Interesting Cases
Everybody Pees…Except Flapjack
FLUTD is Feline Lower Urinary Tract Disease, a common problem in middle-aged male cats that is even more likely if they are overweight. It is also exacerbated by stress, so cats in a multicat household or cats that stress easily are more likely to be affected.
Flapjack is a handsome 6 year old, long haired, orange male cat that has had some litter box mishaps, LOVES food and is a tad overweight. Suddenly, he was straining in his litter box and urinating small spots outside the box. Dr. Lane diagnosed Flapjack with FLUTD. Inflammation in the bladder causes the cat to feel like they need to urinate, even when there is little to no urine in the bladder, so they strain and try to go frequently with accidents. While not caused by a bacterial infection (bladder infection, UTI or cystitis), bacteria can be a contributing factor along with stress. Creating a less stressful environment can be key to controlling FLUTD in some cats. Crystals in the urine are also a contributing factor. Minerals normally leave the cat's body through the urine, but can crystalize during FLUTD, causing increased irritation to the bladder and urethra. Without complete treatment, the crystals can stick together and eventually form bladder stones. Diet is an important part of treating FLUTD to reduce the minerals and crystallization of minerals in the bladder.
Flapjack's urine sample showed both inflammation and infection, but no crystals. He was treated with antibiotics and antiinflammatory/pain relievers and after a day he felt much better. His diet was not changed initially because of the lack of crystals in his urine. He went back to normal for 11 months and then...
A possible consequence of FLUTD is an emergency situation called blocking when a cat cannot pass urine at all. The blockage is created when the inflammation causes clots of debris, cells, crystals or small stones to pack into the long narrow urethra during urination and actually blocks the urine. This is painful and distressing, with many cats straining and crying and getting in and out of the litter box frequently. If not attended to quickly, it can result in permanent damage to the kidneys or even bladder rupture.
Flapjack's caring owners quickly noticed his distress. Dr. Lane admitted Flapjack to the hospital for emergency care and found with Xrays that he had a small stone blocking the urethra. She started immediate treatment by anesthetizing Flapjack for a urinary catheter to push the debris and small stone back into the bladder and reopen the urethra. Once successful, the blockage of urine can pass through the catheter and be immediately relieving to the cat. Typically, the catheter is left in place for 1-2 days while the cat is on IV fluids to help flush the urinary tracts and clean out any debris. Once the urine clears, the urinary catheter is removed and the cat remains in the hospital until it is obvious that he is urinating freely. Antibiotics, antiinflammatorys and prescription diets are all used to help treat then prevent further bouts of FLUTD. Unfortunately, poor Flapjack has more to his story than a couple of days in the hospital!
The stone in the urethra was not willing to move with the prodding of the urinary catheter. The pressure continues to build in Flapjack's bladder and Dr. Lane needed to relieve the obstruction immediately. Flapjack is taken to emergency surgery for a PU (Perineal urethrostomy). A PU involves removing the stone or other obstructions and widening the urethra, thereby fixing the current emergency and likely preventing future obstructions. The surgery was successful and Flapjack stayed in the hospital one day for post surgical care, then returned home with a new diet.
Even with diligent home care and preventative measures such as diet changes, exercise, antiinflammatories and stress reduction, cats that block once are very likely to block again. A PU (Perineal Urethrostomy) does not prevent FLUTD, but can prevent the tiny stones and plugs from getting stuck in the now wider urethra. This is why blocking is a condition almost exclusively of male cats. Females have a naturally shorter, wider urethra that passes debris much easier.
Dr. Lane is now happy to see that Flapjack is urinating freely and eating the prescription diet to prevent him from forming more bladder stones. He is also losing weight which helps prevent future episodes. He is on no chronic medication, but she is ready to prescribe antiinflammatories if he has a flare up of FLUTD.
Amber, A Complex Cat
Amber has been a diabetic for about 2 years. His owners faithfully give him insulin shots and monitor his schedule to keep him stable. And he has done so well! Until he had a bout of Feline Asthma/Allergic Bronchitis.
This breathing problem is very similiar to human asthma, with constriction of the small air passages in the lungs. Cats can have mild symptoms with mild coughing and up to severe wheezing and open mouth breathing. In rare instances, Feline Asthma can be life threatening. Feline Asthma is most effectively treated with steroids. BUT DIABETICS can't take steroids! It messes up their metabolism and worsens their diabetes.
So, how are we going to treat Amber?
Plus, did I mention, he ABSOLUTELY will not take pills. This is a common cat attitude, and can be very stressful to the owner trying to keep their pet healthy and happy!
Amber's answer was going to be inhaled medications. Humans often take them with an inhaler. Cats can take inhaled medicine with a spacer and a mask (Aerocat). They must be trained to breath with the mask on their face. Well, Amber was just saying NO to the face mask. So we moved to nebulized medications. Nebulizing medications means they are carried in small droplets in the air that we breath. Basically, we breath in a medicated mist. Again, most humans get their nebulized medications by a mask, and that was not going to be accepted by Amber! So his owners built him a nebulizer chamber from simple components that can be purchased by anyone. They found a nebulizer online for a reasonable price. Nebulizers are small air pumps that turn liquid medication into a mist that can be breathed. They gathered simple components like a storage bin and some plumbing fittings. Now, Amber goes in his chamber for a few minutes to breath in his medicine! He is less stressed and can breath easier (and so can we)!
If you are interested in building a nebulizer chamber, please see Amber's blog post "How to Build a Nebulizer Chamber for your Asthmatic Pet" at [url=http://www.delmartian.com/null_pointers/2013/10/howto-build-a-nebulizer-chamber-for-your-asthmatic-pet/]http://www.delmartian.com/null_pointers/2013/10/howto-build-a-nebulizer-chamber-for-your-asthmatic-pet/[/url].
And thanks to Amber's dedicated, and very handy, owners!
Meet Melvin!
Melvin is an adorable, loving young black Pug who is very lucky to have quick thinking owners that are cool in an emergency!
Melvin suffered from a proptosed eyeball. Proptosis is when the eyeball pops out of the socket and becomes entrapped in front of the eyelids. It can happen in any dog or cat because of trauma, typically car accidents and dog fights. But it is much more likely to happen in brachiocephalic dogs. Pugs, like Pekinese, Boston Terriers, Bulldogs, and Shih Tzus, have the lovable pushed in nose and wide, round eyes. But because of that body conformation, their eyeballs are not held strongly in place and can be proptosed by mild trauma, in some cases just grasping the skin over the back of the head.
Melvin's owners didn't know just what to do... but they did the right thing anyway! They immediately put light pressure on the eye with a clean, moistened cloth. While fearful, they put light, steady pressure on the eye from the outside corner rolling inward. The eye moved right back into place and they rushed Melvin to us for evaluation. By the time we saw Melvin, his eye was sore and inflammed, but his vision and eyeball were saved by the calm, cool reaction of his loving owners.
Melvin was very lucky. Not only was his vision saved, but there are no problems with eye motion or position. Often, with severe traumas of car accidents, there are complications or problems that end with the eye being saved but not the vision or in sad cases, even loss of the eye. Any proptosis is a surgical emergency, and any time wasted before seeking medical or surgical care reduces chances of full recovery.
Meet Sweetie!
She may just look like a beloved pet having fun in the snow, but she is a miracle. Sweetie is the only dog in our combined 75 years of veterinary medical experience to have survived antifreeze poisoning.
Antifreeze poisoning is common in cats and dogs because it has a naturally sweet taste, making it ATTRACTIVE to animals to lap up. And it only takes a teaspoon to a tablespoon to be toxic to pets. Most animals come in contact with antifreeze when people drain it out of their motor vehicles and spill some in the driveway, leaving behind a small puddle or rinsing it into the gutter. Other animals have been poisoned when people use it in the plumbing of homes that are being winterized (cabins/camps) and it is lapped out of the toilet. Sadly, it has been used for malicous poisonings and inadvertent poisoning of pets when people are trying to poison wildlife or vermin.
The reason Sweetie is the exeption is because she has a very observant owner. She came home from her free run in the rural neighborhood acting mildly disoriented and staggering. The owner had not released any antifreeze, but it was the fall, a time when many home mechanics change their own antifreeze. Her owner wasn't sure what was wrong with her, only that something was wrong. She called the CDAEC (Capital District Animal Emergency Clinic), who asked her some questions and recommended Sweetie come in for an exam. The exam made the veterinarian on call further suspicous of inadvertent antifreeze poisoning, so a test was done that verified Sweetie had ingested a toxic dose of antifreeze. She was immediately
started on antidotes to block the antifreeze and released 1 1/2 days later feeling fine. There was some follow up, to verify there was no long term damage to her kidneys, but Sweetie has had 7 more years of playing in the snow, in a healthy body, because of the quick action of her owner and the emergency veterinarian.
Sadly, this is NOT the norm. Most animals that are not known to ingest antifreeze are not noted to be sick until the 3rd stage of poisoning, 3 or more days after the ingestion. At that point their kidneys are shut down, and many are never able to recover, even with potentially aggressive treatment. Stage 1 symptoms of poisoning can be mild or pass quickly and many owners don't even recognize that these vague and transient signs are significant and require immediate action to save the pet.
Be aware that use of any and all garage and home chemicals requires care and caution.
Use less toxic substitutes when available. And remember, just because you are being careful, not everyone will be.
AND don't be afraid to call your regular or emergency veterinarian to ask about symptoms that worry you! Most times, it is no big deal.
ASPCA Animal Poison Control, fee for service at 1-888-426-4435
A preventable, interesting case
This is a cautionary tale of two lovely, large breed puppies, one 10 months old and the other 6 months old. They lived together in a home after being purchased from breeders. They had each gotten shots in early puppyhood from the breeder, so the family assumed they were safe and protected.
Suddenly, the 6 month old puppy was found dead and the 10 month old puppy was very sick with vomiting and diarrhea. She was taken to the Capital District Animal Emergency Clinic and diagnosed with Parvovirus. Parvo is a virus that causes severe vomiting and diarrhea, often with blood, and rapid dehydration that often results in sudden death in puppies. The CDAEC began emergency treatments to save her life, and after 3 days of treatment there and another 3 days at our animal hospital, she was able to be released to go home again.
So while she was saved, her family spent literally thousands of dollars to save her life. And all she really needed to prevent this was a well-timed Parvo puppy booster.
Puppies need 2-4 distemper and parvo virus vaccines between the ages of 8-16 weeks old. The number of vaccines and the timing of the vaccines is often based on the puppy's risk factor, which vary based on age, breed and environment.
We would love to see your new puppies and establish an appropriate booster schedule to protect your precious new family member! We would also like to use this time to discuss training and behavior, grooming needs, nutrition, parasitism and breed related issues. Please let us keep your puppy safe and help you develop this new family member into a cherished and well-behaved pet.
