Non-Healing Facial Wounds: A Tale of Two TerriersMarch 13, 2014Endodontic disease has long been known as a common cause of a non-healing facial wound.1 The most common manifestation of this is the slab fracture of the maxillary fourth premolar tooth, which often results in pulp exposure, endodontic infection and a draining cutaneous tract below the medial canthus of the ipsilateral eye. This column compares two persistent cases I’ve seen recently that presented with similar problems but different etiologies. Jasper the Westie Case No. 1: Jasper, a 5-year-old male neutered West Highland white terrier, was presented to me with a three-month history of a non-healing wound beneath his left eye. The wound resolved when the primary care veterinarian placed Jasper on antibiotics, but recurred once antibiotics were discontinued. One year earlier, Jasper had received a dental cleaning and extraction of the left maxillary first molar due to severe periodontal disease. Jasper was presented to me for evaluation of any other dental issues that might be causing the non-healing sinus tract and scabbing beneath the left ventral eyelid. On conscious examination, Jasper was reluctant to allow for a good evaluation of the left maxillary quadrant, but I determined that the left maxillary fourth premolar (tooth 208) was present and did …
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A Disaster Turns Into A Happy StoryMarch 13, 2014 Daisy, a 9-year-old diabetic miniature Schnauzer was diagnosed with a mucocele. Four months prior, Daisy had been seen for a splenic mass. We performed a c. Sadly, the biopsy revealed malignant histiocytosis. She recovered well from this procedure, but never 100 percent, according to the owner. She returned for an abdominal ultrasound after the referring veterinarian noticed an enlarged liver on palpation. In addition, the owner complained of Daisy's abdominal discomfort, decreased appetite and abnormal demeanor. Ultrasound confirmed hepatomegaly. The gallbladder was mildly distended and a small amount of free fluid was noticed around the liver. Blood work was supportive of liver disease with gallbladder involvement. Among others, she had an elevated bilirubin and high liver enzymes: alkaline phosphatase (alk. phos.), gamma-glutamyltransferase (GGT), alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Exploratory surgery was recommended for what was considered by the ultrasonographer to be an early mucocele. A standard laparotomy and cholecystectomy were performed. Patency of the common bile duct was reestablished through a duodenotomy. All other abdominal organs appeared within normal limits. After lavage of the abdomen, closure was standard. Daisy recovered uneventfully and went home the next day. It was that simple. Overall …
Certain Cats, Dogs Deemed Best Pets for Allergy SufferersFebruary 13, 2014 Sneezing, runny noses and itchy eyes are the bane of people allergic to their pets. Now, an air purifier manufacturer and an environmental consulting firm have released their list of the top allergen-friendly pets. Making the cut this week for the Allergen All-Star Pet Awards was: • Bedlington terrier • Javanese cat • Schnauzer • Devon Rex cat • Labradoodle • Yorkshire terrier • Irish water spaniel • Labrador retriever • Maltese • Italian greyhound • Iguana The effort was sponsored by Kaz Inc. of Southborough, Mass., which makes the Doctor’s Choice True HEPA Air Purifier under the Honeywell trademark. The Asthma and Allergy Foundation of America found that 15 to 30 percent of Americans are allergic to cats or dogs, said Ted Myatt, a senior scientist at Environmental Health …
Nine Steps For Pain-Free Nine LivesJanuary 30, 2014 Do you think cats feel pain? Does everyone on your team think that? What do your clients think about pain in cats, and what do you say to them to make them think that? Because owned cats outnumber dogs in the U.S. and Canada, that makes them the most popular pet in North America. Still, they receive far less veterinary care than their canine "cousins”–according to recent studies, about 50 percent less. In recent years, a lot of good things have happened to improve cat health–research, guidelines, continuing education, feline practice board certification, feline health initiatives, new medications and products, and even a collaborative feline health and welfare organization, CATalyst Council. So what advances have you made in your practice to identify and treat cats in pain? If you think you can do better, here are nine steps to take to show that you are committed to caring for cats. With compassion, collaboration and consideration of creature comfort, you’ll be seeing them throughout their nine lives. 1. Team agreement: Cats DO experience pain, just like dogs and people. This can start as a simple written, electronic …
Chronic Vomiting in Cats isn’t Normal After AllJanuary 22, 2014 A study of 100 cats with a history of chronic vomiting, weight loss, chronic diarrhea or a combination was recently accepted for publication by the Journal of the American Veterinary Medical Association.1 The authors, whom I led, concluded that chronic small bowel disease likely is the cause of these clinical signs in hundreds of thousands of cats. Chronic vomiting, present in 73 percent of the cases, is so common that many veterinarians and cat owners have made excuses for it. The top four reported to me over the years are: * He eats too fast; * She has a sensitive stomach; * It’s just hairballs; and * “He’s just a puker,” to quote one of my clients. Consequently, the typical approach has been the use of diets for “sensitive stomachs,” diets for hairballs, hypoallergenic diets, medications for hairballs and antiemetics (metoclopramide, ondansetron, maropitant, famotidine, etc.). Often there is improvement in clinical signs, but rarely are they completely relieved. In addition, the improvement often diminishes over time. My two clinical associates and two pathologists teamed with me to better understand the cause of chronic small bowel disease in cats. One …
Three Techniques to Treat Toe FracturesJanuary 22, 2014 Although metacarpal and metatarsal fractures are fairly common injuries in cats and dogs, the best way to treat is somewhat controversial. Incomplete or complete fractures of one or two metacarpal/metatarsal bones can be treated with external coaptation. The splint should immobilize the carpus/tarsus completely to be effective. Generally, external coaptation requires six to 12 weeks to achieve bony union. Splints should be changed at least weekly to decrease the risk of pressure sores in an at-risk area because of the lack of soft tissue coverage. If three or four metacarpal/tarsal bones are fractured and displacement is present, external coaptation may be a poor choice. When multiple bones are fractured, the splint cannot maintain reduction properly, and while union may occur, the recovery will be prolonged and deformity is likely. Surgery is considered a better choice in such cases. Indications for surgery Internal fixation is used for simple or comminuted metacarpal/metatarsal bone fractures or in patients with three or four fractured bones. In multiple bone fractures, the fixation can be used for all fractured bones or for metacarpal/metatarsal bones 3 and 4 only, i.e. weight-bearing toes. Options for fixation include plating or wiring (rarely performed), …
More "Zebras": Mandibular SwellingsDecember 17, 2013 My November and December columns focused on zebras. Not the actual animals, but rather the zebra diagnosis, that rare clinical presentation that may mimic a more common abnormality. I finished my November column by asking readers to share with me any zebras they have encountered. Linda Molesworth, VMD, of Huntingtown, Md., sees a zebra more frequently than most of us, because she is the proud owner of Zena (see photo above). Let’s continue to discuss dental/orofacial zebra diagnoses, in the context of mandibular swellings in dogs. Signalment—age, breed and sex—may be a very important component of the information gathered when creating a list of differential diagnoses. Take the example of a patient that presents for a ventral mandibular swelling. Many a mandibular swelling has been caused by a nonvital tooth with endodontic infection, often as a result of a tooth fracture, or extension of periodontal disease to the level where it can invade the endodontic system of a tooth. However, numerous other possible causes exist. If unilateral mandibular swelling is seen in a 14-year-old dog, the nonzebra diagnosis of neoplasia would come to mind. However, if nonpainful swellings were occurring in both mandibles of a …
The Lastest On The Deadly Canine ParvovirusDecember 3, 2013 While parvovirus’s clinical signs and treatment principles haven’t appreciably changed in recent years, our knowledge base on disease transmission and patient prognosis has vastly improved. At the CVC veterinary conference in Kansas City in August, Stephen C. Barr, BVSc, spoke to attendees on all things parvo. Some of his key points follow. Parvoviruses are extremely hardy, and remain infectious in the environment for more than five months. Not all disinfectant products work on parvo. Barr recommends a 1:30 bleach solution (5 percent sodium hypochlorite). Leukocyte numbers, character help track the course of parvo By Lou Anne Epperley, DVM For Veterinary Practice News The ELISA “snap” test for canine parvovirus is an efficient initial diagnostic test. Then, leukocyte counts and character can provide hints of the virus’s progress and the patient’s prognosis, according to Stephen C. Barr, BVSc, infectious disease specialist at Cornell University College of Veterinary Medicine. Barr told veterinarians at the CVC veterinary conference in Kansas City that CPV-2 infection causes necrolysis of myeloid and erythroid stem cells in bone marrow. …
Wellness Plans Allow Vet Clients To Budget For Pets’ Preventive CareDecember 3, 2013 In the minds of most veterinarians there’s a plan for just about every pet they see to ensure that pet’s immediate and long-term medical needs. But the reality, according to proponents of wellness plans, is that those details too often go unrelated to pet owners. "We really do have a full-year plan for their pets in our head,” said Carol McConnell, DVM, MBA, chief veterinary medical officer with Veterinary Pet Insurance of Brea, Calif. "When a pet comes in you look at the age, where they live, and other factors, and you formulate a plan.” It’s a detailed plan, Dr. McConnell said, adding, "But we’re clearly not good an explaining it to clients.” VPI in January launched a wellness service for veterinarians to offer clients called "Preventive & Wellness Services, which McConnell pronounces as "paws.” "We are basically positing ourselves as a silent partner with veterinarians,” McConnell said. She said the service is proving popular, with between 2,000 and 3,000 plans across the U.S. in place through more than 100 practices. Jeffrey S. Klausner, DVM, MS, Dipl. ACVIM, senior vice president and …
Veterinary Nutrition And You: Redefining The Future Of Pet FoodDecember 3, 2013 I’ve been to AVMA, NAVC, CVC and ACVIM and, after attending at least five of each of the above conferences over the past 15 years, I can attest that they’ve all got loads to offer. But that’s not to say there aren’t other international-level conferences worth your while. Take WINSS, for example. The Waltham International Nutritional Sciences Symposium is arguably the world’s premier pet nutrition conference. Yet until Mars invited me to attend this year’s October meeting in Portland, Ore., I’d never thought to venture outside the confines of my own customary conference rotation. Which would’ve been a shame. Not only would I have lost out on some killer doughnuts (Portland’s VooDoo Doughnuts fries up the finest), this meeting established that attending smaller symposia treating niche-ier topics can prove even more rewarding than the usual suspects. After all, there’s nothing quite so stimulating as some crisp non-tropical air, a fistful of fried dough, a huge conference hall teeming with veterinary nutritionists and three days chock-a-block with talks, presentations, hot topic sessions and even a bit of entertaining dissent. Most exciting of all, however, was not the banter that arose after one speaker attempted to dispel …
