Archive for the ‘Medical Updates’ Category

Canine Influenza outbreak caused by a new strain of virus H3N2 from Asia

Sunday, August 27th, 2017

Midwest Canine Influenza outbreak caused by new strain of virus

April 12, 2015 By Joe Schwartz

ITHACA, N.Y. – The canine influenza outbreak afflicting more than 1,000 dogs in Chicago and other parts of the Midwest is caused by a different strain of the virus than was earlier assumed, according to laboratory scientists at Cornell University and the University of Wisconsin. Researchers at Cornell say results from additional testing indicate that the outbreak is being caused by a virus closely related to Asian strains of influenza A H3N2 viruses, currently in wide circulation in southern Chinese and South Korean dog populations since being identified in 2006. There is no evidence that it can be transmitted to humans.

The outbreak in the Midwest had been attributed to the H3N8 strain of virus, which was identified in the U.S. dog population in 2004 and has been circulating since. The H3N2 virus had not been previously detected in North America. The outbreak in Chicago suggests a recent introduction of the H3N2 virus from Asia.

Testing of clinical samples from the outbreak conducted at The New York State Animal Diagnostic Laboratory at Cornell indicated that the virus was Influenza A. Further testing led researchers to believe a new strain was at fault. Subsequent testing, carried out with the assistance of the Wisconsin Veterinary Diagnostic Laboratory, identified the new subtype as H3N2. The National Veterinary Services Laboratories in Ames, IA is sequencing two isolates from this outbreak, which were isolated at Cornell, to facilitate rapid complete characterization of the viruses.

Both Influenza strains can cause high fever, loss of appetite, coughing, nasal discharge, and lethargy. Symptoms may be more severe in cases caused by the H3N2 virus. Some infected dogs may not show symptoms at all.

H3N2 has caused infection and respiratory illness in cats.

Veterinary professionals are advised that diagnostic testing of samples from sick pets can be done using a broadly targeted Influenza A matrix reverse transciptase-polymerase chain reaction assay (Rt-PCR). The canine-specific Influenza A H3N8 Rt-PCR in use in several laboratories will not detect this virus. Serology is also currently not available as the H3N2 virus is different enough from H3N8 that antibodies may not cross react. However, an H3N2-specific serologic assay is under development and will be available soon.

It is not known if the current vaccine will provide any protection from this new virus. It does protect against H3N8, which is in circulation in some areas. Other preventive advice remains the same: In areas where the viruses are active, avoid places where dogs congregate, such as dog parks and grooming salons.

Owners of symptomatic dogs and cats should consult our office.

Senior Pets – Part 3 of 3

Tuesday, August 22nd, 2017

 

Dog patient

One of our very patient patients.

In our three part series of posts on Senior and geriatric pets we focused on:

Part 1: Describing/defining a senior or geriatric pet

Part 2: Important Conditions and Focus Areas for an aging pet

 

 

Now in part 3 of our 3 part posts we will focus on Medical Management / Early Detection and Screening

Medical Management / Early Detection and Screening

Cat patient

Dr. Toncray enjoying a patient.

   Although the list of medical conditions can be very long in our older pets, many of them can be managed successfully. We advise our patient’s caregivers to consider a senior health care plan that will target early detection and treatment.

Early detection will allow for prompt, specific care for your pet that will prevent, delay, or temper an illness, extend life span, promote increased quality of life and extend the human-animal bond.  It begins by defining baseline values for your pet as they move into their senior life stage. This will help set the foundation to provide the best preventive and medical care for the years ahead. It continues with frequent evaluation, therapy and monitoring as medical conditions require.

 

Physical Examinations

Dr. Leslie monitoring the weight of one of our feline patients

   A complete and thorough physical examination will help localize and uncover any problems or suspect areas. Initially annual exams are advised, however, increasing the examination frequency to two times a year as your pet ages will increase the chance of detecting a problem early. We recommend monitoring body weight more frequently, 2-4 times a year. You can come in and use our scale in the waiting area.

 

 

Observations and History

    Dialogue between our doctors and pet owners in this life stage is exceptionally valuable.

older dogs eye issues

Dr. Swindell consulting with a client.

Observations and notations of subtle changes in interactions and day-to-day routines can provide important information and direction for early detection of health issues. Education on what signs to watch for and their significance can heighten detection of early changes.

 

Laboratory and diagnostic testing

Routine diagnostic tests can give additional depth to your pet’s health evaluation

Simple blood test

and can specifically target organ system changes at a significantly earlier time than waiting for abnormal symptoms to present on a physical exam.

These tests may include: complete blood cell counts, serum chemistry panels and a urinalysis. Each pet has a unique set of examination findings and pertinent history which may require more specialized diagnostics that specifically meet their needs.

 

Dr. Richerson listening to the internal sounds of a patient.

 

We understand that the senior/geriatric life stage can be more demanding than the younger adult years. However, by approaching their health care preemptively we can minimize those demands and allow our pets to be happy, active and healthy members of our family for years to come.

cardiatric patient

Dr. Carlson and a patient.

 

 

 

 

It is our pleasure to serve you and your pets. Please do not hesitate to call our offices if you have any questions or concerns. Thank you for allowing us to be a part of your veterinary healthcare team.

www.carlsonanimalhospitals.com

Carlson Animal Hospital, Oak Park, IL 708.383.3606

Senior Pets – part 2 of 3

Wednesday, August 9th, 2017

Aging is not a disease

In our first of three posts on Senior Pets, we reported the good news that our pets are living longer and healthier lives. We celebrated our privilege of participating in this change during the 37 years of our practice. We covered the definitions of aging and what this means for our pets.

In this post we address: Important Conditions and  Focus Areas

The conditions below can contribute to illness as well as play a vital role in maintaining optimal quality of life and longevity. All these areas are interconnected physiologically in our senior pets and each pet’s health condition as it ages. We know that because of this each pet requires its own unique treatment plan. Our doctors and staff at CAH can advise and completely review your pet’s needs in order to plan out a specific senior/geriatric health care course with you and your pet.

I. Nutrition and Body Condition

Dietary needs change with age and many common diseases and age-related conditions can benefit from shifts in nutrition as part of prevention and treatment. Overall body condition as well as body weight play critical roles in senior health.

II. Oral/dental health

Dog teeth brushing

Good oral health helps to extend pets’ lives

The mouth, teeth, and gums can be an easy portal of entry for bacteria as well as a source of pain and discomfort if not maintained in the later years of life.

 

 

 

III. Gastrointestinal

The GI tract is highly complex and has many roles in the body. Digestive efficiency and body requirements can shift with age and maintaining optimal health of the entire gastrointestinal system will significantly impact our dog and cats longevity.

Keeping pets flexible

Dr. Swindell examining a patient for orthopedic flexibility.

IV. Orthopedic conditions and mobility

Movement and exercise are essential during the senior years. Addressing health issues such as arthritis and muscle strength will allow your pet to maintain mobility and pain-free movement.

V. Endocrine/ Hormones

One of the most common areas in which our geriatric veterinary patients experience functional changes is in hormone production. Thyroid, adrenal and insulin hormones are the most commonly involved. Fortunately, the majority of these conditions are very responsive to treatment and can be managed successfully. Early detection can make this management less complicated.

VI. Cardiovascular/Renal/Respiratory

Dopper to analyze a pet's heart murmur

Doppler image of blood flow in a pet’s heart.

These organ systems also have numerous changes as they age. Here too, many of these common conditions can be slowed and managed to maximize the working lifetime of these organs. Often times months to years of quality life can be added to our pet’s life expectancy.

 

 

 

VII. Skin

Healthy skin is important for our seniors and coat quality and changes can be early indicators of health changes. Masses and lumps are common at this life stage and should be discussed and evaluated.

VIII. Mental Health/ cognition/ behavior

Our pets do face behavioral and cognitive/neurological changes as they age. These changes can be addressed in a variety of ways, some through nutrition, environmental changes, and medications.

IX. Sensory

nuclear sclerosis

We illuminated Fluffy’s eye to show her mild lenticular sclerosis.

Changes in the major senses especially eyesight and hearing can require adjustments in environment and lifestyle to prevent injury and anxiety.

 

 

 

X. Environmental Conditions

Older pets will usually need changes in their environment and lifestyle to accommodate their health care needs and still provide and promote safe movement and mental stimulation.

 

 

XI. Pain Management and Pharmacology

Senior health conditions that might have discomfort or pain associated with them should be targeted and treated either temporarily or long term as the condition requires. All drugs must be used with the most current knowledge of  senior/geriatric metabolism to prevent drug related illness or toxicity.

In the third of our three part series on Senior and geriatric pets our next post will focus on:

In our next post, Part 3 of 3, we will focus on: 

Medical Management / Early Detection and Screening. 

It is our pleasure to serve you and your pets. Please do not hesitate to call our offices if you have any questions or concerns. Thank you for allowing us to be a part of your veterinary healthcare team.

www.carlsonanimalhospitals.com

Carlson Animal Hospital, Oak Park, IL 708.383.3606

Senior pets – Part 1 of 3

Wednesday, July 26th, 2017

Senior/ Geriatric Pet Health

We are happy to report that our pets are living much longer healthier lives. We’ve been a part of the great changes in veterinary medicine for these 35+ years and continue to keep up with the pace of the advancements.

No matter the life stage – growth, adult, senior/geriatric – we work hard to help you make the best of each of your pet’s stages. We have particularly focused on the senior/geriatric stages . The medical staff at Carlson Animal Hospital can help provide the most current and advanced medical care to help you and your pet navigate this complex life stage.

The senior/geriatric pet 

The exact definition of a senior or geriatric pet varies. Due to differences in species (feline versus canine), breed, and size, there is not an exact year that defines senior or geriatric. One guideline states that pets are seniors if they are in the last 25% of their predicted lifespan for their species and breed. This is when they are at significantly higher risk for numerous health conditions and disorders. The generally accepted veterinary guidelines are:

1) cats and small to medium size dogs are considered senior/geriatric at age 7 years and older

2) larger breed dogs with naturally shorter life spans are considered senior at age 6.

Often the term senior refers to the earlier part of this life stage and geriatric refers to the latter years. Many cat and dog caregivers like to equate their pet’s age with comparable human years and there are several conversion charts and formulas devised to attempt those comparisons.

In addition to the above table the American Veterinary Medical Association lists the oldest recorded age of a cat at 34 years old.The oldest recorded age of a dog at 29 years old. Recent statistics report that between 33% and 50% of all the dogs and cats in the United States are now 7 years of age or older.

Aging

Aging itself is not a disease. There are physiologic changes that occur as the body ages. They involve the gradual and irreversible loss of function of the body’s organ systems as well as any reserve capability they may have.  During the aging process, individual cells and the cell cycles begin to decrease to the point where they stop functioning altogether. Throughout the pet’s lifetime, outside influences/insults from the environment have also been exerting effects on the body systems and its innate genetic programming.

In our next two posts we expand and focus on:

Part 2 of 3: Important Conditions and  Focus Areas

Part 3 of 3: Medical Management / Early Detection and Screening

 

It is our pleasure to serve you and your pets. Please do not hesitate to call our offices if you have any questions or concerns. Thank you for allowing us to be a part of your veterinary healthcare team.

www.carlsonanimalhospitals.com

Carlson Animal Hospital, Oak Park, IL 708.383.3606

 

 

 

 

 

 

Feline Upper Respiratory Infections

Saturday, March 25th, 2017

Ah-choo!

 

Aachoooo!  Uh oh.

First a sneeze, then what next? A runny nose?  Watery eyes? A cough? To you, these are the signs of a cold setting in, but what happens when it is your CAT showing these signs?  Can a cat get a cold? Can it be contagious to you or your other pets?   And what can you do to help them feel better?  All these answers and more as we cover FELINE UPPER RESPIRATORY INFECTIONS in today’s blog.

What is a feline upper respiratory infection (URI)?

A feline URI is an infection of feline species (domestic and exotic) that affects the beginning part of the respiratory tract, including the nasal passages, sinuses, and pharynx (throat).

cat throat

Feline Pharynx – upper respiratory system

Depending on the infectious agent, sometimes the eyes, oral cavity and lower respiratory tract can also be affected.  The infectious agent of a URI is commonly a virus, but can also be a bacterium, and in rare instances even a fungus or parasite.  Some URIs can be a combination of multiple infectious agents.  Common upper respiratory viruses that infect cats are HerpesvirusCalicivirusChlamydophila felis and Influenza.  Some of the more common bacterial causes of feline URIs are Bordetella bronchiseptica and Mycoplasma felis.

How do cats get URIs? Are they contagious?

Feline URIs are highly contagious, with transmission occurring through direct contact with an infectious individual, aerosolized droplets or fomites (objects or materials like clothes or furniture on which infectious agents can survive away from an animal host).  Cats that come from shelter situations, spend time outdoors around other cats or have owners that interact with cats outside the home, are at risk.  Clinical signs can last for a few days in mild cases, but can persist for weeks before resolving in moderate to severe cases.  Some infections can be chronic, entering into a latent (inactive) phase and then re-emerging intermittently throughout life during times of stress.

Can a cat get a cold?

While most URI viral agents are highly contagious only among feline species, there are some agents that can affect dogs and even some that are considered zoonotic (infectious to people). Bordetella bronchiseptica, for instance, can be transmitted between dogs and cats, and very rarely humans.

The influenza virus, notorious for crossing species lines, has many strains.  An avian strain, the H7N2 influenza virus, has recently begun infecting shelter cats in New York City, and was even determined to have caused illness in a veterinarian as well.  Thus, well known feline URI causative agents, as well as newly emerging agents, can pose a threat to our feline friends. Additionally, the feline chlamydial agent has been reported to cause human conjunctivitis.

How do I know if my cat has a URI?

eye infection

Feline conjunctivitis

Clinical signs such as sneezing, conjunctivitis, nasal and ocular discharge, wheezing and general malaise can be an indication that your pet has a URI.  If you are suspicious of a URI, please contact us to set up an appointment.  During your appointment a thorough history and physical examination will allow us to determine an appropriate diagnostic and treatment plan for you and your pet.  We have the ability to test for feline URI causative agents, enabling us to develop an appropriate treatment regimen for each individual.

Are URIs treatable?  How can I protect my cat?

Feline URIs can be treated.  Treatment is determined by the causative agent of the URI.  Some URIs can be treated with antibiotics, while others can resolve with supportive care or, in rare instances, an anti-fungal or anthelminthic.  If your cat is showing signs of a URI, please consult with us to determine which treatment options may be effective for your pet.

Veterinarian and feline patient

Dr. Richerson and Carrot

If you own a cat, preventing infection before it occurs is the best medicine.  The 3 year

FVRCP (Distemper) vaccine we offer is designed to protect your cat against URIs.  Bringing your cat in for examinations and immunizations, as recommend, will help ensure his/her protection against URIs.  Additionally, keeping your pet away from high risk situations like outdoor cat interactions, unclean multi-cat boarding situations, and introduction of new shelter cats to the household, can reduce the chance of infection.

cat being inoculated

Proper inoculation will help protect your cat against illness.

If you are concerned your cat has a URI or would like more information on how to prevent infection, please do not hesitate to contact our hospital.

It is our pleasure to serve you and your pets. Please do not hesitate to call our offices if you have any questions or concerns. Thank you for allowing us to be a part of your veterinary healthcare team.

www.carlsonanimalhospitals.com

Carlson Animal Hospital, Oak Park, IL 708.383.3606

Osteoarthritis in our dog and cat companions

Monday, February 27th, 2017

Geriatric pet care

Our canine and feline companions are living long active lives well into their geriatric years. Therefore assessing and treating osteoarthritis is an important part of geriatric pet care. Many pet owners make the comment that they believe arthritis is the cause of stiffness and a slow rising from rest in their pets.  Up to 60% of dogs are diagnosed with the disease based upon radiographic evidence at some time in their life.

As with most medical conditions, treatments for osteoarthritis are specifically targeted to the physiologic processes that cause the disease.  At Carlson Animal Hospital we strive to educate pet owners about the physiologic basis of the treatments we employ. In this blog we will delve into a bit more detail about the disease itself.

Osteoarthritis and the synovial joints

Osteoarthritis is a chronic, degenerative disease that affects synovial joints.  Synovial joints are articular joints between two bones that are joined by a joint capsule containing fluid and cartilage. The purpose of synovial joints are to allow smooth movement between two bones. The term arthritis, without the osteo prefix, refers to inflammation of a joint of any sort.  Whereas osteoarthritis refers to the chronic degenerative process of cartilage breakdown and associated inflammation.

cat being examined for osteoarthritis

Dr. Swindell examining a feline patient.

Osteoarthritis affects both dogs and cats.   Sometimes the disease is related to aging and sometimes it is not.  Osteoarthritis may also occur secondary to an injury or instability of a joint. A common orthopedic injury in dogs is a rupture of an anterior cruciate ligament (also known as an ACL rupture).

dog hip examination

Dr. Swindell performing a hip exam.

Hip dysplasia is an instability of the hip joint that is often diagnosed earlier in life. These pets will eventually develop osteoarthritis in that joint due to the chronic instability/inflammation.

Physiology of osteoarthritis

Moving on to the physiology of osteoarthritis. We’ve included a definition of a few key terms:

  1. Cartilage– firm, smooth, flexible connective tissue found inside the surface of a joint.
  2. Chondrocyte – a cell that creates the matrix of the cartilage that is found inside cartilage.
  3. Hyaluronate and Chondroitin sulfate – polysaccharides associated with cartilage that are the joint’s shock absorbers.
  4. Inflammatory mediators – signals sent by cells in the body as a response to damage- they cause the body’s protective response, including inflammation. (This is a very simplified discussion of a very complex process!)

The primary pathology of osteoarthritis is cartilage breakdown.  The cartilage becomes weaker, less elastic with less ability to absorb shock.  Small fissures within the cartilage develop propagating a self-perpetuating degenerative process.  Enzymes are produced that degrade the chondroitin, hyaluronate and the collagen of the cartilage further.  As the cartilage is degraded the fluid in the joint secretes inflammatory mediators which cause inflammation inside the joint.  As the osteoarthritis progresses,  osteophytes ( new bone formation) occur around the joint.  These are little outgrowths of bone that occur near where there is damaged cartilage. These osteophytes further create a decreased range of motion and pain.  Osteophytes have sometimes been described as bone spurs.

dog hip with osteoarthritis damage

Model of a normal canine hip joint on the left and a hip joint with osteophytes and chances from osteoarthritis on the right.

Diagnosis includes a physical exam and radiographs (X-rays)

We believe that it is important to diagnose osteoarthritis prior to beginning treatment, especially since the treatment and the disease are frequently chronic.  The initial portion of the diagnosis is based upon a physical examination of the pet.  Joints with osteoarthritis often have a decreased range of motion with associated pain upon careful manipulation.  Radiographs (x-rays)  of the affected joints are advised.  While radiographs will not show us damaged cartilage, they will document the osteophytes that occur in the advanced stages of osteoarthritis, as well as an increase in joint fluid if present,  which is usually associated with inflammation and discomfort. The radiographs below demonstrate a normal canine knee joint on the left.  A radiograph of a knee joint with osteophytes (the osteophytes are noted as small irregularities along the margins of the larger bones surrounding the joint) and osteoarthritis on the right.

dog's knee radiograph

A dog’s normal knee joint – no osteophytes.

dog knee arthritis radiograph

A dog’s arthritic knee joint with osteophytes.

 

 

 

 

 

 

 

 

Multi-modal treatment

At Carlson Animal Hospital we employ a multi-modal approach to the treatment of osteoarthritis.  This means that we target the disease based on the various physiologic processes you  just learned about in this blog.  We decrease inflammation with medication, we help build and support cartilage with supplements, we incorporate a moderate exercise program and weight loss program.  We can even employ a very safe and effective drug that helps decrease the enzymes that cause the breakdown of chondroitin and collagen.

By using all these tools,  we can actually modify the course of the disease, rather than just decreasing pain and stiffness.  We continually re-assess management options based upon the current research through the medical literature and medical conferences.  Fortunately, we continue to see treatment options which increase the comfort of pets affected by osteoarthritis, and decrease the speed of the process of cartilage breakdown.

Our Doctors would be pleased to speak with you about these treatment options and whether they may be helpful to your four legged family members.

It is our pleasure to serve you and your pets. Please do not hesitate to call our offices if you have any questions or concerns. Thank you for allowing us to be a part of your veterinary healthcare team.

www.carlsonanimalhospitals.com

Carlson Animal Hospital, Oak Park, IL 708.383.3606


 

 

Diabetes Mellitus In Cats and Dogs: A General Understanding

Wednesday, February 8th, 2017

Early detection of diabetes mellitus

The increase in diabetes mellitus in cats and dogs mirrors the increase in people; it can be serious and is on the rise. Because of this, we recommend an annual physical examination to address any early warning signs.  With early detection we can increase the chances of the most favorable outcome. When we test for diabetes mellitus we recommend a physical examination, a simple blood test, and urinalysis.

Pancreas and it’s role in diabetes mellitus

To understand diabetes, let’s start with a brief understanding of the pancreas and one of its main functions. The pancreas has several functions, but we will focus on the role of insulin production.

The pancreas produces insulin and regulates blood glucose levels. Glucose, as well as sucrose and fructose, are carbohydrates (we often refer to them as simple sugars).

Dog ultra-sound pancreas

Normal dog pancreas ultra-sound

Cat ultra-sound pancreas

Normal cat pancreas ultra-sound

A normal pancreas should produce insulin as a response to increasing glucose in the blood (after a meal, for example) or when the body recognizes that the cells need glucose. The insulin then regulates the flux of glucose out of the blood stream and into cells.  This is a very important cellular function. Without insulin, glucose cannot enter the cells and provide the energy they need. Without cellular glucose, the body thinks it is starving and searches for an alternate energy source. This sets off a cascade of protein (muscle) and fat breakdown within the body as an alternate energy source.  This in turn leads to harmful metabolic by-products such as ketones formation and weight loss.  This occurs while there is an abundance of glucose in the body just waiting to be used as energy, but it is unable to be utilized.

feline weight loss and diabetes

An increase in appetite coupled with weight loss might be an indicator of illness. Dr. Leslie weighing a feline patient.

Clinical signs including increased appetite may appear even though the pet is losing weight and experiencing muscle breakdown. Next the glucose is so abundant in the blood stream that the kidneys are unable to filter it entirely. Glucose spills over into the urine, bringing water with it, resulting in increased urine production and a secondary increased thirst to make up for the increased urine losses.Therefore pets will drink more water than usual and urinate more than usual.

It is our goal that pet owners recognize the abnormal signs early. Earlier detection means better outcomes!  By the time a pet has reached the life threatening advanced stage of diabetes it has become very lethargic and severely anorexic.  Once an animal reaches this stage, treatment and management are much more difficult.

Types of pet diabetes

Many of you have probably heard, or read about or even known somebody with type 1 ( juvenile onset) or type II  (adult onset) diabetes mellitus. Dogs and cats develop these types of diabetes as well. Many subtypes are being recognized, but for our discussion, we will only briefly discuss these types.

Type 1 is also known as insulin dependent diabetes. In these cases, the pancreas produces decreased insulin or no insulin at all. Type II can also be referred to as non-insulin dependent (although insulin may be needed for the management of this disease). In Type II diabetes the pancreas produces insulin,  but it is either insufficient amounts or the insulin is unable to enter the cell at the receptor level.

 Insulin dependent – typically dogs

In our four legged friends, dogs are typically considered to have insulin dependent diabetes, or Type I, and it is frequently seen in conjunction or secondary to other diseases.  The majority of cats have non-insulin dependent diabetes or Type II.

Diabetes in Dogs

canine diabetes annual examination

Dr. Carlson examining a patient with Diabetes Mellitus.

As opposed to the majority of cats, dogs are generally considered to have Type I diabetes or “latent autoimmune diabetes.” In these cases, the pancreatic beta cells are not producing insulin. In addition to the decreased insulin production by the pancreas, these patients frequently present with underlying causes of insulin resistance secondary to other disease processes.  Some of these underlying diseases include: hyperadrenocorticism (Cushing’s disease), pancreatitis, pancreatic exocrine insufficiency, obesity, any systemic inflammatory disease, severe dental disease, steroid usage, thyroid disease, acromegaly (growth hormone abnormality) and chronic diseases such as kidney disease. These patients will require insulin and addressing each of the associated abnormalities to manage their diabetes.

Diabetes in Cats

cat diabetes risks

Diabetes risk factors include: obesity, eating a high carbohydrate diet, feeding free choice dry food, orange coat color and an age of 8-12 years.

The risk factors for developing diabetes mellituss in a cat include obesity, eating a high carbohydrate diet (most commercially available dry foods), feeding free choice dry food, orange coat color, and an age of 8-12 years.The pathophysiology of diabetes mellitus in a cat is associated with obesity, deficiency of an enzyme glucokinase and genetics. We will briefly discuss each since they are important in the prevention and management of diabetes mellitus in cats.

Obesity is the major contributing factor in the development of diabetes mellitus in cats. Fat cells produce hormones that predispose a patient to diabetes mellitus.  These hormones play a complex role in the body and start a cascading process of negative changes. The hormones produced by excess fat cells decrease the utilization of glucose, decrease insulin production by the pancreas, decrease insulin response, increase insulin receptor resistance at the cellular level, increase inflammatory mediators and increase steroid receptors at the cellular level. All of these changes favor developing diabetes mellitus.  Please be cognizant that over feeding your cat predisposes them to obesity and diabetes.

Diet is a second risk factor for developing diabetes in cats. All cats are deficient in an important enzyme glucokinase that allows the removal of the ingested glucose (sugars) from the blood stream following a meal, and the conversion of these sugars to a usable storage form within the body. Therefore, the commercially available high carbohydrate dry food diets are not an ideal diet for cats. Since cats are carnivores, their insulin production is not based upon a glucose stimulus as in dogs but, rather on a protein stimulus. Talk with us about the best diet for your cat; our discussion might extend the length of your cat’s healthy life.

Genetics is the final contributing factor in the formation of diabetes mellitus. Some cats produce and deposit excessive amyloid in the cells of the pancreas where insulin is produced damaging the pancreas.  This is an inherited trait; cats that produce this extra amyloid are genetically predisposed to developing diabetes.

Certainly many of the same diseases that predispose dogs to developing diabetes mellitus may also complicate the management in cats.  These include pancreatitis, a growth hormone abnormality, dental disease, any inflammatory disease, thyroid disease and others.

Diseased cat pancreas ultra sound

Abnormal cat pancreas ultra-sound

In many instances, the management of diabetes mellitus in cats consists of a diet change and weight management. Frequently we will advise a high protein, low carbohydrate diet +/- insulin supplementation. However, in cats there is a chance that the pancreatic cells can recover and regain their normal function over time.  When this occurs, cats are considered to be in a diabetic remission.

Early identification and prevention of diabetes mellitus is paramount

It is the goal of our team to recognize associated risk factors and the “pre-diabetic” or carbohydrate intolerant patient prior to the development of diabetes.

human treats are can be harmful to pets

Avoid giving pets human treats to aid general health and wellness.

Two of the most important actions a pet owner can take to prevent diabetes are to keep your pet’s weight within a normal range and have annual physical examinations.  Although we may show our love by giving our pets treats or excessive food,  please remember that excess weight is bad for them. Please speak to one of our doctors if you have any questions or concerns about diabetes, the most ideal diet or if you are are noticing any increased urination, increased thirst, weight loss or increased appetite with your pet. We recommend every pet be evaluated at least annually so we can recognize any disease process early and give our patients the best chance at a favorable outcome and treatment.

It is our pleasure to serve you and your pets. Please do not hesitate to call our offices if you have any questions or concerns. Thank you for allowing us to be a part of your veterinary healthcare team.

carlsonanimalhospitals.com

Carlson Animal Hospital, Oak Park, IL 708.383.3606

Feline Renal Disease

Tuesday, December 13th, 2016

kidney-adult-catOver the years we have seen many changes in feline health, from advancements in medical knowledge and techniques to increasing longevity in our feline companions. At Carlson Animal Hospital our feline patients benefit from the most current, advanced medicine and knowledge. Feline kidney disease is one area where both our feline caregivers and your Carlson Animal Hospital team can make a big impact.

Renal disease refers to any form of impaired function of the kidneys.

The kidneys are paired organs that are located in the abdomen just behind the ribs and directly below the spine on the left and right side. They are part of the urinary system and along with the two ureters are designated as the upper urinary system. Each ureter leads from the kidney to the lower urinary tract which is comprised of the bladder and the single urethra taking urine out of the body.kidney-kitten

One cat out of every three has the probability of developing some form of kidney disease in their lifetime. As cats age this probability increases. We see all types of feline renal disease each and every day, so we are very familiar with diagnosis and treatment of this illness.

Normal Kidney Function

kidney-nephron-of-kidneyEach kidney is made up of 1,000,000 nephrons. Some nephrons are  functional and are doing the work while others are in reserve. When the blood from the heart comes to the kidneys it travels through a network of decreasingly sized vessels until it arrives at the smallest structures in the nephrons called glomeruliIt is here that the blood is filtered. Greater than 90% of the blood and its contents is returned to the body freshly cleaned and filtered by the kidneys. The fluid that remains contains the waste products and exits the body as urine. The kidneys also produce a variety of substances and hormones that the body depends on and uses to regulate other functions such as electrolyte balance, red blood cell production, vitamin D levels, and blood pressure to name a few.

If the kidneys begin to malfunction or become less efficient in their role many complications can occur throughout the body. These complications can lead to varying levels of illness and even death.

Renal Disease

Feline kidneys can be affected by many factors that can decrease their ability to function properly. Some of these factor can be related to the environment like diet, toxic substances, age, and genetics, while others are not completely understood at this time.

kidney-persian-kitty

Persian patient

Some forms of kidney disease can be inherited and breeds such as PersianHimalayanMaine CoonRagdollAbyssinians, and the Rex breeds; these breeds demonstrate a genetic predisposition to kidney disease. Most feline kidney diseases are acquired during a cat’s lifetime and not inherited. These acquired conditions are divided into two categories: acute and chronic disease.

cat renal diseases kidney-pictures

Feline kidney with chronic changes

Acute –  this type of kidney disease is a severe condition with a sudden (acute) presentation of clinical signs that begin over a matter of days to weeks.

Two of the most common causes for acute injury or failure in cats are ingestion of toxins and blockages of either urine flow from the body or blood flow to the kidneys. Examples of kidney toxic substances include household plants and chemicals such as the authentic lily family of plants( Easter, Tiger, Day, Oriental etc.) as well as water in the vase containing these lilies, antifreeze, lead paint, and household cleaning products.

 Accidental ingestion of  some human medications, one of the most common being ibuprofen capsules, can also cause kidney damage.

Decreased blood flow to the kidneys can cause acute injury and can occur in cases of shock or trauma such as a car accident or dehydration. Blockage of urine from leaving the body occurs  commonly in cats because they are predisposed to highly concentrated urine that allows for crystallization of minerals that contribute to forming plugs as well as stones that can obstruct their urinary tract, particularly in male cats.

Chronic – this type of kidney disease is a much slower progressing form of injury and can take months to years to develop. It is common that clinical signs are absent in the early stages of chronic disease. Clinical signs will gradually begin to emerge as the disease progresses. Some factors that contribute to chronic disease include; infections, progressive dental disease, trauma, breed, elderly age, and concurrent diseases. It is not uncommon that the specific cause of chronic renal disease goes undetermined in many cases.

International Renal Interest Society (IRIS) – This is a group of veterinarians from around the world, that has developed a four tier staging of kidney disease based upon specific objective parameters.  It is important and very valuable to stage the kidney disease.

Detecting Renal Disease

cheryl-snuggles

Dr. Toncray with one of our patients.

Clinical signs that you may notice in a cat with acute kidney disease can be sudden onset of vomiting, lethargy, anorexia, and general malaise. These signs can be very pronounced.

With early chronic kidney disease there is often an absence of any clinical illness. In the later stages of chronic disease, owners may begin to notice their cats drinking and urinating more as well as losing weight and looking thinner. There may also be lethargy, weakness, vomiting, decreased appetite (possibly related to nausea) and bad breath.

On physical examination our doctors may detect painful or enlarged kidneys in acute disease or small and irregular shaped kidneys in chronic disease. The size and fullness of the bladder can also add information as well as the appearance of the eyes (retinas), mouth, gums, body condition, and hair coat.

If we suspect kidney disease we will advise additional diagnostic tests that will help clarify and further evaluate the kidneys. These tests include blood work (complete blood counts and serum chemistry panels), urinalysis, radio-graphs,ultrasound, and blood pressure evaluations.

Prognosis

Many cats with acute kidney disease do well while others do poorly dependent upon the cause. Ingested toxins such as lilies generally carry a more guarded prognosis, while urinary obstructions in male cats generally have a good prognosis.  If diagnosed early and removed directly,  cats with urinary tract stones/ plugs that are causing kidney damage because of obstructed urine flow can have a favorable outcome. 

The outcome for chronic disease is generally much better particularly if the IRIS stage is 1 or 2.  Treatment is aimed at slowing the progression of nephron loss and damage. Ultimately, all of the nephrons in reserve will be utilized and it is important to help each remaining nephron to function as long as possible.  If diagnosed early, monitored routinely, and treated with supportive therapy, many cats live long full lives with chronic renal disease.

Treating Renal Disease

Treatment will vary depending on the cause, the length of time there has been illness, and the amount of kidney damage that has occurred. Acute cases of kidney disease are considered emergency situations and we will most often recommend hospitalization.  Most cases require intensive care while hospitalized. Treating and/or removing the specific cause, if identified,can be a possible cure in some acute kidney diseases.

We focus on early detection and therapy  to treat chronic kidney disease treatment to increase the working lifetime of the kidney. Diet changes can help decrease the kidney’s work load and allow optimal nutrient availability. Focused treatment to avoid secondary complications like anemia,electrolyte alterations, high blood pressure, and protein loss in the urine will support kidney function. As the condition gradually advances, supplying fluids for support will also increase health and longevity.

We work with each patient and family individually to provide the most comprehensive treatment plan to support their pet’s kidneys.

Preventing kidney disease

       One of the best preventive efforts is to remove potential kidney toxic substances from your cat’s environment. This is a good way to minimize toxic exposure.

water makes the cat's kidneys function better

Lots of water helps a cat’s kidney function and overall health.

Encouraging water consumption such as feeding canned foods as part of the diet ( 70% water) can help maintain hydration and encourage optimal urine concentration. Routine annual monitoring in middle age (7-9 years) and older cats will allow for early detection of chronic kidney changes.  Early monitoring in breeds that are at high risk will allow for specific planning and increased life span.

Everyone at Carlson Animal Hospital is dedicated to the successful management of kidney disease through prevention, treatment and improving quality of life time for our feline companions.

It is our pleasure to serve you and your pets. Please do not hesitate to call our offices if you have any questions or concerns. Thank you for allowing us to be a part of your veterinary healthcare team.

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Carlson Animal Hospital               708.383.3606

 

 

How frequently do indoor cats need a physical examination and vaccinations?

Tuesday, October 25th, 2016

vaccine-cat-in-cardboard-carrierAs veterinarians, we know a feline physical examination appointment may be a big event for you and your pet.  It frequently begins well before you step into the exam room.

There’s often a game of hide and seek to find our feline friends, a game of trickery or wrestling to get them in the carrier, and oftentimes a car ride filled with choruses of plaintive meowing before you even walk through our front door.  And then comes the exam!  Which we know can be a big production in and of itself for some patients.

So, why do we put ourselves and our feline companions through all this?  These days most of our kitties spend their entire lives sheltered in our comfortable homes away from contagious diseases.

Why then, do they need examinations and immunizations regularly?  Well, although it may not be the most exciting event on your calendar, annual feline physical examination appointments are far more important than you realize.  Annual exams are vital to preventing unnecessary suffering, illness and heartbreak down the line.

How frequently do indoor cats need a physical examination?

diana-checking-vitals-on-a-declawed-kittenA comprehensive physical examination is an important measure of an animal’s health just as it is for our own health.  Examinations not only allow us to evaluate countless parameters of health, such as weight changes, hydration status, heart health and dental health.  They also open up conversation about habits at home that allow insight into abnormalities that may be red flags for declining health or a change in health status such as a change in appetite,  urinary habits or water consumption.

Cats should have a physical examination at least once a year. Kittens require frequent exams and vaccinations during their first 4 months of development.  We recommend more frequent physical examinations for senior cats and cats with chronic health problems. We make this recommendation on a case by case basis. For  a healthy adult cat, an annual examination, which conveniently coincides with their annual rabies immunization requirement, is sufficient as long as the cat is doing well at home.

What immunizations are recommended for indoor cats?

There are two core vaccines recommended for every cat.  Any additional vaccines are recommended based on lifestyle.

  1. Rabies vaccine: Rabies vaccination is required by Illinois state law. Rabies is transmitted through the saliva of an infected animal by route of a bite wound or contaminated scratch wound.  Rabies is always fatal.  It also is a significant human health risk given that rabies can be transmitted from infected animals to humans.  There are serious implications if an outbreak occurs.Our feline rabies vaccine is a 1 year vaccine produced by Merial. It is adjuvant free, which reduces the risk of injection site reaction, injection site granuloma, and chronic inflammation in cats.Please visit the Merial website for more information and to view an informative video on rabies: http://www.vaccinateyourpet.net/pages/vaccinesforcats.aspx
  1. Feline viral rhinotracheitis, calicivirus, and panleukopenia vaccine (referred to as the FVRCP or distemper vaccine). The FVRCP vaccine is a combination vaccine that protects against two upper respiratory viruses (rhinotracheitis and calicivirus) and panleukopenia (distemper). Upper respiratory diseases are highly contagious and potentially fatal in immunocompromised patients. Panleukopenia is also highly contagious and can be fatal.  It can cause loss of appetite, fever and frequent vomiting. The vaccine we carry is a 3 year vaccine in boostered adult cats.  It is also made by Merial, and you can find additional information on the company’s website: http://www.vaccinateyourpet.net/pages/vaccinesforcats.aspx

 

vaccine-cat-door

Whether it be through a faulty latch or screen, a careless visitor, or a fire/natural disaster, indoor cats can find themselves outside unexpectedly.  The great outdoors are riddled with dangers for a vulnerable indoor cat, but for the unvaccinated indoor cat, the dangers increase many fold.

Transmissible disease exposure occurs through contact with other animals or fomites, inanimate objects that carry traces of virus from contact with an infected animal.  There are many risks for exposure for a cat on the loose.  Outdoor cats, wild animals and even contact with shelter animals or household pets from well intentioned rescuers can lead to transmission of potentially deadly diseases.

Even if an indoor cat doesn’t find itself in the great outdoors, there is still possibility for exposure in the home.  Rabid animals are unpredictable and dangerous.  Many a rabid bat has found its way into people’s homes.  Bats frequently live in the eaves of older wood frame homes.  Recently,  two cats were diagnosed with rabies in Illinois and Missouri. (abc7chicago.com/pets)  Any animal may become infected with rabies if exposed to the rabies virus. Rabid raccoons and skunks have also been known to break into homes through unsecured windows or doors.  Please remember that rabies is still a very serious disease that is uniformly fatal. Regular immunizations for rabies are required by law to protect the safety of our pets as well as their owners.

bat-raccoon-skunk

Additionally, you may unwittingly be a danger to your indoor cat.  If you are exposed to a virus outside of the home, either by contact with an infected animal or fomite, you can carry that virus into the home on yourself or your clothing. Calicivirus, one of the viruses protected for in the FVRCP vaccine,  lives on clothing for up to 28 days.  We administer this immunization every three years.

And finally, rabies vaccination of your pets is required by law. (https://www.agr.state.il.us/Laws/Regs/AnimalActReg.pdf ). This is a global health issue. It is also an important safety precaution that we enforce in order to protect our staff, clients and veterinarians.

vaccine-law

It is our pleasure to serve you and your pets. Please do not hesitate to call our offices if you have any questions or concerns. Thank you for allowing us to be a part of your veterinary healthcare team.

 

cah-logo-pngCarlson Animal Hospital
708.383.3606

Heart murmurs in Cats

Tuesday, August 30th, 2016

murmurDuring an examination we sometimes detect a heart murmur in a cat, but this finding is not always cause for immediate concern. During an exam we have two primary goals:

  • > identify any issues
  • > educate you as a pet caretaker

We want to make certain that you understand what having a heart murmur, or any of your pet’s medical conditions, mean.  Having and understanding this information will then help you to make educated decisions about your cat’s care.

Scoring a cat’s heart murmur

Scoring a heart murmur’s volume

cat heart murmur

Dr. Swindell listening to a patient’s heart.

You have seen us use our stethoscope every time you have brought your pet in for a check-up or visit. When we listen with our stethoscope to a cat’s heart we can pick up subtleties in the sounds. So when we hear a heart murmur in a cat we are assessing loudness, pitch, and in which stage of the heart beat the murmur is occurring.

Veterinarians always grade a heart murmur. We use a 1-6 scale to grade the loudness of a murmur, therefore we have something objective we can track over time. Grade 1 is hardly audible with a stethoscope, while grade 6 is not only audible with our stethoscope, but is also palpable with a hand on the outside of the chest. There is no defined rule that a heart murmur will get louder as the disease affecting the heart progresses, but it often will.

The goal is to identify the cause of the cat’s heart murmur

A heart murmur in a cat is not a diagnosis in itself.

It is a manifestation of a disorder of the heart or the blood vessels.  We make the diagnosis through further investigation into the cause of the murmur.  The simple definition of a heart murmur is turbulence of blood flow through the valves of the heart. There are 4 main valves in the heart. The blood flows at high speeds through these valves in one direction only. Anytime there is some regurgitation of blood through a valve in the opposite direction we can hear the turbulence of the blood flow as a slight “wooshing” sound, called a murmur.

The ‘lub’ and “dub’ sounds of a cat’s heart

The physiology of the heart is very similar across many species of mammals; a cat’s heart is very similar to our own human heart. There are two main heart sounds in a heartbeat. A ‘lub’-when the blood is ejected from the heart into either the lungs or the aorta before being delivered all over the body.  And a ‘dub’- when the heart fills with blood and the valves to the ‘exits’ of the heart are closed.

Dopper to analyze a pet's heart murmur

Doppler image of blood flow in a pet’s heart.


While there are many causes of heart murmurs in cats there are some more common causes in the species.  High blood pressure (or hypertension) is common, especially in older cats. Also, an overactive thyroid (Hyperthyroidism) can affect the heart in a few ways; it can increase the heart rate, thus the flow and velocity of blood through the heart, and it can cause a high blood pressure, and change the heart muscle by making it do more work. Hyperthyroidism tends to also affect older cats (9 years old or older).  Disorders of the heart itself include enlargement of the heart chamber muscles (hypertrophic cardiomyopathy), degeneration of the heart valves as a cat ages, and a systemic (whole body) infection that can subsequently infect the heart valves themselves (endocarditis). Heartworm disease

(Blog post on heartworm disease), of course can also cause heart murmurs.

Simple blood test

Simple blood test

So you see, there are diseases that originate elsewhere in the body that affect the heart in various ways. Because of this, one of the most important tools we have for diagnosing the cause of a heart murmur in a cat is general blood-work. Of course we’ll recommend x-rays and blood pressure to help us diagnose heart problems as needed.

A Veterinary Cardiologist often makes the final diagnosis about a cat’s heart murmur

echo-cardiogram of a pet's heart with a murmur

Echocardiogram of a pet’s heart with valves labeled.

We have the benefit of having a Board Certified Veterinary Cardiologist as a part of our team at Carlson Animal Hospital, so often the final step to a final diagnosis is a visit with her for an ultrasound of the heart.

This is called an Echocardiogram, and will provide just about everything we need to know about the inside of the heart and its full functionality.

With the diagnostic information complete, we can then provide you and your pet with a diagnosis, prognosis, and treatment options. We can also use this information to make patient-specific anesthesia plans that are as safe as possible for surgeries or dental cleanings. Often, no matter the diagnosis, cats can live happy years with heart disease with your good care and ours.

Always our goal is to provide the best and most comprehensive medical care possible for your pet and the best education for you.

JP and Chloe