Monthly Archives: August, 2012

Check your dog’s mouth for cancer : Dr. Kathryn Taylor (Board Certified – Oncology)

The oral cavity is the fourth most common site of cancer in the dog. Malignant melanoma is the most common malignant oral tumor comprising 30 to 40% of all oral cancer. Oral melanoma is significantly more common in Poodles, Scottish Terriers, Dachshunds, Cocker Spaniels and large breed dogs with a pigmented mouth such as the Chow Chow.

Oral melanomas are often diagnosed late in the course of disease with the presence of local, regional or distant spread of cancer (metastasis) at presentation. Early diagnosis is an important key to finding an effective therapy. Therefore, it is important to look inside your dog’s mouth regularly. Even a brief exam by lifting up the lips and looking at the back teeth each month may allow you to find these masses earlier. If you notice any swellings or masses in your pet’s mouth, bleeding from the mouth or a foul odor to the breath contact your veterinarian immediately. Below is a picture of a non-pigmented oral melanoma in the right upper jaw of a dog. While many melanomas are black in color, some have little to no black pigment.

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About chemotherapy: Dr. Michelle Wall (Board Certified-Oncology)

Chemotherapy in Pets

There are numerous preconceived beliefs regarding the use of chemotherapy for our four legged family members.  Most of us have unfortunately either personally experienced chemotherapy, or have witnessed a family member or close friend undergo treatments.  Since many of our first time clients assume chemotherapy would be a dreadful experience for their pets, and therefore are understandably apprehensive to choose this route for their furry family members, we decided to discuss chemotherapy in pets.

What is chemotherapy?

Chemotherapy drugs are compounds that are toxic to cancer cells.  Chemotherapy may be given by intravenous (in the vein) or subcutaneous (under the skin) injections, or by mouth.

How does chemotherapy work?

Cancer cells generally multiply very rapidly.  Most chemotherapy drugs work by damaging the ability of these rapidly growing cells to divide, eventually killing them.

What are the benefits of chemotherapy? 

  1. Chemotherapy is the most effective single treatment for some types of cancer, offering the best opportunity for remission while at the same time preserving a good quality of life.  A good example of this type of cancer is lymphoma.
  1. Chemotherapy is often recommended after surgical removal of a malignant cancer.  The purpose of chemotherapy in this setting is not only to prevent recurrence of the cancer at the original site, but also to prevent spread (metastasis).  Examples of cancers in which chemotherapy is used in this way is hemangiosarcoma of the spleen in dogs and malignant bone tumors in dogs.
  1. Occasionally, chemotherapy will be used alone for the treatment of cancers in which it is not possible to perform surgical removal or radiation therapy, or in cancers that have already metastasized.   In most cases, the goal of treatment will not be to cure the cancer, but rather to improve that patient’s quality of life temporarily by reducing pressure, bleeding, and/or pain.

Are there risks or side effects associated with chemotherapy?

There are risks involved with any type of treatment for cancer.  Some normal cells will be injured and killed by the chemotherapy.  Side effects may be apparent because of these normal cells being killed.  However, these side effects are usually outweighed by the benefits of killing the cancer cells.

Dogs and cats tolerate chemotherapy much better than human patients do.  We do not use as intensive of a dosing regimen as is utilized in human oncology.  The two side effects encountered most commonly in our animal patients are toxicity to the gastrointestinal tract and toxicity to the bone marrow.  Normal cells in both of these areas divide very rapidly, so they are more susceptible to the toxic effects of the chemotherapy.  When the cells lining the gastrointestinal tract are affected, the result may be vomiting and/or diarrhea.  Most patients will experience this side effect at least once or twice during their course of chemotherapy treatment, but the symptoms are usually mild and can be overcome with supportive care at home.  White blood cells are cells of the immune system responsible for fighting infections.  The bone marrow produces these cells (called progenitor cells).  If these progenitor cells are damaged, the patient’s white blood cell count may drop low enough to result in an increased susceptibility to infection.  Even bacteria to which a patient would normally be resistant can cause serious illness in this situation.  White blood cells are therefore monitored very carefully.

Hair loss in cats and dogs receiving chemotherapy is usually very minor, with some notable exceptions.  If you own a poodle, Old English sheepdog, schnauzer, puli, lhasa apso, shih tzu, bichon fries, terrier, or maltese, you should expect that your pet will lose a significant amount of hair during the initial stages of chemotherapy.  However, the hair that is lost will grow back after your dog’s course of chemotherapy has been completed, or once the treatments are being administered less frequently.  Cats do not usually lose hair, although many will lose their whiskers.

Is chemotherapy expensive?

Treatment of cancer with chemotherapy can be costly.  It involves the use of the same drugs to treat human cancer patients, and many of these are expensive.  In addition, your pet will benefit from the expertise of several highly trained health care professionals.  The exact cost of chemotherapy varies with the size of the animal, the number of treatments, and the drugs being administered.

Is it safe for me to be around my pet during the time he/she is receiving chemotherapy?

Generally speaking, the risk f a person becoming exposed to significant amounts of chemotherapy as a result of handling their pet is very low.  We do not recommend changing you or your pet’s lifestyle as part of chemotherapy treatments (i.e. do not ban your pet from sleeping with you if this is part of their normal routine).  Some of the chemotherapy drugs that your pet may receive may be found in trace amounts in their urine or feces for 1-2 days after administration.

The most important goal is quality of life for your family member during the entire chemotherapy protocol, and after.

 

Luna’s Story – Dr. Carrie Davis

Dr. Carrie Davis  
Learn a Lesson from Luna’s Misfortune!

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Luna came into our ER after a horrible accident.  She was to travel a short distance with the owner in a vehicle.  Her owner thought it would be safest to tie her in the bed of the truck, so she could not jump out and injure herself.  However, she did jump from the moving vehicle.   The leash held her dangling from the truck.  Thus, allowing her toes, feet and butt to be dragged on the fast moving pavement.

Luna was carried in to the ER by her owner.  She was unable to walk due to the pads of her feet literally getting burned off.  Her toe nails were ground down to the bone.  She was in excruciating pain.

After stabilization, over 1 hour of anesthesia and wound care, she was hospitalized in the ICU on aggressive pain control, antibiotics and supportive care.  All 4 of her feet were bandaged, the hind feet most severely damaged.  She required daily sedation and bandage changes to promote healing of new skin and to prevent infection.

After 4 weeks, >$1200 in treatments, bandages, medications and loving care, Miss Luna is still recovering.  Her front feet no longer require bandaging and are to healing well.  Her back feet still require bandage changes every 2-3 days.  One of her hind feet may require a skin graft, due to the severe damage to her weight bearing foot pad.

This was a loving owner who never meant for any harm to come to the beloved pet.  Please let this accident be a lesson to all pet owners!  Let’s prevent another injury of this nature!  Spread the word and be safe!

Luna’s Lesson:

Please transport your pet’s safely inside a vehicle.  They should be secured in a pet safety belt, so that they cannot be tossed about the vehicle.  If they are in a crate, be sure this is securely fastened in the vehicle. 

If they must be in the bed of a truck, be sure there is a secure, attached kennel for their safe travel, with adequate ventilation.

Do not allow your dog to ride freely in the bed of a truck. 

Do not tie your dog to the bed of the truck for travel.

Image  Luna’s feet upon arrival to ER

 

Image  Luna’s feet now

Title : Interesting Visitor by: Danielle Cromb ( ER Technician)

 

Here at Veterinary Specialty Care we have plenty of visitors. Most of them are owners who are coming to see their beloved pet while he/she is  being treated in our hospital. Some visitors, however, aren’t at all what you think!!!!  Meet Maximus, a rainbow parrot who could not be left at home (Myrtle Beach) without his beloved canine housemate Jake the German Shepard. Jake’s dad had to make a special trip back to Myrtle Beach to get Maximus after he found out Jake needed to be hospitalized.
Jake was able to go and spend some time visiting with dad while Maximus proceeded to groom him from head to toe. It was an awesome site to see these two very different species get along so well. It should really serve as a lesson to us humans….can’t we all just get along??

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Frequently Asked Questions about Cancer in Pets

How common is cancer in dogs in cats?
Cancer is the number one natural cause of death in geriatric cats and dogs, and it accounts for nearly 50 percent of deaths each year.

What causes cancer?
The cause of cancer in animals, just like in people, is largely unknown. There are certain breeds that tend to get cancer more often than others. There are environmental factors, such as sun exposure, that may be associated with an increased incidence of cancer. However, not enough is known about the causes of most cancers to completely prevent them.

What are the signs of cancer?
Like the American Cancer Society’s “Seven Early Signs of Cancer,” the Veterinary Cancer Society and the AVMA have developed a list of 10 common signs, to educate pet owners about cancer.

     * Abnormal swellings that persist or continue to grow
    * Sores that do not heal
    * Weight loss
    * Loss of appetite
    * Bleeding or discharge from any body opening
    * Offensive odor
    * Difficulty eating or swallowing
    * Hesitation to exercise or loss of stamina
    * Persistent lameness or stiffness
    * Difficulty breathing, urinating, or defecating

Can cancer be treated in animals?
Yes. Surgery, radiation therapy, and/or chemotherapy are three of the most commonly recommended treatments. While some cancers can be cured, many are managed long term and some progress despite our best efforts.

 Is cancer in dogs similar to cancer in people?
Yes! Many cancers in dogs behave in a very similar manner to cancers in people. Bone cancer, bladder cancer, lymphoma and multiple myeloma are just a few examples. In fact, some of our veterinary research in pets with cancer has lead to advances in the treatment of people. We hope that this connection between people and pets with cancer will improve our ability to find cures for all types of cancer.

Kathryn Taylor, DVM, MS, DACVIM (Oncology)

Veterinary Specialty Care, LLC
 

Read the Pet Docs newest article!

PET DOCS: New procedures offer better prognosis for cardiac patients

  • Pet Docs
  • Posted: Sunday, August 12, 2012 12:01 a.m.

 

A pacemaker (small, pointed end near bottom center) is attached to the wall inside of a dog's heart. A fluorscope helps the cardiologist guide the device from the jugular vein down to the heart.
ProvidedA pacemaker (small, pointed end near bottom center) is attached to the wall inside of a dog’s heart. A fluorscope helps the cardiologist guide the device from the jugular vein down to the heart.

 

Just like our human counterparts, veterinarians are constantly improving what we can offer our animal patients.

Cardiac patients who in the past would have had dramatically shortened lives now can live a decade a more thanks to newer, minimally invasive procedures, which are available to treat myriad conditions.

Stenosis

Pulmonic stenosis is one of these. Dogs with this condition are born with a narrower pulmonary artery, which takes blood from the right side of the heart to the lungs. This will eventually cause the right side to fail, resulting in fluid accumulating in the abdomen, fainting and exercise intolerance.

Using fluoroscopy, which is a radiograph in real time, a veterinary cardiologist can guide a balloon down a vessel and to the narrowed area.

When in place, the balloon can expand the narrowed area allowing blood to easily pass through.

The earlier these are corrected, the better patients do as, over time, the heart changes may not reverse even after treatment.

PDA

Another congenital defect that can be corrected with this technique is a patent ductus arteriosus. In the womb, a puppy does not need blood to pass through its lungs. The ductus arteriosus allows blood that would have gone to the lungs instead to be diverted to the aorta.

At birth, this vessel should close so blood will fill the lungs and be oxygenated.

A PDA occurs when the vessel remains open (patent). Over time, this abnormal flow of blood taxes the heart resulting in heart failure.

Using the fluoroscope, a cardiologist is able to pass an occluding device down a vessel and into the PDA and close it off. The ability to do this means we no longer have to go into the chest cavity to tie this PDA with suture. This, too, should be corrected at an early age to prevent irreversible cardiac changes.

Heartworms

Heartworm disease is an ever-present problem for dogs in South Carolina.

Most dogs can be treated with a medication that kills the worms.

Occasionally, a dog will have so many worms that it cannot wait for the medication to work.

Here again the cardiologist can pass a grasper down the jugular vein and into the heart, using the fluoroscope as a guide, and extract the worms.

This does not remove every worm but decreases the worm burden enough to where the dog can tolerate the medication to kill the remaining worms.

Recent case

While working in our North Charleston practice recently, I (Dr. Perry Jameson) received a call that I was needed at the Mount Pleasant hospital to assist in putting in a pacemaker.

Three years ago, I would have been trying to stabilize this patient myself and then send the family to the veterinary school in Raleigh, N.C., hoping the dog would survive the trip.

This time, however, our cardiologist, Dr. Ryan Baumwart, only wanted me to provide an extra set of hands.

He had a 1-year-old Labrador/chow mix that was collapsing every 5 to 10 minutes.

Her heart was either stopping because of 10-15 seconds of sinus arrest or racing with episodes of ventricular tachycardia.

We had to try to get her heart beating at a normal rate and rhythm soon.

He made a small incision in her neck to expose her jugular vein. He then inserted the pacemaker down this vein and into her heart. During the mere minutes it took to get the pacemaker in place (it felt more like an hour), she was going in and out of her arrhythmias.

Once it was in place, Baumwart connected the pacemaker, and her heart rate immediately normalized. It took about another 15 minutes for my heart rate to get back to normal.

About an hour later, this dog that could not go five minutes without fainting was up wagging her tail and barking for attention.

“Without the pacemaker, she would have died. We really had no other choice,” Baumwart said following the procedure.

Dr. Henri Bianucci and Dr. Perry Jameson are with Veterinary Specialty Care LLC. Send questions to petdocs@postandcourier.com.

Read an interesting case by our neurologist, Dr. Peter Brofman

Intervertebral Disk Disease

Presented by Veterinary Neurosurgeon, Dr. Peter Brofman, DVM, MS, ACVIM

peterbrofman@gmail.com; www.facebook.com/drpeterbrofman

 

One of the most common reasons I see pets from the Charleston, SC area in need of a veterinary neurosurgeon is intervertebral disk disease (IVDD). IVDD occurs when the intervertebral disk degenerates resulting in extrusion or protrusion of disk material causing compression of the spinal cord and/or the nerve roots. Clinical presentation is variable and your pet may have mild signs of intermittent pain or severe signs with paralysis of the limbs and loss of any sensation. The intervertebral disk is made of a jelly-like inner nucleus pulposus and a fibrous outer ring called the annulus fibrosus. The disk acts as a cushion between adjacent vertebrae (back or neck bones). Effectiveness as a cushion is dependent upon the water content of the nucleus pulposus and the integrity and flexibility of the outer annulus fibrosus.

There are two main types of disk protrusion that may occur. Type I IVD extrusion most commonly occurs in chondrodystrophic breeds (long and short dogs such as the Dachshund). In chondrosytrophic dogs the disks undergo degeneration between 8 months and 2 years of age (75% of disks are degenerating by 1 year). The degeneration results in loss disk flexibility and calcification and then often ruptures causing a sudden onset of signs. This rupture may be precipitated by an activity but is also often a result from less strenuous, everyday activities.

Type II IVD protrusion is more commonly seen in nonchondrodystrophoid breeds (example; German Shepherd) and usually at a later time in life. These usually present with a more chronic and gradual onset of signs. While the Type I and Type II disk disease are more likely to occur in the respective breeds as stated above, this is not always the case and either may occur in any breed.

 

There are many diseases that may present with signs similar to IVD herniation, including meningitis, fibrocartilaginous embolism (FCE; a spinal cord stroke), diskospondylitis, and others. Diagnosis of IVD herniation cannot be made from plain x-rays and requires advanced imaging, such as a myelogram, CT scan, or MRI. All imaging modalities require general anesthesia. Myelograms are x-rays taken following the injection of a liquid dye into the subarachnoid space (similar to an epidural injection) so that it outlines the spinal cord. A CT scan and MRI do not require the invasiveness of the subarachnoid injection and give much more detail and information than the myelogram. Their costs are often greater than a myelogram; however, a myelogram carries risks that the MRI and CT scan do not, such as seizures, worsening of neurological signs including complete paralysis, bleeding into the spinal cord or brain, or fatal reactions to the contrast. The pros and cons can be discussed more specifically on case by case basis with each owner.

Based upon the history and signs being exhibited will help determine the best treatment options for IVD herniation. In some cases with mild weakness or short term pain, conservative medical management may be appropriate. In cases of severe or chronic pain, severe weakness, or rapid worsening of signs surgery may be a more appropriate choice.  Again, these options will be discussed in more detail on a case by case basis. With surgery the prognosis for recovery is generally quite good with approximately 90% of the patients regaining function of their limbs and being pain free. The chance of recovery is less in patients that have lost sensation in their limbs. As with any surgical procedure, there are risks of anesthesia, bleeding complications, or worsening or no improvement of neurological signs, however, these are uncommon.

Postoperative care at home will vary depending upon the neurological status of your pet. All pets need to be restricted for at least 4-6 weeks. Some pets may require manual expression of their bladder, range of motion exercises of their limbs, and sling support to get them around.

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Case presented by Dr. Peter Brofman, DVM, MS, ACVIM (Veterinary Neurosurgeon)

Pedro’s story

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Pedro came in to our clinic with a sudden onset of back pain. He was able to walk but had constant, severe pain that made him cry out any time he tried to move or was picked up. His pain was located in his lower back near his tail. Possible causes included a bulging disk, an infection or inflammation of the spinal cord, or a spinal tumor. Because Pedro was in so much pain, we immediately performed an MRI to try to find out what was responsible for his pain and how we could help him. Within an hour we had an answer, although, it was an unusual finding. There appeared to be an infection of the muscle under the lower back bones (lumbosacral). This is a very rare condition. Images of the MRI are attached in this presentation. Despite antibiotics he seemed to be getting worse, so we performed surgery to take samples of the muscle to see if it was bacterial or if it was cancer. The biopsy confirmed it was a bacterial infection and when placed on the appropriate antibiotics based upon the testing he rapidly improved. Four weeks later Pedro was doing great and was running up and down the lobby of our hospital. He is now at home and back to his old self and soaking up all the love his family has to give him. We were all so excited to see him recover and finally be pain free again! Great fight, Pedro (and family)!

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Make a first aid kit for your pet!

Q We want to put together a first-aid kit for our pet but are unsure how to get started. What do you recommend?

A: We recommend that every pet owner have a well-stocked first-aid kit for their pets.

Most of the items are the same ones needed for us, so they might already be in your human first aid kit. You can have a shared kit or one that you put together specifically with your pet in mind. Here are the specifics:

Phone numbers. You should have your veterinarian’s number for daytime questions and emergencies, as well as the number to an emergency veterinary clinic for questions and emergencies that happen after hours, on weekends or holidays. It is also a good idea to have the number for the Animal Poison Control Center (888-426-4435). This helpline is staffed 24 hours a day, 365 days a year. They can let you know whether a trip to the animal ER is warranted.

Body weight. Have a current body weight written on the same card as the important phone numbers. Dogs and cats are not like people, where we all pretty much take the same size pill. Their doses are based on their weight, which means they can vary dramatically.

Roll gauze. This is a multifunctional piece of first-aid equipment for animals. Its main purpose is to wrap wounds and hold bandages in place. Never wrap too tightly, as you can cause more harm than good by cutting off blood flow below the bandage. This also can be used as a muzzle. When in extreme pain, even the most docile pet may try to bite. Often a soft gauze muzzle will help protect you and allow you to help an injured animal when moving one with broken bones.

Nonstick bandage. These are bandages that can be placed directly on a wound. This allows a wound to be covered so it remains clean or allows you to apply pressure to control bleeding.

Adhesive tape. A roll of 1 inch medical tape is used to secure gauze wraps and bandages.

Hydrogen peroxide. If your pet has ingested a toxin, you want to eliminate it from the body before it is absorbed. Hydrogen peroxide will induce vomiting in most dogs and cats. Always contact a veterinarian before administering. There are certain poisons where vomiting may make the situation worse. Also, the veterinarian can calculate the safe amount for your pet.

Digital thermometer. Just like in humans, temperature is an important way to determine how sick a pet is. Temperatures in pets are taken rectally. It is important to remember that cats’ and dogs’ temperatures normally are higher than ours with normal being 100.5 degrees to 102.5 degrees.

Syringe. This is useful in administering liquid medications orally, force feeding a liquid diet or flushing debris from wounds.

Muzzle. Even though gauze can be used for a muzzle, it does not work as well as a true muzzle. Make sure it is sized properly so it is comfortable but not too loose. Do not muzzle if they are vomiting or having trouble breathing.

Leash. This allows for easy restraint if the pet can walk.

Tweezers. It is better to remove ticks with tweezers than by hand. You want to remove the tick’s entire head, as leaving it in place may cause inflammation or infection, and this is hard to do with your fingers. Tweezers also are helpful for removing splinters.

Antihistamine. Dogs and cats frequently come in contact with snakes and other insects, which results in a bite or sting. Antihistamines administered early on may decrease the severity of the inflammation. Diphenhydramine is a good one to keep on hand. Touch base with a veterinarian before administering to ensure you give the correct amount.

Blunt-ended scissors. Are useful for cutting bandage material, tape and gauze.

Antibiotic ointment. A general purpose antibiotic ointment for humans is useful to apply to small, superficial wounds. Remember that pets will lick it off if not bandaged.

Antiseptic wipes. These can be used to clean a wound. Betadine or chlorhexidine are recommended over alcohol because they sting less.

Customize. If your pet has an existing illness, you may want to have a specific medication to treat that problem. For example, for diabetic dogs and cats, it is a good idea to have honey or Karo syrup on hand in case their blood sugar drops. Also, if you have an epileptic dog, valium that can be given rectally during a seizure might be in your kit.

With a well-stocked first-aid kit, you will be prepared to administer aid to your pet when a veterinarian is not readily available.

Once stable, get your pet immediately to a veterinarian, as first aid is never a substitute for veterinary care but may save your pet’s life until you can get him to the ER.

Dr. Henri Bianucci and Dr. Perry Jameson are with Veterinary Specialty Care LLC. Send questions to petdocs@postandcourier.com.

Pet Safety Sundays


Pet Safety Sunday’s
A FREE monthly lecture series for the public presented by:

Dr. Carrie Davis, ER Veterinarian of 8 years

All lectures held at:
Veterinary Specialty Care
985 Johnnie Dodds Blvd.
Mt. Pleasant, SC

843-216-7554

www.facebook.com/drcarriedavis

To register for any of the lectures please leave your name and number of people attending by posting to Dr. Davis’s Facebook page, Veterinary Specialty Care’s Facebook page, by calling 843-606-9100 or by email to DRecupido@veterinaryspecialtycare.com

 Schedule of Topics:

 August     “Backyard and Household Toxins”   August 12, 2012 @4:00 PM
Learn the common dangers that are lurking in your pet’s environment!

 September   “Know your pet’s normal parameters and basic handling tips”
September 16, 2012 @ 4:00 PM
Learn how to take a heart rate, respiratory rate, temperature and to examine your pet for abnormalities.  And tricks on how administer medications!

October  Pet Basic First Aid” October 14, 2012 @4:00 PM
Learn how to help at home before transport to the veterinarian: Choking, lacerations, broken toe nails, wounds, snake bites, approaching an injured pet, how to transport an injured pet, seizures and more.

This is NOT a certification course. 

 November  Pet CPR” November 4, 2012 @ 4:00 PM
This is NOT a certification course.

 December  ” Dog Bite Prevention”   December 2, 2012 @ 4:00 PM
Focus on child safety around dogs.  Bring the kids!  Free coloring books to all children