Rappie

Elevations in ALT reflects damage to the cells of the liver. The size of the elevation doesn't necessarily reflect the severity of damage or the reversibility of damage, although generally speaking larger numbers indicate more significant disease (200 compared to 1000 etc). In the absence of clinical disease, it is more important to monitor trends, a continuing upwards trend is a reason to investigate further. Although ALT indicate the liver is involved, there are several things that can make ALT go up like drug treatment, toxin exposure, hypoxia as well as liver disease. Maltese can have a higher resting bile acids level than other dogs, so elevations may or may not be significant. If you have an increasing trend the options are: - investigate --> blood tests (bile acids, ammonia tolerance test though this is less commonly done and not without risk), abdominal ultrasound to look for shunts and physical changes / nodules / masses within the liver. Further investigation is usually in the form of a biopsy - sometimes done under sedation with ultrasound guidance, or done via an exploratory surgery. - treat symptomatically --> liver diets, antioxidants / neutraceuticals like SAMe, silymarin, Vit E. Which path is chosen usually depends on a number of factors including the age and breed of the patient, whether there are clinical signs (or it was an incidental finding), whether there were any other abnormalities and how much investigation you are prepared to do to determine the cause.

I'm not aware of it either. There is new product from Elanco that does heartworm, fleas and intestinal worms but I don't know of any long acting tablets for fleas and ticks.

Chest radiographs would be the next step. It could be mild chronic bronchitis or there could be a mass or something causing compression of the airways (including a heart, but I would guess if the heart is normal that there is no murmur?). Edit to add: It's also probably a good idea to know this dog's heartworm status.

If we're only going away overnight, we ask our neighbours to come and feed our little dog. If it's any longer than that he goes to stay at work, where he is doted on by all the nurses. He's quite a social little beastie so he couldn't care less if we leave him with other hoomans

Crepitus is a fairly non specific finding, but it can indicate inflammation or bony changes within a joint (it also possible to feel 'crepitus' just from doing orthopaedic examination). Is is associated with pain on examination or limping? The best way to determine whether it is significant would be to radiograph the affected joints but that may not be possible in a rescue / rehoming situation. Edit: Certainly a second opinion is worthwhile.

Yes, including the one that turned out to be botulism. A few have required IV fluids but generally only for a few days until they are able to eat and drink without too much assistance. One of the hardest things is that it just takes time for them to get better and there is no set time frame. Mostly though I have seen them improve fairly quickly after 1-2 weeks.

Acute polyradiculoneuritis is quite uncommon but it's by not rare - I probably see about 1-2 cases per year. It's unfortunately often a diagnosis of exclusion but depending on the presenting signs there are a limited number of things that cause the same set of clinical signs. The other disease that can look like it botulism which should be considered if the dog has access to rotting carcasses, there is often facial nerve paralysis that can distinguish it from polyradiculoneuritis. Recovery from polyradiculoneuritis can take several weeks and there is no specific treatment - nursing care is the most important aspect of treatment.

'Colitis' is a non specific diagnosis and in general yes, it is diagnosed without biopsies and is quite common. For a definite diagnosis of histiocytic ulcerative colitis you should have a biopsy, but sometimes that isn't possible. It sounds like your vet is intending to treat with enrofloxacin given her comments about growth - this is the correct antibiotic and there are reports of it interfering with cartilage growth in young, large breed dogs but it is not something seen clinically at the standard dose rates. For treatment of general colitis then yes, I would generally go for a suitable antibiotic (usually metronidazole) and a low residue or hypoallergenic diet. I'd also be more inclined to continue this is a stable patient and pursue an alternate diagnosis if there wasn't sufficient response (ie, I was concerned about histiocytic ulcerative colitis). Colitis and haemorrhagic gastroenteritis aren't that uncommon in young dogs, particularly if they have a propensity to eat 'things that are not food'

A diagnosis of histiocytic ulcerative colitis should ideally be made after biopsying the colon and identifying bacteria within the mucosal wall. This along with tissue culture leads to the diagnosis, rather than just young Boxer + diarrhoea = HUC. If it is not HUC, then there are several general recommendations for colitis including definitive treatment for intestinal parasites including whipworm, a hypoallergenic or novel protein trial and fibre supplementation. However, if there is a positive diagnosis of histiocytic ulcerative colitis then there are several recent reports suggesting that a long course of treatment (4-16 weeks) with a specific antibiotic has lead to complete resolution. Feel free to PM me if you like.

It sounds as though the surgeon is concerned about rotation in the limb causing the patella luxation, which is something that would determined with radiographs and a thorough examination under GA. If the problem is 'just' patella luxation then a normal repair (probably with a triple technique) will resolve it. If the patella luxation is occurring due to an anatomical misalignment that affects the whole limb, doing a normal repair wont change the underlying problem and there may be failure further down the track. It may be that a normal repair will be sufficient despite an underlying problem but this is something that couldn't be decided without the GA and xrays.

There are other specialist surgeons at SASH - Andrew Marchevsky, Stephen Fearnside and Martin Havlicek. Also depending on location, there are other specialist centres as well like North Shore Veterinary Specialist Centre, Animal Referral Hospital and the Uni. I refer most of my orthopaedic cases to David Lidbetter. This is partly due to location, partly because he's an excellent surgeon who does loads of orthopaedic work.

He isn't really in a state to respond. Medications are not a quick fix, they're not going to solve your problems instantly. They reduce the general levels of anxiety and make the dogs more receptive to behavioural modification for their particular problem. Medications shouldn't be used alone, they won't achieve the specific results we want without teaching dogs what we DO want them to do. So - all the changes and routines you are already doing will still need to be done. If there is a lesser (or no) component of generalised anxiety and it is really only separation anxiety, then sometimes intermittent medication with a benzodiazepine (valium or xanax) can be used but these have no effect on the long term situation. They just reduce stress in the short term after dosing - which in some cases is very beneficial like dogs with a storm phobia, they can then be used whenever we predict there will be a storm. They do however interfere with learning and memory so using them along for a long term solution is not as effective as a daily medication. The traditional schedule of graduated departure for separation anxiety can be tedious, and some behaviourists that I've spoken to don't use it. They work on teaching a 'calm' cue, making your departure a fun time (having a game, then going to a mat with a treat) and then leaving - using this routine when you know you're only going to be a short time and are definitely coming back soon. Other times (if you don't know when you will return), just leave quietly after going through the stages of 'calm'. Difficult to explain properly in a few sentences. I wouldn't' discount medication as an option, it needn't have a stigma of failure associated with it. If you're considering it as an option, find a veterinary behaviourist and speak to them about it. It may not be what you decide to go ahead with but it will be a good place to get information from.

We use the term 'shifty' a lot at work. I'm wary of shifty dogs. Not so much the aggressive ones (we have ways, means and drugs for dealing with those), nor the fearful ones (ways, means and drugs for them too!) just the shifty ones. A slightly too confident manner, the mostly friendly until you want to do something one. Often owned by owners who either don't have a clue, or don't care (or both). As a gross generalisation, I'm wary of Maremmas, Belgian Shepherds, red Cattle Dogs and anytime our nurses say their dogs need their butts examined because that nearly always means by me

Just wrote a response and lost it, so here is the short version - I can elaborate if necessary. The result was most likely a total T4 which is common in many screening profiles from commercial labs. Normal total T4 indicates a normal T4. Low total T4 doesn't mean a great deal considered alone. A great number of non-thyroidal things may cause a total T4 to be reduced and it cannot be used alone to diagnose hypothyroidism. This is important to remember in skin disease, as some conditions will respond to thyroid supplementation even if hypothyroidism is not the primary problem. Investigation of hypothyroidism is only warranted if you have concurrent clinical signs consistent with hypothyroidism. Investigation will generally involve at least a free T4 by equilibrium dialysis and a TSH level. Testing the anti-thyroid antibodies can add weight to a diagnosis, but their presence alone doesn't indicate hypothyroidism, and doesn't warrant treatment if there are no clinical signs or other abnormalities on blood work. Recent thinking is that autoimmune thyroiditis and thyroid atrophy are part of the same spectrum and not distinct diseases. Regardless, it is important to identify ANY other underlying diseases as they may affect testing results.

It would really depend on the patient and the type of fracture, and whether you're specifically referring to the phalanges or digit (and not a metacarpal or metatarsal bone - which do require treatment). Digit fractures don't necessarily need definitive treatment, but any fracture will benefit from stabilising by placing a splint. If they are associated with a skin wound they may well require antibiotic treatment.

If it is vomited up, the client should contact Elanco - I think they will replace the tablet. It is usually only with the first dose that vomiting occurs. Stormie - the dermatologists at Murdoch recommend off label use of Comfortis for cats (I get Derm updates through the uni - I'm doing my Masters through Murdoch).

The eye drops providing lubrication are most often an adjunct treatment for KCS, but do nothing to modify the cause (which is mostly immune mediated). Panalog is used for because the steroid is fairly long acting, however cyclosporin is normally the treatment of choice (and is not cheap). Does depend to some extent whether a patient has "Dry eye" (KCS) or eyes that are dry (sometimes allergic irritation) as to what meds are used and whether eye lubricants are going to make a significant difference. Lots of human drugs are used but often the dose rate or frequency is different to that used in human medicine and require veterinary prescription.

Has a fine needle aspirate been taken already? If there's not a lot of room, having some idea of what a lump is before attempting removal is a good idea. There are some skin flaps that can be used to cover the hock, but they require some planning before and during surgery.

Bruce retired. The other opthalmologists are Mark Bilson at the Small Animal Specialist Hospital or Cameron Whittaker at the Animal Referral Hospital (where Jeff Smith consults).

My little dog sleeps in our room at night. He generally chooses to go to bed in his bed on the floor, but I always seem to wake up with him snuggled up in my arms He likes to lounge on top of the bed during the day, but always under the doona at night. I think it's quite normal, and always have a little chuckle at clients who are embarrassed to tell me they let their dog sleep in their bed. As far as I'm concerned, the only problems are if there's no room left for you, or if they wont get out when you ask.

Other than protophane, the two human insulins I know of used in dogs are Mixtard 30/70 and Humulin 30/70 which have a similar composition to Caninsulin. The formulations are not the same, but have the same ratio of short and long acting insulin components. The long acting insulin, glargine is the first choice of insulin in cats but is not used in dogs.

Is dosing scheme from the specialist or your regular vet? As someone else said, prednisolone is a very good drug with a bad reputation. It does it's job well, but is frequently used inappropriately. All drugs have potential side effects, however the long term side effects of steroid administration as generally seen with very long term treatment and/or at high doses. For skin conditions or acute inflammatory conditions, short reducing courses are indicated (initial dose for 3-5 days, then reducing over 1-2 weeks). For most immune mediated diseases though, a long reducing course is indicated, often a minimum of 8-12 weeks. I started my own dog on prednisolone for inflammatory polyarthropathy in March with a dose reduction every 2-3 weeks - he's only been on an alternate day dose for the last 2 weeks.

I have been a nurse mentor for a few nurses going through the Provet / Crampton Consulting vet nursing courses. The organisation of the course and standard of information provided is very good. Keen students will get a lot from it if they put the effort in. Although the course information is provided as theory, most nurses are also working in practice to develop the required practical skills.

The MRI may not be required, but an ear flush under GA is often the most effective way of cleaning out an ear regardless of the underlying cause. It is more efficient than regular ear cleaning, especially in cases where there is an anatomical problem such as narrowing of the ear canal. Alone, it will not solve ear problems but it is much more beneficial to apply topical treatment to a very clean ear than to simply keep applying it to a plug of wax in the ear. It is not a solution in itself, the underlying problem still requires investigation.

Except in the land of insulin!!! Human insulin is 100 IU / ml and the stanard insulin syringes are either 1ml (100 units) or increments of (mainly 0.3ml or 0.5ml). Caninsulin is an exception. The concentration is 40 IU / ml and if we are doing things correctly, then the appropriate syringes are also 40 IU /ml. These are a 1ml syringe, with a scale from 0-40 units. Here comes the tricky part (and where being pedantic is quite important). Sometimes (for reasons of practicality or economy) vets might prescribe Caninsulin and then give an owner standard 100IU syringes. In this case they have converted the dose (in units) to a volume (in millilitres). For example, if a dog is on 10 IU of Caninsulin, but you have a 100IU syringe (of whatever size 0.3ml, 0.5ml or 1ml), the dose is 0.25ml. The tricky part is that this if often referred to by owners (and sometimes, infuriatingly by vets) as "25 units", which is absolutely is not.