{"id":717,"date":"2015-08-07T16:53:00","date_gmt":"2015-08-07T21:53:00","guid":{"rendered":"http:\/\/www.blackearthvet.com\/?page_id=717"},"modified":"2024-08-07T12:06:06","modified_gmt":"2024-08-07T17:06:06","slug":"hot-topics","status":"publish","type":"page","link":"https:\/\/www.blackearthvet.com\/?page_id=717","title":{"rendered":"Important Pet Information"},"content":{"rendered":"<div id=\"pl-717\"  class=\"panel-layout\" ><div id=\"pg-717-0\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-0\" ><div id=\"pgc-717-0-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-0-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"0\" ><div class=\"textwidget\"><h3 style=\"text-align: center;\"><em><strong>The information on this page is not meant to be a substitute for veterinary care. Always follow the instructions provided by your veterinarian.<\/strong><\/em><\/h3>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-717-1\"  class=\"panel-grid panel-no-style\" ><div id=\"pgc-717-1-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-1-0-0\" class=\"so-panel widget widget_sow-editor panel-first-child panel-last-child\" data-index=\"1\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-editor so-widget-sow-editor-base\"\n\t\t\t\n\t\t><h3 class=\"widget-title\">8 Cat Diseases you Can Prevent with Vaccination and Deworming<\/h3>\n<div class=\"siteorigin-widget-tinymce textwidget\">\n\t<p>1. Rabies (this can be spread to people)<\/p>\n<p>2. Feline panleukopenia (feline distemper)<\/p>\n<p>3. Feline herpesvirus infection<\/p>\n<p>4. Feline calicivirus infection<\/p>\n<p>5. Feline leukemia (FeLV)<\/p>\n<p>6. Feline immunodeficiency virus (FIV) infection<\/p>\n<p>7. Heartworm disease<\/p>\n<p>8. Intestinal worms (roundworms, hookworms, whipworms, tapeworms, etc., some of which can also infect people)<\/p>\n<\/div>\n<\/div><\/div><\/div><\/div><div id=\"pg-717-2\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-2\" ><div id=\"pgc-717-2-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-2-0-0\" class=\"so-panel widget widget_sow-editor panel-first-child\" data-index=\"2\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-editor so-widget-sow-editor-base\"\n\t\t\t\n\t\t><h3 class=\"widget-title\">12 Dog Diseases You Can Combat with Vaccination and Deworming<\/h3>\n<div class=\"siteorigin-widget-tinymce textwidget\">\n\t<p>12 Dog Diseases You Can Combat with Vaccination and Deworming<\/p>\n<p>1. Rabies (this can be spread to people)<\/p>\n<p>2. Canine parvovirus infection (\"parvo\")<\/p>\n<p>3. Canine distemper<\/p>\n<p>4. Leptospirosis<\/p>\n<p>5. Canine adenovirus-2<\/p>\n<p>6. Canine parainfluenza<\/p>\n<p>7. Canine enteric coronavirus<\/p>\n<p>8. Canine influenza<\/p>\n<p>9. Lyme disease<\/p>\n<p>10. Bordetella (\"kennel cough\")<\/p>\n<p>11. Heartworm disease<\/p>\n<p>12. Intestinal worms (roundworms, hookworms, whipworms, tapeworms, etc., some of which can also infect people)<\/p>\n<\/div>\n<\/div><\/div><div id=\"panel-717-2-0-1\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-last-child\" data-index=\"3\" ><div class=\"textwidget\"><h3 style=\"text-align: center;\"><span style=\"color: #000000;\"><em><strong>TICKS!!!<\/strong><\/em><\/span><\/h3>\n<p style=\"text-align: center;\"><span style=\"color: #000000;\">Click on the photo below to go to Tickencounter.org to help identify ticks and find a lot of other helpful information on avoiding these creepy crawly critters!<\/span><\/p>\n<p style=\"text-align: center;\"><a href=\"https:\/\/tickencounter.org\/\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-3571\" src=\"http:\/\/www.blackearthvet.com\/wp-content\/uploads\/2020\/05\/Ticks-1-262x300.jpg\" alt=\"\" width=\"262\" height=\"300\" srcset=\"https:\/\/www.blackearthvet.com\/wp-content\/uploads\/2020\/05\/Ticks-1-262x300.jpg 262w, https:\/\/www.blackearthvet.com\/wp-content\/uploads\/2020\/05\/Ticks-1-300x343.jpg 300w, https:\/\/www.blackearthvet.com\/wp-content\/uploads\/2020\/05\/Ticks-1-390x446.jpg 390w, https:\/\/www.blackearthvet.com\/wp-content\/uploads\/2020\/05\/Ticks-1.jpg 447w\" sizes=\"auto, (max-width: 262px) 100vw, 262px\" \/><\/a><\/p>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-717-3\"  class=\"panel-grid panel-no-style\" ><div id=\"pgc-717-3-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-3-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"4\" ><div class=\"textwidget\"><h3 class=\"widget-title\" style=\"text-align: center;\"><span style=\"color: #000000;\"><em><strong>What You Should Know About Preventing Fleas and Ticks<br \/>\n<\/strong><\/em><\/span><\/h3>\n<p style=\"text-align: center;\"><span style=\"color: #000000;\">Click the map below to learn more about vector-borne disease in our area<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"color: #000000;\"><a style=\"color: #000000;\" href=\"http:\/\/www.dogsandticks.com\/diseases_in_your_area.php\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-medium wp-image-1117\" src=\"http:\/\/www.blackearthvet.com\/wp-content\/uploads\/2014\/10\/Idexx-vector-map-300x234.png\" alt=\"\" width=\"300\" height=\"234\" srcset=\"https:\/\/www.blackearthvet.com\/wp-content\/uploads\/2014\/10\/Idexx-vector-map-300x234.png 300w, https:\/\/www.blackearthvet.com\/wp-content\/uploads\/2014\/10\/Idexx-vector-map-390x304.png 390w, https:\/\/www.blackearthvet.com\/wp-content\/uploads\/2014\/10\/Idexx-vector-map.png 480w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/span><\/p>\n<p><span style=\"color: #000000;\">The thought of insects crawling on your skin and living off your blood probably, well, makes your skin crawl. Yet, too often as pet owners, we allow <a class=\"\" style=\"color: #000000;\" href=\"http:\/\/www.vetstreet.com\/care\/fleas-what-you-need-to-know\">fleas<\/a> and ticks to treat our pets like bed-and-breakfasts. And it is only after these pests make themselves at home that we might realize showing them the door can be difficult, expensive and painfully slow.<\/span><\/p>\n<p><span style=\"color: #000000;\">Fleas and ticks aren\u2019t just irritating and distasteful; they can lead to medical problems. Flea allergies can cause severe itching and skin damage; fleas can also carry the causative agents of <a class=\"\" style=\"color: #000000;\" href=\"http:\/\/www.vetstreet.com\/care\/bartonellosis-cat-scratch-disease\">cat-scratch disease<\/a>, while ticks carry the organisms that can lead to debilitating illnesses like <a class=\"\" style=\"color: #000000;\" href=\"http:\/\/www.vetstreet.com\/our-pet-experts\/help-prevent-these-5-pricey-parasite-problems\">Lyme disease and Rocky Mountain spotted fever<\/a>. So it\u2019s crucial to continuously and effectively <a class=\"\" style=\"color: #000000;\" title=\"Link: http:\/\/www.vetstreet.com\/our-pet-experts\/how-to-get-rid-of-fleas-on-pets-and-prevent-them-from-coming-back\" href=\"http:\/\/www.vetstreet.com\/our-pet-experts\/how-to-get-rid-of-fleas-on-pets-and-prevent-them-from-coming-back\">prevent infestations<\/a> of these parasites for the health and safety of our pets, our families and ourselves.<\/span><\/p>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-XF1Id' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-XF1Id' class='yrm-inner-content-wrapper yrm-cntent-2'><strong>\u00a0<\/strong><\/span><\/p>\n<h2 class=\"cms-customHeadings-h2\"><span style=\"color: #000000;\">Fleas: The Prolific, Perplexing Parasite<\/span><\/h2>\n<p><span style=\"color: #000000;\">Consider the life cycle of the common flea: The average female can lay 40 to 50 eggs daily. The eggs develop into maggot-like larvae and progress to a cocoon stage called pupae. These pupae wait several weeks to months for the ideal temperature and humidity to mature into adult fleas. That single adult flea you find on your pet represents about 5 percent of the total flea problem in your home; eggs, larvae, and pupae comprise the rest. Your pet \u2014 and your home \u2014 can be infested before a single flea is found. And finding them can be tough, especially on cats, because of their constant grooming. That\u2019s why a one-time treatment for fleas isn\u2019t usually enough.<\/span><\/p>\n<p><span style=\"color: #000000;\">Pet owners often discover a flea problem because of a pet\u2019s severe <a class=\"crosslinked cl-mapping-vetstreet cl-dictionary-vetstreet\" style=\"color: #000000;\" href=\"http:\/\/www.vetstreet.com\/care\/helping-your-itchy-pet\">itching<\/a>, which sometimes is due to <a class=\"\" style=\"color: #000000;\" title=\"Link: http:\/\/www.vetstreet.com\/care\/flea-allergy-dermatitis-in-cats-and-dogs\" href=\"http:\/\/www.vetstreet.com\/care\/flea-allergy-dermatitis-in-cats-and-dogs\">flea allergy dermatitis<\/a> \u2014 a sensitization to the flea\u2019s saliva when it draws a blood meal. No pet is safe from fleas and their bites, but not all pets are hypersensitive to them. This means severe infestations can occur without your dog or <a class=\"crosslinked cl-mapping-vetstreet cl-dictionary-vetstreet\" style=\"color: #000000;\" href=\"http:\/\/www.vetstreet.com\/cats\/\">cat<\/a> showing any obvious discomfort. Therefore, it\u2019s best to use preventive tactics to help keep fleas from infesting your pet and home in the first place.<\/span><\/p>\n<p><span style=\"color: #000000;\">To do this, speak with your veterinarian about safe flea-control products that you can administer to your pet year-round. Some products are administered once a month, but other products provide longer-lasting protection. Ask your vet about the best choice for your pets. Consistent use of safe prevention products is the primary method of managing fleas. Newly hatched young adult fleas usually feed right away. If your pet has been treated with an appropriate flea product when these adult fleas emerge, you can help break the cycle of infestation. (Remember to treat <i>all<\/i> of the pets in the house, regardless of whether or not they\u2019re <a class=\"crosslinked cl-mapping-vetstreet cl-dictionary-vetstreet\" style=\"color: #000000;\" href=\"http:\/\/www.vetstreet.com\/care\/helping-your-itchy-pet\">itching<\/a>.)<\/span><\/p>\n<p><span style=\"color: #000000;\">Treating your pet\u2019s environment is also an important part of controlling and preventing flea infestations. Fleas lay their eggs on your pet, but the eggs usually fall off. Once in the environment, they molt into larvae and develop into the pupae stage. Larvae don\u2019t survive well in sunlight, preferring instead to hide in dark, protected areas like deep carpet or pet bedding. Therefore, focus on treating the places your pet likes to rest, especially those that are out of sunlight, like a resting place in the shady area of the yard, your pet\u2019s blanket or pillow \u2014 or even your bed (ick). Frequent cleaning or vacuuming can help reduce the pupal and larval stages of fleas in the carpet, and many flea control products used on pets also kill eggs and larvae.<\/span><\/p>\n<p><span style=\"color: #000000;\">But don\u2019t forget that fleas can gain access to your house or yard in many ways, including wildlife, neighborhood <a class=\"crosslinked cl-mapping-vetstreet cl-dictionary-vetstreet\" style=\"color: #000000;\" href=\"http:\/\/www.vetstreet.com\/cats\/\">cats<\/a> and you, just to name a few. Also remember that if your dogs or cats are allowed access to other areas \u2014 such as parks, nature areas, crawl spaces or even the neighbor\u2019s yard \u2014 they\u2019ll have ample opportunity to encounter fleas. Therefore, even if you\u2019re treating your pet, areas of your home and yard may also need regular attention.<\/span><\/p>\n<h2 class=\"cms-customHeadings-h2\"><span style=\"color: #000000;\">Ticks: Expanding Their Disease-Carrying Reach<\/span><\/h2>\n<p><span style=\"color: #000000;\">Like fleas, ticks can now be found throughout most of the country. Though the severity of tick infestations varies by region, ticks are now spreading into areas that previously had very limited tick problems.<\/span><\/p>\n<p><span style=\"color: #000000;\">Unlike fleas, ticks may not cause dramatic irritation when they attach to your pet\u2019s skin. This lets the tick slowly fill with blood without interference. Before feeding, ticks are often small and easily overlooked; once a tick has eaten and is engorged with blood, it grows in size and often looks bloated. These bloated ticks are usually easier to spot (depending on species\u2014some of them can still be very small), but can be <a class=\"\" style=\"color: #000000;\" title=\"Link: null\" href=\"http:\/\/www.vetstreet.com\/our-pet-experts\/how-to-properly-remove-ticks-common-myths-and-foolproof-methods\">difficult to remove<\/a> \u2014especially if you aren't used to doing it. If you see a bloated tick, your best bet is to visit your veterinarian so she can remove it and check for any additional ticks.<\/span><\/p>\n<p><span style=\"color: #000000;\">There are several species of ticks that pose a risk to pets and people. Ticks can be hosts to several types of disease-producing organisms that can be transmitted to pets or people while the tick is feeding. These organisms can cause illnesses like Lyme disease and Rocky Mountain spotted fever. Again, the lesson here is that it\u2019s best to protect your pets \u2014 and yourself \u2014 from ticks rather than react to them after the fact.<\/span><\/p>\n<p><span style=\"color: #000000;\">Most ticks lurk in tall grass or low-hanging bushes and crawl onto pets or people as they walk by. The tick can then travel on the host \u2014 that\u2019s you or your pet \u2014 to find a suitable place to attach and feed. Considering how stealthy these travelers are, the most reliable plan is to keep your pet on an effective tick preventive all year. Conveniently, many products combine protection from ticks with flea protection. Your veterinarian can recommend a product that is safe and appropriate for your pet.<\/span><\/p>\n<p><span style=\"color: #000000;\">You can also help prevent ticks by keeping the grass and bushes in your pet\u2019s outdoor area mowed and trimmed. If you\u2019re hiking, camping or playing in untended and possibly tick-infested outdoor areas, wear long pants, long-sleeved shirts and headgear to help prevent tick exposure. Afterward, be sure to check both your pets and your family for ticks.<\/span><\/p>\n<h2 class=\"cms-customHeadings-h2\"><span style=\"color: #000000;\">The Risk-Free Myth<\/span><\/h2>\n<p><span style=\"color: #000000;\">Some circumstances may seem like they\u2019d be guaranteed <a class=\"crosslinked cl-mapping-vetstreet cl-dictionary-vetstreet\" style=\"color: #000000;\" href=\"http:\/\/www.vetstreet.com\/category\/sitecontent\/flea-and-tick-prevention\">flea and tick<\/a> free, but this is not so. There is no such thing as a completely risk-free situation. Pets need prevention in every situation.<\/span><\/p>\n<p><span style=\"color: #000000;\">Think your indoor pet is safe? Think again. You\u2019ve seen bugs inside your house \u2014 fleas and ticks can sneak indoors, too. Even pets who don\u2019t venture outside \u2014 such as an indoor cat or a dog who only goes in the yard for potty breaks \u2014 are at risk of <a class=\"crosslinked cl-mapping-vetstreet cl-dictionary-vetstreet\" style=\"color: #000000;\" href=\"http:\/\/www.vetstreet.com\/category\/sitecontent\/flea-and-tick-prevention\">flea and tick<\/a> infestation. Granted, their infestation chances are lower than those of outdoor pets, but you can help protect them by using safe and effective flea and tick control products year-round.<\/span><\/p>\n<p><span style=\"color: #000000;\">And don't assume that there's a flea- and tick-free season. Fall and winter may seem like distant memories at this time of year, but they\u2019re not to be forgotten when it comes to <a class=\"\" style=\"color: #000000;\" href=\"http:\/\/www.vetstreet.com\/our-pet-experts\/why-should-you-care-about-parasites\">parasite prevention<\/a>. Fleas and ticks have a way of popping up in the colder months. In fact, flea numbers can surge in the fall in temperate climates.<\/span><\/p>\n<p><span style=\"color: #000000;\">What\u2019s more, fleas enjoy a wonderful, climate-controlled environment inside your house year-round. They can gain inside access by hitching a ride on outside sources, such as you and your pets, or adult fleas can develop from eggs or larvae that were already hiding in your house. Don\u2019t forget that ticks are extremely tough, too, and can often survive outside even during the winter months. The only way to ensure your <a class=\"crosslinked cl-mapping-vetstreet cl-dictionary-vetstreet\" style=\"color: #000000;\" href=\"http:\/\/www.vetstreet.com\/dogs\/\">dog<\/a> or cat is safe from fleas and ticks is to keep him on a parasite preventive all year.<\/span><\/p>\n<h2 class=\"cms-customHeadings-h2\"><span style=\"color: #000000;\">Keeping Fleas off Pets: Your Options for Preventives<\/span><\/h2>\n<p><span style=\"color: #000000;\">Today\u2019s highly effective parasite preventives each work a little differently to keep fleas off your pets; your veterinarian can recommend a product that best suits your pet\u2019s health needs and your lifestyle. Here\u2019s a look at the differences between oral products (which your pet eats) and topical products (which you apply to your pet\u2019s skin). There are also some effective collars that you may want to ask your vet about.<\/span><\/p>\n<p><span style=\"color: #000000;\">Oral Flea Control<\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">Available as palatable, flavored tablets, therefore, generally easy to administer to most dogs.<\/span><\/li>\n<li><span style=\"color: #000000;\">No mess.<\/span><\/li>\n<li><span style=\"color: #000000;\">No worry about accidental contact with skin (children\u2019s or other pets\u2019) or potential discoloration of household surfaces (furniture or flooring) from topicals immediately after application.<\/span><\/li>\n<li><span style=\"color: #000000;\">No need to worry about swimming or bathing. (Frequent swimming or bathing may reduce the effectiveness of some topicals.)<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\">Topical Flea Control<\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">No risk of your pet <a class=\"crosslinked cl-mapping-vetstreet cl-dictionary-vetstreet\" style=\"color: #000000;\" href=\"http:\/\/www.vetstreet.com\/care\/vomiting-in-cats-and-dogs\">vomiting<\/a> up the medication.<\/span><\/li>\n<li><span style=\"color: #000000;\">No worries about whether your pet ate the whole tablet.<\/span><\/li>\n<li><span style=\"color: #000000;\">An alternative for pets who won't take oral products or are difficult to medicate.<\/span><\/li>\n<\/ul>\n<h2 class=\"cms-customHeadings-h2\"><span style=\"color: #000000;\">Stop Fleas and Ticks Before They Start<\/span><\/h2>\n<p><span style=\"color: #000000;\">Remember this mantra: When it comes to fleas and ticks, it\u2019s best \u2014 and safest \u2014 to prevent an infestation than it is to deal with the consequences. Your veterinarian, as an expert in parasite control and prevention, can recommend the best products to help prevent infestation. (Keep in mind that not all insecticides are safe for both cats and <a class=\"crosslinked cl-mapping-vetstreet cl-dictionary-vetstreet\" style=\"color: #000000;\" href=\"http:\/\/www.vetstreet.com\/dogs\/\">dogs<\/a> of all sizes, so carefully follow your veterinarian\u2019s recommendations.)<\/span><\/p>\n<p><span style=\"color: #000000;\">With a little effort and a year-round prevention plan, you can keep your pets virtually parasite free \u2014 and help ensure that your home sports a \u201cno vacancy\u201d sign when it comes to fleas and ticks.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-XF1Id' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/strong><\/span><\/p>\n<\/div><\/div><\/div><div id=\"pgc-717-3-1\"  class=\"panel-grid-cell\" ><div id=\"panel-717-3-1-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"5\" ><div class=\"textwidget\"><h3><a href=\"http:\/\/www.blackearthvet.com\/wp-content\/uploads\/2014\/10\/pet-first-aid-1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-1012\" src=\"http:\/\/www.blackearthvet.com\/wp-content\/uploads\/2014\/10\/pet-first-aid-1.jpg\" alt=\"\" width=\"197\" height=\"196\" \/><\/a><\/h3>\n<h3 style=\"text-align: center;\"><span style=\"color: #000000;\"><em><strong>Pet First Aid Tips<\/strong><\/em><\/span><\/h3>\n<h4 class=\"ms-rteElement-H2\" style=\"text-align: center;\"><span style=\"color: #000000;\">What would you do if<\/span><\/h4>\n<h5 class=\"ms-rteElement-H2\" style=\"text-align: center;\"><span style=\"color: #000000;\">...your dog ate the bag of semi-sweet chocolate chips that was left out on the kitchen counter?<\/span><\/h5>\n<h5 class=\"ms-rteElement-H3\" style=\"text-align: center;\"><span style=\"color: #000000;\">...your cat had a seizure right in front of you?<\/span><\/h5>\n<h5 class=\"ms-rteElement-H3\" style=\"text-align: center;\"><span style=\"color: #000000;\">...your dog fell down the stairs and started limping?<\/span><\/h5>\n<h5 class=\"ms-rteElement-H3\" style=\"text-align: center;\"><span style=\"color: #000000;\">...your cat was overheating on a hot summer day?<\/span><\/h5>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-Vemtg' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-Vemtg' class='yrm-inner-content-wrapper yrm-cntent-2'><strong>\u00a0<\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\"><a style=\"color: #000000;\" href=\"https:\/\/ebusiness.avma.org\/ProductCatalog\/product.aspx?ID=934\">View our Pet First Aid brochure<\/a><\/span><\/p>\n<p><span style=\"color: #000000;\">To avoid the feelings of panic that may accompany these situations, we recommend the following steps to better prepare you for a pet medical emergency. The following links summarize the basics you need for giving first aid care to your pet.<\/span><\/p>\n<div>\n<hr class=\"ms-rteElement-Hr\" \/>\n<p><span style=\"color: #000000;\"><strong class=\"ms-rteThemeBackColor-10-2\">Always remember that any first aid administered to your pet should be followed by immediate veterinary care. First aid care is not a substitute for veterinary care, but it may save your pet's life until it receives veterinary treatment.<\/strong><\/span><\/p>\n<\/div>\n<p><span style=\"color: #000000;\"><a style=\"color: #000000;\" href=\"https:\/\/www.avma.org\/public\/EmergencyCare\/Pages\/Supplies-Checklist.aspx\">First aid supplies<\/a><\/span><br \/>\n<span style=\"color: #000000;\">Our handy checklist tells you all the supplies you should have on hand for pet first aid. Print out a copy to use for shopping, and keep a copy on your refrigerator or next to the first aid kit for your family, for quick reference in emergencies.<\/span><\/p>\n<p><span style=\"color: #000000;\"><a style=\"color: #000000;\" href=\"https:\/\/www.avma.org\/public\/EmergencyCare\/Pages\/Handling-an-Injured-Pet.aspx\">How to handle an injured pet<\/a><\/span><br \/>\n<span style=\"color: #000000;\">Knowing how to comfort an injured pet can help minimize your pet's anxiety and also protect you and your family from injury.<\/span><\/p>\n<p><span style=\"color: #000000;\"><a style=\"color: #000000;\" href=\"https:\/\/www.avma.org\/public\/EmergencyCare\/Pages\/Basic-Pet-First-Aid-Procedures.aspx\">Basic pet first aid procedures<\/a><\/span><br \/>\n<span style=\"color: #000000;\">Read our simple instructions for providing emergency first aid if your pet is suffering from poisoning, seizures, broken bones, bleeding, burns, shock, heatstroke, choking or other urgent medical problems. Print out a copy to keep with your pet emergency kit.<\/span><\/p>\n<p><span style=\"color: #000000;\"><a style=\"color: #000000;\" href=\"https:\/\/www.avma.org\/public\/EmergencyCare\/Pages\/First-Aid-When-Traveling.aspx\">First aid when traveling with your pet<\/a><\/span><br \/>\n<span style=\"color: #000000;\">A few simple steps can better prepare you to help your pet in first aid situations while you are traveling. Remember: pet medical emergencies don't just happen at home.<\/span><\/p>\n<p><span style=\"color: #000000;\"><a style=\"color: #000000;\" href=\"https:\/\/www.avma.org\/public\/EmergencyCare\/Pages\/Pets-and-Disasters.aspx\">Pets and disasters<\/a><\/span><br \/>\n<span style=\"color: #000000;\">Whether confronted by natural disasters such as hurricanes, or unexpected catastrophes such as a house fire, you need to be prepared to take care of your animals. A pre-determined disaster plan will help you remain calm and think clearly.<\/span><\/p>\n<h3 class=\"ms-rteElement-H3\"><span style=\"color: #000000;\">Additional pet first aid links<\/span><\/h3>\n<ul>\n<li><span style=\"color: #000000;\">American Animal Hospital Association (AAHA)\/Healthy Pet: <a style=\"color: #000000;\" href=\"http:\/\/www.healthypet.com\/library_view.aspx?ID=81&amp;sid=1\" target=\"_blank\" rel=\"noopener\">Pet First Aid<\/a><\/span><\/li>\n<li><span style=\"color: #000000;\">The University of Illinois College of Veterinary Medicine: <a style=\"color: #000000;\" href=\"http:\/\/vetmed.illinois.edu\/petcolumns\/index.cfm?function=showarticle&amp;id=530\" target=\"_blank\" rel=\"noopener\">Basic First Aid for Your Pet<\/a><\/span><\/li>\n<li><span style=\"color: #000000;\">American Red Cross: <a style=\"color: #000000;\" href=\"http:\/\/www.redcross.org\/SERVICES\/disaster\/beprepared\/firstaid.html\" target=\"_blank\" rel=\"noopener\">First Aid for Pets<\/a><\/span><\/li>\n<li><span style=\"color: #000000;\">VeterinaryPartner.com: <a style=\"color: #000000;\" href=\"http:\/\/www.veterinarypartner.com\/Content.plx?P=SRC&amp;S=1&amp;SourceID=20\" target=\"_blank\" rel=\"noopener\">First Aid and Emergency Care<\/a><\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\"><strong><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-Vemtg' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/strong><\/span><\/p>\n<\/div><\/div><\/div><\/div><div id=\"pg-717-4\"  class=\"panel-grid panel-no-style\" ><div id=\"pgc-717-4-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-4-0-0\" class=\"so-panel widget widget_sow-editor panel-first-child panel-last-child\" data-index=\"6\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-editor so-widget-sow-editor-base\"\n\t\t\t\n\t\t><h3 class=\"widget-title\">!!Fleas!! Myth vs Fact!<\/h3>\n<div class=\"siteorigin-widget-tinymce textwidget\">\n\t<p>!!Fleas!! Myth vs Fact!<\/p>\n<p>My house has no carpet, so I do not have to worry about fleas in my home.<\/p>\n<p>Fact: Flea eggs will drop off the pet and accumulate in the cracks of hardwood floors and along the baseboards. The larvae will then move deep into these crevices to avoid exposure to light. Fleas can survive and multiply in most environments.<\/p>\n<p>I do not see fleas on my pet, so there must not be any.<\/p>\n<p>Fact: Visible adult fleas are only a small portion of the infestation. Fleas exist in the environment as \u224857% eggs, 34% larvae, 8% pupae, and 1% adults. Fleas are difficult to see on many types of hair coats. They can be harder to see on cats, who are very good at removing the fleas when they groom.<\/p>\n<p>My pet never leaves my yard, and my lawn is short and well maintained.<\/p>\n<p>Fact: Fleas will survive in any shady, moist environment where pets rest.<\/p>\n<p>I do not need to use preventives during the winter months.<\/p>\n<p>Fact: Fleas can survive for 10 days at 37.4oF. In cold climates, adult fleas survive on the warm bodies of dogs, cats, and other mammals, and indoors within pupal casings as pre-emerged adults.<\/p>\n<p>I give my dog garlic as a natural flea preventive.<\/p>\n<p>Fact: Garlic ingestion is an ineffective flea remedy that can have negative health effects. Garlic toxicity can result in oxidative damage to erythrocytes, which may lead to Heinz body formation, hemolytic anemia, methemoglobinemia, and impaired oxygen transportation.<\/p>\n<\/div>\n<\/div><\/div><\/div><\/div><div id=\"pg-717-5\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-5\" ><div id=\"pgc-717-5-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-5-0-0\" class=\"so-panel widget widget_sow-editor panel-first-child\" data-index=\"7\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-editor so-widget-sow-editor-base\"\n\t\t\t\n\t\t><h3 class=\"widget-title\">Why you Should Not Feed Grain Free Diets<\/h3>\n<div class=\"siteorigin-widget-tinymce textwidget\">\n\t<p>FDA Investigation into Potential Link between Certain Diets and Canine Dilated Cardiomyopathy<\/p>\n<p>Check out the links below to learn more:<\/p>\n<p><a href=\"https:\/\/www.fda.gov\/animal-veterinary\/animal-health-literacy\/questions-answers-fdas-work-potential-causes-non-hereditary-dcm-dogs\">https:\/\/www.fda.gov\/animal-veterinary\/animal-health-literacy\/questions-answers-fdas-work-potential-causes-non-hereditary-dcm-dogs<\/a><\/p>\n<p><a href=\"https:\/\/www.aaha.org\/publications\/newstat\/articles\/2021-08\/new-clues-to-diet-associated-dcm-in-dogs\/\">https:\/\/www.aaha.org\/publications\/newstat\/articles\/2021-08\/new-clues-to-diet-associated-dcm-in-dogs\/<\/a><\/p>\n<p>&nbsp;<\/p>\n<\/div>\n<\/div><\/div><div id=\"panel-717-5-0-1\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-last-child\" data-index=\"8\" ><div class=\"textwidget\"><h3><span style=\"color: #000000;\"><em><strong>Bathing Your Dog<\/strong><\/em><\/span><\/h3>\n<p><span style=\"color: #000000;\">Every pet owner has an olfactory (smell) memory that triggers their gag reflex, \u201cI\u2019ve never smelled anything like it!\u00a0 (S)He must have rolled in something dead!Odors that defy classification have an obvious solution; bathe the dog. Soap choice is where the confusion starts. In some situations it seems nothing but the harshest solvents will be adequate to clean your pet. It may also seem reasonable to use dish soap or a product designed for human hygiene, such as shampoo. \u201cHarsh chemicals aren\u2019t necessary,\u201d assured Terese DeManuelle, a veterinary dermatologist from Portland, Oregon. \u201cA mild hypoallergenic soap that\u2019s formulated for veterinary use is all you need.\u201d \u201cFormulated for veterinary use\u201d means a product that\u2019s designed to work with a dog\u2019s body. While dish soap or your favorite shampoo might strip away the dirt, and more importantly the odor, from your pet\u2019s coat, it will also strip natural oils from their fur and may irritate their skin.<\/span><\/p>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-74Tkm' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-74Tkm' class='yrm-inner-content-wrapper yrm-cntent-2'><\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>\u00a0<\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\">All grooming products (human and animal) are designed to maximize cleaning and minimize irritation. Human products work best on human skin and veterinary products are designed to work best on dog skin. The chemistry of a dog\u2019s skin and fur are different than the chemistry of a human\u2019s skin and hair.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">In addition to the odor- provoked \u201cemergency bath\u201d Dr. DeManuelle notes it\u2019s safe to bathe your dog with veterinary shampoo once a week. However, if the veterinary shampoo you\u2019re using contains any medication or insecticide, follow the instructions provided by your veterinarian. Prescription shampoos treat specific problems and may necessitate bathing more or less frequently than once a week.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>A final insight pertaining to bathing your pet is to comb their coat prior to bathing. Wet fur mats more than dry fur so a wet tangled coat is harder to brush out and will take longer to dry. This small detail can save you time and prevent an uncomfortable brushing for your pet.\u00a0<\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\">After a bath your dog will smell good, look good, and probably feel good. Make sure your dog is dry before you allow it back outside or it will feel good enough to dry itself. It will streak from the tub straight outside to find a new exotic aroma to frolic in and bring home to share.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>This Pet Health Topic was written by Sarah Hoggan, Washington State University, Class of 2001.<\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-74Tkm' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/strong><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-717-6\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-6\" ><div id=\"pgc-717-6-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-6-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"9\" ><div class=\"textwidget\"><h3><span style=\"color: #000000;\"><em><strong>An Overview of Cancer<\/strong><\/em><\/span><\/h3>\n<p><span style=\"color: #000000;\">Cancer is caused by uncontrolled and purposeless growth of cells in the body. Other terms for cancer are malignancy, tumor and neoplasia. Cancer can arise from any tissue in the body so there are many types of cancer.<\/span><\/p>\n<p><span style=\"color: #000000;\">Some forms of cancer have the ability to spread to other sites in the body which are often far from the original site. This happens when cancer cells enter the blood or lymph vessels and are then carried to other organs. Cancers with this type of behavior are considered malignant.<\/span><\/p>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-4El3N' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-4El3N' class='yrm-inner-content-wrapper yrm-cntent-2'><\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>\u00a0<\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\">Often, it is the spread of a cancer that causes the greatest problems. When a cancer has spread in this fashion, it is said to have metastasized. Some cancers lack the ability to metastasize, but may cause significant damage due to growth and invasion into local tissues. Tumors that do not metastasize and are not invasive are considered benign. Tumor is a general term for cancer whether it is benign (\u201cgood cancer\u201d) or malignant (\u201cbad cancer\u201d). Oncology is the branch of medicine dedicated to the study of cancer, and the people treating your pet at WSU are Oncologists and Oncology nurses.<\/span><\/p>\n<h4><span style=\"color: #000000;\"><strong><br \/>\nTumor Evaluation (Work-up): Tumor Staging<\/strong><\/span><\/h4>\n<p><span style=\"color: #000000;\">The first task for the veterinarian is to determine the extent of the tumor which is a process called tumor staging. Staging information is vital for several reasons including:<\/span><\/p>\n<p><span style=\"color: #000000;\">1. determination of your pet\u2019s prognosis (i.e., the expected outcome for your pet from the illness) and, <\/span><br \/>\n<span style=\"color: #000000;\">2. formulation of a plan for treatment.<\/span><\/p>\n<p><span style=\"color: #000000;\">To gather information that can help to determine the extent of the cancer, your veterinarian will need to evaluate your pet by several methods. These usually include blood tests (e.g., blood count, chemistry profile), urinalysis, radiographs (x-rays), tissue aspirate (a sample taken with a fine needle) and biopsy. Tests which your veterinarian may have performed might be repeated at WSU due to the changing nature of your pet\u2019s illness. In addition, as indicated for specific patients, other testing procedures may include: ultrasound, specialized radiologic studies (e.g., CT scan, dye contrast studies), bone marrow aspirate, lymph node aspirate, endoscopy (direct examination of the stomach, colon or bronchi with a specialized scope), and immunologic studies. It is important to note that medicine is not an exact science and despite these staging procedures, it is still possible to fail to recognize small sites of tumor or the presence of tumor in organs that are difficult to study.<\/span><\/p>\n<p><span style=\"color: #000000;\">Once the tumor staging has been completed, your veterinarian will better be able to discuss treatment options for your pet. The goal of such therapy will also be discussed. Tumors that have metastasized extensively are usually not curable. Therefore, the objective of therapy for these animals is palliation (i.e., afford relief of signs without providing cure, and possibly, prolong life). Localized tumors that are not deeply invasive have the best chance to be cured.<\/span><\/p>\n<h4><span style=\"color: #000000;\"><strong>Cancer Therapy<\/strong><\/span><\/h4>\n<p><span style=\"color: #000000;\">There are several types of therapy used to treat cancer in dogs and cats at WSU. These include surgery, chemotherapy, radiation therapy, and immunotherapy. For some tumors, treatment will consist of a single type of therapy, while combination therapy may be recommended for other types of cancer or for animals with a more advanced stage of disease. On occasion, due to the rarity of a particular tumor, a precise treatment recommendation may not be known. In an effort to test newer (and hopefully more effective) forms of therapy, you may be asked to enroll your pet in an investigative clinical trial. The purpose of such a trial is to learn more about the specific type of treatment (that may be of value to humans and other pets with cancer) as well as hopefully providing a benefit to your pet. Only pet owners of animals with tumors for which there is no effective treatment, or tumors that have not responded to conventional treatment will be offered investigative therapy for their pets.<\/span><\/p>\n<h4><span style=\"color: #000000;\"><strong>Should You Treat Your Pet?<\/strong><\/span><\/h4>\n<p><span style=\"color: #000000;\">Treating animals with cancer is not appropriate for every pet owner. It takes a strong commitment on the part of the owner. Therapy requires frequent trips to the veterinary hospital and can be expensive. For some forms of cancer treatment, once begun treatment is never stopped during the animal\u2019s life although the frequency of these treatments can be decreased. Your veterinarian cannot do it alone since treating pets with cancer is truly a team effort and the pet owner is on the team. It is important for you to present your pet for treatment precisely when requested to do so by your veterinarian since the timing of cancer therapy is critical for obtaining an optimal outcome. In addition, medicines to be given to your pet at home should be administered by you exactly as instructed by your oncologist. Any abnormalities or problems you encounter should be reported to your regular veterinarian or oncologist promptly. Always feel free to ask questions and communicate with us.<\/span><\/p>\n<p><span style=\"color: #000000;\">Keep in mind your veterinarian is as concerned about the quality of your pet\u2019s life as you are. The goal of the therapy is to keep your pet happy and minimize discomfort. Although some animals may experience transient discomfort from therapy, treatment of most pets with cancer can be accomplished without major distress or detraction from your pet\u2019s enjoyment of life. Just because an animal has been diagnosed with cancer does not mean its life is immediately over. Your commitment to your pet and your veterinarians dedication to providing state-of-the-art care will work together to keep your pet as happy as possible.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-4El3N' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/strong><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-717-7\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-7\" ><div id=\"pgc-717-7-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-7-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"10\" ><div class=\"textwidget\"><h3><span style=\"color: #000000;\"><strong><em>Chronic Kidney Disease and Failure<\/em><\/strong><\/span><\/h3>\n<p><span style=\"color: #000000;\">Chronic kidney disease is defined as kidney disease that has been present for months to years. Chronic renal disease (CRD), chronic renal failure (CRF), and chronic renal insufficiency refer to the same condition.<\/span><\/p>\n<p><span style=\"color: #000000;\">CKD is not a single disease. There are many different causes of CKD but by the time the animal shows signs of kidney disease the cause may no longer be apparent. Some potential causes of CRF include:<\/span><\/p>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-yDkBY' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-yDkBY' class='yrm-inner-content-wrapper yrm-cntent-2'><\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">congenital malformation of the kidneys (birth defects)<\/span><\/li>\n<li><span style=\"color: #000000;\">chronic bacterial infection of the kidneys with or without kidney stones (pyelonephritis)<\/span><\/li>\n<li><span style=\"color: #000000;\">high blood pressure (hypertension)<\/span><\/li>\n<li><span style=\"color: #000000;\">diseases associated with the immune system (e.g. glomerulonephritis, systemic lupus))<\/span><\/li>\n<li><span style=\"color: #000000;\">acute kidney disease, for example poisoning with antifreeze, that damages the kidneys can lead to CKD<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\"><strong>Often the cause of CKD is unknown.<\/strong><\/span><\/p>\n<h4><span style=\"color: #000000;\">Structure of the kidneys<\/span><\/h4>\n<p><span style=\"color: #000000;\">The microscopic unit of the kidney is called the nephron. Each kidney contains thousands of nephrons. When the pet is young and healthy not all nephrons are working all of the time; some nephrons are held in reserve. As the animal ages or if the kidneys are damaged, some nephrons die and other resting nephrons take over the work of those that die. Eventually all the remaining nephrons are working. When there are no extra nephrons remaining and kidney damage continues the pet will start showing signs of CKD. Because of this stepwise loss of nephrons the kidneys are able to \"hide\" the fact that they are damaged until the damage is severe. When 2\/3 of the nephrons have been lost the pet is no longer able to conserve water and the pet passes larger amounts of dilute urine. By the time a pet has an elevation in the waste product creatinine in its blood, 75% of the nephrons in both kidneys have been lost.<\/span><\/p>\n<h4><span style=\"color: #000000;\">What do the kidneys do?<\/span><\/h4>\n<p><span style=\"color: #000000;\">When blood flows through the kidneys, the kidneys act as a complex filter that removes from blood wastes that are generated from break down of food, old cells, toxins or poisons and many drugs that are given for treatment of other diseases. The wastes are removed with water as urine. Waste products than can be measured in the blood include creatinine and urea nitrogen but there are many other waste products that are not measured by blood tests. The kidneys also acts as a filter to keep \"good\" substances in the blood. The kidneys regulate the amount of water in the blood by excreting extra water and retaining water to prevent dehydration by varying the amount of urine that is produced. The kidneys help regulate blood pressure by saving or eliminating sodium based on how much sodium the pet is eating. The kidneys help regulate calcium and vitamin D which keep bones strong. The kidneys produce a substance that helps with the creation of new red blood cells. Because the kidneys have so many functions, when the kidneys are not working normally, there are many signs that the pet may show.<\/span><\/p>\n<h4><span style=\"color: #000000;\">CKD is progressive<\/span><\/h4>\n<p><span style=\"color: #000000;\">By the time the pet shows signs of CKD, the damage is severe. There is no cure for CKD. The remaining nephrons are working so hard that with time they will fail as well. CKD is usually fatal in months to years but various treatments can keep the pet comfortable and with a good quality of life for months to years.<\/span><\/p>\n<h4><span style=\"color: #000000;\">Signs of CKD<\/span><\/h4>\n<p><span style=\"color: #000000;\">Because the kidneys perform so many functions, the signs pets with CKD show can vary quite a bit. The signs may be severe or may be subtle and slowly progressive. Despite the chronic nature of the disease, sometimes signs appear suddenly. Some of the more common signs of CKD include:<\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">drinking too much (polydipsia) and urinating large volumes of urine (polyuria)<\/span><\/li>\n<li><span style=\"color: #000000;\">the increased volume of urine in the bladder may lead to, or worsen incontinence (leaking urine), especially at night<\/span><\/li>\n<li><span style=\"color: #000000;\">vomiting and\/or diarrhea<\/span><\/li>\n<li><span style=\"color: #000000;\">lack of appetite and weight loss<\/span><\/li>\n<li><span style=\"color: #000000;\">general depression related to the elevation of waste products in the blood<\/span><\/li>\n<li><span style=\"color: #000000;\">anemia resulting in pale gums and weakness due to a low blood count<\/span><\/li>\n<li><span style=\"color: #000000;\">overall weakness from low blood potassium<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\"><strong><br \/>\nLess common signs include<\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">weakened bones can result in bone fractures<\/span><\/li>\n<li><span style=\"color: #000000;\">high blood pressure can lead to sudden blindness<\/span><\/li>\n<li><span style=\"color: #000000;\">itchy skin from calcium and phosphorous depositing in the skin<\/span><\/li>\n<li><span style=\"color: #000000;\">bleeding into the stomach or gut or bruising of skin<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\">Signs you <strong>may<\/strong> see if you examine your pet include: dehydration, weight loss, pale gums and ulcers in the mouth.<\/span><\/p>\n<p><span style=\"color: #000000;\">The signs seen in pets with CKD and the findings on examination are not specific for CKD and may be seen with many other diseases so blood and urine tests are needed to make a diagnosis of CKD.<\/span><\/p>\n<h4><span style=\"color: #000000;\">Diagnostic Tests<\/span><\/h4>\n<p><span style=\"color: #000000;\">Abnormalities that are often seen on diagnostic blood and urine tests include:<\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">anemia without signs of a response by the body to the low blood count (non regenerative anemia)<\/span><\/li>\n<li><span style=\"color: #000000;\">increased wastes that are normally removed by the kidneys (blood urea nitrogen [BUN] and creatinine)<\/span><\/li>\n<li><span style=\"color: #000000;\">increased phosphorus<\/span><\/li>\n<li><span style=\"color: #000000;\">calcium is often normal but can be elevated in some pets with CKD and rarely is decreased<\/span><\/li>\n<li><span style=\"color: #000000;\">dilute urine<\/span><\/li>\n<li><span style=\"color: #000000;\">+\/- protein or bacteria in the urine<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\">Sometimes bruising occurs where the blood sample was drawn as pets with CKD may have platelets that are less sticky than normal (normal platelets prevent bruising).<\/span><\/p>\n<p><span style=\"color: #000000;\">A diagnosis of CKD can usually be made based on the signs, physical examination and blood and urine tests but other tests may be performed to look for an underlying cause for the CKD and\/or to \"stage\" the CKD.<\/span><\/p>\n<div class=\"droplink\"><span style=\"color: #000000;\"><strong><a style=\"color: #000000;\" title=\"Details about staging\" href=\"http:\/\/www.vetmed.wsu.edu\/ClientED\/Details%20about%20staging\" name=\"bookmark\"> Details about staging<\/a><\/strong> <span class=\"style3\">\u00a0(click to expand)<\/span><\/span><\/div>\n<div id=\"Details about staging\" class=\"dropdown\">\n<p><span style=\"color: #000000;\">The severity of chronic kidney disease (CKD) can be estimated based on blood waste product elevation and abnormalities in the urine such as the presence of protein. The International Renal Interest Society (IRIS) has developed a method to estimate the stages of CKD.\u00a0 Stages are numbered 1 through 4 where one is the least severe and four is the most severe.\u00a0 The higher the stage number also generally corresponds to the greater number of symptoms seen in the pet.\u00a0 Some treatments are recommended to be started when the pet has a certain stage of CKD.<\/span><\/p>\n<p><span style=\"color: #000000;\">See the <a style=\"color: #000000;\" href=\"http:\/\/www.iris-kidney.com\/pdf\/IRIS%202006%20Staging%20of%20CKD.pdf\"> IRIS site for full details on staging<\/a>.<\/span><\/p>\n<hr \/>\n<\/div>\n<h4><span style=\"color: #000000;\">Other tests that may be performed include<\/span><\/h4>\n<ol>\n<li><span style=\"color: #000000;\">Determination of kidney size using abdominal radiographs (x-rays) or ultrasound <\/span><br \/>\n<span style=\"color: #000000;\"><em>What might this test show?<\/em><strong>\u00a0 <\/strong>The kidneys in pets with CRD are usually small reflecting the death of a large number of nephrons. If the kidneys are large then certain causes for the CKD should be considered such as lymphoma (cancer) of the kidneys, or an uncommon disease called amyloidosis. Some pets with signs of kidney disease who have large or normal sized kidneys may have acute kidney failure rather than CKD. The treatment and prognosis for pets with acute kidney disease differs from the treatment and prognosis of pets with CKD.<\/span><\/li>\n<li value=\"2\"><span style=\"color: #000000;\">Kidney biopsy<strong><br \/>\n<\/strong><em>What might this test show?<\/em><strong>\u00a0 <\/strong>A biopsy is not required to make a diagnosis of CKD but the results of a biopsy may show a cause for the CKD. A biopsy is more likely to show specific information when the kidneys are big rather than small. A biopsy can be valuable in pets who develop CKD at a young age or who are of a breed known to develop congenital kidney disease. There may be specific microscopic changes in a kidney biopsy from an animal with congenital kidney disease that may suggest that related animals are also at risk for developing CKD. Knowledge that the cause of CKD is caused by congenital kidney disease does not change the treatment of the affected animal but does provide information for related animals, for example if you should remove them from a breeding program. When a biopsy is planned, usually the biopsy is collected using ultrasound or laparoscopy to see the kidney during the biopsy so that no other organs are damaged during the biopsy.<\/span><\/li>\n<li value=\"3\"><span style=\"color: #000000;\">Bacterial culture<\/span><br \/>\n<span style=\"color: #000000;\"><em>What might this test show?<\/em><strong>\u00a0 <\/strong>Bacterial infection is not a common cause of CRD but pets with CKD may develop a bacterial infection as several aspects of the pet's immune system may be less functional when the kidneys are failing.\u00a0 If white blood cells are observed on microscopic examination of the pet's urine, a bacterial culture of the urine should be obtained.<\/span><\/li>\n<li value=\"4\"><span style=\"color: #000000;\">Tests of clotting ability<strong><br \/>\n<\/strong><em>What might this test show?<\/em><strong>\u00a0 <\/strong>If a pet is going to under go kidney biopsy, tests may be performed in advance to evaluate the ability to stop the bleeding from the biopsy site.<\/span><\/li>\n<\/ol>\n<h4><span style=\"color: #000000;\">Treatment of CRF<\/span><\/h4>\n<p><span style=\"color: #000000;\">The severity of the pet's signs will determine what treatments are needed. Not all treatments presented below may be needed or appropriate for each pet with a diagnosis of CKD. Treatments may also be started incrementally (a few treatments are started and then based on patient response, additional treatments may be added later). <strong><span class=\"style4\">The information below is not meant to be a substitute for veterinary care.<\/span><\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\">Pets with severe signs may be hospitalized for fluid and intravenous drug treatment to reduce the amount of waste products in their body. Many pets with CKD will feel better in response to treatment with IV fluids but if the kidney disease is extremely severe the pet may not respond to treatment.<\/span><\/p>\n<p><span style=\"color: #000000;\">Those pets who are still eating and not showing severe signs are treated with a variety of treatments, often introducing treatments incrementally as new signs develop. The treatment approach is often called \"conservative\" compared to more aggressive treatments such as hospitalization for fluid therapy, dialysis or kidney transplantation. <strong>Remember that CKD is not a disease that can be cured. <\/strong>Treatments are designed to reduce the work the kidneys need to perform, to replace substances that may be too low (such as potassium) and to reduce wastes that accumulate such as urea (generated by the body from proteins) and phosphorus. The initial response to conservative therapy may be relatively slow, taking weeks to months to see a response.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Diet<br \/>\n<\/strong>Feeding of a kidney diet is usually recommended. Kidney diets contain less protein compared to other diets and the protein is high in quality. It is protein in the diet that is converted to waste products that the kidneys must remove in the urine. The higher the quality of the protein in the diet, the less wastes created for the kidneys to eliminate. Low quality protein requires the kidneys remove more wastes. which makes them work harder. Egg and meat contain higher quality protein; cereal grain protein is of lower quality which leads to more wastes for the kidneys to eliminate. Protein is used by the body to repair cells and tissues that are continually regenerating, so a pet needs some protein in their diet. By feeding a low quantity, but high quality protein diet that contains an appropriate amount of fats and carbohydrates, the pet's body can use the protein for replacing the cells and tissues and use the fat and carbohydrates for energy. Kidney diets also contain a lower amount of phosphorus. Phosphorus accumulates in the blood when the kidneys are diseased. Kidney diets control the amount of other substances that may be too high or too low in patients with CKD such as salt, potassium, magnesium and B vitamins. There are differences in the kidney diets for dogs and cats. When making diet changes it is often beneficial to gradually introduce the new diet by adding increasing amounts of the new diet while reducing the amount of the current diet over 1 to 2 weeks. The pet is more likely to accept a new diet when it is introduced gradually and it is less stressful to the kidneys to gradually adapt to changes in the diet.<\/span><\/p>\n<p><span style=\"color: #000000;\">Protein restricted diets are less palatable than higher protein diets. Pets with CKD that are still eating are more likely to accept a change in diet to a protein restricted diet than are pets who are very ill and refusing most foods. Protein restricted diets are more expensive than higher protein diets.<\/span><\/p>\n<p><span style=\"color: #000000;\">There are many pet food companies that sell kidney diets.\u00a0 Dr. Tony Buffington at the Ohio State University is a good source of information on available diets. <a style=\"color: #000000;\" href=\"http:\/\/vet.osu.edu\/1442.htm\"> http:\/\/vet.osu.edu\/1442.htm<\/a>\u00a0 select a species, a diet form and select <em>Reduced Phosphorous\/Protein<\/em> for a list of diets for pets with kidney disease. Homemade diets can be fed but it is best to work with your veterinarian to formulate a diet that is balanced.<\/span><\/p>\n<div class=\"droplink\"><span style=\"color: #000000;\"><a style=\"color: #000000;\" title=\"Diet effect\" href=\"http:\/\/www.vetmed.wsu.edu\/ClientED\/ckd.aspx#\" name=\"bookmark\"><strong> Diet effect<\/strong><\/a>\u00a0 <span class=\"style5\">(click to expand for published information about diet in pets with CKD) <\/span><\/span><\/div>\n<div id=\"Diet effect\" class=\"dropdown\">\n<p><span style=\"color: #000000;\">It is generally agreed that feeding renal failure diets to dogs and cats with kidney disease improves their quality of live and <strong>may<\/strong> minimize the progression of the disease resulting in a longer life span. Studies that evaluate the effect of dietary changes on quality and quantity of life typically use commercial diets that differ in their composition of protein, phosphorus, sodium and lipids compared to maintenance diets so that positive effects are not attributable to a single component of the diet but rather to a \"<em>diet effect<\/em>\".<\/span><\/p>\n<p><span style=\"color: #000000;\">A randomized, double masked, clinical study in 38 dogs with spontaneous stage 3 or 4 kidney disease, half of which were fed a kidney failure diet and the other half a maintenance diet, published in <a style=\"color: #000000;\" href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/11990962?\"> JAVMA in 2002<\/a>, demonstrated improved quality and increased quantity of life in the group fed the renal failure diet.<\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">The median interval before development of a uremic crisis was twice as long in the group fed the renal diet<\/span><\/li>\n<li><span style=\"color: #000000;\">Dogs fed the renal diet survived at least 13 months longer (average 593 vs 188 days)<\/span><\/li>\n<li><span style=\"color: #000000;\">Owners of dogs fed the renal diet reported significantly higher quality of life scores for their dogs<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\">The results of a <a style=\"color: #000000;\" href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/10879400?\"> study of cats with naturally occurring stable chronic renal failure<\/a> fed a diet restricted in phosphorus and protein compared to cats with CKD fed a maintenance diet reported a median survival of 633 days for 29 cats fed the renal diet compared to 264 days for 21 cats fed a regular diet. The groups were not randomly determined but based on cat &amp; owners willingness to change to the renal diet.<\/span><\/p>\n<p><span style=\"color: #000000;\">In a study published in <a style=\"color: #000000;\" href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/16978113?ordinalpos=1&amp;itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&amp;linkpos=5&amp;log$=relatedarticles&amp;dbfrom=pubmed\"> JAVMA in 2006<\/a>, 45 client-owned cats with spontaneous stage 2 or 3 CKD were randomly assigned to an adult maintenance diet (23 cats) or a renal diet (22 cats) and evaluated for up to 24 months. Findings included:<\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">Significant differences: BUN lower and blood bicarbonate higher in the renal diet group<\/span><\/li>\n<li><span style=\"color: #000000;\">No Significant differences <\/span><br \/>\n<span style=\"color: #000000;\">body weight<\/span><br \/>\n<span style=\"color: #000000;\">PCV<\/span><br \/>\n<span style=\"color: #000000;\">urine protein-to-creatinine ratio<\/span><br \/>\n<span style=\"color: #000000;\">creatinine<\/span><br \/>\n<span style=\"color: #000000;\">potassium<\/span><br \/>\n<span style=\"color: #000000;\">calcium<\/span><br \/>\n<span style=\"color: #000000;\">parathyroid hormone concentrations.<\/span><\/li>\n<li><span style=\"color: #000000;\">26% of cats fed the maintenance diet had uremic episodes (26%), compared with 0% cats fed the renal diet<\/span><\/li>\n<li><span style=\"color: #000000;\">At the conclusion of the study, 5 (21.7%) cats in the maintenance diet group had died from renal causes and there were no renal-related deaths in the renal diet group.<\/span><\/li>\n<li><span style=\"color: #000000;\">There were no significant differences in quality of life as perceived by owners responding to a questionnaire.<\/span><\/li>\n<li><span style=\"color: #000000;\">Owners impressions of cats willingness to consume the diets did not differ between groups<\/span><\/li>\n<\/ul>\n<\/div>\n<hr \/>\n<p><span style=\"color: #000000;\"><strong>Water<br \/>\n<\/strong>Because pets with kidney disease cannot conserve water by making concentrated urine, their water intake is very important to prevent dehydration. Make sure they always have plenty of fresh water available.\u00a0 If the pet is not eating well, or is vomiting, then s(he) may not be drinking enough and may get dehydrated. Pets can be encouraged to drink by giving them flavored broths in addition to plain water. The broth should be low in sodium and its best to discuss with your veterinarian other ingredients in the broth to make sure it doesn't contain substances that will make the kidneys work harder.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Water soluble vitamins<\/strong> like B and C are lost in greater amounts when the pet is urinating greater amounts. Kidney diets contain increased amounts of water soluble vitamins so additional vitamins do not need to be given unless a homemade diet is being fed.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Potassium<br \/>\n<\/strong>Lack of appetite and increased loss of potassium in urine may result in low body potassium (hypokalemia).\u00a0 Cats with CKD are more likely to have low body potassium than are dogs. Cats with low potassium may develop painful muscles. Both cats and dogs may be weak when potassium is low. Cat kidney diets contain higher levels of potassium so additional supplementation is probably not needed unless the cat shows signs of muscle pain.\u00a0 Potassium gluconate or citrate can be given by\u00a0 mouth if potassium supplementation is needed. Potassium chloride is acidifying and is not recommended.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Phosphorus, calcium and PTH<br \/>\n<\/strong>Pets with CKD usually have increased blood phosphorus. In health, phosphorus and calcium are controlled by a hormone called parathyroid hormone (PTH). PTH works with vitamin D on the intestine, kidney and bone to keep calcium and phosphorus normal.\u00a0 As the kidneys fail the amount of PTH in the body is elevated and the amount of vitamin D is reduced. Elevated PTH itself may be responsible for some of the signs shown by pets with CKD.\u00a0 PTH draws calcium and phosphorus from the bones which can weaken bones which can lead to bone fracture.<\/span><\/p>\n<p><span style=\"color: #000000;\">Kidney diets typically contain reduced phosphorus and an appropriate amount of calcium but if phosphorus remains elevated when the pet is eating a kidney diet then phosphorus can be tied up in the intestinal tract so it can be eliminated in the stool. Intestinal phosphate binding agents include aluminum carbonate, aluminum hydroxide, aluminum oxide, calcium citrate, calcium acetate and calcium carbonate and sevelamer hydrochloride.\u00a0 Phosphate binding agents which contain calcium should not be used until blood phosphorus is normal to prevent calcium and phosphorus from combining and precipitating in tissues including the kidneys. It is not usually necessary to give additional calcium but if a pet has low blood calcium, the phosphorus should be normalized before giving calcium.\u00a0 Even when blood phosphorus is normalized, PTH levels are still higher than normal. The administration of low doses of vitamin D (1, 25 dihydroxycholecalciferol [calcitriol]) will suppress PTH and possibly\u00a0 slow the rate of progression of kidney deterioration. <\/span><\/p>\n<p><span style=\"color: #000000;\">It is <strong>not<\/strong> 100% agreed that giving your pet calcitriol will slow the deterioration of the kidneys. <\/span><\/p>\n<p><span style=\"color: #000000;\"><span class=\"style6\">Here are some web sites on using <\/span> calcitriol <a style=\"color: #000000;\" href=\"http:\/\/members.bellatlantic.net\/%7Evze2r6qt\/calcitriol\/\"> http:\/\/members.bellatlantic.net\/~vze2r6qt\/calcitriol\/<\/a><\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Acidosis<br \/>\n<\/strong>Some pets with CKD will have an acid blood pH.\u00a0 Kidney diets are designed to counteract the acidosis but very sick animals that are hospitalized may need addition treatment to correct the acidosis.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Sodium<br \/>\n<\/strong>Diseased kidneys are less efficient at regulating sodium and sodium in turn helps control blood volume and pressure. Excess sodium can lead to water retention and not enough sodium can lead to dehydration. When changing diets that contain different amounts of sodium (kidney diets usually have less sodium than regular diets) make the change\u00a0 gradually over several weeks. Use caution when giving your pet table scraps or treats that may be high in sodium.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>High blood pressure (hypertension)<\/strong><\/span><br \/>\n<span style=\"color: #000000;\">Many pets with CKD have high blood pressure. High blood pressure can contribute to further decline of kidney function and can occasionally lead to sudden blindness from retinal detachment. Ideally blood pressure should be measured by your veterinarian and hypertension confirmed before giving drugs to treat high blood pressure but measuring true blood pressure in dogs and cats can be difficult.\u00a0 If the pet has an elevation in blood pressure it may be due to the excitement of being examined or due to CKD. The calmer you are able to keep your pet during examination, the more reliable the readings for blood pressure. There are several drugs that may be used to manage high blood pressure including enalapril, benazepril, or amlodipine (and others).\u00a0 Enalapril and benazepril are in a class of drugs called &lt;align=\"left\"&gt; ACE inhibitors and are sometimes used in pets with CKD that have abnormal amounts of protein in their urine even when blood pressure is normal.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Anemia<br \/>\n<\/strong>The kidneys play a role in producing a hormone called erythropoietin which stimulates the production of new red blood cells. Red blood cells live about a hundred days so new cells are continually being made. Less erythropoietin is made in pets with CKD leading to anemia.\u00a0 The packed cell volume (PVC) (also called hematocrit) is the percentage of blood cells compared to fluid in whole blood. When the PCV is ~20 in cats and ~ 25% in dogs, anemia may contribute to lack of activity and weakness.<\/span><\/p>\n<p><span style=\"color: #000000;\">Anemia can be treated by blood transfusion or by the administration of human erythropoietin. Erythropoietin is very effective in increasing PCV but because human erythropoietin is not exactly the same as dog and cat erythropoietin, over time, the pet may form antibodies that cause the medication to become ineffective. Canine and feline erythropoietin are currently being studied.<\/span><\/p>\n<p align=\"left\"><span style=\"color: #000000;\"><strong>Fats\/lipids<br \/>\n<\/strong>Certain types of fats (polyunsaturated omega 6 fatty acids) may slow the decline in kidney function are are often present in kidney diets.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Subcutaneous Fluids<br \/>\n<\/strong>Some cats and dogs with kidney disease may not drink enough to prevent becoming dehydrated and may benefit from the administration of intermittent SC fluids. If your veterinarian feels your pet may benefit from giving subcutaneous fluids, we provide some instructions on how to give SC fluids.\u00a0 See <a style=\"color: #000000;\" href=\"http:\/\/www.vetmed.wsu.edu\/ClientED\/cat_fluids.aspx\">Cat Fluids<\/a> or <a style=\"color: #000000;\" href=\"http:\/\/www.vetmed.wsu.edu\/ClientED\/dog_fluids.aspx\">Dog Fluids<\/a><\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Lack of Appetite<br \/>\n<\/strong>The accumulation of wastes in the body often decreases appetite. A goal of several of the above treatments is to reduce the amount of wastes in the blood. If the pet remains off food despite above treatments you might try different brands of renal failure diets, warming the food or adding odiferous toppings to entice the pet to eat.<\/span><\/p>\n<p align=\"left\"><span style=\"color: #000000;\"><strong>Vomiting<br \/>\n<\/strong>Increased levels of waste products cause the pet to vomit. Your veterinarian may recommend medications that reduce nausea or act directly on brain centers to reduce the urge to vomit.<\/span><\/p>\n<p align=\"left\"><span style=\"color: #000000;\"><b>Drugs used to treat other diseases<br \/>\n<\/b>Because the kidneys are responsible for elimination of many drugs, make sure that your veterinarian is aware of any other medications you are giving your pet as these may accumulate in the body to toxic levels if the kidneys cannot eliminate them.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><strong>Antibiotics<\/strong><br \/>\nIf the urine shows signs of infection or if a urine culture grows bacteria then antibiotics may be administered. If a urinary tract infection is involving the kidneys, the period of treatment is much longer than a infection of the bladder. <\/strong><\/span><\/p>\n<p>&nbsp;<\/p>\n<h4><span style=\"color: #000000;\">Avoiding Stress<\/span><\/h4>\n<p><span style=\"color: #000000;\">You are in the best position to judge what is stressful to your pet. When a pet is stressed they may drink and eat less than normal. Reduced water intake is detrimental to diseased kidneys. When possible, keep your pet calm. That might mean for example: having an in-home pet sitter if your pet is stressed by boarding, removing the pet from the household during a party or limiting contact with other animals if these situations appear to be a source of stress for your pet. Extremes in heat or cold are stresses.\u00a0 Certain drugs such as prednisone\/cortisone make the kidneys work harder.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-yDkBY' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/strong><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-717-8\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-8\" ><div id=\"pgc-717-8-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-8-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"11\" ><div class=\"textwidget\"><h3><span style=\"color: #000000;\"><em><strong>Diabetes<\/strong><\/em><\/span><\/h3>\n<p><span style=\"color: #000000;\">Diabetes mellitus occurs when the pancreas doesn't\u00a0 produce enough insulin. Insulin is required for the body to efficiently use sugars, fats and proteins.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">Diabetes most commonly occurs in middle age to older dogs and cats, but occasionally occurs in young animals. When diabetes occurs in young animals, it is often genetic and may occur in related animals. Diabetes mellitus occurs more commonly in female dogs and in male cats.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-OsyPh' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-OsyPh' class='yrm-inner-content-wrapper yrm-cntent-2'><\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>\u00a0<\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\">Certain conditions predispose a dog or cat to developing diabetes. Animals that are overweight or those with inflammation of the pancreas are predisposed to developing diabetes. Some drugs can interfere with insulin, leading to diabetes. Glucocorticoids, which are cortisone-type drugs, and hormones used for heat control are drugs that are most likely to cause diabetes.\u00a0 These are commonly used drugs and only a small percentage of animals receiving these drugs develop diabetes after long term use.<\/span><\/p>\n<p><span style=\"color: #000000;\">The body needs insulin to use sugar, fat and protein from the diet for energy. Without insulin, sugar accumulates in the blood and spills into the urine.\u00a0 Sugar in the urine causes the pet to pass large amounts of urine and to drink lots of water. Levels of\u00a0 sugar in the brain control appetite. Without insulin, the brain becomes sugar deprived and the animal is constantly hungry, yet they may lose weight due to improper use of nutrients from the diet. Untreated diabetic pets are more likely to develop infections and commonly get bladder, kidney, or skin infections. Diabetic dogs, and rarely cats, can develop cataracts in the eyes. Cataracts are caused by the accumulation of water in the lens and can lead to blindness. Fat accumulates in the liver of animals with diabetes. Less common signs of diabetes are weakness or abnormal gait due to nerve or muscle dysfunction.\u00a0 There are two major forms of diabetes in the dog and cat: 1) uncomplicated diabetes and 2) diabetes with ketoacidosis. Pets with uncomplicated diabetes may have the signs just described but are not extremely ill.\u00a0 Diabetic pets with ketoacidosis are very ill and may be vomiting and depressed.<\/span><\/p>\n<p><span style=\"color: #000000;\">The diagnosis of diabetes is made by finding a large increase in blood sugar and a large amount of sugar in the urine. Animals, especially cats, stressed by having a blood sample drawn, can have a temporary increase in blood sugar, but there is no sugar in the urine.\u00a0 A blood screen of other organs is obtained to look for changes in the liver, kidney and pancreas. A urine sample may be cultured to look for infection of the kidneys or bladder. Diabetic patients with ketoacidosis may have an elevation of waste products that are normally removed by the kidneys.<\/span><\/p>\n<p><span style=\"color: #000000;\">The treatment is different for patients with uncomplicated diabetes and those with ketoacidosis.\u00a0 Ketoacidotic diabetics are treated with intravenous fluids and rapid acting insulin.\u00a0 This treatment is continued until the pet is no longer vomiting and is eating, then the treatment is the same as for uncomplicated diabetes.<\/span><\/p>\n<div align=\"left\">\n<table border=\"0\" cellspacing=\"0\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"top\">&nbsp;<\/p>\n<p>&nbsp;<\/td>\n<td align=\"left\" valign=\"top\"><span style=\"color: #000000;\">Diabetes is managed long term by the injection of\u00a0 insulin by the owner once or twice a day. Some diabetic cats can be treated with oral medications instead of insulin injections, but the oral medications are rarely effective in the dog. There are three general types of insulin used in dogs and cats:<\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">short- acting insulin (regular or crystalline) is used in sick diabetic animals until they are eating again\u00a0<\/span><\/li>\n<li><span style=\"color: #000000;\">NPH and Lente are intermediate- acting insulins\u00a0<\/span><\/li>\n<li><span style=\"color: #000000;\">Ultralente and PZI are long- acting insulins<\/span><\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<p><span style=\"color: #000000;\"><strong>\u00a0 Insulin comes from different sources including beef or pork pancreas and a human genetically engineered form called Humulin.\u00a0 The availability of animal-source insulins continues to decline.<\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\">In general, cats and small dogs need insulin injections more frequently, usually twice daily, compared to large breed dogs that may only require one dose of insulin daily. The action of insulin varies in each individual and some large dogs will need 2 insulin shots daily.\u00a0 The insulin needs of the individual animal are determined by collecting small amounts of blood for glucose (sugar) levels every 1-2 hours for 12-24 hours. This is called an insulin-glucose-response curve. When insulin treatment is first begun,\u00a0 it is often\u00a0 necessary to perform several insulin-glucose-response curves to determine:<\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">which insulin type to use<\/span><\/li>\n<li><span style=\"color: #000000;\">how much insulin to give<\/span><\/li>\n<li><span style=\"color: #000000;\">how often to give insulin<\/span><\/li>\n<li><span style=\"color: #000000;\">when is the best time to feed the animal<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\">The animal's insulin needs may change over time requiring a change in insulin type or frequency of injection. Insulin- glucose- response curves are usually performed several days after a change in insulin is made.<\/span><\/p>\n<p><span style=\"color: #000000;\">\u00a0 Before you give insulin injections to your pet, your veterinarian will show you how to:<\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">handle insulin<\/span><\/li>\n<li><span style=\"color: #000000;\">use a syringe<\/span><\/li>\n<li><span style=\"color: #000000;\">draw insulin from the bottle in the correct amount<\/span><\/li>\n<li><span style=\"color: #000000;\">give your pet the insulin shot<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\">Insulin is fragile and will become less effective or even inactive, if it gets too hot or cold, or is shaken vigorously.\u00a0Pay attention to the expiration date on the bottle. Discard insulin that is outdated.<\/span><\/p>\n<p><span style=\"color: #000000;\">You may be able to practice using water and giving the \"shot\" to an object such as a piece of fruit until you are comfortable using needles, syringes and drawing accurate amounts of fluid into a syringe.\u00a0<\/span><\/p>\n<div align=\"left\">\n<table border=\"0\" cellspacing=\"0\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><span style=\"color: #000000;\">Not all syringes used to inject insulin are alike. When you buy additional supplies, make sure that you buy the right kind of syringes. Insulin needles are very thin to reduce discomfort during injection.<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<p><span style=\"color: #000000;\">Insulin syringes can fill to hold:<\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">30 units<\/span><\/li>\n<li><span style=\"color: #000000;\">50 units<\/span><\/li>\n<li><span style=\"color: #000000;\">100 units<\/span><\/li>\n<\/ul>\n<table border=\"0\" cellspacing=\"0\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><span style=\"color: #000000;\">The syringe is packaged in sterile paper or plastic wrapping or in a plastic case. The needle is covered with a plastic cap to keep it sterile. Use a new syringe-needle combination for each injection.\u00a0<\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><span style=\"color: #000000;\">Insulin syringes have the needle attached. The needle is covered with a plastic cap to prevent the needle from puncturing the wrapping and to keep the needle from bending or breaking.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">Remove the syringe and needle from the outer wrapping. Do not remove the needle cap until you are ready to draw insulin into the syringe.\u00a0<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<div align=\"left\">\n<table border=\"0\" cellspacing=\"0\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><span style=\"color: #000000;\">The plunger fits inside the hollow barrel of the syringe and is pulled part way out of the barrel to draw insulin into the syringe. The plunger is pushed into the barrel of the syringe to push insulin through the needle. The finger grip makes it easier to hold the syringe.\u00a0<\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<div align=\"left\">\n<table border=\"0\" cellspacing=\"0\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><span style=\"color: #000000;\">100 unit syringes are numbered by 10's; 10, 20, 30, etc.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">The smallest lines between the numbers on a 100 unit syringe, measure 2 units of insulin.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">30 unit syringes are numbered by 5's; 5, 10 , 15, etc.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">The smallest lines between the numbers on a 30 unit syringe, measure 1 unit of insulin.\u00a0<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<div align=\"left\">\n<table border=\"0\" cellspacing=\"0\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><span style=\"color: #000000;\">The position of the <b>TOP<\/b> of the black rubber stopper on the plunger is used to measure the volume of insulin in the syringe. The <b>TOP <\/b>of the<b> <\/b> black rubber stopper is the part closest to the needle.<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<div align=\"left\">\n<table border=\"0\" cellspacing=\"0\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><span style=\"color: #000000;\"><b>Before each injection,<\/b><\/span><\/p>\n<p><span style=\"color: #000000;\">The insulin bottle should not be shaken but rather gently rolled between your hands to mix the insulin in the bottle.<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<div align=\"left\">\n<table border=\"0\" cellspacing=\"0\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><span style=\"color: #000000;\">Remove the plastic cap from the needle.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">Hold the syringe between the thumb and index finger.<\/span><\/p>\n<p><span style=\"color: #000000;\">Pull back on the plunger to the desired dose level drawing some air into the syringe.<\/span><\/p>\n<p><span style=\"color: #000000;\">You can either pull back the plunger using the middle finger of the hand holding the syringe or...<\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><span style=\"color: #000000;\">Hold the syringe in your left hand between the thumb and index finger and use the thumb and index finger of the other hand to pull the plunger or...<\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><span style=\"color: #000000;\">Place your index finger against the finger grip and pull the plunger with your thumb and middle fingers.<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<div align=\"left\">\n<table border=\"0\" cellspacing=\"0\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><span style=\"color: #000000;\">Hold the insulin bottle upside down in your left hand if you are right handed (opposite for left-handed individuals).\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">Place the needle in the center of the rubber stopper. If the needle is not centered you may be trying to force the needle through the metal ring that is holding the rubber stopper in place and will break the needle.<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<div align=\"left\">\n<table border=\"0\" cellspacing=\"0\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><span style=\"color: #000000;\">Use your thumb to push the plunger and inject the air into the bottle.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">The air is placed in the bottle so a vacuum does not form in the bottle which makes it more difficult to draw insulin from the bottle.<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<div align=\"left\">\n<table border=\"0\" cellspacing=\"0\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><span style=\"color: #000000;\">Insert the entire length of the needle into the insulin bottle as long as the tip of the needle is in the fluid in the bottle. Insulin needles are very thin and easily bent. You are less likely to bend the needle while drawing insulin into the syringe, if the needle is inserted all the way into the bottle.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">If there is only a small amount of insulin left in the bottle, you may only be able to insert the needle into the bottle part way or else you will pass through the fluid and into the air in the bottle.<\/span><\/p>\n<p><span style=\"color: #000000;\">Draw back on the plunger to the correct dose using your middle finger to pull back the plunger.<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<div align=\"left\">\n<table border=\"0\" cellspacing=\"0\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><span style=\"color: #000000;\">If it is difficult for you to pull the plunger with your middle finger, you can use the thumb and index finger to pull the plunger. So that you do not pull the needle out of the bottle, curl the three fingers of your right hand that are not holding the bottle around the syringe trapping it against your palm. Then pull the plunger with the thumb and index finger. Your fingers may be covering the numbers on the syringe so draw more than you need, then push the extra back into the bottle, until the correct amount remains in the syringe.<\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><span style=\"color: #000000;\">...or place your index finger against the finger grip to keep the needle from pulling out of the bottle and pull the plunger with your thumb and middle fingers.<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<div align=\"left\">\n<table border=\"0\" cellspacing=\"0\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><span style=\"color: #000000;\">If there is an air bubble in the syringe, draw a little more insulin than the correct dose.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">Remove the syringe and needle from the insulin bottle. Holding the syringe with the needle pointed up, gently \"flick\" the syringe to get the air to rise to the top.<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<div align=\"left\">\n<table border=\"0\" cellspacing=\"0\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><span style=\"color: #000000;\">Press the plunger with your thumb to push the air out of the syringe, until the correct amount of insulin remains in the syringe.<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<div align=\"left\">\n<table border=\"0\" cellspacing=\"0\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><span style=\"color: #000000;\">This 30 unit syringe has been filled to 14.5 units.\u00a0<\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><span style=\"color: #000000;\">There is 1 unit between each back line on this smaller syringe. Smaller syringes allow for more accurate measurements of small amounts of insulin. The top of the black rubber stopper is half way between 14 and 15 units.<\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><span style=\"color: #000000;\">This 100 unit syringe has been filled to 48 units. There are 2 units between each black line on the barrel. The volume is measured at the <b>TOP<\/b> of the black rubber stopper on the plunger.<\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<div align=\"left\">\n<table border=\"0\" cellspacing=\"0\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><span style=\"color: #000000;\">Pinch up a fold of skin anywhere along the neck or back using your left hand if you are right-handed. Use your right hand to place the needle into the skin fold along the long axis of the fold.\u00a0<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<p><span style=\"color: #000000;\">Usually the skin is <b>not<\/b> cleansed before inserting the needle. If the cat has a normal immune system, the few bacteria that are pushed under the skin with the needle will be killed by the cat's immune system.<\/span><\/p>\n<p><span style=\"color: #000000;\">You can use alcohol on a cotton ball to make the hair lay flat so it is easier to see where the hair ends and the skin starts. Alcohol takes about 30 minutes before bacteria are killed, so just swiping the hair with alcohol is not effective in killing bacteria.<\/span><\/p>\n<div align=\"left\">\n<table border=\"0\" cellspacing=\"0\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><span style=\"color: #000000;\">If you place the needle in the opposite direction, across the skin fold, it is more likely that the needle will go through one fold of skin and out the other fold of skin, or may poke into your finger.<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<div align=\"left\">\n<table border=\"0\" cellspacing=\"0\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><span style=\"color: #000000;\">Pull back the plunger. If you get air, you placed the needle through both folds of skin. Remove the needle and try again. If you get blood, the tip of the needle is in a blood vessel. Remove the needle and try again.<\/span><\/p>\n<p><span style=\"color: #000000;\">If you get neither air nor blood, the needle is placed correctly and you can push the plunger to inject the insulin.<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<p><span style=\"color: #000000;\">Give the insulin shots in different locations each time.<\/span><\/p>\n<p><span style=\"color: #000000;\">Syringes and needles used to give insulin should not be discarded in the trash but should be placed in a puncture-proof container and taken to your veterinarian for disposal.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">Insulin injections are not as perfect as the insulin produced by the pancreas. Blood sugar levels will not always be normal in diabetic pets. The goal of treatment is to reduce the\u00a0 signs of diabetes. When diabetes is well controlled with insulin, the pet should drink, eat and urinate normal amounts.\u00a0 They should have a good appetite, without becoming fat and should have normal activity.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">Insulin needs are closely related to the type of\u00a0 food eaten by the pet. Your veterinarian will recommend a specific diet and feeding regimen that will enhance the effectiveness of insulin. If your pet is overweight,\u00a0s(he) will be placed on a weight-reducing diet. As the pet loses weight, less insulin will be needed.\u00a0Only feed the recommended diet..NO table scraps or treats that are not part of the recommended diet.<\/span><\/p>\n<p><span style=\"color: #000000;\">Heavy exercise will reduce the amount of insulin needed. It is important\u00a0 to talk to your veterinarian before making changes in diet or exercise.<\/span><\/p>\n<p><span style=\"color: #000000;\">There is always some risk that a diabetic patient will develop low blood sugar. Signs of low blood sugar include weakness, staggering, seizures, or just being more quiet than usual. You should keep corn syrup on hand to rub on the animals gums if they have signs suggestive of low blood sugar.\u00a0 Don't pour large amounts of corn syrup in the mouth of an animal that is not fully conscious as the syrup may be inhaled into the lungs.<\/span><\/p>\n<p><span style=\"color: #000000;\">Because insulin needs vary with the activity and lifestyle of your pet, you may want to keep a written daily log of:<\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">the dose of insulin<\/span><\/li>\n<li><span style=\"color: #000000;\">location in which the insulin is injected<\/span><\/li>\n<li><span style=\"color: #000000;\">any changes in the pet\u2019s activity or appetite<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\">Your veterinarian may ask you to check your pet's urine for sugar using a test strip. If your pet is well regulated on insulin, the sugar readings in most urine samples will be negative or trace. The strips may have color pads only for glucose or for glucose and ketones.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"color: #000000;\">The strip is placed in fresh urine and the color change compared with the colors on the bottle. Be sure to follow the label instructions for timing when to read the results. \u00a0<\/span><\/p>\n<div align=\"left\">\n<table border=\"0\" cellspacing=\"0\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><span style=\"color: #000000;\">The top color pad is to read urine sugar. This sample is negative for sugar. The bottom color pad is for ketones and is also negative for ketones.<\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><span style=\"color: #000000;\">The glucose pad has turned brown indicating a large amount (&gt;2000mg\/dl) of sugar in the urine. The urine is negative for ketones.<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<p><span style=\"color: #000000;\">You should <b>never<\/b> change the dose of insulin based on the urine sugar reading alone. Animals can have lots of sugar in their urine either when the insulin dose is too low or is too high.\u00a0\u00a0\u00a0<\/span><\/p>\n<div align=\"left\">\n<table border=\"0\" cellspacing=\"0\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><span style=\"color: #000000;\">If your pet is difficult to regulate with the proper dose of insulin you may be taught how to take a small blood sample from your pet to measure blood sugar readings at home.<\/span><\/p>\n<p><span style=\"color: #000000;\">There are many styles of machines used to measure blood sugar. The machines are called glucometers. They use color sticks which are read by the glucometer rather than by color changes you can see. Different styles of glucometers use different color strips.<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<p><span style=\"color: #000000;\">Diabetes is rarely reversible in dogs, but diabetic cats will sometimes regain the ability to produce their own insulin in the pancreas. Cats that developed diabetes after receiving long term glucocorticoids or hormones are more likely to stop needing insulin after a while compared to cats that developed diabetes without a known cause.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">You should have your diabetic pet evaluated by a veterinarian at 2-4 month intervals or anytime another health problem develops. The development of other health problems will often interfere with insulin regulation.<\/span><\/p>\n<p><span style=\"color: #000000;\">\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-OsyPh' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/strong><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-717-9\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-9\" ><div id=\"pgc-717-9-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-9-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"12\" ><div class=\"textwidget\"><h3 style=\"text-align: left;\"><span style=\"color: #000000;\"><em><strong>Diarrhea<\/strong><\/em><\/span><\/h3>\n<p><span style=\"color: #000000;\">Diarrhea is the passing of loose or liquid stool, more often than normal. Diarrhea can be caused by diseases of the small intestine, large intestine or by diseases\u00a0of organs other than the intestinal tract. Your ability to answer questions about your pet's diet, habits, environment and specific details about the diarrhea can help the veterinarian narrow the list of possible causes, and to plan for specific tests to determine the cause of diarrhea. (Anatomy of the digestive system: <a style=\"color: #000000;\" href=\"http:\/\/www.vetmed.wsu.edu\/ClientED\/anatomy\/dog_digest.aspx\">dog<\/a> \/ <a style=\"color: #000000;\" href=\"http:\/\/www.vetmed.wsu.edu\/ClientED\/anatomy\/cat_digest.aspx\">cat<\/a>)<\/span><\/p>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-6XltW' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-6XltW' class='yrm-inner-content-wrapper yrm-cntent-2'><\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>\u00a0<\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\">Small intestinal and large intestinal diarrhea have different causes, require different tests to diagnose and are treated differently.\u00a0 Small intestinal diseases result in a larger amount of stool passed with a mild increase in frequency; about 3 to 5 bowel movements per day. The pet doesn't strain or have difficulty passing stool. Animals with small intestinal disease may also vomit and lose weight. Excess gas production is sometimes seen and you may hear the rumbling of gas in the belly. If there is blood in the stool it is digested and black in color.<\/span><\/p>\n<p><span style=\"color: #000000;\">Disease of\u00a0 the large intestine including the colon and rectum cause the pet to pass small amounts of loose stool very often, usually more than 5 times daily. The pet strains to pass stool. If there is blood in the stool,\u00a0 it is red in color. The stool may be slimy with mucus. The pet does not usually vomit or lose weight with large bowel diarrhea. A sudden onset of small intestinal diarrhea may be caused by viruses including canine distemper, canine parvovirus, canine coronavirus, feline panleukopenia virus or feline coronavirus, in young, poorly vaccinated pets. Small intestinal diarrhea can be caused by bacteria such as salmonella, clostridia or campylobacter although these same bacteria can be found in the stool of normal dogs and cats.<\/span><\/p>\n<p><span style=\"color: #000000;\">Worms and giardia can cause small intestinal diarrhea, mostly in young animals. Foreign bodies including bones, sticks and other objects can pass through the stomach and get stuck in the intestine causing both diarrhea and vomiting. These same foreign materials may pass through the intestinal tract without getting stuck but may damage the lining of the intestinal tract causing diarrhea. Dietary indiscretion or a sudden change in diet can cause diarrhea with or without vomiting.\u00a0 Food allergies in dogs and cats can cause diarrhea, vomiting or itchy skin. Toxins including lead and insecticides can cause diarrhea usually with vomiting.\u00a0 Inflammatory bowel disease (IBD) occurs commonly in both dogs and cats. In IBD the walls of the intestine contain abnormal numbers of inflammatory cells which can be eosinophils, lymphocytes or plasma cells.\u00a0 The cause of IBD is not known but is suspected to be an allergic reaction to components of food, bacteria or parasites. IBD can be congenital in some breeds of dogs, for example Basenji dogs may develop a severe inflammatory bowel disease. Tumors of the intestine are another cause of diarrhea usually occurring in older pets. The tumor may be a single mass when the tumor is from the glands of the intestine (adenocarcinoma) and may be removed by surgery or the tumor may occur diffusely along the intestine. Lymphosarcoma occurs in both dogs and cats and can either be a single or multiple masses in the intestine or the abnormal lymphocytes may be spread through out the intestine. Lymphosarcoma is often responsive to anti-cancer drugs in cats but rarely responds to anti-cancer drugs in dogs.<\/span><\/p>\n<p><span style=\"color: #000000;\">In certain parts of the country small intestinal disease can be caused by fungal infections including histoplasmosis. Your veterinarian can discuss with you whether histoplasmosis is seen in your part of the country. Diseases outside the intestinal tract that may cause diarrhea include kidney failure, liver failure, pancreatic disease and hyperthyroidism in the cat. Severe inflammation of the pancreas (pancreatitis) can lead to damage of the pancreas and an inability to make enough enzymes to digest fat. This is called pancreatic insufficiency and causes diarrhea with a large volume of\u00a0 greasy stool.\u00a0 Pancreatic insufficiency can occur in young animals due to a congenital deficiency of pancreatic enzymes.<\/span><\/p>\n<p><span style=\"color: #000000;\">The cause of small intestinal diarrhea may be determined from blood tests, examination of the stool, x-rays or ultrasound of the abdomen or by endoscopy.\u00a0 Endoscopy is the technique of passing a flexible scope through the stomach into the upper intestine. Small biopsies of the lining of the intestine can be taken for microscopic evaluation. Endoscopy requires general anesthesia. A diagnosis of intestinal lymphosarcoma may be missed on endoscopy as the biopsies taken using endoscopy do not include the full thickness of the wall of the intestine and the cancerous cells may be deep in the wall of the intestine. A diagnosis in that case requires surgery in order to take a larger biopsy of the entire thickness of the intestine.<\/span><\/p>\n<p><span style=\"color: #000000;\">Dogs and cats with chronic small intestinal diarrhea will lose weight as they are unable to properly absorb nutrients and may develop edema of the legs or fluid accumulation in the belly or chest. A small protein, albumin may be lost in diarrhea. Albumin acts like a sponge to keep water in the blood vessels. When albumin is lost in the stool, blood albumin gets low and water leaks out of blood vessels to accumulate in other locations. Chronic diarrhea may cause the fur to look dull and brittle due to nutrient deficiencies. Acute small intestinal diarrhea can be managed by withholding food, but not water for 24 - 48 hours. If diarrhea stops, small amounts of a bland low-fat food are fed 3 to 6 times daily for a few days, with a gradual increase in the amount fed and a gradual transition to the pet's normal diet. Foods designed as intestinal diets usually contain rice as rice is more digestible than other grains. You are discouraged from administering over-the-counter diarrhea medications without first consulting a veterinarian.\u00a0 If the pet is active, not dehydrated and has been previously healthy, acute diarrhea can often be managed at home. Diarrhea that continues for more than a few days or is accompanied by depression or other signs is an indication to take your pet to a veterinarian.<\/span><\/p>\n<p><span style=\"color: #000000;\">Diarrhea of\u00a0 large intestinal origin can be caused by whipworms, polyps, inflammatory bowel disease, colonic ulcers or colonic cancer. Stress can cause large bowel diarrhea in excitable dogs.\u00a0 The diagnosis of large intestinal diarrhea is also made by blood tests and examination of the stool. A rectal examination using a gloved finger may provide some information about the cause of large bowel problems including rectal polyps and rectal cancer.\u00a0 Endoscopy to examine the large intestine is performed using a rigid or flexible scope passed up the rectum. Because the rectum is often very irritated, colon exams are usually performed under general anesthesia.<\/span><\/p>\n<p><span style=\"color: #000000;\">The treatment of large bowel diarrhea may be based on a specific diagnosis. Non specific treatment of large bowel diarrhea often includes a high fiber diet and sullfasalazine, an anti-inflammatory drug.<\/span><\/p>\n<p><span style=\"color: #000000;\">Black Earth Veterinary Clinic assumes no liability for injury to you or your pet incurred by following these descriptions or procedures.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-6XltW' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/strong><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-717-10\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-10\" ><div id=\"pgc-717-10-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-10-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"13\" ><div class=\"textwidget\"><h3><span style=\"color: #000000;\"><em><strong>Hypertrophic Cardiomyopathy (HCM)<\/strong> <\/em><\/span><\/h3>\n<p><span style=\"color: #000000;\"><strong>Anatomy of the heart of a cat<\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\">HCM is a disease that causes <b>thickening of the heart muscle<\/b> resulting in poor relaxing and filling ability. As the heart\u2019s pumping chamber (ventricle) becomes progressively thicker, less blood can enter the chamber; thus, less blood is ejected out to the body. The cause of HCM is unknown, although certain breeds of cats appear to be predisposed. Middle-aged male cats may be more commonly affected. Sometimes heart muscle thickening similar to HCM can develop secondary to other disorders such as hyperthyroidism (elevated thyroid hormone) and systemic hypertension (elevated blood pressure). Blood pressure measurement and, in cats over five years of age, a blood thyroid hormone test should be done to exclude these secondary causes when cardiac hypertrophy (thickening) is diagnosed.<\/span><\/p>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-NGBgD' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-NGBgD' class='yrm-inner-content-wrapper yrm-cntent-2'><\/span><\/p>\n<p><span style=\"color: #000000;\">Some pets show no sign of illness, especially early in the disease. In other cases, signs of left-sided congestive <b>heart failure<\/b> (fluid accumulation in the lung) may occur. These signs include <b>lethargy, decreased activity level, rapid and\/or labored breathing <\/b>and possibly open mouth breathing with excitement or exercise. Sometimes left and right-sided congestive heart failure develop with fluid accumulation inside the chest or abdominal cavity causing greater respiratory (breathing) effort and abdominal distention. Once fluid accumulations have occurred, clinical heart failure is present and aggressive medical therapy should be sought. Other signs of this disease can include <b>sudden weakness, collapsing episodes<\/b>, and unfortunately even <b> sudden death<\/b> due to disturbances in heart rhythm. In some cats with a very large heart chamber (i.e. left atrium) a blood clot may form and if it enters the circulation may cause <b>weakness or paralysis (usually of the rear legs)<\/b>. If this occurs, contact your veterinarian right away to determine if complications related to heart disease (or another disease) are present.<\/span><\/p>\n<p><span style=\"color: #000000;\">A physical examination performed by your veterinarian may reveal a heart murmur, abnormal heart sounds, abnormal lung sounds, or irregularities in heart rhythm. Chest radiographs (x-rays), an electrocardiogram (ECG..sometimes called an EKG), and an echocardiogram (heart ultrasound) are tests often utilized to confirm a suspected diagnosis and to determine severity. A routine physical exam and one or more of these tests may be recommended every six months to one year to look for any progression of disease in cats without clinical signs.<\/span><\/p>\n<p><span style=\"color: #000000;\">Asymptomatic pets may not need medical therapy depending on the findings of the tests listed above, but routine reevaluations will often be recommended. Other cats will need medications to slow the heart rate, and promote relaxation of the pumping chambers (ventricles). If arrhythmias or congestive heart failure signs are present, additional medications used may be required. Since this disease can be progressive, the number and the amount of medications used may change with time. Therapy is always tailored to the needs of the individual patient. If congestive heart failure is present, dietary salt reduction is also recommended.<\/span><\/p>\n<p><span style=\"color: #000000;\">Medications commonly used for HCM:<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>Beta-adrenergic blockers<\/b> such as atenolol (Tenormin) or propanolol (Inderal). These medications slow the heart rate, which enhances filling and relaxation of the pumping chambers. Beta-blockers also allow more time for blood flow to the heart muscle itself, and reduce the amount of oxygen used by the heart. In some cases, the incidence of arrhythmias is also lessened. Side effects may include bronchospasm (spasm of the airways) (propranolol), fatigue, and in excessive doses,\u00a0 slow heart rate and low blood pressure.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>Calcium-channel blockers<\/b> such as diltiazem (Cardizem CD, Dilacor XR). This class of drug has similar actions to the beta-blockers. Some differing characteristics of the calcium-blockers include little or no anti-arrhythmic activity in some cases, possible a greater ventricular relaxing effect, and a greater propensity for low blood pressure at higher doses.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>Other medications<\/b> may be prescribed in some patients. Diuretics (furosemide, spironolactone, etc.) may be needed to control edema and effusions (congestive heart failure). In pets that have had or may be prone to blood clot formation, anti-coagulants such as aspirin, warfarin, or heparin may be prescribed.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>Medical therapy is always chosen to meet the needs of the individual patient. <\/b>Frequent recheck examinations and adjustments may be needed especially early in the course of treatment to individualize a medication regimen.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>This Pet Health Topic was written by <a style=\"color: #000000;\" href=\"http:\/\/vcs.vetmed.wsu.edu\/people\/faculty\/h-o\/nelson\">O. L. Nelson<\/a>, DVM, MS, Diplomate ACVIM (Cardiology &amp; Internal Medicine) Washington State University.<\/b><\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-NGBgD' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/strong><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-717-11\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-11\" ><div id=\"pgc-717-11-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-11-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"14\" ><div class=\"textwidget\"><h3><span style=\"color: #000000;\"><em><strong>Dilated Cardiomyopathy (DCM)\u00a0\u00a0<\/strong> <\/em><\/span><\/h3>\n<p><span style=\"color: #000000;\"><a style=\"color: #000000;\" href=\"http:\/\/www.vetmed.wsu.edu\/ClientED\/anatomy\/cardiovascular.aspx\">Anatomy of the heart of a dog<\/a> <b> <\/b><\/span><\/p>\n<p><span style=\"color: #000000;\"><b>What is it?<\/b><\/span><\/p>\n<p><span style=\"color: #000000;\">DCM is a disease of the heart muscle that results in weakened contractions and poor pumping ability. As the disease progresses the heart chambers become enlarged, one or more valves may leak, and signs of congestive heart failure develop. The cause of DCM is unclear in most cases, but certain breeds appear to have an inherited predisposition. Large breeds of dogs are most often affected, although DCM also occurs in some smaller breeds such as cocker spaniels. Occasionally, DCM-like heart muscle dysfunction develops secondary to an identifiable cause such as a toxin or an infection. In contrast to people, heart muscle dysfunction in dogs and cats is almost never the result of chronic coronary artery disease (\"heart attacks\").<\/span><\/p>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-mT3pa' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-mT3pa' class='yrm-inner-content-wrapper yrm-cntent-2'><\/span><\/p>\n<p><span style=\"color: #000000;\">What are the signs of this disease?<\/span><\/p>\n<p><span style=\"color: #000000;\">Early in the disease process there may be no clinical sign detectable, or the pet may show reduced exercise tolerance. In some cases, a heart murmur (usually soft), other abnormal heart sounds, and\/or irregular heart rhythm is detected by your veterinarian on physical examination. Such findings are more likely as the disease progresses.<\/span><\/p>\n<p><span style=\"color: #000000;\">As the heart\u2019s pumping ability worsens, blood pressure starts to increase in the veins behind one or both sides of the heart. Lung (pulmonary) congestion and fluid accumulation (edema) often develop behind the left ventricle\/atrium. Fluid also may accumulate in the abdomen (ascites) or around the lungs (pleural effusion) if the right side of the heart is also diseased. When congestion, edema and\/or effusions occur, heart failure is present. Weakness, fainting episodes, and unfortunately, even sudden death can result from heart rhythm disturbances (even without \"heart failure\" signs).<\/span><\/p>\n<p><span style=\"color: #000000;\">What are the signs of heart failure?<\/span><\/p>\n<p><span style=\"color: #000000;\">Dogs with heart failure caused by DCM often show signs of left-sided congestive failure. These include reduced exercise ability and tiring quickly, increased breathing rate or effort for the level of their activity excess panting, and cough (especially with activity). Sometimes the cough seems soft, like the dog is clearing its throat. Poor heart pumping ability and arrhythmias can cause episodes of sudden weakness, fainting, or sudden death as noted above. Some dogs with DCM experience abdominal enlargement or heavy breathing because of fluid accumulation in the abdomen or chest, respectively. Presence of any of these signs should prompt a visit to your veterinarian to determine if heart failure (or another disease) has developed.<\/span><\/p>\n<p><span style=\"color: #000000;\">More advanced signs of heart failure could include labored breathing, reluctance to lie down, inability to rest comfortably, worsened cough, reduced activity, loss of appetite, and collapse. A veterinarian should be consulted right away if these signs occur. Signs of severe heart failure may seem to develop quickly with DCM, but the development of underlying heart muscle abnormalities and progression to overt heart failure probably takes months to years.<\/span><\/p>\n<p><span style=\"color: #000000;\">How is this disease diagnosed?<\/span><\/p>\n<p><span style=\"color: #000000;\">A cardiac exam by a veterinarian can detect abnormal heart sounds (when present) and many signs of heart failure. Usually chest radiographs (x-rays), an electrocardiogram (ECG), and echocardiogram are performed to confirm a suspected diagnosis and to assess severity. Echocardiography also can be used to screen for early DCM in breeds with a higher incidence of the disease. Resting and 24-hour (Holter) ECGs are sometimes used as screening tests for the frequent arrhythmias that usually accompany DCM in some breeds, especially boxers and Doberman pinchers.<\/span><\/p>\n<p><span style=\"color: #000000;\">What can be done if my pet has this disease?<\/span><\/p>\n<p><span style=\"color: #000000;\">Asymptomatic (subclinical) cases of DCM may be treated with enalapril or another <a style=\"color: #000000;\" href=\"http:\/\/www.vetmed.wsu.edu\/ClientED\/cardiacDrugs.aspx#Enalapril\">ACE inhibitor<\/a> to slow progression of the changes leading to heart failure. Other medications and strategies are also used as signs of heart failure develop and\/or if rhythm abnormalities are present. Therapy is always tailored to the needs of the individual patient. Since this disease is not reversible and heart failure tends to be progressive, the intensity of therapy (for example, the number of medicines and the dosages used) usually must be increase over time.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>This Pet Health Topic was written by <a style=\"color: #000000;\" href=\"http:\/\/vcs.vetmed.wsu.edu\/people\/faculty\/h-o\/nelson\">O. L. Nelson<\/a>, DVM, MS, Diplomate ACVIM (Cardiology &amp; Internal Medicine) Washington State University.<\/b><\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-mT3pa' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/strong><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-717-12\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-12\" ><div id=\"pgc-717-12-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-12-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"15\" ><div class=\"textwidget\"><h3 align=\"left\"><span style=\"color: #000000;\"><em><strong>Heart Valve Malfunction in the Dog (Mitral Insufficiency)<\/strong> <\/em><\/span><\/h3>\n<p align=\"left\"><span style=\"color: #000000;\"><a style=\"color: #000000;\" href=\"http:\/\/www.vetmed.wsu.edu\/ClientED\/anatomy\/cardiovascular.aspx\">Anatomy of the heart of a dog<\/a><\/span><\/p>\n<p align=\"left\"><span style=\"color: #000000;\">Many dogs slowly develop degenerative thickening and progressive deformity of one or more heart valves as they age. In time, these changes cause the valve to leak. The <b>mitral<\/b> valve is most commonly affected. This valve separates the blood collecting chamber (left atrium) from the pumping chamber (left ventricle) leading to the body. Some dogs also develop these changes in the <b>tricuspid<\/b> valve, which separates the collecting (right atrium) and pumping (right ventricle) chamber leading to the lungs.<\/span><\/p>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-9IX8m' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-9IX8m' class='yrm-inner-content-wrapper yrm-cntent-2'><\/span><\/p>\n<p align=\"left\"><span style=\"color: #000000;\">Certain breeds have an inherited predisposition to this disease. Degenerative valvular disease is slowly progressive over years and is non-reversible. The volume of blood that leaks back into the atrium with each heartbeat tends to increase slowly over time. However, many dogs with this disease never develop signs of congestive heart failure even though they may have a loud murmur. Early in the disease process, your veterinarian may hear a soft murmur when the affected valve starts to leak. There usually is no noticeable change in the dog\u2019s activity level or behavior for a long period of time. Gradually, though, the valve leak tends to get worse and the heart slowly enlarges. If the leak becomes severe, blood may start to back up behind the heart \u2013 usually into the lungs. This causes lung congestion and fluid accumulation (edema). When lung congestion and edema occur, congestive heart failure is present.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>Reduced exercise ability may be the first sign of heart failure.<\/b> Most dogs with heart failure caused by degenerative valve disease show signs of \"left-sided\" congestive failure. These signs include tiring quickly, increased breathing rate or effort for the level of activity, excessive panting, and cough (especially with activity). The presence of any of these signs should prompt a visit to your veterinarian to determine if heart failure (or another disease) has developed.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">More advanced signs of heart failure could include labored breathing, reluctance to lie down, inability to rest comfortably, worsened cough, reduced activity, and loss of appetite. Your veterinarian should be consulted right away if these signs occur.<\/span><\/p>\n<p><span style=\"color: #000000;\">Some dogs that become symptomatic from their heart disease develop fluid in the abdomen (ascites); others have episodes of sudden weakness or fainting that can result from irregular heartbeats or other complications. As long as no sign of heart failure develops, no treatment is necessary, although reduction of dietary salt intake is often advised. Again, there are many dogs with degenerative valvular disease that never progress to heart failure.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">However, if heart failure develops, several medications and other strategies are used to control the signs. Since the disease is not reversible and heart failure, when it occurs, tends to be progressive, the intensity of the therapy (including the number of medicines and dosages used) usually must be increased over time.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>Therapy is always tailored to the needs of the individual patient.<\/b><\/span><\/p>\n<p><span style=\"color: #000000;\"><b>This Pet Health Topic was written by <a style=\"color: #000000;\" href=\"http:\/\/vcs.vetmed.wsu.edu\/people\/faculty\/h-o\/nelson\">O. L. Nelson<\/a>, DVM, MS, Diplomate ACVIM (Cardiology &amp; Internal Medicine) Washington State University.<\/b><\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-9IX8m' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/strong><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-717-13\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-13\" ><div id=\"pgc-717-13-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-13-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"16\" ><div class=\"textwidget\"><h3><span style=\"color: #000000;\"><strong><em>Holiday Health Hazards<\/em> <\/strong><\/span><\/h3>\n<h5><span style=\"color: #000000;\"><em>If you want to get festive, mix some of your pet's regular food with water to make a \"dough\" and roll out and cut into festive shapes, then bake until crunchy.<\/em><\/span><\/h5>\n<p><span style=\"color: #000000;\">The holiday season brings excitement and commotion associated with shopping, final exams, travel, and other seasonal preparations. In all the activities of the season our beloved pets may be exposed to hazards less commonly found other times of the year. As homes fill with holiday spirit, pets may be intrigued by the new sites, smells and tastes. The following are some of the most common health concerns for your pet during the holidays. If you have specific questions regarding any pet health concern please contact your veterinarian.<\/span><\/p>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-OhKZP' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-OhKZP' class='yrm-inner-content-wrapper yrm-cntent-2'><\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>\u00a0<\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\"><b>Tinsel, Ribbon and other Pretty Things<\/b><\/span><\/p>\n<p><span style=\"color: #000000;\">Ribbons, wrapping paper, ornaments, tinsel, extension cords and gifts may be appealing \"chew toys\" that may make your pet sick.<\/span><\/p>\n<p><span style=\"color: #000000;\">There is something about those shiny strands of Christmas tree decor, which drives kitties wild. Although the sight of your cat pawing at the tree may be cute, the ingestion of tinsel can be deadly. Eating tinsel or other string-like items such as ribbon (often called linear foreign bodies)\u00a0 can cause serious damage to the intestine. One end can get stuck while the rest is pulled into the intestine as it contracts; the contractions may cause the ribbon or tinsel to saw through the intestine. If not caught in time, infection of the belly cavity develops and the prognosis for recovery becomes poor. Pets with linear foreign bodies quickly become ill with signs including vomiting, diarrhea, depression, belly pain and sometimes fever.<\/span><\/p>\n<p><span style=\"color: #000000;\">Eating other holiday decorations can cause signs ranging from mild depression to severe vomiting or diarrhea, depending upon whether or not the foreign matter can be passed in the stool or gets stuck along the way. Foreign matter stuck in the intestine often does NOT show up on \"x-ray\" but sometimes the foreign matter will trap air in the intestine, which helps your veterinarian make a diagnosis. Surgery is required to remove foreign matter that does not pass out on its own.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>Holiday Lights<\/b><\/span><\/p>\n<p><span style=\"color: #000000;\">Decorative lights are another attraction for pets to chew on. Both indoor and outdoor lights should be carefully examined to ensure safety for your household pets. Electrical shock may occur from defective cords as well as from pets chewing on cords. Check cords for any signs of bite marks, loose or frayed wires, proximity to the tree's water supply or evidence of short circuits. Use grounded \"3-prong\" extension cords and strictly follow manufacturer's guidelines for light usage.<\/span><\/p>\n<p><span style=\"color: #000000;\">Electrical shock can cause burns, difficulty breathing, abnormal heart rhythm, loss of consciousness, and death. Call a veterinarian immediately if your pet has been injured by electrical shock. Treatment will be most effective if begun soon after the shock.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>Water, Water...<\/b><\/span><\/p>\n<p><span style=\"color: #000000;\">Even though they have their own water bowel, there is something enticing about a novel source of water; whether it's the toilet bowl or the Christmas tree stand. If you add chemicals to the water meant to keep your tree fresh longer, be sure to read the label to make sure it is safe for pets.<\/span><\/p>\n<p><span style=\"color: #000000;\">Potpourri makes your house smell festive but may be another attraction for pets to drink. Make sure that potpourri pots are covered or otherwise inaccessible to pets.<\/span><\/p>\n<p><span style=\"color: #000000;\">It may be difficult to curb your pet's fascination with all those pretty decorations. Child gates can be used across doorways to keep your pet away from the Christmas tree and decorations at times they cannot be watched.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>Overindulgence<\/b><\/span><\/p>\n<p><span style=\"color: #000000;\">Well-intentioned family and friends may share holiday foods with pets causing the pet to develop a stomach upset or worse, <a style=\"color: #000000;\" href=\"http:\/\/www.vetmed.wsu.edu\/ClientED\/vomiting.aspx#Pancreatitis\">pancreatitis<\/a> (inflammation of the pancreas) which can be caused by eating fatty foods. To control excessive food intake by your pets and meet your guests' desires to feed the pets, dole out the treats your pets would normally receive and let your guests \"treat\" the pets. If you want to get festive, mix some of your pet's regular food with water to make a \"dough\" and roll out and cut into festive shapes, then bake until crunchy.<\/span><\/p>\n<p><span style=\"color: #000000;\">Extra attention from visiting relatives and friends may be relished by some pets while others seek solitude in their favorite hiding spot. Make sure pets are given some \"personal space\" if they want to get away from the commotion.<\/span><\/p>\n<p><span style=\"color: #000000;\">Some pets may respond to all the hullabaloo with a change in behavior including bad behaviors like eliminating in the house. Try to spend a little extra \"quality time\" with your pet to assure them they have not been forgotten.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>Chocolate<\/b><\/span><\/p>\n<p><span style=\"color: #000000;\">What would the holidays be without boxes of chocolate and warm cocoa in front of the fire? However, chocolate can be toxic or even fatal to dogs and cats. Chocolate may be mistakenly given to pets as treats and may be irresistible to the curious canine. Chocolate poisoning occurs most frequently in dogs but other species are also susceptible. Theobromine is the toxic compound found in chocolate. Signs which may appear within 1 to 4 hours of eating chocolate include:<\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">Vomiting\u00a0<\/span><\/li>\n<li><span style=\"color: #000000;\">Increased thirst\u00a0<\/span><\/li>\n<li><span style=\"color: #000000;\">Diarrhea<\/span><\/li>\n<li><span style=\"color: #000000;\">Weakness<\/span><\/li>\n<li><span style=\"color: #000000;\">Difficulty keeping balance<\/span><\/li>\n<li><span style=\"color: #000000;\">Hyperexcitability<\/span><\/li>\n<li><span style=\"color: #000000;\">Muscle spasms, seizures, coma<\/span><\/li>\n<li><span style=\"color: #000000;\">Death from abnormal heart rhythm<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\">The toxicity of chocolate depends on the amount and type of chocolate ingested:<\/span><\/p>\n<table border=\"0\" cellspacing=\"0\" cellpadding=\"6\">\n<tbody>\n<tr>\n<td><span style=\"color: #000000;\"><b>Source\u00a0<\/b><\/span><\/td>\n<td><span style=\"color: #000000;\"><b>Potential Toxic Dose (44lb dog)<\/b><\/span><\/td>\n<\/tr>\n<tr>\n<td><span style=\"color: #000000;\">Unsweetened Cocoa\u00a0\u00a0\u00a0\u00a0<\/span><\/td>\n<td><span style=\"color: #000000;\">3oz<\/span><\/td>\n<\/tr>\n<tr>\n<td><span style=\"color: #000000;\">Baking Chocolate\u00a0<\/span><\/td>\n<td><span style=\"color: #000000;\">5oz<\/span><\/td>\n<\/tr>\n<tr>\n<td><span style=\"color: #000000;\">Semisweet Chocolate\u00a0<\/span><\/td>\n<td><span style=\"color: #000000;\">7oz<\/span><\/td>\n<\/tr>\n<tr>\n<td><span style=\"color: #000000;\">Milk Chocolate\u00a0<\/span><\/td>\n<td><span style=\"color: #000000;\">20oz<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><span style=\"color: #000000;\">The amount of theobromine in white chocolate or chocolate flavored dog treats is usually negligible. As with any poisoning, call your veterinarian or an emergency veterinary hospital immediately if you suspect your pet may have ingested chocolate. Have the product label information available when you call your veterinarian. There are national and regional poison control hotlines for animals. In general, the treatment of poisonings is most effective if begun soon after eating the poison, before large amounts are absorbed into the blood.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>Poinsettias &amp; Mistletoe<\/b><\/span><\/p>\n<p><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/www.vetmed.wsu.edu\/ClientED\/images\/poinsetta.jpg\" alt=\"poinsettias\" width=\"150\" height=\"113\" align=\"left\" border=\"0\" hspace=\"10\" vspace=\"10\" \/>Poinsettias fill homes with color during the holidays. Poinsettias have received bad publicity in the past whereas in fact, poinsettias are not very toxic to pets. They do contain a milky sap that can irritate the mouth but if signs develop they are usually mild.<\/span><\/p>\n<p><span style=\"color: #000000;\">Mistletoe can be very toxic to animals and you should seek veterinary consultation immediately if your pet has potentially ingested any part of the plant. Mistletoe can cause vomiting, severe diarrhea, difficult breathing, shock and death within hours of ingestion.<\/span><\/p>\n<p><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/www.vetmed.wsu.edu\/ClientED\/images\/holly.jpg\" alt=\"Holly plant\" width=\"125\" height=\"175\" align=\"left\" border=\"0\" hspace=\"10\" vspace=\"10\" \/>There are many species of Holly (genus Ilex) Berries and leaves can be a problem although signs of poisonings are generally mild, and include vomiting, belly pain, and diarrhea.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>\u00a0 <b>Pets as Gifts<\/b><\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\">A cute, cuddly puppy or kitten may seem to be the perfect gift but unfortunately after the holiday season the population of animal shelters explodes with these \"surprise gifts\". Owning a pet is a long-term commitment that not every one can make.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>Dealing With Death or Severe Illness over the Holidays<\/b><\/span><\/p>\n<p><span style=\"color: #000000;\">The holiday season heightens our emotions and can be a very difficult time to deal with the loss or illness of a companion animal. The bond between animals and humans is often very strong and losses can be very painful. If you or someone you know needs support without judgment from those who appreciate your feelings and may be able to help, please contact the WSU College of Veterinary Medicine <a style=\"color: #000000;\" href=\"http:\/\/www.vetmed.wsu.edu\/PLHL\/\">Pet Loss Hotline<\/a>.<\/span><\/p>\n<p><span style=\"color: #000000;\">From all of us at the College of Veterinary Medicine at WSU, best wishes for a safe and happy holiday season for you and your pets.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>Other Holiday &amp; Seasonal Tips:<\/b><\/span><\/p>\n<p><span style=\"color: #000000;\"><a style=\"color: #000000;\" href=\"http:\/\/www.vetmed.wsu.edu\/ClientED\/cold.aspx\">Cold Weather Pet Tips<\/a><\/span><\/p>\n<p><span style=\"color: #000000;\"><a style=\"color: #000000;\" href=\"http:\/\/www.vetmed.wsu.edu\/ClientED\/gifts.aspx\">Gifts for the Pet Owner and other Holiday Tips<\/a><\/span><\/p>\n<p><span style=\"color: #000000;\"><a style=\"color: #000000;\" href=\"http:\/\/www.vetmed.wsu.edu\/ClientED\/antifreeze.aspx\"> Prevention of Antifreeze Poisoning<\/a><\/span><\/p>\n<p><span style=\"color: #000000;\"><b>This Pet Health Topic was written by Paul Chauvin, Washington State University, Class of 2004.<\/b><\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-OhKZP' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/strong><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-717-14\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-14\" ><div id=\"pgc-717-14-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-14-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"17\" ><div class=\"textwidget\"><h3><span style=\"color: #000000;\"><strong><em>Hyperthyroidism in the Cat<\/em> <\/strong><\/span><\/h3>\n<p><span style=\"color: #000000;\">Hyperthyroidism is the overproduction of thyroid hormone by the thyroid glands. Hyperthyroidism occurs most commonly in older cats and is rare in dogs. The average age of cats with hyperthyroidism is 13 years of age; only about 5 % of hyperthyroid cats are younger than 10 years of age. There are 2 thyroid glands located in the neck. One or\u00a0 both of the glands can enlarge and overproduce thyroid hormone.\u00a0 Involvement of\u00a0 both glands is more common than involvement of one gland. Thyroid hormone affects the function of most organs in the body, so the signs of hyperthyroidism are quite variable.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-HMjlq' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-HMjlq' class='yrm-inner-content-wrapper yrm-cntent-2'><\/span><\/p>\n<p><span style=\"color: #000000;\"><b>Signs of hyperthyroidism can include:\u00a0\u00a0\u00a0\u00a0\u00a0<\/b><\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">weight loss<\/span><\/li>\n<li><span style=\"color: #000000;\">increased appetite<\/span><\/li>\n<li><span style=\"color: #000000;\">increased activity and restlessness<\/span><\/li>\n<li><span style=\"color: #000000;\">aggressive or \"cranky\" behavior<\/span><\/li>\n<li><span style=\"color: #000000;\">a poor hair coat<\/span><\/li>\n<li><span style=\"color: #000000;\">a fast heart rate<\/span><\/li>\n<li><span style=\"color: #000000;\">increased water drinking\u00a0<\/span><\/li>\n<li><span style=\"color: #000000;\">increased urination<\/span><\/li>\n<li><span style=\"color: #000000;\">periodic vomiting<\/span><\/li>\n<li><span style=\"color: #000000;\">increased amount of stool or diarrhea<\/span><\/li>\n<li><span style=\"color: #000000;\">occasionally difficulty breathing\u00a0<\/span><\/li>\n<li><span style=\"color: #000000;\">occasionally weakness<\/span><\/li>\n<li><span style=\"color: #000000;\">occasionally depression<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\"><strong>A diagnosis of hyperthyroidism is made when the level of thyroid hormone is increased in the blood.\u00a0 Most hyperthyroid cats have very high levels of hormone but some cats will have signs of hyperthyroidism with normal or only slightly increased levels of thyroid hormone.\u00a0 Thyroid hormone levels can vary over time so it may be necessary to check blood levels several times or perform a different test called a T3 suppression test. The enlarged thyroid gland(s) can often be felt in the neck. If the diagnosis is not obvious by blood tests, a nuclear medicine scan of the thyroid glands can be performed at certain specialty veterinary practices. The cat is given a small dose of a radioactive compound that travels by the blood to the thyroid glands. Hyperactive thyroid glands accumulate more of the compound than normal glands. After this test the cat must be hospitalized for a few days while it clears the radioactive compound from its body.\u00a0<\/strong><\/span><\/p>\n<div align=\"left\">\n<table id=\"AutoNumber4\" border=\"0\" cellspacing=\"0\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/www.vetmed.wsu.edu\/ClientED\/images\/scan_thyroid.GIF\" alt=\"nuclear medicine scan of cat lying on side and on back\" width=\"228\" height=\"350\" border=\"0\" \/><\/span><\/td>\n<td><span style=\"color: #000000;\">A nuclear medicine scan of the thyroid glands.<\/span><br \/>\n<span style=\"color: #000000;\">Both thyroid glands are abnormal in this cat and take up the radioactive compound. The other black spot is the stomach lining which will also take up the compound.\u00a0<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<p><span style=\"color: #000000;\">A blood panel and urinalysis are also performed to screen for abnormalities in other organs such as liver and kidney that may be present due to the advanced age of the animal.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">High levels of\u00a0 thyroid hormone may cause heart disease. The heart may appear enlarged on x-ray or ultrasound and may show abnormal electrical activity on an ECG (electrocardiogram).\u00a0 Heart disease may cause fluid to build up in or around the lungs. Cats with serious heart disease and hyperthyroidism need to be treated for both diseases. The heart disease will reverse in many cats after successful treatment of hyperthyroidism.\u00a0 <b>There are three types of\u00a0 treatment for hyperthyroidism:\u00a0<\/b><\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">life long oral anti-thyroid\u00a0 medications<\/span><\/li>\n<li><span style=\"color: #000000;\">surgical removal of affected thyroid glands<\/span><\/li>\n<li><span style=\"color: #000000;\">treatment with radioactive iodine<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\">All three treatments will reduce thyroid hormone levels and the signs of hyperthyroidism. Discuss the 3 options with your veterinarian. If your pet has other diseases, one treatment may be better for your cat than another.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">The anti-thyroid pill is methimazole, also known as Tapazole. Methimazole is given one to three times daily and must be continued life long. It takes several weeks for methimazole to reduce blood thyroid hormone levels to normal. If methimazole is discontinued, thyroid hormone levels will return to high levels over a few weeks. Methimazole may be used to reduce thyroid hormone levels to normal before surgically removing the thyroid gland(s). Cats with heart disease may be too sick and fragile to anesthetize for surgery in which case methimazole can be given until the heart improves and the cat is stronger. Some owners (and their cats) find it difficult to give pills daily and may decide, after starting anti-thyroid pills, to later have their cat treated with radioactive iodine or surgery. Methimazole may produce side effects in cats including depression, vomiting and lack of appetite. These signs usually resolve without stopping the medication. A more serious side effect is the development of low blood cell counts which are more likely to develop during the first 3 months of treatment.\u00a0 Blood cell counts should be evaluated every 2 weeks during the first 3 months. If blood cell counts decrease methimazole is stopped and another treatment method should be considered.\u00a0 Enlarged thyroid glands can be surgically removed. Methimazole\u00a0 is given for 1 to 2 months before surgery so that thyroid hormone levels are normal at the time of surgery. If both glands are enlarged, they can both be removed and most cats will still produce enough thyroid hormone by a few thyroid cells scattered through out the body to prevent hypothyroidism (abnormally low thyroid hormone levels).\u00a0 A few cats will become hypothyroid and may need to take thyroid pills. Surgical removal of the thyroid gland(s) can usually be performed without complications. Occasionally complications may develop including damage to the parathyroid glands, which are closely attached to the thyroid gland, damage to nerves close to the thyroid gland or damage to the voice box. Parathyroid gland damage causes low blood calcium that may cause seizures.\u00a0 Low blood calcium is treated with calcium or vitamin D.\u00a0 Nerve damage causes abnormal size of the pupils of the eyes and droopy eyelids. Damage to the voice box causes a change in voice.<\/span><\/p>\n<p><span style=\"color: #000000;\">Some cats will remain hyperthyroid after surgical removal of the thyroid glands. These cats have thyroid cells in abnormal locations, including\u00a0 inside the chest cavity where surgical removal is difficult. This extra thyroid tissue is called ectopic thyroid. If you and your veterinarian decide that surgery is the best treatment option for your cat, a nuclear medicine scan (described in the diagnosis section) could be performed at a specialty veterinary practice before surgery to see if your cat has ectopic thyroid tissue. If ectopic thyroid tissue is seen on the nuclear medicine scan, then a different treatment, either methimazole or radioactive thyroid treatment should be selected.\u00a0 Cats that have had surgery may have recurrence of hyperthyroidism.\u00a0 Blood thyroid hormone levels should be measured once or twice a year. Treatment with radioactive iodine is only performed at selected specialty veterinary practices. Radioactive iodine is given intravenously and will accumulate in the abnormal thyroid tissue killing the abnormal thyroid cells but sparing the normal thyroid cells.\u00a0 Radioactive iodine will also accumulate in ectopic thyroid tissue. Radioactive iodine treatment is very effective and rarely causes hypothyroidism.\u00a0 The cats do not have to be placed under anesthesia for the procedure. The disadvantages of radioactive iodine treatment include the need to travel to a facility that offers this treatment and the need for the cat to remain hospitalized until the level of radioactivity decreases to a safe level as determined by the state radiation control office (usually 1 to 3 weeks).<\/span><\/p>\n<p><span style=\"color: #000000;\">Radioactive iodine treatment of hyperthyroid cats is available at <a style=\"color: #000000;\" href=\"http:\/\/www.vetmed.wsu.edu\/depts-vth\/I131_treatment.asp\" target=\"_blank\" rel=\"noopener\">Washington State University<\/a>.<\/span><\/p>\n<p><span style=\"color: #000000;\">Older cats with hyperthyroidism often also have kidney disease.\u00a0 Treatment of these cats is a delicate balancing act.\u00a0 Hyperthyroidism can actually improve kidney function by increasing blood flow to the kidneys. Some cats with kidney disease will show a worsening of kidney function after treatment for hyperthyroidism. Talk to your veterinarian about monitoring kidney function in hyperthyroid cats.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-HMjlq' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/strong><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-717-15\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-15\" ><div id=\"pgc-717-15-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-15-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"18\" ><div class=\"textwidget\"><h3><span style=\"color: #000000;\"><em><strong>Hypothyroidism in Dogs<\/strong> <\/em><\/span><\/h3>\n<p><span style=\"color: #000000;\">The thyroid glands located in the neck produce hormones that affect the function of many parts of the body. Although <a style=\"color: #000000;\" href=\"http:\/\/www.vetmed.wsu.edu\/ClientED\/hyperthyroidism.aspx\">thyroid disease in cats<\/a> often causes over productive glands and too much hormone, dogs with thyroid disease usually have a low production of thyroid hormones.<\/span><\/p>\n<p><span style=\"color: #000000;\">Overactive thyroid glands in the dog are rare and are usually associated with cancer. Hypothyroidism in dogs is usually caused by inflammation or shrinkage of the thyroid gland. Thyroid cancer can cause hypothyroidism although it does not occur commonly in dogs. Hypothyroidism occurs more commonly in medium to large breed dogs and usually in middle aged dogs. Breeds commonly affected include:<\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">Golden retriever<\/span><\/li>\n<li><span style=\"color: #000000;\">Doberman pincher<\/span><\/li>\n<li><span style=\"color: #000000;\">Irish setter<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-gIemr' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-gIemr' class='yrm-inner-content-wrapper yrm-cntent-2'><\/span><\/p>\n<p><span style=\"color: #000000;\">The most common signs of low thyroid function in dogs include loss or thinning of the fur, dull hair coat, excess shedding or scaling, weight gain, reduced activity and reduced ability to tolerate the cold. The hair loss occurs primarily over the body, sparing the head and legs, and is usually not accompanied by itching or redness of the skin. Some dogs will have thickening of the skin and increased skin pigment, especially in areas of friction, such as the armpit (axilla). Hypothyroid dogs often have ear infections and show ear pain, redness, and odor. Hypothyroid dogs may also develop skin infections which may be itchy and result in sores on the body. The accumulation of substances called mucopolysaccharides can cause the muscles of the face to droop giving the dog a facial expression that is sometimes called \u201ctragic\u201d.<\/span><\/p>\n<p><span style=\"color: #000000;\">Less commonly recognized signs that may be seen in a small number of dogs with hypothyroidism include dilation of the esophagus (megaesophagus) causing regurgitation, and abnormal function of nerves or muscles leading to weakness or abnormal ability to walk.<\/span><\/p>\n<p><span style=\"color: #000000;\">Routine blood tests can be affected by hypothyroidism, although the changes are not consistent and can be subtle. Dogs may have a mild anemia and increased levels of cholesterol.<\/span><\/p>\n<p><span style=\"color: #000000;\">There are several blood tests that can be used to confirm a suspected diagnosis of hypothyroidism. Blood testing for hypothyroidism is often performed as a panel of several tests in order to increase the yield of these tests. The results of some of these tests can be influenced by the presence of other non-thyroid diseases, so test results must be considered in light of the whole picture.<\/span><\/p>\n<p><span style=\"color: #000000;\">Treatment of hypothyroidism is by giving oral replacement hormone for the rest of the dog\u2019s life. Initially thyroid hormone is usually given twice daily. Once the hair coat begins to improve, some dogs can be maintained on once daily medication. There are two general forms of thyroid medication, T3 and T4. T4 is converted to T3 by the body. Most hypothyroid dogs given T4 will convert it to T3 so almost all hypothyroid dogs receive T4 (levothyroxine or L-thyroxine). A few dogs are unable to make this conversion and require T3 medication.<\/span><\/p>\n<p><span style=\"color: #000000;\">It usually takes 4 to 6 weeks before regrowth of the fur is apparent. In dogs with associated ear infection, the ears should be cleaned and treated with antibiotics either in the ear or by mouth. Blood levels of the T4 are often measured in order to fine tune the dose.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-gIemr' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/strong><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-717-16\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-16\" ><div id=\"pgc-717-16-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-16-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"19\" ><div class=\"textwidget\"><h3><span style=\"color: #000000;\"><em><strong>Urinary Incontinence<\/strong><\/em><\/span><\/h3>\n<p><span style=\"color: #000000;\">Urinary incontinence is the involuntary passing of urine. Pets can be incontinent for many different reasons. Those reasons can involve the bladder, the urethra which is the tube from the bladder to the outside, or incontinence can be caused by abnormalities in the parts of the brain and spinal cord that control bladder function. Related anatomy <a style=\"color: #000000;\" href=\"http:\/\/www.vetmed.wsu.edu\/ClientED\/anatomy\/dog_ug.aspx\">dog<\/a>\/ <a style=\"color: #000000;\" href=\"http:\/\/www.vetmed.wsu.edu\/ClientED\/anatomy\/cat_ug.aspx\">cat<\/a><\/span><\/p>\n<p><span style=\"color: #000000;\">Incontinence can be confused with diseases that cause a pet to urinate frequently. This pet health topic only discusses incontinence, not frequent urination.<\/span><\/p>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-Xc3K0' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-Xc3K0' class='yrm-inner-content-wrapper yrm-cntent-2'>Read more hidden text<\/span><\/p>\n<p><span style=\"color: #000000;\">Incontinence can also be confused with submissive urination. Submissive urination occurs when a dog is acting submissive to a person or to another dog. Submissive urination occurs more frequently in young animals. The dog usually rolls on its back and urinates. These dogs can also urinate normally.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Young animals may have a birth defect causing incontinence. The most common birth defect that causes incontinence in young dogs is ectopic ureter(s). The ureters carry urine from the kidneys to the bladder. If one or both ureters by-pass the bladder and connect to an abnormal location such as the urethra or vagina, the puppy may drip urine. Siberian Huskies are most often affected. Other breeds that have a higher occurrence of this birth defect include:<\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">Miniature Poodle<\/span><\/li>\n<li><span style=\"color: #000000;\">Labrador Retriever<\/span><\/li>\n<li><span style=\"color: #000000;\">Collie<\/span><\/li>\n<li><span style=\"color: #000000;\">Welsh Corgi<\/span><\/li>\n<li><span style=\"color: #000000;\">Wire-haired Fox Terrier<\/span><\/li>\n<li><span style=\"color: #000000;\">West Highland White Terrier<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\">Female dogs are more commonly affected. If only one ureter is abnormal the dog will dribble urine but can also urinate normally. If both ureters are affected then the puppy will only dribble urine and cannot pass urine normally.<\/span><\/p>\n<p><span style=\"color: #000000;\">To diagnose this condition a dye study of the bladder is usually performed. Sometimes the abnormal opening into the vagina can be seen during a careful examination under anesthesia using special equipment.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">Most puppies with ectopic ureter(s) also have a bladder infection that will improve with antibiotics but the infection will return until the problem is corrected.<\/span><\/p>\n<p><span style=\"color: #000000;\">In some cases the ureter can be surgically moved back to the normal location in the bladder and incontinence may resolve. In other cases, long standing infection of the kidney may have damaged the kidney requiring the removal of one kidney. In yet other cases the abnormality of the ureter can be corrected but the pet remains incontinent, probably due to the presence of other birth defects in the urinary system.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">A bladder infection can cause either a strong urge to urinate or if the bladder infection is long standing it can cause scarring of the bladder preventing it from stretching to hold urine. In this case the pet is usually not truly incontinent in that <b> they<\/b> <b> know<\/b> they are urinating, but they have such a strong urge to empty their bladder that they may urinate in abnormal locations or urinate very frequently. It is common to evaluate incontinent pets for the presence of a bladder infection.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">Pets with a partial blockage of the urethra with a stone or a tumor may show incontinence. If they cannot empty their bladder completely because something is blocking the path to the outside, the bladder may get so large that the back pressure of urine in the bladder actually forces some urine to leak around the blockage. In these pets the enlarged bladder can be felt on examination. Total blockage of urine flow is usually fatal in 3 to 4 days.<\/span><\/p>\n<p><span style=\"color: #000000;\">Hormone-responsive incontinence occurs in neutered dogs of both sexes and occasionally in spayed female cats but occurs most commonly in female dogs. The pet can urinate normally, but they leak urine while resting. Physical examination and blood and urine tests are usually normal in these pets. Hormone-responsive incontinence can occur months to years after a pet is neutered.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">As pets age they may become incontinent. This may be due to a weakening of the muscles that hold urine in the bladder. There are many diseases that can cause a pet to create more urine than normal (polyuria) and several of these occur in older pets. If a pet has one of these diseases and often has a full bladder, the full bladder can push against the weakened sphincter and cause incontinence. Older pets can also develop senility and simply be unaware that they are dribbling urine.<\/span><\/p>\n<p><span style=\"color: #000000;\">Dogs and cats with brain or spinal cord disease may either dribble urine or be unable to pass urine. Most often they will have other signs of nervous system disease such as muscle weakness or paralysis.<\/span><\/p>\n<p><span style=\"color: #000000;\">Intermittent incontinence, primarily at rest, has been reported in cats of both sexes that are positive for the feline leukemia virus. How the virus causes incontinence is unknown.<\/span><\/p>\n<p><span style=\"color: #000000;\">A less common cause of incontinence in female dogs is called vulvovaginal stenosis. It is a condition in which the vagina at the level where the urethra ends is narrowed. Occasionally when the pet urinates, some urine will get trapped in the vagina in front of this narrowed area. Then when they rise after lying down the urine pours out. This condition can be diagnosed by feeling the vagina with a gloved finger. In some dogs the narrowing can be stretched under anesthesia. The incontinence may or may not resolve as sometimes other defects are also present.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><b>Diagnosis of incontinence<\/b><\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\">The tests performed to evaluate a pet with incontinence depend upon the age of the pet and on the presence or absence of other signs. It is common to collect a urine sample for bacterial culture and to see if the urine is dilute or shows evidence of an infection. Infections of the urine may be secondary to another cause of incontinence.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><b>Questions that your veterinarian will ask to help identify the cause of your pet\u2019s problem include:\u00a0<\/b><\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">The age when incontinence first appeared\u00a0<\/span><\/li>\n<li><span style=\"color: #000000;\">When the incontinence is usually observed, for example at rest or with activity<\/span><\/li>\n<li><span style=\"color: #000000;\">Whether the pet can urinate normally\u00a0<\/span><\/li>\n<li><span style=\"color: #000000;\">Previous surgeries (such as neutering) and illness\u00a0<\/span><\/li>\n<li><span style=\"color: #000000;\">Use of medications that might cause the urine to be dilute such as diuretics, anticonvulsants or prednisone\u00a0<\/span><\/li>\n<li><span style=\"color: #000000;\">How much water the pet drinks<\/span><\/li>\n<li><span style=\"color: #000000;\">How frequently the pet urinates and whether the pet seems to be uncomfortable when he or she urinates<\/span><\/li>\n<li><span style=\"color: #000000;\">Whether the pet shows any signs of nervous system disease such as weakness or seizures<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\">Blood tests may be performed to look for evidence of kidney damage from infection or for the presence of diseases that might lead to increased urine production.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">Plain and\/or dye X-rays or ultrasound may be performed to look at the parts of the urinary tract.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><b>Treating the incontinent patient<\/b><\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\">Specific treatment of an underlying disease may resolve incontinence; for example, surgery to correct an ectopic ureter. Inappropriate urination caused by behavioral problems may be corrected with training that modifies the pet\u2019s behavior.<\/span><\/p>\n<p><span style=\"color: #000000;\">When no specific cause can be identified for the incontinence drugs may be given that increase the tone of the muscles that hold urine in the bladder. Some drugs that are used for this purpose include estrogen, ephedrine and phenylpropanolamine.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">Drug therapy for incontinence may be based on \u201ctrial\u201d of different drugs in various doses. Since some of these drugs can have side effects so low doses are tried first. Some drugs may be slow to have an effect so as long as there are no undesirable side effects, a drug trial should continue for several weeks before the drug is considered not to be effective.<\/span><\/p>\n<p><span style=\"color: #000000;\"><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-Xc3K0' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/span><\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-717-17\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-17\" ><div id=\"pgc-717-17-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-17-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"20\" ><div class=\"textwidget\"><h3><span style=\"color: #000000;\"><em><strong>Intervertebral Disk Disease<\/strong><\/em><\/span><\/h3>\n<p><span style=\"color: #000000;\">The intervertebral disks sit between the vertebrae in the spine. They function as shock-absorbers to help dissipate the forces placed on the spine. Each disc is made up of two parts, an outer fibrous covering (the annulus fibrosus) and an inner, gelatinous portion, the nucleus pulposus.<\/span><\/p>\n<p><span style=\"color: #000000;\">Invertebral disc disease (IVDD) occurs when there is degeneration of the intervertebral disks. As disks degenerate, they lose some of their water content, the nucleus becomes less gelatinous and more calcified. This calcified disc is less stable and more apt to herniate (type I IVDD) or protrude (type II IVDD). Discs usually rupture or protrude in an upward direction. Sitting above the disc anatomically is the spinal cord.<\/span><\/p>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-HeClu' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-HeClu' class='yrm-inner-content-wrapper yrm-cntent-2'><\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>\u00a0<\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\">Type I IVDD can occur in any area of the spinal cord. Dachshunds and other chondrodystrophic dogs (dogs with short legs and longer bodies) appear predisposed, as their disks age or degenerate more readily than most dogs. Young to middle-aged dogs are most commonly affected. Dogs less than 1 year of age rarely have intervertebral disc disease. Middle-aged to older large breed dogs can also develop disk disease (usually type II IVDD). Disc disease, in general, is rare in cats.<\/span><\/p>\n<p><span style=\"color: #000000;\">Signs of spinal cord disease (anything from back pain, to weakness in the limbs to paralysis of the limbs) develop due to the force of the disk material hitting the spinal cord, or because of the amount of disk material that enters the spinal canal and compresses the spinal cord. The more spinal cord damage, the more severe the clinical signs. The most important determinant of prognosis in a dog with IVDD is the ability to consciously feel their limbs. If a patient can still feel his limbs, even if he can no longer move his legs, there is an 80-85% that, if surgery is performed, he will have a functional recovery and be able to walk again.<\/span><\/p>\n<p><span style=\"color: #000000;\">IVDD is suspected as a diagnosis based on physical and neurologic exam findings, breed and history. To definitively diagnose IVDD, spinal x-rays, and either a CT scan or MRI of the spine are performed. Anesthesia is required to perform the latter two diagnostic procedures. Following advanced imaging, and the diagnosis of IVDD, surgery is then, sometimes, pursued. . General guidelines have been established for therapy depending upon severity of clinical signs. Mildly affected animals (animals back pain alone or those with mild weakness who are able to strongly walk) may be managed medically. Medical management entails strict cage confinement and appropriate pain medications for a total of 6-8 weeks. Confinement is very important to allow for healing of a degenerative disk. If, despite appropriate medical management a patient\u00e2\u20ac\u2122s back pain is refractory or if the patient\u00e2\u20ac\u2122s neurologic status worsens, surgery is pursued. Surgery is usually recommended in cases where animals are more severely affected (those who are unable to stand and walk). The goal of surgery is the removal of the extruded (type I IVDD) or protruded (type II IVDD).and subsequent relief of spinal cord compression.<\/span><\/p>\n<p><span style=\"color: #000000;\">This information was made possible by funds from the\u00a0<a style=\"color: #000000;\" href=\"http:\/\/vth.vetmed.wsu.edu\/specialties\/neurology\/neurology-endowment\">Neurology Endowment<\/a>\u00a0at Washington State University.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-HeClu' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/strong><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-717-18\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-18\" ><div id=\"pgc-717-18-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-18-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"21\" ><div class=\"textwidget\"><h3><span style=\"color: #000000;\"><em><strong>Chronic Kidney Disease and Failure (CKD, CRF, CRD)<\/strong> <\/em><\/span><\/h3>\n<p><span style=\"color: #000000;\">Chronic kidney disease is defined as kidney disease that has been present for months to years. Chronic renal disease (CRD), chronic renal failure (CRF), and chronic renal insufficiency refer to the same condition.<\/span><\/p>\n<p><span style=\"color: #000000;\">CKD is not a single disease. There are many different causes of CKD but by the time the animal shows signs of kidney disease the cause may no longer be apparent. Some potential causes of CRF include:<\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">congenital malformation of the kidneys (birth defects)<\/span><\/li>\n<li><span style=\"color: #000000;\">chronic bacterial infection of the kidneys with or without kidney stones (pyelonephritis)<\/span><\/li>\n<li><span style=\"color: #000000;\">high blood pressure (hypertension)<\/span><\/li>\n<li><span style=\"color: #000000;\">diseases associated with the immune system (e.g. glomerulonephritis, systemic lupus))<\/span><\/li>\n<li><span style=\"color: #000000;\">acute kidney disease, for example poisoning with antifreeze, that damages the kidneys can lead to CKD<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\">Often the cause of CKD is unknown.<\/span><\/p>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-ECzhQ' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-ECzhQ' class='yrm-inner-content-wrapper yrm-cntent-2'><\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>\u00a0<\/strong><\/span><\/p>\n<h4><span style=\"color: #000000;\">Structure of the kidneys<\/span><\/h4>\n<p><span style=\"color: #000000;\">The microscopic unit of the kidney is called the nephron. Each kidney contains thousands of nephrons. When the pet is young and healthy not all nephrons are working all of the time; some nephrons are held in reserve. As the animal ages or if the kidneys are damaged, some nephrons die and other resting nephrons take over the work of those that die. Eventually all the remaining nephrons are working. When there are no extra nephrons remaining and kidney damage continues the pet will start showing signs of CKD. Because of this stepwise loss of nephrons the kidneys are able to \"hide\" the fact that they are damaged until the damage is severe. When 2\/3 of the nephrons have been lost the pet is no longer able to conserve water and the pet passes larger amounts of dilute urine. By the time a pet has an elevation in the waste product creatinine in its blood, 75% of the nephrons in both kidneys have been lost.<\/span><\/p>\n<h4><span style=\"color: #000000;\">What do the kidneys do?<\/span><\/h4>\n<p><span style=\"color: #000000;\">When blood flows through the kidneys, the kidneys act as a complex filter that removes from blood wastes that are generated from break down of food, old cells, toxins or poisons and many drugs that are given for treatment of other diseases. The wastes are removed with water as urine. Waste products than can be measured in the blood include creatinine and urea nitrogen but there are many other waste products that are not measured by blood tests. The kidneys also acts as a filter to keep \"good\" substances in the blood. The kidneys regulate the amount of water in the blood by excreting extra water and retaining water to prevent dehydration by varying the amount of urine that is produced. The kidneys help regulate blood pressure by saving or eliminating sodium based on how much sodium the pet is eating. The kidneys help regulate calcium and vitamin D which keep bones strong. The kidneys produce a substance that helps with the creation of new red blood cells. Because the kidneys have so many functions, when the kidneys are not working normally, there are many signs that the pet may show.<\/span><\/p>\n<h4><span style=\"color: #000000;\">CKD is progressive<\/span><\/h4>\n<p><span style=\"color: #000000;\">By the time the pet shows signs of CKD, the damage is severe. There is no cure for CKD. The remaining nephrons are working so hard that with time they will fail as well. CKD is usually fatal in months to years but various treatments can keep the pet comfortable and with a good quality of life for months to years.<\/span><\/p>\n<h4><span style=\"color: #000000;\">Signs of CKD<\/span><\/h4>\n<p><span style=\"color: #000000;\">Because the kidneys perform so many functions, the signs pets with CKD show can vary quite a bit. The signs may be severe or may be subtle and slowly progressive. Despite the chronic nature of the disease, sometimes signs appear suddenly. Some of the more common signs of CKD include:<\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">drinking too much (polydipsia) and urinating large volumes of urine (polyuria)<\/span><\/li>\n<li><span style=\"color: #000000;\">the increased volume of urine in the bladder may lead to, or worsen incontinence (leaking urine), especially at night<\/span><\/li>\n<li><span style=\"color: #000000;\">vomiting and\/or diarrhea<\/span><\/li>\n<li><span style=\"color: #000000;\">lack of appetite and weight loss<\/span><\/li>\n<li><span style=\"color: #000000;\">general depression related to the elevation of waste products in the blood<\/span><\/li>\n<li><span style=\"color: #000000;\">anemia resulting in pale gums and weakness due to a low blood count<\/span><\/li>\n<li><span style=\"color: #000000;\">overall weakness from low blood potassium<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\"><strong><br \/>\nLess common signs include<\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">weakened bones can result in bone fractures<\/span><\/li>\n<li><span style=\"color: #000000;\">high blood pressure can lead to sudden blindness<\/span><\/li>\n<li><span style=\"color: #000000;\">itchy skin from calcium and phosphorous depositing in the skin<\/span><\/li>\n<li><span style=\"color: #000000;\">bleeding into the stomach or gut or bruising of skin<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\">Signs you <strong>may<\/strong> see if you examine your pet include: dehydration, weight loss, pale gums and ulcers in the mouth.<\/span><\/p>\n<p><span style=\"color: #000000;\">The signs seen in pets with CKD and the findings on examination are not specific for CKD and may be seen with many other diseases so blood and urine tests are needed to make a diagnosis of CKD.<\/span><\/p>\n<h4><span style=\"color: #000000;\">Diagnostic Tests<\/span><\/h4>\n<p><span style=\"color: #000000;\">Abnormalities that are often seen on diagnostic blood and urine tests include:<\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">anemia without signs of a response by the body to the low blood count (non regenerative anemia)<\/span><\/li>\n<li><span style=\"color: #000000;\">increased wastes that are normally removed by the kidneys (blood urea nitrogen [BUN] and creatinine)<\/span><\/li>\n<li><span style=\"color: #000000;\">increased phosphorus<\/span><\/li>\n<li><span style=\"color: #000000;\">calcium is often normal but can be elevated in some pets with CKD and rarely is decreased<\/span><\/li>\n<li><span style=\"color: #000000;\">dilute urine<\/span><\/li>\n<li><span style=\"color: #000000;\">+\/- protein or bacteria in the urine<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\">Sometimes bruising occurs where the blood sample was drawn as pets with CKD may have platelets that are less sticky than normal (normal platelets prevent bruising).<\/span><\/p>\n<p><span style=\"color: #000000;\">A diagnosis of CKD can usually be made based on the signs, physical examination and blood and urine tests but other tests may be performed to look for an underlying cause for the CKD and\/or to \"stage\" the CKD.<\/span><\/p>\n<div class=\"droplink\"><span style=\"color: #000000;\"><strong><a style=\"color: #000000;\" title=\"Details about staging\" href=\"http:\/\/www.vetmed.wsu.edu\/ClientED\/Details%20about%20staging\" name=\"bookmark\"> Details about staging<\/a><\/strong> <span class=\"style3\">\u00a0(click to expand)<\/span><\/span><\/div>\n<div id=\"Details about staging\" class=\"dropdown\">\n<p><span style=\"color: #000000;\">The severity of chronic kidney disease (CKD) can be estimated based on blood waste product elevation and abnormalities in the urine such as the presence of protein. The International Renal Interest Society (IRIS) has developed a method to estimate the stages of CKD.\u00a0 Stages are numbered 1 through 4 where one is the least severe and four is the most severe.\u00a0 The higher the stage number also generally corresponds to the greater number of symptoms seen in the pet.\u00a0 Some treatments are recommended to be started when the pet has a certain stage of CKD.<\/span><\/p>\n<p><span style=\"color: #000000;\">See the <a style=\"color: #000000;\" href=\"http:\/\/www.iris-kidney.com\/pdf\/IRIS%202006%20Staging%20of%20CKD.pdf\"> IRIS site for full details on staging<\/a>.<\/span><\/p>\n<hr \/>\n<\/div>\n<h4><span style=\"color: #000000;\">Other tests that may be performed include<\/span><\/h4>\n<ol>\n<li><span style=\"color: #000000;\">Determination of kidney size using abdominal radiographs (x-rays) or ultrasound <\/span><br \/>\n<span style=\"color: #000000;\"><em>What might this test show?<\/em><strong>\u00a0 <\/strong>The kidneys in pets with CRD are usually small reflecting the death of a large number of nephrons. If the kidneys are large then certain causes for the CKD should be considered such as lymphoma (cancer) of the kidneys, or an uncommon disease called amyloidosis. Some pets with signs of kidney disease who have large or normal sized kidneys may have acute kidney failure rather than CKD. The treatment and prognosis for pets with acute kidney disease differs from the treatment and prognosis of pets with CKD.<\/span><\/li>\n<li value=\"2\"><span style=\"color: #000000;\">Kidney biopsy<strong><br \/>\n<\/strong><em>What might this test show?<\/em><strong>\u00a0 <\/strong>A biopsy is not required to make a diagnosis of CKD but the results of a biopsy may show a cause for the CKD. A biopsy is more likely to show specific information when the kidneys are big rather than small. A biopsy can be valuable in pets who develop CKD at a young age or who are of a breed known to develop congenital kidney disease. There may be specific microscopic changes in a kidney biopsy from an animal with congenital kidney disease that may suggest that related animals are also at risk for developing CKD. Knowledge that the cause of CKD is caused by congenital kidney disease does not change the treatment of the affected animal but does provide information for related animals, for example if you should remove them from a breeding program. When a biopsy is planned, usually the biopsy is collected using ultrasound or laparoscopy to see the kidney during the biopsy so that no other organs are damaged during the biopsy.<\/span><\/li>\n<li value=\"3\"><span style=\"color: #000000;\">Bacterial culture<\/span><br \/>\n<span style=\"color: #000000;\"><em>What might this test show?<\/em><strong>\u00a0 <\/strong>Bacterial infection is not a common cause of CRD but pets with CKD may develop a bacterial infection as several aspects of the pet's immune system may be less functional when the kidneys are failing.\u00a0 If white blood cells are observed on microscopic examination of the pet's urine, a bacterial culture of the urine should be obtained.<\/span><\/li>\n<li value=\"4\"><span style=\"color: #000000;\">Tests of clotting ability<strong><br \/>\n<\/strong><em>What might this test show?<\/em><strong>\u00a0 <\/strong>If a pet is going to under go kidney biopsy, tests may be performed in advance to evaluate the ability to stop the bleeding from the biopsy site.<\/span><\/li>\n<\/ol>\n<h4><span style=\"color: #000000;\">Treatment of CRF<\/span><\/h4>\n<p><span style=\"color: #000000;\">The severity of the pet's signs will determine what treatments are needed. Not all treatments presented below may be needed or appropriate for each pet with a diagnosis of CKD. Treatments may also be started incrementally (a few treatments are started and then based on patient response, additional treatments may be added later). <strong><span class=\"style4\">The information below is not meant to be a substitute for veterinary care.<\/span><\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\">Pets with severe signs may be hospitalized for fluid and intravenous drug treatment to reduce the amount of waste products in their body. Many pets with CKD will feel better in response to treatment with IV fluids but if the kidney disease is extremely severe the pet may not respond to treatment.<\/span><\/p>\n<p><span style=\"color: #000000;\">Those pets who are still eating and not showing severe signs are treated with a variety of treatments, often introducing treatments incrementally as new signs develop. The treatment approach is often called \"conservative\" compared to more aggressive treatments such as hospitalization for fluid therapy, dialysis or kidney transplantation. <strong>Remember that CKD is not a disease that can be cured. <\/strong>Treatments are designed to reduce the work the kidneys need to perform, to replace substances that may be too low (such as potassium) and to reduce wastes that accumulate such as urea (generated by the body from proteins) and phosphorus. The initial response to conservative therapy may be relatively slow, taking weeks to months to see a response.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Diet<br \/>\n<\/strong>Feeding of a kidney diet is usually recommended. Kidney diets contain less protein compared to other diets and the protein is high in quality. It is protein in the diet that is converted to waste products that the kidneys must remove in the urine. The higher the quality of the protein in the diet, the less wastes created for the kidneys to eliminate. Low quality protein requires the kidneys remove more wastes. which makes them work harder. Egg and meat contain higher quality protein; cereal grain protein is of lower quality which leads to more wastes for the kidneys to eliminate. Protein is used by the body to repair cells and tissues that are continually regenerating, so a pet needs some protein in their diet. By feeding a low quantity, but high quality protein diet that contains an appropriate amount of fats and carbohydrates, the pet's body can use the protein for replacing the cells and tissues and use the fat and carbohydrates for energy. Kidney diets also contain a lower amount of phosphorus. Phosphorus accumulates in the blood when the kidneys are diseased. Kidney diets control the amount of other substances that may be too high or too low in patients with CKD such as salt, potassium, magnesium and B vitamins. There are differences in the kidney diets for dogs and cats. When making diet changes it is often beneficial to gradually introduce the new diet by adding increasing amounts of the new diet while reducing the amount of the current diet over 1 to 2 weeks. The pet is more likely to accept a new diet when it is introduced gradually and it is less stressful to the kidneys to gradually adapt to changes in the diet.<\/span><\/p>\n<p><span style=\"color: #000000;\">Protein restricted diets are less palatable than higher protein diets. Pets with CKD that are still eating are more likely to accept a change in diet to a protein restricted diet than are pets who are very ill and refusing most foods. Protein restricted diets are more expensive than higher protein diets.<\/span><\/p>\n<p><span style=\"color: #000000;\">There are many pet food companies that sell kidney diets.\u00a0 Dr. Tony Buffington at the Ohio State University is a good source of information on available diets. <a style=\"color: #000000;\" href=\"http:\/\/vet.osu.edu\/1442.htm\"> http:\/\/vet.osu.edu\/1442.htm<\/a>\u00a0 select a species, a diet form and select <em>Reduced Phosphorous\/Protein<\/em> for a list of diets for pets with kidney disease. Homemade diets can be fed but it is best to work with your veterinarian to formulate a diet that is balanced.<\/span><\/p>\n<div class=\"droplink\"><span style=\"color: #000000;\"><a style=\"color: #000000;\" title=\"Diet effect\" href=\"http:\/\/www.vetmed.wsu.edu\/ClientED\/ckd.aspx#\" name=\"bookmark\"><strong> Diet effect<\/strong><\/a>\u00a0 <span class=\"style5\">(click to expand for published information about diet in pets with CKD) <\/span><\/span><\/div>\n<div id=\"Diet effect\" class=\"dropdown\">\n<p><span style=\"color: #000000;\">It is generally agreed that feeding renal failure diets to dogs and cats with kidney disease improves their quality of live and <strong>may<\/strong> minimize the progression of the disease resulting in a longer life span. Studies that evaluate the effect of dietary changes on quality and quantity of life typically use commercial diets that differ in their composition of protein, phosphorus, sodium and lipids compared to maintenance diets so that positive effects are not attributable to a single component of the diet but rather to a \"<em>diet effect<\/em>\".<\/span><\/p>\n<p><span style=\"color: #000000;\">A randomized, double masked, clinical study in 38 dogs with spontaneous stage 3 or 4 kidney disease, half of which were fed a kidney failure diet and the other half a maintenance diet, published in <a style=\"color: #000000;\" href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/11990962?\"> JAVMA in 2002<\/a>, demonstrated improved quality and increased quantity of life in the group fed the renal failure diet.<\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">The median interval before development of a uremic crisis was twice as long in the group fed the renal diet<\/span><\/li>\n<li><span style=\"color: #000000;\">Dogs fed the renal diet survived at least 13 months longer (average 593 vs 188 days)<\/span><\/li>\n<li><span style=\"color: #000000;\">Owners of dogs fed the renal diet reported significantly higher quality of life scores for their dogs<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\">The results of a <a style=\"color: #000000;\" href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/10879400?\"> study of cats with naturally occurring stable chronic renal failure<\/a> fed a diet restricted in phosphorus and protein compared to cats with CKD fed a maintenance diet reported a median survival of 633 days for 29 cats fed the renal diet compared to 264 days for 21 cats fed a regular diet. The groups were not randomly determined but based on cat &amp; owners willingness to change to the renal diet.<\/span><\/p>\n<p><span style=\"color: #000000;\">In a study published in <a style=\"color: #000000;\" href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/16978113?ordinalpos=1&amp;itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&amp;linkpos=5&amp;log$=relatedarticles&amp;dbfrom=pubmed\"> JAVMA in 2006<\/a>, 45 client-owned cats with spontaneous stage 2 or 3 CKD were randomly assigned to an adult maintenance diet (23 cats) or a renal diet (22 cats) and evaluated for up to 24 months. Findings included:<\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">Significant differences: BUN lower and blood bicarbonate higher in the renal diet group<\/span><\/li>\n<li><span style=\"color: #000000;\">No Significant differences <\/span><br \/>\n<span style=\"color: #000000;\">body weight<\/span><br \/>\n<span style=\"color: #000000;\">PCV<\/span><br \/>\n<span style=\"color: #000000;\">urine protein-to-creatinine ratio<\/span><br \/>\n<span style=\"color: #000000;\">creatinine<\/span><br \/>\n<span style=\"color: #000000;\">potassium<\/span><br \/>\n<span style=\"color: #000000;\">calcium<\/span><br \/>\n<span style=\"color: #000000;\">parathyroid hormone concentrations.<\/span><\/li>\n<li><span style=\"color: #000000;\">26% of cats fed the maintenance diet had uremic episodes (26%), compared with 0% cats fed the renal diet<\/span><\/li>\n<li><span style=\"color: #000000;\">At the conclusion of the study, 5 (21.7%) cats in the maintenance diet group had died from renal causes and there were no renal-related deaths in the renal diet group.<\/span><\/li>\n<li><span style=\"color: #000000;\">There were no significant differences in quality of life as perceived by owners responding to a questionnaire.<\/span><\/li>\n<li><span style=\"color: #000000;\">Owners impressions of cats willingness to consume the diets did not differ between groups<\/span><\/li>\n<\/ul>\n<\/div>\n<hr \/>\n<p><span style=\"color: #000000;\"><strong>Water<br \/>\n<\/strong>Because pets with kidney disease cannot conserve water by making concentrated urine, their water intake is very important to prevent dehydration. Make sure they always have plenty of fresh water available.\u00a0 If the pet is not eating well, or is vomiting, then s(he) may not be drinking enough and may get dehydrated. Pets can be encouraged to drink by giving them flavored broths in addition to plain water. The broth should be low in sodium and its best to discuss with your veterinarian other ingredients in the broth to make sure it doesn't contain substances that will make the kidneys work harder.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Water soluble vitamins<\/strong> like B and C are lost in greater amounts when the pet is urinating greater amounts. Kidney diets contain increased amounts of water soluble vitamins so additional vitamins do not need to be given unless a homemade diet is being fed.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Potassium<br \/>\n<\/strong>Lack of appetite and increased loss of potassium in urine may result in low body potassium (hypokalemia).\u00a0 Cats with CKD are more likely to have low body potassium than are dogs. Cats with low potassium may develop painful muscles. Both cats and dogs may be weak when potassium is low. Cat kidney diets contain higher levels of potassium so additional supplementation is probably not needed unless the cat shows signs of muscle pain.\u00a0 Potassium gluconate or citrate can be given by\u00a0 mouth if potassium supplementation is needed. Potassium chloride is acidifying and is not recommended.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Phosphorus, calcium and PTH<br \/>\n<\/strong>Pets with CKD usually have increased blood phosphorus. In health, phosphorus and calcium are controlled by a hormone called parathyroid hormone (PTH). PTH works with vitamin D on the intestine, kidney and bone to keep calcium and phosphorus normal.\u00a0 As the kidneys fail the amount of PTH in the body is elevated and the amount of vitamin D is reduced. Elevated PTH itself may be responsible for some of the signs shown by pets with CKD.\u00a0 PTH draws calcium and phosphorus from the bones which can weaken bones which can lead to bone fracture.<\/span><\/p>\n<p><span style=\"color: #000000;\">Kidney diets typically contain reduced phosphorus and an appropriate amount of calcium but if phosphorus remains elevated when the pet is eating a kidney diet then phosphorus can be tied up in the intestinal tract so it can be eliminated in the stool. Intestinal phosphate binding agents include aluminum carbonate, aluminum hydroxide, aluminum oxide, calcium citrate, calcium acetate and calcium carbonate and sevelamer hydrochloride.\u00a0 Phosphate binding agents which contain calcium should not be used until blood phosphorus is normal to prevent calcium and phosphorus from combining and precipitating in tissues including the kidneys. It is not usually necessary to give additional calcium but if a pet has low blood calcium, the phosphorus should be normalized before giving calcium.\u00a0 Even when blood phosphorus is normalized, PTH levels are still higher than normal. The administration of low doses of vitamin D (1, 25 dihydroxycholecalciferol [calcitriol]) will suppress PTH and possibly\u00a0 slow the rate of progression of kidney deterioration. <\/span><\/p>\n<p><span style=\"color: #000000;\">It is <strong>not<\/strong> 100% agreed that giving your pet calcitriol will slow the deterioration of the kidneys. <\/span><\/p>\n<p><span style=\"color: #000000;\"><span class=\"style6\">Here are some web sites on using <\/span> calcitriol <a style=\"color: #000000;\" href=\"http:\/\/members.bellatlantic.net\/%7Evze2r6qt\/calcitriol\/\"> http:\/\/members.bellatlantic.net\/~vze2r6qt\/calcitriol\/<\/a><\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Acidosis<br \/>\n<\/strong>Some pets with CKD will have an acid blood pH.\u00a0 Kidney diets are designed to counteract the acidosis but very sick animals that are hospitalized may need addition treatment to correct the acidosis.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Sodium<br \/>\n<\/strong>Diseased kidneys are less efficient at regulating sodium and sodium in turn helps control blood volume and pressure. Excess sodium can lead to water retention and not enough sodium can lead to dehydration. When changing diets that contain different amounts of sodium (kidney diets usually have less sodium than regular diets) make the change\u00a0 gradually over several weeks. Use caution when giving your pet table scraps or treats that may be high in sodium.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>High blood pressure (hypertension)<\/strong><\/span><br \/>\n<span style=\"color: #000000;\">Many pets with CKD have high blood pressure. High blood pressure can contribute to further decline of kidney function and can occasionally lead to sudden blindness from retinal detachment. Ideally blood pressure should be measured by your veterinarian and hypertension confirmed before giving drugs to treat high blood pressure but measuring true blood pressure in dogs and cats can be difficult.\u00a0 If the pet has an elevation in blood pressure it may be due to the excitement of being examined or due to CKD. The calmer you are able to keep your pet during examination, the more reliable the readings for blood pressure. There are several drugs that may be used to manage high blood pressure including enalapril, benazepril, or amlodipine (and others).\u00a0 Enalapril and benazepril are in a class of drugs called &lt;align=\"left\"&gt; ACE inhibitors and are sometimes used in pets with CKD that have abnormal amounts of protein in their urine even when blood pressure is normal.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Anemia<br \/>\n<\/strong>The kidneys play a role in producing a hormone called erythropoietin which stimulates the production of new red blood cells. Red blood cells live about a hundred days so new cells are continually being made. Less erythropoietin is made in pets with CKD leading to anemia.\u00a0 The packed cell volume (PVC) (also called hematocrit) is the percentage of blood cells compared to fluid in whole blood. When the PCV is ~20 in cats and ~ 25% in dogs, anemia may contribute to lack of activity and weakness.<\/span><\/p>\n<p><span style=\"color: #000000;\">Anemia can be treated by blood transfusion or by the administration of human erythropoietin. Erythropoietin is very effective in increasing PCV but because human erythropoietin is not exactly the same as dog and cat erythropoietin, over time, the pet may form antibodies that cause the medication to become ineffective. Canine and feline erythropoietin are currently being studied.<\/span><\/p>\n<p align=\"left\"><span style=\"color: #000000;\"><strong>Fats\/lipids<br \/>\n<\/strong>Certain types of fats (polyunsaturated omega 6 fatty acids) may slow the decline in kidney function are are often present in kidney diets.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Subcutaneous Fluids<br \/>\n<\/strong>Some cats and dogs with kidney disease may not drink enough to prevent becoming dehydrated and may benefit from the administration of intermittent SC fluids. If your veterinarian feels your pet may benefit from giving subcutaneous fluids, we provide some instructions on how to give SC fluids.\u00a0 See <a style=\"color: #000000;\" href=\"http:\/\/www.vetmed.wsu.edu\/ClientED\/cat_fluids.aspx\">Cat Fluids<\/a> or <a style=\"color: #000000;\" href=\"http:\/\/www.vetmed.wsu.edu\/ClientED\/dog_fluids.aspx\">Dog Fluids<\/a><\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Lack of Appetite<br \/>\n<\/strong>The accumulation of wastes in the body often decreases appetite. A goal of several of the above treatments is to reduce the amount of wastes in the blood. If the pet remains off food despite above treatments you might try different brands of renal failure diets, warming the food or adding odiferous toppings to entice the pet to eat.<\/span><\/p>\n<p align=\"left\"><span style=\"color: #000000;\"><strong>Vomiting<br \/>\n<\/strong>Increased levels of waste products cause the pet to vomit. Your veterinarian may recommend medications that reduce nausea or act directly on brain centers to reduce the urge to vomit.<\/span><\/p>\n<p align=\"left\"><span style=\"color: #000000;\"><b>Drugs used to treat other diseases<br \/>\n<\/b>Because the kidneys are responsible for elimination of many drugs, make sure that your veterinarian is aware of any other medications you are giving your pet as these may accumulate in the body to toxic levels if the kidneys cannot eliminate them.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><strong>Antibiotics<\/strong><br \/>\nIf the urine shows signs of infection or if a urine culture grows bacteria then antibiotics may be administered. If a urinary tract infection is involving the kidneys, the period of treatment is much longer than a infection of the bladder. <\/strong><\/span><\/p>\n<p>&nbsp;<\/p>\n<h4><span style=\"color: #000000;\">Avoiding Stress<\/span><\/h4>\n<p><span style=\"color: #000000;\">You are in the best position to judge what is stressful to your pet. When a pet is stressed they may drink and eat less than normal. Reduced water intake is detrimental to diseased kidneys. When possible, keep your pet calm. That might mean for example: having an in-home pet sitter if your pet is stressed by boarding, removing the pet from the household during a party or limiting contact with other animals if these situations appear to be a source of stress for your pet. Extremes in heat or cold are stresses.\u00a0 Certain drugs such as prednisone\/cortisone make the kidneys work harder.<\/span><\/p>\n<h4><span style=\"color: #000000;\">Kidney Transplantation<\/span><\/h4>\n<p><span style=\"color: #000000;\">There has been progress made in transplantation of kidneys, more for cats than for dogs.<\/span><\/p>\n<p><span style=\"color: #000000;\">See <a style=\"color: #000000;\" href=\"http:\/\/www.felinecrf.com\/transb.htm\"> http:\/\/www.felinecrf.com\/transb.htm<\/a>\u00a0 for a list of facilities that currently offer transplanation.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-ECzhQ' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/strong><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-717-19\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-19\" ><div id=\"pgc-717-19-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-19-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"22\" ><div class=\"textwidget\"><h3><span style=\"color: #000000;\"><em><strong>Determining Gender (Sex) of a Kitten<\/strong><\/em><\/span><\/h3>\n<p><span style=\"color: #000000;\">You just brought home a kitten that you intend to name Sam but your roommate tells you that you had better consider the name Samantha instead.<\/span><\/p>\n<p><span style=\"color: #000000;\">Determining the sex (gender) of a kitten is easy when you know what to look for.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">Lift the kitten's tail. The opening just under the tail is the anus. Below the anus is the genital opening which is round in males and is a vertical slit in females. In kittens of similar size, the distance between the anus and the genital opening is greater in the male than the female.<\/span><\/p>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-DBXEN' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-DBXEN' class='yrm-inner-content-wrapper yrm-cntent-2'><\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>\u00a0<\/strong><\/span><\/p>\n<table style=\"height: 207px;\" border=\"0\" width=\"313\" cellspacing=\"0\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td rowspan=\"2\" align=\"left\" valign=\"top\"><\/td>\n<td align=\"center\"><\/td>\n<td rowspan=\"2\" align=\"left\" valign=\"top\"><span style=\"color: #000000;\"><img decoding=\"async\" class=\"pswp__img\" src=\"https:\/\/cf-s3.petcoach.co\/uploads\/noslidesarticleimages\/kitten_gender.gif?align=right\" \/><\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"center\"><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><\/td>\n<td align=\"left\" valign=\"top\"><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><span style=\"color: #000000;\">As the male kitten grows the testicles become more apparent.<\/span><\/p>\n<p><span style=\"color: #000000;\">The color of the kitten may suggest its gender. Almost all (but not ALL) kittens of calico (black, white and orange) or tortishell (black and orange) color are females. More orange kittens are male than female although the association between color and sex is not as strong as in the calico\/tortishell colored kitten.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"color: #000000;\"><strong><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-DBXEN' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/strong><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-717-20\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-20\" ><div id=\"pgc-717-20-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-20-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"23\" ><div class=\"textwidget\"><h3><span style=\"color: #000000;\"><em><strong>Laboratory: What Do Those Lab Tests Mean?<\/strong> <\/em><\/span><\/h3>\n<p><span style=\"color: #000000;\">The results of laboratory tests on a patient are compared to reference ranges established by measuring the laboratory parameters in a group of normal animals. The reference ranges for each laboratory test differ between laboratories and across species. Be careful interpreting laboratory tests. An occasional animal will have a value for a laboratory test that falls outside the reference range, but the value may still be normal for that animal.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">Your veterinarian will interpret laboratory tests in light of the entire evaluation of your pet. Sometimes laboratory tests need to be repeated to evaluate trends, which may provide more information than measurement of a single test.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-yeiWG' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-yeiWG' class='yrm-inner-content-wrapper yrm-cntent-2'><\/span><\/p>\n<p><span style=\"color: #000000;\">The results of laboratory tests may be influenced by drugs your pet is receiving and some are influenced by a recent meal. Always provide your veterinarian with information about any drug your pet is receiving. Inquire when you make an appointment for veterinary care, whether you should fast your pet before the visit in case laboratory samples are collected.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b> Complete blood count (CBC)<\/b><\/span><br \/>\n<span style=\"color: #000000;\">The complete blood count measures the number of cells of different types circulating in the bloodstream. There are three major types of blood cells in circulation; red blood cells (RBC), white blood cells (WBC), and platelets. Red blood cells are produced in the bone marrow, which is the soft center of bones. RBCs pick up oxygen brought into the body by the lungs, and bring that oxygen to cells throughout the body. Red blood cells live in the blood stream for about 100 days although the actual time varies with the type of animal. Old red blood cells are removed from the blood stream by the spleen and liver. Red blood cell numbers can be decreased (anemia) if they are not produced in adequate numbers by the bone marrow, if their life span is shortened (a condition called hemolysis), or if they are lost due to bleeding. Increased red blood cell numbers is called polycythemia and is usually due to concentration of the blood due to dehydration.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">The complete blood count also includes a measure of hemoglobin, which is the actual substance in the red blood cell that carries oxygen.<\/span><\/p>\n<p><span style=\"color: #000000;\">There are several types of white blood cells in blood, including neutrophils (PMNs), lymphocytes, monocytes, eosinophils and basophils. Lymphocytes are produced in lymph nodes throughout the body. The other white blood cell types are produced in the bone marrow along with the red blood cells and platelets. The majority of white blood cells in circulation are neutrophils, which help the animal fight infections. Neutrophils can be decreased in pets with bone marrow disease, in some viral diseases, and in some pets receiving cancer chemotherapy drugs. Neutrophils are increased in pets with inflammation or infection of any part of the body and in pets receiving prednisone or other cortisone-type drugs.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">Lymphocytes also help fight infection and produce antibodies against infectious agents (viruses, bacteria, etc.). Lymphocytes may be increased in puppies and kittens with an infection, they can be decreased in pets who are severely stressed, and lymphocytes might be lost in some types of diarrhea. Certain drugs, such as prednisone (a cortisone-type drug) will decrease the number of lymphocytes in the blood stream.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">Monocytes may be increased in pets with chronic infections. Eosinophils and basophils are increased in pets with allergic diseases, or parasitic infections (worms, fleas, etc.).\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">Platelets are produced in the bone marrow and are involved in the process of making a blood clot. Platelets live a few weeks and are constantly being produced by the bone marrow. Low platelet counts occur if the bone marrow is damaged and doesn\u2019t produce them, or if the platelets are destroyed at a faster rate than normal. The two primary causes of platelet destruction are immune-mediated destruction (ITP or IMT) and DIC (disseminated intravascular coagulation). Immune-mediated thrombocytopenia happens when the animal\u2019s immune system destroys platelets. DIC is a complex problem in which blood clots form in the body using the platelets faster than the bone marrow can produce new ones. Animals with a low platelet count bruise easily and may have blood in their urine or stool.<\/span><\/p>\n<p><span style=\"color: #000000;\">Packed cell volume (PCV) (called hematocrit, HCT, in humans) is another measure of red blood cells. A small amount of blood is placed in a tiny glass tube and spun in a centrifuge. The blood cells pack to the bottom of the tube and the fluid floats on top. The PCV is the percent of blood, that is cells, compared to the total volume of blood. In normal dogs and cats, 40-50% of the blood is made up of blood cells and the remainder is fluid.<\/span><\/p>\n<p><span style=\"color: #000000;\">Blood and urine tests are performed to get an initial overview of the health, and sometimes the function, of body organs. Some blood tests are very specific for a single organ, whereas other tests are affected by several organs. Blood tests are often performed as a biochemistry profile, or chemistry panel, which is a collection of blood tests to screen several organs at one time. The makeup of a biochemical profile varies with the laboratory in which it is performed. Following are some of the more commonly performed chemical tests:<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>Albumin<\/b> is a small protein produced by the liver. Albumin acts as a sponge to hold water in the blood vessels. When blood albumin is decreased, the pressure created by the heart forcing blood through the blood vessels causes fluid to leak out of the blood vessels and accumulate in body cavities such as the abdominal cavity or in tissues as edema. Albumin is decreased if the liver is damaged and cannot produce an adequate amount of albumin or if albumin is lost through damaged intestine or in the urine due to kidney disease. The only cause of increased albumin is dehydration.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>Alkaline phosphatase<\/b> originates from many tissues in the body. When alkaline phosphatase is increased in the bloodstream of a dog the most common causes are liver disease, bone disease or increased blood cortisol either because prednisone or similar drug is being given to the pet or because the animal has Cushing's disease (hyperadrenocorticism). In cats, the most common causes of increased alkaline phosphatase are liver and bone disease.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>ALT<\/b> is an enzyme produced by liver cells. Liver damage causes ALT to increase in the bloodstream. ALT elevation does not provide information as to whether the liver disease is reversible or not.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>Amylase<\/b> is an enzyme produced by the pancreas and the intestinal tract. Amylase helps the body breakdown sugars. Amylase may be increased in the blood in animals with inflammation (pancreatitis) or cancer of the pancreas. Sometimes pancreatitis is difficult to diagnose and some dogs and cats with pancreatitis will have normal amounts of amylase in the blood. Lipase is another pancreatic enzyme which is responsible for the breakdown of fats and which may be increased in patients with pancreatic inflammation or cancer.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>Bile acids<\/b> are produced by the liver and are involved in fat breakdown. A bile acid test is used to evaluate the function of the liver and the blood flow to the liver. Patients with abnormal blood flow to the liver, a condition known as portosystemic shunt will have abnormal levels of bile acids. The bile acid test measures a fasting blood sample and a blood sample two hours after eating.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>Bilirubin<\/b> is produced by the liver from old red blood cells. Bilirubin is further broken down and eliminated in both the urine and stool. Bilirubin is increased in the blood in patients with some types of liver disease, gallbladder disease or in patients who are destroying the red blood cells at a faster than normal rate (hemolysis). Large amounts of bilirubin in the bloodstream will give a yellow color to non-furred parts of the body, which is called icterus or jaundice. Icterus is most easily recognized in the tissues around the eye, inside the ears and on the gums.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>BUN <\/b> (blood urea nitrogen) is influenced by the liver, kidneys, and by dehydration. Blood urea nitrogen is a waste product produced by the liver from proteins from the diet, and is eliminated from the body by the kidneys. A low BUN can be seen with liver disease and an increased BUN is seen in pets with kidney disease. The kidneys must be damaged to the point that 75% of the kidneys are nonfunctional before BUN will increase. Pets that are severely dehydrated will have an increased BUN as the kidneys of a dehydrated patient don\u2019t get a normal amount of blood presented to them, so the waste products do not get to the kidneys to be eliminated.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><b> Calcium<\/b> in the bloodstream originates from the bones. The body has hormones, which cause bone to release calcium into the blood and to remove calcium from the blood and place it back into bone. Abnormally high calcium in the blood occurs much more commonly than low calcium. High blood calcium is most commonly associated with cancer. Less common causes of elevated calcium are chronic kidney failure, primary hyperparathyroidism which is over-function of the parathyroid gland, poisoning with certain types of rodent bait and bone disease.\u00a0<\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\">Low blood calcium may occur in dogs and cats just before giving birth or while they are nursing their young. This is called eclampsia and occurs more commonly in small breed dogs. Eclampsia causes the animal to have rigid muscles which is called tetany. Another cause of low blood calcium is malfunction of the parathyroid glands which produce a hormone (PTH) that controls blood calcium levels. Animals poisoned with antifreeze may have a very low blood calcium.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b> Cholesterol<\/b> is a form of fat. Cholesterol can be increased in the bloodstream for many reasons in dogs. It is much less common for cats to have increased cholesterol. Some of the diseases that cause elevated cholesterol are hypothyroidism, Cushing's disease, diabetes and kidney diseases that cause protein to be lost in the urine. High cholesterol does not predispose dogs and cats to heart and blood vessel disease as it does in people.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b> Creatinine<\/b> is a waste product that originates from muscles and is eliminated from the body by the kidneys. An elevation of creatinine is due to kidney disease or dehydration. Both creatinine and BUN increase in the bloodstream at the same time in patients with kidney disease.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b> Creatinine kinase (CK)<\/b> is released into the blood from damaged muscle. Elevation of creatinine kinase therefore suggests damage to muscle including heart muscle.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b> Glucose<\/b> is blood sugar. Glucose is increased in dogs and cats with diabetes mellitus. It may be mildly increased in dogs with Cushing's disease. Glucose can temporarily increase in the blood if the dog or cat is excited by having a blood sample drawn. This is especially true of cats. A quick test to determine whether a glucose elevation is transient or permanent is to look at the urine. If the glucose is chronically elevated there will be an increased amount of glucose in the urine as well.<\/span><\/p>\n<p><span style=\"color: #000000;\">Low blood sugar occurs less commonly and can be a sign of pancreatic cancer or overwhelming infection (sepsis). Low blood sugar can cause depression or seizures. Low blood sugar can be seen if the blood sample is improperly handled. Red blood cells will use glucose so typically red blood cells are removed from the blood sample and the clear part of the blood (plasma or serum), is used for analysis.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b> Phosphorus<\/b> in the bloodstream originates from bones and is controlled by the same hormone, PTH (parathyroid hormone) which controls blood calcium. Phosphorus is increased in the bloodstream in patients with chronic kidney disease. Like BUN and creatinine, phosphorus increases in these patients when about 75 percent of both kidneys is damaged.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><b> Potassium<\/b> is increased in the bloodstream in the pet with acute kidney failure such as kidney failure caused by antifreeze poisoning, in dogs with Addison's disease and in animals with a ruptured or obstructed bladder.\u00a0<\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\">Potassium is lost from the body in vomit, diarrhea and urine. Pets that are not eating may have a low blood potassium. Low blood potassium can cause the pet to feel weak. Cats with low potassium may develop painful muscles.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>Sodium<\/b> may be slightly increased in the blood if the patient is dehydrated although many dehydrated dogs and cats have a normal blood sodium. Low blood sodium is most commonly seen with Addison's disease (hypoadrenocorticism).<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>Total protein<\/b> includes albumin and larger proteins called globulins. Included in the globulins are antibodies which are protein molecules. Total protein can be increased if the dog or cat is dehydrated or if the pet's immune system is being stimulated to produce large amounts of antibody. Total protein is decreased in the same situations which reduce albumin or if the pet has an abnormal immune system and cannot produce antibodies.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>Urinalysis:<\/b> A urine sample can provide information about several organ systems. The concentration, color, clarity and microscopic examination of the urine sample can provide diagnostic information.<\/span><\/p>\n<p><span style=\"color: #000000;\">Urine may be obtained by catching a sample during normal urination, by passing a catheter into the bladder or by placing a small needle through the body wall into the bladder, a procedure called cystocentesis. Depending upon why the urine sample is being collected, one collection method may be preferred over another. Inquire at the time you make an appointment for veterinary care if a urine sample may be collected. Preventing your pet from urinating prior to the appointment will assure that your pet\u2019s bladder will contain urine for sampling.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-yeiWG' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/strong><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-717-21\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-21\" ><div id=\"pgc-717-21-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-21-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"24\" ><div class=\"textwidget\"><h3><span style=\"color: #000000;\"><em><strong>Lyme Disease<\/strong> <\/em><\/span><\/h3>\n<p><span style=\"color: #000000;\"><b>What is Lyme disease?<\/b><\/span><br \/>\n<span style=\"color: #000000;\">Lyme disease is caused by the corkscrew-shaped bacteria, <i>Borrelia burgdorferi\u00a0 <\/i>which is also called a spirochete. The bacteria are carried by ticks which transmit the infection when they feed on animals and humans. The disease can cause generalized illness in animals and humans worldwide.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\"><img decoding=\"async\" src=\"http:\/\/files.dvm360.com\/alfresco_images\/DVM360\/\/2018\/04\/26\/5291fb06-842f-4173-961d-7650080bd909\/veterinary-CAPC-forecast2018-450.jpg\" alt=\"\" \/><\/span><\/p>\n<div align=\"left\">\n<table style=\"height: 135px;\" border=\"0\" width=\"1005\" cellspacing=\"0\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td><\/td>\n<td><span style=\"color: #000000;\">In the United States, Lyme disease occurs predominantly on the Pacific coast and in the Midwest, and Atlantic coast states.\u00a0 Regions in which the disease occurs commonly are called endemic regions. About 75% of dogs living in endemic regions are exposed to infected ticks, but only a small percentage of exposed dogs develop signs of disease.<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-9UoqT' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-9UoqT' class='yrm-inner-content-wrapper yrm-cntent-2'><\/span><\/p>\n<p><span style=\"color: #000000;\">Lyme disease was first described in 1975 when an unusual outbreak of\u00a0 rheumatoid arthritis occurring in children was reported in Lyme, Connecticut. In 1982, the bacteria <i>Borrelia burgdorferi<\/i> was determined to be the cause of that outbreak. Since Lyme disease was first described in the early 1980's, the frequency of occurrence of disease has increased twenty-five fold. Today, Lyme disease is the most common vector-borne (transmitted by insects or arthropods) disease occurring in people and probably in dogs in the United States. Dogs are most frequently infected with the Lyme disease bacteria, but infections can also occur in horses, cattle, and cats.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><b>How is Lyme disease transmitted?<br \/>\n<\/b>The bacteria live in mice, deer and other small mammals. The type of ticks that can transmit the bacteria from these wildlife\u00a0 to humans and domestic animals are the <i>Ixodes <\/i>ticks.\u00a0 The bacteria replicate (increase in number) in the\u00a0 wildlife without causing them to become sick. When a tick feeds on the infected wildlife the tick picks up the bacteria, then they transmit the bacteria to another animal the next time they feed.\u00a0\u00a0<\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\">If your pet is diagnosed with Lyme disease you are not at risk of getting Lyme disease directly from your pet. The bacteria increase to high levels in the blood of wildlife whereas humans and domestic animals develop very low levels of the bacteria in their blood and these low levels will not infect a feeding tick.\u00a0\u00a0 Researchers have learned that infected ticks must feed for about 24 hours to transmit the bacteria to a susceptible animal so quick removal of ticks from your pet reduces the chance of infection.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>Clinical signs\u00a0<\/b><\/span><br \/>\n<span style=\"color: #000000;\">The most common sign of Lyme disease in dogs is arthritis, which causes sudden lameness, pain ands sometimes swelling in one or more joints.\u00a0 Other signs that may be seen include fever, lack of appetite, dehydration, inactivity, and swollen lymph nodes. In severe cases, the infection can cause kidney failure and death although this does not occur commonly in dogs. The signs of heart and nervous system dysfunction seen in infected humans are not often seen in animals.<\/span><\/p>\n<div align=\"left\">\n<table border=\"0\" cellspacing=\"0\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<p><span style=\"color: #000000;\"><strong>\u00a0D<\/strong><b>iagnosis\u00a0<\/b><\/span><br \/>\n<span style=\"color: #000000;\">A diagnosis of Lyme disease is usually made based upon a history of\u00a0 being in an endemic area, signs of arthritis and favorable response to treatment. There is a blood test that measures antibodies to the bacteria but many dogs that live in endemic regions will have a positive blood test. A positive blood test just means that the dog was exposed to <i>Borrelia burgdorferi<\/i>\u00a0 but not all dogs that are exposed will show signs of disease.\u00a0 Early in the disease dogs may not yet have a positive blood test. Dogs that have been vaccinated for Lyme disease may have a positive blood test depending upon the type of blood test that is performed. There are several other causes of arthritis that occur in dogs that must also be considered.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>Treatment<br \/>\n<\/b><i>Borrelia burgdorferi<\/i>\u00a0 is easily treated with antibiotics. The signs of Lyme disease usually regress rapidly in response to treatment. If the disease remains untreated the disease becomes chronic and can cause kidney damage although dogs are much less likely to develop chronic disease than are people.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><b>Prevention<\/b><br \/>\nAnimals in endemic areas are at greatest risk for infection. The best method of prevention is to avoid tick infested areas, especially in the spring when the young ticks are most active. When returning from a tick-infested area do a thorough search for ticks on both yourself and your animals. Ticks should be removed carefully with a tweezers, pinching the tick near the point they enter the skin. There are also many highly effective veterinary products that will kill ticks on your dog before the tick can transmit the bacteria.\u00a0Remember that early removal of ticks reduces the chance that the tick will transmit Lyme disease.<\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\">There is a vaccine approved for use in dogs for Lyme disease prevention. Most authors of veterinary articles on Lyme disease do not recommend vaccinating dogs in <b>non<\/b>-endemic areas. Not all authors agree on how effective the vaccine is in preventing Lyme disease and not all authors agree that the vaccine should be given in endemic regions. The vaccine can cause some blood tests for Lyme disease to become positive. For more information about tick control products or Lyme disease, consult your veterinarian.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><b>References:<\/b><br \/>\nFor additional information on Lyme disease see: the <a style=\"color: #000000;\" href=\"http:\/\/www.cdc.gov\/ncidod\/dvbid\/lymeinfo.htm\">Centers for Disease Control (CDC) website<\/a><\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\">This topic was written by Wendy Harless, Oregon State University, class of 2002 with the guidance of Dr.Diana Stone, Washington State University.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-9UoqT' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/strong><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-717-22\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-22\" ><div id=\"pgc-717-22-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-22-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"25\" ><div class=\"textwidget\"><h3><span style=\"color: #000000;\"><em><strong>Canine Lymphosarcoma (Lymphoma, LSA)<\/strong><\/em><\/span><\/h3>\n<h4><span style=\"color: #000000;\">Incidence\/cause<\/span><\/h4>\n<p><span style=\"color: #000000;\">LSA, a tumor caused by a cancerous proliferation of lymphocytes (cells that normally function in the immune system), is one of the most common tumors seen in dogs. It affects dogs of any breed and age, although most dogs will be middle-aged or older at the time of diagnosis; Golden retrievers are considered a breed at increased risk of developing LSA. The cause of LSA in dogs, as is true for most canine tumors, is not known.<\/span><\/p>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-yan49' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-yan49' class='yrm-inner-content-wrapper yrm-cntent-2'><\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>\u00a0<\/strong><\/span><\/p>\n<h4><span style=\"color: #000000;\">What you might see\/ Clinical presentation<\/span><\/h4>\n<p><span style=\"color: #000000;\">The presentation of dogs with LSA is highly variable as lymphocytes can be found in virtually any organ in the body. Nonetheless, the most common form (referred to as stages) of LSA causes a non-painful enlargement of one or more lymph nodes that can be seen or felt from the body surface. Occasionally, a lymph node becomes large enough to impair function (obstruction of blood flow or airway, for example). Other forms of LSA can involve the liver, spleen, bone marrow and gastrointestinal tract, skin or nervous system (and other organs) and the clinical signs will reflect the organ system involved (e.g. vomiting or diarrhea with gastrointestinal forms; weakness or pale mucous membranes and others that reflect impaired production of blood cells from the bone marrow); many dogs will simply feel ill (lose appetite, become lethargic) with any of the different forms. In some dogs, lymph node enlargement is an incidental finding when an otherwise healthy-appearing dog is seen by a veterinarian for an unrelated reason (e.g. vaccination).<\/span><\/p>\n<h4><span style=\"color: #000000;\">Lymph node staging<\/span><\/h4>\n<p><span style=\"color: #000000;\">Stage I: single lymph node enlarged\u00a0<\/span><br \/>\n<span style=\"color: #000000;\">Stage II: multiple nodes enlarged on either the front half or back half of the body\u00a0<\/span><br \/>\n<span style=\"color: #000000;\">Stage III: multiple nodes enlarged on both front and back halves of body\u00a0<\/span><br \/>\n<span style=\"color: #000000;\">Stage IV: involvement of the liver and\/or spleen\u00a0<\/span><br \/>\n<span style=\"color: #000000;\">Stage V: bone marrow involvement, or involvement of other organs (e.g. gastrointestinal, skin, nervous system)\u00a0<\/span><br \/>\n<span style=\"color: #000000;\">Each numbered stage can be further divided into substages, of which there are two: a and b. Patients with substage a feel well while patients with substage b are ill.<\/span><\/p>\n<h4><span style=\"color: #000000;\">Biological behavior of LSA<\/span><\/h4>\n<p><span style=\"color: #000000;\">LSA is viewed as a systemic disease, and as such is not really viewed to \"spread\" to other organs. This tumor is not generally viewed as a curable tumor in dogs, although occasional dogs will experience what seems to be a cure with appropriate treatment (see below). A dog can start with one stage of the disease and progress over time to another (usually more advanced) stage of LSA.<\/span><\/p>\n<h4><span style=\"color: #000000;\">Clinical staging (determination of the extent of the tumor)<\/span><\/h4>\n<p><span style=\"color: #000000;\">Because of the organs that LSA commonly involves, staging a dog with a LSA can involve aspiration of one or more lymph nodes, thoracic radiographs abdominal radiographs or ultrasound (to look for big nodes in the abdomen and to look at the liver and spleen), or bone marrow examination. Often, obtaining blood for a complete blood count and biochemical profile, and a urinalysis will be advised as these can help assess overall health and provide information that potentially influences treatment recommendations. Sometimes, special stains to determine if the LSA is of B-cell or T-cell origin (B-cells and T-cells are specific types of lymphocytes) are recommended because of prognostic significance, although treatment recommendations are the same for either type.<\/span><\/p>\n<h4><span style=\"color: #000000;\">Treatment options<\/span><\/h4>\n<p><span style=\"color: #000000;\">The mainstay of treatment of LSA is administration of chemotherapy drugs; the best responses in terms of length of tumor control and survival are generally seen with protocols that entail administration of more than one chemotherapy drug, although there are approaches that involve administration of a single drug. Chemotherapy drugs commonly used include: doxorubicin, vincristine, cyclophosphamide, prednisone, and L-Aspariginase, but many others are also used. In some dogs with very localized disease, surgery or radiation therapy can play a role in treatment, although chemotherapy is still often recommended in these cases.<\/span><\/p>\n<h4><span style=\"color: #000000;\">Prognosis<\/span><\/h4>\n<p><span style=\"color: #000000;\">The prognosis of dogs with LSA is highly variable, and depends on the clinical stage (ill dogs fare more poorly than dogs that feel well, and dogs with Stage V disease are generally considered to have a poorer prognosis), the type of tumor (dogs with B-cell LSA usually do better than dogs with T-cell LSA). Most dogs treated with chemotherapy will experience a remission, a period in which there is no detectable cancer and the dog feels well. Remission times are variable, but most dogs with the lymph node forms of LSA will have initial remissions lasting in the range of 6-9 months before evidence of the tumor is seen again; second remissions can be achieved in many of these dogs, but any subsequent remission is expected to be shorter in duration than the first remission. Survival times for most dogs treated with combination chemotherapy protocols are in the range of approximately 1 year. And even though an individual dog will have received a lot of chemotherapy over that year, their quality of lfe is generally very good. Statistics, while useful, can never predict how an individual dog will fare with or without specific treatment.<\/span><\/p>\n<h4><span style=\"color: #000000;\">Future treatment options:<\/span><\/h4>\n<p><span style=\"color: #000000;\">New protocols are tried with great regularity in canine lymphoma but results have been similar with each drug regime investigated. Most likely our survivals will always be similar until we either accept greater toxicity (meaning most dogs will be very sick from the treatment and some may even die), or a completely novel treatment is invented. Using half or whole body radiation therapy may prove helpful. The development an antibody specific for dog lymphoma, which could recognize all dog lymphomas and yet no normal lymphocytes, and be attached to a toxin or other cell killing mechanism, is a far off dream.<\/span><\/p>\n<h4><span style=\"color: #000000;\">Key points<\/span><\/h4>\n<p><span style=\"color: #000000;\">LSA is one of the most chemotherapy-responsive tumors seen in veterinary medicine, and most dogs tolerate chemotherapy very well with minimal impact on their quality of life. If you notice fast growing lumps on your dog that seem to be in the area of the major joints (at the neck, in front of the shoulders, in the armpits, at the back of the knees or in the groin) have your dog examined soon by a veterinarian even if he feels well. Remember, lower stage disease, and dogs that feel well, will do better with treatment than dogs that are ill and\/or have more advanced disease.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-yan49' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/strong><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-717-23\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-23\" ><div id=\"pgc-717-23-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-23-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"26\" ><div class=\"textwidget\"><h3><span style=\"color: #000000;\"><em><strong>Feline Lymphosarcoma (Lymphoma, LSA)<\/strong><\/em><\/span><\/h3>\n<h4><span style=\"color: #000000;\">Incidence\/Cause<\/span><\/h4>\n<p><span style=\"color: #000000;\">Lymphosarcoma is a tumor caused by a cancerous proliferation of lymphocytes or, cells that normally function in the immune system. This is a very common tumor in cats and can present in a variety of ways. At one time, feline leukemia virus (FeLV) was a leading cause of LSA in cats and typically young cats were infected. Now that the incidence of FeLV has decreased cats still develop LSA but it is generally older cats and different forms. The Feline aids virus (FIV) has also been shown to increase the risk of a cat developing LSA six times over a non-infected cat. Any breed of cat can develop LSA. The cause of the disease unrelated to FeLV or FIV is unknown although environmental smoke exposure has been found to increase a cat\u2019s risk of LSA, and a possible link to long standing inflammatory disease has long been theorized.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-kL1dn' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-kL1dn' class='yrm-inner-content-wrapper yrm-cntent-2'><\/span><\/p>\n<h4><span style=\"color: #000000;\">What you might see\/ Clinical presentation<\/span><\/h4>\n<p><span style=\"color: #000000;\">Cats with LSA present with a variety of signs because lymphocytes can be found in nearly every organ in the body. Also, cats seem to have more forms of LSA in atypical locations or not in normal lymphoid tissues, as compared to other species. Most species including man present with large lymph nodes, but this is a rare form of LSA in cats. Young cats typically present for masses in the chest cavity and owners notice signs of difficulties breathing or vomiting of food. Older cats develop the tumor in their intestines quite commonly and owners may notice signs such as weight loss, diarrhea or vomiting. They also can however develop LSA in areas as diverse as the nasal passages, kidneys, spinal cord, liver, eyes, or a single lymph node, and the signs seen will be more specific for the organ affected. Because cats present with such a variety of organs affected there is no valid staging system for feline LSA and a cat diagnosed with the disease will more likely be staged by the organ affected (eg. gastrointestinal LSA, mediastinal LSA etc.)<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>\u00a0<\/strong><\/span><\/p>\n<h4><span style=\"color: #000000;\">Biological behavior of LSA<\/span><\/h4>\n<p><span style=\"color: #000000;\">Even though many cats present with only a single site of involvement, LSA is viewed as a systemic disease. Lymphocytes in their normal functioning capacity travel throughout the body and as a cancer the disease is also moving though not in a classical sense \"metastasizing\". Even if a tumor diagnosed as LSA has been surgically removed the disease is not gone.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>\u00a0<\/strong><\/span><\/p>\n<h4><span style=\"color: #000000;\">Clinical staging (determination of the extent of the tumor)<\/span><\/h4>\n<p><span style=\"color: #000000;\">Because of the organs that LSA commonly involves, staging a cat with a LSA can involve aspiration of one or more lymph nodes or masses, thoracic radiographs abdominal radiographs or ultrasound (to look for big nodes in the abdomen and to look at the liver and spleen), or bone marrow examination. Obtaining blood for a complete blood count and biochemical profile, FeLV, FIV, and a urinalysis is always advised as these can help assess overall health and provide information that potentially influences treatment recommendations. Sometimes, special stains to determine if the LSA is of B-cell or T-cell origin (B-cells and T-cells are specific types of lymphocytes) are recommended because of prognostic significance, although treatment recommendations may be the same for either type. Staging the disease can be critical in choosing treatment protocols.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>\u00a0<\/strong><\/span><\/p>\n<h4><span style=\"color: #000000;\">Treatment options<\/span><\/h4>\n<p><span style=\"color: #000000;\">Chemotherapy should always be considered a critical part of the treatment for LSA. The best responses in terms of length of tumor control and survival are generally seen with protocols that entail administration of more than one chemotherapy drug, although there are approaches that involve administration of a single drug. Chemotherapy drugs commonly used include: doxorubicin, vincristine, cyclophosphamide, prednisone, and L-Aspariginase, but many others are also used. Some protocols are very aggressive and relatively short (six month total) and others are less aggressive but extend for one to two years. The decision of which protocol is to be used does depend on the results of the tumor biopsy (not all LSA is the same) and the staging results. Thankfully, the chemotherapy generally act quickly so that even cats with sever signs can have relief fairly soon after starting therapy (sometimes as quickly as 24 hours). Surgery is sometimes recommended as a part of the treatment but this is usually either to reach a diagnosis or to remove a potentially life threatening problem (for example intestinal rupture due to a tumor mass). Surgery is never curative and should always be followed by chemotherapy to best extend the cat\u2019s life. Radiation can also play a role in the treatment of very localized LSA. The primary site most benefiting from radiation therapy is nasal LSA.<\/span><\/p>\n<h4><span style=\"color: #000000;\">Prognosis<\/span><\/h4>\n<p><span style=\"color: #000000;\">Cats with LSA have unpredictable responses and survivals. Depending on the site of the tumor, mean survivals with chemotherapy range from 6-9 months. The problem is that this is only an average and most cats tend to do either much worse or much better. Young cats, FeLV negative, with mediastinal LSA are quite regularly cured with chemotherapy; cats with LSA in their central nervous system typically have a bad prognosis, but most other forms of LSA in cats have unpredictable outcomes. Generally it is best to at least try a chemotherapy protocol because it may be the only way to see how an individual cat will do. Cats often do not enjoy receiving chemotherapy, but veterinary oncologist try hard to make the regime tolerable for each feline patient even if it means modifications in a protocol.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>\u00a0<\/strong><\/span><\/p>\n<h4><span style=\"color: #000000;\">Future treatment options<\/span><\/h4>\n<p><span style=\"color: #000000;\">New protocols are tried in feline lymphoma but results have been similar with each drug regime investigated. Most likely our survivals will always be similar until we either accept greater toxicity (meaning most cats will be very sick from the treatment and some may even die), or a completely novel treatment is invented. Using half or whole body radiation therapy may prove helpful. The development an antibody specific for cat lymphoma, which could recognize all cat lymphomas and yet no normal lymphocytes, and be attached to a toxin or other cell killing mechanism, is a far off dream.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>\u00a0<\/strong><\/span><\/p>\n<h4><span style=\"color: #000000;\">Key points<\/span><\/h4>\n<p><span style=\"color: #000000;\">LSA is one of the most chemotherapy-responsive tumors seen in veterinary medicine and cats can tolerate chemotherapy relatively well, or protocols can be modified so that an individual cat can maintain a good quality of life while on chemotherapy. Unfortunately we have few strong predictors of which cats will have good responses to chemotherapy and long survivals, and survival is therefore difficult to estimate at the outset. Often the only way to know how a cat will respond to treatment, is to start treatment.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-kL1dn' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/strong><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-717-24\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-24\" ><div id=\"pgc-717-24-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-24-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"27\" ><div class=\"textwidget\"><h3><span style=\"color: #000000;\"><em><strong>Canine Mast Cell Tumors<\/strong><\/em><\/span><\/h3>\n<h4><span style=\"color: #000000;\">Incidence\/Cause<\/span><\/h4>\n<p><span style=\"color: #000000;\">Mast cell tumors (MCT) in dogs are very common, accounting for approximately 20% of all skin tumors in dogs. For most dogs, the underlying cause promoting the development of the tumor is not known. Mast cell tumors can arise from any skin site on the body, and can have a variety of appearances. Veterinary oncologists recommend that before any skin lump is removed, the cells from the mass be collected for examination to rule out the lump as a mast cell (or other malignant) tumor. And mast cells are something that are easily identified on aspiration.<\/span><\/p>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-IWS6T' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-IWS6T' class='yrm-inner-content-wrapper yrm-cntent-2'><\/span><\/p>\n<h4><span style=\"color: #000000;\">What you might see\/ Clinical presentation<\/span><\/h4>\n<p><span style=\"color: #000000;\">MCT most commonly are seen as solitary lumps or masses in or underneath the skin; occasional dogs can have multiple masses from MCT. MCT can look like just about anything, ranging from benign-appearing lumps (such as a lipoma), to more angry or ulcerated lumps, masses with a stalk or focal thickenings in the skin. MCT may change quickly in size (become larger then smaller ) because of reactions around the mass. Some dogs may have signs of systemic disease, which can be caused by some of the biologically active compounds found within mast cells. In most cases, evidence of a MCT is easily generated by examination of a fine-needle aspirate of the suspect mass, and aspiration is advised before removal of a mass to be sure it is not a MCT (or other skin malignancy), a finding that would demand a more aggressive surgical removal. Often, obtaining blood for a complete blood count and biochemical profile, and a urinalysis will be advised as these can help assess overall health and provide information that potentially influences treatment recommendations.<\/span><\/p>\n<h4><span style=\"color: #000000;\">Biological behavior of mast cell tumors<\/span><\/h4>\n<p><span style=\"color: #000000;\">Most mast cell tumors are considered locally invasive, and can be difficult to remove completely because of the extent of local spread. The behavior of mast cell tumors reflects their grade (a term used by pathologists and oncologists to describe such things as how-well differentiated a tumor is, how frequently it is dividing, how invasive to adjacent structures, and other criteria). Mast cell tumors have 3 grades, with grade I being the least aggressive and least likely to spread to other organs (metastasize), and grade III being highly aggressive tumors with a high likelihood of metastasis; most grade II tumors tend not to metastasize, although they can do so. Mast cell tumors show a predilection to spread to regional lymph nodes, liver, spleen, and bone marrow.<\/span><\/p>\n<h4><span style=\"color: #000000;\">Clinical staging (determination of the extent of the tumor)<\/span><\/h4>\n<p><span style=\"color: #000000;\">Because of the organs to which these tumors like to spread (metastasize) to, staging a dog with a mast cell tumor (usually reserved for occasional grade I tumors, most grade II tumors and all grade III tumors) entails collection of cells from regional lymph nodes for microscopic examination, imaging the thorax (radiographs) and abdomen (radiographs, abdominal ultrasound) for enlargement of lymph nodes, liver or spleen, and some assessment of bone marrow involvement, either a bone marrow collection for microscopic examination, or examination of the white blood cells for circulating mast cells (interpreted to mean that mast cells are in the bone marrow).<\/span><\/p>\n<h4><span style=\"color: #000000;\">Treatment options<\/span><\/h4>\n<p><span style=\"color: #000000;\">Surgical removal is the mainstay of treatment of canine mast cell tumors. Because of their locally invasive behavior, wide margins of what appears to be normal tissue around the tumor needs to be removed to increase the likelihood that the tumor has been completely removed. For mast cell tumors that were not, or because of location, could not be completely removed, radiation therapy is often the best treatment for residual disease, although a more aggressive second surgery is possible for some dogs. Chemotherapy is sometimes used to treat mast cell tumors, but chemotherapy is usually reserved for dogs with grade III tumors; mast cell tumors are notoriously unpredictable tumors with regards to response to chemotherapy. In addition to treatment of the tumors, some dogs will be treated with medications that tend to help fight the secondary effects of the tumor. These usually include drugs like prednisone, an anti-histamine like Benadryl, and an antacid type medication like Pepcid.<\/span><\/p>\n<h4><span style=\"color: #000000;\">Prognosis<\/span><\/h4>\n<p><span style=\"color: #000000;\">The prognosis for completely removed grade I and grade II tumors is excellent. The prognosis for incompletely removed grade I and II tumors treated with radiation therapy after surgery is also excellent with approximately 90-95% of dogs having no recurrence of tumor within 3 years of receiving radiation therapy. The prognosis for dogs with grade III tumors is considered guarded as local recurrence and\/or spread is likely in most dogs. If your dog is diagnosed with a grade III Mast cell tumor most likely chemotherapy will be recommended as at least part of the protocol. Drugs used at WSU include Lomustine and Vinblastine.<\/span><\/p>\n<h4><span style=\"color: #000000;\">Future treatment options<\/span><\/h4>\n<p><span style=\"color: #000000;\">Mast cell tumors have been examined for mutations in a certain gene known as c-kit. This c-kit gene belongs to a family of genes codes for receptor tyrosine kinases. Receptor tyrosine kinase inhibitors are an active part of cancer treatment research in the human field and these drugs are being looked at treatments for canine Mast cell tumors as well. No drug is currently available commercially.<\/span><\/p>\n<h4><span style=\"color: #000000;\">Key points<\/span><\/h4>\n<p><span style=\"color: #000000;\">Dogs that develop Mast cell tumors seem to like to develop more of them and this is not necessarily the same as metastasis. So any dog diagnosed with a mast cell tumor must be watch closely in the future for the development of new tumors. As long as tumors are caught when small, surgical removal is usually adequate for treatment. Mast cell tumors can also be very unpredictable tumors. Even grade I and II tumors can behave aggressively in terms of metastasizing and or being difficult to control locally, in any given individual dog. Statistics, while useful, can never predict how an individual dog will fare with or without specific treatment.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-IWS6T' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/strong><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-717-25\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-25\" ><div id=\"pgc-717-25-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-25-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"28\" ><div class=\"textwidget\"><section class=\"cvmBannerContent\"><\/section>\n<section class=\"main-section\">\n<div>\n<div>\n<h2><span style=\"color: #000000;\">Giving Oral Medications to Your Cat<\/span><\/h2>\n<\/div>\n<\/div>\n<div>\n<div>\n<p><span style=\"color: #000000;\"><strong>This information is not meant to be a substitute for veterinary care. Always follow the instructions provided by your veterinarian.<\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\">Your veterinarian will tell you if your cat's medication(s) can be given with food or if it must be given on an empty stomach. If the tablet or capsule can be given with food, you may make a \"meatball\" by placing the medication in the center of a small ball of canned cat food or cheese. Always give a test \"meatball\" to your cat to make sure she is willing eat it and also to see if she chews it or gulps it whole. Cats are more likely to chew their food than are dogs, so cats often will eat the \"meatball\" and spit out the tablet or capsule. This causes the tablet or capsule to partially dissolve and become very hard to handle. If the cat bites into the tablet or capsule, which will leave a bad taste in her mouth, she will be harder to medicate on the second attempt. So, you will have to decide what works best with your cat.<\/span><\/div>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-TQhpj' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-TQhpj' class='yrm-inner-content-wrapper yrm-cntent-2'><\/span><\/p>\n<div>\n<p><span style=\"color: #000000;\">The following instructions are presented to help you give medications if you cannot give the medicine in a \"meatball\". Use caution when giving a cat oral medication to avoid a bite. A cat's mouth contains many bacteria and cat bites are often deep punctures. If you are bitten by your cat, clean the wound thoroughly and seek medical attention.<\/span><\/div>\n<\/div>\n<div class=\"row side-left pad-left\" data-sf-element=\"Grid\">\n<div id=\"mainContent_C014_Col00\" class=\"sf_colsIn column one\" data-sf-element=\"Column 1\" data-placeholder-label=\"Column 1\">\n<div>\n<div><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone\" title=\"CatsOralMedication_img1\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/catsoralmedication_img1.jpg?sfvrsn=5484fe38_2\" alt=\"CatsOralMedication_img1\" width=\"304\" height=\"381\" \/><\/span><\/div>\n<\/div>\n<\/div>\n<div id=\"mainContent_C014_Col01\" class=\"sf_colsIn column two\" data-sf-element=\"Column 2\" data-placeholder-label=\"Column 2\">\n<div>\n<div>\n<p><span style=\"color: #000000;\">Medications for oral administration may be in pill, capsule or liquid form.<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"row side-left pad-left\" data-sf-element=\"Grid\">\n<div id=\"mainContent_C017_Col00\" class=\"sf_colsIn column one\" data-sf-element=\"Column 1\" data-placeholder-label=\"Column 1\">\n<div>\n<div><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" title=\"CatsOralMedication_img2\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/catsoralmedication_img2.jpg?sfvrsn=5384fe38_2\" alt=\"CatsOralMedication_img2\" width=\"300\" height=\"299\" \/><\/span><\/div>\n<\/div>\n<\/div>\n<div id=\"mainContent_C017_Col01\" class=\"sf_colsIn column two\" data-sf-element=\"Column 2\" data-placeholder-label=\"Column 2\">\n<div>\n<div>\n<p><span style=\"color: #000000;\">Hold the cat's head from the top using your left hand if you are right-handed. The cat's cheek-bones (called zygomatic arches) provide a convenient handle by which to hold the head firmly without causing the cat any discomfort.<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"row side-left pad-left\" data-sf-element=\"Grid\">\n<div id=\"mainContent_C020_Col00\" class=\"sf_colsIn column one\" data-sf-element=\"Column 1\" data-placeholder-label=\"Column 1\">\n<div>\n<div><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" title=\"CatsOralMedication_img3\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/catsoralmedication_img3.jpg?sfvrsn=5284fe38_2\" alt=\"CatsOralMedication_img3\" width=\"296\" height=\"257\" \/><\/span><\/div>\n<\/div>\n<\/div>\n<div id=\"mainContent_C020_Col01\" class=\"sf_colsIn column two\" data-sf-element=\"Column 2\" data-placeholder-label=\"Column 2\">\n<div>\n<div>\n<p><span style=\"color: #000000;\">Tilt the head back and the cat will often drop its lower jaw open.<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"row side-left pad-left\" data-sf-element=\"Grid\">\n<div id=\"mainContent_C023_Col00\" class=\"sf_colsIn column one\" data-sf-element=\"Column 1\" data-placeholder-label=\"Column 1\">\n<div>\n<div><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" title=\"CatsOralMedication_img4\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/catsoralmedication_img4.jpg?sfvrsn=5184fe38_2\" alt=\"CatsOralMedication_img4\" width=\"284\" height=\"196\" \/><\/span><\/div>\n<\/div>\n<\/div>\n<div id=\"mainContent_C023_Col01\" class=\"sf_colsIn column two\" data-sf-element=\"Column 2\" data-placeholder-label=\"Column 2\">\n<div>\n<div>\n<p><span style=\"color: #000000;\">Hold the pill or capsule in your right hand between your thumb and index finger. You can place one of the remaining fingers on your right hand on the lower incisors to keep the lower jaw open. Keep your finger over the small incisor teeth NOT over the sharp fangs (canine teeth). Drop the pill or capsule as far back over the tongue as possible, then immediately close the mouth and blow on the cat's nose which will encourage them to swallow.<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"row side-left pad-left\" data-sf-element=\"Grid\">\n<div id=\"mainContent_C026_Col00\" class=\"sf_colsIn column one\" data-sf-element=\"Column 1\" data-placeholder-label=\"Column 1\">\n<div>\n<div><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" title=\"CatsOralMedication_img5\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/catsoralmedication_img5.jpg?sfvrsn=5084fe38_2\" alt=\"CatsOralMedication_img5\" width=\"238\" height=\"263\" \/><\/span><\/div>\n<\/div>\n<\/div>\n<div id=\"mainContent_C026_Col01\" class=\"sf_colsIn column two\" data-sf-element=\"Column 2\" data-placeholder-label=\"Column 2\">\n<div>\n<div>\n<p><span style=\"color: #000000;\">If the cat does not open its mouth when you tilt back the head, holding the pill as before between the thumb and index finger...<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"row side-left pad-left\" data-sf-element=\"Grid\">\n<div id=\"mainContent_C029_Col00\" class=\"sf_colsIn column one\" data-sf-element=\"Column 1\" data-placeholder-label=\"Column 1\">\n<div>\n<div><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" title=\"CatsOralMedication_img6\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/catsoralmedication_img6.jpg?sfvrsn=4f84fe38_2\" alt=\"CatsOralMedication_img6\" width=\"233\" height=\"188\" \/><\/span><\/div>\n<\/div>\n<\/div>\n<div id=\"mainContent_C029_Col01\" class=\"sf_colsIn column two\" data-sf-element=\"Column 2\" data-placeholder-label=\"Column 2\">\n<div>\n<div>\n<p><span style=\"color: #000000;\">...use the middle finger of the same hand holding the pill or capsule, to pry open the lower jaw. Place your middle finger over the small incisor teeth NOT over the sharp fangs (canine teeth)...<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"row side-left pad-left\" data-sf-element=\"Grid\">\n<div id=\"mainContent_C032_Col00\" class=\"sf_colsIn column one\" data-sf-element=\"Column 1\" data-placeholder-label=\"Column 1\">\n<div>\n<div><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" title=\"CatsOralMedication_img7\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/catsoralmedication_img7.jpg?sfvrsn=3c84fe38_2\" alt=\"CatsOralMedication_img7\" width=\"209\" height=\"205\" \/><\/span><\/div>\n<\/div>\n<\/div>\n<div id=\"mainContent_C032_Col01\" class=\"sf_colsIn column two\" data-sf-element=\"Column 2\" data-placeholder-label=\"Column 2\">\n<div>\n<div>\n<p><span style=\"color: #000000;\">...and pull open the lower jaw.<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"row side-left pad-left\" data-sf-element=\"Grid\">\n<div id=\"mainContent_C035_Col00\" class=\"sf_colsIn column one\" data-sf-element=\"Column 1\" data-placeholder-label=\"Column 1\">\n<div>\n<div><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" title=\"CatsOralMedication_img8\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/catsoralmedication_img8.jpg?sfvrsn=3b84fe38_2\" alt=\"CatsOralMedication_img8\" width=\"197\" height=\"139\" \/><\/span><\/div>\n<\/div>\n<\/div>\n<div id=\"mainContent_C035_Col01\" class=\"sf_colsIn column two\" data-sf-element=\"Column 2\" data-placeholder-label=\"Column 2\">\n<div>\n<div>\n<p><span style=\"color: #000000;\">Keep the middle finger in place to hold the lower jaw open (3), then either drop the pill or capsule as far back on the tongue as possible, or the index finger (1) and thumb (2) can be used to push the pill over the back of the tongue.<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"row side-left pad-left\" data-sf-element=\"Grid\">\n<div id=\"mainContent_C038_Col00\" class=\"sf_colsIn column one\" data-sf-element=\"Column 1\" data-placeholder-label=\"Column 1\">\n<div>\n<div><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" title=\"CatsOralMedication_img9\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/catsoralmedication_img9.jpg?sfvrsn=3884fe38_2\" alt=\"CatsOralMedication_img9\" width=\"196\" height=\"164\" \/><\/span><\/div>\n<\/div>\n<\/div>\n<div id=\"mainContent_C038_Col01\" class=\"sf_colsIn column two\" data-sf-element=\"Column 2\" data-placeholder-label=\"Column 2\">\n<div>\n<div>\n<p><span style=\"color: #000000;\">IMPORTANT: If you use your thumb and index finger to push the pill over the base of the tongue, your fingers will be inside the cat's mouth and you must work rapidly to avoid getting bit.<\/span><\/p>\n<p><span style=\"color: #000000;\">Close the mouth and stroke the cat's neck or blow sharply on his\/her nose to encourage the cat to swallow<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"row side-left pad-left\" data-sf-element=\"Grid\">\n<div id=\"mainContent_C042_Col00\" class=\"sf_colsIn column one\" data-sf-element=\"Column 1\" data-placeholder-label=\"Column 1\">\n<div>\n<div><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" title=\"CatsOralMedication_img10\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/catsoralmedication_img10.jpg?sfvrsn=3784fe38_2\" alt=\"CatsOralMedication_img10\" width=\"214\" height=\"95\" \/><\/span><\/div>\n<\/div>\n<\/div>\n<div id=\"mainContent_C042_Col01\" class=\"sf_colsIn column two\" data-sf-element=\"Column 2\" data-placeholder-label=\"Column 2\">\n<div>\n<div>\n<p><span style=\"color: #000000;\">There are several styles of pilling devices that can be used to place a pill or capsule over the base of the tongue so that you do not have to place your fingers in the cat's mouth.<\/span><\/p>\n<p><span style=\"color: #000000;\">There are several ways to hold the pilling device.<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"row halves gutter\" data-sf-element=\"Grid\">\n<div id=\"mainContent_C046_Col00\" class=\"sf_colsIn column one\" data-sf-element=\"Column 1\" data-placeholder-label=\"Column 1\">\n<div>\n<div><span style=\"color: #000000;\"><img decoding=\"async\" title=\"CatsOralMedication_img11\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/catsoralmedication_img11.jpg?sfvrsn=3684fe38_2\" alt=\"CatsOralMedication_img11\" \/><img decoding=\"async\" title=\"CatsOralMedication_img12\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/catsoralmedication_img12.jpg?sfvrsn=3584fe38_2\" alt=\"CatsOralMedication_img12\" \/><\/span><\/div>\n<\/div>\n<\/div>\n<div id=\"mainContent_C046_Col01\" class=\"sf_colsIn column two\" data-sf-element=\"Column 2\" data-placeholder-label=\"Column 2\">\n<div>\n<div>\n<p><span style=\"color: #000000;\">You can hold the device between your thumb and middle finger, with the index finger positioned to \"push\" the trigger. Or to prevent premature release of the pill, move the index finger to push the trigger just before dislodging the pill in the back of the throat.<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"row halves gutter\" data-sf-element=\"Grid\">\n<div id=\"mainContent_C049_Col00\" class=\"sf_colsIn column one\" data-sf-element=\"Column 1\" data-placeholder-label=\"Column 1\">\n<div>\n<div><span style=\"color: #000000;\"><img decoding=\"async\" title=\"CatsOralMedication_img13\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/catsoralmedication_img13.jpg?sfvrsn=2684fe38_2\" alt=\"CatsOralMedication_img13\" \/><img decoding=\"async\" title=\"CatsOralMedication_img14\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/catsoralmedication_img14.jpg?sfvrsn=2584fe38_2\" alt=\"CatsOralMedication_img14\" \/><\/span><\/div>\n<\/div>\n<\/div>\n<div id=\"mainContent_C049_Col01\" class=\"sf_colsIn column two\" data-sf-element=\"Column 2\" data-placeholder-label=\"Column 2\">\n<div>\n<div>\n<p><span style=\"color: #000000;\">You could also hold the device between curled fingers and palm either with the thumb positioned to \"push\" the trigger. Or to prevent premature release of the pill, you may move the thumb to push the trigger just before dislodging the pill in the back of the throat.<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"row side-left pad-left\" data-sf-element=\"Grid\">\n<div id=\"mainContent_C052_Col00\" class=\"sf_colsIn column one\" data-sf-element=\"Column 1\" data-placeholder-label=\"Column 1\">\n<div>\n<div><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" title=\"CatsOralMedication_img15\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/catsoralmedication_img15.jpg?sfvrsn=2284fe38_2\" alt=\"CatsOralMedication_img15\" width=\"253\" height=\"323\" \/><\/span><\/div>\n<\/div>\n<\/div>\n<div id=\"mainContent_C052_Col01\" class=\"sf_colsIn column two\" data-sf-element=\"Column 2\" data-placeholder-label=\"Column 2\">\n<div>\n<div>\n<p><span style=\"color: #000000;\">Or you can hold the device between the index and middle fingers with the thumb positioned to \"push\" the trigger.<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"row side-left pad-left\" data-sf-element=\"Grid\">\n<div id=\"mainContent_C055_Col00\" class=\"sf_colsIn column one\" data-sf-element=\"Column 1\" data-placeholder-label=\"Column 1\">\n<div>\n<div><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" title=\"CatsOralMedication_img16\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/catsoralmedication_img16.jpg?sfvrsn=2084fe38_2\" alt=\"CatsOralMedication_img16\" width=\"254\" height=\"179\" \/><\/span><\/div>\n<\/div>\n<\/div>\n<div id=\"mainContent_C055_Col01\" class=\"sf_colsIn column two\" data-sf-element=\"Column 2\" data-placeholder-label=\"Column 2\">\n<div>\n<div>\n<p><span style=\"color: #000000;\">Tilt the head back and the cat will often drop their lower jaw open. Insert the pill at the end of the pilling device over the base of the tongue.<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"row side-left pad-left\" data-sf-element=\"Grid\">\n<div id=\"mainContent_C058_Col00\" class=\"sf_colsIn column one\" data-sf-element=\"Column 1\" data-placeholder-label=\"Column 1\">\n<div>\n<div><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" title=\"CatsOralMedication_img17\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/catsoralmedication_img17.jpg?sfvrsn=1e84fe38_2\" alt=\"CatsOralMedication_img17\" width=\"251\" height=\"251\" \/><\/span><\/div>\n<\/div>\n<\/div>\n<div id=\"mainContent_C058_Col01\" class=\"sf_colsIn column two\" data-sf-element=\"Column 2\" data-placeholder-label=\"Column 2\">\n<div>\n<div>\n<p><span style=\"color: #000000;\">If the cat doesn't open it's mouth, use the middle finger of the hand holding the pilling device to open the lower jaw.<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"row side-left pad-left\" data-sf-element=\"Grid\">\n<div id=\"mainContent_C061_Col00\" class=\"sf_colsIn column one\" data-sf-element=\"Column 1\" data-placeholder-label=\"Column 1\">\n<div>\n<div><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" title=\"CatsOralMedication_img18\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/catsoralmedication_img18.jpg?sfvrsn=1c84fe38_2\" alt=\"CatsOralMedication_img18\" width=\"244\" height=\"149\" \/><\/span><\/div>\n<\/div>\n<\/div>\n<div id=\"mainContent_C061_Col01\" class=\"sf_colsIn column two\" data-sf-element=\"Column 2\" data-placeholder-label=\"Column 2\">\n<div>\n<div>\n<p><span style=\"color: #000000;\">Insert the pill at the end of the pilling device over the base of the tongue.<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"row side-left pad-left\" data-sf-element=\"Grid\">\n<div id=\"mainContent_C064_Col00\" class=\"sf_colsIn column one\" data-sf-element=\"Column 1\" data-placeholder-label=\"Column 1\">\n<div>\n<div><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" title=\"CatsOralMedication_img19\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/catsoralmedication_img19.jpg?sfvrsn=c84fe38_2\" alt=\"CatsOralMedication_img19\" width=\"245\" height=\"222\" \/><\/span><\/div>\n<\/div>\n<\/div>\n<div id=\"mainContent_C064_Col01\" class=\"sf_colsIn column two\" data-sf-element=\"Column 2\" data-placeholder-label=\"Column 2\">\n<div>\n<div>\n<p><span style=\"color: #000000;\">Push the plunger on the pilling device with your thumb or index finger to deposit the pill far back in the cat's mouth.<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"row side-left pad-left\" data-sf-element=\"Grid\">\n<div id=\"mainContent_C067_Col00\" class=\"sf_colsIn column one\" data-sf-element=\"Column 1\" data-placeholder-label=\"Column 1\">\n<div>\n<div><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" title=\"CatsOralMedication_img20\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/catsoralmedication_img20.jpg?sfvrsn=b84fe38_2\" alt=\"CatsOralMedication_img20\" width=\"241\" height=\"178\" \/><\/span><\/div>\n<\/div>\n<\/div>\n<div id=\"mainContent_C067_Col01\" class=\"sf_colsIn column two\" data-sf-element=\"Column 2\" data-placeholder-label=\"Column 2\">\n<div>\n<div>\n<p><span style=\"color: #000000;\">Liquid medications are given in a pouch between the teeth and cheek. The medication is quickly squirted into this pouch, the mouth is held closed and the neck stroked or the nose sharply blown on to encourage the cat to swallow.<\/span><\/p>\n<p><span style=\"color: #000000;\">Liquids are more likely to accidentally enter the windpipe compared to pills or capsules. To avoid the cat inhaling liquid into the windpipe, DO NOT tilt the cat's head backward.<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div>\n<div>\n<p><span style=\"color: #000000;\">If you find it difficult to give your cat a pill or capsule, speak to your veterinarian about suspending the pill or capsule into a liquid. Some medications can be suspended in liquid while others lose their effectiveness when placed in a suspension. Always talk to your veterinarian before altering the medication.<\/span><\/p>\n<p><span style=\"color: #000000;\"><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-TQhpj' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/span><\/div>\n<\/div>\n<\/section>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-717-26\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-26\" ><div id=\"pgc-717-26-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-26-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"29\" ><div class=\"textwidget\"><div>\n<div>\n<h2><span style=\"color: #000000;\">Giving Oral Medications to Your Dog<\/span><\/h2>\n<\/div>\n<\/div>\n<div>\n<div>\n<p><span style=\"color: #000000;\"><strong>This information is not meant to be a substitute for veterinary care. Always follow the instructions provided by your veterinarian.<\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>In the photographs below, the dog's nose is pointed to your right.<\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Variations on these instructions exist.<\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\">Your veterinarian will tell you if your dog's medication(s) can be given with food or if it must be given on an empty stomach. If the tablet or capsule can be given with food, you may make a \"meatball\" by placing the medication in the center of a small ball of canned dog food or cheese. Always give a test \"meatball\" to your dog to make sure she is willing eat it and also to see if she chews it or gulps it whole. Dogs are more likely to gulp the \"meatball\" without chewing. If they do chew the \"meatball\" and spit out the pill, the tablet or capsule will partially dissolve and become very hard to handle. If the dog bites into the tablet or capsule, which will leave a bad taste in her mouth, she will be harder to medicate on the second attempt. So, you will have to decide what works best with your dog.<\/span><\/div>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-BDVAG' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-BDVAG' class='yrm-inner-content-wrapper yrm-cntent-2'><\/span><\/p>\n<div>\n<p><span style=\"color: #000000;\">The following instructions are presented to help you give medications if you cannot give the medicine in a \"meatball\". Use caution when giving a dog oral medication to avoid a bite. A dog's mouth contains many bacteria. If you are bitten by your dog, clean the wound thoroughly and seek medical attention.<\/span><\/div>\n<\/div>\n<div class=\"row side-left pad-left\" data-sf-element=\"Grid\">\n<div id=\"mainContent_C013_Col00\" class=\"sf_colsIn column one\" data-sf-element=\"Column 1\" data-placeholder-label=\"Column 1\">\n<div>\n<div><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/meds3.jpg?sfvrsn=2\" alt=\"tablet, pill and liquid form of medication\" width=\"212\" height=\"265\" \/><\/span><\/div>\n<\/div>\n<\/div>\n<div id=\"mainContent_C013_Col01\" class=\"sf_colsIn column two\" data-sf-element=\"Column 2\" data-placeholder-label=\"Column 2\">\n<div>\n<div>\n<p><span style=\"color: #000000;\">Medications for oral administration may be in pill, capsule or liquid form.<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"row side-left pad-left\" data-sf-element=\"Grid\">\n<div id=\"mainContent_C016_Col00\" class=\"sf_colsIn column one\" data-sf-element=\"Column 1\" data-placeholder-label=\"Column 1\">\n<div>\n<div><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/hold_muzzle.jpg?sfvrsn=2\" alt=\"holding the dogs head and its jaw with the other hand\" width=\"212\" height=\"191\" \/><\/span><\/div>\n<\/div>\n<\/div>\n<div id=\"mainContent_C016_Col01\" class=\"sf_colsIn column two\" data-sf-element=\"Column 2\" data-placeholder-label=\"Column 2\">\n<div>\n<div>\n<p><span style=\"color: #000000;\">Hold the dog's head from the top using your left hand if you are right-handed. If the dog has a long nose hold the upper jaw between thumb and index finger. If the dog has a short nose, hold the head like a cat (<a style=\"color: #000000;\" href=\"https:\/\/www.vetmed.wsu.edu\/outreach\/Pet-Health-Topics\/categories\/procedures\/cats\/giving-oral-medications-to-your-cat\">see giving oral medications to a cat<\/a>).<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"row side-left pad-left\" data-sf-element=\"Grid\">\n<div id=\"mainContent_C019_Col00\" class=\"sf_colsIn column one\" data-sf-element=\"Column 1\" data-placeholder-label=\"Column 1\">\n<div>\n<div><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/open_mouth.jpg?sfvrsn=2\" alt=\"folding back the head and folding its upper teeth around its jaw\" width=\"215\" height=\"248\" \/><\/span><\/div>\n<\/div>\n<\/div>\n<div id=\"mainContent_C019_Col01\" class=\"sf_colsIn column two\" data-sf-element=\"Column 2\" data-placeholder-label=\"Column 2\">\n<div>\n<div>\n<p><span style=\"color: #000000;\">Tilt the head back. Dogs have stronger jaw muscles than cats and unlike the cat, the lower jaw does not usually drop open far enough to place the pill or capsule over the base of the tongue.<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"row side-left pad-left\" data-sf-element=\"Grid\">\n<div id=\"mainContent_C022_Col00\" class=\"sf_colsIn column one\" data-sf-element=\"Column 1\" data-placeholder-label=\"Column 1\">\n<div>\n<div><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/grayhnd.jpg?sfvrsn=2\" alt=\"holding down the dogs jaw with your index and middle fingers\" width=\"228\" height=\"336\" \/><\/span><\/div>\n<\/div>\n<\/div>\n<div id=\"mainContent_C022_Col01\" class=\"sf_colsIn column two\" data-sf-element=\"Column 2\" data-placeholder-label=\"Column 2\">\n<div>\n<div>\n<p><span style=\"color: #000000;\">Gently fold the upper lip over the teeth as you open the mouth. If the dog bites down with your hand in her mouth, she will bite her lip and will not bite your hand. Place your thumb on the roof of the dog's mouth. You do not have to fold the dog's lip over their teeth but this does reduce the chance of you being bit.<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"row side-left pad-left\" data-sf-element=\"Grid\">\n<div id=\"mainContent_C025_Col00\" class=\"sf_colsIn column one\" data-sf-element=\"Column 1\" data-placeholder-label=\"Column 1\">\n<div>\n<div><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/droppill.jpg?sfvrsn=2\" alt=\"using your middle finger to pry open the dogs mouth\" width=\"222\" height=\"292\" \/><\/span><\/div>\n<\/div>\n<\/div>\n<div id=\"mainContent_C025_Col01\" class=\"sf_colsIn column two\" data-sf-element=\"Column 2\" data-placeholder-label=\"Column 2\">\n<div>\n<div>\n<p><span style=\"color: #000000;\">Hold the pill or capsule in your right hand between your thumb and index finger. Use the middle finger of your right hand to pull open the lower jaw. Keep your middle finger over the small incisor teeth NOT over the sharp fangs (canine teeth).<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"row side-left pad-left\" data-sf-element=\"Grid\">\n<div id=\"mainContent_C028_Col00\" class=\"sf_colsIn column one\" data-sf-element=\"Column 1\" data-placeholder-label=\"Column 1\">\n<div>\n<div><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/droppill2.jpg?sfvrsn=2\" alt=\"dropping the pill in the dogs mouth\" width=\"231\" height=\"195\" \/><\/span><\/div>\n<\/div>\n<\/div>\n<div id=\"mainContent_C028_Col01\" class=\"sf_colsIn column two\" data-sf-element=\"Column 2\" data-placeholder-label=\"Column 2\">\n<div>\n<div>\n<p><span style=\"color: #000000;\">Drop the pill or capsule as far back over the tongue as possible, then immediately close the mouth and blow on the dog's nose which will encourage her to swallow.<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"row side-left pad-left\" data-sf-element=\"Grid\">\n<div id=\"mainContent_C031_Col00\" class=\"sf_colsIn column one\" data-sf-element=\"Column 1\" data-placeholder-label=\"Column 1\">\n<div>\n<div><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/pushpill.jpg?sfvrsn=2\" alt=\"inserting hand in dogs mouth so as to get the pill over the base of the tongue\" width=\"250\" height=\"249\" \/><\/span><\/div>\n<\/div>\n<\/div>\n<div id=\"mainContent_C031_Col01\" class=\"sf_colsIn column two\" data-sf-element=\"Column 2\" data-placeholder-label=\"Column 2\">\n<div>\n<div>\n<p><span style=\"color: #000000;\">If you are unable to get the pill far enough over the base of the tongue, the dog will spit it out. You may need to use your index finger and thumb to push the pill over the back of the tongue.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>IMPORTANT: If you use your thumb and index finger to push the pill over the base of the tongue, your fingers will be inside the dog's mouth and you must work rapidly to avoid getting bit.<\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\">Close the mouth and stroke the dog's neck or blow sharply on his\/her nose to encourage the dog to swallow.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Notice the dog's lip is still folded over the upper teeth to protect the hand from being bitten.<\/strong><\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div>\n<div>\n<p><span style=\"color: #000000;\">There are several styles of pilling devices that can used to place a pill or capsule over the base of the tongue so that you do not have to place your fingers in the dog's mouth. See section on <a style=\"color: #000000;\" href=\"https:\/\/www.vetmed.wsu.edu\/outreach\/Pet-Health-Topics\/categories\/procedures\/cats\/giving-oral-medications-to-your-cat\" target=\"_blank\" rel=\"noopener\">pilling a cat<\/a> for details.<\/span><\/div>\n<\/div>\n<div class=\"row side-left pad-left\" data-sf-element=\"Grid\">\n<div id=\"mainContent_C035_Col00\" class=\"sf_colsIn column one\" data-sf-element=\"Column 1\" data-placeholder-label=\"Column 1\">\n<div>\n<div><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/pouch.jpg?sfvrsn=2\" alt=\"pulling the dogs cheek away from its mouth\" width=\"244\" height=\"194\" \/><\/span><\/div>\n<\/div>\n<\/div>\n<div id=\"mainContent_C035_Col01\" class=\"sf_colsIn column two\" data-sf-element=\"Column 2\" data-placeholder-label=\"Column 2\">\n<div>\n<div>\n<p><span style=\"color: #000000;\">Liquid medications are given in a pouch between the teeth and cheek.<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"row side-left pad-left\" data-sf-element=\"Grid\">\n<div id=\"mainContent_C038_Col00\" class=\"sf_colsIn column one\" data-sf-element=\"Column 1\" data-placeholder-label=\"Column 1\">\n<div>\n<div><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"http:\/\/www.vetmed.wsu.edu\/images\/librariesprovider19\/pet-care\/procedures\/dropper.jpg?sfvrsn=2\" alt=\"inserting the medication in the dogs cheek with an eye dropper\" width=\"249\" height=\"188\" \/><\/span><\/div>\n<\/div>\n<\/div>\n<div id=\"mainContent_C038_Col01\" class=\"sf_colsIn column two\" data-sf-element=\"Column 2\" data-placeholder-label=\"Column 2\">\n<div>\n<div>\n<p><span style=\"color: #000000;\">The medication is quickly squirted into this pouch, the mouth is held closed and the neck stroked or the nose sharply blown on to encourage the dog to swallow.<\/span><\/p>\n<p><span style=\"color: #000000;\">Liquids are more likely to accidentally enter the windpipe compared to pills or capsules. To avoid the dog inhaling liquid into the windpipe, DO NOT tilt the dog's head backward.<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div>\n<div>\n<p><span style=\"color: #000000;\">If you find it difficult to give your dog a pill or capsule, speak to your veterinarian about suspending the pill or capsule in a liquid. Some medications can be suspended in liquid while others lose their effectiveness when placed in a suspension. Always talk to your veterinarian before altering the medication.<\/span><\/p>\n<p><span style=\"color: #000000;\"><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-BDVAG' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/span><\/div>\n<\/div>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-717-27\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-27\" ><div id=\"pgc-717-27-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-27-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"30\" ><div class=\"textwidget\"><h3><span style=\"color: #000000;\"><strong><em>Canine Osteosarcoma (OSA)<\/em><\/strong><\/span><\/h3>\n<h4><span style=\"color: #000000;\">Incidence\/Cause<\/span><\/h4>\n<p><span style=\"color: #000000;\">OSA is the most common primary bone tumor of dogs and is estimated to account for roughly 85% of tumors in the canine skeleton. It is most often a tumor of the front limb with tumors near the \"wrist\" (in the radius or ulna) common and tumor in other sites of the front and rear leg somewhat less common. Another rule of thumb often stated is that these tumor occur away from the elbow and towards the knee. OSA can, however, occur in any bone. Middle aged to older large to giant breed dogs are most often affected by the form of tumor involving the long bones such as the radius, ulna, humerus, femur and tibia. The cause of this tumor is largely unknown.<\/span><\/p>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-GQpJ7' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-GQpJ7' class='yrm-inner-content-wrapper yrm-cntent-2'><\/span><\/p>\n<h4><span style=\"color: #000000;\">What you might see\/ Clinical presentation<\/span><\/h4>\n<p><span style=\"color: #000000;\">The most common sign seen in dogs with OSA is lameness. Lameness may develop suddenly (for example, after vigorous activity), or may develop more slowly. Depending on the location of the tumor, a swelling or mass-like effect could be seen in the affected leg. Any lameness in a large-breed dog that does not promptly resolve with symptomatic therapy should be further investigated (examination, radiographs).<\/span><\/p>\n<h4><span style=\"color: #000000;\"><strong>Biological behavior of\u00a0<\/strong>Osteosarcoma<\/span><\/h4>\n<p><span style=\"color: #000000;\">OSA is both a locally invasive tumor and a tumor with a high likelihood of spread (metastasis) to other organs, most commonly the lung, although metastasis to other organs is possible. Most (approximately 90-95%) of dogs with OSA are considered to have metastasis at the time of their diagnosis, although metastasis will only be evident at the time of diagnosis in approximately 10% of dogs and in others the metastatic tumors are considered to be microscopic. Tumors in bone are quite painful to affected dogs, accounting for the lameness that is seen as the most common presenting complaint in affected dogs.<\/span><\/p>\n<h4><span style=\"color: #000000;\"><strong>Clinical staging (determination of the extent of the tumor)<\/strong><\/span><\/h4>\n<p><span style=\"color: #000000;\">Radiographs of the affected leg, and radiographs of the thorax are the most critical elements of clinical staging; dogs with enlarged lymph nodes will also typically have the lymph nodes sampled for microscopic examination. Radiographs of affected legs are often highly suggestive of the diagnosis, and biopsies are not necessary for all dogs with compatible lesions on radiographs. Often, obtaining blood for a complete blood count and biochemical profile, and a urinalysis will be advised as these can help assess overall health and provide information that potentially influences treatment recommendations. When aggressive therapy is being considered, a CT examination of the lungs will also be recommended to screen the lungs for metastasis even more precisely than the radiographs can show us.<\/span><\/p>\n<h4><span style=\"color: #000000;\"><strong>Treatment options<\/strong><\/span><\/h4>\n<p><span style=\"color: #000000;\">Amputation to remove the primary tumor, combined with chemotherapy to treat the metastatic disease we can\u2019t yet see, is the best treatment for preservation of quality (relief of pain) and quantity of life for dogs with the limb form of OSA. Not every dog is a candidate for amputation and the decision to amputate is often difficult for owners. Dogs with severe arthritis in the unaffected limbs, or weakness due to neurologic disease may not be candidates for amputation but most other dogs are. Dogs can function on three legs much better than most owners think. Some institutions offer limb-sparing surgery, in conjunction with chemotherapy, but this can only be done when the tumor is in the radius or ulna near the carpal joint (wrist). Not every owner is prepared for the expense and time commitment to chemotherapy either. Generally therapy is done once every 3-4 weeks for 5 doses of chemotherapy. Drugs commonly used include cisplaitn, carboplatin and doxorubicin. Amputation without chemotherapy can remove the source of pain, but generally metastases will become apparent in 3-4 months.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">Palliative therapies are those aimed at keeping the leg more comfortable so that the dog can live with it longer. There is no benefit expected in most dogs from the administration of chemotherapy drugs if the primary tumor is not removed. Radiation therapy will improve comfort in approximately 70-80% of treated dogs. Generally only a few large doses of radiation are administered. Administration of analgesics, which can be done in conjunction with palliative radiation therapy, can improve the level of comfort in some dogs. Additionally a class of drugs known as bis-phosphonates is being tried for dogs with osteosarcomas. These drugs inhibit bone resorption, or break down. They have been use in the human field for osteoporosis but also in the treatment of tumors which have metastasized to bone to relieve bone pain. Clinical trials are underway to determine if these drugs actually relieve pain in primary bone tumors of dogs.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">Dogs with OSA in other bone locations are often treated with a combination of surgery, radiation therapy and chemotherapy.<\/span><\/p>\n<h4><span style=\"color: #000000;\"><strong>Prognosis<\/strong><\/span><\/h4>\n<p><span style=\"color: #000000;\">The prognosis for dogs undergoing surgery to remove the primary limb tumor (ampuation or limb-sparing surgery) and treated with chemotherapy is fair to good. About half of dogs with OSA treated in this manner will be alive 1 year after diagnosis; approximately 25% of dogs treated in this fashion are alive 2 years after diagnosis, and occasional dogs will be cured. Dogs treated with either amputation or palliative radiation therapy live, on average, approximately 6 months before complication of the local tumor or metastatic disease cause death or prompt euthanasia.<\/span><\/p>\n<h4><span style=\"color: #000000;\"><strong>Future treatment options<\/strong><\/span><\/h4>\n<p><span style=\"color: #000000;\">Many therapies being developed in the human field aimed at stopping metastatic disease could be helpful in dogs with osteosarcomas. Bisphosphonate drugs may also prove useful for palliation of tumor pain, particularly when combined with palliative radiation therapy. A Gene therapy trial administering a gene coding for a potent immune stimulant (IL-2) has shown promise in preliminary studies.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">Key points Most dogs do amazingly well with three legs; amputation, however, is not appropriate for all dogs, particularly those with other orthopedic or neurologic diseases. For such patients, palliative radiation therapy is considered an excellent treatment alternative with a high likelihood of improving patient comfort. Unfortunately, most dogs will die from complications of OSA. Statistics, while useful, can never predict how an individual dog will fare with or without specific treatment.<\/span><\/p>\n<h4><span style=\"color: #000000;\"><strong>Other helpful sites<\/strong><\/span><\/h4>\n<p><span style=\"color: #000000;\"><a class=\"external\" style=\"color: #000000;\" href=\"http:\/\/caninecancerawareness.org\/canine-cancer-diagnosis\/osteosarcoma\" target=\"_blank\" rel=\"noopener\">Canine Cancer Awareness<\/a><\/span><\/p>\n<p><span style=\"color: #000000;\"><a class=\"external\" style=\"color: #000000;\" href=\"http:\/\/www.marvistavet.com\/html\/canine_osteosarcoma.html\" target=\"_blank\" rel=\"noopener\">Canine Osteosarcoma<\/a><\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-GQpJ7' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/strong><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-717-28\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-28\" ><div id=\"pgc-717-28-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-28-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"31\" ><div class=\"textwidget\"><h3><span style=\"color: #000000;\"><em><strong>Seizures<\/strong><\/em><\/span><\/h3>\n<p><span style=\"color: #000000;\">A seizure is defined as a paroxysmal, transitory disturbance of brain function that has a sudden onset, ceases spontaneously, and has a tendency to recur. Generalized seizures affect the entire body. Most commonly, animals will fall to the side, make paddling movements with the limbs; they will often will urinate, salivate and defecate during the episodes. Generalized seizures usually last from several seconds to upwards of a couple minutes. Focal seizures remain localized to one body region and are usually shorter in duration, lasting a couple seconds. Seizures may start focal and then become generalized.\u00a0<\/span><br \/>\n<span style=\"color: #000000;\">After the veterinarian is convinced that a seizure disorder is present, the most important question to be answered is whether the seizure is the result of primary brain disease (intracranial disease), or the result of a disturbance outside the brain (extracranial disease), The most common intracranial causes of seizures include: structural disease including hydrocephalus, head trauma, inflammatory brain disease (encephalitis), strokes and neoplasia (brain cancer). The most common causes of extracranial diseases that cause secondary brain signs include: toxins and metabolic diseases. Metabolic diseases include: low blood sugar (hypoglycemia), high blood sugar (hyperglycemia), liver disease, kidney disease, electrolyte disturbances, toxins (poisons), anemia.<\/span><\/p>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-YALzW' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-YALzW' class='yrm-inner-content-wrapper yrm-cntent-2'><\/span><\/p>\n<h4><span style=\"color: #000000;\">Idiopathic epilepsy<\/span><\/h4>\n<p><span style=\"color: #000000;\">Idiopathic epilepsy is another common cause of seizures in dogs and less commonly in cats. It is by definition, seizures of unknown cause. These episodes are thought to be due to \"mal-wiring\" within the brain. Idiopathic epilepsy is seen in dogs between the ages of 6 months and 6 years of age. It is more common in certain breeds: border collies, Australian Shepherds, Labrador retrievers, beagles, Belgian Tervurens, collies and German shepherds. That being said, seizures can occur in any breed of dog or cat. To search for the cause of seizures, a systemic work up is performed (physical and neurologic exam, blood work, blood pressure, sometimes chest x-rays, specific liver function test including bile acid testing). Once an extra-cranial cause of seizures is ruled out, then the brain is imaged using either a CT scan or an MRI. Following brain imaging, a cerebrospinal fluid (CSF) tap is performed in order to look for encephalitis. If an underlying disease can be found, then primary treatment for that disease may help to make the seizures stop. If the seizures are recurrent, anticonvulsant medications are often given. The choice of medication depends upon the characteristics of the individual animal's problem. Some of the more commonly used anticonvulsants are listed below. It is important to remember that once an anticonvulsant is initiated, it should not be changed without veterinary assistance. Most animals with idiopathic epilepsy will require anticonvulsant medication for the rest of their life.<\/span><\/p>\n<h4><span style=\"color: #000000;\">Drugs Used to Treat Seizures<\/span><\/h4>\n<ul>\n<li><span style=\"color: #000000;\"><strong>Phenobarbital<\/strong>\u00a0is the most commonly used anticonvulsants in veterinary medicine because it is effective and also inexpensive. Side effects include: sedation, incoordination and rear limb weakness, , increased drinking, urination and appetite. With high dosages or prolonged use, phenobarbital can cause damage to the liver. Paradoxically, some animals given phenobarbital may become restless and excitable. If any of these signs are observed, occurs, consult your veterinarian for assistance. For best results, this drug needs to be given consistently (every day) at least twice daily. This drug should not be altered without veterinary consultation.<\/span><\/li>\n<li><span style=\"color: #000000;\"><strong>Potassium Bromide<\/strong>\u00a0is another effective first-line seizure medication used in veterinary medicine. Due to its lack of metabolism it is the ideal anticonvulsant for patients with liver disease. Side effects include: sedation, incoordination, limb weakness and vomiting. Pancreatitis has also been described as a possible complication. If any of these signs are observed, occurs, consult your veterinarian for assistance.<\/span><\/li>\n<li><span style=\"color: #000000;\"><strong>Levetiracetam (Keppra)<\/strong>\u00a0is a newer anti-convulsant for use in veterinary medicine. It is also not liver metabolized making it safe in patients with liver disease. It is to be given three times daily. Side effects are rare and include sedation and incoordination.<\/span><\/li>\n<li><span style=\"color: #000000;\"><strong>Zonisamide (Zonegram)<\/strong>\u00a0is a newer anti-convulsant for use in veterinary medicine. It, like phenobarbital, is metabolized by the liver. It is a sulfonamide medication and can therefore cause dry eye, decreases in white and red blood cells. It can also cause liver disease and sedation and incoordination.<\/span><\/li>\n<li><span style=\"color: #000000;\"><strong>Diazepam (Valium)<\/strong>\u00a0is a medication to be given on an emergency basis to halt an active seizure in dogs and cats because its effects are very short acting. Thus, this medication is not used on a daily basis. Side effects include drowsiness, lethargy, and depression and liver disease.<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\">This information was made possible by funds from the\u00a0<a style=\"color: #000000;\" href=\"http:\/\/www.vetmed.wsu.edu\/deptsNeurology\/giving.aspx\">Neurology Endowment<\/a>\u00a0at Washington State University.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-YALzW' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/strong><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-717-29\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-29\" ><div id=\"pgc-717-29-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-29-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child panel-last-child\" data-index=\"32\" ><div class=\"textwidget\"><h3><span style=\"color: #000000;\"><em><strong>Assistance (Service ) Dogs<\/strong><\/em><\/span><\/h3>\n<p><span style=\"color: #000000;\">Dogs can certainly be a best friend, but when they are assistance animals they are much more. These dogs allow people freedoms many of us take for granted everyday.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">Rachael Armstrong is a Washington State University sophomore veterinary student at who provides \"basic training\" to assistance dogs. \"Zack\" is the two-year-old German shepherd currently under Rachael\u2019s tutelage. His title is prominently displayed on the red vest he wears. Given his job will be to assist someone with day to day living, Zack must be exposed to every possible public environment.<\/span><\/p>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-NBd3H' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-NBd3H' class='yrm-inner-content-wrapper yrm-cntent-2'><\/span><\/p>\n<p><span style=\"color: #000000;\">It is essential for people to understand that assistance dogs, even in training, are not pets. They receive between one and two years of \"basic\" training exposing them to public places and then go on to \"finishing\" school for several more months to perfect their skills.<\/span><\/p>\n<p><span style=\"color: #000000;\">If you encounter a person with an assistance dog there are a few simple guidelines to follow:<\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">Do not touch or speak to the assistance dog. This is a distraction that interferes with their work and could endanger their human companion.\u00a0<\/span><\/li>\n<li><span style=\"color: #000000;\">Never attempt to feed an assistance dog! Food is a significant distraction.<\/span><\/li>\n<li><span style=\"color: #000000;\">Speak to the person, not the dog, if you have a question or would like information about their dog.<\/span><\/li>\n<li><span style=\"color: #000000;\">If you feel compelled to help someone with an assistance dog, offer your assistance and wait for it to be accepted. Well meaning or not, assistance that is not sought is interference and can endanger both the handler and the dog.<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\">Look at service dogs as you would any other hard working service provider, with respect for the job they are doing.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>This Pet Health Topic was written by Sarah Hoggan, Washington State University, Class of 2001.<\/b><\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-NBd3H' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/strong><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-717-30\"  class=\"panel-grid panel-has-style\" ><div class=\"panel-row-style panel-row-style-for-717-30\" ><div id=\"pgc-717-30-0\"  class=\"panel-grid-cell\" ><div id=\"panel-717-30-0-0\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-first-child\" data-index=\"33\" ><div class=\"textwidget\"><h3><span style=\"color: #000000;\"><em><strong>Vomiting\u00a0\u00a0<\/strong> <\/em><\/span><\/h3>\n<p><span style=\"color: #000000;\">Vomiting is a very common problem in dogs and cats. There are many causes of vomiting. Primary or gastric causes of vomiting are those that are due to diseases of the stomach and upper intestinal tract. Secondary or non-gastric causes of vomiting are caused by diseases of other organs that cause an accumulation\u00a0 of\u00a0 toxic substances in the blood. These toxic substances stimulate the vomiting center in the brain causing the animal to vomit. (Anatomy of the digestive system: <a style=\"color: #000000;\" href=\"http:\/\/www.vetmed.wsu.edu\/ClientED\/anatomy\/dog_digest.aspx\">dog<\/a> \/ <a style=\"color: #000000;\" href=\"http:\/\/www.vetmed.wsu.edu\/ClientED\/anatomy\/cat_digest.aspx\">cat<\/a>)<\/span><\/p>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-rAFsW' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-rAFsW' class='yrm-inner-content-wrapper yrm-cntent-2'><\/span><\/p>\n<p><span style=\"color: #000000;\">A problem that can be confused with vomiting is regurgitation. Vomiting is the ejection of contents of the stomach and upper intestine; regurgitation is the ejection of contents of the esophagus. The esophagus is a narrow, muscular tube that food passes through on its way to the stomach. In health, food moves quickly through the esophagus to the stomach. If the muscle of the esophagus loses tone, the esophagus dilates, a condition called megaesophagus. A dilated esophagus does not effectively move food to the stomach and the animal will regurgitate food usually shortly after eating. The food may also be inhaled into the airways causing pneumonia and cough.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">When you present your pet to the veterinarian because he or she is vomiting, the veterinarian will ask questions in attempt to differentiate between vomiting and regurgitation and to try to determine if your pet is vomiting due to gastric or non gastric disease. Vomiting is an active process. The pet is apprehensive and heaves and retches to vomit. If food is present in vomit, it is partially digested and a yellow fluid, bile may be present. Regurgitation is fairly passive. The animal\u00a0 lowers its head and food is expelled without effort.\u00a0 The food brought up by regurgitation is usually undigested, may have a tubular shape, and is often covered with a slimy mucus.\u00a0The pet will often try to eat the regurgitated material. You may bring a fresh sample of \"vomit\" for the veterinarian\u00a0 to examine. The pH of vomit containing food is acid, the pH of regurgitated materials is higher. Your ability to answer questions about your pet's activity, habits and environment will help the veterinarian decide which causes of vomiting are most likely in your pet. A history of any drugs your pet is receiving is important. Over-the-counter pain medications such as aspirin and ibuprofen can cause severe stomach ulcers in dogs depending upon the dose and duration of treatment.\u00a0 The veterinarian may ask you to describe the appearance of the vomit, as well as describe how your pet looks when it vomits and the relation ship of vomiting to eating. If the vomit contains blood it may be fresh, red blood or look like coffee grounds if the blood is digested. Blood is most often seen with stomach ulcers, stomach cancer or uremia (a collection of signs including vomiting seen in pets with kidney failure). Stomach ulcers can be caused by drugs or the presence of a mast cell cancer in the skin. Mast cell cancers release histamine that leads to stomach ulcers. Regurgitation often, but not always, happens right after eating and the pet will try to eat the regurgitated food.\u00a0 Vomiting occurs a variable time after eating or may occur in a pet who is off food. Animals with a twisted stomach, gastric dilation-torsion, may make frequent attempts to vomit without producing anything. Pets with a hacking cough may retch and sometime vomit at the end of an episode of forceful coughing.\u00a0 An accurate description in this case would lead to an investigation of the causes of coughing, rather than vomiting.<\/span><\/p>\n<p><span style=\"color: #000000;\">If your pet vomits just occasionally and has a specific series of actions associated with vomiting, you may consider video taping an episode of vomiting to help describe the episodes to the veterinarian.<\/span><\/p>\n<p><span style=\"color: #000000;\">The physical examination of the vomiting pet can also provide information to narrow the list of possible causes.\u00a0 The presence of fever, abdominal pain, jaundice, anemia or abnormal masses in the abdomen will help the veterinarian make a more specific diagnosis. The mouth should be carefully examined as some foreign objects such as string can wind around the base of the tongue with the rest of the object extending into the stomach or small intestine. A nodule may be palpated in the neck of cats with hyperthyroidism.<\/span><\/p>\n<p><span style=\"color: #000000;\"><b>The list of non-gastric causes of vomiting is long.\u00a0<\/b><\/span><\/p>\n<p><span style=\"color: #000000;\"><a style=\"color: #000000;\" name=\"Pancreatitis\"><\/a>Pancreatitis in the dog causes vomiting that is sudden in onset and often severe. The dog may have a painful belly. Pets with pancreatitis often have a\u00a0 history of eating garbage or fatty table scraps. Tumors of the pancreas can cause similar signs to pancreatitis. Pancreatitis occurs in the cat but the signs are subtle and non specific and often don't\u00a0 include vomiting<\/span><\/p>\n<p><span style=\"color: #000000;\">Kidney failure is a common cause of vomiting in dogs and cats. The kidneys can be acutely (suddenly) damaged by poisons such as antifreeze or by severe dehydration. \u00a0 Waste products that the kidneys normally get rid of, rise to high levels in just a few days. The kidneys can also gradually lose their ability to remove waste products from the body as the pet ages. Early signs of kidney failure include drinking and urinating large amounts called polyuria and polydipsia or PU-PD. PU-PD may be present for months to years before the kidney failure is severe enough to lead to waste product accumulation and vomiting. Vomiting in chronic kidney failure may began as occasional episodes and progress to severe, frequent vomiting. The pet with chronic kidney failure will often lose body condition and may have pale gums due to anemia.<\/span><\/p>\n<p><span style=\"color: #000000;\">Non-spayed, middle aged female pets can develop\u00a0a uterine infection called pyometra. Pyometra occurs\u00a0within 2 months\u00a0after a heat cycle and often results in discharge of pus from the vagina. The pet may frequently lick the vagina so discharge may not be seen. Dogs develop pyometra more often than cats. Other signs may include PU-PD and depression.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">Liver failure causes vomiting as well as other signs depending on the type of liver disease. Other signs of liver disease may include seizures, jaundice (a yellow discoloration of the areas of skin not covered by fur), PU-PD and fluid accumulation in the belly or legs. Bladder obstruction or rupture will cause a sudden onset of vomiting. The urethra that leads from the bladder to the outside can get plugged by stones or tumors. The animal\u00a0 will strain and pass just a few drops of urine or none at all. They will also have a painful belly. Bladder obstruction if not corrected, is fatal in just a few days. The bladder can be ruptured by blunt trauma such as being hit by a car or kicked.<\/span><\/p>\n<p><span style=\"color: #000000;\">A form of diabetes called ketoacidosis will cause vomiting along with depression and PU-PD.<\/span><\/p>\n<p><span style=\"color: #000000;\">Addison's disease is a deficiency of hormones from the adrenal gland\u00a0and causes vomiting, diarrhea and weakness. Addison's disease occurs most commonly in young to middle aged dogs, most of which are female. Addison's is rare in the cat.\u00a0 The signs of Addison's disease may be intermittent or may be very severe and constant.<\/span><\/p>\n<p><span style=\"color: #000000;\">Diseases of the inner ear can cause vomiting accompanied by incoordination, circling and tilting of the head to the side. Motion during car rides stimulates the inner ear and can cause vomiting.<\/span><\/p>\n<p><span style=\"color: #000000;\">A sudden onset of vomiting in young, poorly vaccinated pets may be caused by infectious agents including canine distemper, canine parvovirus and feline panleukopenia virus.<\/span><\/p>\n<p><span style=\"color: #000000;\">There are many toxins including lead, insecticides, antifreeze and other chemicals that can cause vomiting.<\/span><\/p>\n<p><span style=\"color: #000000;\">Cats with elevated thyroid function, hyperthyroidism, may vomit in addition to other signs including, increased appetite, weight loss, hyperactivity and a poorly kept coat. Heartworm disease in cats may cause vomiting in addition to coughing, respiratory distress, weight loss and depression.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">Primary causes of vomiting include acute gastritis often due to eating garbage or other types of dietary indiscretions; the ingestion of large amounts of hair during grooming; ulcers of the stomach; stomach or upper intestinal cancer; parasites; food allergies; the presence of a foreign body stuck in the stomach or upper intestine; twisting and dilation of the stomach; and intussusception which is a telescoping of one part of the intestine into another piece of intestine.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\">The stomach is usually empty 6 to 8 hours after eating. Vomiting of\u00a0 food when the stomach should be empty suggests an obstruction of the stomach or abnormal motion of the stomach muscles that normally grind food and push the ground food out of the stomach.<\/span><\/p>\n<p><span style=\"color: #000000;\">Tests to differentiate primary causes of vomiting include x-rays or ultrasound of the abdomen and endoscopy. Endoscopy is the technique of passing a flexible scope into the stomach and upper intestine to examine the inside of these structures. It may be possible to remove a foreign body with endoscopy and small biopsies of the lining of the stomach and intestine can be taken for microscopic evaluation. Endoscopy requires general anesthesia.<\/span><\/p>\n<p><span style=\"color: #000000;\">If the pet vomits sporadically, the results of all tests may be normal. Many healthy dogs and cats vomit occasionally without identifying a cause. Sometimes the cause of vomiting is as simple as the pet eating too fast.\u00a0 The treatment for vomiting depends upon the cause. Nonspecific treatment for vomiting includes fasting, and fluids to correct or prevent dehydration.\u00a0 In episodes of sudden onset of vomiting,\u00a0 food is withheld for 24 - 48 hours and water for 24 hours. Water should never be withheld from an animal with known or suspected kidney disease without replacing fluids intravenously or subcutaneously (under the skin). If vomiting stops, small amounts of a bland low-fat food are fed 3 to 6 times daily for a few days, with a gradual increase in the amount fed and a gradual transition to the pet's normal diet. Water is also reintroduced in small amounts on the second day. You may start with\u00a0 ice cubes and then gradually increase the amount of water over the day if vomiting does not reoccur.<\/span><\/p>\n<p><span style=\"color: #000000;\">If the pet is bright and alert and has had no previous health problems, episodes of acute vomiting\u00a0 may be managed at home, although veterinary consultation prior to home treatment is advised.\u00a0 Consultation with a veterinarian in your region may reveal a recent outbreak of an infectious disease causing vomiting or identify\u00a0 a cluster of recent poisonings. With this type of knowledge you will want to have your pet evaluated rather than waiting a few days. Dogs and cats who vomit for longer than a few days or are depressed or dehydrated should be presented for veterinary evaluation.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-rAFsW' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/strong><\/span><\/p>\n<\/div><\/div><div id=\"panel-717-30-0-1\" class=\"so-panel widget widget_black-studio-tinymce widget_black_studio_tinymce panel-last-child\" data-index=\"34\" ><div class=\"textwidget\"><h3 style=\"text-align: left;\"><span style=\"color: #000000;\"><em><strong>Veterinary Acupuncture\u00a0<\/strong><\/em><\/span><\/h3>\n<p><span style=\"color: #000000;\">Despite the fact many of its practices are thousands of years old, Eastern, or non-traditional, medicine is becoming more popular today than ever. Acupuncture is one specialized facet of non-traditional medicine that not only entered the mainstream; it\u2019s become a treatment option for our pets.<\/span><\/p>\n<p><span style=\"color: #000000;\">\u201cThe specific origin of acupuncture is uncertain,\u201d said Rodney Bagley, a veterinary neurosurgeon. \u201cNo one knows if it originally came from China, Korea, or India but it\u2019s widely held that the Chinese perfected it.\u201d Dr. Bagley recently completed a three-week certification course learning veterinary acupuncture techniques.<\/span><\/p>\n<p><span style=\"color: #000000;\"><div class='yrm-content yrm-content-2 yrm-content-hide  ' id='yrm-F6cAV' data-id='2' data-show-status='false' data-after-action='' style=\"visibility: hidden;height: 0;\">\n\t\t\t<div id='yrm-inner-content-yrm-F6cAV' class='yrm-inner-content-wrapper yrm-cntent-2'><\/span><\/p>\n<p><span style=\"color: #000000;\">The specific mechanism of how acupuncture works is uncertain. Theories include stimulation of the release of natural chemicals with in the body or stimulation of neuromechanical mechanisms that diminish pain and promote healing. Local micro-trauma from the needle itself may also play a role.<\/span><\/p>\n<p><span style=\"color: #000000;\">There are more than 150 acupuncture points on a dog\u2019s body with 50-100 of those points being most commonly used. Overall, acupuncture is based on a principle of restoring balance with in the body.<\/span><\/p>\n<p><span style=\"color: #000000;\">Veterinary ailments acupuncture is most commonly used for are pain management and diseases of the liver, kidney, and skin. Generally, acupuncture treatments are combined with traditional approaches to healing such as physical therapy or the use of medications.<\/span><\/p>\n<p><span style=\"color: #000000;\">Just as with any medical treatment, acupuncture has innate risks associated with it. According to Dr. Bagley \u201cThere is always potential for site infection, but that\u2019s rare because the needles used are small. Acupuncture\u2019s effect on animals is usually positive or none at all. There have been some studies that showed it increased the growth of certain forms of cancer so it shouldn\u2019t be used in those circumstances.\u201d<\/span><\/p>\n<p><span style=\"color: #000000;\">Veterinary acupuncture isn\u2019t widely available yet. If you think it could benefit your pet ask your veterinarian for more information or a referral.<\/span><\/p>\n<p><span style=\"color: #000000;\">Acupuncture isn\u2019t a panacea, but it\u2019s another tool to treat ailments and enhance the quality of our pet\u2019s lives. Despite the amazing scientific advances in veterinary medicine, one of the most exciting new treatments may be thousands of years old.<\/span><\/p>\n<p><span style=\"color: #000000;\"><\/div>\n\t\t<\/div><div class='yrm-btn-wrapper yrm-btn-wrapper-2 yrm-more-button-wrapper  '\n\t\tdata-custom-more-class-name='' data-custom-less-class-name=''><span title='' data-less-title='' data-more-title='' class='yrm-toggle-expand  yrm-toggle-expand-2 ' data-rel='yrm-F6cAV' data-more='Read more' data-less='Read less'><span class='yrm-text-wrapper yrm-text-wrapper-custom-dimensions'><span class=\"yrm-button-text-2 yrm-button-text-span\">Read more<\/span><\/span><\/span><\/div><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"<p>The information on this page is not meant to be a substitute for veterinary care. Always follow the instructions provided by your veterinarian. 1. Rabies (this can be spread to people) 2. Feline panleukopenia (feline distemper) 3. Feline herpesvirus infection 4. Feline calicivirus infection 5. Feline leukemia (FeLV) 6. Feline immunodeficiency virus (FIV) infection 7. [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"two_page_speed":{"previous_score":{"status":"error_no_score"},"current_score":{"desktop_score":88,"desktop_tti":"1.2\u00a0","mobile_score":57.99999999999999289457264239899814128875732421875,"mobile_tti":"8.1\u00a0","date":"07.08.2024 12:07:07 pm","status":"completed"}},"footnotes":""},"class_list":["post-717","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.blackearthvet.com\/index.php?rest_route=\/wp\/v2\/pages\/717","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.blackearthvet.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.blackearthvet.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.blackearthvet.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.blackearthvet.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=717"}],"version-history":[{"count":75,"href":"https:\/\/www.blackearthvet.com\/index.php?rest_route=\/wp\/v2\/pages\/717\/revisions"}],"predecessor-version":[{"id":4239,"href":"https:\/\/www.blackearthvet.com\/index.php?rest_route=\/wp\/v2\/pages\/717\/revisions\/4239"}],"wp:attachment":[{"href":"https:\/\/www.blackearthvet.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=717"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}