In veterinary medicine, fluid therapy is given in four ways,
Oral – by mouth
Intravenous – through an intravenous catheter
Intramedullary – within the medullary canal of bones
Subcutaneous – under the skin
Subcutaneous administration means fluids are injected under the skin using a needle. The fluids accumulate into a large pouch between the shoulder blades. This gives the patient a ‘hunchback’ look. Overtime, the fluids are absorbed into the animal’s bloodstream. Because it takes time for the absorption to take effect, the subcutaneous route is not appropriate for animals who need fluids immediately. The intravenous or intramedullary route is used for these cases.
To perform subcutaneous fluid therapy, I recommend cleaning the skin where the needle will be placed with an antiseptic solution to prevent infection. Next, the skin is pulled up off the animal’s body making a ‘tent’. A sterile needle is inserted into the base of the tent and the fluids are injected. A new needle is used for every treatment. Needles should not be reused under any circumstances as they become dull and contaminated.
Only sterile, non antigenic fluid can be injected under the skin. Examples of appropriate fluids include lactated ringers solution, Normasol, Plasmalyte or saline. Fluids that contain any form of sugar (glucose or dextrose), high osmolality and/or unsterilized fluids should never be used for subcutaneous administration. Sugar causes a horrific reaction that often causes abscess formation and sloughing of the skin. The sugar placed in the warm subcutaneous space creates a perfect incubator for bacteria. I saw a dog go into septic shock after it was given Pedialyte subcutaneously. These animals are in extreme pain. I have seen dogs and cats lose all of the skin on their backs from sugar. Even with extensive skin grafts and hospital care, some of these animals died. Here are a few examples of fluids that should never be used for subcutaneous fluids. Pedialyte, D5W, Gatorade and mannitol.
Please talk to your veterinarian before giving any medications or therapy to your pet!
One of my favorite duties as a veterinarian is performing puppy examinations. I love to play with the puppy and feed them treats, especially during vaccinations. I try to make it a good experience to prevent a long term fear of veterinarians. Part of the exam includes a careful auscultation of the chest to listen for heart problems. Newfoundland dogs are prone to a heart condition that causes a murmur. Name the condition.
Diagnosis: Subvalvular Aortic Stenosis
Subvalvular aortic stenosis (SAS) is an inherited condition of Newfoundland dogs caused by a genetic mutation. Dogs with SAS develop a ring of thickened tissue right below the aortic valve that impedes blood flow out of the heart into the aorta. When I listen with my stethoscope to dogs with SAS I hear a murmur on the left side of their chest. Typically, the murmur is softer in the beginning and gets louder as the puppy grows. These dogs often show signs of heart failure characterized by fainting, lack of energy, collapse and death.
Dr. Joshua Stern, leader of the team of researchers at the University of California, College of Veterinary Medicine who identified the mutation hopes breeders will use this information to ‘breed’ the condition out of Newfoundland dogs.
Source: -Preidt, Robert. Mutant Gene Spurs Dangerous Heart Condition in Newfoundland Dogs: Ridge of abnormal tissue forms below the aorta, restricts blood flow ad can cause sudden death. HealthDay, August 8, 2014.
Bull terriers are a fun breed, full of personality. Unfortunately, they are prone to a few skin problems. Name the most common skin conditions seen in this breed. Thankfully, this cute little puppy had healthy skin.
Mange caused by the demodex mite. (I see this mite causing problems in puppies from many breeds).
Solar dermatitis as well as cancer – Any dog with white hair and pink skin is prone to sunburn and eventually cancer from sun exposure. I have removed many hemangiomas, hemangiosarcomas and squamous cell carcinomas from dogs who love to sunbathe.
Recently, I found two large black colored growths on the front legs of a dog. These growths were located right behind the carpus or wrist. They were firm to the touch and did not seem to bother the dog at all. Once and awhile, the dog would chew on the growths but they never bled. Study the image below then answer the following question: What is the name of this condition? What is the name of the pad in this area? How is it treated?
Diagnosis: Hyperkeratosis of the accessory carpal pad
Hyperkeratosis is a benign condition that occurs on the nose and pads of dogs. Keratin is a firm material that provides structure for hair, skin and nails. Hyperkeratosis, which means too much keratin, can be caused by many things. In practice, I see it most often in older dogs. Treatment of hyperkeratosis is similar to treating a callous in humans. The extra material is removed down to healthy skin. In this patient, the keratin was cut away with a tough scissors. For the nose, I generally soak the keratin with a moist paper towel to soften it, then scrape it off. There are medications designed to dissolve the keratin but I generally don’t recommend them because they sometimes irritate the skin.
Certain cats are the host for an intestinal roundworm called Toxoplasma gondii. Adult worms live in the cat’s intestines and reproduce by releasing eggs into the cat’s feces. When humans are infected by inadvertently ingesting the infective oocysts (for example children sometimes put things in their mouths that they shouldn’t), the victim’s immune system springs into action producing natural killer cells and cytotoxic T cells. These destroy the parasite. Most people don’t even know they have the parasite while others develop flu-like symptoms. Researchers hope to use this same response to fight cancer.
Dr. David Bzik and Barbara Fox from the department of microbiology and immunology, Geisel school of Medicine at Dartmouth developed a vaccine made from T. gondii. The pair used a genetically altered form of the parasite called “cps” that cannot replicate yet still causes the immune reaction when given to humans. Because of this modification, the cps vaccine would be safe even for people with suppressed immune systems. So far, the vaccine has shown great success in laboratory mice with aggressive forms of melanoma and ovarian cancer.
The ultimate goal is to create a vaccine tailored to the patient. Dr. Bzik hopes to remove cancer cells from a patient, infect them with cps and then reintroduce the cells. This will stimulate the patient’s immune system to target the cancer and hopefully, cure the patient.
Source: -Does cat poop parasite play a role in curing cancer? Norris Cotton Cancer Center Dartmouth-Hitchcock Medical Center, SCIENCEDAILY, July 15, 2014. www.sciencedaily.com/releases/2014/07/140715095515.htm.
Recently, I read a paper written by Dr. Dave McRuer outlining the unintended consequences of feeding waterfowl at parks. Good natured people who want to help the ducks and geese with a free meal are actually harming them. Supplemental feeding of waterfowl is actually killing them with kindness. Here are some of the problems associated with this activity:
Overcrowding – Ducks and geese are a lot like humans. When they find out that ‘free food’ is available, they flock to it. When large numbers of any species congregate in one small area, the huge number of animals cause overcrowding. Overcrowding leads to disease transmission and destruction of the environment. It is also bad for the birds. Dr. McRuer states that during mating season, female ducks may drown when they cannot escape the large number of amorous males.
Poor nutrition – In the wild, ducks and geese eat a variety of food. When they live off of people food which is often high and carbohydrates and protein, they suffer nutritional problems. If they are eating high carbohydrate foods such as bread, crackers and popcorn, they often develop calcium deficiency. This causes soft bones that break easily, weak shells when they lay eggs, heart and nerve problems. If they are fed pellets which are high in protein, a condition called ‘angel wings’ occurs. (More information at http://drnelsonsveterinaryblog.com/2014/08/avoid-feeding-bread-to-ducks-and-geese-to-prevent-angel-wings/ )
Delayed migration – Due to the free food, the birds hang around instead of migrating. When the weather changes, many birds will freeze to death. Others will starve to death when the cold weather forces people inside leaving the birds with no food.
Loss of fear for humans – One of the best defense mechanisms for all wild animals is a healthy fear of humans. Animals of any kind that lose their fear of humans are prone to death from dogs and cats as well as automobiles. They also may be poisoned by humans who don’t want the mess that comes with a large number of waterfowl.
For these reasons, I must strongly encourage you not to feed wild animals. The Wildlife Center of Virginia has come up with a great saying for this.
“No crackers for quackers!”
Source: -McRuer, Dave, Consequences of feeding waterfowl in public parks. 2012. http://wildlifecenter.org/news_events/news/problem-feeding-ducks
Pictured below is a friendly cat who suffers from a skin condition that primarily affects her face, mouth and pads. It is thought to be an allergic reaction to something in the environment. Her skin becomes itchy and then she scratches her face until it literally bleeds. Study the image and the answer the following question. What is the name of this disease?
Diagnosis: Eosinophilic Granuloma Complex
Eosinophilic granuloma complex is thought to be caused by allergies. The disease affects the face, ears, mouth and pads. It can cause ulcers as seen in this cat as well as plaques (thickened areas of skin) and granulomas (a lump of inflammatory cells). Most of these cats are treated with immunosuppressant doses of steroids to calm down the immune response. At the same time, a search begins to find out what is causing the reaction. Food and fleas are often the culprits.
-Brooks, Wendy. Eosinophilic Granuloma Complex. The Pet Health Library. VIN, 2/11/2003 and revised 11/4/2012.
With more and more battery powered gadgets in our homes, battery ingestion is becoming a bigger and bigger problem. The family comes home to find their remote control chewed into several pieces, the battery is missing. Unfortunately, batteries are very dangerous. Alkaline dry cell batteries ( 9-volts, D, C, AA, etc) and button or disc batteries contain hazardous chemicals that can destroy tissue. The chemical causes severe ulcers. If a dog punctures the battery and then swallows it, they usually sustain severe damage to the mouth, esophagus and stomach. I often find a black powdery material on the lips and in the mouth of these patients.
The goal of treatment is to remove the battery as quickly as possible with either an endoscope or during surgery. DO NOT INDUCE VOMITING! When the battery is vomited back up, more damage will occur. If you think your pet may have eaten a battery, seek veterinary care immediately. In my experience, quick action is critical for this type of toxicity.
Lee, Justine. Tope Ten Small Animal Toxins: Recognition, Diagnosis, Treatment. ACVIM 2010.
‘Angel wings’ is a term used to describe an orthopedic abnormality in ducks and geese. Birds afflicted with this condition have a malformation of the metacarpal joint in their wings. This makes the ends stick out to the side like an ‘angel’s wings.’ Unfortunately, there is nothing angelic about this condition. Ducks and geese with angel wings are unable to fly and hence, escape danger. Most die from automobile accidents, predator attacks or severe weather. If they are lucky enough to live in an area free from the above dangers, they often die of starvation when they are unable to migrate.
The exact cause of angel wings is not known at this time. It is thought to be caused by an unbalanced diet, too much protein or carbohydrates, causing abnormal growth. According to veterinarian, Dave McRuer, “It occurs when the weight of growing feathers causes rotation of the wing tip by forces exerted on the underlying ligaments and muscles. ” It is usually seen in birds where humans feed them an unbalanced diet. It makes me sad to think the people who want to help these birds are the ones who are hurting them. This reminds me of the marmonts in Glacier Park who die during hibernation because they ate crackers and cookies instead of their normal diet.
Treatment options for angel wings are limited at best. If caught early in young birds, the wings are wrapped back into the correct position and the chick is fed a balanced diet. If the condition is chronic, there are no treatments for correcting the abnormal metacarpal joint. The bird will never be able to fly.
To prevent angel wings, please help spread the word that feeding wild animals people food does more harm than good. For bird feeding, purchase a balanced pelleted diet from your local pet store. Kindness should never kill . . . .
Source: -McRuer, Dave, Consequences of feeding waterfowl in public parks. 2012. http://wildlifecenter.org/news_events/news/problem-feeding-ducks
Discoid lupus erythematosus (DLE) is an autoimmune disease seen in dogs. It occurs when the dog’s own immune system reacts to free DNA. It is commonly seen in collies hence the common name ‘collie nose’. People with a background in Latin are probably wondering why the word lupus which is Latin for ‘bite of wolf’ is included in the name. Since collies were used to protect sheep from wolves, it was thought that the condition was caused by a wolf bite.
DLE usually affects the nose but may also strike the ears and mouth. The first sign is often when the nose changes from black to gray. Next, the nose starts to blister and crack until most of the normal tissue is gone. The dog is left with on open painful wound.
The goal of treatment is to control the immune system to lessen the severity of the disease. Here’s a list of some of the common treatments:
1) Keep the dog inside during the day as sunlight exacerbates this condition. 2) Doxycycline and niacinamide work together to suppress the immune response. These two drugs are the mainstay of therapy. 3) In really severe cases, short term steroid therapy may be required to control the immune system. 4) Fatty acids, especially omega 3, combined with vitamin E help decrease the immune response. In some patients, therapy with omega 3 fatty acids and vitamin E dramatically decreased the required dose of doxycycline and niacinamide.
Source: -Brooks, Wendy. Discoid Lupus Erythematosus. The Pet Health Care Library, Client Education, VIN.