Senior Wellness

November is national Pet Senior Wellness month. We all know our beloved 4 legged children age at a rate of 7 years to our 1. Typically pets are seen yearly for their physical exams, vaccinations, heartworm checks, and fecal exams. We encourage our clients to bring in their pets biannually, especially when they reach middle age at the age of 6.

We all can relate to our own annual exams with our own doctors. A typical annual physical for us includes, weight, temperature, blood pressure, comprehensive bloodwork, urinalysis, EKG, and possible chest  x-rays. Our pets deserve no less. We can articulate to our doctors our concerns and pains, animals cannot. There are many disease processes that, if caught early, can be treated. It is heartbreaking to have pets brought in advanced stages of kidney, thyroid, or cardiac disease which could have been managed if they had only been diagnosed earlier.

Hypertension is something one does not think about in our pets, but occurs with some frequency. High blood pressure can lead to kidney disease and vice versa. In cats the most common presenting complaint is acute blindness. This is called hypertensive retinopathy. When the blood pressure gets high in some cats, it causes the pressure in the eyes to go up and can lead to retinal detachments and acute blindness. This can be prevented and controlled by routine blood pressure checks and medication.

This economy has forced many of us to make difficult decisions regarding to what we can spend on our pets. Pet insurance purchased when the pet is young without any pre existing conditions is an investment that can literally save our pets’ lives. People who purchase pet insurance are much more likely to invest in early diagnostic testing that can diagnose conditions in the early, treatable stages.
Most veterinary practices, including our own, offer senior wellness packages. These packages offer substantial savings than if the individual components were purchased separately in the event a pet is brought in with an illness. November would be a good month to start an annual routine of preventive wellness exams for our beloved furry family members.

Rabies

Rabies is a neurotropic  rhabdovirus that can affect any warm blooded animal. This means that the virus has an affinity for nervous tissue, this includes nerves, spinal cord, and brain. There are 3 main carriers of rabies in the United States, bats, raccoons, and foxes. Mongoose is the main carrier of rabies in Puerto Rico. The predominant wildlife host on the east coast, including Florida, is the raccoon.

Rabies is transmitted from the saliva of an infected animal to an exposed host. This usually takes place as a bite, but the virus can be transmitted from a scratch, if there is saliva on the nails of the infected animal. Rabies can be transmitted from aerosol exposure. This is especially important with spelunkers (cave explorers) who enter caves where there is a large population of bats. The virus can be inhaled through the mucuous membranes by a susceptible host.

Early clinical signs of rabies include fever, muscle aches, anxiety, and progress to hallucinations, deliria, seizures, muscle twitching, change in behavior, aggression (madness), and hydrophobia (fear of water). The incubation period is dependent on where the entry point of the vrus. The virus travels up the nerves, to the spinal cord, then enters the brain. The closer to the head the person or pet is exposed, the shorter the incubation period. Death without treatment is almost a certainty within 2-10 days after exposure.

Transmission of the rabies occurs via the saliva. The animal is capable of transmitting rabies when the virus migrates from the brain to the salivary glands. When a domestic animal with an unknown vaccination history bites a person, they are quarantined for 10 days. The animal can only transmit the virus when it is in the salivary gland and studies have shown that if they were infective at the time of the bite, they will be dead within 10 days. The bitten person then is subjected to rabies post exposure treatment. This treatment involves 5 painful injections and is very expensive, but without treatment, death is almost a certainty. There have been only a few cases of people surviving rabies without post exposure treatment.

All pets should be vaccinated for rabies and kept inside. Cats are more likely to contract rabies and more likely to transmit the disease because they are more predatory by nature and become much more aggressive when they develop rabies. The vaccination is inexpensive, safe and very effective.

Pancreatitis

As we approach the holiday season, we veterinarians prepare for an increase in the cases of pancreatitis.

 The pancreas is an organ attached to the small intestine.
It serves two basic functions:

The endocrine side produces insulin which enables the body to process glucose. Glucose is the body’s main energy source.

The exocrine side produces enzymes to digest food. Food must be digested in order for the intestines to absorb the nutrients contained in the food consumed.

When a pet consumes food that is high in fat, the pancreas gets overworked, swells and actually leaks enzymes into the abdominal cavity. This causes autodigestion and is very painful and can even cause death. The most common cause of pancreatitis we see in veterinary practice is when pets are fed people food. We see the most cases of pancreatitis the days after Thanksgiving, Christmas, and Easter. The clinical signs of pancreatitis include vomiting, diarrhea, fever, painful abdomen, and inappetance.  Untreated cases can cause death.

Treatment is usually supportive with iv fluids, hospitalization, antibiotics, anti-emetics, and antidiarrheals. We often withhold food in dogs for several days to give the pancreas a chance to settle down. Feeding a dog with pancreatitis literally fuels the fire, stimulating the pancreas to produce more enzymes. A new treatment for severe cases of pancreatitis is hyperbaric chamber treatment. Some patients require surgery and drains. Management of dogs and cats with pancreatitis is done with a high fiber, low fat diet. Prevention is the key. We cannot say this loudly enough or more emphatically, DO NOT GIVE PETS PEOPLE FOOD!

Discussing pancreatitis with clients is a daily occurrence. Pancreatitis does not happen to every pet fed people food, but the risk is certainly much higher. The human analogy is not all smokers die of lung cancer, but your odds certainly go up if you do.

Pet owners often equate food with love. I am all for spoiling our pets, but this can be accomplished without endangering their health and lives. Have a safe holiday season!

Hypertension

Hypertension in our pets is not something most pet owners give a second thought to, but it is much more prevalent than you think. We associate hypertension in humans with stress, smoking, diabetes, obesity, too much salt consumption, or familial history. Hypertension in humans is often considered own primary, meaning an underlying cause cannot be determined. In animals, hypertension is usually secondary.  The most commonly associated diseases with hypertension are hyperthyroidism (in cats), Cushings disease ( overactive adrenal disease in dogs),  diabetes mellitus, and kidney disease.

The most common sign associated with hypertension is vision loss.  The retinas are very sensitive to high blood pressure and are usually the first organs to be affected. Unfortunately, a pet cannot communicate a loss in visual acuity, and often a pet owner does not realize this until the pet becomes acutely blind. This is most common in cats. The presenting sign is a cat that was normal one day, and the next has huge dilated, unresponsive pupils, and is bumping into things. Oftentimes once this happens, the retina has detached and the blindness is permanent.

Early diagnosis is key to good control just like in humans. We take it for granted that our blood pressure is measured every time we visit our own physicians, don’t our pets deserve the same? We encourage blood pressure checks in any pet 6 years of age and older at least twice a year, and in any pet that has a disease that is associated with hypertension. We include blood pressure checks in any pet with kidney disease, dilute urine, protein in the urine, Cushings disease, diabetes, and hyperthyroidism. We usually do blood pressure checks after we have the results of the bloodwork. If a cat is diagnosed with hyperthyroidism, we treat that condition first, and oftentimes the blood pressure normalizes.

Blood pressure is measured in pets similarly to humans. A special inflatable cuff is applied to the foreleg of the pet and a series of measurements are taken. We usually take 3-5 blood pressure readings and the average is interpreted. This allows the pet to calm down and minimize the “white coat syndrome”, which can artificially elevate the blood pressure.The most important reading is the systolic blood pressure. We  want the systolic blood pressure to be below 160.

Treatment is similar to humans. The underlying disease needs to be controlled. The most common blood pressure medications we use in veterinary medicine are benazepril, enalapril, and amlodipine. These are the same medications we use in human medicine to control hypertension.
Hypertension is common and treatable if diagnosed early. Blood pressure checks should become as routine in veterinary medicine as it is in human medicine.

Hurricane Preparedness

We are at the peak of hurricane season and we are monitoring several systems in the Atlantic.  It only takes one like Hurricane Andrew to cause devastation. Pet owners should prepare before a hurricane is on their doorstep.

There are many things people can do to protect their beloved pets in the event of a storm.
Make sure their pets are up to date on all their vaccines and that proof of vaccinations are in a readily accessible place. If you have to evacuate and board your pets at a boarding facility or veterinary hospital, you will have to show proof of updated vaccinations.

Make sure any medications your pet may need are refilled. It may be days to weeks  after a hurricane makes landfall, before veterinary hospitals or pharmacies might be able to reopen.
Consider microchipping your pet. Pets can become lost if dwellings are damaged during a storm. Microchips enhance the odds that your pet will be returned to you safely.  Make sure the microchips are registered with updated information.

Make sure you have enough food and water for your pet for at least a week. Provide the boarding facility with both for your pet. Power and water may be lost for days to weeks after a storm hits.
Make provisions for your large animals like horses. We bought wax markers and wrote our cell phone numbers on both sides of our horses. In the event of a hurricane where the barn is damaged, horses may wander off. We also microchipped our horses. We installed hurricane garage doors and hurricane panels on our barn and had it reinforced to withstand 140 mph winds. The barn has withstood 3 hurricanes and the horses were very safe and comfortable.

People who are forced to evacuate should go online and find hotels and motels that are pet friendly. ( http://www.petswelcome.com/ ,  http://www.pet-friendly-hotels.net/ ). Do not wait until the last minute to get reservations.

Contact your veterinarian long before a hurricane becomes an imminent threat and see if they have hurricane boarding facilities. Most animal hospitals are not equipped to handle that many animals in a situation where electricity and water may not be available.

Hurricane season can be extremely stressful. By following these simple steps, it will make a difficult situation easier to endure and ensure your beloved pets remain safe.

Parvovirus

Parvo is a highly contagious viral disease that affects dogs. Transmission is mainly from exposure to the virus through feces from infected dogs. Parvovirus causes the lining of the intestines to necrose (slough). Clinical signs include diarrhea, often bloody, vomiting, lethargy, and dehydration. The less common cardiac form can cause sudden death. Most infected dogs are puppies and dogs that are not current on their parvovirus vaccination.

Parvovirus is a relatively new disease, appearing in the late 1970’s. There were widespread outbreaks and the mortality rate was quite high before the development of a vaccine. Puppies are vaccinated monthly in a series of 3 injections starting at 8 weeks of age until they are 4 months old. Boosters are given yearly after that. Parvovirus is highly contagious and the mortality rate in untreated dogs can reach 91% in as little as 24-72 hours. Concurrent illness with bacteria, parasites, and malnutrition worsens the clinical signs. Certain breeds are predisposed: Rottweilers, Dobermans, and Pit Bull Terriers. Treatment is mainly supportive and can be quite expensive. Dogs are hospitalized for several days on intravenous fluids, antibiotics, antidiarrheals, and anti-emetics.  Infected dogs that recover can shed virus in their feces for up to 3-6 weeks and should be kept away from any other dogs until this period is over. The virus can persist in the environment for up to a year and is cold and heat tolerant. The only disinfectant that effectively kills the virus is bleach. We recommend that infected dogs be taken to a small area in the yard to defecate, and the fecal material be picked up to avoid exposing other dogs by contaminating the environment.

There have been several parvovirus outbreaks locally. In these difficult economic times, dog owners are cutting corners with their pets’ health. The parvovirus vaccine is usually included the distemper vaccine that is given yearly to dogs. Prevention of this deadly disease is the key. It is an inexpensive, and safe way to ensure the health of our beloved canine family members.

Pet Insurance

Pet insurance is a good investment in your pet’s health. There are many insurance companies and plans, so it is important do do your homework. The best source of information is your veterinarian. We promote health insurance at our veterinary practice, because pets that are insured tend to be better taken care of. Pet owners are more likely to keep up with wellness programs, routine physical exams, bloodwork, and treatment plans.

Pet insurance is similar to human dental health insurance in the fact that it is a reimbursement plan. An insured patient pays for services, then submits a claim to the insurance company who then reimburses them a percentage of the bill. There are many pet insurance companies and it is up to the pet owner to research them and select the one that best fits their needs.

There are many factors to consider when choosing a health plan for a pet. Ideally, insurance is taken out on a young pet with no pre-existing conditions. I cannot tell you how many clients ask if they can get insurance when their pet is seriously ill. There is usually a waiting period for illnesses on most policies. An insurance company, for example,  will not pay for an anterior cruciate ligament tear a week after a policy has been taken out. Deductibles vary depending on the plan. There are plans that cover wellness exams, vaccinations, heartworm prevention,  spays and neuters. These tend to be more expensive and it may make more economic sense to pay out of pocket for wellness issues and take out a policy that covers accidents or catastrophic illnesses like cancer. This prevents financial euthanasia. There have been many cases of pets having treatable but expensive to treat illnesses that end up being euthanized because the owners can’t afford to treat.

For more information, you can contact us at our hospital at (772) 336-8111, or visit our website http://kellysanimalhospital.com/ and click links.

Leptospirosis

Leptospirosis is a zoonotic disease transmitted by the spirochete bacterium Leptospira spp.  The bacteria is shed in the urine of an infected host which can include mice, raccoons, skunks, deer, sheep, dogs and even humans. The bacteria remains viable in the environment as long as it is moist, so it is most prevalent in Florida during the wet summer months.

Dogs most commonly come in contact with the bacteria by licking urine off the grass, or drinking from puddles in the yard that have been contaminated with infected urine. Clinical signs are jaundice (yellowing of the skin, eyes), bloody urine, fever, lethargy, vomiting, inappetance, and kidney failure, and death. The incubation period in dogs is 2-20 days. In humans the signs include lethargy, fever, severe headache, chills, muscle aches, vomiting, diarrhea, and jaundice, and death. The incubation period in humans is 4-14 days. People who are exposed to contaminated water such as surfers, and professionals who are exposed to contaminated urine such as veterinarians, and slaughterhouse workers are most at risk.

Diagnosis is made from blood samples and fresh urine in early infections.
Treatment if caught early, is with antibiotics such as penicillin, and doxycycline. Penicillin is given initially to control shedding of the bacteria in the urine, then doxycycline is used to get rid of the carrier state. The key is prevention. There are no vaccines available for humans, but there are effective vaccines for dogs. The canine leptospirosis vaccine contains the 4 most common serovars, and is included in most distemper/parvo vaccine combination protocols. There are many veterinary practices that do not include leptospirosis vaccine in their annual vaccination protocol and 3 years ago we had 4 cases of leptospirosis. Two of the dogs were not current on any vaccines, and the other two came from veterinary hospitals that did not include leptospirosis in their vaccine protocol. We were able to save two of the dogs. This also posed a significant risk to the owners’ health. We advised them to avoid contact with their dogs’ urine and confine the area where their dogs urinate to limit the area that could become contaminated. This past month we had 2 young dogs with unexplained kidney disease that were had not been vaccinated against leptospirosis by their previous vets. Their owners spent some anxious moments while we waited for the leptospirosis titers to come in.

We strongly recommend that all dogs be vaccinated against leptospirosis annually to prevent this potentially fatal disease.

Heartworm Disease

The hot summer months and humidity bring with it mosquitoes which can transmit many diseases to pets and humans. Heartworm disease is prevalent in dogs and to a lesser extent cats and ferrets. Mosquitoes feed on the blood of warm blooded animals. Mammals infected with heartworms have circulating larvae in the bloodstream. When a mosquito ingests blood from a heartworm infected animal, the larvae mature and develop in the host. The larvae eventually migrate into the heart and pulmonary vessels where they mature and cause clinical signs of heartworm disease.

The clinical signs of heartworm disease in dogs often to do not become evident until  late in the course of the disease. These  signs include coughing, exercise intolerance, lethargy, collapse, and even sudden death.

Heartworm disease diagnosis in cats can be challenging. The disease in cats tends to cause signs that mimic asthma. Coughing is the predominant sign, but vomiting and acute sudden unexplained death has been reported. There is no treatment for heartworm disease in cats because cats go into anaphylactic shock when the worms die. The object of heartworm treatment is to kill the heartworms which could induce anaphylaxis. The drugs that are used to treat heartworm disease are also toxic in cats.

Heartworm disease is preventable in all the affected species. The heartworm prevention comes in many forms including : chewable monthly tablets, monthly topical applications that have flea prevention included, and now a 6 month shot for dogs.

Heartworm treatment is expensive. Heartworm prevention is inexpensive and safe. Heartworm disease can cause permanent damage to the pet’s heart. Pets that are not on heartworm prevention, especially in Florida where the mosquito is the state bird, are likely to result in the pet becoming infected with heartworms. I tell clients it’s the proverbial, “ You  can pay me now or you can pay me later!”

There is no reason for an animal to develop heartworm disease. Yearly heartworm blood tests and monthly heartworm prevention will ensure our pets will not contract this potentially deadly disease.

Heat Stroke - Hyperthermia

With summer almost upon us, we have recently been reminded what the southern heat can do to our beloved pets. We were involved in a case last year where 2 large dogs were left in a  car while the owner attended classes at a local university. He had the windows cracked and left water in the car for them to drink. The outside temperature was 94 degrees F and the heat index was over 100 degrees F.  Good Samaritan bystanders discovered the distressed dogs and called Animal Control. When they arrived the female dog was dead and the male was unconscious. The officer wet the dog down with cool water and transported him to our veterinary hospital. His rectal temperature was 105 degrees F and he was non responsive. The normal rectal temperature of a dog is 100-102 degrees F. We applied wet towels on his body and turned on a hose with cool water to wet him down. We applied ice packs to his head and groin and armpit areas. An intravenous catheter was inserted and vigorous amount of fluids were administered. An oxygen mask was placed on his nose and his heart rate and temperature were monitored. Once we felt he was stable enough for transport to the Animal Emergency and Referral Center, he was taken there by Animal Control. He unfortunately did not respond and had to be euthanized later that evening. The owner is facing 2 felony counts of animal cruelty.

 Two days later I read of a K-9 police officer in Woodstock, Georgia with 12 years experience, was arrested after leaving his canine police officer in his cruiser. The dog died, and he faces a felony count of animal cruelty, and he has lost his job. This is particularly disturbing because this happened to a person with experience dealing with dogs.

Hyperthermia can occur very quickly in this brutal Florida heat. The temperature in a car can reach 140-150 degrees F in a very short period of time. Dogs do not perspire. They can only dissipate heat from panting and from slight sweating of the pads of their feet. If the ambient temperature is higher than the dog’s core temperature, panting cannot dissipate the heat, and the dog’s internal temperature can rise very rapidly. Signs of hyperthermia are obvious; panting, restlessness, crying, lethargy, red and tacky gums, unconsciousness, and death.

When the body’s core temperature rises above 105 degrees F, serious damage can occur in a very short period of time to the brain, kidneys, intestines, and blood. Once clinical signs begin, they progress rapidly and can result in irreversible organ damage and death.

Prevention is the key. Dogs and other animals should never be left in a car, especially in the summer. In the heat of the day, pets should be allowed to go outside for short periods of time and they should avoid strenuous physical exertion. If they have to be outside, there should be plenty of shade and adequate amounts of water should always be available. We had an English Bulldog present to our hospital 2 years ago on a Saturday morning with heat stroke. The owner had taken the dog out for a walk on a hot morning. The dog began to pant, and collapsed. The owner carried the dog a half a mile to her house before bringing it to our hospital. The dog  presented  unconscious with a rectal temperature of over 110 degrees F. The owner was riddled with guilt. She innocently took the dog out for a walk, and 2 hours later, the dog was dead. Overweight and brachycephalic dogs are more predisposed to heat stroke. Brachycephalic dogs have the “pushed in noses” and they cannot dissipate heat as well by panting.

Dogs are not the only animals that can experience heat stroke. We own 8 horses and during the summer, we are constantly vigilant of the outdoor temperatures and heat indices. Once the heat index reaches 100 degrees F, we bring the horses in their stalls. We have overhead fans and they have automatic waterers in their stalls.

The people that were responsible for their dogs dying of heat stroke are not bad people. They were people who took chances with their pets’ lives and lost. I am not a gambler because I am not willing to lose. Let’s be safe and enjoy our summer with our pets!

Addison's Disease

Addison’s disease, also known as hypoadrenocorticism, is a condition where the adrenal gland does not produce adequate levels of hormones needed to balance metabolic functions. The adrenal gland produces two types of hormones:

Corticosteroids are hormones that allow us to handle stress, the “flight or flight syndrome”. They control protein and glucose metabolism which are the main sources of energy that allow us to cope with stress factors.
Mineralocorticoids are hormones that control electrolyte balance. This in turn affects kidney function.

The cause of Addison’s disease is rarely found, but it typically affects younger patients, typically 4-5 years of age and it affects females twice as often as males. This disease affects dogs, and very rarely, cats.  Clinical signs can range from no signs, to an acute crisis where the patient is presented comatose.  The first signs an owner might notice is a dog that is consuming more water  and urinating more. As the disease progresses, lethargy, inappetance, vomiting and cardiac signs develop as the potassium levels rise.

Diagnosis is made based on clinical signs, urinalysis, and bloodwork. The classic Addisonian has an elevated potassium and a decreased sodium. The ratio of sodium to potassium typically drops below 25. Kidney values will begin to elevate as the disease progresses. Not all Addisonian patients fit this classic presentation and the clinician must be open to the possibility of Addisosn’s disease in a young dog that presents with unexplained signs of kidney disease even with normal electrolyte levels. Confirmation of the disease is made with a blood test called an ACTH Stimulation test. ACTH (adreno corticotropic hormone) is a hormone produced in the pituitary gland in the brain that stimulates the adrenal gland to secrete corticosteroids and mineralocorticoid hormones. Addisonian patients have low corticosteroid levels and do not stimulate post acth administration.

Treatment is usually very successful. A patient in crisis is given intravenous fluids with sodium chloride, and corticosteroids. Mineralocoricoid supplementation is begun and can be accomplished with an oral medication called Florinef,  or an every 28 day injection called Percortin. Dogs tend to do better with the injection. Care must be taken with future stresses such as surgery, and low dose oral steroid supplementation may be needed for life.

Dogs can live normal happy, productive lives with Addison’s disease as long as they are managed appropriately. The most famous human that had Addison’s  disease was President John F. Kennedy.

Allergic Skin Disease

One of the most frequent reasons pet owners visit their veterinarians for, is to treat and consult over allergic skin disease. The most common clinical signs are: scratching, licking and chewing at their skin and feet, shaking their heads, scales and flakiness of their skin, discoloration of the hair and skin, and hair loss (alopecia).

There are many causes to allergic skin disease:

Inhalent  allergies occur when a patient has an allergic reaction to things that are in the air. The most common of these is pollen. Pets that have inhalant skin disease tend to have clinical signs that are seasonal, or are worse at certain times during the year. This is by far the most common cause, and pets tend to chew at their feet, have ear infections, and scratch to the point where secondary bacterial infections develop which aggravates the itchiness. Most pets develop skin infections as a result of scratching and licking. The itchiness comes first. This is why it is important to identify the cause of the discomfort and not just treat the infections.

Food allergies are an important component in the skin puzzle. Oftentimes they are not the sole cause of the problem, but they contribute to the symptoms. Pets that have food allergies tend to develop these at early ages and have hairloss in the backside , under the tail. Food elimination trials can be implemented to address this potential cause skin discomfort.

Ectoparasites, ie. fleas and ticks are a smaller proportion of the allergic puzzle with the advent of effective products to control  them. Thankfully, we see very few cases of flea bite dermatitis anymore. It is important to exercise good preventive measures to control fleas and ticks, especially in allergic pets.

Contact dermatitis occurs when a susceptible pet is exposed to something they are allergic to by direct contact. The most common areas of the body affected are the feet. A pet that is chewing at their feet and nowhere else, is likely allergic to the grass they are exposed to. Another common sign is redness in the groin area because it is the most hairless part of the body and the part most likely to contact the grass, when a pet lays down. Other possible causes of contact dermatitis are rugs, or towels and even the laundry detergent used to clean the pet’s bedding.

Treatment is aimed at controlling the itch. This is achieved with topical sprays and shampoos, antihistamines, and sometimes steroids. Steroids should be used with caution, and only on a short term basis because of potential long term side effects. Antibiotics are used to control secondary infections and must be continued until the infection is cleared. This could take 2-6 weeks.
Underlying conditions such as hypothyroidism need to be addressed and treated as well.

Diagnosis is made by trial and error, and allergy testing. This can be done with blood testing (RAST) and intradermal skin testing, usually done by a dermatologist. Food trials can be done without expensive testing by trying novel diets. The definition of a hypoallergenic diet is one protein and one grain. If a food trial is instituted, the pet must get nothing other than the food for 30-45 days for an objective assessment to be made.

Anterior Cruciate Injuries

Anterior cruciate injuries are the most common cause of acute lameness in dogs. Cats can develop ACL injuries but do so much less frequently.  Large breed, and overweight dogs tend to be more predisposed. The anterior cruciate ligament is one of two ligaments that help stabilize the stifle or knee joint. Injury can occur in a young active dog, or an overweight dog that has abnormal stresses on the dynamics of the stifle. An injury typically occurs when a dog twists his leg, either running around a corner, or mis-stepping in a hole in the back yard. This is a common injury in professional athletes like football players and skiers.

The typical presentation is a dog that is presented three legged lame, and toe touching. There is usually no pain elicited and the knee may or not be swollen.

Diagnosis is made on clinical history and the presence of an anterior drawer sign. An anterior drawer is when the is abnormal forward movement of the tibia in relation to the femur. This sign can be difficult to elicit in a nervous dog because the tensing of the muscles could artificially stabilize the stifle. Sedation sometimes is required. ACL pull or tear is suspected in any dog that presents with acute, non painful, toe touching lameness. I normally recommend a series of therapeutic laser treatments in our office and send the dog home with glucosamine chondroitin sulfate/ MSM supplements, non steroidal pain medication,  and orders for strict rest, leash walks only, and no running or jumping for at least two weeks. The rule of thumb is if the dog is still lame after two weeks, surgery is usually required to stabilize the joint. If this is not done degenerative joint disease or arthritis sets in very quickly.

There are several surgical options to stabilize the knee joint after an ACL tear:

Extracapsular repair- The stifle is opened and inspected and any remnants of the torn ligaments are removed. If the meniscus is damaged, it is removed, and any bone fragments are cleaned away. A large suture is placed around the back of the joint and inserted in the front of the stifle. This stabilizes the knee. This procedure is best used in smaller dogs that don’t have to support as much weight.

TPLO (Tibial Plateau Leveling Osteotomy)-  This is considered by many, the best way to stabilize the stifle after acl rupture. It is a complex surgery requiring specialized equipment, and many radiographs. This is done by a surgical specialist.

TTA(Tibial Tuberosity Advancement)- This procedure is also complicated, but considered by many to be the preferred method of repair. It is less invasive than the TPLO, but also requires specialized equipment and expertise.

Rehabilitation is important to the ultimate success of any procedure. Rest, and leash walks are a must for 4-6 weeks post surgery. Icing the joint can reduce swelling. Passive range of motion exercises can be begun in 2-3 weeks. Light exercise can be introduced slowly.  Full return to normal function can be expected in 2-3 months.

Fleas

Fleas

We are blessed to live in the semitropical climate of Florida. It is a paradise for humans, but it is also an ideal environment for fleas. Fleas are a year round problem in South Florida. It is important to understand the flea life cycle in order for us to adequately protect ourselves and our pets against these biting pests.

There are 4 stages in the life cycle of the flea:

Egg:  A female flea can lay up to 40 eggs per day. Eggs incubate in warm temperatures of about 65-85 degrees and high humidity. Female fleas lay their eggs on the pet where they fall off into the environment
Larva:  eggs hatch into larvae which feed on the “flea dirt” or flea feces left behind by the adults in the environment. This stage is the stage that picks up the tapeworm eggs that later become infective to the host.
Pupa:  This is the cocoon stage of the flea. They can remain dormant in the carpet for months, waiting for the ideal environmental conditions, and a nearby viable host to feed on, before they emerge as adult fleas.
Adult: Fleas can survive for months without a bloodmeal. Once a suitable host is found, they aggressively attach and feed. A female flea will begin to lay eggs about 24-48 hours after feeding, and continue until she dies. The average life span of a flea is 4-6 weeks and the average time from egg to adult is 21 days.

Fleas can spread several diseases to pets. The most common is tapeworms. A dog or cat will ingest a flea in the process of grooming. If that flea was carrying tapeworm eggs, it will develop into adult tapeworms in the intestine of the host. The eggs are shed in the pet’s stool in egg packets or segments that the pet owner can readily see. The flea larvae then ingest the eggs and the cycle continues.
Flea control must occur on the pet as well as in the environment. Environmental sprays do not kill the egg, larva l, or pupal stages, so if there is a severe infestation, the environment should be resprayed in 3 weeks, when the eggs hatch into adults.

There are many effective products for flea control on the pet. Topical flea applications and oral flea prevention are common and effective.  It is important to coordinate flea control on the pet and the environment to effectively keep these pesky parasites out of our lives.