Welcome To Ask The Vet
Welcome to "Ask The Vet", a category of my blog dedicated to answering questions about the medical care of animals. Please post questions that conform to the following guidelines:
- Readers are advised to consult a licensed veterinarian in your area for medical advice regarding your pet. I can not comment on specific cases and will only provide information that is general in nature. It is my hope and expectation that this will prove useful as you consult your own veterinarian.
- As demands on my time change regularly, there is no set frequency for the posting of blog entries. I encourage you to register for e-mail alerts to be notified of new postings.
- I will select questions to answer based upon general interest to the larger community.
- All writers should conduct themselves in a courteous manner and respect other opinions.
- Information about my background can be found at: veterinarycreative.com
I have two cats. I leave dry food out for them to eat as they need. I also feed them wet food. I have been feeding them one small can a day in the morning. I give each cat a half of the small can and separate them. I was wondering if this amount of wet food is too much or too little for them?
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I recommend feeding cats a combination of wet and dry food as you are doing. The dry food is good for oral health. Wet food increases water consumption which may help prevent kidney disease later in life. As for the amount of food, that depends on your cats activity and metabolic rate. Just like humans, some cats can eat all they want while others must consume limited amounts of a calorie restricted diet. I have one cat who eats to live and another that lives to eat. Check each cat and make diet changes based on their body condition. In general, when dry food is left out all the time, I recommend three to four tablespoons of wet food per day as a treat.
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We have a Lab mix and a Corgy mix. The Lab is very territorial with all the toys. She doesn't necessarily play with them just hordes them. Should we take them from her and give them to our Corgy?
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I am glad you asked about this Dorothy. Possessive toy guarding can escalate into more serious behaviors including interdog aggression and even aggression towards humans. Last weekend I had to treat a Chihuahua who was attacked by the family's other dog when the little one ventured too close to a food bowl. It is important to nip this behavior in the bud to prevent injury to you and your Corgy.
In my experience, the best way to deal with possessive toy guarding is to teach the Lab mix the "leave it" command. Step 1: Put all the toys away. Both dogs should only have access to toys when you are home to prevent injuries. Do not take the toys from the Lab and give them to the Corgy. This might trigger the Lab to attack the Corgy. Step 2: Separate the two dogs for the training session. The Corgy can have toys in another room while you work with the Lab. Step 3: Hold a small toy in your hand. When the Lab tries to retrieve it say "leave it" in a firm but unemotional voice. We do not want the dog to think you are mad. When the dog complies (i.e., looks away, turns their head away or any other sign of submission) reward her. You can use praise, a belly rub or a treat. Repeat the exercise two to five times more to reinforce the behavior. Step 3: Once the Lab mix has mastered the "leave it" command with the toy in your hand, put the toy next to you and repeat the same process. Move the toy further and further away until you can utter the command from across the room and get the desired behavior. It may take days to weeks to get to this point. Step 4: Give the Lab mix and the Corgy mix their own toy while in the same room. When the Lab mix tries to grab the Corgy's toy, correct the behavior with a sharp "Leave it!".
Keep the training sessions short and fun. The key to success is repetition, repetition, repitition. Patience and consistency are the foundation of eliminating unwanted behaviors. Don't be discouraged if you encounter a few setbacks along the way. This is normal.
Here's one last tip. If the Lab mix succeeds in grabbing a toy and guarding it on her bed, do not resort to punishment. She doesn't associate the punishment with the act of guarding the toys. Take her outside, away from the toys and start over. If she doesn't know the "come" command, leave a long leash attached to her collar. You can use the leash to gently remove her from the bed without a major confrontation over the toys.
Please keep me appraised of the progress Dorothy.
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Dr. Nelson,
My wife and I are caring for a litter of Chihuahua puppies that are 6 1/2 weeks old. One night we stepped out, and when we had returned one of the male pups had been beaten up pretty bad. It appeared that his head had been bitten, and judging by the teeth marks our assumption is that mom lashed out. None of the other pups had wounds of that nature, aside from the regular nicks and scratches that puppy teeth and claws leave. He was terrified, and would 'freak out,' any time he was around his mom or if our mouths were any where near his head.
Anyway, the hurt pup is healing well and back to playing with his siblings, but his forehead has accumulated a pocket of liquid. My guess is that it is a reservoir of pus from the swelling. It doesn't appear to hurt him if we touch it. I think that the fluid is between the layers of his skin. I am concerned that it might be serious. Aside from monitoring this problem, what should I do?
Thanks,
Doug
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The first thing I recommend is separating the puppies from the mother. I am concerned that she might do even more damage the second time around. Next, I would take the little guy to a veterinarian right away. Chihuahua puppies often have open fontanelles (soft spots in their skulls) at this age. If the lump or a bite wound is near the fontanelle, infection might spread into the brain. The veterinarian will probably want to aspirate the lump to see what it contains before recommending a treatment. Besides pus, the lump could contain cerebral spinal fluid if a puncture wound penetrated the skull. Watch his eyes closely to make sure the pupils are the same size. Unequal pupils might indicate serious disease. Good luck with the little guy and please keep me posted on his progress.
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Thanks Dr.Nelson. Will do.
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Hi Dr. Nelson, my wife and I have two year-old boxers. One male and one female. We feed them at 6:00pm and 6:00am. Yet they get us up every morning around 5:00am. We need to sleep, can you offer any advice?
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Dogs wake-up early for several reasons. The first step in dealing with this behavior is to determine the cause. Common ones include hunger, a desire to play, a need for relief and photosensitivity.
1) If they are hungry, I recommend giving them a lite "snack" right before bedtime. For a Boxer, I would try a quarter cup of kibble. Remember, this is a snack, not a meal.
2) For dogs who want to play, I recommend more evening exercise to tire them out before bedtime. Do not play with them first thing in the morning as that only encourages the dogs to wake-up early.
3) Some young dogs wake their owners because they need to urinate or defecate. This usually improves with age unless the dog has a medical condition.
4) Many dogs, including my Golden Retriever, wake up with the sun. Black-out curtains work well with my dog to reduce sunlight and keep her asleep longer.
Good luck with your early risers. I hope these suggestions help your entire family sleep longer.
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My 4.5 year old black lab has been shedding excessively for the past couple months! Is this normal? He hasn't shed this much hair in previous years.
We changed his diet to a more holistic food 5 months ago and have been occasionally giving him a bit of raw egg, cod liver oil or raw meat.
We don't give him baths very often (only in the winter when all the water is frozen - maybe 2 or 3 times over a 4 month period). Normally we don't him very often (about once every 6 weeks), but lately we've been brushing him about once per week to try and help reduce the amount of hair around the house.
Do you know what could be causing him to shed so much, and do you have any suggestions on how I can help him out with this problem?
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Excessive shedding is a difficult problem to workup. Based on the history you provided, I will cover some of the more common causes.
1) Telogen defluxion (also called telogen effluvium): After a stressful situation, all of the hair is thrown into the same phase of growth. Individual hairs reach the telogen phase at the same time and fall out. I see this most commonly after surgery, orthopedic trauma or life-threatening disease. A trichogram is used to confirm the diagnosis. With time, the hair will return to the normal state where each follicle is on its own schedule.
2) Seasonal shedding: Some people are unaware that dogs shed more in the spring and fall. Since you report the hair loss is more than in prior years, I doubt this is the problem.
3) Hypothyroidism: In my experience, Labs often develop thyroid problems as they age. A poor hair coat and hair loss is often the first sign. Other signs include weight gain, lethargy and heat-seeking behavior.
4) Protein deficiency: Protein is the building block of hair. Any medical problem which effects protein absorption and metabolism may cause hair loss and an abnormal coat. Animals who are starving or on a protein deficient diet usually have poor hair coats. Other medical conditions include malabsorptive syndromes (intestines don't absorb the protein) and liver problems (protein isn't metabolized into usable products).
5) Other hormone-related problems: Animals who suffer from endocrine diseases such as Cushings often lose their hair.
6) Drug induced: A side effect of some medications is hair loss.
As you can see, this is a difficult condition to diagnose. Did your dog have a stressful experience before the shedding started? Is he on any medications? Is the protein content adequate in the new food? Does he display other signs?
The answers to the above questions will determine how I would proceed. In general, I recommend some blood work that includes a T4 and TSH level because hypothyroidism is so common in labs. I would also consider going back to your dog's prior diet if he did well on it. Be careful with raw meats. I treat a ton of vomiting and diarrhea problems in dogs fed raw diets.
Lastly, I'll pass along a trick used in a large hunting dog kennel to prevent hair-clogged drains. Every three months, they soak each dog in warm water for three days in a row. A few days later, the dogs blow their coats. The staff uses hair catchers in the drains while the shedding occurs. After a few days, the shedding is over and the hair catchers are removed. I'm not sure why this works, but it really seems to help get the shedding over quickly.
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We love our pups! one of our Havanese sometimes drags his bottom on the carpet. What suggestions do you have aside from our regular grooming routine? thank you!! we love your website!
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I am concerned that your pup has a problem with his anal glands. Dogs have two sacs called anal glands. They are located on each side of the anus at approximately the 4 and 8 o'clock positions. Normally, the contents of the sac are emptied on the feces during a bowel movement. It is not uncommon for the openings of these glands to plug after periods of diarrhea, constipation or anything else that interferes with normal bowel movements. Dogs drag their rear ends on the ground to relieve the discomfort. When it works, the dog leaves a smelly mark on the floor.
The most effective treatment is to have the glands emptied. Most groomers use an external technique to empty the glands before the bath. Veterinarians and Veterinary Technicians use an internal technique to make sure the entire sac is emptied. If the gland is not emptied, they often rupture through the skin next to the anus. It is both messy and painful for the animal.
To prevent anal gland problems, I would increase the fiber in your dog's diet. Many diets are formulated with increased amounts of fiber for exactly this reason. In addition, you may use carrots or other high fiber vegetables for treats. In both dogs and cats, I recommend canned pumpkin for hair balls as well as anal gland problems. I know it sounds hard to believe, but many cats actually like it!
If the problem becomes severe, the glands may require surgical removal. I had to do this for my own dog, Buddy. His glands filled up every three days. I removed them last fall and he has been pain free since then. I have been happier too . . .
Other lesser causes of scooting include anal pruritis and dermatitis. Havanese have problems with bits of feces sticking to their beautiful coats. The feces irritate the skin and make them uncomfortable. Keep this area trimmed short. If the area is soiled, wash it with a dog shampoo. Rinse the area well and apply a little petroleum jelly to help with the itch.
This condition is more common than you may think so please do not be ashamed to ask your veterinarian about it should it continue.
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I rescued a German Shepherd several years ago. They weren't sure of his "exact" age (I'm calculating 8 today based upon their documentation). Back then, I took him to an orthopaedic surgeon because of the way he walks (I describe it as a balerina in toeshoes), it was diagnosed as something like 'Bilateral Miasitis' (he outgrew of his hind leg tendons). Vet said as long as there's no pain, no need for the VERY $$$ / invasive surgery.
Over the past few weeks I've had to pick up his rear end to get into the car, on the bed, couch, etc. Now, his rear legs just "cave" while walking and he falls, slides, and trips over himself. At first I thought maybe he hurt himself jumping out of the car but he doesn't seem to be in pain, he just has no strength. I thought it may be the ACL (having done that myself) but I've palpated, done shelf tests, etc., nothing out of the ordinary but cannot detect what may be wrong. His tendons still appear to be in tact, albeit tight due to the other problem. He's lethargic but SITS on the side that appears to be the most problematic.
I'm jobless & can't aford pricey treatment right now, should I monitor for a while and help as much as I can? Aspirin doesn't appear affective, but again, he doesn't appear in pain.
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Thank you for writing and for taking him into your home. I too have a German Shepherd and so enjoy having a Shep in the house. I wish I had better news to share. There are five problems that cause hind limb weakness in older German Shepherds. They are; disc protrusion, cancer of the spine, a nerve sheath tumor, osteomyelitis (infection of the bones of the spine) and degenerative myelopathy. Unfortunately, degenerative myelopathy is fairly common in German Shepherds over the age of five. In this disease, the spinal cord in the dog's rear end degenerates. Further diagnostics are required to differentiate between these five problems because they can all present with similar signs. Another reason to see your veterinarian is because some of these conditions are treatable and I do wish to emphasize that point.
There is now available a blood test to identify degenerative myelopathy in German Shepherd's. It is offered through the Orthopedic Foundation For Animals. If this is the cause of your dog's issues however, the condition can not be treated.
Low impact exercise such as swimming may slow progression of degenerative myelopathy but I understand that you may not have access to a pool for the dog. Regarding funding, my best idea is to talk to the German Shepherd rescue group in your area. These groups are amazing. I have seen wonderful, caring people in rescue clubs and the are sometimes able to help in a situation like yours. I also know that "Care Credit" is available at some veterinary clinics.
I hope somehow it may be possible to see a veterinarian and I wish you and your dog, a good outcome. Thanks again for writing!
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Dear Dr. Kris Nelson,
I am currently a student in my transitional year of high school to post-secondary education. I've always wanted to become a veterinarian ever since i was a young girl and now I'm going after my dream.
However, I'm finding it extremely difficult to find any information or tips on what courses i should take in order to set myself up for success. I am enrolled in the Bachelor of Science Degree program (four years) as my pre-requisite for my Doctorate of Veterinary Medicine. I only have to worry about first year courses right now, but I'm completely lost after that.
Do you have any words of advice? If you don't mind me asking, where did you go to school? What did you do for a pre-req? What specific courses did you take?
Thank you for your time!
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I am thrilled you have chosen to pursue a career in veterinary medicine! Like you, I decided to become a vet at a young age. It has been a wonderful career - full of twists and turns, but always rewarding. I did my undergraduate work at Seattle Pacific University, a small private school. I was a triple major in biology, chemistry and Biblical Studies. I attended veterinary school at the University of Minnesota, College of Veterinary Medicine.
I always advise undergraduate students to study the requirements of the veterinary schools you are likely to attend. Many of the required classes build on each other so it is vital that you take them in the proper sequence. Chemistry is a great example. General chemistry is the building block for everything else. Take that your first year. After that, most students move onto organic chemistry their second year, followed by analytical chemistry their third and biochemistry their fourth year. In addition, some schools require that you complete all the required courses before a certain date in order to be accepted. Plot a rough draft of your four year schedule with your adviser to make sure you meet the requirements.
The most helpful course I took in my undergraduate training was histology. Learning how to recognize tissue types and cell structures under the microscope gave me a huge advantage in veterinary school. I strongly recommend that you include this upper level biology course in your program. After histology, I would list comparative anatomy and biochemistry as my next two. Because I took extra classes in biochemistry, I was able to test out of the lab my first year of veterinary school. It freed up my schedule and was a huge blessing. Check with each veterinary school to see if testing out is an option.
There are more tips for college students listed at www.vetschoolapp.com that you may find helpful. In my opinion, careful planning and good experience are the keys to getting into veterinary school. Establishing a plan before college will give you a leg up in the process. It goes without saying that solid grades are also required. I wish you the best of luck as you pursue your dream. Having done so myself, I can say that veterinary medicine is a wonderful profession and well worth the hard work required to achieve it! I look forward to calling you a colleague in the future!
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Dr. Nelson
I need your help. I have a 7 year old 18 lbs dog that has been in perfect health her whole life. A month ago she quit eating, became very withdrawn, limped on one paw and her breathing became labored - every sign of valley fever. She had a complete checkup in April and blood work was perfect. I had her tested last week for valley fever. Came back negative. I understand false positives. The vet has her on a pill that has stimulated her appetite and relieved her of her joint stiffness. She appears to be recovering fine. What happens when she is out of pills in 3 days? When should I have her retested for valley fever? Is there something else the dog should be tested? Sophie is the only animal in the household and has been a perfect dog. Thank you for taking time to read this. Any suggestions you may have are greatly appreciated.
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Valley Fever is most commonly diagnosed by serology. A blood sample is taken from the dog and checked for the presence of antibodies against the Valley Fever organism. There are two types of tests, Complement fixation for IgG and Tube Precipitin for IgM. Once an animal is exposed to the organism, it may take 2 to 4 weeks for antibody production. Since IgM is a short-lived antibody, it will often become negative 4 to 6 weeks later. The other method of diagnosing the disease it to find the fungus on a biopsy sample.
The most common cause of a false negative test is that the animal's immune system has not had enough time to make antibodies. For that reason, I often wait three weeks and then repeat another test. The other reason for a false negative is immunosuppression. Dogs that are chronically treated with steroids for allergies, inflammatory bowel syndrome or other immune-related diseases are often difficult to diagnose. If the x-rays, clinical signs, other blood values suggest Valley Fever and I've ruled out everything else, I run a therapeutic trial. If it is Valley Fever, most dogs will show dramatic improvement within a week of treatment.
For this patient I would see how she does when the pills run out. Weigh her daily to make sure she is not losing weight. (Another sign of Valley Fever.) If the anorexia and joint stiffness return, I would consider x-rays of her chest and affected joint(s). As long as your dog is not on any immuno-suppressive drugs, I would repeat another blood test in three weeks.
As for other potential diseases, it is hard to say without actually examining the dog and looking at her medical record. I have observed similar signs in dogs with Lyme Disease, Tick Fever, Histoplasmosis, scorpion stings, spider bites, cancer and auto-immune problems just to name a few. Most of the time, animals with any of these problems will show other abnormalities on their blood work.
I know from personal experience how frustrating this disease can be to diagnose and treat. Stay in close contact with your veterinarian as your dog finishes her medicine. Report any changes in behavior or new clinical signs right away. Good luck with her!
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Dear Dr Nelson,
I have an adult cat with acute diarrhea for 4 months now. It turned out that he has some internal parasites and he was given Profender for this reason. Blood, microbiological and enzyme tests showed nothing. Last week he was on Norodine and Gentamicine, but the diarrhea has not stopped. Despite being on a Hill’s diet, the cat is losing weight and the diarrhea is getting worse every day.It seems that my vet does not know what to do! Pls, help me!
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I am sorry about your cat. He must be miserable with diarrhea for four months. In order to help I need to know more about him. Send me the answers to the following questions and I will get back to you as quickly as possible.
Please tell me more about his age, breed, neutered or not, indoor or outdoor, his normal weight, current weight and any unusual behaviors that started around the time of the diarrhea. In addition I would like to know the results of his lab tests, especially T4, FELV, FIV, lymphocyte count, rbc count, platelet count and types of parasites identified. Was a recheck fecal performed to make sure all the parasites are gone? You mentioned the drugs he was on but I need to know the dose and length of treatment. Which Hill's diet is he on now? What were you feeding before? Lastly, please describe the diarrhea. Is it liquid or more like custard? Any blood or mucus? What color is it? How often does he go? How much does he produce at a time? Can he control it or is he having accidents?
Sorry about all the questions. The additional information will help me give you guidance with this serious problem. I look forward to hearing from you.
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Dear Dr Nelson,
I have sent all the required info to your email. I look forward to hearing from you.
Best regards,
Toni
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Dear Toni,
Thank you for sending the information. I desperately wish to help you and your cat so found it helpful. Let me start with common causes.
The most common causes of chronic diarrhea I see in cats around ten years of age are as follows:
-Hyperthyroidism
-Diabetes Mellitus
-Chronic Pancreatitis
-Inflammatory Bowel Disease
-Bacterial Overgrowth
-Cancer, especially lymphoma
Less common causes include:
-Diet: Older cats sometimes develop allergies to their food. I have also seen some who lose the ability to digest fat.
-Parasites
For your cat I recommend the following:
-Recheck a fecal to make sure the parasites are gone. Collect feces over three days and send in a composite to get an accurate sample. I would test the feces with a direct smear looking for bacterial overgrowth as well as a fecal flotation by centrifugation.
-Do more extensive blood work on the cat. Perform a CBC, complete chemistries, FELV/FIV, T4, Cobalamine, folate, fPLI and TLI as well as a urinalysis.
-If your veterinarian is open to it, I would post this case on the Veterinary Information Network. This is an on-line community of veterinarians from around the world. Your vet can post lab results, etc., and a specialist will answer within 24 hours. I would post your cat in the internal medicine folder and then cross-post to parasitology and nutrition. There is also a search option that will pull up all the archived cases of feline diarrhea. If your veterinarian is not a member, they can sign up for a free thirty day trial membership.
-Last, this sounds like a case that would benefit from the perspective of a specialist. The Royal Academy has many fine veterinary internists. If you go this route, select an internist who is a gastroenterologist. (Yes, those exist in veterinary medicine.)
Chronic diarrhea can be frustrating to diagnose and treat. I feel for your cat, you and your veterinarian. Since your cat responded well to the medications before, I am optimistic that his condition is treatable. Hopefully, these suggestions will give your veterinarian some new avenues to pursue or revisit. Please keep me posted, I truly hope this is resolved quickly.
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Dear Dr Nelson,
Thank you for your response.
Yesterday we went to another vet. He wants to perform microbiology and blood tests again. However, we have to wait for 3 days before the blood and feces samples are to be taken.
He also prescribed activated carbon(250mg/twice a day)and boiled rice water to control the diarrhea for the coming 2 days. Unfortunately, that is not working! Could you pls give me an idea for another natural or/and harmless medicine to control the diarrhea?
Thank you
Toni
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In my experience, most over-the-counter remedies don't work well for chronic diarrhea in cats. You could try kaolin/pectin several times a day. In the U.S. it is sold under the brand name Kaopectate. The dose is based on the animal's weight so you will need to contact your vet. Another common anti-diarrheal medication is bismuth subsalicyate. Since cats do not tolerate subsalicyates well, I only use this if the cat has a helicobacter infection. Even then, close monitoring by a veterinarian is required. So I really have to refer you to the veterinarian who is attending to the pet. At this juncture, it is impossible for me to go further without seeing the animal clinically and having the benefit of the test results.
I wish you and your cat the best in this difficult situation.
P.S. Keep plenty of fresh water out at all times. It is easy for a cat with diarrhea to become dehydrated.
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Dear Dr Nelson,
I am writing again concerning my cat's health. While waiting for the microbiological tests to come out, The vet prescribed us Sulfasalazine. But he said that could be toxic for cats.Since he is more like a "dog vet", I was wondering have you ever treated cats with this antibiotic? Is it really so dangerous or alertness is just a precaution measure?
I will be grateful if you could give me some idea.
thank you!
Toni
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Sulfasalazine is a great drug for treating colitis. Unfortunately, it often causes vomiting and anorexia in cats. I use enteric coated tablets to prevent this. The other side affect is anemia (decreased number of red blood cells). To catch this early, I check a PCV on the cat every 7 to 14 days. I also keep them on the lower end of the dose.
I am glad that your veterinarian warned you as a precautionary measure. Be sure to contact him right away if your cat's behavior changes. Watch for lethargy and/or pale gums. I often see these two signs with anemia.
The good news about sulfasalazine is that patients usually respond to the drug quickly. Hang in there Toni! Your cat should be feeling better soon.
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Dear Dr Nelson,
The sulfasalazine was stopped. It turned out that he has Streptococci infection (3 times more bacteria above the limit). The antibiotic susceptibility test showed macrolide antibiotics as an option for treatment. We have been giving him clarythromicin orally for 5 days now (20mg/12h), but there is no effect!!!! Despite being on a Hill’s diet, the cat is losing weight and the diarrhea is still not gone. What to do??????
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I am worried that the Strep infection is secondary to something else. I would ask your veterinarian for a referral to a veterinary internist before your cat loses anymore weight. In addition, have your veterinarian contact a nutritionist at Hill's. Since your cat is on their diet, there is no charge for the consultation. I have found them very helpful with other cases.
This is obviously a very difficult condition and one which I strongly believe requires a specialist at the earliest possible moment. Good luck and know I am pulling for you and your cat from across the pond!
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Dear Dr Nelson,
I managed to speak with a microbiologist who was not very optimistic about the Streptococci infection. Despite the fact that Strep bacteria are part of the normal gut flora, the doc thinks that when bacteria become pathogenic, it is hard to cure. Hopefully not impossible. There has been some improvement in cat's condition, expressed in less frequency of defecation and increase in appetite. Actually, he has a great appetite. However, the diarrhea is still present. We have to give the antibiotic for more five days and afterwards- I still do not know.
I would like to ask you about any herbal solutions that might help support the treatment. My vet prescribed probiotics. But I was wondering do you have any experience with RuniPoo Relief?
Thank you!!!
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Unfortunately, my knowledge of herbs is minimal but I do prescribe probiotics in cases of diarrhea. In my experience, some cats respond really well while it doesn't seem to make a difference with others. I have not heard of RuniPoo Relief. Great name for a product though.
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What about vitamin complex or immune stimulants that could be useful? Homeopathy? Our vet is a bit of a traditionalist....
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I would consider all possible therapies. Unfortunately, I am not familiar with the products available in your country so I cannot recommend specific ones. With supplements, I add one at a time and observe for a period of time to make sure the patient does not have an adverse reaction.
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Dear Dr Nelson,
I am writing again concerning my cat health. It has been a long time I have not had any news. My pet still has the diarrhea (when not given activated carbon daily). But yesterday, I saw a photo of the possible cause of that terrible condition. It was a photo of MAY BE Balantidium coli, isolated from the feces. That was a surprise not only for me (none from the other vets had seen it before?!!), but also for the vet (the "new" one). Since she is not sure, the sample is going to be sent to a lab in USA or Japan. Also, she informed me that this protozoan is not related to cats, but to people and pigs. Moreover, at the same clinic there is another cat (kitten) with the same problem and the same species.
So that I was wondering have you ever had such case or heard about one?
As you suggested, more work has been done regarding the blood tests, without any abnormal results so far. But it turned out that his kidneys are just a bit enlarged as well as the small intestine. Cause-not known...
Thank you for help! It is precious!
Toni
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Unfortunately, I have not treated Balantidium coli in any species. I live in a desert region while the organism likes tropical and temperate areas. The eggs and trophozoites are released in the stool from the colon. Transmission occurs when an animal or person ingests contaminated food or water.
Your veterinarian is right that humans, dogs and pigs serve as the reservoir for this protozoan. I have never heard of a domestic cat with it. Perhaps your cat is the first. I am glad your veterinarian is sending off pictures for verification. Who knows, your cat might end up famous in a case report. If it is Balantidium coli, there are several different drugs used to treat it. Some of them are not tolerated well in cats so you have to be careful. Animals often reinfect themselves from the environment. Clean up well after your cat. Wear gloves as this parasite is transmissible to people and other animals.
I hope the lab works quickly for your cat's sake. It seems like he has been dealing with this for a long time. Please let me know as soon as you get the results.
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That's good information, Dr. Kris. I live in a subtropical climate in the country so that could be what's troubling my two kittens, although none of my adult cats have it.
They all use the same litterboxes. I scoop and disinfect twice a day and change them and bleach them once a month.
But they all also go outside and use the leaves and pine straw. So maybe there's something in the soil.
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In my experience, animals seem to develop a resistance to parasites with age. That's why it is common to see ear mites in kittens but not adults. Besides B. coli, I would worry about Tritrichomonas foetus, giardia and cryptosporidium. It sounds like you are diligent about good hygiene. This is key to controlling and preventing infections so keep that part up. I hope this helps!
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it does, however the vet didn't find any parasites in the fecals he did. He said he found bacteria, but he didn't identify it. It seems to be responding to the Albon, whatever it is.
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I didn't realize that parasites were not observed on the fecal. These cases can be very frustrating. As you know, some parasites are shed intermittently so it's hard to know if it's only bacteria or bacteria complicated with something else. I'm glad the kittens are responding to the Albon. Happy Holidays Mj!
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Dear Dr Nelson,
Today the vet called to inform me that the second sample of the feces was negative-so they have nothing to send for verification.
About medication-it is strange because the recommeded drug for Balantidiasis(metronidazole) didn't work after 15 days of treatment. Now, we give him Trimethoprim /Sulfamethoxazole,Fenbendazole and activated carbon. This combination works perfectly, however, if the carbon is stopped for a day, the feces become mushy.
I hope that I will be able to collect some successful samples in the coming days for lab tests.
I will let you know as soon as I have some new information.
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Dear Dr Nelson,
I am very concerned about my cat. After 3 days of treatment on Trimethoprim /Sulfamethoxazole a watery diarrhea started again.Neither Smecta nor activated carbon helps. I think that the cause is the antibiotic itself, because before its administration only the diet+carbon was enough to control the diarrhea. Now I remember that during the previous antibiotic treatment the watery diarrhea was also a problem. How is that possible?
I called my vet and she is willing to try him on immunesuppresive therapy. However, I do not like that idea at all!! Having in mind that he has some intestinal parasites and sneezes all the time, suppressing the immune system wouldn't make his condition worse? Also, as far as I understood from literature isn't the IBD "the last stop" after checking for
hyperthyroidism,diabetes,kidney disease,pancreatitis??? Cancer, vit deficiency, bacterial overgrowth have been ruled out in our case.
In brief, should I give him prednisolone or may be I have to insist on further exams? I do not want his diarrhea to be cured at the expense of a more serious illness.Do you think Tylosin is a better option?
I really need the objective opinion of a vet not involved in the case.
I will be grateful!!
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I always try to have a concrete diagnosis before starting steroids for all the reasons you outlined. As you know, I suspect the diarrhea is secondary to something else. I would perform more tests to rule out all the diseases you listed. Diagnosis of IBD is made from histological examination of an intestinal biopsy. This can be done with a endoscope although the biopsies are not full thickness, they just capture mucosa. Surgery is required to get the full thickness biopsy.
My own cat passed away several years ago and suffered from IBD. After I ruled out everything else, I performed exploratory surgery and took multiple biopsies of his intestinal tract. The pathologist diagnosed his condition on histopath when he observed lymphocytic/plasmacytic infiltrates in the submucosa. The cat did well for many years on pred, tylan and ZD after he recovered from surgery.
I'm sorry to keep sounding the same refrain Toni but I truly believe your cat needs to see a veterinary internist (preferably a gastroenterologist) for further care.
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Dear Dr Nelson,
I have not written for a long time. During this time, my cat has been improving taking every day co-amoxiclav and probiotics. Two weeks ago he was fine, eating properly, walking around...Unfortunately, last week his gums started bleeding again and he stopped eating. We took him to the vet and he performed a physical check as well as an ultrasound. Here the bad news came-it turned out that the kidneys, liver and some part of the mesentery are damaged (kidneys and liver are enlarged, there is a mass in the abdomen). Pretty bad! A biopsy was recommended. However, I am afraid that he will not survive the procedure. Because of the gums, he has lost weight and has no appetite. I am not sure whether to go with it or go directly with prednisolone.
I will appreciate your opinion. You have helped me a lot and gave me some precious advice. THANK YOU!
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I am so sorry to hear about your cat. I assumed he was doing better since I hadn't heard from you. Unfortunately, I would need to examine your cat before I could advise you which way to go in this specific case. In general, it is always best to get a biopsy of the mass so you know exactly what kind of tumor it is. Not all cancers respond to pred which is why it is important to get an accurate diagnosis.
On the other hand, I understand your concern about anesthesia. The best advice I can give you is to talk honestly with your veterinarian and tell him/her you are afraid your cat might not be strong enough to survive anesthesia. Since they know you and your cat, they will be able to advise you accordingly.
Again, I am so sorry about your cat. I'll keep my fingers crossed that the tumor is something that responds well to chemotherapy.
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Dear Dr Nelson,
Thank you for your explanation concerning biopsy taking. My cat is almost diarrhea free now (being on boiled chicken only and vitamins, probiotics), but with vomiting periods. Ultrasound revealed inflamed pancreatic canal in addition to the abdominal mass and thyroid lumps. I do not understand why his overall condition has improved significantly despite vomiting and in the same tome ultrasound examination reveals much damage to have been done? I do not find the answer.....My vet does not want to prescribe prednisolone, without biopsy, so I guess that it is. But I do have some questions about the thyroid lumps. There are no signs of functioning (normal FT4, FT3, TSH, no usual clinical signs). However, he thinks that my cat might have hyperthyroidism and want to perform biopsy of the gland. After reading a number of articles about such problems, I do no agree on this procedure. Isn't it a better option to leave it without treatment since it seems nonfunctional? Or to do a needle biopsy instead? Could it be an autoimmune thyroiditis? What other tests could be done?
Thank you again, you have been very supportive!
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I am glad your cat's diarrhea has cleared up. Because of the inflamed pancreatic canal, your cat will likely have periods of vomiting and might require supplemental fluids during these episodes to insure hydration. As for the thyroid nodules, I understand your vet's desire to biopsy because as we discussed before, it is always best to have an accurate diagnosis. However, I also understand your reluctance to undertake this procedure in light of the other medical concerns. If the thyroid lumps are large enough, then a fine needle aspirate is a reasonable option. If small, your veterinarian may choose to monitor with another thyroid profile (fT4, fT3, TSH and T4) in two to three months. I'm afraid this case falls into the category of the gray area of medicine. There is no perfect approach. The bottom line is that you must make the best decision for your cat based on science and your judgment. This is where the art of practicing medicine comes into play. This sounds like a tough situation and I wish you and your pet the best. Please keep me posted on developments.
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Dear Dr Nelson,
I am writing just to inform you about the result from the biopsy. Unfortunately, it showed slow progressing lymphoma. We decided for chemotherapy with prednisolone and chlorambucil. I guess that is the only way or at least that what the vet proposed. He also added that it might be virus related, though FIV and FeLV tests were negative. I do not know what to think anymore. However, I would like to ask if there is any special care to help him during the treatment? My vet told almost nothing about this part. Thank you again!
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Hi Toni. I strongly recommend that you speak with a veterinary oncologist to make sure you are doing everything possible for your cat. When I have a patient on chemotherapy, I try to minimize stress, support their nutritional needs and prevent exposure to infectious disease. Wash your hands before handling the kitty. Watch the food consumption closely. If it decreases, talk to your veterinarian right away. To reduce stress, keep your routine as consistent as possible. Avoid having guests, pets or guests, in your home during the treatment. Good luck.
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Dear Dr Nelson,
You haven't heard from us for a while. The good thing is that my cat is still with us, though on chemo (prednisolone/day + chlorambucil/every 3days). There are some good and some bad days. Unfortunately, the bad days have become more frequent recently. Nausea and vomiting, lack of appetite persist sometimes for a week and it is tough for my cat to deal with it. We give him Metoclopramide and maropitant citrate (cerenia, which, as far as I know, is not approved for cats, but it is much more effective). However sometimes this does not resolve the issue and I was wondering if there are any supporting options/tips on a daily basis. So that the vomiting part does not come at all....or at least passes more quickly.
Also, if I got it right, the vet told us that this combination is a life-long treatment. And despite that the treatment is stopped every time when vomiting occurs, so far diarrhea is under control. I hope it stays this way.
I am trying to follow your advice and act as though there is nothing wrong (not always achievable). It is good for all :) Thank you! It is priceless!
Toni
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Have a question concerning chronic diahrea in my kittens.
Both Binky and Jr. were recently adopted from our local shelter and both have had chronic diahrea since I brought them home.
They've been dewormed several times and have had a number of fecals which always come back negative.
I saw your post to Toni and found it helpful. REcently, Jr. broke with uncontrollable diahrea (I call it "splatter poop" because it goes everywhere in the litter box like it's being shot out of a gun). he's had to have many a little sponge bath to get it off his backside, feet, legs, etc. poor guy.
I had some Albon in pill form and began giving him 1/4 tab once a day. That has stopped the splattering, but they both still what I describe as "cow pie" poop.
They free freed on a mix of Science Diet adult and Iams Kitten. Plus they all get 1/4 6oz can of Friskies twice a day.
Kaopectate and Immodium have not helped at all. Neither has yogurt or Acedophilus (sp?).
got any ideas?
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In my experience explosive diarrhea in youngsters is usually caused by coccidia. The little organisms can be difficult to detect with a standard fecal by flotation. Sulfa drugs such as Albon (Pfizer Animal Health) work well as long as you understand they are coccidiostatic, not coccidiocidal. It takes longer to get rid of an infection with a static drug. That is probably why the diarrhea improved but was not cured in the kittens. In my hands, I use Albon for 14 to 20 days to get the stools back to normal.
Your description of the diarrhea as "splatter poop" is right on the mark. In veterinary school, they called it "shingle-splitting" diarrhea. You might want to put some petroleum jelly on the kittens rear ends to protect the mucosa. It makes clean up easier as well!
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Thanks...have you heard of using tiny amounts of Marquis paste to cure coccidea?
It's normally used as dewormer in horses, but my vet has used it successfully to treat coccidea in cats and kittens. It cures it in one or two doses.
He waters it down and uses only about a 1/8 - 1/4 cc the first dose and then about two days to a week later, a second dose, same amount.
I may just go ask him to dose little Jr. then this weekend even though he didn't see anything in the fecal.
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Yes, ponazuril is the active ingredient in Marquis. It is a coccidiacidal drug which is why only two doses are required. I know that it is being used by some shelter vets to treat coccidia. Unfortunately, it is not approved in dogs or cats which is why I do not use it.
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Hello, I have an intact male 6 month old American Eskimo puppy. We have had him for three weeks now. Last Tuesday morning i awoke to find the left side of his face swollen and yellow discharge coming from his eyes. I took him to his vet on Tuesday afternoon, and she said she really didnt know what caused it. She said it could be a bite by an insect or many other things. We live in Chicago and its January so no bees or wasps around now. She gave him Amoxicillin 100mg, which we give him a total of 4 pills a day.She also gave him an anti-inflamatory for three days. She said if he is not better in 7 days to bring him back in. The woman i purchased him from said he was up to date on all vaccinations but provided no proof of that. My vet would not give them to him now because of his face but we will get them as soon as he is better.
My concern is that this could be a food allergy because his face swells up again within 30 minutes of eating. I recently changed his wet food to another brand due to his bad gas. This was maybe 2 days before his face swelled the first time. I am not comfortable waiting 4 more days to see if it goes away, i am wondering if i can switch his food now? I appreciate your taking time out of your very busy schedule to answer this. Thank you!!!!
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I am sorry to hear about your puppy. To answer your question about diet change, I usually recommend a gradual transition over two weeks when changing to a new diet. This helps to prevent diarrhea. However, if you change back to the original food after only a few days on the new food, most dogs do not get diarrhea. As for vaccinations, I agree with your veterinarian. Wait until he's healthy before you tax his immune system with a vaccine.
To help you further, I need more information about your dog. Where exactly is the facial swelling? (Upper jaw, lower jaw, Temporal Mandibular joint, associated with a tooth, etc.) Does it seem painful? What does it feel like? If you push your finger into it, will it leave a dent? Does it completely disappear between meals? The answers to these questions will help me rule in and out possible causes.
In general, facial swelling caused by food is rare, especially in a puppy. Tooth problems, a foreign body, allergic reaction from an insect bite, infection(strangles) or a leak in the salivary system are much more common. When I am faced with a case like this, I like to perform a needle aspiration and look at material from the mass under a microscope. This procedure combined with an x-ray usually gives me an answer.
I look forward to hearing more and hope I can be help.
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Hi Dr. Nelson,
Thank you for getting back to me. The swelling is right under his eye above his top gum line. His Vet said it shouldnt be a tooth problem since he is only 6 months old. The first morning he woke us up crying, he was in a lot of pain. It is hard not squishy. He is back to acting normal and not crying at all so i dont think he is in pain anymore. It does not go completely away between meals, it is still there but barely noticeable. When he eats or chews on his toys it swells more. I have taken away all his chew toys so it doesnt aggravate it more. It just seems like a hard swollen lump.
Thank you for your help!
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Last fall I attended a lecture at the American College of Veterinary Dentists symposium about dental problems in puppies and kittens. It was amazing how many problems these youngsters may have including impacted teeth, fractured teeth, dentigerous cysts, developmental cancer and fractures of the jaw or facial bones. If caught early, many of these conditions are treatable. I strongly encourage you to pursue further diagnostics including an x-ray of the area and a needle aspirate for cytology as soon as possible. In my experience, these problems are very painful. Take away his chew toys and soften his kibble with water to less the pain. Please feel free to contact me with more questions. I want to get your pup back to normal so he can enjoy his puppyhood.
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Hi Dr. Nelson,
I was wondering if you have any advice on how to treat early onset of hip displasia in dogs? My previous vet suggested pain management with Rimadyl, however, I would like to try a more homeopathic approach. My dog Stella is 2 and a half years old and we have been using the supplement Dasequin (from the makers of Cosequin) with some success. How do you feel about the newer supplements such as Dasequin that don't have as much research behind them? Do you have any suggestions about other options? Stella goes through phases of limping and lameness and I want to do something that will make her more comfortable. I really appreciate everything you do! Thanks so much!
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Thanks for writing. Successful treatment of hip dysplasia requires a combination of therapies including diet, drugs (anti-inflamatories), supplements, weight loss and physical therapy. Most supplements are not regulated so their claims of success are often anecdotal. Cosequin is the gold standard because it is the only product with scientific studies to support its efficacy. In theory, Dasuquin should be even better but we will have to wait for the research to prove this. In addition, Cosequin and Dasuquin are the only ones I know of that have a low enough molecular weight to penetrate into the joint.
Instead of giving a supplement, I prefer to use a diet that contains supplements that promote joint health. The dog gets more consistent dosing with this approach and it is usually less expensive for their owners. The three diets I recommend are Hill's j/d, Purina JM or Royal Canin Mobility.
In addition to supplements, I recommend low impact exericise and strict weight control for dogs with hip dysplasia. My own dog, Susie, suffered from severe laxity of her hip joints. Instead of running on hard surfaces for exercise, Susie spent 45 minutes a day swiming. Besides burning off calories, it helped her retain a good range of motion even as she aged.
Last, when a dog with hip dysplasia overdoes it, Rimadyl (carporfen) or one of the other NSAIDS is needed to reduce the acute inflammation that causes pain and stiffness. With my own dog, I used it sparingly to keep her comfortable just as you do with Stella. Many of my colleagues who typically practice holistic medicine also use Rimadyl for these acute situations.
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So what do you do when a dog has already burned paws? My son took our dog for a walk in the heat of the day (7/21) and our poodle's paw pad is slightly torn and he is limping. Any home remedies for burned pads? Thanks for your post on carring them and only letting them walk in the shade and on grass!
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Burns can be tricky to treat. Many require bandaging, antibiotics, soaks and surgical debridement to heal properly. They are also very painful. Since your poodle is lame, he needs to see a veterinarian for treatment and analgesic medicine. Many veterinarians will teach you how to perform the treatments at home, saving you trips to the clinic. Good luck with him!
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I have taken in a feral cat and she has adapted well to our home. She eats wet and dry food, but will not drink water or broth of any type. I am adding water to wet food, but it is not enough and she gets UTI's. Can you give me suggestions to get her to drink?
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Congratulations on adding a feral cat to your home. Lack of adequate water consumption is often caused by a host of factors. First, have you veterinarian examine her mouth. Dental disease or oral abrasions may make it painful to drink. If her mouth is normal, then consider the location of the bowl. Feral cats prefer a quiet area for eating a drink with a least two routes of escape. Another problem in dry climates is a shock when an animal touches their metal water bowl. Pets avoid drinking to avoid the painful stimulus. Use a ceramic bowl and remove metal tags from collars to prevent this condition. Feed a high quality prescription diet formulated to prevent urinary infections by producing an acidic urine. Lastly, feral cats prefer running water. I have had good luck using a table fountain to encourage more water consumption. Use distilled water to prevent mineral buildup inside the fountain. Good luck!
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