Category Archives: Sick

Conjunctivitis

Conjunctivitis
By Dr. Karen Burgess

What is conjunctival tissue?
The conjunctiva is the pink fleshy tissue that covers the eye and tissue surrounding it.  In a cat or dog with healthy eyes this conjunctiva should not be easily seen.  In cases of conjunctivitis where the conjunctiva is inflamed owners will often notice angry red tissue near the eyelid.  The conjunctiva is made up of mucous secreting cells similar to that found in the mouth and nose and serves to help protect and lubricate the eye.

What are symptoms of conjunctivitis?
Mild cases of conjunctivitis may appear as increased tearing that is clear or colored in nature.  More severe cases can develop swollen pink or red bulging tissue that appears to almost cover the eyeball.  The eye may become increasingly painful causing a pet to hold it shut or paw/rub at eye.  In severe cases it may be difficult to see any part of the normal eye.

Why do cats and dogs develop conjunctivitis?
There are numerous reasons for the conjunctiva to become inflamed.  Infectious causes include viruses and/or bacteria.  In some cases infections will develop secondary to some other underlying cause of conjunctival inflammation.  For cats viral conjunctivitis is extremely common and closely related to upper respiratory viral infections they are exposed to at a very young age.  In several of these situations the cat may recover from the initial infection but the virus remains dormant in their body reappearing later in life at times of stress or illness.  Non-infectious causes of conjunctivitis are typically related to the anatomy (size, shape, and location) of the eyeball itself.  Dogs often develop a condition where they stop producing tears which then leads to a “dry eye” and secondary conjunctivitis.  Some breeds of cats and dogs are more prone to having flat faces or bulging eyes which can change how the eyelid sits against the eye.  In these cases eyelashes or facial fur may rub against the eye and conjunctiva causing inflammation.  Allergic disease, foreign material caught in the eye, tumors, and immune disease are all additional causes of conjunctivitis.

How is conjunctivitis diagnosed?
A veterinary examination will typically reveal the presence of conjunctivitis.  Additional testing of the cornea and tear production may also be necessary.  If systemic disease is suspected bloodwork may be recommended.  In complicated cases referral to an ophthalmologist may be recommended.

What are treatment options for conjunctivitis?
Definitive treatment of conjunctivitis involves diagnosing the underlying cause for treatment and controlling secondary bacterial infections.  This may involve topical drops or ointment, oral medications, eye lubricants, or surgery.  It is important to protect the eye from self-trauma by using a protective collar or Elizabethean collar.  Pain medication may also be prescribed to help with associated discomfort.

What is the prognosis with conjunctivitis?
Prognosis is directly related to the ability to treat the underlying condition causing the inflammation.

Labwork, FAQ

FAQ’s About Laboratory Work
By Dr. Karen Burgess

Why should laboratory work be performed on a pet?
There are many reasons to perform testing on a pet, some of the more common include:

  • As part of a wellness examination-our goal with annual labwork is to prove that a pet is healthy and not find abnormalities. The idea is to establish a baseline so that if and when a problem develops there is a “normal” reference point to refer back to.  This becomes increasingly important with age, thus why it is recommended that senior pets have labwork done twice a year.  In some situations a pet may seem healthy and an unknown medical condition may be identified thus allowing earlier intervention and possibly a better prognosis.
  • With illness-labwork allows further evaluation of the sick pet in an effort to further isolate the problem, assist with treatment, and provide prognosis.
  • Prior to anesthesia-the key to safe anesthesia is to plan ahead. A key component of this is preanesthetic labwork which helps to determine safe drug and dose selection.

How are labwork samples obtained?
Bloodwork is performed on a blood sample.  This sample is drawn from a neck or leg vein using a syringe and needle.  Urine is either collected in a clean container while a pet is naturally voiding or while being restrained using a syringe and needle.

Where are blood tests performed?
Bloodwork can be done either by an automated analyzer in the hospital providing results within the hour or at a commercial laboratory yielding results within a day or so.  Urine evaluation is done by automated analyzers and under the microscope visually.   Some samples are also evaluated by trained personnel under the microscope.

Canine Influenza – Update

Update- Dr. Burgess on Canine Influenza
in the Crystal Lake, Algonquin and Lake in the Hills area

This week new information has become available concerning the current Influenza outbreak.  Cases of this upper respiratory infection (symptoms may include fever, lethargy, cough, nasal discharge, pneumonia) have been reported now in various locations outside of the city.  The strain of Influenza causing most of these cases has not been previously diagnosed in the United States which is making testing and treatment more complicated.  The current Influenza vaccination may not have any efficacy against this new Asian strain.  This Influenza virus while not contagious to humans is highly contagious to dogs and possibly cats (no reported cases as of yet) staying alive on surfaces for forty eight hours, clothing for twenty four hours, and hands for twelve hours.  Current recommendations include:

  1. Be aware that any exposure to any other dog that is infected may put your pet at risk.  Dogs are able to spread the infection several days prior to showing any symptoms.
  2. If planning to board, use doggie daycare, visit a dog park, participate in group dog classes, or attend dog events, be aware that your pet may be at greater risk for contracting this infection.
  3. Contemplate vaccination for Canine Influenza.  While the currently available vaccine may not prevent this strain, it does still prevent the original strain which has also been found in some affected Chicago pets.  Bottom line is we just do not know enough yet about this new strain, but vaccination for Bordetella and Influenza is what we have available at this point in time.
  4. Avoiding exposure is the number one preventative.

Below is the American Veterinary Medical Associations thoughts on Canine Influenza:

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

Canine Influenza

 Canine Influenza
By Dr. Karen Burgess

  

What is Canine Influenza?
Canine Influenza is a virus that primarily affects a dog’s respiratory system causing a cough, fever, and in some cases pneumonia.  The infection is often difficult to differentiate from other more common causes of respiratory disease in dogs (i.e. kennel cough).

How common is Canine Influenza diagnosed?
First diagnosed at Greyhound racetracks in 2004, Influenza has subsequently been diagnosed sporadically in pockets throughout the United States.  The occurrence is much less frequent in nature than other causes of “kennel cough” or infectious respiratory disease.  In spring 2015 there was an increase in respiratory disease seen in downtown Chicago; several of these cases tested positive for Canine Influenza.  It is important to remember that while the broadcast news may report “thousands affected” this has not been confirmed and many of these cases may in fact be from other more common causes of kennel cough.

How is Canine Influenza spread?
The virus is spread in respiratory secretions that have been aerosolized or landed on objects that another dog then comes in contact with.  Canine Influenza is highly infectious with 80% of exposed dogs developing some form of infection.  The 20% that do not become infected can however still spread the disease.  Group dog situations (daycare, boarding, dog classes, dog parks, veterinary hospitals) are more apt to encourage the spread of the disease.  Objects used with or by infected dogs (bowls, grooming utensils, leashes) can also spread infection.

What are the symptoms of Canine Influenza?
Most dogs infected with Canine Influenza develop minimal signs of a persistent cough lasting for two to three weeks.  Nasal discharge, loss of appetite, fever, breathing difficulties, and pneumonia may develop in more severely affected patients.  It is thought that the very young and very old are more susceptible.  In rare cases, infection and its subsequent complications may be fatal.  Any pet that develops signs of an upper respiratory infection that has been recently exposed to other dogs in particular in an area where an outbreak is or has occurred would be considered at higher risk for infection.

How is Canine Influenza treated?
For most dogs, at home care with possible antibiotics and cough suppressants is sufficient.  For more severely affected patients, hospitalization for fluid therapy, injectable antibiotics, and oxygen therapy may be necessary.

How is Canine Influenza exposure prevented?
The most reliable prevention is not having exposure to other dogs during an outbreak.  Avoiding group dog situations for several weeks until the risk has passed or vaccination is performed would be recommended.  It is important to remember that even with vaccination disease will likely not be 100% prevented.  From a hygiene standpoint, Canine Influenza stays alive on surfaces for forty eight hours, clothing for twenty four hours, and hands for twelve hours.  Cleaning with standard disinfectants such as dilute bleach kills the virus.  Dogs that have been exposed to the virus can shed or pass the virus on for two weeks after exposure.  More importantly, dogs will shed the virus most in the days prior to showing clinical signs.  This emphasized the importance of limiting exposure to other dogs if Canine Influenza has been identified in a region.

What about vaccination?
While there is a vaccine for Canine Influenza, it requires two injections and protection is not provided for two weeks minimum after the second dose is administered.  This means if the first vaccination is given today, a pet would not be protected for at least four weeks.  The vaccine does not 100% prevent disease or the spread of disease.  Considered a non-core vaccination (meaning only recommended for at risk dogs), Canine Influenza has not been a vaccine routinely given in this area.  With this recent outbreak vaccination of dogs frequently exposed to other dogs may be recommended.  In a large degree, this will depend on the extent the disease spreads and the duration of the outbreak.   Healthy Paws Animal Hospital is in the process of obtaining the vaccination for owners that are interested.  There are no major side effects associated with vaccination.

Kennel Cough

Infectious Tracheobronchitis (Kennel Cough)
By Dr. Karen Burgess

What is infectious tracheobronchitis?
Infectious tracheobronchitis is often also referred to as kennel cough.  The trachea or windpipe is the major airway that divides into smaller bronchi in the lungs.  Finally bronchi become bronchioles and alveoli where oxygen is ultimately exchanged with red blood cells in blood circulating through the body.  A variety of bacteria and viruses (likely more than fifteen) are capable of causing inflammation in the trachea and bronchi thus leading to a typical dry hacking cough.  While often described as one disease, kennel cough is actually a generalization that would be similar to a person saying they have a cold or the flu but not knowing the specific causative virus or bacteria.  Kennel cough is considered highly contagious from dog to dog.

What are symptoms of kennel cough?
Kennel cough is notorious for causing a dry hacking, non-productive, or honking cough that is easily exacerbated by excitement, exercise, or pressure on the neck/trachea.  Owners will often note that coughing is worse after barking or pulling on a collar.  Dogs with uncomplicated kennel cough do not show signs of general illness and are typically eating, drinking, and active.  Symptoms may only last for days or a mild cough may be present for weeks after infection.  If a pet is acting sick in any way other than a cough the problem may be more serious than kennel cough.

How is kennel cough spread?
Kennel cough is easily spread to healthy dogs from aerosolized cough droplets originating from an infected dog.  Objects such as toys and food bowls can also be methods of transmission.  Symptoms can develop anywhere from two days to two weeks after exposure.  Large numbers of dog in small confines with poor ventilation all contribute to risk.  Dogs that have had kennel cough can technically be contagious for two to three months after exposure.  Some dogs may not even show signs themselves of infection but still be able to spread the disease to other dogs.

What is the significance of a kennel cough?
Kennel cough is typically more of an inconvenience than a true medical problem.   Sleep for the pet and owner may be interrupted and severe cases.  Very young, very old, or immunocompromised dogs may be more prone to developing pneumonia from kennel cough.  The contagious nature of kennel cough requires infected dogs to be confined even after symptom free for some time.  Kennel cough is a not uncommon risk to boarding or exposing dogs to group situations.

How is kennel cough diagnosed?
Kennel cough is typically diagnosed by physical examination and review of patient history (recent exposure to other dogs, no other signs of illness).  Testing for the specific bacteria or virus responsible for an infection is typically not warranted and tests available are limited.  In some cases radiographs of the lungs may be recommended to help rule out other possible causes of a cough.

How is kennel cough typically treated?
Assuming no other symptoms are present, supportive care and time are often the only treatment required.  Rest, avoiding irritation of the trachea (ex. using a harness), and monitoring appetite are all recommended.  If the cough is such that it is keeping an owner or pet from sleeping through the night a cough suppressant may be recommended.  In some cases a course of antibiotics may be recommended, although this will not help if the original problem is viral in nature.

Can kennel cough be prevented?
Vaccination for distemper, adenovirus, Bordetella, and Parainfluenza (all potential causes of kennel cough) are available.  Distemper and adenovirus are core vaccinations recommended for all dogs and typically given as a puppy and adult in combination with parvovirus.  Bordetella and Parainfluenza are non-core vaccinations recommended only for dogs considered at increased risk for exposure to kennel cough.  Vaccination is available in both an intranasal and injectable formulation, however the intranasal is thought to be slightly more effective.  Surfaces exposed to kennel cough should be disinfecte with dilute bleach.

Can a dog get kennel cough even if they are vaccinated?
It is important to note that no vaccine is 100% effective against kennel cough and that if a vaccinated pet develops the disease this does not mean that the vaccine was “bad” or a place of business where exposure occurred “dirty”.  It just means that similar to the human flu vaccination, the vaccine was not effective against the particular disease strain a dog was exposed to.  In some cases vaccination will not prevent the disease 100% but shorten its course or lessen the severity of symptoms.  The most effective way to prevent kennel cough is to not expose a dog to any other dogs.

 

Heartworm Disease

Heartworm Disease
By Dr. Karen Burgess

What is heartworm?
Heartworm disease is caused by Dirofilaria immitus, an up to foot long spaghetti-like worm that grows to maturity in the heart and pulmonary artery (blood vessel connecting the heart to the lungs).  Dogs become infected with heartworm disease when they are bitten by an infected mosquito that acts as an intermediary host.

What are symptoms of heartworm disease?
Dogs with heartworm disease range in showing no symptoms to experiencing heart failure.  More common symptoms include exercise intolerance or a cough.  The adult heartworm can clog blood vessels and cause dangerous inflammation within the lungs.  Symptoms often do not develop for several years after initial infection, but by this time extensive and permanent damage to the lungs has often already developed.

What is the life cycle of the heartworm?
Heartworms develop through five different life stages.  The adult heartworm resides in an infected dog’s pulmonary artery (blood vessel connecting the heart to the lungs).  After mating, adult female heartworms produce microfilaria, or microscopic larva that travels through the blood stream.  When a mosquito bites an infected dog, they ingest microfilaria along with blood.  The heartworm larva goes through two life stages in the mosquito over a several week timespan before being infectious to another dog via mosquito bite.   After a dog is infected, the heartworm must then go through three more lifestages before becoming an adult in the heart.  Ultimately it takes approximately four months from time of mosquito bite to when a mature heartworm is found in the heart.

How is heartworm disease diagnosed?
There are several blood tests readily available to screen for heartworm disease.  The biggest limitation being that most tests are only able to detect more than three adult female heartworms.  Since it takes four months from time of infection to having an adult heartworm, some dogs may test falsely negative for heartworm disease initially.

How is heartworm disease typically treated?
There are several components to successful treatment for heartworm disease.

The microfiliaria (baby heartworms, L1) and recently injected and developing heartworms (L3 and L4) are killed by ivermectin based heartworm preventatives (Heartgard Plus).  This prevents other dogs from being infected and recently injected larva from growing into adult heartworms in an exposed dog.  Injected heartworms (L3) remain in the skin for three months developing to the larval stage that ultimately migrates to the heart (L5).  Developing larval heartworms (L3, L4) are killed by ivermectin based (Heartgard Plus) heartworm preventatives.

Treatment for the adult heartworm (L5) involves a very specific medication called immiticide, a derivative of arsenic.  Prior to treatment, dogs should have their overall health and stage of disease determined.  Blood tests and thoracic (chest) radiographs are recommended at a minimum.  If there is evidence of lung or heart disease on radiographs, a modified treatment regimen or further testing may be necessary in an effort to prevent complications.  Current recommendations for treatment involve an initial one month course of doxycycline.  Research has shown that doxycycline kills a specific bacteria associated with the adult heartworm thus making it more susceptible to immiticide and potentially decreasing side effects of treatment.  After the course of doxycycline, there is a month delay prior to treatment with immiticide.  This allows time for immature heartworms to either be killed by preventative or mature to adulthood allowing immiticide to kill them.  A confirmatory heartworm test should be performed after this eight week delay and prior to immiticide therapy.

Immiticide is administered as an injection in the back muscle.  One month after this first injection, the same injection is given again twice over a two day period.  Each injection of immiticide kills a certain percentage of heartworms.  By dividing the treatment over a two month period, the total number of dead worms a dog is exposed to at any one time is limited.

What is follow-up care after treatment for heartworms?
Dying adult heartworms and the ensuing inflammation they cause in the lungs is a potentially life-threatening problem for dogs undergoing heartworm treatment.  There is no way to completely prevent complications secondary to heartworm treatment.  Anti-inflammatories are often administered immediately after treatment to assist with any local pain at the injection site which can be severe enough to cause a dog to bite.  An estimated 30% of dogs will experience some sort of reaction secondary to the injection.  Strict rest is required for four weeks after each injection; this means short leash walk to go to the bathroom in the yard, no running, walks, playing, or excessive excitement.  The dying adult heartworm can be very dangerous and the more the heart is rested the safer it is for the dog.  It is better to error on the side of caution (crating a pet) than risk a possible complication.  A heartworm test should be performed again six months after treatment.

What are signs of complications from treatment?
Cough (often closely resembling vomiting but with no food present), lethargy, vomiting, difficulty breathing, loss of appetite, or collapse are all possible complications and warrant immediate medical attention.

Can heartworm be prevented?
There are several different products available to prevent heartworm disease.  These are typically a pill that is administered once monthly year round.  Care should be taken to purchase a reliable product from a trusted brand as several product lines have experienced recalls over the years.

Can a dog get heartworm disease while on preventative?
Heartworm treatment is nearly 100% effective.  Reasons for breakthrough include failure of pet to ingest pill, poor owner compliance in giving pill monthly, resistant strains of heartworm (not a current problem in this region), and an animal that had immature worms that were not detected on a previous heartworm test.

Why do dogs need to be tested for heartworm disease prior to giving preventative?
Heartworm preventatives quickly kill off microfilaria.  In rare instances this can lead to a potentially fatal anaphylactic reaction in a dog.  Heartworm positive dogs with microfilaria should be monitored in a hospital setting when first being given preventative.

 

Hypoglycemia

Hypoglycemia
By Dr. Karen Burgess

 

What is hypoglycemia?
Hypoglycemia, or low blood sugar, is a relatively common problem in young puppies.  Other potential causes include liver disease, Addison’s disease, and severe bacterial infections.  Small breed and very young puppies are more prone to this condition as the liver is a reservoir of sugar and its functioning ability is often not fully developed.

What are signs of hypoglycemia?
Common signs of low blood sugar include weakness, vomiting, collapse, or seizures.

How is hypoglycemia diagnosed?
Low blood sugar is diagnosed based on history (young puppy) with consistent symptoms.  A blood test that evaluates glucose levels is confirmatory.  Additional testing may be necessary to rule out other potential causes for a low blood sugar.

What is the treatment for hypoglycemia?
Hypoglycemia can be life threatening in a very short time period.  If your puppy is showing signs of hypoglycemia, first offer them food.  If they are unwilling to eat, rub Karo syrup, maple syrup, or honey on their gums.  Life-saving sugar can be absorbed directly through mucous membranes.  Take your puppy immediately to a veterinarian even if this means an emergency visit in the middle of the night.  Many conditions can make a puppy more prone to hypoglycemia and the issue may recur if not addressed.  Make sure to keep your puppy warm (wrapped in blanket) while on the way as low blood sugar can predispose to low body temperature.

A puppy with signs of hypoglycemia requires immediate potentially life-saving treatment.  Notify hospital staff as to the severity of the situation and allow them to take your pet directly to a veterinarian even if this means being separated for a period of time.  Intravenous injections of glucose are typically administered.  Hospitalization until the puppy is able to maintain a safe blood sugar level is common.

What can be done to prevent hypoglycemia?
Preventing hypoglycemia involves providing a source of energy (sugar) on a regular and frequent basis.  For predisposed, small, or young puppies offering and ensuring eating of some amount of food every four to six hours minimum is recommended.  Nutrical, a commercial high caloric vitamin paste, is an often used product by breeders and veterinarians to further ensure safe levels are maintained.  If a puppy is experiencing vomiting or diarrhea or has lost their appetite for even eight to twelve hours this can be an urgent medical concern and should be addressed by a veterinarian.  Fortunately most puppies grow out of juvenile hypoglycemia by six months of age.

Bladder Stones

  Bladder Stones
By Dr. Karen Burgess

What is a bladder stone?
Uroliths or bladder stones are the accumulation of minerals in the urinary tract that form rock like structures.  Bladder stones can range in size from the size of sand to as large as an orange.  There are many different types of bladder stones and they are described based on their mineral makeup.  Bladder stones can take days to years to develop and can be a one-time only or chronic condition.

What are common signs and problems associated with bladder stones?
Bladder stones often abrade or rub the bladder wall causing irritation.  This can lead to blood in the urine and decreased ability to fight off bacterial infections.  In severe cases the stone can block the passage of urine out of the bladder causing the bladder to distend and potentially causing life-threatening complications.  Owners will often note that their pet has increased urgency to urinate, is urinating more frequently, or having accidents in the house.  In some cases the pet may posture to urinate frequently but have a poor stream of urine (dribbling).  Pain, inappetance, vomiting, and collapse can all develop with more severe disease.

What causes bladder stones to develop?
The type of stone often helps determine the underlying cause along with the patient’s age, sex, and breed.  Some stones (struvite/triple phosphate) are almost exclusively secondary to bacterial infection of the bladder.  Other types such as urate or cystine have a genetic correlation with certain breeds having a higher incidence.  There are also many cases in which there is not a direct cause and effect in a patient and for whatever reason (physical, metabolic, physiologic) a pet is predisposed to stone formation.  Diet has been associated in the past with some stone formation and often diet manipulation is essential in preventing or treating bladder stones.

How is my pet diagnosed with bladder stones?
In some cases larger stones can even be palpated on physical exam.   The definitive diagnosis of bladder stones involves visualizing the stones typically via radiographs or ultrasound.  While ultrasound may be more expensive at face value, some stones due to their mineral composition or size are not readily visible on radiographs while they would be apparent on ultrasound.  Since many pets present initially with symptoms of a urinary tract infection (straining, bloody urine), initial testing often involves collection of urine for examination.  This urine sample needs to be sterile or collected directly from the bladder with a needle (similar to a blood draw).  Performing a culture on the urine allows diagnosis of specific bacterial infections if present.

What is the treatment for bladder stones?
The treatment for bladder stones depends largely on their specific composition.  For some, specific prescription diets will dissolve even existing stones.  For other stone types physical removal is necessary either via surgery or a procedure where the stones are expelled with compression of the under anesthesia.  In cases of urinary tract obstruction due to a stone immediate intervention either with catheterization or surgery may be necessary.

How are bladder stones prevented?
The specific stone type determines how best to prevent recurrence.  Increasing water intake and thus diluting the urine is appropriate for all types of stones.  Manipulation of urine acidity via diet or medication is also utilized in many cases.  Monitoring for bladder infections that may be silent and periodic radiographs or ultrasound to look for “silent” stones may also be recommended.  The ultimate goal is to detect stones at a time where intervention other than surgery is an option.

 

Diarrhea, Canine & Feline

Diarrhea in Dogs and Cats
By Dr. Karen Burgess

Diarrhea, including loose stools, increased frequency of stools, or a watery stream of feces, is a symptom of an underlying problem – not a disease in itself – and should always be cause for concern.  Infections (viral, bacterial, parasitic), toxins, inflammation, or disease of the intestinal tract can all lead to diarrhea.  Although mild cases of diarrhea may resolve without intervention, diarrhea accompanied by vomiting, lethargy or any other behavioral changes should be treated as a medical emergency.

One of the most common causes of diarrhea is intestinal upset from a sudden change in diet, giving an unfamiliar treat, or feeding table scraps. Diarrhea caused by food changes can often be resolved at home as long as it is not severe and the pet continues to act and feel normally. Withholding food for 24 hours (while continuing to encourage water consumption) allows the digestive system to heal. After 24 hours small amounts of a bland diet such as white rice and chicken can be offered (see recipe/schedule below). After two days of normal stool appearance, regular food can be gradually reintroduced over several days.  If diarrhea does not improve or gets worse, veterinary treatment is recommended.

In order to avoid intestinal upset due to a new food, all changes should take place over several days to allow for the digestive system to acclimate. For the first three days of a food switch, feed ¼ of the new diet and ¾ of the old food. If no issues develop, then feed half new food and half old food for another three days, then ¼ old food and ¾ new food for another three days. This slow transition will help to minimize intestinal upsets and decrease the chances of diarrhea.

Although many pets regularly receive table scraps, care must be taken to ensure that these human foods are not too rich for their system. Fatty foods in particular can cause diarrhea, vomiting, and may lead to pancreatitis (a potentially life threatening inflammation of the pancreas). It is also important to remember that pets should NEVER be given turkey, chicken, or rib bones as these can splinter into small pieces and puncture the stomach and intestines.

While the goal of diarrhea treatment is aimed at solving a specific underlying problem many times this is difficult to accomplish.  Supportive or symptomatic care is often what ends up resolving the problem.  If loose stools are present for less than 24 hours and there are no other signs of illness (normal energy level, eating and drinking normally), a conservative approach of “wait and see” may be appropriate. However, if there are any additional signs of distress, such as increasing amounts of diarrhea for any length of time or bloody stools, a visit to the veterinarian is required.

Upon visiting the veterinarian a full history will be obtained.  When the diarrhea started, its frequency, volume, and consistency will be discussed. It is helpful to bring a fresh stool sample to the visit.  After a comprehensive physical exam, the following tests may be performed:

  • Fecal examination – Testing for parasite infections or bacterial overgrowth
  • Blood work – Evaluation of a variety of body systems (ex. kidneys, liver, hydration, red and white blood cells) to give a reading of basic health
  • X-rays – Radiographs may be recommended to diagnose potential intestinal obstructions or ingested foreign bodies

Treatment of diarrhea may involve a bland diet, probiotics, deworming, or antibiotics. Severe cases may require hospitalization and intravenous therapy

Chronic diarrhea (lasting for three or more weeks), while less common, is also reason for a visit to your veterinarian. Often the stool may begin to firm up only to become soft and unformed again. It is also not uncommon to see mucous or even small amounts of blood. Chronic diarrhea can lead to poor digestion and absorption of nutrients, low energy levels, and poor quality hair coat.

Food allergies and intolerances are a common cause of mild chronic diarrhea. Similar to lactose intolerance in people, pets may have or develop allergies or sensitivities to a variety of ingredients in pet food leading to chronic inflammation in the intestinal tract. Pancreatic diseases, inflammatory bowel disease, and cancer are also causes of chronic diarrhea.

Whether chronic or acute, diarrhea is almost always a sign of an underlying medical condition that needs to be addressed. Because diarrhea in itself has the potential to be life threatening, any pet suffering from more than a short-term bout or showing signs of other medical problems should be seen by a veterinarian. In addition, because young animals are so susceptible to several potentially fatal viruses, the presence of diarrhea in any puppy or kitten should be treated as a medical emergency until proven otherwise.

Bland diet recipes – 8 ounces cooked white rice (baby rice cereal for cats), 4 ounces single protein source (ex. boiled beef, boiled chicken, low fat cottage cheese). Can boil together, use lean meat, 1# food mixture daily for a 30# dog.

 

Sample bland diet schedule

 

Food type

Volume

Frequency  (adjust volume for size of dog)

Day 1 No food No food No food
Day 2 Bland 1/2 of normal caloric intake 6-8 small feedings (ex. 1/4 cup every 2-3 hours)
Day 3 Bland 3/4 of normal caloric intake 4-6 small feedings (ex. 1/2 cup every 4 hours)
Day 4 Bland Full caloric intake 4 feedings (ex. 3/4 cup every 6 hours)
Day 5 75% bland, 25% regular dog food 75% bland:25% regular food 2-4 feedings
Day 6 50% bland, 25% regular dog food 50%:50% 2-4 feedings
Day 7 25% bland, 75% regular dog food 75%:25% 2 feedings
Day 8 Regular dog food Regular amount Regular interval

 

HGE, Canine

Hemorrhagic Gastroenteritis (HGE)
By Dr. Karen Burgess

Your pet and HGE…..
Hemorrhagic gastroenteritis  is a potentially fatal disease that causes severe bloody diarrhea (often resembling raspberry jam), vomiting, depression, and abdominal discomfort.  The cause of this disease is unknown, although both bacterial infections and immune problems have been suggested.  The good news is that the prognosis for recovery is good with aggressive treatment.

Diagnosing HGE….
To diagnose HGE other causes of bloody diarrhea and vomiting must first be ruled out.  Bloodwork is one of the first tests to be run.  It tells us how dehydrated your pet has become, whether infection is in the bloodstream, and whether other problems may be present (for example, pancreatitis, liver disease, or bleeding disorders).  Examination of feces under the microscope also helps us look for parasitic infections.

Treating HGE….
After being admitted to the hospital your pet will have an intravenous (IV) catheter placed in one of their veins.  This allows us to give fluids and medication directly into the bloodstream.  Initially a large dose (bolus) of fluids is given until your dog’s hydration has improved.  Maintenance fluids are then given until vomiting and/or diarrhea resolve.  At the same time antibiotics are given and any other necessary medications.  A physical examination is performed each day your pet is hospitalized along with nursing care and necessary treatments or diagnostics.  We will be keeping in touch with you daily as to how your dog is doing, changes in treatment, and expense.

After HGE….
Your pet will likely go home with a specific food and oral medications.  It is important to monitor your pet closely after discharge for any vomiting, stool consistency, appetite/water consumption, and attitude.  It is not uncommon for pets to be tired after being sick and hospitalized, but if you are at all concerned, please call.  Fortunately, HGE tends to only occur once in a dog’s life, but always watch your pet closely for any signs of recurrence.