joint are minimal.

Conservative management would include:

  • Strict weight control, which helps reduce the stress on not only the elbows but all the joints.
  • Controlling exercise is also an important factor, ensuring that exercise with lots of concussive forces, such as jumping for a frisbee are kept to a minimum. Controlled leash walks and swimming are examples of low impact exercise. Hydrotherapy (controlled swimming exercises) works the muscles without putting extra strain on the joints and is also beneficial in controlling the weight.  
    A veterinary prescription diet for the management of the joint disease or joint supplements has also been found to be beneficial. Omega-3s, chondroitin and glucosamine which are substances which feed the cartilage all help nourish the joint and can slow the progression of arthritis.
  • Medications such as anti-inflammatories and other pain medications may be required daily to control pain and inflammation, but other cases only require them occasionally.

Take home message

Elbow dysplasia is most common in large and giant breed dogs but can occur in any breed of dog. There does appear to be a genetic component to elbow dysplasia and breeds such as Labradors, Golden Retrievers, Rottweilers and German Shepherds have been overrepresented. It is possible to have elbows graded and scored and it is advisable that dogs showing signs of elbow dysplasia are not bred with. This is done by X-ray under general anaesthesia after which the X-rays are sent to a specialist radiologist vet who does the analysis and scoring. Elbow dysplasia can be managed both medically and surgically, but it depends on the symptoms and syndrome present. A lot of dogs will be able to function very well however the long-term prognosis is guarded as most if not all of them will succumb to degenerative joint disease and arthritis in the affected joints.

© 2018 Vetwebsites – The Code Company Trading (Pty.) Ltd.