The Heartbreak of Heartworms
We are often amazed at how gentle and sweet animals are in the face of illness. Even when feeling badly, they will often muster up a tail wag or a soft purr. This was Jake’s way.
Jake, a 3-4 year old Labrador mix, was adopted by a family in August, 2005. He was “free to a good home” (believe your mother when she says “there is no such thing as a free lunch”). He was very, very thin and seemed to have a swollen stomach. His humans thought he wasn’t used to good food and that he had worms. However, he had a heart murmur, was coughing and had fluid in his abdomen – all signs of Heart failure. He had heartworms.
We considered him a poor risk for heartworm treatment and suggested blood work and chest x-rays. His x-rays showed the biggest heart that we had ever seen in a dog. It took up his entire chest. How could this dog run, jump, lick your face or even breathe when his heart and lungs were already severely damaged? Could he even survive the treatment and return to normalcy? His humans decided to take the chance. Due to the severity, Jake would have a split treatment – treatment would take place in 2 stages, over 5 months.
The first half of treatment went well. When he returned the next month for the second half, his abdomen was still enlarged and he was coughing up blood. He was starting to show signs of thromboembolism and/or clotting problems. The discussion of euthanasia was brought up. His family said, “No, not yet.” They took him home for more rest and medications of Aspirin and Lasix. Jake returned for a recheck the next month. The tincture of time hadn’t made a difference. We decided to manually remove the fluid from his abdomen. We removed 1 ½ liters of fluid. Another month passed, Jake returned for a recheck. He was his usual happy self and finally looked wonderful – 9 lbs lighter with little coughing. We completed the last part of his heartworm treatment.
Jake boarded with us in 2006 and tested negative for heartworms. Unfortunately, that was the last time we ever saw him. His family emailed us to let us know that he had passed away in February, 2007.
Some pets leave a lasting impression. Jake had the biggest heart (literrally and figuratively) we have ever seen.
Lymphoma - a Common Cancer in a Uncommon Area
All Labs are “puppy dogs” – meaning, they are full of silliness, good cheer and absolute adoration for their owners. Charlie exemplified all that was “Lab”. He was a big boy, always seeming to hover around 100 lbs, and whenever he visited our clinic he would bust through the double doors and head for the scale and sit down, as if to ask “have I lost any weight yet?”.
Unfortunately for Charlie, his genes for good bones weren’t as good as his genes for good character. Following our suggestion to x-ray his hips following his neuter procedure, dysplasia was found in both hips. Due to his young age and being clear of any arthritis, Charlie had the first of two hip reconstructions. We referred him to the S.C. Veterinary Specialists in Columbia and a TPO was done (Total Pelvic Osteotomy). His pelvis bone surrounding the hip joint was cut into 3 places, rotated over his femur to give a better and tighter “fit”, then pieced back together with a special curved plate and screws. Charlie came through both surgeries (a year apart) wonderfully, and the stage was set for a long life with no pain.
It wasn’t meant to be though. In November, 2006, Charlie developed a lameness in his left hindleg. For fear that his hips had been strained or the metal was moving, we referred him back to the surgical clinic. This time he had torn his ACL (Anterior Cruciate Ligament). Just as in human athletes who twist and turn at the knees, so do dogs. Once again, Charlie had surgery and did great. Except for one thing…he developed chronic diarrhea.
We tried everything…diagnostics, consults, medications, diet changes and yet nothing seemed to work. Over a six week period, Charlie lost 23 lbs and still his cheerful disposition remained. The timing of this problem, closely associated with his ACL surgery, baffled everyone. His owners and I had to face the fact that cancer was lurking. Despite all of our diagnostic aids and referrals to Board certified veterinarians, sometimes a diagnosis cannot be made – especially with cancer. The basic, indisputable symptom of unexplained weight loss can always point to cancer.
Rather than subject his wonderful, aging dog to another surgery (where questionable results can occur), Charlie was euthanized on January 24, 2007. What a sad, sad day. We had to know though – was it truly cancer that was slowly killing Charlie? Had we made the right decision? Permission was given for an autopsy.
Five abnormal areas were found in the small intestinal wall. Samples were sent to the Clemson Diagnostic Lab. Charlie had had Lymphoma, the most common cancer that affects our dogs. We all breathed a huge sigh of relief. The right decision had been made for Charlie.
Insulinoma - A Rare Pancreatic Cancer
Jessie's was a problem child to begin with, but she was adopted from the SPCA by a lady with a heart of gold who wouldn't give up on her. She was lucky.
It was difficult to get the real story on Jessie because shecame from a broken home and was left behind when her second family moved from Aiken. She was, literally, a throwaway. Her behavior ranged from being timid to agressive. She suffered from separation anxiety. We consulted with sevral Behavior Therapist and her human read a lot more. She eventually become a well adjusted, loving family member.
She started having seizures which were not being controlled well by conventional medicine. Her diagnositics didn't definitively suggest a casue so she was referrred to the SC Veterinary Specialists. She was going to have an MRI, but the Internist noticed a consistently low glucose level with a high insulin/glucose ration. She was diagnosed with a rare Insulinoma, a very difficult to find tomor located in the pancreas. Massive amounts of insulin is secreted, which, literally, consumes the body's glucose stores. Jessie's tumor was a 4 mm in size and was successully removed.
Jessie's story continued though. Her glucose stayed low. She stillhad problems with her energy level and mild seizures continued. Special nutrition and steriods seemed to make little difference. A microscopic Insulinoma was still lurking in herlymph or pancreatic tissues.
Her humans decided against chemothrerapy and moe surgery. They didn't want to combat the side-effects or the resultant Diabetes. The Insulimona continued to grow with a vengence and Jessie was lovingly put to slee in her own home on March 25, 2005.
It took 17 years to have the first patient with an Insulinoma. We have had 3 more diagnosed. Strange.
Wobbler's Syndrome - Going the Extra Mile
Howie, the big red Dobie that could look at you , standing over our frount counter could be quite intimidating. He weighed 110 pounds and was as gentle a dog as we have ever known.
In January, 2004 he began to sway and not be able to coordinate his hind legs very well. His mistress, a marathon runner, wondered if her running buddy had simply over trained with her. We knew better. Howie had Wobbler’s Syndrome. His neck vertebrae were unstable, and he was likely to continue his downward spiral into total paralysis regardless of the conservative treatments we had started. Referral to the S.C. Veterinary Specialistswas made and serious discussions concerning surgery and the aftercare of such a big dog started. Surgery to stabilize the compressive vertebrae by grafting and plating was done within the week. Nothing seemed to go right. He was totally paralyzed after the surgery and his graft broke down. The plating had moved so another surgery had to be done. His pain was constant and he HATED the neck brace he had to wear. He was unable to urinate well.
He spent approximately the next 6 months at the Animal Rehabilitation and Fitness Center under the expert hands of Dr. Maria Glinski and her staff. They used acupuncture, electrical stimulation, underwater treadmill, swimming…everything imaginable was done to change the direction of his healing. It was a race against time. Would he EVER get well? His humans were exhausted and not sure if they had made the right decision. They were not, however, about to quit.
And so, the deadline of 6 months (regardless of tears shed and money spent) neared. Could Howie, the Dobie, who loved to run and eat, continue to live prostate and dependent upon humans? The answer was clear to everyone, and Howie heard us. The light switched on, and he began to respond. He began to move his limbs on his own!
Howie died unexpectedly on Nov 10, 2006 of reasons unknown. He exemplified hope and will be missed by all of us.
Autoimmune Hemolytic Anemia (AIHA)
“Something is wrong with Rosie, Doc. I’m not sure, but she is acting as if she’s run out of gas in the last couple of days” said her owner. My exam of this sweet, Springer Spaniel showed nothing except a possible paleness to her gum color. Her owner was convinced something was terribly wrong and I had a feeling that he was right. I drew some blood for analysis and I gave her a massive dose of steroids intravenously. In retrospect, the owner’s sixth sense and the prompt steroid injection saved Rosie’s life.
Rosie had Autoimmune Hemolytic Anemia (AIHA). Her immune system had turned on her and was destroying its’ own red blood cells. Normal PCV (the percent of red blood cells) for a dog runs between 35-55%. Rosie only had 15% that first day. Her heart was unable to oxygenate her body. Soon her kidneys would begin to fail and toxins would overwhelm her body. Rosie’s condition worsened. Her PCV would drop to 6% in the next 24 hours. A product called Oxyglobin (a super charged, oxygen carrying fluid derived from cow’s blood!) was the last hope for Rosie.
Veterinarians are unsure what triggers the hemolysis or destruction of red blood cells in these healthy dogs. AIHA is in the family of the diseases that we call “Blood Dyscrasias”. Some whole red blood cells are destroyed, platelets are destroyed or clotting factors are disrupted. We rely upon steroids and chemotherapy to stop the destruction. Transfusions are usually not enough. Oxyglobin saved her life. It worked and she is indeed a miracle.
The Bionic Dog (Almost)
Tess is a young, “sorta” Catahoula Leopard dog that doesn’t have a clue as to what “bad attitude” means. She is the perfect example of kindness. When her family met her they didn’t want or need a fourth dog but who could resist her?
When she was 10 months old, her owner noticed that she didn’t walk well after exercising. She would push up her body with her front legs instead of scooting her back legs underneath her. She seemed “out of alignment”. Taking x-rays confirmed the worst. She had Hip Dysplasia and her femur was on the verge of popping out of the hip socket with the mere act of walking.
Hip Dysplasia is a problem that affects the hip joint in primarily large breed dogs. When the ball-shaped portion of the top of the thigh bone (femur) does not fit the socket of the pelvis, the joint becomes loose. Loose hip joints are unstable and likely to deteriorate and develop degenerative joint disease (DJD) which brings on a life time of pain and limitations to the dog’s ability to jump or even walk. The best way to prevent this painful disease is for breeders to avoid breeding adults that have loose hip joints. One way to determine if the potential breeding dogs have Hip Dysplasia is with The Penn Hip examination. For this test x-rays requiring anesthesia are performed and then submitted to the University of Pennsylvania for a careful analysis and computer measurement of the hip joints. This exam can be performed as early as four months of age.
The appropriate treatment for Hip Dysplasia depends on the severity, age and size of the dog. A limited exercise program and medications like Rimadyl or Estogesic can be used to reduce inflammation and pain. Aspirin is commonly used but it can cause stomach irritation and gas. Some dogs are placed on joint supplements (Cosequin, glucosamine, chondroitin-sulfate). Dogs with extremely severe hip dysplasia can benefit from surgery. Tess needed surgery! Her condition would require a triple pelvic osteotomy (TPO). It would be a difficult surgery, but luck was actually on her side! She was so young and had no degenerative bone changes. During the surgery her pelvis was sectioned into pieces, put together with plates and “rolled” over her femur to tighten it up. Total hip replacements and Femural Head Osteotomy are other options for dysplasia.Tess is doing great! She and her owners look forward to a lifetime of painless Frisbee tossing.
Hyperthyroidism - When More is not Better
Posey had a textbook case of Hyperthyroidism. Hyperactivity, weight loss in spite of a ravenous appetite, diarrhea, rapid heart rate, occasional vomiting, lack of grooming and overgrown claws are common as well. Hyperthyroidism is easy to diagnose with a blood test which measures the level of one of the thyroid hormones, thyroxine (T4). It is a very common disease in our aging cat population. Thankfully, if treated, the cat has a good prognosis of growing even older. If left untreated, hyperthyroidism kills. The disease severely affects virtually every organ system in the body, with the heart and the kidneys taking the biggest hits.
There are 3 ways to treat:
