Heartworm disease - 03/27/2018
Spring is finally upon us, so it is again time to refresh our understanding of Heartworm Disease (HWD). As the name implies, HWD affects the heart. It is caused by an infection with a parasite called Dirofilaria immitis, which is passed between animals by mosquitoes.
What happens is mosquitoes will feed on an infected animal (typically a dog, but also coyotes, foxes, and cats); where they will pick up younger stages of the parasite called microfilaria. Over the course of 2 weeks, these microfilaria will grow into young larval stages of the parasite, then the mosquito will feed on your pet and transfer these young stages into your pet. During the next 6-7 months, these larva travel throughout the body growing into adult worms, which ultimately reside in the right side of the heart (pulmonary artery). Here, the adult worms will mate and produce more microfilaria, completing the life cycle.
The worms in the heart cause problems by blocking the flow of blood through the vessels and by causing inflammation in the lungs when the body tries to clear the infection. The infection can range from just a couple worms, which may not cause any clinical signs, to hundreds of worms, which prevent proper blood flow causing weakness, coughing, and difficulty breathing.
The best way to combat the disease is to prevent the infection in the first place. There are two main ways of doing this: limiting exposure to mosquitoes and using heartworm prevention medications.
Most species of mosquitoes are most active during the dusk hours, so limiting your dog from going outside during these times can help. Also, there are topical products that can be applied to your dog’s skin that help repel mosquitoes (Vectra, Advantix), as well as environmental treatments and clean up (prevent standing water) that can be performed.
There are also many HWD prevention products. The range from oral medications (Heartgard, Trifexis) to topical medications (Revolution, Advantage Multi) to injectable medications (ProHeart). Most of the products are administered or applied monthly and work by killing the larval stage of the worm before it can grow up into an adult. Although there have been reports of lack of efficiency in many products, by-and-large these products are very effective. It is important to follow the label accordingly when giving these medications (with or without food, no bath before applying topical meds, etc) in order to make them the most effective.
It is also recommended to test your dog for HWD yearly. There are many bench-side tests that can be performed on a blood sample to check whether your pet is heartworm free. Even if your pet is on continual heartworm prevention, it is recommended to screen them for infections since, even though rare, there have been reports of lack of effectiveness. Some companies will help pay for heartworm treatment if your pet becomes infected while using their product.
If your pet does somehow become infected with heartworm disease, there is still a treatment available to clear the infection. Most veterinarians will recommended treating with an injectable medication called Melarsomine. A series of 3 injections are typically performed over the course of a month. There can be serious complications associated with treatment, so it is important to prevent the disease if possible.
Dental Health in Pets - 01/18/2018
Periodontal disease is the most common disease in dogs and cats. Since most pet’s teeth do not get brushed daily, plaque can accumulate quickly on the teeth. Plaque contains bacteria, which can make its way under the gums and down the root of the tooth leading to periodontal disease. Toxins released by bacteria cause destruction of the gums and bone surrounding the teeth which leads to oral pain, loose teeth, and bad breath. In early stages (red, puffy gums) the affected teeth may be saved, but later stages of periodontitis can lead to extraction of teeth.
Clinical signs of periodontitis:
- Bad breath
- Oral pain
- Poor appetite / Dropping food
The best way to prevent dental disease is routine dental care at home. Just like with people, brushing your pet’s teeth is the best way to prevent plaque accumulation. It can take some time training your pet to be comfortable with brushing his/her teeth. If your pet is resistant to tooth brushing, start by rubbing around the muzzle and face while rewarding with treats and praise. After a few days, move on to lifting the lip and rubbing the teeth with a soft rag; again, while rewarding with treats. Once your pet is comfortable with this, then you can move on to using a tooth brush with an enzymatic tooth paste. Brush the teeth in a circular motion focusing on the upper canine teeth and upper cheek teeth.
If your pet isn’t amenable to having their teeth brushed, then you can consider specialized treats or water additives that are designed to reduce plaque. The Veterinary Oral Health Council has a list of treats at their website www.vohc.org
that can be used to combat dental disease
In-Clinic Dental Cleaning
Even with the best of care at home, most pets need a periodic cleaning in the clinic. Dental cleanings for pets are similar to when humans go to the dentist. One of the main differences, though, is that pets must be anesthetized to perform the cleaning. This not only keeps the pet safe and allows a thorough cleaning, but also keeps the staff safe from a possible bite wound.
The teeth are first cleared of calculus and plaque using a scaler (typically an ultrasonic scaler). Then, the teeth are probed along their gum surface to look for any large gingival pockets, which indicates periodontal disease. Dental x-rays may be performed as well. If any teeth are unhealthy, then these teeth are treated appropriately or if the tooth is too far gone, it is extracted. The teeth are then polished and fluoride or a sealant is applied to the teeth.
Depending on the amount of home care performed, pets may need in-clinic cleanings every 6 month to 2 years.
February is National Pet Dental Health Month, so in response we are offering 10% off dental cleaning in our clinics.
Cruciate disease - 11/27/2017
What is the cruciate ligament?
Like people, dog's have cruciate ligaments. These are ligaments in the knee that prevent the thigh and skin bone from moving forward and backward independently of one another. The one that causes particular problems in the dog is the cranial cruciate ligament. This ligament spans from the back of the femur (thigh bone) to the front of the tibia (skin bone).
Unlike with people where most cruciate injuries occur during activity (sports in particular), dogs tend to tear their ligament due to chronic, degeneration of the ligament which leads to weakness. When dogs do tear their ligament, an owner could notice signs ranging from a subtle lameness to holding the hind-limb up completely.How is a cruciate tear diagnosed?
In most cases, a cruciate tear can be diagnosed with a thorough orthopedic exam of the knee. In particular, a veterinarian is looking for either the "drawer" sign or tibial thrust.
|Drawer is when the tibia (shin) can be moved forward independently of the femur (thigh)|
|Thrust is when the ankle is flexed, which then moves the tibia forward|
If a pet is particularly anxious, he/she may need to be sedated to fully evaluate the knee. X-rays of the knee may also be performed, which can show swelling of the knee consistent with injury. It is rare to perform an MRI to confirm a cruciate tear as many tears can be diagnosed with just the physical exam.The ligament is torn, what now?
If the ligament is torn, then surgery to explore the joint and then stabalize the knee should be considered. Exploration:
Exploration of the knee joint can be done is one of two ways. The first, less invasive way to explore the knee is through arthroscopy (camera in the knee). Small incisions are made into the knee joint to allow for a camera and instruments to be inserted. Once inside, the ligaments and meniscus can be evaluated. If the cruciate ligament is torn, the remnants of the ligament are typically removed, as they can be a source of inflammation. The meniscus (cartilage in the knee) is also evaluated because many times a meniscal tear is also found with cruciate tears. If torn, that section of the menincus may be removed or a release of the meniscus is performed. The benefits of arthroscopy are that it is less invasive than tradition arthrotomy (opening the knee joint completely) and the camera allows for magnification of the ligaments. The cons are that not everyone has the equipment to perform this and it adds cost to the procedure.
The other way to explore the knee is to open the joint with a scapel, which is called arthrotomy. Prior to arthroscopy cameras being available, this was the traditional way to evaluate the knee. Since a larger incision is needed, it is more invasive. Similar to athroscopy, the ligaments are evaluated, remnants are removed, and the meniscus is evaluated. The con of this procedure is it is more invasive, however, no special equipment is needed for it.Stabilization:
Once the joint has been explored and the ligament is confirmed as torn, the knee must then be stabilized. Unlike with people where the cruciate ligament is reconstructed using a tendon, in dogs veterinarians stabilize the knee in a different way. The two most common procedures are either the lateral stabilization technique or the TPLO surgery. There is a lot of information about these procedures at other websites, but this one from Colorado State
does a good job of explaining things.
In some situations surgery may not be an option for a pet, whether it be due to financial restrictions or due to other health problems with the pet. In these situations, the knee will start to develop arthritis which then can be managed in other ways
Reuniting with a Lost Pet - 10/19/2017
We see it a lot at our clinic: A family comes in with a picture of their lost pet and wants us to put up a flier trying to reunite them with their beloved animal. We are happy to oblige, but unfortunately, many times the owner isn't able to recover their animal. What can be done to increase the chances of finding their pet? One word: MICROCHIP.
Microchipping pets has been around for a couple of decades, but is becoming more common in each passing year. There are a number of companies that produce microchips, which is good and bad. It is good as it gives many options and can keep costs low due to competition, but bad as not all companies use similar frequencies for their chips, so not every scanner will pick up every microchip.
The good news is that there are now scanners that pick up multiple frequencies of chips, so hopefully won't miss a pet who is microchipped.
How do the microchips work?
The chips are about the size of a grain of rice and are implanted under the skin using a needle. Once implanted, the body will produce scar tissue around the chip that holds it in place.
The chips use RFID technology (radio-frequency), so do not require an internal battery source. They are powered by the scanner when it is slide a few inches over the chip. The chip is encoded with a unique number, which the scanner picks up and then can be matched to the owners information. Using the website http://www.petmicrochiplookup.org/
the number is matched to the microchip company and then the company can be contacted to recover the the owner's information.
The most important thing besides microchipping your pet is making sure that your information is registered to the microchip number and up to date. If the pet owners information isn't linked to the number encoded in the chip, then the microchip is worthless. At our clinic, we register the owner's information for them to ensure that this step isn't forgotten.
We use HomeAgain (www.homeagain.com
/) microchips at our clinic. We typically try to implant them during a pet's spay or neuter, since the pet is asleep and won't feel the needle used during implantation. However, we can also implant the chip when pets are awake, using treats to distract them while the injection takes place.
Once registered, the number is in the system for the life of the pet. There is no additional charge unless your information changes. Home Again does offer an annual renewal, which gives access to additional resources including producing fliers if your pet is lost, access to a poison control hotline, and help with transportation back home if your pet is found more than 500 miles away.
Bottom line is that a microchip will give you your best chance at finding your pet if it is lost.
Spring Is Here, and It’s Time To Prepare For Heartworm Season
Spring has arrived! The temperatures are rising, the sun is shining, and the mosquitos and ticks have already been spotted hanging around our four-legged friends. You know what that means… time to get your dog tested for Heartworm Disease if their test is not current and get them on their monthly preventative if they are not on a year round prevention plan! The Heartworm test is a core part of your canine’s annual wellness examination. Heartworm testing is important for the following reasons: 1. The Heartworm preventative we recommend giving your dog on a monthly basis is most safely administered after we know your dog is negative for heartworm.
2. If you have your dog tested once a year for Heartworm disease and give them monthly Heartworm preventive purchased from our clinics and your dog STILL gets Heartworm disease, the company that manufacturers the preventative guarantees their product’s efficacy and will cover the very high cost of treatment.
3. We run our Heartworm tests in the clinic, it requires just a few drops of blood, and just about 10 minutes to give us a result for your dog.