Monthly Archives: January 2011

Follicular Conjunctivitis

As previously written in my article on “Conjunctivitis” in January 2011, conjunctivitis is an inflammation and/or infection of the lining of the eye, not including the cornea or sclera (white) portion of the eyeball. Follicular Conjunctivitis is an inflammation and/or infection specifically of the third eyelid, also known as the nictitating membrane. Every time the eyelids close, or blink as we call it, the third eyelid sweeps across the cornea and part of the sclera. This functions as a windshield wiper does on a car, cleaning away any debris. The debris of an eye can be dirt, dust, pollen, pus, or foreign bodies such as pieces of leaves, hair, etc. This cleansing function is to protect the cornea from any damage. But, when the inflammation or infection is very severe, the inside lining of the third eyelid becomes irritated itself and small cysts or follicles develop. This is what we refer to as Follicular Conjunctivitis. Any eye irritant can cause the surface of the conjunctiva and especially the lining of the third eyelid to become this way. I once removed a cats’ nail from the inside of the third eye-lid. Obviously, they were fighting and fortunately the eyeball itself was not damaged. When severe irritants like this occur, the tear gland of the eye responds by producing more and more mucus (tears) to lubricate the eye. Sometimes the gland is so swollen it is visible in the corner of the eye. (See “Cherry Eye” at my website.) Fortunately, Follicular Conjunctivitis does not cause any visual impairment and usually will respond to a few weeks of therapy with properly prescribed eye ointment or drops. On occasion, for those resistant cases, a minor surgical procedure is necessary to remove the follicles so the medicine can get to the conjunctiva. The most common symptoms of Follicular Conjunctivitis are: excess blinking, excess tearing, pus discharge from eyes, redness of eyelids, rubbing and scratching of the eyes, swollen eyelids and sometimes sneezing, coughing. It is imperative that a diagnosis be made early and treatment is initiated early so the cornea does not get damaged. As with any medical condition, diagnose and treat early for the best success.

Intestinal Parasites (worms)

It amazes me that one of the afflictions of dogs and cats easiest to diagnose and treat is such a common condition veterinarians still see. Because of lack of sanitary conditions, ignorance, and/or greed, dogs and cats continue to be sold with intestinal parasites. The breeders, pet stores and even the puppy mills are all familiar with these parasites and choose either to do nothing about their eradication, or do it improperly. It is getting better though–twenty years ago over 80% of all dogs and cats used to have one or more of these intestinal parasites present when veterinarians first examined them, as compared to only 20% today. It should be 0 %. There are six common intestinal parasites of dogs and cats, and some are communicable to humans. 1. Roundworms live in the small intestines and pass eggs in the stool. Puppies can get an infection from their mother via the placenta, infected feces, or by ingestion of other infected animals such as rats. The larva can penetrate human skin and cause a condition known as “Visceral larval migrans”. 2. Hookworms also live in the small intestines and pass eggs in the feces. The larva can burrow through the dog and cat footpads and skin. The larva can also penetrate human skin and cause a condition known as “cutaneous larval migrans”. 3. Whipworms live in the large intestines and infection is also transmitted through the feces-oral route. Humans do not get any form of this parasite. 4. Tapeworms also live in the intestines but are transmitted by the consumption of fleas or infected rats or rabbits. Segments of the tapeworm are shed and occasionally the eggs. Human infection is very rare but can occur from eating contaminated meat. 5. Coccidia are microscopic protozoan parasites of the intestines and also shed eggs that are very contagious among all animals. They rarely cause a problem in humans but can be found in raw meat. 6. Giardia is a very common intestinal microscopic protozoan parasite of all animals. It is very communicable to people through infected drinking water, rivers, lakes, and animal feces, etc. All of these are easy to treat and require specific medications for varying periods of time. Have your pets’ stool checked by your veterinarian 1-2 times yearly. Remove feces from lawn and street daily. Try to walk and exercise your dog where other dogs DO NOT go. Prevent pets from eating rodents and rabbits, and control fleas.

Addison’s Disease

Last week I wrote of Cushing’s Disease, and this weeks disease is just the opposite of Cushing’s: Addison’s Disease, which occurs because too little steroids are produced by the body that are essential for life. Because the symptoms are very vague and similar to many other diseases, it is one of the misunderstood and misdiagnosed diseases that dogs can get. These symptoms can include all or some of the following: diarrhea, vomiting, fatigue, muscle pain, lack of appetite, and weight loss. Occasionally sudden collapse and shock occurs and, without proper treatment, it can be fatal. This collapse is known as an “Addisonian Crisis”. Addison’s Disease can show up in any breed of dog or sex, and occurs more frequently in young to middle age females. It is very rare in cats. Certain breeds seem to get it more which implies a genetic predisposition. These breeds are Standard Poodles, Great Danes, Soft Coated Wheaten Terriers, Bearded Collies, and Portuguese Water Dogs. A deficiency in the hormones produced by the adrenal glands is the usual cause of Addison’s Disease. The adrenal glands are located by the kidneys and produce cortisol and aldosterone. Cortisol is a glucocorticoid (steroid) that aids in metabolism and conversion of food into energy. It is essential in maintaining the body’s immune system and its response to inflammatory conditions. Aldosterone is a hormone in the mineral corticoid (steroid) family. It is essential in maintaining proper blood pressure and essential electrolyte balance, such as sodium and potassium. There are two forms of this disease: primary and secondary. Primary is the result of improper function or injury to the adrenal glands and secondary involves the pituitary gland located at the base of the brain, or the hypothalamus (part of the brain) which produces a hormone known as corticotropin. The pituitary produces a hormone known as ACTH which stimulates the adrenal gland to produce its hormones. If the pituitary and/or the hypothalamus does not do this properly, the dog gets secondary Addison’s Disease. Regardless which form of the disease occurs, both can be properly diagnosed by special blood tests and both can be successfully treated. Fortunately, once treated the dog can live a normal life, but will require medication for its entire life.

Cushing’s Disease

This is a disease that occurs more frequently than was initially believed. At one time it was considered the most misdiagnosed disease because it was  confused with other diseases with similar symptoms. These symptoms include some or all of the following: increased thirst, increased urination, increased appetite, thinning of the hair, severe loss of hair, weight gain, and an enlargement of the abdomen.  Diseases like diabetes, hypothyroidism, kidney disease, some forms of cancer, and certain skin disorders have the same symptoms. Cushing’s Disease occurs mostly in dogs, and occasionally in cats, and has no breed predisposition. The disease occurs because of the overproduction of  glucocorticoids (steroids) in the body. There are three forms of the disease:  Pituitary, Adrenal, and Iatrogenic. Simply put, the pituitary gland, located at the base of the brain, produces a hormone that stimulates the adrenal glands, located by the kidneys, to produce the steroids the body must have to survive. With Cushing’s Disease, 80% of the time there is a tumor of the pituitary gland that causes  the overproduction of the hormone. 20% of the time there is a tumor of the adrenal gland that causes the same thing. The “iatrogenic” form occurs as the result of high doses of steroids being given to the patient, or lower doses given for a very long time. Usually, regardless of which form of Cushing’s Disease, the symptoms develop slowly in dogs 6 years and older, but rarely in younger dogs.  The loss of hair appears to be the primary symptom for bringing the dog to the vet as the increased thirst and urination is usually thought, by the owner, to be the result of getting older. There are a number of blood tests available to  veterinarians to make a proper diagnosis as well as ultrasound technology. In the last few years new drugs have surfaced and treatments are now more successful. Only rarely is surgery performed today. The ‘iatrogenic” form usually responds to the cessation of steroids administered either by the veterinarian or owner.

Pancreatitis

This painful condition occurs in dogs more frequently than you think, especially around holiday season. Dogs live on the floor, food drops onto the floor and the dogs eat it, or guests give your pet table food. Either way, eating the wrong thing is the most common cause of pancreatitis. Other causes include trauma, certain medications, obesity, high fat content in the  diet, diseases like Hypothyroidism and Cushing’s disease, and  genetics. The breeds more prone to the disease are Schnauzers and Yorkshire Terriers, but it occurs in Beagles, German Shepherds also. In fact, it can occur in any dog with a tendency to eat table food or get into the garbage. The pancreas is an important organ for the production of insulin and the two enzymes necessary for starch and fat metabolism. When inflamed, the enzymes overproduce and sometimes leak out into the surrounding tissue. This inflammation of the pancreas can be acute or chronic. The symptoms can include some or most of the following: vomiting, painful abdomen, fever, depression, lack of appetite and reluctance to move. If left untreated, it can cause heart irregularities and severe infection through-out the body, known as sepsis. Diagnosis is done by a complete physical exam, history, blood tests, radiographs, and sometimes ultrasound. There are no “anti-pancreatitis” drugs on the market, thus no simple cure. The treatment usually is successful and requires intravenous fluids for the associated dehydration and electrolyte imbalance, anti-vomiting drugs, antibiotics, antacids, pain-relief medications, and NO FOOD for a few days. This gives the pancreas time to slow down on the production of these enzymes, in case there is leakage, and gives the irritations in the stomach and intestines time to heal. Most of the treatment is done by injections the first few days, so nothing is given orally  Special low fat foods are then gradually introduced to the patient, as well as oral medications. Once a dog has pancreatitis, there is a tendency for reoccurrence, so special diets and medications are often prescribed for life.