Elbow Hygromas in Dogs
Wendy Brooks, DVM, DABVP Date Published: 02/04/2007 Date Reviewed/Revised: 03/06/2024 The usual patient for this condition is a short-haired, large breed dog, usually an adolescent, brought to the veterinarian for a fluid-filled swelling at the point of one or both elbows. The swelling is generally non-painful but can be quite bulbous and bizarre looking. What has happened is relatively simple: the dog has most likely been resting on a fairly hard surface and the pressure of their weight has created tissue damage over the elbow bones. The area is not able to heal because of the repeated tissue damage from the dog simply resting on their elbows. A fluid pocket forms as the body attempts to create its own cushion. This fluid pocket is called a hygroma. The most common location for a hygroma is the elbow, though they can occur on the "sit bones" of the pelvis as well. The Uncomplicated Hygroma The simple or uncomplicated hygroma is not painful and is mostly of cosmetic concern. Changing the dog’s bedding generally solves the problem though sometimes elbow pads or bandages must be constructed or purchased. If the dog begins to lie on softer, more pliant materials, the hygroma is likely to simply resolve over two to three weeks as the inflammatory tissue is able to scar down. It is best not to tap off the fluid as any time the hygroma is pierced, infection can be introduced, potentially creating a complicated hygroma. Surgery on a hygroma should be avoided if possible for reasons described later on. Treatment for uncomplicated hygroma is basically changing the bedding or surface upon which the dog lies. The Complicated Hygroma Complicated hygroma after surgical healing is complete. The callus did not require removal here. Photo by MarVistaVet.If the hygroma becomes infected, it will become tender and surgical drainage becomes necessary. If the surface of the hygroma is not ulcerated, it can be drained and flushed. Rubber drains can be inserted into it to allow for further drainage into bandages. The bandages should be changed daily but it should resolve after a couple of weeks. If only drains are needed and no trimming is needed, the natural callus on the elbow will be preserved to protect the area; any surgery that disrupts the natural callus is asking for trouble. Any time a hygroma is lanced and opened, the potential exists for the area to be unable to heal. After all, the reason the hygroma formed in the first place is because the damaged soft tissue was unable to heal. The extensive motion of the elbow area also hampers healing. Establishing soft bedding is critical. If the hygroma is infected, there is no choice but to flush and drain it. Treatment for the infected but not ulcerated hygroma is placing a surgical drain in addition to changing bedding as above. If the hygroma is severely proliferative or chronically draining, or basically has a big sore on it, a more extensive surgery is needed. The callus is too far gone and must be removed. Skin flaps or even grafts may be needed to reconstruct the skin after the infected callus is removed. A splint will likely be needed to sufficiently pad and immobilize the leg during healing, which takes a month or so. As mentioned, the motion of the area works against healing, and removing the natural callus and elbow soft tissue is also an obstacle. It is important to recognize the hygroma early in its course so that it need not progress to a complicated status. If you are unsure about any swelling on a pet, see your veterinarian promptly. Other Hygromas Technically, a hygroma can form over any bony protuberance that repeatedly receives the patient's weight. The elbow is the most common area to form a hygroma but the "sit bones" of the pelvis is the second most likely area. These are called ischial hygromas and look like swellings under the tail right where the dog sits down. Again, softer bedding generally resolves the problem. Credit: VIN
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Common Diseases of Hedgehogs
Amanda McWreath, Veterinary Student Class of 2023 Date Published: 11/10/2020 Of the 17 different species of hedgehogs found throughout the world not a single one is native to North America, but that has not stopped these cute little immigrants from making their way into our homes and hearts throughout the United States. African pygmy hedgehogs, the most popular species to have as a pet, are adored for their cuteness and uniqueness in the animal kingdom. They are highly active nocturnal animals that spend their days resting and come alive at night to collect (and chase) their meals, which usually consist of fruits, vegetables, and insects in the wild. Hedgehogs enjoy a simple life of solitude, and they rely on their spikes and ability to curl up into a ball to protect them from the terrors of the outside world, which can include anything from owls and wolves in the wild to loud noises or new people in our homes. Hedgehogs usually live for anywhere from 4-6 years, and males should weigh between 500-700g (17.6-24.7 oz) whereas females should weigh around 250-400g (8.8-14.1 oz). As with any other species, there are certain diseases that we commonly see in hedgehogs ranging from obesity to neurological problems, and veterinarians can use the specific signs associated with each disease to determine which part of the body is being affected and what the best treatment will be. Skin Disease Skin diseases are fairly common in hedgehogs, and they typically lead to dry, scaly skin. Diagnosing these conditions can be done by taking skin scrapes and looking at them under a microscope or culturing them to see what irritants are causing the problem. Dermatophytosis is a skin disease common to hedgehogs that involves scaly areas around the base of the spines, which can be treated with topical antifungals. Mite infestations also include crusting and flaking of the skin and anti-parasitic drugs are used to eliminate the infestation; however, it is also important to keep your hedgehog’s environment clean and treat any other hedgehogs living in the home, as mites are very good at spreading through the environment- don’t worry, these mites are specific to hedgehogs. Obesity Obesity is a common issue seen in hedgehogs because most pet hedgehogs have unlimited access to food, likely in addition to not being active enough throughout the day. This combination can lead to a variety of problems from not being able to roll into a ball for protection to other more serious diseases like hepatic lipidosis (fatty liver disease). Prevention is the best way to approach obesity, which is why it is important that you feed appropriate amounts of high quality food to your hedgehog, provide enrichment opportunities that promote activity, and monitor their weight so that you can catch any weight gain early and adjust their diet accordingly. Getting a food scale to weigh your hedgehog on weekly is a great way to stay on top of their weight. Once an animal has become obese, treatment involves a weight loss program, which means fewer calories a day and more enrichment to promote activity. Offering insects to eat is a great way to increase a hedgehog’s activity level while also supporting their natural feeding behaviors and providing a valuable source of nutrients. Gastrointestinal Diseases Gastrointestinal diseases include anything that affects the mouth, esophagus, stomach, intestine, colon, or rectum. Signs to look out for include diarrhea, dehydration, decreased appetite, and weight loss. Salmonella infection, which is the most common type in hedgehogs, can be diagnosed with a fecal culture. Treatment involves supportive care and antibiotics. It is also important to consider that this bacteria can be spread to humans – Salmonella is a zoonotic disease - therefore, we must be careful when handling and treating potentially infected animals. Fractured teeth can make it difficult for your hedgehog to eat, which can lead to unwanted weight loss and excessive salivation. Dental radiographs and an oral exam can diagnose those bad teeth, and treatment includes pain medicine, antibiotics, and potentially even tooth extractions if the fracture is causing additional problems. Diarrhea and intestinal inflammation are somewhat non-specific signs, which means they can result from a variety of different problems ranging from an inappropriate diet to a bacterial infection. The specific cause of these issues can be diagnosed using diet trials, fecal cultures, and radiographs, and the specific findings will guide the treatment. One specific disease, Hepatic lipidosis, is relatively common in hedgehogs and can develop as a result of any disease that leads to a sudden lack of appetite, like infections or cancer. Cancer Cancer is unfortunately common in hedgehogs above the age of 3 years old. They can get many different types of cancer including squamous cell carcinomas, cutaneous mast cell tumors, mammary gland tumors, cutaneous hemangiosarcomas, and reproductive tumors, all of which must be removed. Signs vary based on the type of cancer that they have, but they can include difficulty eating, lethargy, weakness, swelling of the belly, weight loss, blood in the urine, or vaginal discharge. Diagnosis can potentially require bloodwork, radiographs, ultrasound, or a biopsy, and treatment involves removing the tumor, supportive care, and possibly chemotherapy and radiation. Heart Disease Heart disease in hedgehogs is usually in the form of dilated cardiomyopathy (DCM), which means one or more of the heart’s chambers are enlarged. Hedgehogs with DCM can experience difficulty breathing, lethargy, weight loss, and potentially a heart murmur, but it can also lead to sudden death if not treated when these signs arise. Therapy involves medication to manage chronic heart failure, but unfortunately the damage to the heart is irreversible. Respiratory Disease Hedgehogs are sensitive to respiratory disease caused by Bordetella, Pasteurella, and Corynebacterium infections. Watch out for sneezing, nasal discharge, or difficulty breathing. Diagnosis involves radiographs and a culture of their discharge and is treated with antibiotics. . In severe cases, oxygen and opening of the airways may be needed to avoid a serious lack of oxygen. Neurological Disease Wobbly hedgehog syndrome is a neurologic condition characterized by progressive loss of control of their limbs and weight loss that ultimately leads to paralysis. It can potentially be fatal. The cause of wobbly hedgehog is unknown, however, genetics is believed to play a role. Treatment involves supportive care and hand feeding. Unfortunately, there is no cure for this condition. Musculoskeletal Injuries Musculoskeletal injuries involve those that affect the hedgehog’s ability to move and use their muscles. Some common injuries include strangling of their little toes and legs due to frayed cloth in bedding (chewed by hedgehogs, of course) and overgrown toenails that get caught in the cage or grow into their footpad. Avoid injuries like these with consistent grooming and monitoring of their environment. Zoonotic Disease Should you be concerned about your own safety if your hedgehog gets sick? Some of the diseases we discussed, like Salmonella and dermatophytosis, can spread from hedgehogs to humans. Also, foot and mouth disease, which is highly contagious in humans, has been documented in wild-caught hedgehogs but not in any that are captive bred. Diseases like this are a great reminder of why it is so important to:
Credit: VIN Classroom Pets: Things to Consider
J. Scott Weese, DVM, DACVIM Having pets in school classrooms is a somewhat controversial subject. For every good point that's raised (e.g., promoting empathy, entertainment, learning about animals and their care) there are bad points (e.g., poor environment for the pet, rough handling, disorganized or absent medical care, disease transmission, fear, allergies, distraction). Some organizations have developed detailed guidelines for using animals in classrooms, but animals are often in classrooms with little consideration of the issues. PetSmart and the Pet Care Trust have a "Pets in the Classroom" program where kindergarten to grade six teachers can get support for having a pet in the classroom. Their release outlines a few of their perceived benefits, and some of the complexities of having pets in classrooms. Their points are in italics, with some comments from me.Little is known about what happens with these pets. We tried to do a survey of teachers from some school boards a few years ago and only ended up getting about two responses out of hundreds of eligible teacher participants (the overall lack of support from board administration didn't really help get the survey out and get teachers interested either, but that's another story). So, we really don't have a good idea of the types of animal contact that occur in classrooms or the problems that result, but we know from various case reports that complications like infections can and do occur. Hamsters make fun classroom pets because they are active and teach children the importance of schedules and responsibilities. Yes and no. They can be entertaining, but they can also be distracting. You have to differentiate something that's a novelty from something that is being used as part of the educational curriculum. Hamsters can be injured with rough handling by young children and close supervision is required. They may also bite when handled, especially when handled by young kids who don't know what they are doing. Plans to take care of the hamster over holidays and the summer are needed, and are often not considered in advance. The disease risks of hamsters are relatively low, but not non-existent. Having nocturnal animals in a busy daytime setting is also questionable ethically. Guinea Pigs are easily handled and encourage children to follow a regimented routine. They are similar to hamsters in their benefits and risk, but their larger size makes them more robust and less prone to handling injury. They are probably one of the better mammals to have in a classroom, but still require good organization, planning and practices. Fish are a great way to illustrate basic chemistry and biology principles while students follow regularly scheduled water changes. Fish can be great classroom animals. There are ways to incorporate them into the curriculum, from behaviour to animal care to feeding to water quality and environmental concerns. They need some care, with regular feeding and proper water maintenance, but with basic supervision and planning, the risks to the animals and people are minimal and they can be of benefit educationally. Bearded Dragons depend on their environment for heating and cooling and are a great way to teach about geography and the environment. Bearded dragons are great little reptiles with a lot of personality. However, they have specific requirements for care and feeding, something that cannot be easily fulfilled in a lot of classrooms. Also, being reptiles, they are high risk for Salmonella shedding. In a low risk household, it's not a big deal with basic hygiene practices. However, in a classroom with lots of kids, perhaps limited enforcement of hygiene, and kids eating in the area where the reptile is, the risks get higher. General guidelines are that children less than five years of age and people with compromised immune systems should not have contact with reptiles. This means they should not be in kindergarten classrooms or rooms where such students may spend time. More complicated is the issue of immunocompromised individuals. I'm not convinced that teachers always know when one of their students is immunocompromised, and what happens if there's an established pet and a student becomes immunocompromised? Bottom line: Reptiles shouldn't be in classrooms. Leopard Geckos are docile in nature and teach children about different nocturnal behaviors. These are interesting little critters, but not good classroom pets, like other reptiles, for the reasons outlined above. Nocturnal pets may not be great for classrooms either since the daytime activity and disruption may be harmful to them in the long term. Certain pets can be good additions to certain classrooms, with some logical planning and common sense, but poor planning and bad animal choices can be harmful to students and animals. School boards should be proactive and develop or adopt sound protocols for classroom pets. Reprinted from Worms and Germs Blog with permission of Dr. Weese Credit: VIN Practical dental Care Tips for Dogs and Cats
Jan Bellows, DVM, Board Certified Veterinary Dentist™, Dipl. ABVP (canine and feline) Date Published: 02/15/2024 Introduction There are simple, down-to-earth steps to ensure your pet's dental health is within reach. Neglecting your pet's oral hygiene can lead to pain and health problems. Here are some easy-to-follow tips on how to care for your pet's teeth without overwhelming yourself or your furry companion. Dental-Friendly Treats and Toys Start by incorporating dental-safe and effective treats, chews, and toys into your pet's daily routine. These can be a fun and effortless way to promote dental health. Look for treats and toys designed to clean teeth and massage gums while your pet chews on them. When choosing treats and toys, ensure they are appropriate for your pet's size and chewing habits. These can be a tasty, practical solution that helps reduce plaque and tartar buildup. The Veterinary Oral Health Counsel was created over 25 years ago and accepts products that decrease the accumulation of plaque or tartar. VOHC.org hosts a constantly updated list of over 70 dog and 20 cat products. Deer antlers, bones of any type, dried Yak milk, and nylon toys must be avoided because they can break teeth, exposing the tooth’s nerves. Dental Gel or Spray If your pet isn't a fan of toothbrushes or you find brushing challenging, consider using dental gels or sprays. These products are easy to apply and can help maintain oral hygiene. They contain enzymes or antimicrobial agents that work to reduce plaque and tartar. Look for the Veterinary Oral Health Seal of Acceptance on the product container. The products that have achieved acceptance status are considered safe and effective in decreasing the accumulation of plaque and/or tartar. Follow the instructions on the product label to apply the gel or spray to your pet's teeth and gums. It's a hassle-free alternative that can significantly impact your pet's dental health. Dental Wipes For some pets, using dental wipes can be a practical option. These pre-moistened wipes are designed to be gentle on your pet's gums while effectively cleaning teeth. Dental wipes are especially useful for pets that resist brushing or have a small mouth. To use dental wipes, gently wrap the wipe around your finger and rub it along the outer surfaces of your pet's teeth. Make sure to choose safe wipes for pets and free from harmful ingredients. There are simple, down-to-earth steps to ensure your pet's dental health is within reach. Neglecting your pet's oral hygiene can lead to pain and health problems. Here are some easy-to-follow tips on how to care for your pet's teeth without overwhelming yourself or your furry companion. Dental Water Additives Another practical tool for maintaining your pet's dental health is a dental water additive. These liquid solutions that you add to your pet's drinking water work to control plaque and tartar. While they are not a substitute for brushing and professional cleanings, they can be a convenient addition to your pet's daily routine. Follow the manufacturer's instructions for the correct dosage and ensure your pet can access the treated water throughout the day. Also, look for the VOHC seal of acceptance on the product you choose to ensure safety and efficacy. Regular Check-ups Twice yearly veterinary dental check-ups are crucial for your pet's dental health to examine your pet's teeth and gums. As needed, pofessional dental cleanings under anesthesia performed by a veterinarian are the most effective way to remove stubborn tartar and address underlying dental issues. During these check-ups, your veterinarian can identify dental problems early on, such as infections or gum disease. Early detection can prevent these issues from escalating into more severe health problems. Many veterinarians employ a thiol detection strip (OraStripdx®) in the exam room to help identify the presence of periodontal disease. The positive result confirms the periodontal disease and the need for immediate dental care. At Home Checks Be vigilant for any signs of dental problems in your pet. Keep an eye out for the following warning signs:
Conclusion Practical dental care for your pet doesn't have to be complicated or time-consuming. Incorporating dental treats, toys, gels, sprays, wipes, and water additives into your pet's routine can positively impact their oral health. Remember to schedule regular check-ups with your veterinarian and be attentive to any warning signs of dental problems. Your pet's dental well-being is an essential aspect of their overall health. Credit: VIN Inappropriate Elimination (House-Soiling) in Cats
Wendy Brooks, DVM, DABVP Despite the cat’s reputation for fastidious cleanliness, house-soiling is the number one behavior problem of our feline friends. Many cats are turned outside, given away, or even put to sleep for this behavior problem, and it behooves the veterinary profession to address it. Urinating in odd places can mean a medical problem, a territorial marking problem, or some sort of social or environmental problem and sometimes the differences are not clear cut. Several factors may be in play and some conditions involve medical symptoms resulting from psychological stress. In other words, a combination of medical and behavior issues may be at work. Should the Approach be Medical? Illustration by Wendy Brooks, DVMThere are several medical conditions that can lead a cat to inappropriate urination and these should be ruled out so as not to get on the wrong track. The cat will need to be examined and get some testing. Conditions to rule out in part depend on the cat's age because young adults tend to get different diseases than do senior cats but, briefly, here are some conditions that should be checked out.
As mentioned, your veterinarian should evaluate your cat medically before you conclude that the problem is behavioral and you embark on a long-term behavioral approach. Urine Marking / Territorial Anxiety Cats use urination and defecation as a means of communication with other cats. By leaving their mark, they are telling other cats “I was here on this date at this time.” Other cats may then know this land has been claimed (or has not been recently claimed) and may act accordingly. Cats also mark by rubbing their faces on objects and by scratching vertically on surfaces. Psychological stress, such as other cats, moving to a new home, prolonged or sudden absence of the owner (who is usually viewed as a parent by the cat), noisy construction outside, visiting humans or other animals, or even new furniture may create a need for a cat to reassert a territorial claim. Signs that this kind of stress is causing the problem might include some or all of the following:
If any of these scenarios seem to fit, anti-anxiety medications may be tremendously helpful if the source of stress cannot be identified or cannot be altered. Medications commonly used as anti-anxiety treatments for inappropriate urination include the following. Clomipramine This medication has been helpful treating obsessive-compulsive disease and depression in humans and has been approved for canine separation anxiety. It has come to be the first choice of many behaviorists for urine-marking cats. In one study 80% of cats showed at least a 75% reduction in episodes of inappropriate urination within 4 weeks. Fluoxetine This medication is more commonly known as Prozac®. It has been used for feline urine marking and has been found of comparable efficacy to clomipramine. At least 8 weeks of treatment was required to achieve results in over 90% of cats and as long as they took the medication, they did not mark. If the medication is discontinued, marking may resume but is just as likely to respond a second time if the initial treatment was successful. Buspar This medication acts by blocking the effect of serotonin, a brain chemical. Studies have found this medication to be approximately 75% effective in reducing inappropriate urination in about half the cats that used it. It is typically given orally twice a day for a 2-week period. If it seems to work, the course is continued for a total of 8 weeks. After this period, it may be discontinued. Approximately half the cats in whom it is used do not resume inappropriate urination. The other half re-develop the problem and must continue on Buspar. A Word on Female Hormone Treatments These treatments have not shown as wide success as the newer medications listed above plus they have been fraught with serious side effect potential (mammary cancer and/or induction of diabetes mellitus). I recommend that these hormones be used only as an alternative to euthanasia. Other Products for Anxiety Several other products that help with anxiety are noteworthy, especially in situations where a cat is not amenable to taking medication or there is a medical condition that rules out medication. Dietary Supplements Alpha-casozepine is a natural protein contained in milk and is responsible for the calming features of drinking warm milk. It is available in pill form and has been formulated into calming diets. It is not particularly sedating but has anti-anxiety properties helpful in creating a more "zen" brain chemistry. L-theonine is derived from green tea leaves and is available in tablet form for dogs and cats, and can also be used for anxiety management. Supplements such as these are compatible with the other therapies listed above so they may be used in combination with pheromones or with medications. Pheromone Sprays and Diffusers Feliway® spray is for the area being marked rather than a medication given to the cat. The spray has feline pheromones of the type that cats deposit when facial marking (i.e., rubbing their face/cheeks on things to scent mark). These pheromones provide a message in the cat's own language proclaiming that the territory is secure and there is nothing to worry about. This confers a general calming effect and reduces the cat's interest in marking. Feliway is available as a spray to apply to marking surfaces or as a plug-in deffuser that spreads pheromones through the room. Defusers last approximately one month. When pheromone therapy was new, a study was conducted in 57 households with urine spraying cats. These cats marked on either vertical surfaces only or a combination of vertical and horizontal surfaces. Feliway spray was used twice a day on the urine marked areas for a one-month period. In one-third of households, urine marking stopped completely. In 57% of the households, urine marking was reduced and in 9.3% of households marking was unchanged. (Hunthausen, W., Evaluating a feline facial pheromone analogue to control urine spraying, Veterinary Medicine, Feb 2000, p 151 - 155) Neutering is the first step in addressing this problem. Hormonal motivations to mark territory are potent and must be removed from the picture. Litter Box Aversion/Environmental Factors Another reason why cats urinate or defecate outside the box is simply that the box is not acceptable to them. The box may be dirty, may not be adequately private, may smell funny or be uncomfortable. The following are clues that an inappropriate urination problem reflects litter box aversion:
The box should not be in a high traffic area. In a single cat home, the cat may have experienced something unpleasant in association with the current litter box (molestation by a child or dog, loud noise etc.) and needs a new bathroom area. It is important not to keep the cat’s food in a location near the box as the cat will not want to use the feeding area as a toilet. Obviously, any litter boxes should be scooped daily or even twice daily and kept as clean as possible. Clumping litter should be changed at least monthly and non-clumping litter should be changed twice weekly. The box should be washed with soapy water or water alone with no strong-smelling disinfectants that might be objectionable to the cat. Cat Attract is an herbal product designed to return the cat to the box. If the problem is difficulty in keeping the box clean, a self-cleaning box may be helpful. On the other hand, some cats object to the moving parts so use your judgement. Another type of litter can be provided to see if the cat prefers a different brand or type. Signs that the cat does not like the litter include: sitting on the plastic lip of the litter box to eliminate, failing to dig a hole in the litter, and/or shaking the litter off the paws after exiting the box. If nothing seems to work, the cat should be confined in a small area, such as a large plastic carrier, with a litter box. The cat is gradually allowed more area after proving that they will use the box. First, the carrier is the housing area, then a small room such as a bathroom or playpen is allowed, next a large room is added, etc. until the cat again has their usual access. Alternatively, the cat may be boarded in an animal hospital as housing in a small cage commonly brings the cat back to the litter box, plus the cat can be observed for other concerns that might be contributing to the elimination problem. Odor eliminators should be used in marked areas to discourage the cat’s tendency to return there. If these tips are not effective in restoring the cat’s proper toilet behaviors, a behavior specialist should be called in. Contact your veterinarian for the best consultant in your area. Many people waste time and effort on the wrong approach until they are at their wit's end and are considering euthanasia. If your cat occasionally eliminates inappropriately, please inform your vet erinarian promptly. Credit: VIN Heat Sroke Havoc: Horses and Cows and Pigs, Oh My!
“Heat stroke? Horses get that?" July 22, 2013 (published) | June 20, 2023 (revised) By Christy Corp-Minamiji, DVM It’s pretty hard to accidentally lock your horse or cow in the car. Small animal veterinarians, humane societies, and even municipal police and fire departments have done a great job of reminding folks that car = greenhouse/oven and car + warm day + dog or cat = baked pet. Yet, for most people, that seems to be where the link between animals and heatstroke ends. Somehow, in the public mind, a car-external animal is magically free of all heat-related danger. I think we may be victims of our own PR, or rather our animals may be the unintended victims of this small, but effective, snapshot of heat stress. Here’s a slightly different picture of heatstroke – no broken windows involved… It was the sort of puffy April day made for Easter cards. Before I removed the rapidly rising thermometer from my shaking, flared-nostril patient, I knew the sort of response I was going to get as soon as I made my diagnosis. “Heat stroke.” “What?” “He has heat stroke; can you turn on that hose over there?” I had already moved the horse into the shade for the examination. My client, an experienced, educated horseman was nonplussed. “Heat stroke? Horses get that? But it’s only about 80F out.” “Yep. Heat stroke.” I showed him the thermometer which had topped out near an impressive 107°F (a normal horse resides in the 99-101°F range). “We need to cool him down. Ummmm…the hose?” Heat stress – also known as heatstroke, heat exhaustion, or more officially hyperthermia – happens when an animal either produces too much heat or doesn’t dissipate (get rid of) enough. The dog-in-car case is an example of a failure of dissipation. Temperatures rise in the enclosed environment and the normal methods of heat dissipation (i.e. panting) don’t work since there is nowhere for the extra heat to go. In healthy animals not receiving medications or carrying genes that may predispose them to hyperthermia, excess production usually results from excessive activity. “But aren’t animals smart enough not to over-do it on a hot day?” Ummmm…. Met any human long-distance runners lately? Humans aren’t smart enough not to work ourselves into heat stress (card-carrying member of the Stupidly Prone to Overdoing it on Warm Days League here), and neither are our four-legged friends. The horse with the Death Valley worthy temperature had demonstrated a classic disregard for his own well-being. The owner, taking advantage of the lovely weather, had turned the normally barn-housed young stallion out for a nice romp in the front paddock. Spring is breeding season in the equine world and this young lad could smell all sorts of lovely ladies. The horse equivalent of an early-20s human male, he responded just as his human counterparts would: by showing off. For two hours, the stallion ran himself silly, bucking, prancing, and bugling to any mare within the county limits. He did not stop for water in his corral, nor did he seek the shade that was at one end of the corral. A dog turned loose in the dog park or on a beach on a deceptively warm day can run (literally) into the same trouble. Rarely did I ever treat heat stress cases in July or August when sidewalks in our region are made for egg-cookery. Like humans, animals tend to mope around looking for air-conditioning and ice cream when the mercury bursts from the top of the thermometer. It’s the first warm days of spring you have to watch out for. Even outside the solar-cooker that is an automobile, heat dissipation can become seriously compromised for many animals. Animals cool their bodies through water evaporation from: sweating (horses), panting (dogs), or soaking themselves in water (pigs). On high humidity days, the cooling effect of evaporation is lost or at least significantly diminished. Adding in even a little extra heat production on those days can precipitate a hot mess. Dark-coated animals (such as black Angus cattle) or animals with thick fleeces are also at a disadvantage in the heat dissipation game. The “down” (i.e. can’t get up because she’s sick or her foot is injured) black cow, the un-shorn sheep, or heavily fleeced male llama are all heatstroke victims who have crossed my clinical path. Black cows are not quite as unlucky as black cats when it comes to path-crossing unless they step on your toes. Pity the pig. “Sweating like a pig” is not only an exaggeration. It’s an out-and-out lie. Pigs don’t sweat. They can’t sweat. They don’t pant particularly well either. So, for Wilbur and friends, heat dissipation requires cooperation from their environment. “Happy as a pig in mud” isn’t an exaggeration. Pigs wallow in mud or water in order to cool themselves, not because they have the same aversion to cleanliness as my kids. Pigs need a pond, pool, or misters and fans in order to properly dissipate heat. Since pigs can’t self-cool, it’s important to consider temperature and ventilation when transporting them. The client who brought a pig to me one day for a pre-fair health check nearly had a baked ham by the time he opened the door of the non-ventilated cargo hauler that he had decided to use as a swine-mobile. (We were able to treat the pig in time, and I advised the owner that pigs have different transportation requirements from dirt bikes.) Just about any animal is susceptible to heat stress; even fish can poach if their bathwater warms. So how can you prevent heatstroke and how (leaving fish out of it) do you recognize signs of heat stress? Prevention of heat stress is a matter of monitoring the balance between heat production and heat dissipation. Obvious steps like making sure the animal has access to water and shade – yes, even if you’re just at the dog park or riding your horse for a couple of hours – are important, as is verifying that said animal can reach said water or shade. Shade, especially, tends to move. A horse tied to a trailer in the shade at a show may not stay in the shade, ditto for a dog tied to a tree, stake, picnic bench, etc. Monitor exercise closely, especially if the weather is warmer than usual, the animal is overweight or out of condition, or there are factors, such as in-season mares, that may cause the animal to exercise more vigorously than normal. Plan transportation for cool times of the day. This should go without saying, but do NOT leave animals in an enclosed, non-air-conditioned vehicle. Even stock and horse trailers with open vents/windows can get very, very warm when not moving (large aluminum box + heat-producing animals). Shearing fleeced animals in spring can minimize heat stress, not to mention reducing disturbing fly/maggot antics that tend to accompany warm weather and soiled fleece. (Don’t ask.) Signs of overheating vary a little between species, but here are some basics:
Definitely don’t leave your pet in the car, but think also of the running horse, the Frisbee-catching dog, the wooly sheep, the invalid cow, and the puddle-less pig. Any animal, yes, even those who live in the great outdoors, can over-do a day in the sun. Credit: VETz Insight Watch out for Dog Holes
Digging is normal canine behavior By Phyllis DeGioia, editor of VIN My ankle is fractured in two places. It hurt about as much as you'd think. I'm hoping you can learn from my stupid mistake. Maybe I currently care more about your bones than you do, but at a certain point you may come to care a lot more, as I did. Safety Tip #1: Do not put the canoe away in the back yard in pitch dark. Safety Tip #2: Do not step into a hole dug by your dog during the kind of deep darkness that makes fireworks look good. I'm pretty sure Zita, my 20-lb Pomeranian mix, excavated that particular hole. She often comes into the house with dirt on her nose, indicating she's been digging. In the immediate aftermath of the high-volume post-double-fracture screaming, my boyfriend Erik went to look for my ancient crutches in the basement. While he was getting them, I crawled through the back yard on my hands and knees towards the back door. I almost threw up. Knowledge Tip #1: The orthopedic nurse said if you feel nauseous almost immediately afterwards, you have likely broken a bone because nausea is one of your brain's reflexive responses to pain. Your fibula and tibia would really, really, really like for you to stay as far away as possible from any irregular ground caused by digging canines. A few other bones are likely to feel the same way. Safety Tip #3: In daylight, look for holes dug by your dog(s). Varmint holes aren't likely to bother an adult human fibula. However, the convex hole typically dug by canines is usually big enough to be noticed, has no lawn or flowers left, is surrounded by loose dirt, and may not seem big or deep but waits for you like a tick on a blade of grass. Fill in those holes. You may be asking yourself at this point why dogs dig. Digging is normal canine behavior, according to veterinary behaviorist Dr. Christine Calder of CattleDogPublishing. Some dogs are not interested in moving so much as a nail full of dirt; Lady of Lady & The Tramp comes to mind, flipping her stunning ears around like a movie star's tresses. But I'd bet my bottom dental chew that Tramp scored more than a few holes. Some dogs dig because they were bred to do so. In French, ‘terrier' translates as ‘burrow,' and In German, ‘dachs' means badger, and ‘hund' means dog, indicating a dog who hunts rather vicious animals that weigh up to 30 pounds. During fox hunts, fox terriers were released when the fox went below ground. The deceptively innocent-looking Australian terrier goes after snakes and vermin, and usually wins. A Bedlington terrier will go after rabbits or mice, and so on: it's part of the genetic job description. In dogs not bred to excavate, holes can still wait for your ankle for a number of reasons, Dr. Calder tells me. (By the way, as an undergraduate she fell off a horse and broke her talus – the main ankle bone that your fibula and tibia are attached to - and was supposed to be non-weight bearing for 6 long months. Because we are all stupid at that age, she went to classes rather than dropping out for a semester. She ended up repeating the classes anyway, but let's give her points for effort. Also, like me, Dr. Calder is barely taller than a garden gnome, so falling from a horse is quite a distance.) Anyway, non-hereditary reasons for dogs to dig holes include:
At any rate, I am pleased to say that as soon as I'd crawled my way to the house and got inside, it pretty much stopped hurting. I could move my toes and bear a teeny tiny amount of weight. “Oh gosh, it's not that bad!” The ER said I could wait until the next day. Knowledge Tip #2: Don't wait. If you think you've broken a bone, go to the ER. I waited about 15 hours, which is when I could get into my regular clinic in the afternoon on Monday. They took x-rays, gave me a walking boot, and referred me to an orthopedist, but I didn't get in there until Friday. Had I gone to the ER, I could have had five less days being non-weight bearing in the fiberglass cast, and if I'd needed surgery, I would have had it sooner. Non-weight bearing is so frustrating to independent types (like me and Dr. Calder) that in the beginning I cried several times every day. I must say that except for those excruciating minutes right after the fracture, my ankle has not hurt as long as I don't bear weight on it, so I didn't need pain pills. Safety Tip #4: On hard floors, be careful not to place the tip of either crutch in one of those swirling tumbleweeds of dog hair dust bunnies unless you want to fall again, possibly emulating a turtle stuck on their back. Life can be brutal. Sadly, I suck at crutching due to insufficient upper body strength from being an LOL (Little Old Lady). I get around in a wheelchair or crutches right now and have a walker and a quad cane ready to go for later, because I also suck at being non-weight bearing with a walker. I've even crunched a toe on the good foot by running the wheelchair into it; it's summer and I'm foolishly barefoot. Given my generally clumsy nature, which Erik insists is due to inattention rather than actual clumsiness – and who am I to argue? – I will eventually need mobility aids again. I'll be in a walking boot for two or three weeks after the cast comes off, then taper off. The boot is decorated with stickers of bunnies and capybaras because last time I used one I learned the Swarovski crystals eventually fall off. Here in the Midwest, summer is the best weather of the year. It is awful to miss it, and I won't be in our new canoe for a while. I will have spent the majority of these lovely summer days on the couch with my leg elevated, whining like a puppy. For the first few weeks after the injury, I cried a few times every day about the unfairness of life. Well, suck it up, buttercup. However long it takes to heal, I am truly grateful that it wasn't worse, like Dr. Calder's injury. I strongly recommend that you check for holes around your yard and add some enrichment activities for your dogs if they have any tendency to dig. Don't be lazy like me: just get out there and do it. It may save you from the unspeakable indignity of imitating turtles. Credit: VETz Insight The Opioid Crisis Affects Pets, Too
It was the simplest thing to give Gucci a dose of naloxone By Tony Johnson, DVM, DACVECC My otherwise peaceful Thursday ER shift was abruptly disrupted by the metallic clang of the treatment room's doors opening and the squeak of a gurney. Heaped atop said gurney was a pile of dark grey pit bull, unresponsive and laying on her side, breathing slowly. I noticed mammary development, which probably meant she was an unspayed female, and may have given birth recently. “OK – what do we have?” I asked the tech steering the gurney to the treatment table and oxygen. “Intact female pit, 2-3 years old, found unresponsive at home.” “Nothing, else, huh?” I asked. “Nope.” I did a quick physical exam called the primary survey, which is just the initial things that threaten life: airway, breathing, and circulation. I found nothing but the slow breathing and a slow, but steady, heart rate. Owners of pets brought into our ER are asked to answer two questions before anything else is done, even before registration paperwork with the pet's name, address, etc. Can we begin treatment for pets needing immediate care? In the event it is needed, should we begin CPR? Both questions are accompanied by rough costs for each. The tech's Vocera (a little Star Trek communicator gizmo that each tech wears to communicate within the hospital) made its little bloopy sound and one of the receptionists chirped “She's a yes and yes,” which was our shorthand that the owner had answered yes to both questions. So, we started in. We gave oxygen through a facemask and placed an IV catheter. I did a more complete physical exam and found not much more than on the primary survey. Blood was drawn for later analysis. We set about getting a few vitals, like body temperature and blood pressure. I dispatched the tech to talk to the owner, and to specifically ask about toxins and drugs, either of the prescription or recreational kind while I attended to my nonresponsive new patient. My tech (we'll call her Laura) came back a few minutes later. “Nothing in the house. She says she has a 4-year-old kid, her place is childproofed, and no drugs. Dog's name is Gucci.” “Anything in the yard? Antifreeze, rat poison?” I asked. “Nothing, doc.” “OK,” I said, thinking perhaps she had a uterine infection (common in unspayed females) and had become septic due to overwhelming infection. “One more thing,” Laura said. I had a pretty good idea what was coming. “She has no money, no insurance.” “OK – we'll do what we can.” This is an every day occurrence in the veterinary ER, and I'll refer the reader to the many times we've covered this at VetzInsight. I am well-versed at working within an owner's financial constraints, and, thankfully, most of the time we can get done what needs to be done for the patient. Not every time, and there are many cases that still gnaw at me – cases I could have saved, but it was not realistic or possible for the family. I had a sinking feeling about this one, though. If she was septic, the rule #1 of treating sepsis is “remove the septic focus,” meaning cut out (or drain) what is killing the patient. This almost always involves surgery, an extensive ICU stay, and significant cost. At the intersection of “no money” and “septic shock,” the shops sell only sadness. The other informal rule we have in the ER is that pets named after luxury items (Versace, Vuitton, etc.) rarely have the financial backing needed to get the job done. Perhaps the owners have already spent too much on other things to afford medical care for their pets. I don't know. I don't judge, but I do notice. Just about then, Laura's phone rang. We usually discourage taking calls while on the clinical floor, but she took it anyway. And good thing she did. After hanging up, Laura told me that (completely by chance) she and the owner of the dog on my gurney had a common friend. The friend told her that the owner was reluctant to tell us what happened to Gucci because she thought she'd get in trouble. I asked Laura if she wanted me to go in the room, and she said, “Hold on, give me a minute with her.” I don't know what went down in the room, but Laura came back a few minutes later and said, “She's ready to talk to you.” I didn't wait for more explanations. Just as I got into the room, before I could extend my hand and introduce myself, the owner said “It's fentanyl.” So much for childproof. Fentanyl, as nearly everyone now knows, is a potent opioid. It is 50 times stronger than heroin and 100 times stronger than morphine. I use it almost every day for my patients, as it is a truly effective means of controlling pain. It is also highly addictive, and one of the main drugs that has been abused and has killed thousands of people across the U.S. and the world. Luckily, it has an effective and cheap antidote: naloxone (trade name: Narcan). I was recently lecturing to a group of veterinarians in Kentucky and saw my first naloxone/overdose station at the lecture hall. It brought into stark relief how bad the opioid crisis has grown. And now it's affecting pets like Gucci. Not to mention the child that also lives in that home. What if it had been her instead of Gucci? A 4-year-old little girl snuffling around on the floor and wondering if that white powder was sugar? I told the owner I would be right back after giving Gucci the antidote, and assured her it was not my job to call the police unless the dog was intentionally poisoned, which she hadn't been. But, I said, I wanted to talk to her about safety in her home. I usually stay in my lane, but this one was just too egregious to overlook, and I have received some criticism for not notifying Child Protective Services about conditions in the home. Since we already had an IV catheter in place, it was the simplest thing to give Gucci a dose of naloxone straight through her IV. It takes effect almost immediately, and within about a minute she popped her head up and she looked around as if to say “How did I get here? Who are you people?” She did just fine. Fentanyl has a short duration (usually less than an hour), but we watched Gucci for a couple of more hours to be sure. She did not need any further testing or treatment, and the owner managed to find the money to pay her bill. (If memory serves, it ended up being less than $300.) I stepped back in to talk to the owner and basically re-stated what I said above about her daughter and the implications if she had ingested the fentanyl instead of Gucci. That would be trouble. I didn't want to see her daughter exposed to the same substance that had sickened Gucci and killed so many people; in the U.S. alone, fatal fentanyl overdoses have risen 279% since 2016. And I didn't want the state to have to take away her child. She got the message. I hope. Credit: VETzInsight Zinc Poisoning in Dogs and Cats Wendy Brooks, DVM, DABVP Most people have at least a passing familiarity with hemoglobin. Hemoglobin is the iron-containing protein that is responsible for the red color of blood. It binds the oxygen we breathe in and carries it to our tissues, exchanging oxygen for carbon dioxide and carrying that to our lungs to be exhaled away. Our red blood cells have no nucleus and no DNA, and they do not participate in most normal cellular functions; they are simply bags of hemoglobin being conducted around our blood vessels. A normal canine red blood cell lives approximately 120 days (60 days for feline red cells), and it dies when it either becomes too stiff to fold itself through tiny capillaries and bursts trying to do so, or it simply cannot generate enough energy to keep itself alive. The spleen is responsible for removing old red blood cells. The spleen possesses many tortuous, winding blood vessels where red blood cells may break if they are not supple enough to pass through. The spleen then collects the hemoglobin for recycling, but since hemoglobin by itself is not safe for release into the bloodstream, a conversion is necessary. The hemoglobin is broken into a protein part (which is broken apart and recycled), iron (also broken off even further and recycled) and heme which is converted into a substance called bilirubin for transport. Bilirubin is sent to the liver to be chemically processed for removal (the process is called conjugation). This process enables the bilirubin to dissolve in water so that it can be excreted in bile and disposed of through the intestinal tract. Bilirubin is responsible for the brown color of feces. If too many red blood cells are being destroyed at once, the systems described above get overwhelmed. What is Hemolysis? Hemolysis is the destruction of red blood cells. Red blood cells may be destroyed by:
Zinc This dog has swallowed a coin (readily visible as a white disk in the stomach). Photo courtesy of Jennie Marvelle, DVM, Boothbay Animal Hospital Boothbay, MEIn 1983, the U.S. government began minting pennies made of zinc wafers coated in copper rather than out of pure copper. As it is not uncommon for young animals to swallow pennies, zinc toxicity became recognized. Other zinc sources include nuts, bolts, zippers (some metal zippers contain zinc), and zinc oxide-based skin creams, such as diaper rash cream and sunscreen. You can see a penny or other radiodense object of about the right size on a radiograph, or there may be a known history of penny eating. It is important to rule out immune-mediated hemolysis as this is a common condition requiring specific (and very different) treatment. Clinical Signs The clinical signs of zinc toxicosis include:
Treatment If an object possibly made of zinc is seen on an X-ray, it should be removed promptly. This might involve surgery, endoscopy, or possibly inducing vomiting if the object does not have sharp edges. Support then becomes crucial. Fluid therapy is important to keep adequate circulation to the kidneys and help prevent failure. Transfusion may be necessary to combat anemia, and anti-nausea therapy is justified. Zinc is corrosive to the stomach so medication to protect the stomach will be needed. Antacids are helpful in reducing the absorption of zinc, which is enhanced by stomach acid. Research is looking at methods for binding excess zinc in the circulation similar to the way lead poisoning is treated. Once the zinc source is removed, most pets are able to recover within 48-72 hours with supportive care, but of course, this depends on the severity of the poisoning. Credit: VIN
Anorexia, or Lack of Appetite, in Dogs and Cats Wendy Brooks, DVM, DABVP Appetite loss and appetite reduction are important factors in illness assessment, and they must be recognized and reported as soon as possible. Acceptance of favorite foods often determines if a pet should be hospitalized or not. A couple of off days is generally not a big problem as long as the pet maintains hydration one way or another and recovers promptly, but recurring episodes of poor appetite or slow, gradual reduction in appetite are important and frequently point to a chronic progressive illness. Nutritional support not only helps the pet recover but buys time to keep the pet stable while diagnosis and treatment are worked out. The pet must be fed in order to get well. The term anorexia simply means eating no food. Many people get confused by the human eating disorder anorexia nervosa. When the veterinarian says the pet has anorexia, it does not mean the pet has a distorted body image; it simply means the pet is not eating. So how do we get a pet to eat? We will review some techniques here. Be sure to check with your veterinarian regarding the proper amount of food to feed and which foods are acceptable. Eating only a few bites of food or drinking the gravy does not constitute a good appetite so when asked if your pet is eating, this isn't really a yes or no question. Be specific about quantity. Don't wait for the appetite to completely disappear before seeking veterinary assistance. Pets with a poor appetite are sick, and if you wait until the appetite is completely gone, it may be too late for recovery. This is particularly true for cats. As the appetite fades, the pet must depend on stored fat for nutrients. When large amounts of fats are mobilized to meet energy demands, they must be processed by the liver before being used for calories. The feline liver is not designed to handle large amounts of fat and will fail in a condition called hepatic lipidosis. First Offer Canned Food If you think your pet’s appetite is poor but are offering only kibbled food, your first step is to get some canned food and offer that. Most animals find canned diets far more palatable than dry foods, and you may find that this step alone fully alleviates the problem. There is a misconception that canned food is somehow of poor nutritional quality. In fact, canned food and dry food differ primarily in their water content and, thus in texture. If you consider the food without water, the unprepared diet is basically a powdered meat mix similar to a flour. It can be baked into a kibble or steamed into a canned food. Canned foods differ in quality just as dry foods do. See if the pet will eat a canned food or a mixture of dry and canned food. Adding a flavored broth or cooked egg is also helpful in enticing the pet to eat a kibbled diet. Second, Offer a Delicacy Foods that are generally regarded as delicacies among pets include canned chicken, cooked egg, and canned tuna. Therapeutic recovery formula diets are generally well accepted. With the exception of the recovery diets, these treats are not nutritionally complete but can make a good jump starter for pets. A pet who has not been eating may feel continued discomfort until eating begins again. Something tasty may be necessary to get the appetite restarted. Do not simply put the food in a dish in front of your pet. Instead, rub a small amount on the teeth or spoon a little in the mouth so that the pet can get a taste. Don't be surprised if he spits it out; we are just trying to get the taste of the food in his mouth. Hold the bowl up to the pet's nose so that the aroma is inescapable. You may find that coaxing in this way gets the appetite started. A Note on Gourmet Cat Foods (Yes, Dogs Eat Them, too) Several "extra tasty" products available in the grocery store can be really helpful in tempting a pet with a poor appetite. Fancy Feast by Purina comes in numerous textures and flavors, each can containing approximately 100 calories. The diet is complete and balanced for cats and is often a good appetite jump starter. Temptations®, by Mars Petcare, are especially well-accepted treats made for cats. Because many cats will not eat anything else, they have been balanced to be nutritionally complete for cats and can be used as a cat's sole diet if necessary. A Note on Starting Prescription Diets If the pet is supposed to eat a prescription diet but refuses, do not attempt to starve the pet into eating the prescription food. Many prescription diets are relatively bland and pets do not wish to eat them, particularly if they are used to eating large amounts of table scraps (always a bad practice) or a more flavorful regular food. Starving the pet will only make him sicker. Try a gradual change from the regular food to the new food over a week or so. If the pet simply will not accept the new food, be sure to let your veterinarian know this. There may be an alternative flavor to try; further, prescription diets are guaranteed by the manufacturer meaning you can get a full refund on the bag or case if the pet does not accept the food. Sometimes it is necessary to forgo the therapeutic aspect of the special diet just to get the pet to eat, but your veterinarian will help you with these guidelines. Provide Privacy Be sure other pets at home do not bully or distract the sick pet. In a multi-pet home, it may be difficult for the sickly or elderly pet to eat without the younger pets taking his food. Many animals wish to eat at their leisure, particularly if they do not feel well. Consider giving your pet a private area and her own dish. Never feed multiple pets from the same bowl as one is sure to get the lion’s share of the food to the other’s disadvantage. Many pets like to eat overnight when no one is watching. Medical Assistance Appetite-stimulating medications are available. There are several products available that can create a sense of hunger: Capromorelin: This is an oral liquid that mimics the body’s natural system that generates the sense of hunger. It is best given daily rather than only on bad days. Capromorelin is available in both a canine and a feline formula. Mirtazapine: This is a pill originally developed as an anti-depressant for humans but was found to have appetite increase as a side effect. It is available as a tablet, typically given daily for dogs or every two to three days for cats, or as a transdermal gel for cats which is applied daily to the inner surface of the ear. Cyproheptadine: This is a psychoactive anti-histamine that has an appetite stimulation side effect. It is available as a pill and is typically used twice daily. Prednisolone/Prednisone: This hormonal anti-inflammatory has a number of uses in the treatment of immune mediated conditions, inflammatory conditions, cancer therapy and many other situations. One of its side effects is increased appetite and it is sometimes used for this effect, though because it affects so many body systems, it is generally not used for its appetite effect alone. These medications represent non-invasive ways to medically improve appetite. Assisted Feeding Non-invasive methods are all well and good but the bottom line is that an animal that does not eat will get sicker and ultimately die. Receiving nutrients is the basis of recovery and one cannot simply wait around for days for medications to work. Nutrients must be delivered ideally in a way that is not stressful for either the pet or the human caretaker. Feeding Tubes An E tube. Photo by Dr. Jen DeveyFeeding tubes are the least stressful method of delivering nutrition and can be placed through the nose, throat, directly into the stomach or into the intestine. Liquid diets are delivered through the tube, usually with no resistance from the patient whatsoever since the mouth and face are not manipulated. Gaining in popularity is the esophagostomy or E tube. This tube is placed in the esophagus via an incision in the side of the neck. A bandage or special cloth collar may be used to hold it in place though many patients do not require a wrap of any kind. The placement procedure is fairly short, and the tube is comfortable for the pet. Protective cone collars are not generally needed and the pet can go about his or her life with the tube in place. The larger size of the tube allows for blenderized diets which can be prepared at home for less expense than prepared liquid diets. Feeding does not require fussing with the pet’s face and thus is more comfortable. Bandages must be kept clean around the area, and tubes must be kept in place for a minimum amount of time to allow for proper scar tissue to form, sealing the feeding hole to the outer tissue. When the time comes, the tube can be pulled, and the hole seals up. These kinds of tubes require brief surgical placement, and thus anesthetic risks apply. Nasogastric tubes (N-G) that go through the nose require no anesthesia to place but do require an Elizabethan collar to prevent the pet from yanking the tube out. They can accommodate only a liquid diet because of their small diameter and are difficult to manage at home. Most animals will not want a piece of equipment attached to their face and will try to remove it. N-G tubes are best used for patients that are too sick to try to pull out the tube. Alternatively, they can be placed for the feeding process and then removed. Feeding tubes can similarly be placed in the stomach (G-tube) and protrude from a belly bandage. The G-tube has all the advantages of the E-tube and is favored by some doctors. Again, the tube diameter is large enough to accommodate a slurry rather than a liquid, and the tube is comfortable to wear and use. A brief surgery under general anesthesia is required to place the tube. Syringe or Force Feeding An E tube. Photo by Dr. Deb ZoranIn the past, syringe or force-feeding was used in an effort to get calories into a pet. There are several disadvantages to this technique and no advantages. First, the pet is not going to like it, and there will be struggling, stress, and mess. The pet may be too sick to withstand stressful feedings, and creating ongoing unpleasant feeding experiences can result in what is called "food aversion," where the pet may not ever have a normal appetite again. Feeding too quickly can lead to choking or food aspiration if the feeder is too aggressive. Talk with your veterinarian before using this method, as it can be detrimental to your pet. Nutritional support is essential to proper recovery and it is important to realize that there are several techniques available to see that the pet does not suffer extra debilitation from malnourishment. If you think your pet has a problem with weight loss or inadequate appetite, do not wait until the problem is extreme; see your veterinarian promptly. Credit: VIN
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