Case of the Week

June 1, 2011

A four year old, male, intact Tibetan Terrier was brought to the clinic this week after his owner notice a firm, irregular mass on his hind end. The owner explained that he seemed to be very healthy and was not acting any differently. During the appointment it was explained that, while we can sometimes make an educated guess as to what type of mass is growing on the patient by its appearance or location, it is impossible to identify most masses just by looking at them. It was recommended that a small needle be used to obtain a sample of the mass to examine microscopically. This was performed and the sample was found to contain many cells of the same type. The slide was sent to a clinical pathologist for identification. Twelve hours later we were able to call the owner and inform them that the mass was a benign glandular tumor that is common in this area. Perianal adenomas are generally found in intact male dogs and are stimulated to grow by the presence of testosterone. While generally benign, they can grow very large and cause local discomfort and infection if not removed. Neutering at the time of mass removal will discourage future tumor growth and neutering at an early age (prior to 18 months) will significantly reduce the incidence of these tumors.

Alex Berthrong, DVM

May 16, 2011

Why can't my dog lose weight?

A nine year old, obese Golden Retriever presented for a several year history of progressive weight gain, poor hair coat, and lethargy. The owners had been trying in vain to manage his weight by increasing exercise and reducing calories. Finally the combination of clinical signs prompted a visit to Milner Veterinary Hospital.

After examining the patient it was recommended that blood work be performed to rule out hypothyroidism (low thyroid hormone levels). The blood work confirmed that the patient had hypothyroidism and treatment with a thyroid supplement was started. Within one month, the owner reported visible weight loss and a dramatic increase in activity. They also noted that, while his skin was comfortable, it was very flaky.

His thyroid levels were tested again to verify that the dose of thyroid supplement was appropriate. It was then explained that in some cases a transient period of flaky skin (usually lasting only 3-4 weeks) is noted after correcting hypothyroidism. It is hypothesized that this occurs due to the important effect that thyroid hormone has on the vitality and health of the skin. After receiving the normal level of hormone the skin starts repairing itself by shedding the old, devitalized layers. Most of the time, this happens more gradually and is less perceptible.

It is common for hypothyroid dogs to be obese, have a poor, thin hair coat, and itchy, uncomfortable skin. Lethargy is also common. They can also have a "sad" expression. In most dogs this disease is a direct result of insufficient production of hormone by the gland. In some cases the decreased production is caused by an immune mediated attack on the gland by antibodies produced by the patient's own immune system. Rarely it can be caused by cancer of the thyroid gland. In general, this is a very satisfying disease to treat for both owner and veterinarian. Usually within 1-3 months of starting treatment, the coat is back to looking shiny and thick as the hair follicles come back to life and the skin becomes comfortable again. Most patients start "acting like a puppy" again and shed some extra pounds. Treatment is always life long and yearly monitoring of thyroid levels helps the veterinarian make adjustments to the dose to keep the patient healthy.

Alex Berthrong, DVM

May 2, 2011

Nikka vs the Cat

As she lay in her hospital bed, Nikka realized it might have been a set up.  The cat was a lot faster than he looked. And everyone knows cats can't be trusted. She just couldn't figure how the cat arranged for the car to come around the corner at just the right time. She could swear the cat was laughing as Bob scooped her up and took her to the emergency clinic.

At the emergency clinic the doctors put Nikka's hip back in place but, as everyone knows, it's very hard to keep a hip in joint once it has been dislocated. When the hip popped out the second time it felt like she had been hit by a car again. And not one of those sissy hybrid cars but a real car like a Ford.

Once the doctors decided her hip wouldn't stay in joint, they started talking about an FHO. It turns out FHO stands for femoral head osteotomy. With the femoral head being the ball in the ball and socket joint of her hip and osteotomy meaning "to cut off." Nikka was pretty sure with her super Siberian Husky hearing that she could still hear the cat laughing.

From the emergency clinic Nikka went to Milner Veterinary Hospital where Dr. Steve did surgery. He took an osteotome (which is a really expensive word for a chisel) and a mallet (an expensive word a hammer) and removed the head of her femur. He said that a pocket of scar tissue would form around the end of the femur and form a cup that would act as a new joint and that in 4 to 6 months, she would be pretty much back to normal.

The other cool thing Dr. Steve did was to treat the surgery site with a therapeutic laser to reduce swelling and speed up the healing process. He did his right after surgery and again the next morning. The sensation was amazing. It felt like he was holding a warm, wet wash rag on her hip. When he was done much of the pain had gone away and it stayed away for most of the day.

The absence of pain gave Nikka a chance to reflect on her life. Was it time to make peace with cats and give up chasing them or did she have one last score to settle? She wasn't sure, but she didn't have to decide right then. She had 5 to 6 months of rehab to think about it.

Steve Milner, DVM

April 20, 2011

Always be sure to check the label!

A one year old cat presented with muscle twitches and hyper-excitability with a history of having Advantix flea product applied to skin the night before.  As soon as clinical signs were noted, the owner realized the potential for toxicity to cats with this product and immediately bathed the patient with Dawn dish soap.  The patient was brought to the clinic and was bathed with Dawn dish soap for a second time, attempting to remove any left over residue from the Advantix.  An intravenous catheter was placed and the patient was kept on intravenous fluids for 48 hours.  An intravenous muscle relaxer was also used to control muscle tremors.  The patient responded well to treatment and was discharged.

Advantix is a topical flea preventative labeled for dogs that contains an ingredient called Permethrin. Permethrin is in a class of synthetic insecticides called Pyrethroids.  Most dogs can tolerate this ingredient, but cats are more sensitive to it.  Possible effects include muscle tremors and seizures that can result in hyperthermia (abnormal elevation in body temperature) and even death.  There are multiple flea products available that contain this ingredient so always be sure to check the label for it's safety, especially in cats.

Angela Turra, DVM

Here's the small print:

 advantix^® has been developed specifically for dogs.