Wednesday, September 30, 2015

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!


Monday, September 14, 2015

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.