Seriously Scary - GDV

First off, GDV stands for gastric dilation and volvulus. This is a serious, life-threatening condition that can occur in any dog breed, but most commonly in deep-chested dog breeds like Great Danes, Labradors, Weimaraners, Standard Poodles and Saint Bernards. The direct cause of GDV is not known but there are many factors that contribute to the development of the condition. These factors include rapidly consuming food, exercise immediately before or after eating, stressful conditions, increased age or inherent motility disorders of the stomach. There is a gas accumulation in the stomach that then leads to distention and a rotation or twist of the entire stomach.

So, how do you recognize this condition? The most common signs are abdominal distension, vomiting or retching (unproductive vomiting), restlessness or signs of pain. Occasionally, the dog may even collapse. These signs usually progress as the condition worsens. This condition can become very serious very quickly. As the stomach twists, the blood supply is cut off. This is a life-threatening situation that can lead to necrosis of the stomach. If your pet is showing any of these signs, they should already be in the car and on the way to a vet!

Diagnosing GDV is usually fairly straightforward. Abdominal radiographs show a dilated stomach that is full of gas and some food materials. Often times, a stomach tube cannot be passed due to the rotated stomach. Treatment of a GDV is multi-faceted. IV fluids must be administered for cardiovascular support. The patient is typically placed under anesthesia and decompression of the stomach is attempted. Usually, surgery is required to reposition the stomach. The stomach is then sutured to the abdominal wall in a procedure called a gastropexy. This prevents the stomach from twisting again in the future, as this condition often repeats itself. If the condition is severe enough, sometimes the stomach or the spleen may need to be resected due to necrosis. These conditions unfortunately increase the mortality rate of this condition. Recovery from the condition takes several days, as food is slowly re-introduced post-operatively.

This radiograph of a canine abdomen shows a severely distended stomach full of gas. 

There are many things you can do to try to prevent this condition from occurring in your pet. Changes to feeding habits can decrease the incidence rate. Feed multiple, smaller meals throughout the day and have a significant time gap in between feeding and exercise. Some dogs, like my mother’s dog Milly, often inhale their food within seconds. Placing a rock or large ball in the bowl to slow down eating is often helpful. None of these methods, however, are 100% effective. A prophylactic gastropexy may prevent this condition from occurring in your pet. This procedure tacks the stomach to the abdominal wall to prevent twisting from occurring. This procedure does involve an abdominal laparotomy; it is often done when spaying female dogs that are pre-disposed to this condition.

Hopefully, this gives you a bit of insight on a serious and life-threatening condition many dogs face. Most famously, Marley from the film “Marley and Me” suffered from a GDV at some point in the film. 

Marley from the classic canine film "Marley and Me". Just had to throw a cute lab puppy picture in for a smile. 

Halloween Hazards - Household Toxins

With Halloween around the corner, and everyone stocking up on their chocolate candy for trick-or-treaters, a blog post about common household toxins for pets seems in order. This will not be all inclusive, but hopefully I can cover the major toxic items inside and outside the home.

Let’s start with foods. The most well known is of course, CHOCOLATE. With chocolate, the dark, baking chocolate is the most toxic. Also, white chocolate is in fact not toxic at all to your pup (but please do not give it to your dog). Other common food items that are toxic include avocado, onions and garlic, grapes and raisins, any beverages with caffeine or alcohol, macadamia nuts and any chewing gum containing xylitol.

Another major source of toxins for pets is household plants. This list is very long and new plants are constantly added to it. The ones that immediately pop into my head are LILIES (all kinds – especially in your feline friends), oleander, foxgloves, daffodils, philodendrons and sago palms (a huge problem in Louisiana and Florida). Other plants on the list include: English ivy, poision ivy and poison oak, rhododendron, poinsettias and holly (Christmas!), yews, dumb cane, elephant ears, hibiscus and aloe vera.

Outside you can find other toxins as well. Garden mulch and mushrooms can be toxic to dogs and cats. Also, many fertilizers, herbicides and insecticides, especially organophosphates, are not safe for pets. Please keep your pets away from these products when they must be used. The worst toxin I can think of is ANTI-FREEZE. This always becomes a problem with cooler weather coming. This chemical is very potent and just the smallest drop can cause a severe problem for cats and small dogs. Please be extremely careful with the product. It is naturally sweet tasting, so pets can often be attracted to the smell. Always clean up anti-freeze spills when they occur.

Another major toxin is RAT POISON. This can cause internal bleeding if ingested. These rodenticide and other baits in the home can cause serious problems if your pet happens to get into them. Also, household cleaners, especially bleach, should be kept in a safe place out of your pet’s reach.

The most common toxin exposure we see at CSAH is human medications given to pets inappropriately. We recommend calling us before giving your pet ANY household medication. If you don’t know already, TYLENOL is extremely toxic, especially to cats. Also, please do not give your pet ibuprofen (Motrin) as overdoses are very common. Decongestant medications containing pseudoephedrine can cause hyper-excitability and liver damage. Another common toxin we see is topical flea and tick medication labeled only for dogs being used on cats. If this happens, the first thing you should do is bathe the cat with dawn (or another gentle soap) to get the product off the fur.

Signs of toxin exposure can be very variable. The most common signs include vomiting (GI toxins), lethargy and weakness, or seizures (CNS toxins). You may also see labored or shallow breathing, drooling, stumbling, staggering or tremors. Some toxins cause increased heart rate, hyperactivity, increased thirst and dilated pupils.

If you think your pet has ingested a toxin, please give us or any emergency center a call immediately. If you need to bring your pet into the hospital, always remember to bring the packaging that the toxin came in. This can provide very valuable information when handling toxin exposure cases.

Hopefully this blog post opened your eyes to some of the pet toxins found around your home and in the yard. Please comment if you have any questions about this information.

ASPCA Toxin Hotline: (888) 426-4435

Above, a picture of George, one of our regulars in his Halloween attire. 

- H

Better a day late, than never - Rabies

Did you see Old Yeller? If not, go watch it stat. I saw it when I was about eight, and I think it changed my life for three reasons. One, it is partially responsible for me becoming a veterinarian. Two, it solidified my love of Labradors. Three, it made me very afraid of Rabies. Why the movie reference? Well, I had grandiose plans of making a blog post in honor of World Rabies Day. However, World Rabies Day is September 28^th, so I missed my deadline by a day. My apologies, but we are still going to do an overview of the worst, most fatal viral disease, rabies.

Rabies is a viral disease (a Rhabdovirus to be exact – thanks Dr. Gyimah!) that is almost always fatal in animals and humans. It is secreted in salvia and typically transmitted from a bite by an infected animal. Rabies affects only mammals, mainly skunks, raccoons, bats foxes and coyotes. In household animals, cats are most commonly affected and have been since 1988. This is partly due to decreased compliance with rabies vaccines in cats (note: vaccinate your cat!). It also affects dogs, cattle, horses and other livestock.

Once an animal is infected with rabies, the virus travels along nerves from the wound site to the brain. It can take weeks or months for the virus to travel to the brain, depending on where the infection occurred. From there, the clinical signs begin. The signs are variable, but include your Hollywood perception of foamy mouth, aggression, staggering, etc. This is known as the furious form of rabies and is often referred to as “mad-dog syndrome.” There can also be fearfulness, seizures, difficulty swallowing (paralytic form), depression, light sensitivity or just acting in an unusual manner. Once clinical signs appear, the disease is nearly always fatal.

Diagnosis of rabies is an unpleasant topic. A definitive diagnosis is usually required if rabies is suspected. A rabies test involves humane euthanasia and decapitation. The head is then sent to a qualified laboratory for immunofluorescense microscopy.

Rabies control is the main mechanism of disease prevention. Annual vaccinations are a MUST for all dogs and cats. These days, many rabies vaccines are good for 3 years, with a new rabies tag being issued at each annual visit. As a bonus, rabies tag numbers can be used to help locate a pet’s home if they get lost. Also important is to limit your pet’s exposure risk. Keep your pet in a contained environment, such as inside or in a fenced yard. Avoid wild animals and never attempt to keep them as pets.

If another pet or a wild animal bites your dog, please give us (or any veterinarian) a call immediately. Even if the pet is current on vaccines, there are many risks associated with puncture wounds from animal bites. An observation period may be needed, depending on the situation. Unfortunately, if your pet is not current on vaccines and is exposed to a rabid animal, the only options are euthanasia or a strict isolation for 6 months. I cannot express enough how important it is to keep your pet current on their rabies vaccines.

How does this affect the pet owners? If an animal ever bites you, wash the wound immediately and see a doctor. If the animal is a pet, get information on the vaccination status and report the incident to the local health department. These cases are evaluated based on risk assessment, which may be too complicated to discuss in a brief blog post.

So, the moral of this story and the classic film Old Yeller? Vaccinate your pets EVERY YEAR! Questions? Let me know!

- H

CYTAUX

For our first informative post, I am writing about one of my LEAST favorite diseases ever. This nasty tick-borne disease affects cats and causes non-specific signs with a high mortality. This is Cytauxazoonosis.

Cytauxazoonosis is an infection of the organism Cytauzxoon felis in cats. It is transmitted by ticks in the southeastern states. It is found in several feline species as reservoir hosts, most notably in the bobcat. This is where it gets its nickname, “Bobcat Fever.”

Cats infected with Cytauxazoonosis typically become extremely ill, very suddenly. They can become icteric (jaundiced – yellow gums), lethargic, weak and anorexic. They typically have a very high fever. They also may have pale gums, depending on how severe their anemia has become.

Bloodwork on cats with Cytauxazoonosis typically shows an anemia (low red blood cell count) and a variable white blood cell count. The white blood cell count (WBC) can sometimes indicate the stage of the disease. Early on, cats may have an elevated WBC, but as their disease advances, the WBC may drop dramatically. A diagnosis is usually made by examining a blood smear and visualizing the “signet ring” shaped organisms in red blood cells. Cats can also be dehydrated or have elevated liver enzymes, depending on the severity and duration of their disease.

Treatment of Cytauxazoonosis is a little controversial. The older treatment regime has been two injections of Imidocarb (an anti-babesia drug) 14 days apart, along with an antibiotic (typically enrofloxacin or azithromycin). A newer protocol is an anti-malarial drug named Atoquovaone combined with an antibiotic (typically azithromycin). The problem with Atoquavaone is that it is a bit hard to come by and very expensive. There are some reports of 60% survival rate with this newer protocol.

Prognosis is grave and there is typically a poor response to treatment. Most cats die within two weeks of their initial visit to the vet. Unfortunately, this disease attacks red blood cells quickly and cats can have a severe infection before you even know your kitty is sick.

So, this is such a nasty disease that is prevalent in the Middle Tennessee area. How can you protect your feline friends? Using a monthly topical product to repel fleas and TICKS is very important. This is recommended in all cats with access to the outdoors (perhaps even in all cats, period). Topical ectoparasite medication is an easy, economical and effective way to ensure you never lose a cat to such a nasty disease like Cytauxazoonosis.

Flea and tick prevention recommended in cats includes Easy Spot and Frontline Plus. Remember, even indoor cats need protection from fleas and ticks. Mark your calendar and give ectoparasites control to your cats every month.

Please post any questions you have, and I will do my best to answer them!

- H