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Tuesday, November 25, 2014

The Dreaded "C" Word

The Dreaded “C” Word

            As pets age, concerns arise regarding their overall health.  In some instances diseases can develop that may be terminal or require intensive treatment or management.  Just as in humans, one group of diseases that can strike fear in every pet owner is the dreaded “C” word, or cancer (also known as neoplasia).

            Like in humans, cancer in pets can affect various systems and organs of the body.  Some forms are more prominent or are at increased risk of occurrence in a certain breed or sex.  The typical age group for diagnosis is middle to old age (7 yrs old or greater), but it can be diagnosed earlier in life.  Clinical signs that can be seen will depend on what organ or system is being affected.  For instance, bone cancer may cause a lameness or swelling to develop on the affected limb; cancer of the gastrointestinal tract, liver, or spleen may cause a decreased appetite, listlessness, vomiting or diarrhea, or anemia (a decrease in the red blood cell count); cancer of the central nervous system may cause seizures, an unsteady gait, or change in a pet’s behavior (i.e. becoming aggressive). 

            How to determine a diagnosis will also vary based on what type of cancer is suspected.  The most common diagnostics that are performed in all cases include complete blood work, urinalysis, and chest radiographs.  Additional diagnostics that may be considered, depending on which organs are affected, include fine needle aspiration, biopsy, abdominal radiographs and/or ultrasound, or additional blood work.  Occasionally more advanced diagnostics such as CT scan or MRI may be needed.  Once a definitive diagnosis is reached treatment protocols can be discussed, which can include surgery, chemotherapy, radiation, or palliative treatment. 

            There have been great advancements in the methods of detection, diagnosis, and treatment of cancer in veterinary medicine through the years.  There are increasing numbers of board-certified veterinary oncologists throughout the US that offer cutting-edge therapy to cancer patients. Research is continuously being conducted to determine earlier detection methods, clarify the use of biomarkers to aid in identification of the presence of certain types of cancer, and improve treatment options.  These enhancements are improving the veterinarians’ ability to maintain an acceptable quality of life for pets and their owners and hopefully improve longevity. 

            If you have any questions or would like to schedule a wellness visit for your pet, please contact us today at (407)366-4486 to schedule an appointment.

Friday, November 7, 2014

Help! My pet is peeing everywhere!

Help! My pet is peeing everywhere!

            November is Pet Diabetes Month.  When left undiagnosed and unmanaged, diabetes can be a fatal disease in dogs and cats.  By reviewing the most common clinical signs, potential risk factors that may increase the chances of development, and diagnostics and treatments available, pet owners will hopefully become more astute in monitoring at home and in the management of diabetic pets.
            When veterinarians discuss diabetes in pets, it is mainly in reference to diabetes mellitus (referred to in this blog as diabetes).  Diabetes insipidus does occur in dogs and cats but is rare. The clinical signs of this disease are different and will not be discussed in this blog.
 Diabetes is typically diagnosed at approximately 7-9 years old (cats may be 9-11 years old), and it is more frequent in female dogs and male cats. The most common complaint from owners of pets when diabetes may be suspected is an increase in water intake (polydypsia) and increase in urination (polyuria), sometimes to astounding amounts.  An increase in appetite may also be noted (polyphagia) with concurrent weight loss. With more progressed or severe disease, extreme lethargy or a decrease in appetite, abnormal gait in the hind limbs in cats, or the development of cataracts in dogs can occur. A serious progression of diabetes, known as diabetic ketoacidosis (DKA), may occur if left untreated. 
            Diagnosis is based on several criteria.  First, appropriate clinical signs must be present. Second, blood work is used to confirm the presence of high blood glucose (hyperglycemia), as well as elevated liver values and cholesterol.  A positive glucose on a urine sample is confirmation of diabetes mellitus.  In cats, high blood glucose can occur without the presence of glucose in the urine due to stress; this does not indicate the presence of diabetes. Additional diagnostics, such as abdominal ultrasounds, additional blood work, or radiographs may be warranted to rule-out additional underlying diseases, especially if DKA is present. 
           Treatment may be short-term or long-term.  If DKA is present, short-term treatment may include hospitalization, intravenous fluids, insulin therapy, and additional supportive care as indicated.  Long-term treatment with insulin is aimed at lowering and managing blood glucose.  As insulin treatment continues and blood glucose stabilizes, the owner should notice a decrease in water intake and urination to “normal.”  Frequent blood glucose monitoring is necessary, typically through blood work, to ensure the insulin dose is adequate.  Once on insulin dogs remain insulin-dependent for life; however, some cats can become non-insulin dependent.  A diet change to a prescription diet may be recommended.  It is important to work closely with the veterinarian to ensure your pet’s disease is adequately controlled. 
            Not all pets will develop diabetes, but there are risk factors that may increase the probability of this occurring.  Obesity is often the most prominent risk factor.  Additional factors can include recurring or chronic pancreatitis, Cushing’s disease (hyperadrenocorticism), or chronic use of insulin-antagonistic drugs (such as glucocorticoids, progestagens). 
            If you are concerned that your pet may be exhibiting clinical signs related to diabetes, or would like to discuss if your pet may be at risk for future development, please contact your veterinarian to schedule an appointment.