Canine Hypothyroidism - ‘Szadee'

szadee before treatmentSzadee is a 3 year old female Staffy who was seen at our clinic after her owners noticed her activity levels had decreased and she had put on weight. Despite a strict calorie-controlled diet Szadee had not lost weight, in fact she had gained over a kilo! Szadee had also developed hairloss and dandruff along her flanks and a ‘tragic' facial expression. Canine hypothyroidism was strongly suspected and a blood test confirmed the diagnosis.

Szadee was started on twice daily thyroid hormone supplementation and her owners noticed a dramatic improvement. She became more active, her haircoat improved and she now has a happy facial expression rather than a tragic one! She also before treatment  right sidebegan to lose weight. A follow up blood test confirmed her thyroid hormones were now within normal range. Szadee will require lifelong medication and regular monitoring but her owners are very happy at her improvement.

Canine hypothyroidism is a common hormonal disease caused by destruction of the thyroid gland. It is most common in middle-aged dogs and certain breeds are more commonly affected, including Golden Retrievers, Boxers and Miniature Schnauzers. Thyroid hormones are involved in the regulation metabolism so a deficiency of these hormones causes a variety of different signs. The most common signs are:

      • weight gain
      • lethargy
      • weakness/exercise intolerance
      • skin abnormalities such as hair loss (often symmetrical and on the flanks), dandruff or skin infections
      • development of a ‘tragic' facial expression due to swelling of the tissues of the face

As you can see, Szadee presented with all these changes, but many dogs will only have one or two, making the diagnosis more challenging. Using blood tests to diagnose the condition can also present issues, again in this case Szadee was relatively straightforward but there is no test for hypothyroidism that is 100% accurate and a frustratingly large number of dogs will have ‘equivocal' results, meaning additional testing may be needed.

happy dog with thyroxineOnce diagnosed, treatment for hypothyroidism involves giving replacement thyroid hormones for life. The dose is initially estimated based on the dogs weight and a follow up blood test used to check the dose, usually adjustments will need to be made to avoid over- or under-dosing. Regular monitoring is then required as dose requirements may change.

Hypothyroidism is generally a very rewarding disease to treat for both owners and vets as the improvement is usually so pronounced. Generally improvement in activity levels and weight loss occur first, skin and coat changes may be slower.

 

 

 

The cranial cruciate ligament (CCL) provides stability for the knee joint. Rupture of this ligament is one of the most common orthopaedic conditions seen in the dog.

Cause

In people, cruciate ligament rupture is usually a result of trauma, commonly a twisting motion while weight bearing such as happens during football. In dogs, there are many factors that may contribute to cruciate rupture.

5466894 sAcute CCL rupture is often traumatic in origin and most commonly occurs when the leg is extended and rotated while weight bearing, such as can happen when the dog steps in a hole.

CCL rupture can also occur secondary to chronic changes  in the joint, due to age related degenerative change, osteoarthritis, obesity, or conformational abnormalities.

Risk factors include large dogs being very active, obesity (putting extra strain on the joints) and animals that participate in the weekend warrior syndrome - ie unfit dogs overexercising and injuring themselves.

Regardless of the cause, CCL rupture sets off a cascade of events including articular cartilage degeneration, joint capsule inflammation, arthritis development and fibrosis of the joint capsule.

Rupture of the CCL also predisposes the joint to further injury (especially damage to the menisci which are the shock absorbers inside the joint), as the stability of the joint has been compromised.

Diagnosis

Damage to the CCL can vary in presentation from a subtle lameness (especially if only partially ruptured) to a sudden non weight bearing injury.

CCL rupture can be diagnosed by physical examination. Signs include fluid accumulation around the joint, decreased range of motion and clicking of the joint. Instability (detected by a cranial draw movement) is diagnostic of the disease, however it may be difficult to detect with partial tears or in very tense dogs.

Xrays may be taken to confirm fluid acculuation, grade the amount of arthritis present and to rule out concurrent disease conditons such as cancer.

Treatment

Lameness will improve within 3-6 weeks after injury without treatment. Some dogs less than 10 kg will continue to improve and regain good function without surgery. In larger dogs the lameness improves but they never regain good function of the leg without surgery.8118005 s

Conservative treatment involves rest and non steroidal anti inflammatory medication for 6-8 weeks. A graded regime of exercise can be introduced once the pain and inflammation is reduced, and a weight loss program (if necessary) should be intiated. This treatment has the most success in dogs weighing less than 10 kg. Results are more unpredictable in larger animals.

There are various surgical options to treat CCL injury, but broadly they can be divided into 2 categories :- extracapsular (outside the joint), or intracapsular (inside the joint).

Most surgeons favour an extracapsular technique as it delivers equal or better results to intracapsular techniques, without added trauma to the joint.

Extracapsular techniques either aim to stabilise the joint by sutures around the joint (eg DeAngelis technique), or by changing the biomechanics of the joint so the animal can weight bear and walk without a cruciate ligament (eg Tibial Plateau Levelling Osteotomy or TPLO).

TPLO surgery requires cutting the tibia and applying a plate so that the top of the tibia sits at a different angle. It should only be performed by a veterinary surgeon with advanced training.

The decision of which surgery to perform should take into account the dogs age, activity level, size and temperament. Our vets will be able to go through your options with you so you can make the right decision for your pet.

Surgical Complications

Surgical complications include wound problems, bandaging problems, infection, implant (bone plate) failure and failure to return to normal function.

Ten percent of patients may have damage to their meniscus (cushioning cartilage within the joint) at a later date.

Up to 60% of patients will rupture the other cruciate ligament within 2 years.

All joints that have had a CCL rupture will develop arthritis later in life. Surgical repair technique does not appear to affect long term outcome for the joint providing the surgery has been successful, although there are a limited number of long term studies.

After Care

7541475 sActivity is restricted to leash walking for a minimum of 6-8 weeks.

Supervised rehabiliation - including swimming and passive range of motion exercises - can decrease recovery time and facilitate a return to more normal function.

Our vets will advise you on exercises you can do at home, or we can refer you to a dedicated animal physiotherapist to help your dogs recovery.

 

 

What is Addison's Disease?7833318_s

Addison's disease (or hypoadrenocorticism) is a disease in which the adrenal glands are destroyed, usually by the 7833318_sdog's own immune system, resulting in their loss of function. This means that the steroid hormones which are normally produced by the adrenal glands can no longer be produced.
Addison's disease usually develops in young to middle-aged dogs (most commonly between 4-6 years of age) and is more often reported in female dogs.

Signs of Addison's Disease

The clinical signs are often vague and may be episodic, and include lethargy, anorexia, vomiting, weight loss and general weakness. Dogs may drink and urinate more. Unfortunately, these signs are not specific to Addison's disease and may also be noted in a variety of other diseases. Occasionally dogs can experience an ‘Addisonian crisis'and become suddenly seriously unwell.

Diagnosing Addison's Disease

Due to the unspecific nature of the clinical signs, diagnosing Addison's disease often requires several tests to be performed. A combination of physical examination, blood tests and ultrasound 7342646 simaging can be used to aid a diagnosis. Then, once Addison's disease is suspected a test called an ACTH stimulation test can be used to confirm the diagnosis.

Treating Addison's Disease

Fortunately, Addison's disease is generally relatively easy to treat. Treatment is with Florinef tablets, which replace the glucocorticoids and mineralocorticoids that are not being produced from the adrenal glands. Once the diagnosis is conformed and  treatment has commenced, dogs generally do very well; although life long treatment and ongoing monitoring will be required.

What is Cushing's disease?

5911987 sCushing's disease (or hyperadrenocorticism) develops when too much of the hormone cortisol is produced from the adrenal glands, which are located above each kidney. In the majority of dogs this is caused by a growth in part of the brain called the pituitary gland. In some dogs it may be caused by a tumour in one of the adrenal glands.

Who can get Cushing's disease?

Cushing's disease usually develops in dogs older than 6 years of age. Breeds which are commonly diagnosed with Cushing's include 5911987_sPoodles, Dachshunds, German Shepard dogs, Beagles and Labrador retrievers.

Signs of Cushing's

Dogs with Cushing's disease may develop a variety of clinical signs as a result of the excessive cortisol production. Drinking more and urinating more are common clinical signs along with an increased appetite, panting, a potbelly, hair loss and lethargy. These signs are often more obvious in small breed dogs. Dogs with Cushing's disease may be more prone to developing skin or urinary tract infections.

9571533_sDiagnosing Cushing's disease

The clinical signs described above can be used to help a vet diagnose a dog with Cushing's disease. Once signs of Cushing's have been detected, usually, the first step in diagnosis is to test the dog's blood. If the results of the blood test suggest that Cushing's disease is present, then another test is used to confirm the diagnosis.

Treating Cushing's disease

The first line treatment for Cushing's disease in dogs is a drug called Trilostane. This drug halts the excessive production of cortisol from the adrenal glands. Trilostane comes in a capsule and can be given to the dog by mouth with food, but frequent monitoring of treatment is required and a significant cost is involved. Once dogs are treated the clinical signs usually resolve.

8601055 sRecently there has been a lot of discussion amongst veterinarians regarding the best vaccination protocols for cats and dogs. Further studies have been carried out to assess the duration of immunity provided by the vaccines.

We all agree that vaccines should be administered to all animals to protect them against life threatening disease and there are many animals that require further vaccines to help prevent diseases that are a less severe health risk.

Current scientific consensus recommends that adult dogs should be vaccinated for canine distemper virus, canine adenovirus and canine parvovirus every 3 years (C3 vaccine). Dogs living in the city or who have contact with other dogs, should also be vaccinated for parainfluenza virus and Bordetella bronchiseptica (kennel cough vaccine) every year. These 5 components together make up the standard C5 vaccine.

Puppies still require 3 vaccines 4 weeks apart with the final puppy vaccination at 14-16 weeks of age or older. They then require their first booster 12 months later. These vaccines will be a C5 meaning that they include all the components.

What this means for your dog

8125066 sThis means when you receive your reminder for your adult dog's annual health check and vaccination, your dog may only require a booster for kennel cough. It is important to continue this yearly check up and kennel cough booster to maintain immunity against kennel cough and to identify any problems your dog may have.

Your vaccination record will be filled in and you will be reminded for the following year. Your dog will receive a C5 one year, then 2 years of a kennel cough vaccine only. This vaccination schedule will provide full coverage for kennels.

Every animal's vaccination protocol should be determined based on its individual requirements and occasionally it is in the patients best interests not to be vaccinated.

 

Cats3986965 s

Cats require vaccines for feline enteritis and calicivirus and herpes viruses. Kittens need 3 vaccines 4 weeks apart with the final vaccine being at 14 weeks or older. These vaccines have not been proven to last longer than 12 months so at present we will continue to vaccinate adult cats every year. To be allowed to board at a cattery they are required to have had a vaccine in the previous 12 months.
Depending on their lifestyle we also offer a vaccine for feline immunodeficiency virus which is a disease which is transmitted by fighting.