Pelvic Limb Lameness: Palpate Early And OftenApril 5, 2012 Contrary to popular perception, not all pelvic limb lameness in dogs is joint-related, i.e., a “bad hip” or a “blown cruciate.” Definitive diagnosis is crucial, especially before pursuing surgery for the presumptive problem.1-5 Advanced imaging can help, as can arthroscopy, but neither method reveals soft tissue pain as a common source of the tension and altered gait in dogs. Only hands-on touch and informed palpation can “image” this source of discomfort and possible precursor to cruciate rupture. In light of this uncertainty of why a dog unweights a limb or displays caudal end weakness,6 clients who call a referral center for an evaluation are surprised when the receptionist asks them to set aside a surgery date.7 Even with a busy cutting schedule, why wouldn’t an orthopedic practice consider conservative care first? Tragically, some caregivers have complained of having to choose between only two options: costly reconstructive surgery or euthanasia. These caregivers are browbeaten into believing that if they refuse surgery, their dogs will without question suffer painful debilitation from arthritis.8 Is there not a kinder, gentler way? Different Viewpoints …
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Managing Hyperthyroidism With Food? Check ComplianceApril 3, 2012 The team at VCA West Los Angeles Animal Hospital was puzzled. Veterinarians had recently begun managing feline hyperthyroidism with nutrition, using a pet food formally launched in October 2011, Hill’s Prescription Diet y/d Feline Thyroid Health. The food limits dietary iodine intake, and the staff was finding that in the majority of cats, thyroid levels returned to normal within three weeks of transitioning to the food. But one patient’s thyroid levels had barely budged—even though the owner insisted the cat had been fed only the recommended food. So team members started probing, says David Bruyette, DVM, Dipl. ACVIM, medical director at the hospital. Was the cat getting treats? Never. Did it sneak bites from other food bowls? Not that the owner knew. Finally, a new fact emerged: The owner had been out of town for 10 days. And it turned out that when the affected cat’s food bowl ran empty, the owner’s husband had simply re-filled it with the same food that the other cats in the household ate, Bruyette says. Bingo. “This food is so good at limiting iodine that if the (cat’s condition) is not improving, there’s an incredibly high chance …
Hill’s Updates Guidelines For Y/d FelineApril 3, 2012 After the launch of its Prescription Diet y/d Feline Thyroid Health pet food last year, Hill’s Pet Nutrition Inc. of Topeka, Kan., has released an updated set of guidelines and algorithms to assist veterinary care providers who are managing hyperthyroid patients with the food. Hyperthyroidism is one of the most common diseases in middle-aged and older cats. Resulting from too-high levels of thyroid hormone (T4) and increased metabolism, the illness can cause a range of clinical findings, from hypertension to ravenous appetite, weight loss and excessive urination. Some cats also have concurrent kidney disease. Traditional treatment options have included radioactive iodine, the medication methimazole to control levels of thyroid hormone, or a thyroidectomy. A decade in the making, Prescription Diet y/d Feline gives veterinarians a new management tool—and so far, says David Bruyette, DVM, Dipl. ACVIM, medical director of VCA West Los Angeles Animal Hospital, it has been working. Since June, Dr. Bruyette and his veterinary health care team have been using the therapeutic cat food to manage newly diagnosed feline hyperthyroid patients and those previously diagnosed that are transitioning from anti-thyroid medication. “What we’ve seen …
FHS May Have Underlying Schizophrenic LinkApril 3, 2012 Feline hyperesthesia syndrome (FHS) is an enigmatic and controversial behavioral and medical condition that most often affects Oriental cat breeds. I saw my first case many years ago in a Siamese cat that displayed the three cardinal signs: excessive skin rippling or twitching (hence the alternative designation “rolling skin disease”), bouts of manic self-grooming, often initiated by stroking the cat along its back (”hyperesthesia”), and widely dilated pupils during bouts of the behavior. The cat had just bitten one of our students, who was trying to restrain him, sending the student to the hospital for intravenous antibiotic treatment. Mercurial aggression, while being restrained, is another feature of FHS in some cats. Other odd behaviors associated with the syndrome include periods of freezing in position while staring vacuously into space, sudden bouts of running away from what appears to be some unseen enemy and apparent hallucinations (visually following things that aren’t there). Learning More In the early days, feline hyperesthesia syndrome was described as a compulsive disorder or stereotypy, but over time I became skeptical of the label to the point where I now consider it incorrect. The first seeds of doubt regarding the compulsive disorder …
Fabulous Feline Fling!March 26, 2012 Close your eyes, and imagine this…well, you can’t read this if your eyes are closed, so have someone else read it to you with your eyes closed…but not if that person is a prankster, because something bad might happen to you while you’re closing your eyes…so use your best judgment. So where were we? Ah yes, telling you what to imagine. I would have loved to get photos for you, and I did get a digital recording, but I’m not so sure they want this running on VPN’s website! It was a few mornings ago. I walk into the kitty palace, the room in which my four cats nap and eat, and the first thing I notice when I open the door is green plant material on the floor. Now we have bunnies, too, so my first thought is hay. But no, I open the door a little more and find the large plastic sack that used to hold all of their catnip, but now most of it is spread out on the floor! I open the door a little further, and see plastic trash bags askew in the room. Hmm, now they are usually stored …
The Case Of The ‘Tummy Tuck’ I Just Couldn’t Get PastMarch 21, 2012 If I hadn’t seen it for myself, I wouldn’t have believed it. A pre-vet student who works for me finally wore me down and convinced me to Google it. That’s when I settled in with my morning coffee to watch a 30-minute video on the merits and how-tos of “tummy tucking” for cats. Tummy-tucking? Seriously? Apparently. And it was awful (as you might have expected it would be). In this case, undertaken in a mobile surgical unit on what appeared to be a middle-aged domesticated shorthair female with an average-sized “belly pooch,” the cat was subjected to a 30-minute procedure dedicated to removing as much subcutaneous fat as possible. Horrible. More so when you consider that one of the major complications with liposuction (done in humans with “lipo-wands” designed for the task) is the potential destruction of blood supply to the overlying skin and, therefore, full-thickness skin necrosis. This complication is rare when the procedure is performed correctly, seeing these wands are specifically designed to leave major vessels intact. But in the cat and dog (distinct from humans) the blood supply to the overlying skin is even more tenuous. While humans have multiple musculocutaneous vessels scattered …
For ToboMarch 21, 2012 Like many service members returning from war, Army Capt. Sam Wilson brought back from Iraq mental images and experiences that made home life a struggle. The love of his wife and pets helped ease his transition, but still there were flashes of anger that sent him searching for solutions. One solution was named Tobo. The German shepherd came into his life after his wife, Kris, suggested he answer an ad in the paper. “I think she just knew I needed that companionship,” recalled Wilson, now a statistician for a clinical research organization. “You know how you can have lots of pets but there’s always one that holds a special place for you? Tobo is that one for me.” So after watching Tobo, now 8, lose mobility and suffer through the pain of hip dysplasia, arthritic inflammation and degenerative joint disease, Wilson was excited to get a phone call last fall from the family’s veterinarian, Chuck Miller, DVM, a partner at Triangle Veterinary Hospital in Durham, N.C. Prime Candidate Dr. Miller, who in June will mark his 20th anniversary as a veterinarian by continuing to practice at a clinic that has been around since …
AAFP Revising Feline Vaccination GuidelinesMarch 20, 2012 The first installment of feline vaccine guidelines released by the American Association of Feline Practitioners (AAFP) in 1997 caused uproar within the veterinary community. As the organization weaned practitioners off of manufacturers’ annual vaccination recommendations and onto a three-year core booster regimen, veterinarians were uncertain about whose advice to follow. Also in the guidelines’ inaugural year, standardization of injection site location for vaccines was introduced, which made identifying vaccine-induced sarcomas possible. The initially questioned guidance of the panel has now become most veterinarians’ staple. The AAFP is revising its feline vaccine guidelines–the fourth revision—and they are due this year. The group’s international and multidisciplinary panel comprises experts in immunology, infectious disease, internal medicine and clinical practice, and the guidelines will be packed with data supporting every recommendation. “Ten panelists are working on the revision,” says Margie Scherk, DVM, Dipl. ABVP (feline), editor at the Journal of Feline Medicine and Surgery and a past president of AAFP. “The rationale for including international specialists was to ensure that we are capturing a broader and more global base of knowledge, ideas and approaches that may not be commonly considered locally. This will also allow the recommendations to be …
Update On Hospice PatientMarch 16, 2012 For those of you following my blog, you know that my 14-year-old Somali cat is currently in hospice care for suspected infiltrative GI lymphoma. We were given a rainbow of hope when we started Prednisolone, even though it upset me to move to the “last step” in her treatment. In other words, the Pred is the last thing we can do to help her. I knew this, so starting it seems like the end. But she rebounded so nicely, started putting weight back on and grooming herself more. Then we fell under the delusion that maybe she isn’t sick after all? My friend the hospice nurse said this was normal, families begin to feel like maybe the end isn’t coming, because the animal responds so well to the treatment. Yet she warns, it’s just that the palliative care we are giving her is working, for now. In practice, we often have families who cling to the last little bit of hope. Sometimes it borders on denial, and it’s difficult to make them understand that their pet is suffering. This is particularly true because most people don’t understand how a pet demonstrates …
Cats From Hell?March 12, 2012 So are any of you watching the show My Cat From Hell on Animal Planet? What a show! At first I was skeptical; who is this Jackson Galaxy dude, what kind of name is that, why does he shape his facial hair like he does, why does he carry his cat equipment in a guitar case, and most importantly, what credentials does he have that makes him a cat behaviorist? Being a cat person myself, I couldn’t help but watch a few episodes to see what happens…and now they are set up to record on my DVR! From what I can tell, he learned cat behavior by working with shelter cats who were trying to get rehomed. I’m not sure if he has any true credentials in cat behavior, but I tell you, he knows his stuff. They show some of the nastiest cats I’ve ever seen. They lunge at the people in the house, they terrorize each other when there are multiples, they pee in the sink and on the carpet, and one even climbed a trellis out on the back patio, opened the neighbor’s screen door, and stalks her at her own house! What is …
