Rappie

I have been treating my own dog for an inflammatory polyarthropathy for the last few months. Luckily he has responded really well to steroid treatment. My dog also had some signs of neck and back plain, so I suspect his diagnosis should be expanded to be a polyarthropaty / arteritis / meningtis complex. However, I didn't go to a CSF tap so I can't confirm that. What sort of investigation was done before diagnosis?

Absolutely! Dental disease is just that - disease. It can affect a range of body systems (particularly heart and kidneys) and cause pain and discomfort. The signs can be quite subtle, and given the high percentage of dogs (and cats) that have some degree of dental / periodontal disease and show absolutely no signs, it's important that their humans keep on top of it. A dog or cat that chooses not to, or cannot eat due to dental disease hasn't got any other options - they need to eat to survive. The fact that they continue to eat with a festy pus filled mouth and loose teeth doesn't mean "they are fine because they eat well". I've done plenty of dentals on older dogs where they end up with very few, or no teeth and their owners notice an increase in their activity levels, appetite and general improvement in their demeanour afterwards. They make me happy - what doesn't are the cases where I might point out a single tooth, with root exposure, maybe a tiny bit loose, with some pus and recommend removing it - to have owners decline because it will fall out at some stage. We sure as heck wouldn't let that happen to ourselves

I have treated one case, but we did just do a review of the treatment options in my Masters course. The conclusion was basically that there is no single definitive method of treatment, however important factors were: * antibiotic therapy - the specific drug varies but will be one with good action against anaerobic bacteria (penicillin or metronidazole) * antitoxin - there is no consensus on the correct dose, it's use is somewhat controversial in the sense that there is no clear evidence that it works by the time a clinical diagnosis is made but nearly everyone would still administer it. It works by neutralising free toxin, so by the time generalised signs have occurred there may not be much toxin circulating. The dose is variable but generally speaking is lower than previously thought. * sedation - to limit stimulation as the muscle spasms are painful * muscle relaxants - as for sedation Other supportive therapy may be indicated like IV fluids, feeding tubes etc. In generalised cases, problems encountered are not usually related specifically to tetanus, but to secondary complications like aspiration pneumonia etc.

There is a similar human insulin but it's not exactly the same formulation as Caninsulin. If the cost of Caninsulin is becoming problematic then definitely speak to your vet - the human insulin is better than no insulin! There may well be a transition period, perhaps with more frequent blood glucose curves being required. Cats are generally more affected by insulin resistance and glucose toxicity to their insulin producing beta cells, if they are treated swiftly and fairly aggressively with insulin they can go into remission and a non-diabetic state. Dogs generally have insulin dependent diabetes due to a lack of functioning beta cells.

Your dog has more than one anatomical problem (two luxating patellas and hip dysplasia) and is overweight. I would second (third and fourth) a second opinion from a specialist. There may not be a question over the diagnosis but I recommend a specialist opinion on how to best manage this case to determine whether the hips or patellas are the primary, or most painful problem and what the best management options or surgical procedures might be required. The options you have for surgical specialist are The Animal Referral Hospital (Homebush), Small Animal Specialist Hospital (North Ryde) or Parramatta Veterinary Surgical Specialists (David Lidbetter, Parramatta).

Glad you've got an answer! He'll feel much better when the hairs are gone.

I think for most purposes, the testing that we have it adequate IMHO. I would tend to use the anti-thyroglobulins as a further piece of the puzzle, if I believed that a dog was truly hypothyroid and needed further evidence to support that. Having a positive result for antibodies does NOT make a dog hypothyroid but does mean that it has autoimmune thyroditis. However, until the point that it's thyroid function declines, it's not a hypothyroid dog, it's one with thyroiditis which needs it's thyroid function monitored. It's important to recognise that for the most part hypothyroidism is a disease syndrome, not necessarily a distinct and definite state of being and we need to have clinical signs referable to hypothyroidism to diagnose it. It's also important to recognise that there are some dermatological conditions that are 'thyroxine responsive' even when a dog is not hypothyroid. It's generally considered to be inappropriate (in most cases, not all) to do treatment trials with thyroxine unless all reasonable avenues for testing have been undertaken. There's also been some recent work published to suggest that the older dogs with 'thyroid atrophy' are actually probably the end result of younger dogs with autoimmune thyroiditis and that the two clinical syndromes represent each end of a sliding scale, not two separate conditions.

Diseases that are not thyroid related can cause decreased levels of thyroid hormones, without causing true hypothyroidism. Any chronic stress increases the level of cortisol to be secreted which can also affect the measurement of thyroid hormones. It mainly affects the serum total T4 (TT4), but it may affect the other levels including the free T4 unless it is measured using the equilibrium dialysis method (which is considered the gold standard method of measurement, and is less affected by non-thyroidal illness). That said, if a general blood profile is run and happens to include a TT4 and this level is normal, the dog is unlikely to be hypothyroid.

I think a thorough vet check and general blood work, urinalysis and faecal testing is in order. I wouldn't underestimate the effect that severe skin problems can have on body weight and general metabolism, but I wouldn't necessarily jump straight into thyroid testing given the potential effect of non-thyroidal illness on the results. That's not to say it will not be indicated at some point, but I think that general investigation is required first.

I concur. It may require sedation and magnification to find them, but for a recurrent ulceration like you describe I'd be looking for sources of chronic irritation.

The guidelines are generally the same here Staranais.

My own dogs are fed dry food only, but I don't have a specific issue with other diets so long as they are balanced and the dog does well on them. Broadly speaking, I'd allow about 25-30% of "other" added to a dry food before I started to get too concerned. Neither of them have EVER refused food, but the few times they have taken longer than a minute to finish there has been a medical reason behind it. So I don't think boredom with food will ever be an issue with them. I feed one Eukanuba Premium Performance, the other gets either Euk Small Breed Maintenance, Royal Canin Small Breed Adult or Optimum Small Breed Adult (depends on whether I remember to order food, pick it up from work, or have completely run out). They rarely get bones because they both super food motivated and even when separated it will keep tensions high for hours. They both love chews and one adores her solid Nylabone.

Colitis is a symptomatic diagnosis - it's not specific for any one cause, which means that often there is a degree of trial and error involved. It may reflect a food allergy, which is most commonly due to the protein source (often beef, lamb and chicken). In these cases, a hypoallergenic or novel protein diet trial are worth a go. Colitis can also be fibre responsive, but sometimes responds better to a low residue diet. Sometimes it is a reflection of inflammatory bowel disease. Metronidazole (an antibiotic) is commonly used, particularly in cases where the colitis leads to blood in the faeces as it has an anti-inflammatory effect on the gastrointestinal tract. Some cases with resolve with dietary modification, some require further investigation like endoscopy for biopsies. I have also found it useful in chronic and severe cases to test the Vitamin B12 and folate levels - although correcting these will not resolve clinical signs, it can help restore the body's levels while further investigation is done. Sometimes long term meds (steroids and others) are required, but ideally these are started after a more specific diagnosis is made.

Increased fibre was the first thing I listed, dietary management was another. Flushing under GA is only indicated in cases of infection, impaction or chronic inflammation. Management of chronic anal sac problems should involve identifying and treating underlying medical problems, hence the comments regarding a variety of causes and treatments. No, you're just an owner of dogs that do not have chronic anal sac problems.

Anal sac issues are generally not a primary problem, but reflect another issue. Sometimes this is anatomical, sometimes dietary (due to size of the faeces or food allergy) and sometimes secondary to generalised skin allergies. Very generally, I'd try increased fibre and expression, flushing and antibiotic infusion under anaesthetic, then a hypoallergenic or novel protein diet trial if they did not resolve. It depends on whether the issue is just full anal sacs causing irritation or mild chronic inflammation or impaction of the sac as the treatment is different. Fibre is added to increase faecal bulk so that there is increased pressure on the anal sacs, also associated with a modest increase in the effort required to pass faeces. Passing hard faeces (such as those with increased bone content) is not necessarily of benefit, and can often lead to constipation and even obstipation.

I was in one of the first years through Sydney Uni to complete the course with the final year consisting of internship rotations within the university clinics and in private practice. We did surgery practicals on cadavers sourced ethically sourced through the pound. The dogs were not euthanased for us, they were already scheduled to be euthanased (and how they end up in the pound is an entirely different problem to whether vet students use their bodies after the fact). A brief survey of my personal Facebook list shows that of my cohort there are a great proportion of vets in general practice, I have worked with several of them, one is a practice partner, on has gone on to do human medicine, another management. We have a diagnostic radiology resident in the UK, a surgical resident in the US, a dentistry resident in the US, avian and wildlife residents in New Zealand and a game park/zoological vet in Africa. I work with two vets who graduated a few years before me who are both surgery focussed and went from graduation into hospitals with high surgery load. I love medicine, neither of them do - we all graduated from the same type of program. I would hazard a guess that although non recovery surgery helps to develop skills prior to graduation, after that point the learning curve is so steep that skill development will really be dictated by the first practice/s you work in and the support you get. I quite like surgery, I'm a competent surgeon but I don't do much in the way of orthopaedics. Neither does my boss. One of our 'surgeons' will (figuratively!) elbow me out of the way to get at a ruptured cruciate, but would be one of the first to send a diabetic ketoacidosis my way. After a certain point, not having done something before becomes less of an issue. The great thing about being a veterinary graduate is that we have a great range of adaptable skills. We won't have seen everything that comes through the door at uni, or done everything that needs to have been done but that doesn't preclude us from being capable of doing it when we have to.

There could be an underlying problem, it might come back, but not necessarily if it's been treated beyond resolution. How's that for a non specific answer :D

The long term prognosis would depend on several factors including the age of the dog at the time of diagnosis, whether the dog has localised or generalised demodectic mange, the treatment protocols and any underlying medical conditions etc. I have had good success using an induction course of oral ivermectin followed by weekly injections of doramectin. I usually treat for a minimum of 12 weeks unless there is very rapid clinical improvement, but even then I treat for at least 4 weeks past clinical resolution. Most of the cases that do not respond to treatment are due to incomplete treatment (not turning up regularly for injections) or underlying disease that requires further investigation. The occasional dog will require long term treatment (even life long).

I'm a small animal veterinarian, I've been posting here since I was a student at university and this is may main out of work contact with 'the dog world'. Since then I've worked solely in small animal practice. I've since done a postgraduate course in Behavioural Medicine and I'm currently doing a Masters in Veterinary Studies. I own two dogs that I adopted from Monica's Doggie Rescue, have recently avoided being suckered into bring another dog home from work.

All of this and more. My primary interest is the welfare of my patients, however standing up and being their advocate frequently just gets you an earful of abuse from the people that are supposed to care about them. It is balanced out by the great people and great pets and great experiences. Knowing that you've saved an animals life even though the owner then abused you for the bill (happened once this week) and knowing that even when you've got nothing to work with you can still try to save a life (and then get sworn at, happened today) and then, there's those times where you save a life just for the heck of it because it makes you feel good inside (I have recently done surgery on a super sweet stray dog to make him rehomeable, with the blessing of the pound - he's still hanging out with us). As flippant as my signature may sound, there are definitely days I wish I was just a secretary or something.

It could be any number of things, and if you are concerned I would get a vet check sooner rather than later (ie tonight if she is looking worse). Panting may be a sign of pain in general, or potentially any kind of gastrointestinal disturbance ranging from something simple (upset GIT due to worm treatment) to more serious causes like pancreatitis, gastric ulceration etc. There are no specific contraindications for combining the medications you have listed, but you have no provided any information about her medical conditions.

GE Care Credit is often offered as an alternative when the clinic is not able (or willing) to offer an account. The options otherwise are payment in full prior to discharge, having the surgery done elsewhere for less or not doing it at all.

Definitely speak to someone about your concerns, either the practice manager (if they have one) or one of the senior vets. I would even suggest that you do it before you go back for the ear check so it is organised before your recheck. For a patient I've never seen before, I generally do a general physical examination first and come back to the main problem at the end but it does sound like your initial concerns were not addressed, nor your requests in the consult. The clinic won't know that there is a problem unless their clients let them know and you have every right to discuss your concerns with them.

A pyometra is abdominal surgery, not a 'spey', and the pathologic process of developing a pyometra affects many body systems not just the uterus itself. Costs depend on where the surgery is done, what is included, how long the dog is in hospital etc. There will be an often wide variation in cost and also what is included so it is important to compare like with like.

Is the dog clinically unwell? Have other things that cause excessive urination (and thus drinking) been ruled out? You can PM me if you prefer. Edit re: side effects.Adverse effects are uncommon, and usually related to irritation of the eye after administration. Hypersensitivity reactions can occurs but are quite uncommon. Humans sometimes report having headaches, which is possible but sometimes difficult to determine in veterinary patients. The main contraindication for using the drug is in patients that are predisposed to developing thromboemboli, which is not your average patient (usually those with heart disease or hyperadrenocorticism).