Category Archives: Sick

Colitis, Canine

Large Bowel Diarrhea (Colitis)
By Dr. Karen Burgess

Your pet has clinical signs of large-bowel (colon) disease.  Signs typically include soft stools with or without mucous or fresh blood, increased urgency to defecate, and straining to defecate (small amounts of stool in numerous locations).  There are many ways to treat colitis and what might work for one pet may not work for another.  While the goal is to cure the problem, in many cases the underlying cause cannot be completely resolved and control of symptoms becomes our goal.

Diet
There are three different approaches to controlling colitis; low residue, novel antigen/hydrolyzed protein and high fiber diets.  Typically we will start with one of these three products and evaluate for response.  If improvement is not noted after a period of time, another approach may be recommended.  A commercially made prescription version of these diets is recommended as these are made under controlled conditions which ensure reliability.  While feeding any of these diets, it is very important that no other food or treat be given unless specifically approved by your veterinarian.

  • Low-Residue diets are made of highly digestible ingredients therefore leaving less material for the colon to deal with.
  • Novel antigen diets are made with a new protein and carbohydrate source that a pet has not been exposed to previously. Hydrolyzed protein diets contain nutrients that have been reduced to a size that is not recognized by the immune system.  Both of these diets are used to help rule out symptoms that may be related to a specific component of the diet (food sensitivity or food allergy).  These diets usually need to be fed for a minimum of 8 weeks to evaluate for response.  It is extremely important that now other food items pass your pet’s lips during this trial period.
  • High fiber diets bulk up the stool thus enhancing gut mobility and improve cellular health.  Metamucil and canned pumpkin are other options to help bulk up a diet.

Intestinal deworming
An intestinal parasite exam is performed on a fecal sample to help identify parasite issues.  In some cases, eggs may be transiently passed or not detected on a single sample.  For this reason a prophylactic broad spectrum deworming is often administered to ensure that parasites are not a contributing factor in cases of colitis.

Medications
There are several different medications that may be used in conjunction with diet.

Antibiotics

  • The bacteria in the colon can become imbalanced and contribute to signs of colitis.  Metronidazole and Tylan are common antibiotics used in the management of colitis in the short and sometimes even long run.  In addition to assisting with bacterial loads, these medications also have anti-inflammatory and immune-modulating effects that can also help the gut.

Steroids

  • Steroids suppress inflammation and at high doses are immunosuppressant.  While very beneficial when indicated, steroids have numerous known side effects and should ideally only be used in diagnosed cases of steroid responsive diseases (ex. Inflammatory Bowel Disease).  Once steroids have been started they can alter future diagnostic test results or hinder response to other treatments (in the case of cancer).

Anti-inflammatory drugs

  • Anti-inflammatory drugs that target the gut are typically well tolerated and have somewhat lower risk of negative side effects.

Probiotics

  • While not 100% proven to help with gastrointestinal disease, there have been promising results with the use of probiotics that provide pet’s with a dose of “good” bacteria in an effort to normalize their intestinal flora.  With no real side effects, this nutraceutical should be purchased only from your veterinarian to ensure quality of the product.

Constipation

Constipation
By Dr. Karen Burgess

What is constipation?
Constipated animals experience infrequent or difficult defecation with stools being unusually hard or dry.  Some pets with constipation may appear to have diarrhea.  In actuality it is merely fecal liquid that is escaping around the fecal obstruction.  In severe cases of constipation pets may experience loss of appetite, lethargy, abdominal discomfort, and vomiting.  Ultimately sepsis or infection of the blood can develop and create a life threatening situation.

What are potential causes of constipation?

  • Dietery related (insufficient fiber intake, ingestion of abnormal substances such as hair, bones, foreign material, lack of water consumption)
  • Environmental related (changes in daily routine, hospital stay, moving, change in litterbox, dirty litterbox, lack of exercise)
  • Medical related (aging or debilitation, masses or lesions involving the rectum or anus, spinal disease, numerous other metabolic, hormonal, or systemic diseases)
  • Idiopathic constipation is diagnosed when all other causes are ruled out.

What is involved with treatment for constipation?
If your pet’s constipation is severe, a hospital stay, fluid therapy, enemas, or manual removal of the stool all may be required.  Injectable pain medication and/or sedation are often required as the condition can be quite painful.  In cases of chronic recurrent constipation surgical removal of the large intestine may be indicated.

How are pets with constipation treated at home?
Potential at home constipation treatments (consult with veterinarian prior)

  • High fiber diets (i.e. Hills W/D, Purina OM)-these increase water retention in the intestine which then softens the stool.
  • Brushing long-haired animals frequently to remove excess hair.
  • Maintaining a clean litterbox for cats and exercising dogs 30-60 minutes after eating.
  • Always having fresh water available.
  • Fiber supplementation-All-Bran cereal (Kellog’s, etc)   1-5 TBSP daily with food, canned pumpkin pie filling   1-5 TBSP daily with food, Metamucil, Fiberall   1-5 TBSP daily with food, Laxatone, Kat-A-Lax   1-5 ml by mouth daily
  • DO NOT administer enemas at home to your pet unless specifically directed by your veterinarian.  Some products can be toxic to cats and the wall of the rectum/colon can be unintentionally torn or damaged during improper administration.

 

Vomiting, Feline & Canine

Vomiting in Dogs and Cats
By Dr. Karen Burgess

Vomiting is a symptom of an underlying problem not a disease in itself and should always be cause for concern.   Infections (viral, bacterial, parasites), toxins, inflammation, or disease of the intestinal tract can all lead to vomiting, and while mild cases may resolve without intervention, vomiting accompanied by diarrhea, lethargy or any other behavioral changes should be treated as a medical emergency.

One of the most common causes of vomiting is GI (intestinal) upset from a sudden change in diet, giving an unfamiliar treat, or feeding table scraps. When caused by food changes, vomiting can often be resolved at home as long as it is not severe and the pet continues to act and feel normally. Withholding water for 12 hours and food for 24 hours allows the digestive system to settle down. After 12-18 hours, small amounts (1/4 cup or less) of water can be offered every 1-2 hours.  If vomiting does not recur after 12 hours of water being offered, then small amounts (depending on size of pet a teaspoon up to a ¼ cup) of a bland diet such as white rice and chicken can be offered (see recipe/schedule below) every 1-2 hours. If no further symptoms are noted after being on a bland diet for two days, then regular food can be gradually reintroduced over a three to five day time period.  If vomiting persists in spite of nothing being given orally or recurs, veterinary treatment is recommended.

In order to avoid intestinal upset due to a new diet, changes in food should always take place over several days. For the first three days of a food switch, feed ¼ of the new diet and ¾ of the old food. If your pet is doing well, then feed a half new food and half old food for another three days, then ¼ old food and ¾ new food for another three days. This slow transition will help to minimize intestinal upsets and decrease the incidence of food related vomiting and diarrhea.

Although many pets regularly receive table scraps care must be taken to ensure that these are not too rich for their system. Fatty foods in particular can cause diarrhea, vomiting, and may lead to pancreatitis (a potentially life threatening inflammation of the pancreas). It is also important to remember that pets should NEVER be given turkey, chicken, or rib bones as these can splinter into small pieces and puncture the stomach and intestines.

While the goal of treatment for vomiting is aimed at solving a specific underlying problem many times this is difficult to accomplish.  Supportive or symptomatic care is often what ends up resolving the problem.  If vomiting is present for less than 24 hours and there are no other signs of illness (normal energy level, no diarrhea), a conservative approach of wait and see may be successful. However, if there are any additional signs of distress or lethargy, increasing amounts of vomiting, or diarrhea a visit to the veterinarian is required.

Upon visiting the veterinarian a full history will be obtained including when symptoms began, frequency, volume, and consistency.  It is helpful to bring a fresh stool sample to this visit.  After a comprehensive physical exam, the following tests may be performed:

  • Fecal examination-testing for parasite infections or bacterial overgrowth
  • Blood work– evaluation of a variety of body systems (ex. kidneys, liver, hydration, red and white blood cells) to give a reading of basic health
  • X-rays– radiographs may be recommended to diagnose potential intestinal obstructions or ingested foreign bodies

Treatment of vomiting may involve a bland diet, anti-nausea medication, or antacid therapy; severe cases may require hospitalization and intravenous therapy

Chronic intermittent vomiting (lasting for three or more weeks), while less common, is also reason for a visit to your veterinarian.  Keeping track of vomiting episodes on a calendar can help determine frequency.  If a pet is vomiting more than once weekly, this may be indicative of underlying issues. Chronic vomiting can lead to poor digestion and absorption of nutrients, low energy levels, weight loss, and poor quality hair coat.

Food allergies and intolerances are a common cause of mild chronic vomiting. Similar to lactose intolerance in people, dogs may have or develop allergies or sensitivities to a variety of ingredients in dog food leading to chronic inflammation in the intestinal tract.  Pancreatic diseases, inflammatory bowel disease, and cancer are also causes of chronic vomiting.

Whether chronic or acute, vomiting is almost always a sign of an underlying medical condition that needs to be addressed. Because vomiting in itself has the potential to be life threatening, any dog suffering from more than a short-term bout or showing signs of other medical problems should be seen by a veterinarian. In addition, because young animals are so susceptible to several potentially fatal viruses, the presence of vomiting in any puppy or kitten should be treated as a medical emergency until proven otherwise.

Bland diet recipes-8 ounces cooked white rice (baby rice cereal for cats), 4 ounces single protein source (ex. boiled beef, boiled chicken, low fat cottage cheese).  Can boil together, use lean meat, 1# food mixture daily for a 30# dog.

 

Sample bland diet schedule

 

Food type

Volume

     Frequency  (adjust volume for size of dog)

Day 1 No food No food No food
Day 2 Bland 1/2 of normal caloric intake 6-8 small feedings (ex. 1/4 cup every 2-3 hours)
Day 3 Bland 3/4 of normal caloric intake 4-6 small feedings (ex. 1/2 cup every 4 hours)
Day 4 Bland Full caloric intake 4 feedings (ex. 3/4 cup every 6 hours)
Day 5 75% bland, 25% regular dog food 75% bland:25% regular food 2-4 feedings
Day 6 50% bland, 25% regular dog food 50%:50% 2-4 feedings
Day 7 25% bland, 75% regular dog food 75%:25% 2 feedings
Day 8 Regular dog food Regular amount Regular interval

 

Cherry Eye, Canine

 Conjunctivitis (Cherry Eye)
By Dr. Karen Burgess

What is a “cherry eye” technically?
A cherry eye or “haw” as it is often called occurs when a dog’s third eyelid gland prolapses or pops out.  The third eyelid is the pink fleshy tissue seen toward the middle of the lower eyelid.  Instead of moving up and down like upper and lower eyelids, the third eyelid moves from side to side, or from nose to ear.  The third eyelid serves as an extra layer of protection for the eye.  The gland of the third eyelid that is affected by cherry eye produces an important portion of the eye’s protective tear film.

Why do dogs develop cherry eye?
The third eyelid gland is normally firmly attached to the lower portion of the eye.  For unknown reasons, in particular in some breeds, there is weakening of this attachment causing it to pop out.  Over time, the now malpositioned gland becomes inflamed and swollen, making it more difficult for it to stay in its proper position.

What does a cherry eye look like?
What most owners notice with a cherry eye is a red swollen mass like appearance protruding from on the nose side of the eye.  Cherry eye is typically not painful.  They can vary in size and in some cases will come and go.

What are treatment options for cherry eye?
Definitive treatment involves surgically tacking the prolapsed third eyelid gland back in place.  This surgery involves a high degree of technical skill for best chances of success and should be performed by and ophthalmologist (veterinarian that has received advanced training in ocular disease and surgery).  There is another surgical procedure that involves removing or amputating the third eyelid gland.  This is not recommended and can lead to lifelong complications with tear production and thus a potentially painful and non-visual eye.  In some cases, use of a topical steroid and gentle external massage can pop the proptosed gland back in place.  In some milder cases this can be done at home by owners as needed for temporary control.

What is cherry eye’s prognosis?
With surgical treatment performed by an ophthalmologist the prognosis is good.  In some cases (up to 20%) additional surgery may be required, thus making it that much more important to have a skilled person doing the surgery from the beginning.  Untreated cherry eye can eventually damage the cornea, affect vision, and become painful for the pet.