Conjunctivitis

Conjunctivitis
By Dr. Karen Burgess

What is conjunctival tissue?
The conjunctiva is the pink fleshy tissue that covers the eye and tissue surrounding it.  In a cat or dog with healthy eyes this conjunctiva should not be easily seen.  In cases of conjunctivitis where the conjunctiva is inflamed owners will often notice angry red tissue near the eyelid.  The conjunctiva is made up of mucous secreting cells similar to that found in the mouth and nose and serves to help protect and lubricate the eye.

What are symptoms of conjunctivitis?
Mild cases of conjunctivitis may appear as increased tearing that is clear or colored in nature.  More severe cases can develop swollen pink or red bulging tissue that appears to almost cover the eyeball.  The eye may become increasingly painful causing a pet to hold it shut or paw/rub at eye.  In severe cases it may be difficult to see any part of the normal eye.

Why do cats and dogs develop conjunctivitis?
There are numerous reasons for the conjunctiva to become inflamed.  Infectious causes include viruses and/or bacteria.  In some cases infections will develop secondary to some other underlying cause of conjunctival inflammation.  For cats viral conjunctivitis is extremely common and closely related to upper respiratory viral infections they are exposed to at a very young age.  In several of these situations the cat may recover from the initial infection but the virus remains dormant in their body reappearing later in life at times of stress or illness.  Non-infectious causes of conjunctivitis are typically related to the anatomy (size, shape, and location) of the eyeball itself.  Dogs often develop a condition where they stop producing tears which then leads to a “dry eye” and secondary conjunctivitis.  Some breeds of cats and dogs are more prone to having flat faces or bulging eyes which can change how the eyelid sits against the eye.  In these cases eyelashes or facial fur may rub against the eye and conjunctiva causing inflammation.  Allergic disease, foreign material caught in the eye, tumors, and immune disease are all additional causes of conjunctivitis.

How is conjunctivitis diagnosed?
A veterinary examination will typically reveal the presence of conjunctivitis.  Additional testing of the cornea and tear production may also be necessary.  If systemic disease is suspected bloodwork may be recommended.  In complicated cases referral to an ophthalmologist may be recommended.

What are treatment options for conjunctivitis?
Definitive treatment of conjunctivitis involves diagnosing the underlying cause for treatment and controlling secondary bacterial infections.  This may involve topical drops or ointment, oral medications, eye lubricants, or surgery.  It is important to protect the eye from self-trauma by using a protective collar or Elizabethean collar.  Pain medication may also be prescribed to help with associated discomfort.

What is the prognosis with conjunctivitis?
Prognosis is directly related to the ability to treat the underlying condition causing the inflammation.

Cats 411

Cat 411
By Karen Burgess, DVM 

What should be considered before getting a cat?
The introduction of any pet should first be discussed with all family members or potential human housemates.  Cats are a long-term commitment living up to twenty years. If unsure, ensure that no family members have an allergy to cats (typically to their saliva or dander).  If uncertain or unfamiliar with cats in general, it is a good idea to first visit and interact with cats in an animal shelter type setting.

What should I look for in a cat?
Ideally one would have the chance to spend at least an hour observing a prospective cat’s behavior.  Ensure that they are willing to be handled by humans and seem comfortable with all family members.  Cats that have been handled by people from a young age and raised by a mother cat tend to be better options (bottle raised kittens may have more issues with behavior in the future).   Observe for any signs of a respiratory infection (sneezing, nasal discharge), has solid stools, uses the litterbox, and has a good overall appetite.

What do I need to own a cat?
It is best to have the following supplies before bringing your new cat home.

  • Cat carrier, some shelters may provide a cardboard variety, plastic versions are typically more convenient and durable and are often available second hand at garage sales etc.
  • Litterbox, purchase the biggest available (even consider a concrete mixing container from Home Depot, often more affordable and larger than real litterboxes), avoid uncovered versions
  • Litter and scooper, clumping, non-scented preferable, commercial scoopers are typically most durable
  • Water and food bowls, separated
  • Cat food, try and find out what your new kitty is already eating and obtain a small amount of this to start with, having some additional cans of tasty cat food may also serve as a nice treat
  • Scratching post, horizontal and vertical, many types available, taller the better as cats typically want to scratch while in a full stretch, ask Healthy Paws for additional recommendations on scratching in general
  • Cat toys, various types available, favorites tend to be wand toys, balls, food dispensing balls, catnip products
  • Cat bed, covered often preferred
  • Cat hair brush and nail clippers for grooming
  • Cat collar, breakaway type (one that if a cat jumps and is caught by the collar will break away thus preventing choking), bell can be helpful in keeping track or your new friend

Where should my new cat stay?
In the beginning it is best to have a small room (laundry room, bathroom as example) set up as the cat room.  Put food, water, litterbox, bedding, scratching post, and toys in this room and use it as a home base.  Fill the litterbox with 2 inches minimum of litter and place food and water bowls as far away from the litter as possible.  Cats like hiding spots.  Keeping a carrier, covered cat bed, or even a box with one open side in the room may provide added security.  Use of the scratching post can be encouraged by sprinkling it with catnip or hanging a toy from the top.  As your cat and you feel more comfortable, gradually allow more access to other areas of the house.

Do I need to cat-proof my home?
Cats by nature are inquisitive animals often preferring vertical surfaces to allow a better view the lay of the land.  Small areas are also favorite hiding places for cats.  Take a look around the house before introducing your new cat to look for any potential areas that might require blocking off.  Look at all surfaces, including tops of cabinets/higher surfaces to ensure nothing will be harmed if your cat starts exploring.  Some common safety concerns for cats include…

  • Recliners
  • Washers and dryers/piles of laundry that unwittingly contain a sleeping cat
  • Doors left open to the outside
  • String, yarn, rubberbands, and hairties that may be ingested causing life-threating intestinal blockage
  • Trash cans that do not contain lids
  • Dangling electrical or window blind cords
  • Breakable objects that may fall during cat exploration (look for museum or earthquake wax to secure objects)
  • Household plants
  • Fireplaces, ensure have a screen
  • Boxes that are unintentionally thrown out with a cat inside
  • Burning candles
  • Closed closets or drawers that a cat may have hidden in

What about the first day at home?
Once home, take your new cat into their special room in their carrier.  Close the door, get situated sitting on the floor, open the carrier door, and wait patiently kitty decides how they want to explore.  Some cats will come bounding out and be excited about their new surroundings, others may hide for hours in the crate only coming out to explore when left completely alone.  Be patient, even shy cats can make wonderful pets; they just may require a bit more time to adjust.

When should the first veterinary visit be?
New cats should have a complete examination by a veterinarian within a week of coming home to ensure their overall health.

What are some good general cat resources?

tips

 

Labwork, Urine Testing

Urine Testing
By Dr. Karen Burgess 

What is a urinalysis?
A complete urinalysis is made up of chemical (commonly called a dipstick) and microscopic or sediment examination.  The dipstick portion looks for the presence of red and white blood cells, glucose, ketones, protein and bilirubin in the urine.  It also quantifies the concentration and acidity of the urine.  The sediment portion of a urinalysis involves physically looking at a sample under the microscope in search of red blood cells, white blood cells, crystals, bacteria, and abnormal kidney or bladder cells.  The urine is one of the first ways that kidney disease can be identified in pets.  If a bacterial infection is suspected a culture and sensitivity (C&S) may also be performed to identify specific bacteria and the appropriate antibiotic choice for treatment.

Labwork, Blood Chemistry

Blood Chemistry
By Dr. Karen Burgess

chem

What is blood chemistry testing?
Blood chemistry testing uses the serum or non-red blood cell portion of blood to evaluate how a variety or organs and systems work in the body.  Often a variety of tests are combined to form a profile that is specific for a pet’s age or medical situation.

What tests are commonly performed in a blood chemistry profile?

  • Glucose-often also referred to as blood sugar, glucose provides energy to all of the body including the kidneys, brain, and muscles. Low blood sugar can cause seizures or collapse while persistent elevations of blood sugar may be indicative of diabetes.
  • Kidney testing-the kidneys are responsible for filtering the blood and regulating sodium (salt) and water concentrations in the body. Ultimately the kidneys produce urine.   BUN (blood urea nitrogen) and creatinine are waste products that are filtered by the kidneys and elevations can occur with kidney disease or dehydration.  A sample of the urine is necessary to fully evaluate kidney function.  Electrolyte values are also often performed and further help determine kidney function.
  • Liver testing-the liver serves many functions in the body including waste removal and nutrient breakdown. ALT (alanine aminotransferase) is a direct measurement of liver cell damage.  This value goes up and down very quickly allowing real time evaluation of damage to the liver.  ALP (Alkaline phosphatase) is a less specific test and can be elevated with liver disease, stress, or secondary to hormonal diseases.  GGT, AST, and bilirubin are all additional tests of liver function.
  • Protein values-the body requires protein as building blocks and in fighting off disease. Albumin, globulin, and total protein are all measures of protein in the body.   Low values of albumin in particular can lead to life threatening fluid accumulation in the body.
  • ElectrolytesNa (sodium), K (potassium), Cl (chloride), TCO2, and anion gap are all related to electrolyte balance. The body keeps electrolyte values in very narrow ranges.  Abnormally high or low levels can lead to collapse, heart failure, or other signs of disease.
  • MineralsCa (calcium) and Phos (phosphorous) are minerals that are tightly controlled in the body. Elevation in calcium can be associated with cancer and elevations of phosphorous with kidney disease.
  • Thyroid testing-thyroid hormone impacts the metabolism of a pet. Elevations, commonly seen in cats, can lead to heart disease, weight loss, and eventually death.  Abnormally low levels, more common in dogs, can cause abnormal weight gain, behavior changes, and skin disease.

Labwork, Complete Blood Count

Complete Blood Count
By Dr. Karen Burgess

 

What is a CBC (complete blood count)?
A CBC quantifies the number of red and white blood cells and platelets a pet has.  It also describes the cells qualities including how they physically look (ex. too small, too large)

What are red blood cells and what tests are done on them?
Red blood cells make up almost half of the blood’s volume.  They give blood its red color and contain hemoglobin which is responsible for carrying oxygen from the lungs to all of the cells in the body.  Common tests performed include:

  • RBC (red blood cell count), HCT (hematocrit), Hgb (hemoglobin)-measures red blood cell mass and quantity. A decrease in these counts would be suggestive anemia, a potentially serious medical problem.
  • MCV, MCH, MCHC, RDW-measurement of red blood cell size. The size of the red blood cells can give clues about specific disease processes.
  • Retic-quantification of reticulocytes or immature red blood cells. Helps determine whether the bone marrow is working properly.

What are white blood cells and what tests are done on them?
There are five types of white blood cells.  These cells respond to bacteria, viruses, and foreign material in the body.  White blood cell types include:

  • Neutrophils-most common white blood cell, typically fight bacterial infections. Can also be elevated with stress.
  • Lymphocytes-components of immune system
  • Monocytes-are involved with damaged tissue typically
  • Eosinophils-often involved with parasitic and allergic disease
  • Basophils-also related to parasitic and allergic disease, uncommon.

What are platelets and what tests are done on them?
Platelets are the body’s first line of defense in the body’s clotting process.   Low platelet counts can be indicative of potentially life threatening bleeding problems in a pet.

Labwork, FAQ

FAQ’s About Laboratory Work
By Dr. Karen Burgess

Why should laboratory work be performed on a pet?
There are many reasons to perform testing on a pet, some of the more common include:

  • As part of a wellness examination-our goal with annual labwork is to prove that a pet is healthy and not find abnormalities. The idea is to establish a baseline so that if and when a problem develops there is a “normal” reference point to refer back to.  This becomes increasingly important with age, thus why it is recommended that senior pets have labwork done twice a year.  In some situations a pet may seem healthy and an unknown medical condition may be identified thus allowing earlier intervention and possibly a better prognosis.
  • With illness-labwork allows further evaluation of the sick pet in an effort to further isolate the problem, assist with treatment, and provide prognosis.
  • Prior to anesthesia-the key to safe anesthesia is to plan ahead. A key component of this is preanesthetic labwork which helps to determine safe drug and dose selection.

How are labwork samples obtained?
Bloodwork is performed on a blood sample.  This sample is drawn from a neck or leg vein using a syringe and needle.  Urine is either collected in a clean container while a pet is naturally voiding or while being restrained using a syringe and needle.

Where are blood tests performed?
Bloodwork can be done either by an automated analyzer in the hospital providing results within the hour or at a commercial laboratory yielding results within a day or so.  Urine evaluation is done by automated analyzers and under the microscope visually.   Some samples are also evaluated by trained personnel under the microscope.

Canine Influenza – Update

Update- Dr. Burgess on Canine Influenza
in the Crystal Lake, Algonquin and Lake in the Hills area

This week new information has become available concerning the current Influenza outbreak.  Cases of this upper respiratory infection (symptoms may include fever, lethargy, cough, nasal discharge, pneumonia) have been reported now in various locations outside of the city.  The strain of Influenza causing most of these cases has not been previously diagnosed in the United States which is making testing and treatment more complicated.  The current Influenza vaccination may not have any efficacy against this new Asian strain.  This Influenza virus while not contagious to humans is highly contagious to dogs and possibly cats (no reported cases as of yet) staying alive on surfaces for forty eight hours, clothing for twenty four hours, and hands for twelve hours.  Current recommendations include:

  1. Be aware that any exposure to any other dog that is infected may put your pet at risk.  Dogs are able to spread the infection several days prior to showing any symptoms.
  2. If planning to board, use doggie daycare, visit a dog park, participate in group dog classes, or attend dog events, be aware that your pet may be at greater risk for contracting this infection.
  3. Contemplate vaccination for Canine Influenza.  While the currently available vaccine may not prevent this strain, it does still prevent the original strain which has also been found in some affected Chicago pets.  Bottom line is we just do not know enough yet about this new strain, but vaccination for Bordetella and Influenza is what we have available at this point in time.
  4. Avoiding exposure is the number one preventative.

Below is the American Veterinary Medical Associations thoughts on Canine Influenza:

https://www.avma.org/KB/Resources/Reference/Pages/Canine-Influenza-Backgrounder.aspx

Canine Influenza

 Canine Influenza
By Dr. Karen Burgess

  

What is Canine Influenza?
Canine Influenza is a virus that primarily affects a dog’s respiratory system causing a cough, fever, and in some cases pneumonia.  The infection is often difficult to differentiate from other more common causes of respiratory disease in dogs (i.e. kennel cough).

How common is Canine Influenza diagnosed?
First diagnosed at Greyhound racetracks in 2004, Influenza has subsequently been diagnosed sporadically in pockets throughout the United States.  The occurrence is much less frequent in nature than other causes of “kennel cough” or infectious respiratory disease.  In spring 2015 there was an increase in respiratory disease seen in downtown Chicago; several of these cases tested positive for Canine Influenza.  It is important to remember that while the broadcast news may report “thousands affected” this has not been confirmed and many of these cases may in fact be from other more common causes of kennel cough.

How is Canine Influenza spread?
The virus is spread in respiratory secretions that have been aerosolized or landed on objects that another dog then comes in contact with.  Canine Influenza is highly infectious with 80% of exposed dogs developing some form of infection.  The 20% that do not become infected can however still spread the disease.  Group dog situations (daycare, boarding, dog classes, dog parks, veterinary hospitals) are more apt to encourage the spread of the disease.  Objects used with or by infected dogs (bowls, grooming utensils, leashes) can also spread infection.

What are the symptoms of Canine Influenza?
Most dogs infected with Canine Influenza develop minimal signs of a persistent cough lasting for two to three weeks.  Nasal discharge, loss of appetite, fever, breathing difficulties, and pneumonia may develop in more severely affected patients.  It is thought that the very young and very old are more susceptible.  In rare cases, infection and its subsequent complications may be fatal.  Any pet that develops signs of an upper respiratory infection that has been recently exposed to other dogs in particular in an area where an outbreak is or has occurred would be considered at higher risk for infection.

How is Canine Influenza treated?
For most dogs, at home care with possible antibiotics and cough suppressants is sufficient.  For more severely affected patients, hospitalization for fluid therapy, injectable antibiotics, and oxygen therapy may be necessary.

How is Canine Influenza exposure prevented?
The most reliable prevention is not having exposure to other dogs during an outbreak.  Avoiding group dog situations for several weeks until the risk has passed or vaccination is performed would be recommended.  It is important to remember that even with vaccination disease will likely not be 100% prevented.  From a hygiene standpoint, Canine Influenza stays alive on surfaces for forty eight hours, clothing for twenty four hours, and hands for twelve hours.  Cleaning with standard disinfectants such as dilute bleach kills the virus.  Dogs that have been exposed to the virus can shed or pass the virus on for two weeks after exposure.  More importantly, dogs will shed the virus most in the days prior to showing clinical signs.  This emphasized the importance of limiting exposure to other dogs if Canine Influenza has been identified in a region.

What about vaccination?
While there is a vaccine for Canine Influenza, it requires two injections and protection is not provided for two weeks minimum after the second dose is administered.  This means if the first vaccination is given today, a pet would not be protected for at least four weeks.  The vaccine does not 100% prevent disease or the spread of disease.  Considered a non-core vaccination (meaning only recommended for at risk dogs), Canine Influenza has not been a vaccine routinely given in this area.  With this recent outbreak vaccination of dogs frequently exposed to other dogs may be recommended.  In a large degree, this will depend on the extent the disease spreads and the duration of the outbreak.   Healthy Paws Animal Hospital is in the process of obtaining the vaccination for owners that are interested.  There are no major side effects associated with vaccination.

Adequan

Adequan
By Dr. Karen Burgess

 

What are symptoms of arthritis in pets?

“Slowing down”, fatigue, difficulty rising, reluctance to go up and down stairs or jump, abnormal aggression, and lagging behind on normal length walks may all be signs of joint pain and/or arthritis.

What is Adequan?

Adequan is an injectable polysulfatated glycosaminoglycan (PSGAG or GAG). In common terms, it is an injectable medication that when given regularly, acts as a lubricant and inhibitor of proteins that damage joint cartilage. Adequan provides the joints with chondroitin, a GAG that helps with compression in the joint. It also allows for production of collagen which helps create building blocks to make new cartilage. In summary, Adequan protects and helps rebuild joints slowing down the development of osteoarthritis

How is Adequan given?

Adequan is given as an injection either in the muscle or under the skin (subcutaneously). The dose is tapered down from twice weekly initially, to once monthly. These shots are typically not painful and relatively easy for owners to administer at home with some instruction. It is important to understand the annual cost of Adequan is significantly less than the initial four months due to this tapering dose.

What benefits are seen with Adequan usage?  What are the potential risks?

Adequan is a chronic joint pain supportive medication. Pets that benefit from Adequan typically show increased mobility, decreased pain, and overall improvement in arthritis symptoms. This improvement can take several weeks to appreciate. In cats, Adequan is one of the safest available arthritis management tools available. Very rarely, pets are sore at the site of injection for a short period after administration. This is much less likely with subcutaneous injection.

 

Heart Failure

Heart Failure
By Dr. Karen Burgess

What does heart failure mean?
The heart is a muscular organ that contains four separate blood holding chambers.  The heart muscle functions to push or pump blood held in these chambers through the body’s blood vessels.  When the heart is unable to push blood forward at a rate that keeps up with the body’s demand it is considered heart failure.  Heart failure typically leads to fluid backing up into the lungs.

What causes heart failure?
There are a variety of diseases that can lead to heart failure.  Pets with a heart murmur, or leaky heart valve account for 80% of heart failure cases in dogs.   In some cases the heart muscle is abnormal, either too thick or too thin.  Lung disease can also put added stress on heart muscle.

What is the significance of heart failure?
Heart failure can be chronic disease with symptoms waxing and waning or acute in nature leading to sudden death.  When blood flow to the body is affected energy level, organ function, and the ability to breathe can all be affected.  Owners may also notice an enlarged belly (from fluid buildup), gums that are blue or paler than usual, and weight loss.

What are symptoms of heart failure?
Pets experiencing heart failure are often first seen for coughing, in particular after exertion of first thing in the morning.  Other signs include exercise intolerance, reluctance to go for walks, and change in sleep pattern or position.

What tests are indicated if heart failure is suspected?
If a pet is experiencing collapse or severe breathing issue from heart failure it may be life-threatening within minutes to hours and immediate medical attention is necessary.   Hospitalization and oxygen support along with medications may be required in these situations.  Radiographs (x-rays) are often used to evaluate for heart failure which will often produce an enlarged heart shape of evidence of fluid buildup in the lungs.  Blood pressure, EKG evaluation, and blood tests are often recommended to further evaluate the impact of heart failure on the rest of the body.  Ultimately an echocardiogram (ultrasound of the heart) allows a veterinarian to understand the specific disease affecting the heart.

What is involved with treatment for heart failure?
Often pets with heart failure are able to be managed with oral medications for some time period after diagnosis allowing them to live a relatively normal quality of life.   It is helpful in managing heart failure patients to monitor their breathing rate while sleeping; changes in this number may indicate that a pet is having more troubles related to their heart function.

Is heart failure the same as a heart attack?
Heart attacks are common in humans and occur when blood flow to the heart muscle is interrupted thus leading to death of the heart muscle known as a myocardial infarct.  This is not a common cause of death or heart disease in cats and dogs.