Category: Medical & Chronic Health (page 2 of 6)

Dear Gord

Guest Author – Mandy Jackson, RVT

Gord megaesophagus fosterI put a dog to sleep yesterday.  He was my foster dog.  He came to me quite ill, and with a disease I knew I couldn’t cure.  Gord had megaesophagus.  What that meant for him was that his esophagus, the “tube” that carries food from your mouth to your stomach, was stretched out like a balloon that has been blown up and deflated dozens of times.  The muscular contractions, called peristalsis, that help move your and waste through your body did not occur in his esophagus.  I described it as though he had something like a pelican pouch in his throat.  When he ate, much of his food and water would collect in this “pouch”, rather than being digested in his stomach and intestines.  He regurgitated a lot of what he was fed.  He came to me emaciated, needing to gain about 35% of his body weight, a daunting task for both of us.  How do you get a dog who can’t maintain his weight to gain 20 pounds?

megaesophagus foster walkMegaesophagus is an awful disease.  To have a beautiful, kind and gentle soul in your home, starving despite your best attempts to feed him is heartbreaking for you, but unquestionably worse for him.  We tried several different textures and consistencies and with the help of a friend who also cared for Gord in her home while I was unavailable, we learned that “meatballs” worked best for him.  I’d roll his food into golf ball sized nuggets and toss them to him one by one, hold him sitting in the begging position and then go for a short walk.  Water was more difficult, but I taught him to drink from a huge rabbit bottle mounted so he had to hold his head up to drink.  After 3 weeks of trial and error I finally felt like we were on the right path.  That maybe, just maybe, he could be managed.  That he could potentially live a “normal” life.  For almost 5 days he gained weight and strength.  He was producing more urine, and it was becoming paler in colour, showing that he was better hydrated than before.  He walked faster on our short travels, not rude enough to pull me, but enthusiastic enough that I could feel a difference in him.  I was so very proud of him.

And then, on Thursday, I went to check on him in his run at work.  To give him his dinner and spend my lunch break walking him.  He had vomited 3 puddles of blood in his kennel.  My heart sank into my feet.  I will not go into more detail here, but it’s most likely that 2 years of poorly managed megaesophagus left his mind and spirit willing to recover, but his body just too damaged, the last 18 hours of his life caused a shocking transformation in his body and spirit.

Deciding to end the life of a foster is a uniquely horrible experience.  He wasn’t really “my” dog, but I had taken responsibility for his life and his care.  He was mine in trust, on loan, my temporary dog. I was only supposed to be a resting place, a bump in his road.  But there he was, getting sicker in front of me and waiting for me to make it better.  Not able to tell me how he felt, what he wanted.  I sat on my couch with his big, blocky, black velvet head in my lap and promised him that I would make it stop.  My beautiful Gord was not Gord anymore.  For the first time since I met him, he was in pain and that was not part of the deal I made with him.  I took him to work, one last sad car ride.  Carried him into the treatment room and gave his care over to 2 of the loveliest people I’ve ever met.  At the end of his life I wasn’t his nurse or his foster mom anymore.  I was just his person, finally.  Gord of No Fixed Address (the horrible nickname I gave him, a joke that started when a friend suggested I adopt him) was at home in my heart.  I climbed up on the table and wrapped myself around him, buried my face in that perfect spot behind every retriever’s ears and held him close.  He went quietly, left this world in the arms of someone who loved him enough to make that call. Gord with bear

Dear Gord,

I’m sorry.

=======================================

Mandy Jackson RVT

Mandy Jackson is a registered veterinary technician at the Kingston Veterinary Clinic.  Mandy shares her home with her 2 dogs, Auden and Olivia, and her cat, Floyd Pepper.  When she’s not at work, she co-runs Friends of Willow Rescue (an all-breed rescue), is a busy foster-mom, avid reader and a recent convert to the joys of crocheting.

Diabetic Cats – Yes They Can Change!

Sal in hospital

Sal in hospital

The following is a true story (used with permission) of how diabetic cats can change their insulin requirements.

Sal is a 13 year old domestic shorthair cat who was diagnosed with diabetes in 2010.  He had been showing the initial signs of increased urination and having accidents outside the litterbox.  These signs, along with weight loss and increased drinking, are some of the most commonly noted first symptoms of diabetes or an alert to a pet owner that something is wrong.  Some cats may vomit, have a decrease in their appetite, or start to walk in a flat-footed position.  In later stages of not being diagnosed or treated, diabetic cats can have labored breathing and lethargy.

Insulin varieties

Insulin varieties

Back to Sal…  At the time of his diagnosis, he was started on insulin and his diet was changed to a higher protein, lower carbohydrate diet.  He had been doing well for a number of years and was considered to be a well controlled diabetic.  As part of our continuing care of these patients, we recommend doing a glucose curve every 6-12 months as part of their annual examination.  For some cats, we realize that the stress of the clinic setting might be too much for them and encourage home testing (which can be quite easy and most veterinarians will show you how!).  For cats that home testing is difficult either for the patient or the family (not everyone can stand the sight of blood), we do this testing in hospital.  Sal was one of these cats who fit into the latter category.

Hypoglycemia in diabetic cats

Hypoglycemia

Life happens and things don’t always get to go as planned; work or family obligations change, moving might happen, or the budget might be a little tight at times.  That’s okay and can be understandable…it even happens to us as vets too with our own pets and families.  Sal had been delayed in coming in for his annual check up.  His owner brought him in because he was seeming weak and hadn’t been eating well.  I examined him and checked his blood glucose level which was 1.2 (or 21.7 depending on your units)!  The average normal range for a cat is 4.0 – 9.7 (72.6 – 176).

So why did Sal present like this?  His signs were easily attributed to his low blood sugar (hypoglycemia) but his insulin dose had not been increased.  Well, it’s been known for some cats to convert to not needing insulin and their diabetes may be controlled by diet.  This is exactly what happened to Sal.  As he converted, his previously needed insulin dose essentially became that of an overdose.

Normal blood glucose

Normal blood glucose

Rest easy everyone.  Sal is doing fine.  We admitted him to the hospital and put him on intravenous fluids that contained dextrose to help bring his glucose levels up and remove the risk of seizures.  We checked his glucose levels without him getting insulin as well and he never went above the high end of normal so 2 days later he got to go home and now doesn’t need insulin injections!  For now he is doing well, but his family is still going to keep a close eye on him because there may come a time when he might need to start the injections again so he’ll be getting regular checkups from now on.

Disclaimer: All blog posts may contain opinions which are my own and may not reflect those of any current or former employers.

Thanks for reading and don’t forget you can subscribe on the right side to get new posts directly to your email!  And I’m now on Instagram @drryanllera and as always on Facebook, Twitter, and Pinterest!

Senior Pet Care – How You Can Help

senior pet dogPeople everyday are getting a new puppy, kitten, or other pet to join their family.  And yes, most of the time these new additions are just in their first few months of a long life.  For a few of these pets, we as veterinarians will see them for their initial vaccines, adoption exams, maybe a spay or neuter surgery.  Some of them will make annual visits for a check up while others we may not see for several years once they are much older or only if they are sick.  It’s these senior pets that we often can make the most difference in their quality of life.

I cannot stress enough the importance of an annual examination, or in the case of pets with chronic illnesses every 6 months.  This should start from the time they are young adult animals until their final days.  Early detection of a condition can save lives and keep pets healthier for longer.  Who wouldn’t want their furry kid to have a happy life for as long as possible?  That’s the first step you can do to help your pets with the aid of your veterinarian.  Yet, there are somethings you can do yourself or that you should pay special attention to help them out in their golden years.

buzby toe grips

www.toegrips.com

Mobility issues can be quite difficult to overcome but can make a significant improvement in how a pet feels.  Signs can be obvious from a noticeable limp to more subtle signs such as dragging a foot, difficulty with stairs, or a decreased appetite.  While some patients will benefit from supportive medications, the most important thing you can do is to keep them at a healthy weight!  If you have slippery floors, you should look at adding some area rugs or another idea is a product called Dr. Buzby’s Toe Grips.  These grips fit onto the nails on your dog and help them in getting traction so they can walk around better.  Another quick tip: If you’ve got stairs, consider a ramp.

cytology from a lump aspiration

cytology from a lump aspiration

Lumps and bumps are often seen as a part of growing old.  Sometimes these lumps can be benign but that means there’s also a potential chance for them to be malignant.  The tendency for many people tends to be watching the lump to see if it changes in size, color, temperature, or texture.  The problem is when those lumps grow in areas such as the legs which make it difficult to remove them entirely or not without a higher risk of complications.  Another risk if is the pet chews on the lumps or if they burst.  Let’s be honest for a moment…when someone tells me the lump wasn’t there yesterday, that can only be the truth less than 20% of the time.  So as my colleague Dr. Sue Cancer Vet says, “Why wait? Aspirate!”  Basically, if a lump is there for more than a month and is larger than a pea, you should get it checked out before it’s too late.

from dogs-looking-like-people.tumblr.com

from dogs-looking-like-people.tumblr.com

Much like people, senior pets can show signs changes in their behavior similar to Alzheimers disease in people.  In cats & dogs, we call this cognitive dysfunction.  There are no definitively effective treatments unfortunately but there are some things that can help.  In particular, some specialty prescription diets can help protect the brain from free radicals which can lead to oxidation of cells in the brain.  Hence, the idea of antioxidants can help to reduce this damage by blocking the reactions.  Something else to consider would be to go against the adage of “you can’t teach an old dog new tricks” and work/play with them to give their brains something to be challenged by.  Studies show that for people doing activities like crossword puzzles that encourage thought processes can delay or help fight the onset these changes so maybe there’s some hope that it could work for pets too.  Some ideas to work on are scent or food detection (think the object is under one of three bowls sleight of hand trick) or even reinforcing previously learned behaviors or tricks.

corneal disease

corneal disease

Other changes that you might notice might be with their eyes.  Some eye conditions may affect vision but could possibly be painful as well.  For some breeds such as brachycephalics (pugs, pekingese, shih tzus), they will often develop a condition called dry eye which while not necessarily painful, can be uncomfortable and cause a pigmentation of the cornea.  If they are going blind, just don’t rearrange the furniture.  Moving to the back end of the pet, incontinence is often over-represented as a presenting complaint when pets arrive at the clinic.  Yes, they may be leaking urine but in reality, the odds of a urinary tract infection, kidney disease, or diabetes creating urine overflow are much more likely.

Your pets aren’t “just getting old.”  While they are aging, they are living longer than they did 20 years ago and that means we’ll see more health problems.  There are many facets to the care of your senior pet.  You are their biggest advocate and need to be the watchdog over their health.  By noticing subtle changes and having them addressed as soon as possible, you can keep things from getting worse and making treatment less difficult & more promising.  A general rule of thumb is a check up every 6-12 months.  Senior pets are just like our older relatives, treasured companions that are still full of love; so be sure to take care of them!

Disclaimer: All blog posts may contain opinions which are my own and may not reflect those of any current or former employers.

Thanks for reading and don’t forget you can subscribe on the right side to get new posts directly to your email!  And I’m now on Instagram @drryanllera and as always on Facebook, Twitter, and Pinterest!

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