Rappie

^^^ This is my recommendation too - particularly when dealing with a mast cell tumour.

speak to your vet about the options - they may be willing to write scripts, or dispense a larger quantity to reduce the dispensing fee for you. As Karly101 mentioned, Percorten injections may be appropriate for your pet too.

At this point in time, Scottie has an elevated level of ALT - nothing more and nothing less. I tend not to get too excited by levels that are <3x the upper limit and would proceed in much the same way as your vet is at the moment. I am always super pleased to read that some blood testing is done in older dogs when planning to start anti-inflammatory medications. Althoug there may be changes in various levels, they do not always prevent us from using NSAIDs, but we might change our plan or use alternatives. I think a course of antibiotics is a reasonable place to start, as a subclinical cholangiohepatitis is reasonably common in older dogs. Re-testing after the course of antibiotics is complete is going to give more evidence about what the ALT is doing - is it just a blip in time, is it trending upwards or downwards etc etc. There are a few important things to keep in mind about liver levels - with specific reference to ALT in this case. They are frequently a source of much concern, triggers for a lot of investigation and causes of much stress! ALT is what is referred to as a leakage enzyme and is released into the body after cell injury or cell death. The level of increase is related to the NUMBER of cells injured, not the SEVERITY of the damage and it can also be released from regenerating cells. It is also really important to realise that an the levels of the liver enzymes do not reflection liver function. You can have a huge elevation from an acute stress to the liver and normal enzymes in a failing liver (because there are so few healthy cells to release the enzymes!). This is where monitoring trends is more important. Mild elevations in ALT can be also associated with some drugs, cellular injury, muscle injury and heart disease. So, I would not go into full on crazy dog mum mode just yet :laugh: Finish the antibiotics, retest the ALT then develop a plan with your vet - whether that be ongoing monitoring to establish a trend, or further investigation with bile acid testing or abdominal ultrasound. With respect to his dental disease if there is significant tartar build up then dental treatment under anaesthetic would be indicated. This can still be done safely despite the ALT elevation with due attention to medication choices and consideration of his general condition. Once you have a clean, healthy mouth then meticulous home care with daily brushing would be required, and if other mechanical means of reducing plaque and tartar accumulation (such as t/d, chews etc) are not possible then consider supplements such as Healthy Mouth or Plaque Off.

Echoing other posts, corticosteroids are very useful medications however have bad reputation and a tendency to be used inappropriately. Although they are not without side effects, when used judiciously the risk of more serious side effects from short term use is quite small. Developing diabetes secondary to such use would generally suggest that there was an underlying problem or that the patient was, for some reason, already predisposed to developing diabetes. In most circumstances diabetes is life long once it develops but there are a few select circumstances in which it may be transient.

There is Linda Vogelnest and her resident Phillipa Ravens at SASH, Beth MacDonald at the University of Sydney Teaching Hospital and Danielle Hoolahan at ARH. I have had most contact with Linda and very good feedback from clients, the practices I have worked at recently have a close relationship with SASH but that is no particular reflection on the different referral hospitals.

Thanks for the update - hope it all goes well. I'm glad you feel more comfortable with the information and decision making process now

If the teeth are loose then extraction is the best option. Although the teeth themselves may be healthy, there is not much that can be done if the periodontal attachment has been lost. It is unfortunately very common in small breeds and it's not always easy to identify an underlying problem - there is less surrounding tissue, less root to be held in, sometimes particularly in small white fluffy breeds there can be an abnormal inflammatory response. If it is possible, then dental radiographs at the time you get the procedure done would be ideal to identify any other issues with other teeth that can perhaps be dealt with pre-emptively. Unfortunately once there is root exposure and gingival pocketing involved with a loose tooth, they will just serve as a place to accumulate food particles, plaque, tartar and bacteria and serve to lead to further deterioration. Although we do try to save the larger teeth like canines and carnassial teeth, this is sometimes only plausible with meticulous home care and from the point of view of removing a source of pain and discomfort extraction is sometimes the better option. For fractured or damaged teeth with otherwise healthy attachments, veterinary dentists can use procedures like root canals to save teeth. Apart from some cosmetic issues such as protruding tongues and wayward dribble, most dogs that have full mouth extractions cope extremely well.

Some species of white contain thiaminase when raw, which is an enzyme that breaks down thiamine (vitamin B1). It is destroyed by cooking but when active will break down thiamine from any food.

You aren't alone in the deer in head .ights / dumbstruck feeling. Lots of clients do it, I have done it when I go to the GP :laugh: that's part of why I come on here, to answer the questions you have when your clarity returns or explain some things more fully in the hope that you can then more confidently discuss things with your vet. I've heard some pretty dumb questions but nothing you've asked even rates on that radar (you have to try pretty hard!)

It is possible to get quite a bit of information from the in house urine testing (using a dipstick) but the interpretation really depends on what the original results were and what they are now. If there was evidence of infection previously (such as higher pH) and that resolved but bod remains positive then a physical problem might be more likely (like stones or a mass). X-rays and radiographs are used interchangeably but X-rays are the things that create radiographs strictly speaking :laugh: Ultrasounds are performed in much the same way as in people, they usually do not require sedation but in most cases will need the abdomen to be clipped to remove the hair. Radiographs and ultrasound are complementary but radiographs are usually the first step as the most common uroliths will show up clearly on them where as assessing the bladder for masses and wall thickness, kidney structure and sizes etc is better done with ultrasound.

I did read the original post and was going to comment earlier. Essentially my response was going to be "Any or all of the above". A first episode of haematuria (blood in the urine) may be appropriately treated with antibiotics. If it recurs or doesn't resolve then further investigation is warranted. The starting point is a urine culture and sensitivity performed on a specimen collected in a sterile manner. In an older dog, I would also suggest running general blood work to assess kidney function, as renal disease can be a contributing factor to the development of UTI's but also because it may affect the choice of drugs used to treat whatever is causing the haematuria. The underlying cause may be related to the bladder (infections, uroliths / stones and tumours are all possibilities), the urethra, the ureters or the kidneys. Imaging by way of ultrasound or radiographs is also very important.

A good quality puppy food for medium to large dogs should be sufficient - and no additional supplementation. It is very uncommon for these to need specific treatment but limited / monitored exercise and non slip footing are important. Walking on grass and uneven surfaces are good for developing and maintaining strength but it is important that the pup does not get too tired. You might need to stop up the mental stimulation.

Great update :D A pertinent reminder to always keep discussion up with your vet and discuss any concerns you have about medications and their possible side effects.

It is reported to be detected on faecal CPV tests after vaccinations but in my experience, Pups that I have run tests on who have been displaying clinical signs AND have been recently vaccinated are usually positive due to parvovirus. The shedding is usually transient and generally results in a weak positive.

Most of the canine vaccine are modified live vaccines - stimulate a better immune response without causing disease.

I've been accused of failing to desex a dog more than once. The discussions often get very heated once the owners start accusing you of ripping them off because (they think) you left their dogs nuts in situ, lol.

She may have oesophagitis although megaoesophagus is a possibility. What other meds is she on? What diagnostic tests were done to get the diagnosis? (Blood tests? Abdominal ultrasound?) Assuming that she is well covered as far as adequate pain relief, antibiotics and gastroprotectants then a feeding tube is a consideration. Although she may not be tempted by food, constantly feeling unwell and being offered food can lead to food aversion. An early return to feeding (an appropriately low fat diet) is better for enteral health if it can be managed.

On face value only it looks like it could be something called an eosinophilic granuloma. Any lesions like this, particularly an oral lesion requires a biopsy for definitive diagnosis. They can sometimes improve with antibiotic treatment but it will rarely result in resolution. Treatment will often involve steroids but for this reason a more concrete diagnosis is warranted.

The presence of papillomatous lesions in both the mouth and eyes of a young dog is certainly consistent with them being viral papillomas. It is unfortunate that the histopathology was not conclusive, however unless there is interference or repetitive trauma to one of the lesions, treatment is not usually necessary. While they require ongoing monitoring, papillomas will generally spontaneously resolve given time although this may take several months. Being near the eye is a bit awkward, there is limited tissue to resect as you are aware, if there was reasonable confidence in the diagnosis then they could be treated symptomatically with eye lubricants to limit irritation / abrasion to the cornea. There is an old saying that they will either take 3 months or 12 weeks to resolve :)

I had favourable reports from clients who used it and no adverse reactions over a period of a couple of months - I've been on leave since mid January though.

Is it something like a multilobular osteochondrosarcoma? Most of the long names tend to describe either the locatiion or the tissues involved and there can be various terms to describe one thing.

Aminophylline can cause gastrointestinal upset but it most often occurs when it started and resolves with chronic administration.

Yes and also watch out for bones!

PT is the prothrombin time. It is something that is ideal to run but in real life does not always get done, often due to cost. If I don't run a PT for Some reason I would always still start any dog with a suspected poisoning on vitamin K usually for 2 weeks, although 7 days may be sufficient for known warfarin cases. If it's brodifacoum or an unknown bait I usually go for 4 weeks. It is ideal tp test PT 24-48 hours after the last dose of vitamin K, though as I mnetioned it can be used to confirm poisoning - usually I would send this off and still start vitamin K as a precaution.

The ACT is a reasonably easy, cheap test to run in house. If it Is prolonged then it confirms that there is a problem with any one of the mechanisms that come into play in blood clotting including a lack of platelets. In anticoagulant poisoning it is factor 7 which is used up first and it is this pathway (along with the other components of the intrinsic pathway) that is tested with the PT test (and sometimes APTT as well). A dog with a prolonged ACT will also have a prolonged PT but conversely a dog can also be clinically normal and have a slightly prolonged PT, normal ACT and no signs of haemorrhage. This is what I mean by insensitive - it will pick up a problem but if it is prolonged it is no specific to vit K antagonists (rat bait) and the PT will detect a problem at a much earlier stage. There are some factors that could limit the PT being performed - it requires special tubes and is for most practices an external lab test so there is a turnaround time and an increased cost compared to ACT. I am lucky in the area that I practice to have a lab very close so we have either same day or next morning results depending on the time of collection.