Skin Disease: Atopy

Skin Disease: Atopy

This is the most common presenting problem in patients I see at Olive Road. Florida ranks number one in the country for Heartworm Disease, Flea Allergy Dermatitis and Atopic Dermatitis. Florida’s tropical climate is a haven for mosquitoes which cause Heartworm Disease, fleas which cause an Allergic Dermatitis and various grasses, pollen, trees and dust mites which cause Atopy. In addition to Flea Allergy Dermatitis and Atopy is Food Allergy Dermatitis which also causes skin disease either alone or in combination with the other two syndromes. So, basically 3 things cause skin disease I see daily in my practice:
  • Flea Allergy
  • Atopy
  • Food Allergy
  • In this article we will discuss Atopy.
Atopic Dermatitis is a syndrome characterized by pruritus or itching. Atopy is an inhaled or contact type allergy similar to hay fever. Florida is a tropical, humid climate which is conducive to heavy pollenQA, thus this syndrome tends to affect pets year round. Other than blooming plants, dust mites, fleas, grasses and trees also contribute to atopic dermatitis.

There are two types of testing for Atopy:

  • Intradermal skin testing
  • Elisa (RAST) testing
Intradermal skin testing involves injecting small amounts of antigens (allergy particles) under the skin and observing for wheals (allergic responses).
Elisa (RAST) testing involves obtaining a blood sample and sending it to a special allergy lab to be evaluated. This is very common in human medicine, but is not as reliable for animals.
The goal of therapy is to keep the patient comfortably pruritic or itchy. It is almost impossible to rid the pet of all itching, but again the goal is comfort.
Recommended treatment involves treating concomitant disease such as flea allergy and pyoderma (skin infection). Desensitization injections based on Intradermal skin testing or Elisa (RAST) testing provides about a 50% improvement in about 50% of patients. Treatment is usually for the lifetime of the pet. Other studies cite 30% to 70% improvement and treatment cost can be in the several hundred dollar range.
Atopy is very responsive to steroid therapy. Prednisone given on an every other day regimen has proven extremely effective and economical. Most patients need only short infrequent courses of therapy certain times of the year. Side effects include increased thirst, urination and appetite and tend to be does dependent.
Antihistamines are effective in 10% to 30% of cases and may decrease the need for steroids. Examples include hydroxyzine, diphenhydramine, clemastine and others. In my experience, antihistamines have not proven very effective, but are always worth a try before steroid therapy. Another product that may help is Derm Caps (omega 3 and 6 fatty acids) given orally and is also found in some foods (IAMS Lamb and Rice).
Overall, my approach to skin disease involves a step wise progression through these past three months of health columns. I hope these articles have helped you to further understand the etiology and in turn the treatment of the most common diseases seen in veterinary practice.
In the next article, we will discuss Food Allergy.

Health Certificates

Health Certificates

Every year, we see a number of little furry holiday puppies and kittens in for post purchase checkups. This year was no exception! People pay large sums of money for pets without Health Certificates! Whether a person pays a penny or thousands of dollars for a pet, a Health Certificate is required by law, in Florida, to be provided to the buyer from the seller. This document certifies a pet is 8 weeks old, had its first vaccinations, been checked for intestinal parasites and dewormed if necessary, is free of any contagious disease and congenital defects and examined by an accredited veterinarian. (Accreditation means the doctor has met certain requirements by the state which enables them to sign Health Certificates; not all doctors can sign Health Certificates.)
Unfortunately, Health Certificates are not required in Mississippi or Alabama. This year, I saw a Boston Terrier puppy with mange, an eye ulcer and heart murmur bought for $600 from Mississippi; a Persian kitten from a pet store locally covered with Ringworm which is extremely contagious (the new owner had it) bought for $650; a Bichon puppy with a ectopic ureter (tube from kidney bypasses the bladder so the pet dribbles urine continuously) bought in Alabama for $350 which will be surgically repaired at a cost of $2300; plus a few others! As you can see, it is best not to buy a pet without a Heath Certificate! It is always heart breaking to destroy a new owners excitement and joy with bad news of a serious and potentially fatal health problem. If the state you a purchasing a pet from does not require a Health Certificate, make sure there is a clause in the purchase contract that allows you to have the pet examined by your veterinarian and returned for a full refund if there is a problem!
Please feel free to contact the office if you have any questions about breeds or breeders. Most of our clients have very good examples of certain breeds and we will be glad to direct you to the breeder they know and trust.

Euthanasia

Euthanasia

One of the most difficult tasks of my job is performing euthanasia or more commonly “putting a pet to sleep”. No owner wants to make this decision, but understanding that euthanasia can be a final act of kindness for their beloved friend may make this decision a little more bearable. Dr. Michael Schaer at the University of Florida, once gave me a heart to heart talk about euthanasia and when it is an appropriate course of action. He said in his 30-plus years of practice, the patient always dictates his course of treatment, but with consideration to the educated owners’ desire. In doctor’s words, look at the patient and its disease, quality of life, can you improve any aspect for the patient or the owner and if not, consider euthanasia. In owner’s words, you know when it is time to end a patient’s life when they stop interacting with the family, stop eating, drinking or having normal bathroom habits, have a treatable or untreatable disease that carries a horrible prognosis or certain death…in other words, a poor quality of life. Personally, my father died in a nursing home after years of strokes destroyed his physical and mental status. To be honest, there were many times I wish euthanasia could have been available to end my father’s tremendous suffering. Everyone, myself included, wishes their pet will pass away in their sleep, but unfortunately, this is a very, very rare occurrence. Euthanasia is a painless, quick procedure which ends physical suffering for the patient and helps start emotional healing for the owner. Procedurally, a special concentrated barbiturate injection (only used for this purpose) is given intravenously to the patient which stops the heart and breathing. The patient feels nothing and death is instantaneous.
Euthanasia is the most difficult decision an owner can make for their pet. Although not always possible, I try to educate the owner about the disease and prognosis long before a decision has to be made. Having the ability to end a good friends’ suffering, when nothing can be done, is truly the greatest act of kindness an owner can provide.

Feline Heartworm Disease

Feline Heartworm Disease

Canine and Feline Heartworm Disease share only one similarity…both are transmitted by the mosquito. Florida ranks first in the country for heartworm disease in both the dog and cat.
Past teaching in veterinary colleges was that when cats got this disease, it would cause only a transient illness and the patient would fully recover. However, over the past few years, research has shown about 30% of all cats either have been exposed or possess the disease. Indoor cats are more susceptible than outdoor cats to heartworms.
Symptoms include vomiting, asthma like symptoms, lethargy and poor appetite. In some patients however, there are no symptoms and death is sudden. In canine disease, as many as 50 to 100 worms may reside in the right heart ventricle and pulmonary arteries whereas cats may only have 1 to 2 worms in the lungs. Hence, a common symptom is an asthma like syndrome.
Currently, supportive care is the only treatment.Some patients will respond and recover and others will not. Unlike canine heartworm disease, testing is unreliable. Two tests currently available are the Antigen (detects heartworm material in the patient’s body) and the Antibody (examines the patient’s immune system for heartworm exposure). A positive or negative response to either or both tests does not rule in or out heartworm disease. In most positive tests cases, the patient has only been exposed to the disease and infection never occurred. Usually, further testing such as radiographs and bloodwork are required to fully assess the disease status.
Although there is no cure for this potentially deadly disease, there are two preventatives available: Heartguard (ivermectin) which is a chewable product given every 30 days that most cats dislike and Revolution (selamectin) which is a topical product also used every 30 days. Revolution not only prevents heartworm disease, but also treats fleas, ticks, ear mites, intestinal parasites and skin scabies. It is very easy to apply and should be used every 30 days. Unlike canine heartworm disease, Revolution may be used regardless of heartworm status. That is, the dog must have a negative heartworm test result prior to using prevention, whereas in the cat, it is not necessary.
If you have any questions to this puzzling disease, please don’t hesitate to call the clinic.

Canine Heartworm Disease

Canine Heartworm Disease

The Southern states rank first in the nation for heartworm infection (Dirofilaria Immitis). Florida is first among the southern states and therefore first in the nation for this deadly disease.
The mosquito transmits heartworm disease. This occurs by a mosquito obtaining a blood meal from an infected dog and then injecting the larvae in a non infected animal. Over a 6 month period, the larvae develop into adult heartworms and reside in the right side of the heart and vessels leading to the lungs. Adult heartworms begin to produce microfilaria (baby heartworms) which will also develop into adults in about 4 to 6 months. If the infection is allowed to continue, the dog will die from right sided heart failure or a complication thereof.
Diagnosis is quick and easy. The American Heartworm Association recommends an antigen (occult) heartworm test be performed once to twice yearly depending on location and incidence of heartworm disease. The antigen (occult) tests for adult heartworm protein in the patient’s blood. It takes 10 minutes and is virtually 100% specific. Ninety-nine percent of dogs with mature heartworm infection are antigen positive (have an infection). It is imperative your pet be tested at least yearly for heartworms even if you are diligent about giving prevention once monthly. Giving an infected pet heartworm prevention can be lethal and I have seen it occur throughout my career.
There are several heartworm preventatives on the market. Two products we carry are Heartgaurd Plus (Ivermectin/Pyrantel) and Revolution (Selamectin). Heartgaurd is a once a month chewable preventative for heartworms and also intestinal parasites. It does not provide flea or tick prevention. Revolution is the newest product on the market and is applied once a month topically to the skin. It provides heartworm, intestinal parasite, flea, tick, ear mite and skin scabies protection. As with all preventatives however, nothing is 100% effective and is why testing is necessary at least yearly.
We treat 5 to 6 cases a year for heartworm disease costing the owners $400 to $600 per case. Not only is it much less expensive to use a preventative, but also obviously better for your pet. If you have any questions regarding heartworm disease or prevention, feel free to contact the office.

Pets Have Teeth Too!

Pets Have Teeth Too!

A recent study was just published stating pets with regular dental care can live 2 to 4 more years. It has been known for a long time that humans can live 10 more years if they floss regularly. In my opinion, dental disease contributes more to poor health in pets than any other factor I see in my practice. Routinely we see abscessed teeth, severe periodontal disease, decay, ulcerative inflammation and other problems which in turn causes heart murmurs, kidney failure, liver failure, tonsillitis, tracheitis, bronchitis and the list continues. Most of these problems can be avoided by regular dental care by the owner as well as by the veterinarian.
Regular care starting with simple brushing of the teeth daily ideally or every other day usually suffices. It is tolerated by most pets if started when they are young, however older pets may tolerate brushing if consistently and gently approached. One should use a soft child’s toothbrush and special enzymatic toothpaste such as C.E.T.(Do not use human toothpaste as the fluoride can make them vomit). If the pet will not tolerate brushing, regular dental prophys by the veterinarian will suffice. Dental prophys involve general anesthesia which scares some people. Anesthesia is a risk and will kill less than 1% of pets and people in this country each year. However, modern anesthesia and vital signs monitoring available these days have virtually eliminated anesthetic deaths, but it is impossible to eliminate all risks. Pets teeth are examined then ultrasonically cleaned and polished. We offer progressive dental care such as root canals, crowns, fillings etc. for clients who request this service. These are all outpatient services and most pets go home the same day unless extensive work is performed.
Genetics play a role in the frequency of dental prophys needed. Some cats and dogs need dentals once or twice in a lifetime, whereas some will need work every 6 months to a year. Poodles, Yorkies, Dachshunds, Schnauzers, Chihuahuas tend to need care at least yearly and usually more frequently. Pets whohave received regular dental care throughout their lives are healthier and less expensive to care for as they age.
If you have any questions about dental care or prophys, please give us a call.

Identification of Your Pet

Identification of Your Pet

There are many ways to identify your best friend just in case they become lost. Our office gets many calls each month from pet owners looking for their lost companion. Most people rely on a rabies tag or personalized tag which affixes to the pet’s collar. The problem with this method is that collars are easily lost or removed. Another method of identification is tattooing the pet. The problem with this method is the serial number does not easily identify the pet owner with local clinics or animal shelters. The most reliable and easiest method of identification is via the microchip.
Microchipping is a safe and painless procedure. We place a topical anesthetic on the skin between the pet’s shoulder blades. The microchip is manufactured in an administration syringe and injected under the skin. This procedure is very quick and similar to the pet receiving a vaccine. After the microchip is placed, a special scanner is used to read the number inside the microchip. This number registers the pet to the clinic who placed the microchip. Essentially, every clinic and animal shelter have a scanner and is the first thing which is performed when stray pets are rescued. The microchip is permanent (unless the owner wishes to have it removed) and accurate.
A few months ago, the news ran a story on a pet in the Panama City area which was returned to its rightful owner after 7 years. The pet wondered away from its home and was rescued by a couple from out of state whom at the time was vacationing in the area. Unable to locate the owner, the couple took the pet home to Ohio. Years later, this couple returned with the pet to visit Panama City for a few days. While visiting, the pet became lost and was picked up by the local animal shelter. The pet was scanned, identified and returned to the rightful owner. Therefore, it is easy to see why microchipping your pet is a smart move.
If you have any questions regarding microchipping you pet, please don’t hesitate to call the office.