Medical Conditions
When used properly, veterinary medicine is essential and practical for many pet medical conditions. Below you will find a list of some of the most common conditions your pet may suffer from. Learn more about their causes, symptoms, treatment, and prevention. If after perusing this section you don’t find the information you were looking for, please give us a call at (501) 812-5678.
Vomiting
If your pet is bright, alert and feeling great, but vomited once, they may have a mild upset stomach. However, multiple vomiting episodes, or additional symptoms like lethargy, depression, diarrhea, blood in the vomit, or loss of appetite, could be signs of a more serious problem and indicate that your pet needs to be seen by our doctor.
Most products you give to vomiting pets orally like pepto bismol, will likely only produce pink vomit. If your pet has no other symptoms (diarrhea, lack of appetite, depression) and is otherwise feeling good and you want to try something at home, take up food and water and give the stomach a rest with nothing orally for 6 – 8 hours. If the vomiting continues, your pet needs to be seen immediately. Otherwise, try clear liquids like water or pedialyte in small amounts. If vomiting returns, your pet needs to come in, otherwise, slowly increase the clear liquids and try bland food like chicken and rice or gerber strained chicken in small amounts. If the vomiting returns, your pet needs to be seen, otherwise, increase the bland food slowly and start mixing it half and half with your pet’s regular food.
If your pet’s vomiting persists or is accompanied by any other symptom, then it is time to get our doctors involved. Vomiting (frothy, yellow, green, brown or bloody) and diarrhea (mucoid, yellow, watery, black or bloody), or any combination of the two comprise the most common presentations for patients at our Emergency Animal Hospital. There are a wide variety of causes behind gastrointestinal upset in pets ranging from: dietary indiscretion; viral, bacterial, rickettsial, or mycotic infections; metabolic diseases of the liver, pancreas, or kidney; inflammatory bowel diseases; or foreign body ingestion. Often, narrowing down the specific cause in a particular pet requires a little detective work and a series of diagnostic tests.
Blood work can give insight into the function of the major abdominal organs. White blood cell counts may incriminate infectious diseases. Imaging, such as radiographs (x-rays), ultrasound, endoscopy or contrast series (putting radiographic dye in the system and taking serial x-rays over several hours), can sometimes help visualize presence of foreign bodies or masses. They also may help evaluate diseases of gastrointestinal motility. Fecal tests can often identify parasites and some infectious agents, both viral and bacterial.
Sometimes wading through the barrage of diagnostic tests can take time. It is often necessary to start the patient on supportive care, to help keep them from getting worse until a cause can be identified. This usually involves the use of fluids, nausea medications, and often antibiotics if there is evidence of bleeding in the system.
Fluids can be given several ways, including outpatient subcutaneous fluids. However, often the most efficient way is through an intravenous catheter (IV). This ensures fluid absorption and allows the rate to be altered to meet changing patient needs. Additionally, with an IV catheter, all the other medications can be given straight to the system, speeding onset of action over other routes of administration. This does however involve hours of hospitalization, typically 12-24.
So much information at one time could make anyone … nauseous, hopefully this helped you chew through it all. If you need any further help with vomiting or any other pet health issue, please don’t hesitate to give our office a call.
Diarrhea
If your pet is bright, alert and feeling great, but had a bout of diarrhea, they may have a mild intestinal upset. However, multiple diarrhea episodes, or additional symptoms like lethargy, depression, bloody stool, vomiting, or loss of appetite, could be signs of a more serious problem and my indicate that your pet needs to be seen by the doctor.
If your pet is otherwise feeling good, is not vomiting and has no other symptoms, you want to try something at home. Give Imodium AD 1 capsule for every 20 pounds of body weight. Imodium liquid can be given at 1 ml for every 10 pounds of body weight. This can be repeated every 8 hours for up to two days. If the diarrhea continues, its time to call the office for an appointment. Immediately.
Vomiting (frothy, yellow, green, brown or bloody) and diarrhea (mucoid, yellow, watery, black or bloody), or any combination of the two comprise the most common presentations for patients at our Emergency Animal Hospital. There are a wide variety of causes behind gastrointestinal upset in pets ranging from: dietary indiscretion; viral, bacterial, rickettsial, or mycotic infections; metabolic diseases of the liver, pancreas, or kidney; inflammatory bowel diseases; or foreign body ingestion. Often, narrowing down the specific cause in a particular pet requires a little detective work and a series of diagnostic tests.
Blood work can give insight into the function of the major abdominal organs. White blood cell counts may incriminate infectious diseases. Imaging, such as radiographs (x-rays) can sometimes help visualize presence of foreign bodies or masses. Fecal tests can often identify parasites and some infectious agents, both viral and bacterial.
Sometimes wading through the barrage of diagnostic tests can take time. It is often necessary to start the patient on supportive care, to help keep them from getting worse until a cause can be identified. This usually involves the use of fluids, diarrhea and nausea medications, and often antibiotics if there is evidence of bleeding in the system.
Fluids can be given several ways, including outpatient subcutaneous fluids. However, often the most efficient way is through an intravenous catheter (IV). This ensures fluid absorption and allows the rate to be altered to meet changing patient needs. Additionally, with an IV catheter, all the other medications can be given straight to the system, speeding onset of action over other routes of administration. This does however involve hours of hospitalization, typically 12-24.
If your pet is suffering from diarrhea, maybe it is time for you to “trot” on in.
Skin Disease
Skin disease, itching, chewing, scratching and hair loss are some of the most common presenting complaints in veterinary offices.
These are often broken down by Allergies (most common); Infections (bacterial, fungal, or parasitic); or hormonal (not itchy – thyroid or adrenal disease).
Pet allergies have become the top health problem pet owners deal with on a regular basis. Like people, pets with allergies are typically allergic to several things which can include fleas, airborne allergens, food allergens, contact allergens, and bacterial allergens.
Fleas:
The most common pet allergy is to fleas, and most pets who have allergies have at least some flea allergy components. Flea allergies are often manifested in the area of the lower back, tail head, around the neck and base of ears. New technology in flea control products has come a long way toward helping the flea allergic pet. When choosing a flea control product, always chose a topical product for allergic pets since oral products have no effect until after the flea bites to ingest the insecticide. While many products are marketed for monthly use, the flea allergic patient might need application of 2 different products on a twice monthly basis to be stay comfortable. Use topical medications only (not oral). My favorite flea combination is AdvanTix and Revolution. Remember – if you are allergic to bee stings – even one sting can be severe, so the flea allergic pet cannot suffer even one flea bite. Every pet in the household should be maintained on an astringent flea control program –not just the allergic pet, since fleas don’t live only on one pet but can move from pet to pet.
Airborne Allergies:
The second most common allergy is to airborne pollen and spores. While people typically inhale these allergens, they usually impregnate through the skin of pets. These pets often exhibit problems with their ears (which have little hair on the inside to protect them), the belly (where they come in contact with the allergens and where their hair is usually thinner) and licking their feet (where they walk through allergens which get stuck in the hair between the toes). The best solution for inhalant allergies in pets as with people, is to test and identify the allergens than avoid their presence – or go through a vaccine desensitization program for those allergens. Allergy tests can be done on the skin (by a local dermatologist who comes through Little Rock 1 – 2 times monthly) or by testing the blood (done in our office). Your pet needs to be off any steroids for 2 months and antihistamines for 2 weeks prior to the test. Once allergens are identified, a series of vaccine vials are created at different strengths and can be administered on a daily oral program or injection program (once every 4 – 14 days). By the end of the first year, most clients will have spent between $800 – $1200. After the first six months of vaccines 25% of pet owners are very satisfied with the results they receive, 25% are disappointed there was not a better response, and 50% feel there was improvement but not resolution and are left still using regular medications to “make up the difference”. Skin testing with the board certified dermatologist does improve those results a little. Allergy testing and desensitization vaccinations have very minimal adverse side effects and are the ONLY means of affecting a “CURE” for allergies.
An easy thing to help with these allergies is wiping the allergens off several times daily using a wet rag or hypoallergenic baby wipes on the feet, ears and undercarraige to prevent the allergens from starting the migration process through the skin.
Antihistamines are sometimes helpful for managing these allergies if your pet isn’t tested or doesn’t respond well to the vaccination program. While large overdoses of antihistamines can be toxic to pets, appropriate dosed products are very safe and have very minimal side effects with chronic long term usage. Benadryl can be used on a twice daily dose of ~ 1 mg per pound of body weight up to 50 mg every 8 – 12 hours. While it is the most commonly used product, it also seems to have the more limited effects on pets with skin allergies. Claritin and Zyrtec can either one be used daily or twice daily (5 mg up to 30 lbs, 10 mg for over 30 lbs), they should not be used together. Generics can be used but don’t use products with decongestants (NOT “D”). Also it is important to make sure you don’t use products containing Xylitol – an artificial sweetener. Prescription antihistamines are available for pets not benefited by over the counter products. Unlike people, pets normally require 10 – 18 days to see benefit from regular anti-histamine administration. Like people, each pet responds to each anti-histamine differently. If a pet is not improving after 2 – 3 weeks of daily antihistamine use, another antihistamine should be tried. If over the count products are not working, prescription products should be tried.
Fatty acids and skin nutrient supplements (vitamin E, Selenium, Zinc) often help with overall skin health and thereby improve comfort.
Medicated shampoos often help and should be prescribed by your doctor based on your pet’s specific skin problem
Topical application products are available and may be of some temporary relief but should be prescribed by your pet’s doctor since everything you apply to your pet’s skin will likely be promptly licked off and ingested.
For patients not completely managed by anti-histamines, we can add one of three drugs:
Atopica – moderately expensive, minimal long term side effects but occasional short term complications with getting the individual dose titrated for each pet (nausea, diarrhea). Consistently available, should be used on a fairly consistent basis
Apoquel – moderately expensive, minimal side effects, erratically available, should be used fairly consistently.
Prednisone – very inexpensive, causes increased water intake and urine output, can increase appetite and cause weight gain, can increase long term side effects of liver disease/diabetes. Can be taken on an inconsistent as needed basis. If prednisone is needed on a regular consistent basis, Apoquel or Atopica should be considered.
Food allergies:
Pets, like many people, can have allergies to foods. Most often, the allergy is to the primary protein source in the food. (Rarely if ever are the grain sources the problem). It takes 2 – 3 months for the dietary allergens to be cleared from the system so benefits from a diet trial may take several months to appreciate. It is very important to make sure that your pet is not on a protein restricted diet . . . then receiving snacks treats or flavored medications with beef poultry or pork byproducts. There are some Veterinary prescription diets formulated to be NON – Allergenic meaning the protein has been processed so that allergies cannot develop. While these products are the most expensive and most difficult to come by (often ordered in advance), their use in an initial food trial can completely rule out the possibility of food allergies. Novel Protein or HYPO – allergenic diets are made from proteins that are uncommon in dog foods and thereby less likely to have already caused an allergy in your pet. These are less expensive than NON – Allergenic diets and are a little more readily available with greater selection. Care must be taken to ensure that the product is labeled as a Hypo-allergenic product since a dog food can be marketed “with Real Venison” but have beef, pork or poultry added as well, or they could be manufactured on the same line as products with other meats leaving residual amounts in the marketed product. These products should be primarily single protein diets and comprise of proteins like fish, rabbit, venison, kangaroo, or tofu. It should be noted that over time, your pet can develop allergies to this proteins just like they did with beef pork or poultry. Patients improving on a Hypo or Non allergenic diet should never be fed anything else.
Contact allergies:
Household products like carpet cleaners or laundry detergents can cause contact allergies often manifested with a belly or underside pattern. Dust and dander mites can cause contact allergies as well. Use of hypoallergenic detergents and frequent cleaning of hypo allergenic bedding covers often helps these pets.
Bacterial allergies:
Some pets can develop allergies to bacteria. This can be a real problem because once the skin gets inflamed from other allergies, they often get a secondary skin bacterial infection . . . which makes the inflammation worse . . . which makes the infection worse – and so on and so on. Antibiotics are very helpful for these patients – not because they stop the allergies, but because they can kill the bacteria the pet is allergic to.
Successful management of the allergic patient requires tenacity and diligence by the every one involved. Referral to a local dermatologist is available for interested clients.
If your pet’s allergy issues are getting under your skin, call our office for an appointment today to get started on a healthy skin management plan.
Urinary Problems
While skin and ear issues are the number one client concern for dogs, litter box issues are the number one problem for cats.
Urinary issues for both dogs and cats can range from urinating too much to straining to urinate at all.
Pets that are straining to urinate (particularly male pets) may suffer from a urethral blockage or stones. This is a critical emergency warranting immediate medical attention. Unlike Kidney stones in people, these obstructions block the ability to pass urine from the bladder out of the body and result in a bladder that gets bigger and bigger putting backpressure on the kidneys and the heart … which can be fatal. Blood work, imaging, and a urinalysis often precede the need for anesthesia and flushing or sometimes even surgical removal of the urethral blockage. Pets usually recover with a urinary catheter for one to several days while the obstruction site heals.
Urinating too much can result from bladder disease, kidney disease, diabetes, liver or adrenal gland disease. Diagnostic blood tests, urinalysis and sometimes bladder imaging with an ultrasound or radiograph may help narrow down the underlying cause and develop a treatment plan.
Don’t strain yourself over litter box issues, call our office for professional help today.
Ear Disease
Each year, ear problems top the list of the most common presenting problems for canine patients in veterinary hospitals across the country.
Very often, ear issues stem from underlying skin disease – usually airborne allergies. This isn’t hard to understand if you consider the ear is just one flap of skin covered by another flap of skin – all designed to pick up sound waves from the air. On top of that, many of our pets have floppy ears which fold over creating a warm quiet dark place – ideal for yeast to grow. Any inflammation in the ear, generates moisture. Once trapped in a downward pointing ear canal with a warm flap cover -yeast grow rapidly in the moist inflamed canal. After the yeast have established a colony, the pH of the area starts to change creating an ideal environment for bacterial growth to follow.
Management of ear disease is often aimed at treating underlying causes such as the airborne allergies as well as moisture buildup. Maintenance of ear health can often be done by regular use of a pH balanced solvent to help remove oily debris.
Call our office to have your pet seen to help get started on a healthy ear management plan for a happier pet.
Bite Wounds
Because animals harbor so many bacteria in their mouths, pets bitten by other animals are starting with an infected wound from the get-go. Infected puncture wounds have a tendency to swell up and become draining abscesses. The sooner antibiotics are started, the less swelling and discomfort and the sooner that your pet will be on the road to recovery.
When evaluating a patient that has suffered a bite wound, there are several things that your doctor will be considering and a number of things that will be discussed. Evaluations of Bite Wound patients depends a lot on the location, depth and severity of the wounds as well as the overall physical condition of the patient.
Chest: Bite wounds that involve the chest may cause broken ribs, loss of negative pressure to the chest (collapsed lung), punctured or bruised lungs, or bleeding into the chest cavity. Chest x-rays are often recommended to better evaluate for damage to this area.
Abdomen: Bites to or around the abdomen can result in numerous internal injuries. The abdomen houses many organs and systems. Injury to the spleen or liver can cause abdominal bleeding. Tears in the kidney, ureters, bladder or urethra could cause uroperitoneum (free urine in the abdominal cavity). Trauma to the intestines or stomach could result in ingesta in the abdomen which can cause a potentially fatal peritonitis (infection). To better evaluate the abdomen, your doctor may recommend an abdominal ultrasound and blood work.
Bones: Sometimes, in cases of large animals biting small animals, orthopedic injuries can occur that prevent normal limb use. In addition to loss of motor function, injuries of the spine could also affect neurologic function of the bladder and colon. Radiographs of these areas may be indicated to help better assess the extent of orthopedic injuries.
Throat: Bites to the throat can often damage major blood vessels, as well as the trachea (windpipe). Radiographs (x-rays) or bronchoscopy may be necessary to better evaluate such damage.
Ultimately, bite wound patients will need heavy pain medications or general anesthesia. Most veterinarians recommend blood work prior to anesthesia for routine spays and neuters, so discussion of blood work in a trauma patient should be expected.
IV catheters during anesthesia, help provide immediate access to the system if problems develop. Fluids help stabilize the blood pressure and help the body metabolize anesthetic drugs out of the system.
Antibiotics always play a major role in treating bite wounds and because bacteria of the mouth are so varied, it is common to use multiple antibiotics for broader spectrum coverage.
Surgical repair is the ultimate goal of most therapy plans. Often, when animals bite, they shake their victim as well. This produces large wounds and open pockets under the skin, not usually visible from the surface. Depending on the wound, rubber drains are often installed under the skin to help keep these pockets drained out, so that they heal from the inside, rather than scabbing over and producing large abscesses.
Most patients will go home with multiple forms of antibiotics and pain products, along with a timetable plan for removal of drains and sutures/staples. Also, to help prevent licking wounds and chewing out sutures, a large cone collar (Elizabethan collar) is often used.
Hopefully this will help “take a bite out of ” understanding what all goes on with bite wound patients.
Chronic Pain
Much like people, chronic pain in pets is often manifested in the joints of the legs neck or back. Suffice it to say, if we had a cure for arthritic pain, we would not be practicing veterinary medicine but rather sipping Daiquiris on our own Caribbean island.
The only “cure” for failing joints is joint replacement surgery. That having been said, until artificial joints truly are “bionic”, patients with joint replacement surgery often still have some stiffness, reduced joint mobility and may notice some mild discomfort on wet cold days. To consider joint replacement, the patient must have enough dysfunction pre-surgery that the post surgical level of dysfunction is still an improvement.
Otherwise, the remaining options for chronic pain management should come as no surprise:
1. Weight loss – staying lean will help reduce the chronic stress on the bones and joints
2. Joint supplements – Oral glycosaminoglycans and chondro-protectant products are usually safe and have minimal side effects with chronic use. Some patients can appreciate noted benefit though some are only helped minimally by them. Adding omega 3 fatty acids also benefits some patients and is relatively easy and inexpensive to do
3. Polysulfated Glycosaminoglycan injections are one of the few things that can actually improve the condition of the joint cartilage. They tend to have very minimal side effects with long term use and are given twice weekly for 1 month then as needed every 2 – 4 weeks thereafter. Cost of these injections ranges from $40 – $70 each and you won’t always know if they are going to benefit your pet till after the first 4 week series are complete.
4. Non Steroidal Anti Inflammatory drugs (NSAIDs) can actually help with inflammation that causes pain. There are a number of products available for dogs (though only very few safe for limited use in cats). These products can vary in price from very inexpensive to very expensive. Their use is typically on an “as needed” basis. Because their long time use can tax the liver or kidneys, regular blood work may be required for chronic medication refills.
5. Pain drugs don’t do anything to affect the source of discomfort but they can help minimize your pet’s awareness of it. They too are used on and as needed basis when NSAIDs are either not an option or are not successful at managing the pain alone.
6. Acupuncture is available for pets by a few veterinarians in the central Arkansas area. While it does not help every patient, and does not “cure” arthritis, it can effect a temporary benefit for some and is very safe to use (if helpful) on an as needed basis throughout the lifetime of the pet. We can refer to you a local veterinary acupuncturist. If you would like to try it, call Dr. Karen Hooks at 223-5400 in Little Rock.
7. Topical Treatment Devices – over the years, many topical therapeutic devices have been used on people and pets starting with brass or copper bracelets. The next generation of products were magnetic. The most recent products have been laser therapy units and the newest up and coming products around the corner are therapeutic ultrasound and “magma wave” units. Responses to these products are variable both in clinical use and research trials. Studies have been done to compare their effect against no treatment but to date, no one has published a study that compared their efficacy to a warm compress or ice pack. Therapeutic ultrasounds are not yet readily available in our area however, if you would like to try laser therapy, we can refer you to a local practitioner for that effort. For Laser Therapy options, consider Dr. Laurie Geater at the All For Pets Clinic in Cabot 501-941-7387 or Villonia Animal Clinic 501-796-8400, or Dr. Tad Marvin at the Belleview Animal Clinic on Cantrel in Little Rock 224-2444 .
8. “Stem Cell Transplant” options are being sold from time to time to clients with pets desperate for relief from arthritic pain. Stem cell therapy and research are still in their infancy and while it may become a valuable therapeutic option, one should understand that the injection of stem cells into a joint does not produce the “re-growth of a new joint or joint surface”. Careful review of all the data provided by one of the leaders in this service for pets shows an expectancy of a 10% improvement compared to saline injections.
If your pet’s chronic pain is becoming a pain in your neck, call our office today to get started on a chronic pain management program.
Fever
We commonly have clients concerned their pet may be running a fever. Many people report that patient has “warm ears” or “feels warm”. They often are concerned if “the nose is wet” or dry or warm or cold.
Understanding Fever in pets is much simpler than all those worries. Dogs and cats have a normal body temperature of between 101.5 – 102.5 F. And the very best way to determine if they have a fever is with a little lube or Vaseline and a rectal thermometer. Because they normally run temperatures 3 – 4 degrees higher than you and I, they will often “feel warm”. If they have recently licked their nose, it will be cool and wet, if they have not – it will be warm and dry. The condition of their nose has absolutely nothing to do with any correlation to their body temperature.
Pets should never be given over the counter medications for “fever”. While human Non-Steroidal Anti-Inflammatories are rarely used for very specific diseases in pets, they have very narrow dose ranges outside of which they are TOXIC! Tylenol is particularly toxic to cats. Additionally, there is no reported safe dose of Motrin, Naproxen or Aleve that can be used as they are toxic at any amount.
Treating pets with fevers is best approached by treating the cause of the fever rather than the fever itself. The underlying disease does not go away by treating the fever so it should be identified starting with a comprehensive physical to look for localized evidence of disease and blood work or radiographs to get a bird’s eye view of those things on the inside of the body that cannot be seen from without. While fevers are often associated with infections, they can also be caused by auto-immune disease, neoplasia or cancer, inflammation, or bone injuries.
Don’t let fevers get you “hot under the collar”, call our office today and let one of our experienced caring doctors help you find a lasting solution.
Limping
Pets can limp from one of three basic fundamental causes: neurologic, soft tissue (muscles, tendons and ligaments) or orthopedic (bones and joints). The most common mistake made by caring owners is to try to address the pain with some form of home medication. Most Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) taken by humans like Aspirin, Advil, Tylenol and Motrin are not used in pets and many are TOXIC! So, if you find yourself being tempted to try these at home … slowly step away from the medicine cabinet and let us help.
The best course of action is to try to identify the source and cause of the pain and address that instead. This usually starts with a good physical exam with attention to neurologic and musculoskeletal systems. Often radiographs may be needed to image the bones or joints.
Bandaging and splints help many pets but to apply them safely, you need full muscle relaxation of the limb – usually impossible to do at home when it is painful. Applying a bandage too snug will often result in skin damage and sometimes worse. At home bandages should only be used to apply light compression to stop bleeding until you can reach our office or the After Hour Hospital if we are closed.
Don’t let lameness put a “hitch in your get-a-long” call our office today and let one of our experienced caring doctors help you find a lasting solution.
Medications Do’s And Don’ts
MEDICATION DON’TS
Pain Medication and NSAIDs
Aspirin, Advil, Tylenol, Motrin, Ibuprofen, Aleve and all other over the counter pain medications are all dangerous to use on pets at home. While some of these products are specifically prescribed for particular problems for pets from time to time, they should never be indiscriminately used because their margin of safety is very narrow, and their side effects are many – some of which can be fatal.
Antihistamines with Decongestants
Antihistamines are often given to pets for allergy issues however they should never be used if combined with decongestants as the decongestants are toxic.
Xylitol
This artificial sweetener is used in many medications, particularly children’s products and is toxic to pets so always make sure you read the ingredients in human products at home.
MEDICATION DO’S
Antihistamines
These can be given to pets for allergic reactions or insect stings.
Diphenhydramine or Benadryl is given at a dose rate of 1 mg per pound up to 50 mg. Dogs up to 10 lbs can take ½ of a child’s 12.5 mg dose; pets 10 lbs to 20 lbs can take one 12.5 mg child’s dose; dogs 20 – 45 lbs can take a full 25 mg dose and dogs over 45 lbs can take 50 mg. The dose can be repeated every 12 hours for up to 2 – 3 days but if you are needing it for more than 3 days, or if any additional symptoms develop, our office should be contacted for a veterinary visit.
Claritin and Zyrtec can be given as a daily dose of 5 mg for pets under 30 lb pets and 10 mg for dogs over 30 lbs. The dose can be repeated every 24 hours for up to 2 – 3 days but if you are needing it for more than 3 days, or if any additional symptoms develop, our office should be contacted for a veterinary visit.
Imodium AD (Loperamide)
Imodium can be given for diarrhea in many pets, however some specific breeds like sight hounds and collies can be particularly sensitive to it. Liquid Imodium can is used at a dose of ¼ teaspoon full for pets under 10 lbs; ½ teaspoon full for pets 10 – 20 lbs; pets 20 lbs – 40 lbs can take one 2 mg capsule; pets over 40 mg can be given two 2 mg tablets or capsules. This does can be repeated every 8 hours till diarrhea subsides for up to 3 doses – if diarrhea still persists or if any additional symptoms develop such as vomiting, lethargy or loss of appetite, our office should be contacted for a veterinary visit. Note: Imodium does not typically resolve nausea or vomiting.
Pepto Bismol
Pepto Bismol can also be used for diarrhea at a liquid dose of 1 teaspoon full for pets up to 15 lbs, and 1 tablet for pets 15 lbs to 30 lbs and 2 tablets for pets over 30 lbs. It can be repeated every 8 hours for up to 6 doses – if diarrhea still persists or if any additional symptoms develop such as vomiting, lethargy or loss of appetite, our office should be contacted for a veterinary visit. Pepto Bismol does not typically resolve nausea or vomiting.
Motion Sickness Pills
Dramamine (dimenhydrinate) or Bonine (Meclizine) can all be given to pets for motion sickness. Note: these products DO NOT resolve any other cause of vomiting. Either one can be given at a dose of ½ tablet for pets under 25 pounds and 1 table for all bigger pets. Bonine or Meclinzine is given daily but Dramamine (Dimenhydrinate) can be repeated every 12 hours for up to 2 doses. Both should be given 30 – 60 minutes prior to travel.
If your pet is vomiting from any cause other than motion sickness – call our office for a veterinary visit and treatment.
Insect Stings
Welcome to Arkansas, the Natural State. We have numerous biting and stinging insects in addition to two venomous spiders (the Black Widow and Brown Recluse). It is not uncommon for pets to have unfortunate encounters with unfriendly insects in our area.
While one or two stings may be manageable at home with a large breed dog, remember smaller dogs and cats do not have as much body mass to spread the pain of inflammation out over.
Honeybees and Bumble Bees will often leave an attached stinger – which should be scrapped away (not pulled if possible, as this could result in squeezing more venom into the tissue prior to removal). Wasps, hornets and yellow jackets do not leave a stinger behind and can thereby sting multiple times very quickly.
Pets can be given Benadryl at a dose of 1 mg per pound (. Be sure not to use sweetened children’s Benadryl as it may be sweetened with the artificial sweetener “Xylitol” which is toxic to pets. AND make sure you do not use antihistamines combined with Decongestants which are also toxic. Pets under 10 lbs could take 1/2 of a children’s 12.5 mg dose. Pets 10 – 20 lbs can take a full children’s 12.5 mg dose. Dogs weighing 20 – 45 pounds can take a standard 25 mg dose and all dogs over 45 pounds can safely take 50 mg orally. The 50 mg dose should not be exceeded but can be given every 12 hours for up to 3 doses.
While Benadryl is handy and helpful, it may not relieve all the discomfort. Sometimes adding a cold compress using an ice pack or frozen vegetables may help as well. will small pets and especially with multiple stings, some venom victims might need prescription strength pain and anti-inflammatory medications.
Spider bites are a completely different problem as their venom is much more damaging to the local tissue and can cause illness of the entire body as well. When faced with a Black Widow or Brown Recluse bite, the sooner you get professional medical attention, the better.
Let us help you take the sting out of insect encounters, call our office today.
Snake Bites
There are many species of snakes in Arkansas, most of which are harmless and many actually helpful. The local King Snake even eats dangerous venomous snakes. There are however, three species of venomous snakes. The Copperhead snake represents some 88% of snake bites in central Arkansas. Water moccasins also known as Cottonmouth’s account for some 10% with the remaining 2% from Rattlesnakes.
Snake bites are very painful. Snake mouths are full of very nasty bacteria which is injected with the venom. The venom itself causes tissue death, which, when coupled with the bacteria can produce sepsis or blood poisoning. Signs of snake envenomation are seen within 1/2 to 36 hours after the pet is bitten. Different snake venom can have a variety of effects ranging from bleeding to neurological effects. Typically, the first sign of snakebite will be swelling around the area that was bitten which typically worsens over the first 24 hours. In cases where the pet was bitten in the muzzle you might notice swelling in the neck region.
To some extent, snakes can control the volume of venom injected so snakebite cases can range from mild (typically when a small amount of venom is transferred or when envenomation occurs from a snake with low-potency venom) to severe (when a large amount of highly potent venom is transferred). There is no known way to diagnose or test how much venom was injected into the pet. Diagnosis is typically by witnessing the exposure, or by clinical signs such as swelling, pain or collapse after being outdoors. While some bite marks can be located from the bruising and swelling in a area many are quite inconspicuous and may require careful inspection and clipping of hair.
Treatment of patient with only a local reaction to the bite usually involves pain medication, anti-inflammatory medication, anti-histamines and antibiotics due to the amount of very nasty bacteria in the snake’s mouth that is injected with the venom at the time of the bite. However, many patients may develop systemic (whole body) symptoms which might include systemic shock, neurologic disorders, difficulty breathing, vascular shut down, clotting disorders and potential organ failure. Often, basic lab work such as blood and urine tests or a clotting profile may help assess patients plus give doctors a baseline for comparison as the patient’s condition progresses. Hospitalized care including fluids and IV medications may be necessary as well as oxygen support. In patients that develop systemic symptoms, antivenom is often indicated. Our office is one of the few in the state that routinely has access to multi-species anti-venom.
While they can be fatal, with prompt treatment many animals recover within 1-2 days, however hospital treatment may be as long as a week in severe cases with a further 2-3 weeks of rest at home to recuperate. Occasionally the venom site will develop tissue death and sloughing which might require more medical attention or surgical intervention should the area become infected.
We know that snake bites can be stressssssful. If your pet has had a close encounter of a slithering kind, call our office for medical care from our experienced and caring staff immediately.
Poison Exposure
Having pets ingest things they shouldn’t is not an uncommon problem. Lacking opposable thumbs, pet’s often use their mouth as a tool of examination and exploration. Not surprisingly, this frequently results in things being swallowed.
For many substances, there are some basic principles followed by emergency rooms. First and foremost is the principle of decontamination: trying to clear as much of the product from the system as possible. This often includes inducing the patient to vomit to try to evacuate things from the stomach if not already passed into the intestines for absorption. Vomiting usually relies on the exposure to have been within the last ½ – 1 hour. Vomiting should only be encouraged if instructed by a veterinarian and never when the exposure involves anything sharp or caustic (soaps, detergents, etc.). Activated charcoal is frequently given to coat the intestinal tract and minimize absorption of anything that got past the stomach. Typically, a cathartic is added to the charcoal to help speed passage through the system. Commonly, fluids are given to exposure patients to help increase metabolism and excretion of ingested products.
For cases when vomiting is not recommended, not successful, or simply not sufficient to clean out the system; gastric lavage/gavage (“pumping the stomach”) may be necessary. This often involves light anesthesia and having an endotracheal tube (breathing tube) placed down the trachea (windpipe) to help ensure that nothing back washes into the lungs. Warm water is pumped into the stomach, then syphoned back out again. This process is repeated until the return water is clear and clean. Afterwards, charcoal and cathartics are often administered, then the stomach tube is pulled, and the patient is allowed to wake up.
After decontamination is performed, therapeutic plans are established based on the nature of the offending product.
1.There are three common types of rodent bait. The first and somewhat more common of these compounds are blood thinners that bind with vitamin K in the body and prevent blood from clotting – causing the patient to bleed to death. Treatment plans for these will involve serial blood clotting profiles (blood test run every 48 hours for ~7 – 10 days) or the administration of Vitamin K for a long enough period of time for the coumarin to successfully clear the system. This can sometimes take 4 – 8 weeks. Many veterinarians will recommend a clotting test after several weeks of therapy to determine the length of treatment. The other two rodent poisons (bromethalin and cholecalciferol) are much more dangerous as there are no antidotes available and they require immediate treatment when pets are exposed. Successful treatment requires accurate identification of the poison so always keep packaging available for reference if these products are used around the house.
2. While small doses of chocolate won’t hurt most pets, chocolate can be toxic in large doses. Chocolate toxicity starts with a stomach upset at lower doses, moves on to neurologic signs like twitching and jerking at larger doses and then causes heart toxicity at higher doses which can cause cardiac arrest. Toxic levels depend on the strength of the chocolate. Darker, stronger chocolate is more toxic than lighter milk chocolate. Toxic levels can be reached with milk chocolate at about 1/4 oz. of chocolate per pound of body weight. Dark chocolate is twice as toxic with baker’s chocolate twice as toxic as dark chocolate. Cocoa powder is the most toxic at twice the toxicity of baker’s chocolate. After decontamination, many chocolate patients are hospitalized for heart monitoring. An accelerating heart rate could indicate the need for anti-arrhythmia drugs to calm the heart until the chocolate metabolites are out of the system.
3. Many pets are exposed to people medications by chewing on pill vials, and from medication falling on the floor. These products often produce the same symptoms in pets for which they are designed in people – through often the exposure is at dangerously high doses, since pets are smaller than we are. Blood pressure medications can cause dangerous drops in blood pressure, anti-anxiety drugs can cause depression and comas. Anti-inflammatories can often cause gastric and intestinal bleeding or major organ damage. Hospitalized treatment and monitoring of appropriate parameters is often indicated.
Pregnancy Problems
Babies can be a blessed event, but not if things aren’t going well. Gestation in dogs and cats lasts about 63 days. Normally the mother’s temperature drops about one degree the day before having babies. Discharge from the vulva will be seen when the time has come for delivery. Mothers need lots of privacy and should not be the center of attention, this will only slow things down. Contractions can be seen on the mother’s side and if she has had contractions for 45 minutes without producing a puppy, something is stuck, and she needs to come in. Half of puppies and kittens are born breech, so that is not an abnormal presentation. Sometimes several hours can pass between babies. If mom doesn’t clean the babies up well, you can remove them from the placental sac and give them a good rub down. The umbilical cord can be tied with thread or fishing line and cut, and the placenta can be thrown away. If a baby gets stuck, you can apply gentle traction with contractions to help things along but if you aren’t successful, an immediate veterinary visit is in order. If all goes well, mom and puppies should be seen on the day after delivery for a clean out shot and check over.
There are many issues that “complicate” delivery. Delivering one baby can be exhausting (ask any mother) but trying to deliver 6 is tiring to even think about. Some mothers have simply exhausted their ability to push any longer. For these patients, rehydrating fluids with a little dextrose (glucose – sugar) and calcium to “re-prime” the muscles of the uterus along with oxytocin (“Pitocin” drip) is all that is needed to get things moving again.
Successful stimulation of contractions does not however guarantee the delivery of a baby. And delivery of one baby does not guarantee that all will be successfully delivered. Babies that get stuck halfway out of the birth canal may benefit by an episiotomy. Babies that get stuck prior to, or within the birth canal are left with few options other than a cesarean surgery (C-section).
While not always completely accurate, radiographs also help give a general idea of the number of babies that should be expected and confirm that they are likely far enough along to survive delivery. Pre-anesthetic blood work helps determine if there are any underlying conditions that may complicate the anesthesia or surgery for the mother or the babies. Ultrasound can be used to determine if the babies are alive prior to surgery (though even if they are not, it only increase the need to have them removed).
General anesthesia is usually required along with IV fluids to help maintain mother’s blood pressure while laying on her back for surgery with the weight of all the babies on her aorta (primary artery running down the body). An incision large enough to exteriorize the entire uterus is made in the abdominal wall and the uterus is lifted out of the body, off the aorta. Once out, the uterus is cut open and babies removed. After removal, the babies are taken to a resuscitation area to be cleaned and stimulated to start breathing on their own. Mom’s uterus can either be sewn up (to allow for future breeding) or removed, (ovariohysterectomy or “spay”), to prevent future pregnancies. After, being sewn up, mom is returned to the ICU recovery area and started on post-operative pain medicine. Once awake, the puppies will be returned to her for imprinting and nursing care that only she can provide.
We recommend a pre-breading checkup as well as Pre-Natal visits at 3 weeks and 6 weeks post breading.
Hairballs
Hairballs are a common cause of gastric upset for cats and tend to be the first thing people think of when they have a vomiting cat. Interestingly, it should be noted that hairballs more often cause “hacking” followed by expectorating (spitting) out a hairball. Sometimes, however, it is true that hairballs will cause simple vomiting. It should be noted that hairballs do not cause illness, so if your cat is feeling badly in any way, its vomiting is not being caused by hairballs.
When cats groom themselves, they ingest hair. The longer the cat’s hair coat is, the more hair it ingests. Since hair is not digestible, it wads up in the stomach and becomes an irritating ball which is often coughed up and spat out by the cat only for the process to start over once again. Using lubricants orally such as laxative gels, capsules or food additives can help encourage regular passage the ingested hair along the intestinal tract with the daily diet to prevent the accumulation of hair to form a ball.
If your cat is hacking up small bits of hair, then a hairball is likely a problem. Administering a hairball medication may be a solution. If your pet is sick in any way or has any other symptom (diarrhea, listlessness, loss of appetite) then other causes of vomiting should be assessed.
Don’t let hairball concerns keep your stomach “tied up in knots”. If you have concerns about your cat’s health, call our office today for an appointment with one of our experienced caring doctors.
Car Accident
When assessing a High Impact Trauma (HIT) case, there are several things that your doctor will be considering and a number of things that will be discussed. Evaluations of HIT patients go from head to toe… literally.
Head: We are often concerned about evidence of possible head trauma, so, like in human emergency rooms, we often recommend hospitalized observation for 6-8 hours to make sure that signs of cerebral edema (brain swelling), or vascular injury (bleeding or bruising of the brain), don’t develop.
Chest: Injury to the chest could involve trauma to the lungs, the heart or an injury to the chest cavity that houses these two organs. Chest x-rays and ECG monitoring are often recommended to better evaluate for damage to this area.
Abdomen: The abdomen houses many organs and systems. Injury to the spleen or liver can cause abdominal bleeding. Tears in the kidney, ureters, bladder or urethra could cause uro-peritoneum, (free urine in the abdominal cavity). Trauma to the intestines or stomach could result in ingesta in the abdomen which can cause a potentially fatal peritonitis, (infection). To better evaluate the abdomen, your doctor may recommend an abdominal ultrasound and blood work.
Spine and Extremities (Limbs): HIT patients often suffer orthopedic injuries that prevent normal limb use. In addition to loss of motor function, injuries of the spine could also affect neurologic function of the bladder and colon. Radiographs of these areas may be indicated to help better assess the extent of orthopedic injuries.
While your patient is being assessed, there are a number of stabilization efforts often being made including but not limited to:
Pain Management… (lots of pain medications), Oxygen, Shock Therapy, Antibiotics
Because so many things can be happening at once, a lot of ground is often covered in a very short time. Sometimes decisions will need to be made quickly on your part to provide your doctor with consent to proceed with many of these procedures, and it can often be daunting and overwhelming.
We realize that while we do this very often, this is hopefully your first, (and only), time to ever go through such an event, and we will do our best to help guide you through things to help minimize any further “bumps in the road”.
Heat Stroke
Heat distress and Stroke are an all-too-common occurrence here in Arkansas. When the combination of the temperature and humidity exceeds a value of 150 (which it often does in the Arkansas summers) pets are at risk. Because pets don’t exchange heat the same way humans do through sweating and because they are always in a fur coat, heat distress and dehydration can develop rapidly. Those breeds with shorter faces tend to be at the highest risk because panting is not as efficient for them.
Pet’s whose temperatures rise above 105 are at risk for a cascade of metabolic events which can culminate in death. Temperature rise causes tissue damage in all the major organ systems which can cause developing multi organ failure. Additionally, a blood clotting dysfunction develops which can result in uncontrolled bleeding inside the body.
If your pet experiences a heat stress event, start by cooling them down quickly with water especially about the head, neck and feet, while in route to our office or the emergency room for an after-hour event.
Bleeding Transfusions
Causes of bleeding in pets can range from very small like broken or deep cut toenails to very large like trauma injuries. Toenail events may be stopped using a styptic pen or an application of corn starch or flour. Persistent bleeding, bleeding from an unknown cause (such as from the nose or urethra), and bleeding from any source of trauma are always justifications for an immediate veterinary visit. If there is a visible wound, the application of pressure may help control the bleed but if the pet is painful this effort could result in someone being bit … which only results in more bleeding! Tourniquets should never be used except to allow for the placement of a light compression bandage such as an ACE bandage. Bandages should be used only as a means to transport a bleeding patient to our office for wound assessment and hemorrhage control.
If too much blood is lost, a transfusion may be needed to replace the oxygen carrying red blood cells.
Even evidence of unexplained bleeding under the skin like bruising or blood blisters warrants immediate investigation.
Don’t let bleeding issues leave you feeling drained. If your pet is having any evidence of a bleeding problem, please call us today.
Seizures
There are many types and causes of seizures in veterinary patients and some “seizures” that are not seizures at all.
Episodes, involving the loss of limb function, loss of balance, loss of consciousness, loss of bladder or bowel control, muscle or limb tremors, bowed neck, or recumbent paddling (flailing the limbs while on the ground), usually fall into one of two categories: Seizures, (most often) – a central nervous system event; or syncope, (less often) – a cardiac event.
An ECG measures the electrical impulses across the heart. These impulses are represented by the characteristic wave and “beep” seen and heard from an ECG monitor. This electric wave is intended to produce a heartbeat, which in turn should produce a pulse wave of blood throughout the body. When something in the rhythmic system is wrong, waves occur without a responsive pulse. This arrhythmia can cause periods of reduced circulation to the brain and spinal cord and result in spontaneous, inappropriate or incomplete function of the nervous system. Such events can thereby produce symptoms very similar to seizures.
Performing an ECG can often identify the presence and type of arrhythmia causing the event, but some arrhythmias come and go (paroxysmal). For these elusive arrhythmias, 24-hour monitoring may be necessary to find the cause.
Causes of true seizures usually fall into one of five large groups: trauma; toxic; infectious diseases of the brain, spinal cord or their membranes (encephalitis/meningitis); metabolic (liver, kidney, electrolyte disorders, etc.); or primary brain disorders (epilepsy or tumors).
Blood work can help identify (or rule out) problems associated with primary organs, electrolytes and some infections. Additionally, some toxins (like antifreeze) produce characteristic changes in basic blood work. As with humans, an MRI is helpful in evaluation for scars in the brain from trauma or the presence of tumors.
There are no readily available tests for epilepsy. It is often a presumed diagnosis if there is no evidence of any other cause of the event. Epilepsy usually develops as a rhythmic cycle of seizure clusters or period. During this time period, patients may have several seizures, then “cycle out” till the next cluster period. Cluster periods can be separated by days, weeks, months, or years. Seizures that occur while in a cluster period will also often loosely develop a pattern in their number, severity, and length.
Patients that have a few, mild, short seizures, several years apart, will not likely be put on anti-seizure medication. Patients that have many, protracted, severe seizures, several days apart, will be put on medication. Everything in between is a judgement call made based on those parameters.
There are many seizure medications available and each patient reacts a little differently to each medication. Sometimes a little trial and error is necessary to find a program that best fits your pet. Depending on the severity of the event, our doctors will often start immediate IV medication to try and stop existent seizures and recommended appropriate diagnostics and monitoring of your pet to allow better assessment of seizures frequency and intensity.
While your pet is having a seizure, it is imperative that you remain calm. Pets won’t understand that your panic is from their seizure and may subsequently presume there is some other cause for panic in the room – thus making their seizure event worse. Do not try to force anything in their mouth – they won’t “swallow their tongue” but you will obstruct their airway and may get bitten in the process. Place them on a flat low surface to prevent falling and secure the area so they won’t knock things over on themselves.
The presence of one seizure is enough to warrant an immediate visit to our office to get help before the next one comes.
While seizures are an easy thing to get “all shook up over”, we hope that this information helps give you confidence when facing it as a problem with your pet.
Bloat
There is no cause of abdominal distention that is not a medical emergency, although some causes are more “emergent” than others. The most emergent of these causes results when the stomach distends with gas and twists on itself – referred to as Gastric Dilatation and Volvulous or GDV. While many causes of abdominal swelling develop over the course of days, GDV develops over the course of hours.
This terrible condition typically affects large breed, deep chested dogs like the Great Dane, German Shepherd, Boxer, Doberman, and Rottweiler. The cause of this devastating disease is often multi focal and, in and of itself, is a bit difficult to get a good handle on.
There are many predisposing factors to the problem which include but are not limited to: Breed anatomy (deep chested large breeds); heritable tendency (occurrence in close family members); diet; behavior/stress level; eating habits (voracious, aggressive eater or drinkers); and maybe exercise/activity levels after meals.
Typically, the event begins around 2 hours after a meal (usually the evening meal). The stomach fills with gas, (often swallowed while eating – especially in voracious eaters), and starts to distend, (bloat). As it inflates, the lower most part of the stomach rises, until it is above the top of the stomach, (where the esophagus empties). It then continues rolling across the midline to the right side of the body. This twist, (volvulus) closes off the esophagus and the intestine leaving the stomach like two ends of a balloon – nothing goes in, nothing goes out.
Because of the bacteria and food already present in the stomach at the time of the twist, gas starts being produced, (as with any digestive process). The gas builds with no outlet and continues to distend the stomach, eventually cutting off vital blood supply to the stomach itself as well as putting pressure on other major vessels in the abdomen and pressure on the diaphragm making it difficult to breath.
Treating the problem is just as complicated as its development. Once the stomach is returned to normal position, and the blood supply returns, it will flood with toxins from the bacteria that have been brewing in this closed system for several hours. So, first, the body must be prepared for the impending and developing shock. Fluids are starting in large volumes along with antibiotics, oxygen, and pain medication. Very early on, a stomach tube may be successfully passed through the twist, but often a trocar (large needle) will have to be inserted into the stomach through the skin to let the gas out and the pressure off the twisted esophagus. Once deflated, a stomach tube can be passed, and the contents of the stomach washed out to prevent further bacterial toxin absorption.
After decompression, the patient must be stabilized, and a surgical plan developed. Some patients will need surgery right away, (if tubes can’t be passed, or if there is a lot of bleeding in the stomach once the tube is passed). Some patients can take a few hours to stabilize, and some a few days. Ultimately, surgery should be done to evaluate the extent of damage to the stomach from blood supply loss and to tack the stomach down to the inner abdominal wall to help reduce the risk of the problem occurring again.
Treating this disease process can be extensive, can have prolonged recovery period, and should not be undertaken lightly. The costs and prognosis associated with this disease is enough to “make your stomach turn”. If your pet is exhibiting any evidence of abdominal distention, don’t hesitate to call our office immediately.
Difficulty Breathing
Patients having difficulty breathing warrant an immediate office visit. Problems can be related to the lungs themselves, the heart, the windpipe or the cavity in which all these are maintained. Oxygen supplementation is often needed to support patients while diagnostic steps such as blood work, ECGs and radiographs can be taken to better identify the problem source. Medical attention should never be delayed while “waiting to see if a problem will improve on its own”.
If your pet is showing any evidence of difficulty breathing, don’t let them turn blue over trying to save a little green. Call our office immediately.
