The Most Common Ectoparasites in Montana

Ectoparasites are those that live on the outside of a host and consume the host’s blood, skin or hair as a source of food.  They can cause discomfort and secondary infections.   Summertime in Montana is generally the most common time of year for pets to become infected with external parasites; however, the problem varies seasonally from year-to-year, sometimes starting early in the spring or lasting late into the fall.

Fleas

Flea seen under the microscope at MVS

Flea seen under the microscope at MVS

Fleas are wingless insects that live on the blood of a host.  They are very small and move quickly by jumping.  This can make it difficult to see them in the early stages of pet infestation and so we look for other signs like scratching, red skin, scabs and ‘flea dirt’ – it looks like dirt at first glance but is actually the excrement that the fleas leave behind.   Our pets get fleas from other animals with fleas; it could be spread from a feral cat, a neighbors’ dog or from wildlife – raccoons, rabbits, or deer.  While fleas prefer to live on our pets, they can still bite humans and infest our homes.  Once heavily infested, it can be challenging to eradicate and often requires several treatments of the infected pet and environment to completely disrupt the life-cycle of the resilient flea.  Fortunately there are several modern products available that are safe and effective at preventing a flea infestation.  It should be noted that cats and dogs have products specifically designed to be safe for their particular species.  Cats can get severe toxicity from exposure to flea treatment designed for dogs and rabbits can be fatally harmed if the wrong flea treatment is used.

Lice

Canine sucking louse seen under the microscope at MVS

Canine sucking louse seen under the microscope at MVS

Lice is a parasitic insect that are species specific, which means dogs can only get lice from another infected dog and cats can only get lice from another infected cat; lice that infect dogs and cats are not the same species as human head-lice and cannot be transferred to us from our pets.  Lice are about the same size as a flea but unlike fleas, canine and feline lice move very slowly.  This means they do not easily transfer from host to host, but transmission can still occur through direct contact or shared inanimate objects (fomites), such as grooming tools.  Itching or chewing is a typical sign that a pet may be infected.  Treatment of lice is generally very easy but requires a follow-up treatment to ensure that the life-cycle is terminated.

Ticks

Tick recovered at MVS

Tick recovered at MVS

Ticks are more closely related to spiders than insects.  They feed on the blood of a host animal.  They are usually found in low shrubs or grass and are transferred to anyone brushing past them.  They aren’t necessarily spread through direct contact and can survive in the environment for a long time without feeding.  We see them more commonly on dogs than cats since cats are incessant self-groomers.  Ticks don’t necessarily cause itching so we rely on inspection, which can be challenging on long-haired animals.  Since ticks are drawn to hidden areas of the body, the first places to inspect are ears, armpits, toes and groin.  If you find a tick on your pet, it should be removed gently with tweezers by pulling slowly and steadily away from the skin to encourage the tick to back out of the skin.  If the tick’s head is left in the skin, it needs to be removed to make sure the area doesn’t get infected. Ticks have the potential of spreading harmful diseases that affect us and our pets.  The good news is that many of the products that prevent fleas are also effective at preventing ticks from choosing our pets as hosts.

Mange

Mange is a skin disease caused by mites, a microscopic parasite.  There are three types of mange that we see on pets in our area: sarcoptic mange, demodectic mange and otodectic mange.  It is important to differentiate them since they require different treatments.

Sarcoptic mange is a caused by a mite that burrows under the skin.  It causes intense itching and chewing.  If untreated, the skin may eventually become thick and dark.  It is highly contagious to other animals and can be transferred to humans, causing a skin condition called scabies.  The mites cannot complete their life cycle on humans so treating the animal will resolve the human scabies.  We look at skin scrapings under the microscope to confirm the presence of the sarcoptic mite.

Demodectic mange, also known as demodex, is caused by a different type of mite that lives in the hair follicles of affected animals.  These mites live naturally on the skin and as long as the body’s immune system is healthy, they cause no harm.  Young animals with developing immune systems and immune-compromised adult animals are most susceptible.  Since this mite is found naturally on the skin of many animals (including humans), exposure of a healthy animal is not considered harmful.  This mite does not typically cause itching so we look for hair loss around the eyes and face or other localized areas of the body to identify the condition.

Otodectic mange is better known as the ear mite.  They live mostly in the ear canal of an infected animal.  The primary symptoms include itching, shaking head and build-up of a thick, dark residue in the ear.  These are also the symptoms for other types of ear infections so it is important to examine an ear swab under the microscope to identify the mites.  Ear mites from pets can temporarily hang out on humans but do not survive for long or cause us long term problems.

Over-the-counter treatment of the different types of mange is often unsuccessful in part because of the untrained and incorrect diagnosis of well-meaning pet owners but also because the types of products available without a veterinary prescription are lacking in efficacy.  In the case of mange, it really is safest and most cost-effective to seek professional veterinary advice.

Ringworm

“Ringworm” is a bit of a misnomer since it is a skin disease caused by a fungus and has nothing to do with a worm.  The fungi invade hair follicles making them brittle and prone to breaking.  This causes ring-shaped areas of hair loss.  Transmission can occur through direct or indirect contact and the spores can survive for a time on inanimate objects in the environment.   Ringworm can be transmitted to humans and children seem to be more susceptible than adults.  Some species of the fungus will fluoresce under a UV light, but the most accurate diagnosis is made by sending a hair sample to a lab where they place the hair in a special medium to check for fungal growth.  This process may take up to 3 weeks to get a result so we generally begin treatment based on the appearance of the skin lesions.  The treatment of choice depends on the severity of infection, the number of pets and whether there are children involved.

Resource for additional information:

http://www.capcvet.org/

 

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Accolades for Dr. Brenda

BrendawithowlWe are so proud of Dr. Brenda for donating her time and advanced ophthalmological knowledge for the greater good of the raptors at the Wildlife Center of Montana.  She evaluates those with eye injuries or abnormalities and accesses the need for treatment, giving the bird a better chance for success if being released back into the wild.  She was recently honored by the governor for this contribution.

BJCgovernorletter

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Canine Influenza in Helena and How to Keep your Dog Safe


Diego CIV 2

Above: Diego, sick with a cough, at home resting.

What is the ‘Dog Flu’?

Canine influenza virus (CIV) is a respiratory tract disease that mimics bordetellosis (kennel cough or infectious tracheobronchitis). CIV is a highly contagious respiratory illness with symptoms ranging from mild to severe: lethargy, decreased appetite, coughing/gagging, nasal discharge, and fever.  Many dogs may be infected but do not show symptoms and can still spread the virus to other dogs.  This makes it difficult to determine who is exposed.  Most dogs develop only mild symptoms that last for 1-3 weeks. Although not common, some patients may develop pneumonia that can be life threatening.

Types of Canine Influenza

There are two known types of CIV that infect dogs in the USA, H3N8 and H3N2.  H3N8 was first diagnosed in Florida in 2004 and has since spread throughout the country.  Last year, the type known as H3N2 was confirmed in a large outbreak in the Chicago area.  On January 12th  2016, the Helena Independent Record reported a confirmed case of the H3N2 strain in Helena.

How is it Spread?

CIV is transmitted from respiratory secretions in the air from coughing, sneezing and barking or through contaminated surfaces and other shared objects.  It can be killed by many disinfectants, but the disease can still spread directly through airborne particles.

Prevention and Vaccination

Minimizing contact with other dogs is the easiest way to prevent your dog from getting sick.  Avoid places such as boarding facilities, training classes, grooming facilities, and dog parks.  If this is not possible, your dog is elderly, or has a compromised immune system you now have the option of vaccinating.  We offer vaccination for both strains of CIV.  Patients receiving the vaccine will require two doses the first year.  The second dose needs to be given 2-4 weeks after the first dose to be effective.  At this time we will not require it, but will make it available on a case-by-case basis.  Some boarding facilities may require it.

Treatment

For mild cases, cough suppressants are often enough.  For serious cases, hospitalization and more aggressive treatment may be necessary.  Although antibiotics have no direct effect on the flu virus, they can be helpful in fighting secondary bacterial infections.  It should also be noted that many cases of coughing in the dog are secondary to bordetella tracheal bronchitis which is a bacteria that will respond to antibiotics.

The following websites offer more information if needed:

https://www.avma.org/KB/Resources/Reference/Pages/Canine-Influenza-Backgrounder.aspx

http://helenair.com/news/local/case-of-highly-contagious-dog-flu-confirmed-in-helena/article_4e5b283c-cabc-5691-be62-8511da250561.html

 

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Raw Pet Food Diets Can Be Dangerous To Your Pet

iStock_000013833505SmallIn a recent study, one-third of samples of raw dog or cat foods ordered online were positive for Listeria organisms.

An article published in the September edition of Foodborne Pathogens and Disease, “Investigation of Listeria, Salmonella, and toxigenic Escherichia coli in various pet foods” (see link below) indicates 65 out of 196 samples of raw dog or cat foods were positive for Listeria. In addition 15 of the 196 samples were positive for salmonella and two were positive for shiga toxin producing E coli.

“This study showed that raw pet foods may harbor food safety pathogens, such as Listeria and Salmonella” the article states.  Consumers should handle these products carefully, being mindful of the potential risks to human and animal health.”

The authors also found that 2 of 190 jerky-type treats were positive for shiga toxin producing E coli, and one was positive for Listeria.

Investigation of ListeriaSalmonella, and Toxigenic Escherichia coli in Various Pet Foods 

fpd.2014

Also attached is a great article regarding the current knowledge base of the risks and benefits of raw food diets.

javma.243.11fpd.2014

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Halloween can be Spooky for Pets

 

iStock_000011035705Small

Many people like to have fun during the Halloween festivities, but our pets can truly be frightened by all of the noises and costumes. Halloween is a holiday with many dangers for our dogs and cats.

Dressing up is fun for humans, but may not be fun for our pets. If your pet tolerates a costume, keep in mind your pet must be comfortable at all times. Avoid any costumes that use rubber bands or anything that might constrict circulation or breathing. Likewise, avoid costumes with toxic paints, dyes, or that are edible.

Costumes on people can be equally scary to pets. Masks, large hats, and other costume accessories can confuse pets and may even trigger territorial instincts. It is not unusual for pets to act protective and fearful of people in costumes, even if they are normally very social with that person. Remember, you are responsible for controlling your pet and insuring that he doesn’t bite any guests.

Constant visitors to the door along with spooky sights and sounds may cause pets to escape and become injured in a variety of ways. Consider letting your dog spend Halloween inside with special treats, safe and secure. Even in a fenced yard, Halloween is not a good night for a dog to be outside. This is doubly true for cats: they may try to bolt out the door and even if they are allowed outside, they are more at risk for being hit by cars due to the high traffic from trick or treaters. Black cats, especially, are at a higher risk from human cruelty on Halloween. Consider keeping your cats in an interior room where they are unable to bolt out the door.

Some Halloween decorations can be unsafe for your pets. Fake cobwebs or anything resembling string can be tempting to cats, leading to an intestinal obstruction. candles, even inside pumpkins, can be easily knocked over, burning your pet or even lighting them (it has happened before) or your house on fire!

Keep pets away from all Halloween candy. Most people know that chocolate can be toxic to pets, even in small amounts. However lollipop sticks and foil wrappers can cause blockages in the intestinal tract. Candy sweetened with xylitol can cause a life threatening drop in blood sugar if ingested by a pet. Some pets can get an upset stomach just from eating a piece of candy, since it isn’t part of their regular diet.

These simple responsible precautions will help humans and pets alike have a safe holiday. For more information on how to make Halloween less stressful to your pet, contact your veterinarian.

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New Way To Fight Cancer Using Old Drugs

Metronomic Chemotherapy
The definition of metronomic chemotherapy varies, but generally it refers to repetitive, low doses of chemotherapy drugs designed to minimize toxicity and target the endothelium or tumor stroma as opposed to targeting the tumor.” Dr. Harold Burstein of the Dana-Farber Cancer  Institute. 

 

Principles of Metronomic Chemotherapy:

“For almost half a century, systemic therapy of cancer has been dominated by the use of cytotoxic chemotherapeutics.  Most of these drugs are DNA-damaging agents that are designed to inhibit or kill rapidly dividing cells.  They are often administered in single doses or short courses of therapy at the highest possible dosage without causing life-threatening levels of toxicity.  This is referred to as the “Maximum Tolerated Dose” (MTD).  MTD therapy requires prolonged breaks (generally 2-3 weeks in duration) between successive cycles of therapy.  Progress had been modest in terms of curing or significantly prolonging the lives of patients with cancer using MTD—particularly those with advanced-stage or metastatic disease.  The higher the dosage of chemotherapy, the more likely we are to kill the cancer, but the limiting factor is always the adverse side effects that occur with increasing dosages.  More recently, a lot of research has been directed towards a reappraisal of the best ways of administering chemotherapy.  Instead of using short bursts of toxic MTD chemotherapy interspersed with long breaks to allow recovery from the harmful side effects, there is now a shift in thinking towards the view that more compressed or accelerated schedules of drug  administration using much smaller dosages than MTD might be more effective—not only in terms of reducing certain toxicities but perhaps even improving antitumor effects as well.” (Kerbel RS and Kamen BA, The Anti-Angiogenic Basis of Metronomic Chemotherapy, Nature Reviews Cancer 2004.)

“Tumors need a blood supply in order to grow and spread”

 

There is a considerable body of evidence that even very low, nontoxic doses of chemotherapy drugs, when delivered frequently for a prolonged period of time (metronomic chemotherapy)  can retard tumor blood vessel growth (or angiogensis) by destroying endothelial cells.  Endothelial cells are the cells that line the blood vessels.  Angiogenesis, or the orderly formation of the endothelial cells into blood vessels, is necessary for tumors to grow and to spread.  Stopping this process, or anti-angiogenic therapy, has been shown to be an effective way to stop tumor growth and metastasis.  The endothelial cells that form the lining of newly formed blood vessels, such as those whose creation is orchestrated by tumors to fuel their growth are the targets for this type of therapy.  Simply put, if you starve the blood supply to the tumor, it is deprived of necessary oxygen and nutrients needed to survive.

Drawing reproduced from The Stehlin Foundation for Cancer Research September 2003 newsletter.

In veterinary medicine, there have been several studies published that give promise to the principle of metronomic or anti-angiogenic therapy.  In dogs with incompletely resected soft tissue sarcomas, Elmslie, et al. [J Vet Intern Med 2008;22(6):1373-9)]showed that the use of low dose daily cyclophosphamide (cytoxan) and piroxicam (feldene) extended the time to recurrence over patients treated with surgery alone.  In addition,   Lana,  et al. [J Vet Intern Med 2007;21(4):764-9]showed that in patients with hemangiosarcoma, the use of metronomic chemotherapy was associated with survival times equal to that of MTD chemotherapy.

Dr. Robert Kerbel (Toronto, Ontario) is one of the leaders in anti-angiogenic and metronomic therapy.  He has recently suggested that the clinical benefit and impact could be greater if the therapy were initiated at earlier stages of malignancy.  Therefore, at the Animal Cancer and Imaging Center, we recommend standard MTD chemotherapy combined with low dose metronomic therapy for many tumor types such as osteosarcoma and hemangiosarcoma.  For other tumor types, metronomic chemotherapy may be the primary modality of therapy or will start after standard therapy has ended.  We will discuss with you in detail what is the optimum use of this therapy for your pet as your pet’s individual condition and general health other than the cancer may have a impact on the schedule of treatment we utilize.  It must be kept in mind that the laboratory and clinical research with metronomic chemotherapy administration is ongoing but extremely promising.

Schematic of changes in tumor vasculature during the course of anti-angiogenic therapy.  A. Normalvasculature composed of mature vessels and maintained by the perfect balance of pro-and anti-angiogenic molecules, might not change during the course of anti-angiogenic therapy.  B. Abnormal tumor vasculature, composed largely of immature abnormal vessels. C. Judiciously applied direct or indirect anti-angiogenic therapies might prune immature vessels, leading to more normalized tumor vasculature.  This network should be more efficient for the delivery of therapeutics and nutrients.  D.Rapid pruning of, or coagulation in, tumor vasculature might reduce the vasculature to the point that it is inadequate to support tumor growth and might lead to tumor dormancy.  This is the ultimate goal of anti-angiogenic/anti-vascular therapy.
From Nature Medicine 7, 987-989 (2001).

How is treatment given? Prior to beginning metronomic chemotherapy, some baseline information is needed to evaluate your pet’s cancer and his/her general health.   Measurements of existing tumors if present are necessary to determine response.  This may be a physical measurement of an obvious tumor on the outside of the body, or by radiographs or ultrasound for internal tumors.  A CBC, chemistry panel, and urinalysis are needed prior to starting treatment.  If test results are acceptable, then cytoxan and piroxicam are dispensed.  It is important that you follow handling and administration guidelines provided for you at the time of starting chemotherapy.
What are the side effects of treatment? Although side effects to this regimen of therapy have been negligible, monthly CBC’s (complete blood counts), serum chemistry panels, and urinalyses are advised.  We carefully watch renal function and monitor for blood in the urine, as these can be side effects of these drugs at higher dosages.  Our protocol consists of daily oral cytoxan (cyclophosphamide) and Feldene®(piroxicam).  Feldene is a non-steroidal anti-inflammatory drug (NSAID) that is sometimes associated   with gastrointestinal upset.  For this reason, we also advise using Pepcid or a similar medication to prevent gastrointestinal upset and ulceration.

As always, if there are any concerns about symptoms your pet may be exhibiting after starting these drugs, please contact our office.

 

 

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Heartworm Video

This is video clip of Heartworm larva swimming in the blood of a dog seen recently at Montana Veterinary Specialists.

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Heartworm disease is a serious and potentially fatal condition caused by parasitic worms living in the arteries of the lungs and occasionally in the right side of the heart of dogs, cats and other species of mammals. Dogs and cats of any age or breed are susceptible to infection. Infection can be prevented with a monthly heartworm preventative. Learn more at http://www.heartwormsociety.org/pet-owner-resources/heartworm.html

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Skin Allergies (Atopy)

A dog that has allergies most often shows it through skin problems and itching. Allergies may be to a variety of things such as household products, food ingredients, or grasses and pollens. Causes of itchy skin may include bacterial infections mites or fleas, systemic illnesses, or allergies (termed Atopy). Many of these causes can be ruled out during a visit to a veterinarian. Diagnosing allergies means either elimination trials, or direct allergy testing. Although there are blood tests available to rule out allergies, these tests are not specific and  false positive results are very common. The most sensitive and specific test for allergies is intradermal skin testing (skin prick test). Treatment of skin allergies may include symptomatic therapy with antihistamines, fatty acids, prednisone, or other medications that modulate the immune system. Although effective in many cases, many animals have unwanted side effects from these medications and directly treating the condition with immunotherapy (hyposensitization or allergy shots) maybe the best choice for many animals.

 

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Heart Disease

 

A dog’s heart beats between 60 and 120 times per minute, and with each contraction, oxygen and energy are carried in the blood to the muscles and organs of the body, and waste products and carried away. As wit human’s cats’ and dogs’ hearts consist of four chambers separated by valves to ensure the blood flows in only one direction.

Heart disease can either be congenital meaning the animal is born with an abnormality, or acquired meaning the disease occurs later in life. There are a number of different types of acquired heart diseases, but for most pets, the disease typically falls into one of two categories:

  1. Valvular disease is a condition where one or more of the valves of the heart do not close properly. The majority of dogs with heart disease suffer from this.
  2. Cardiomyopathy is a condition where the heart cannot pump effectively. There are several types of cardiomyopathy. This is the most common form of heart disease in cats.

In many cases, the cause of heart disease is unknown, but as with humans, risk increases with age. Certain breeds of dogs and cats appear to be predisposed to different types of heat disease.

Hyperthyroidism can contribute to heart disease in cats, as con diets low in taurine. Heartworms, which are transmitted by mosquitos, can cause heart problems in both dogs and cats.

Signs of heart disease can be subtle, and may be mistaken for normal aging. They include:

  1. Coughing (less common in cats)
  2. Rapid breathing, shortness of breath, difficulty breathing (open-mouth breathing in cats)
  3. Lethargy
  4. Behavior changes (less interested in walks or playing)
  5. Weakness
  6. Loss of appetite and weight loss
  7. Swollen abdomen

Dogs and cats with mild heat disease may not show and signs of illness. Unfortunately, the condition is usually progressive, and eventually heart failure (the inability of the heart to pump an adequate blood supply throughout he body) may occur.

It is sometimes possible to detect heat disease before your pet shows and symptoms. In addition to listening to your pet’s heat for signs of a heart murmur or abnormal rhythm, there are a number of diagnostic tests your veterinarian may recommend, including, radiographs (also referred to as x-rays), ultrasound (echocardiogram), blood work, electrocardiogram (ECG), and blood pressure tests all of which can help determine whether the hear is diseased and the extent of the disease.

There is no cure for most heart disease, but early detection and treatment can help your beloved pet live loner and more comfortably with the disease. One or more long term medications may be prescribed. Modifications to your pet’s diet and exercise regimen may be required, and follow-up examination by your veterinarian at regular intervals is strongly recommended to monitor the progression of the disease.

 

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Xylitol Poisoning

Sugar substitutes are big business. Less sugar can mean weight loss, improved health, diabetic control, and even reduced tooth decay. The quest for products that can sweeten and cook like sugar is ongoing. Xylitol is common sugar substitute, especially when it comes to sugarless gum. Not only does xylitol offer sweetness without calories, it also has antibacterial properties in the mouth so as to reduce periodontal disease and has been found to have far reaching health benefits in other areas of the body. Xylitol may help with osteoporosis, prevention of ear and throat infections, and may reduce risk of endometriosis, uterine fibroids, and even breast cancer.

Sounds wonderful and maybe it is – if you are a human. If you are a dog, xylitol is potentially lethal.

Two Deadly Effects of Xylitol

Hypoglycemia
In the canine body, the pancreas confuses xylitol with real sugar and releases insulin to store the “sugar.” The problem is that xylitol does not offer the extra Calories of sugar and the rush of insulin only serves to remove the real sugar from the circulation. Blood sugar levels plummet resulting in weakness, disorientation, tremors, and potentially seizures.
It does not take many sticks of gum to poison a dog, especially a small dog (see below for toxic doses). Symptoms typically begin within 30 minutes and can last for more than 12 hours. Vomiting and diarrhea may also occur.

Hepatic Necrosis
The other reaction associated with xylitol in the canine body is actual destruction of liver tissue. How this happens remains unknown but the doses of xylitol required to produce this effect are much higher than the hypoglycemic doses described above. Signs take longer to show up (typically 8-12 hours) and surprisingly not all dogs that experience hepatic necrosis, will have experienced hypoglycemia first. A lucky dog experiences only temporary illness but alternatively, a complete and acute liver failure can result with death following. Internal hemorrhage and inability of blood to clot is commonly involved.

How Much Xylitol Is Dangerous?
The hypoglycemic dose of xylitol for dogs is considered to be approximately 0.1 grams per kilogram of body weight (about 0.045 grams per pound). A typical stick of gum contains 0.3 to 0.4 grams of xylitol, which means that a 10 lb dog could be poisoned by as little as a stick and a half of gum.

The dose to cause hepatic necrosis is 1 gram per kilogram of body weight, about ten times more than the above dose. In the example above, the 10 lb dog would have to find an unopened package of gum and eat it for liver destruction to occur.

Treatment
Ideally, the patient can be seen quickly (within 30 minutes) and can be made to vomit the gum or candy. Beyond this, a sugar IV drip is prudent for a good 24 hours. Liver enzyme and blood clotting tests are monitored for 2 to 3 days. Blood levels of potassium are ideally monitored as well. Elevated blood phosphorus levels often bode poorly.

What about Cats?
So far National Animal Poison Control has no reports of xylitol toxicity in cats. At this time, feline toxicity is unknown.

What about Xylitol Containing Mouthwashes for Pets?
The oral health benefits of xylitol do seem to hold true for dogs if appropriately low doses of xylitol are used. A product called Aquadent® has been marketed for canine oral care, specifically for dogs that do not tolerate other methods of dental home care. This product is mixed in drinking water to provide antibacterial benefits. It comes in a 500cc (half liter) bottle that contains a total of 2.5 grams of xylitol as well as in small packets. If one follows the dosing instructions on the bottle or packet, there should be no problems.
Trouble could occur if there are animals of different sizes drinking from the same water bowl (one should dose for the smallest animal to use the bowl to be sure overdose is not possible). A dog finding the bottle and chewing it up, drinking a substantial quantity of the undiluted product could easily be poisoned depending on the dog’s size.

Please read this FDA warning

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