by Lodi Vet | Jun 27, 2017 | Dogs, Educational Materials
Mast cell tumors are one of the most common skin tumors in the dog. They arise from a population of inflammatory cells called mast cells. Mast cells are filled with granules of inflammatory mediators such as histamines. When manipulated these granules are released from the cell and can cause significant swelling, redness, bruising or bleeding at the tumor site. Most mast cell tumors occur either within the skin or just under the skin in the subcutaneous tissues.
The behavior of mast cell tumors is very unpredictable. Tumors can range from a single solitary mass in the skin to an aggressive form called disseminated mast cell tumor, which spreads invasively throughout the body. Mast cell tumors can be classified into three categories:
- Grade I – Well-differentiated, usually solitary nodules but may be multiple. Seldom metastasize or move to other organs in the body.
- Grade II – Moderately differentiated, higher likelihood to metastasize and cause systemic disease.
- Grade III – Poorly differentiated. Most aggressive, most likely to metastasize other parts of the body or cause systemic disease in the blood.
Diagnosis
A MCT can usually be diagnosed from a fine needle aspirate in which a small sample of cells are stained and examined under a microscope. Mast cells typically have a very characteristic appearance with dark granules in the cells. To help stage the spread of the tumor, blood counts, aspirates of regional lymph nodes, ultrasound of abdominal organs, chest x-rays and bone marrow biopsies maybe recommended.
Treatment
Once diagnosed, a mast cell tumor should be surgically removed and biopsied to determine the Grade (I-III) and to check the surgical margins. Healing can be delayed because of the inflammatory component of the mast cells. Often additional medications are advised following removal.
The grade of the tumor, the success of surgical removal, and the stage of the disease (extent of spread) determine the treatment. Surgical excision alone is often curative in a Grade I, completely excised tumor. Higher grades, incomplete excision and evidence of spread may require additional treatment.
Prognosis
Most mast cell tumors (Grade I) that can be completely removed have a good to excellent prognosis. The higher Grades (II + III) tend to have a guarded prognosis, and the aggressive tumors that have metastasized have a poor prognosis. Early detection and removal definitely improves the chances that this tumor can be treated. Continued monitoring of the surgical site for signs of regrowth and screening for metastatic disease is advised for all mast cell tumors.
Mast cell tumors can have a variety of appearances. A dog with a history of having a mast cell tumor removed should have all new lumps evaluated immediately. The doctors or staff at Lodi Veterinary Care will be happy to answer any questions that you may have.
by Lodi Vet | Jun 25, 2017 | Dogs, Educational Materials
Overview
Demodectic mange is caused by a microscopic Demodex mite. All dogs have demodex mites on their skin that live within the hair follicles. Most dogs live in harmony with their mites, never suffering any consequences from being parasitized. However, if the dog’s immune system becomes suppressed (or in young puppies), the Demodex mites proliferate and can cause serious skin disease. It can occur in isolated spots or affect larger areas and multiple spots on the body.
Transmission
Demodex mites are host specific, therefore are not contagious to other species. Canine demodex is typically not contagious to other dogs unless infected dog is in contact with immune suppressed or very young/old dogs.
Diagnosis
Because demodex live within the hair follicles a deep skin scraping is needed to make this diagnosis. In adult dogs with spontaneous demodex infection, further diagnostics may be warranted to determine the cause of immune suppression to result in this type of infection.
Treatment
Localized demodex (those cases of demodex that only occur in few small locations on the body) in young dogs do not always require treatment. Depending on the severity of the case topical (medicated shampoos and ointments) and or oral medications (ivermectin) are used. Occasionally, dogs with demodex have secondary skin infections which require oral antibiotics.
by Lodi Vet | Jun 21, 2017 | Cats, Dogs, Educational Materials
Why do Calcium Oxalate Uroliths form?
Genetics, dietary issues and some metabolic diseases can predispose pets to the formation of calcium crystals or stones. Pets that have more acidic (low) urine pH and very concentrated urine can be factors in calcium oxalate formation. Breeds especially at high risk include: schnauzers, lhasa apsos, yorkies, poodles, shih tzus, bichons, Burmese cats and Himalayan cats.
How do you diagnose calcium oxalate stones?
Although a urinalysis can provide clues (calcium crystals and acidic/low urine pH), and an ultrasound or x ray can confirm the presence of stones, the only way to know the exact stone type is to retrieve the stone(s) surgically (cystotomy) and have a laboratory analyze it.
Do the stones have to be surgically removed?
Unfortunately there is no diet nor medication that would be able to dissolve this type of stone. Leaving the stones in place will predispose your pet to frequent irritation to the bladder wall, infections and possibly life threatening blockage of the urinary tract. Because there are many factors that lead to calcium stone formation, and no foolproof way to prevent them from reforming, studies show that 50% of all pets who have had calcium stones removed will develop new stones within 3 years.
Therapeutic plan to minimize the chance of recurrence
Diet – while specific diets cannot dissolve existing stones, they do help in preventing the development of new stones. Canned form is preferred so as to increase water consumption and thus help dilute urine.
- To be effective, prescription diets must make up >90% of the total calories consumed.
- It is especially important to avoid table scraps, however the following treats are acceptable (in very small quantities) for calcium stone forming pets: plain cooked boneless skinless chicken/turkey breast, cooked eggs, rice, peas, white potatoes, cabbage, cauliflower and bananas.
Urinalysis and Recheck– urine needs to be checked at intervals to help ensure that the concentration and pH are adequate to help reduce risk of reforming stones and check for signs of infection. If pH and concentration are not adequately controlled with diet alone, occasionally other medications will need to be prescribed.
Calcium oxalate bladder stones can be very frustrating. Not only do they tend to recur (sometimes very quickly), management will involve frequent visits to the veterinarian’s office to recheck urine. Keep in mind the trouble and expense of a stone surgery outweighs the trouble and expense of monitoring.
by Lodi Vet | Jun 21, 2017 | Cats, Dogs, Educational Materials
General Information
Chronic kidney disease refers to a condition in which the kidneys have not been performing at least one of their main tasks adequately, resulting in blood or physical abnormalities. Normal kidneys filter the blood, removing wastes and excreting them in the urine. Kidneys in a diseased state lose some of this filtering ability, and waste products accumulate in the bloodstream. Continued re-circulation of this material results in illness. About ¾ of kidney tissue must be damaged before signs of illness appear. For this reason, kidney disease is often considered chronic (present for a long time) even though the affected pet may not have shown signs of the disease for very long. If routine yearly wellness screening of blood and urine is preformed, signs of kidney disease can be caught early and progression of disease can be slowed.
Signs of kidney disease can include:
- Weight loss
- Increased thirst
- Increased urination
- Decreased appetite
- Bad breath
- Depression/lethargy
- Vomiting or diarrhea
Continued illness without treatment can cause a uremic crisis (extremely high waste product accumulation in the blood) resulting in collapse, seizures, coma and death.
Though chronic kidney disease is progressive and not curable, it is often manageable. Many pets can live reasonably normal lives when properly managed in a cooperative effort between owner and veterinarian.
Diagnosis
Initially kidney disease is diagnosed with a combination of blood tests and a urine evaluation. Blood work involves looking at the waste products or enzymes produced by the kidneys (Creatinine and BUN), electrolytes, phosphorus levels and other organ values. A complete blood count helps evaluate a pet’s hydration level and can indicate if they are anemic (anemia can occur in later stages of kidney disease). A urinalysis can help us determine how concentrated or dilute a urine sample is and lets us know if there are any abnormal cells, bacteria or protein in the urine that might indicate a problem.
Once kidney disease has been suspected or diagnosed by blood tests, your veterinarian may order further testing to help determine how advanced the kidney disease is, or try to help determine the cause of kidney disease. These tests may include:
- Urine culture/sensitivity
- Blood pressure
- Infectious disease testing (leptospirosis/lyme)
- Urine protein:creatinine ratio (to determine the amount of protein being lost in the urine)
- Ultrasound of the kidneys (to look for stones or signs of cancer)
Kidney disease will progress, even with treatment. Because of this, close monitoring is required to help your veterinarian adjust your pet’s treatments. Your veterinarian will advise monitoring blood tests, blood pressures or urine tests at intervals to help tailor treatment best for your pet.
Management of Kidney Disease
In many cases, initial treatment involves flushing the blood with intravenous fluids to determine if kidney function can improve. This typically helps decrease the amount of waste product accumulation in the bloodstream, thus improving how a cat/dog feels. In the beginning, this is often done in the hospital. Once a pet is feeling well and kidney values have decreased, fluids can be given under the skin at home.
A prescription diet formulated for dogs/cats in kidney disease is critical to successful treatment. These types of diets come in dry and canned formulas.
Make sure your pet has free access to clean drinking water at all times. Good hydration is critical in managing kidney disease. Water fountains and multiple bowls around the house can be helpful in encouraging your pet to drink.
Medications can be prescribed for helping manage some of the symptoms of kidney disease. Depending on how your pet is being affected by kidney disease any of the following may be prescribed:
- Antacids
- Anti-nausea medications
- Phosphorus binders
- Antibiotics
- Appetite stimulants
Ask your veterinarian if you feel your pet could benefit from any of these medications.
by Lodi Vet | Jun 21, 2017 | Cats, Dogs, Educational Materials
Neck or back pain are two common causes of discomfort in our pets. You may notice subtle changes such as lack of jumping on/off of things, having difficulty with stairs, standing in a hunched position, difficulty getting comfortable laying down or getting up or even more severe symptoms such as weakness or dragging/stumbling over the hind legs.
Causes
Neck and back pain can have several causes from minor muscle spasms, sprains or strains to more serious problems like a bulging or slipped disc which could result in pinched nerves, weakness or even paralysis. Overexertion, jumping on or off of furniture, rough play, or simply twisting wrong can result neck or back pain. Less likely causes of back pain could include spinal or nerve tumors or infections of the fluid around the spinal cord. Serious injuries like pets that have been hit by a vehicle can have trauma that results in swelling around the spine or dislocation of the vertebrae (bones of the spine).
Diagnostics
An exam is done to try and isolate the exact location of the pain and to check nerve function and mobility. Radiographs are often advised to help look for signs of a bulging or slipped disc, bony changes to the spine (arthritis or cancer), and in cases of trauma to look for fractures or dislocations. If your pet is older and has not had routine blood testing, this may be recommended prior to starting on treatments to ensure that there are no underlying conditions that may hinder the use of certain medications.
For severe spinal trauma, disc disease or other conditions, referral to a neurologist may be advised. The neurologist will be able to run advanced diagnostics like a CT scan or MRI to take a detailed look at the vertebrae, discs and spinal cord. A myelogram is a test that is done to help determine the exact location of a bulging disc. In cases where infection or cancer is suspected a CSF (cerebrospinal fluid) or spinal tap is done. If surgery is needed as a form of treatment the neurologist is the doctor to perform the surgery.
Treatment
The mainstay of neck and back pain treatment is strict rest. No running, jumping, playing with other animals and restricting access to jumping on/off of furniture or into/out of vehicles is important.
Monitoring
Close monitoring is very important. In cases of slipped discs or swelling around the spinal cord, it is important to monitor the function of the limbs. If the legs become weaker, or if your pet is dragging or crossing over the legs when walking, cannot use the legs, or cannot control the bladder or bowel this is a sign of worsening or further pressure on the spinal cord an
by Lodi Vet | Jun 21, 2017 | Cats, Dogs, Educational Materials
Why do Struvite Uroliths form?
Several factors are needed to form a struvite stone. Struvite is a urinary mineral composed of ammonium, phosphate and magnesium. These three substances are common in urine, but when they are in high enough concentrations they bind together to form crystals. Ultimately, pets with very concentrated urine of a basic (high) pH can result in the congregation of struvite crystals resulting in a stone. Infections of the bladder that change the urine pH can predispose dogs and cats to struvite bladder stones.
How do you diagnose struvite stones?
Although a urinalysis can provide clues (struvite crystals and high urine pH), and an ultrasound or x ray can confirm the presence of stones, the only way to know the exact stone type is to retrieve the stone(s) surgically (cystotomy) and have a laboratory analyze it.
How do you treat struvite stone?
Struvite stones can be treated in one of two ways: surgically or dissolved through diet.
Surgery – this is the most direct method of removal. The advantage is that the stones are removed and the healing may commence all in one day. This allows the stones to be collected and analyzed to confirm their type.
Dietary Dissolution – There are several therapeutic prescription foods designed to dissolve struvite crystals and stones. They act by creating a bladder environment favorable to dissolution. In order to proceed with this form of treatment, the patient should be female (as the stone dissolves and becomes smaller, we do not want it lodging in the narrow male urinary tract causing obstruction). Monthly urine checks (looking for signs of infection which can cause stone formation) and imaging of the bladder (by x ray or ultrasound) must be performed to know when the stones are gone and to know if this method is helping (dietary dissolution does not work for every pet). Once we know the stones are gone, patients are put on a “maintenance” therapeutic diet to help reduce the risk of reforming these stones. On average it takes 3-4 months for stones to dissolve. If at any time your pet makes attempts to urinate without production of urine, contact your veterinarian immediately – urinary obstruction as stones dissolve is a medical emergency!
