Testing, Treating Feline HyperthyroidismApril 8, 2010 Hyperthyroidism is the most common endocrinopathy of older cats. The disease usually results from adenomatous hyperplasia or adenoma of the thyroid gland; carcinomas are relatively rare. In 70 percent of cases the thyroid gland changes are bilateral. Many clinical signs can be seen, with weight loss being present in about 90 percent of cases and polyphagia in about 50 percent of cases.1 Hyperactivity, polyuria/polydipsia, tachycardia, arterial hypertension, vomiting, diarrhea, panting, generalized weakness and a variety of other signs can be seen. In rare instances, apathetic hyperthyroidism can occur with weakness, inappetance and marked lethargy. Diagnosis in most cases is straightforward in that most cats will have an elevated total T4 values. In some instances, especially with other underlying disease or in older cats, total T4 may still be in the normal reference range. In this situation, additional testing can be useful, especially free T4 with a dialysis procedure. Testing for fT4 is less useful as a screening test since falsely elevated fT4 concentrations can be found in normal cats. In rare instances additional testing such as the T3 suppression test will be needed to confirm a diagnosis. Treating Hyperthyroidism …
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Other Ways To Manage Feline HyperthyroidismApril 8, 2010Radioactive Iodine This is the treatment of choice if available and affordable. Ideally, only abnormal tissue will be destroyed and normal tissue should be spared. It’s equally effective if abnormal tissue is not located in the thyroid gland. Can also be used with adenocarcinomas (higher dose required). Cats do have to be relatively stable clinically to be treated and need to eat in clinic if treatment is to occur. Most cats are euthyroid within one or two months of treatment. Percutaneous Ethanol Injection This treatment has a learning curve, so an experienced operator is needed. Only one thyroid gland should be treated at a given time even if both thyroid glands are enlarged; the contralateral gland should be treated at a later date. The results with treatment of cats with unilateral involvement has been good, while hyperthyroidism has uniformly reoccurred in those with bilateral disease. Laryngeal paralysis is a common complication, which may be permanent or transient; bilateral laryngeal paralysis may be fatal. Horner’s also can occur. Surgical Thyroidectomy This is an effective, permanent treatment for hyperthyroidism with bilateral thyroidectomy being recommended given …
Injecting Insight Into VaccinationsMarch 4, 2010 The low cost of companion animal vaccines has translated into high client compliance, and up to one-fourth of global animal health product revenue comes from vaccines. But things get complicated when veterinarians use vaccines in ways not approved by the U.S. Department of Agriculture or as recommended by the manufacturer. Many manufacturer labels recommend that core vaccinations be given every year, but some veterinarians are administering them every three years. “It’s absolutely possible that the vaccines work for much longer, but the companies have not done the tests to prove that and have no legal or financial motivation to do so,” says Kate E. Creevy, DVM, MS, Dipl. ACVIM, an assistant professor at the University of Georgia. Federal law gives veterinarians some leeway under certain circumstances. “Please realize that every time we do that [booster less than annually] we are technically out of compliance with the legal use of the vaccine in question,” Dr. Creevy says. “To be covered under the federal exception, we must have an established veterinarian-client relationship and must explain this extralabel use to the client. Thus, there are still veterinarians who do not feel comfortable doing that.” To help …
Fleas Persist, But Reason Isn’t ResistanceMarch 2, 2010 Veterinarians are in a tough spot when a client challenges the efficacy of spot-on insecticides. They can’t force the client to follow product directions, nor can they administer the flea control every month. Asking a client about product application, the home environment and untreated pets can reveal a potentially resolvable situation. However, more often than not, the owner projects a sterling report of by-the-book compliance and a bewilderment of continued flea propagation. Attempting to resolve the infestation, veterinarians often switch to a different product and the resistance tale grows. “What clients are likely seeing are new fleas from the environment as opposed to fleas surviving after a proper spot-on application,” says Michael Dryden, DVM, Ph.D., a professor of veterinary parasitology in Kansas State University’s Department of Diagnostic Medicine and Pathobiology. “I have investigated homes that by owner description sound like there could be a resistance problem but found, when I looked closer, there was always a reason for the failure. None was ever resistance.” Without an investigation, experts say, it’s difficult to know why fleas persist on a client’s pet after treatment. One thing researchers agree on is it’s not a resistance issue. “Resistance …
Study Links Ovaries And LongevityFebruary 7, 2010 Female dogs that keep their ovaries longer also live longer, according to a study led by David Waters, DVM, executive director of the Gerald P. Murphy Cancer Foundation. The findings, according to researchers at Purdue Research Park in West Lafayette, Ind., challenge almost four decades of standard operating procedures used in female pets as well as humans. It was the first investigation to look for a link between retained ovaries and exceptional longevity in mammals, the researchers said. “A female survival advantage in humans is well-documented—women outnumber men by 4-to-1 among those who reach 100,” said Dr. Waters, associate director of Purdue University’s Center on Aging and the Life Course. “Like women, female dogs in our study had a distinct survival advantage over males. But taking away ovaries during the first four years of life completely erased the female survival advantage. We found that female Rottweilers that kept their ovaries for at least six years were four times more likely to reach exceptional longevity compared to females who had the shortest lifetime ovary exposure.” The researchers collected and analyzed lifetime medical histories, ages and causes of death for 119 canine “centenarians”—Rottweilers living in the U.S. …
Shelf LifeDecember 30, 2009 When Richard Lisk, DVM, started offering five or six different heartworm products for sale to his clients, he thought he was enhancing his service. After all, the more choices the better, right? Not always. With experience and the help of practice consultant Wendy S. Myers of Communication Solutions in Highland Ranch, Colo., Dr. Lisk decided he wasn’t doing his clients—or himself—any favors by overstocking his retail space. “Clients don’t always know what products are best. They’re looking for medical advice,” says Lisk, owner and operator of two adjacent veterinary practices in Houston: Bay Glen Animal Hospital and the Feline Medical Center. So now Lisk carries one heartworm medication, in a 12-month supply, and he still feels the love from his clients. Plus, he frees up room in his hospitals and resources in his budget for other products and equipment. Practitioners know the decision to sell products as a service to clients comes with limitations. How practices best use their limited space can go a long way toward determining the success of the practice. Sales of products sometimes account for as much as 15 to 25 percent of a hospital’s revenue, say veterinarians and practice …
Education Is Key In Diabetes MaintenanceDecember 30, 2009 More than 1.4 million U.S. companion animals have been diagnosed with diabetes. That’s one in every 500 dogs and one in every 200 cats. “Obesity is a leading factor in the increase of diabetes in dogs and cats,” says Tanya Civco, DVM, Dipl. ACVIM, an assistant professor at Auburn University. “We are seeing more diabetic animals because we are seeing more obese pets. “There are far more diabetic animals today than even five or 10 years ago.” These significant numbers attract the research interests of veterinarians and manufacturers alike. Specialists point the finger at conflicting causes. While some veterinarians believe diet plays a role in the increase, others say cats in particular suffer due to the loss of the lifestyle they evolved with. There is no dispute about the best route to achieve balance for patients: research and education. “There is a great deal of ongoing research in diabetes in dogs and cats,” says David Bruyette, DVM, medical director at VCA West Los Angeles Medical Hospital. “The disease is so common in both species that the newest research is focusing on newer insulin preparations such as lente insulins in dogs and cats—Vetsulin, pork insulin, …
New Wound Therapies Look PromisingDecember 30, 2009 Hard-to-heal wounds are time-consuming, costly and a frustration for veterinarians and clients. Side effects of long-term antibiotic use and patient pain are two of the reasons that researchers and veterinarians are trying to heal wounds faster. Photo courtesy of Dr. Tim Crowe. Sarah suffered a large hole in her frontal sinus and nasal passage when she was hit by a car. Her left eye ruptured from the impact. Experts say better methods of wound care exist, but the benefit of these alternatives isn’t widely documented for use in animals. This lack of statistical evidence slows the adoption of a better standard of care by primary caregivers. “Veterinarians don’t get information on hyperbaric oxygen treatment (HBOT) in school, and the lack of available data means they don’t consider using it,” says Tim Crowe, DVM, Dipl. ACVS, Dipl. ACVECC, chief of staff for Pet Emergency Clinics and Specialty Hospital in Ventura, Calif. “A practice would need to see enough patients in need of HBOT to validate the purchase of a machine, but I think the number of vets owning one will increase once the data showing its benefit in veterinary …
Regenerative MedicineDecember 4, 2009 Lymphoma is one of the most common cancers found in dogs, with a survival rate of 0 to 2 percent under current treatment methods. These poor statistics have researchers constantly looking for better ways to increase diagnosed dogs’ lifespan. Steven Suter, VMD, MS, Ph.D., Dipl. ACVIM, is performing bone marrow transplants using a leukapheresis machine to harvest healthy progenitor cells from a canine patient’s blood. “With this method, the dog receives standard chemotherapy drugs, often referred to as CHOP,” says Dr. Suter, assistant professor of medical oncology at North Carolina State University’s College of Veterinary Medicine. “Once in clinical remission, which means the dogs lymph nodes are of normal size, a high dose of Cytoxan (cyclophosphamide) is given to clear as much cancer as possible from the dog’s blood. About 10 days later, it is then given Neupogen (filgrastim), which costs about $2,000 per patient. This drug increases the dog’s white blood cell count and also drives stem cells, called CD34+ progenitor cells, out of the bone marrow and into the peripheral blood.” After six days of Neupogen, the dog is mildly sedated and connected to the leukapheresis machine, which harvests the CD34+ progenitor cells from …
Pressure’s On To Monitor Blood PressureSeptember 1, 2009 Blood pressure monitoring, long a staple in preventive human medicine, is increasingly being incorporated into veterinary practices to enable earlier detection of many common diseases in pets. Keven Gulikers, DVM, Dipl. ACVIM, of the Center for Veterinary Specialty Care in Carrollton, Texas, notes that blood pressure readings are becoming a more integral part of anesthetic monitoring. “And more family veterinarians are evaluating blood pressures in patients with diseases that can cause hypertension, such as chronic renal failure and Cushing’s disease,” he adds. Indeed, Nora Matthews, DVM, Dipl. ACVA, professor at Texas A&M University’s College of Veterinary Medicine, says regular blood pressure monitoring is commonly used to follow chronic diseases in pets. It is increasingly being incorporated into standard pet wellness programs. Thus, she notes, the cost of a blood pressure monitor is nominal when used on most patients in the practice. Routine Monitoring Andrew Schultz, director of veterinary monitoring and critical care for Sharn Veterinary Inc. of Tampa, Fla., agrees that acceptance and adoption of routine blood pressure screening is increasing, but he says it is still far lower than it should be. “Just think what happens every single time …
