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What is a Hot Spot?

August 17th, 2016 by Audrey Parker

“The spot came up on my dog overnight, and now they won’t leave it alone!” This is usually how the conversation goes with panic-stricken clients that have just noticed the huge, bald sore that is red and oozing. After telling them it looks or sounds like they are describing  a hot spot, the next question is typically, “What is a hot spot?!”

Hot spots, or acute moist superficial pyoderma or pyotraumatic dermatitis, are rapidly developing skin infections where the naturally occurring bacteria on the skin invade through damaged skin. The initial inciting factor can be from many sources. Anything that leads the dog or cat to start itching in a particular location can begin the cycle. The most common reasons for itching are fleas or external parasites, food allergies, seasonal allergies, matted hair, and insect bites or stings. Once the itching and scratching begins, skin abrasions develop which allow the normal Staphylococcal bacteria on the skin to set up an infection.

hotspotThese infections normally progress very rapidly and can become large and very painful in a matter of hours. Once the infection takes hold, the itching and scratching is accelerated- so that the pet constantly licking, biting, or scratching which then makes the lesion worse. The sore becomes moist, oozes pus, and loses hair. Usually the hot spot actually extends into the haired areas as well, and we don’t realize how large it is until we begin to shave the surrounding hair. It is more common to see these in the hot, humid times of the year; but they can occur year round.

So how do we treat this?

Although hot spots look terrible and are very uncomfortable for the pet, fortunately the treatment is straightforward. We may still have to search for the underlying cause to prevent the animal from having recurrent problems, but treatment for the hot spot will still be the same. The first thing I do is shave the entire area, which is usually much larger than it initially appeared. This allows me to visualize the extent of the hot spot, scrub the entire area with an antiseptic, and allows more fresh air to reach the wound. Our goal is to start drying the wound so it will scab over and to avoid anything that will keep the wound wet (like greasy ointments). In severe cases, the animal may have to be sedated to completely shave and clean the area.HotSpot_dog

Once the area is sufficiently cleaned; there are many different topical, oral, and injectable products or combination thereof that can be effective in treating the infection. Every veterinarian has their favorite products that we reach for first; but those can include antibiotics, a steroid for itching and inflammation, NSAIDs for pain, and Elizabethan collars to prevent further scratching. For very large and painful hot spots, topical therapy alone may not be sufficient. To choose the appropriate antibiotic, a skin cytology or skin culture may be needed. Therapy will need to be continued until the hot spot is completely healed, and the pet will need to be reassessed by the veterinarian to determine when the medications can be discontinued.

The thing to remember is that you are not a bad pet owner if your dog or cat develops a hot spot. This a very common skin condition that can become severe before you even notice that it is an issue. Please bring your pet in to see your veterinarian as soon as you notice that there appears to be problem, especially if your pet is prone to get recurrent skin infections. You may even want to place a wrap or cover the affected area until you can get to the vet to keep further damage from being caused from continuous licking or biting. The sooner treatment is initiated by your veterinarian, the faster your pet can be comfortable and on the road to recovery.

Dr. Alison Bradshaw

The Pet Hospitals- Collierville

Is Anesthesia Safe?

August 11th, 2016 by Audrey Parker

 

General anesthesia is used on a daily basis in most veterinary hospitals. A common conversation with clients is over concern regarding the safety of anesthesia for their pet. The good news is that modern anesthesia is very safe. Today we have access to much better drugs. This allows us to tailor the anesthetic plans to each patient’s individual needs. The risk of a pet dying under anesthesia is less than 1%. The rare patients that are lost under anesthesia are generally emergency procedures, when the patient’s condition is already extremely critical prior to surgery. The risk of a pet dying under anesthesia while undergoing a routine procedure, such as a spay, neuter, dental or mass removal, is extremely low. This risk can be affected by the anesthetic drugs used, as well as the monitoring of the patient during the procedure, as well as the recovery period.

The following is a list of questions that you should ask your veterinarian before scheduling any procedure involving anesthesia for your pet:

1) Is pre-anesthetic blood screening performed?

All patients, not just old or sick patients, should have basic pre-anesthetic blood tests performed prior to any anesthetic event. This testing will provide your veterinarian with important information regarding organ function (the kidneys and liver must be healthy to allow a patient to metabolize and excrete anesthetic drugs), as well as screen for infection, anemia or a low platelet count (which would affect a patient’s ability to clot during a surgical procedure). Often times, certain anesthetic protocols or treatment modalities can be used to tailor an anesthetic plan for a patient’s specific needs based on labwork findings. Your veterinarian may even elect to delay a procedure if undesirable results are obtained, or if further testing and treatment are warranted before anesthesia is used. Even in young patients (less than 1 year of age), bloodwork will occasionally detect abnormalities that could affect their ability to handle anesthesia.

2) Are intravenous fluids administered during anesthesia?image1

Many drugs commonly used for general anesthesia tend to cause a drop in blood pressure. Intravenous fluid therapy can be used to maintain a safe blood pressure throughout an anesthetic event. In addition, an intravenous catheter allows for immediate administration of emergency drugs for resuscitation if an adverse reaction occurs during anesthesia.

3) Is the pet’s body temperature regulated during and after anesthesia?

All animals, especially cats, small dogs and older patients, lose a lot of body heat while under anesthesia. This leads to hypothermia, which can slow anesthetic recovery. Warm air blankets are commonly used to maintain a patient’s body temperature during anesthesia. Conventional heating pads are risky because they can cause serious burns.

IMG_19034) Is the pet intubated, and what anesthetic gas is used?

Intubation means that the patient has an endotracheal tube (breathing tube) placed through the mouth and into the trachea (or windpipe). This tube is used to administer gas anesthetic and fresh oxygen to the patient, and allows controlled respirations if the patient is not breathing well on their own. The endotracheal tube also prevents accidental aspiration (or inhalation) of stomach contents if the pet vomits while under anesthesia, which is a potential side-effect of some anesthetic drugs. Endotracheal tubes should always be used during dental procedures, without exception, as they serve to prevent water from the cleaning and harmful bacteria from entering the lungs.

5) What type of pain management is used?

Surgery is always painful, and animals feel pain just as humans do. In modern anesthetic protocols, we strive to achieve pre-emptive analgesia, by blocking the pain pathways before the painful procedure begins. We also use balanced anesthesia to block the pain pathways from as many directions as possible. This will often involve nerve blocks, epidurals, localized injections of lidocaine, etc. These types of techniques allow for us to use less general anesthesia to keep the patient comfortable and asleep during procedures, which is obviously much safer for the patient as well.

6) What monitoring techniques are used?

It is critical to monitor the patient’s vital signs while under anesthesia to ensure that the respiratory and cardiovascular systems are functioning well, and to ensure that the patient is not anesthetized too lightly or too deeply. There should always be someone, besides the surgeon (who is occupied) that is providing dedicated, continuous observation of the patient while monitoring the heart rate, respiratory rate, and anesthetic depth. These parameters should also be recorded in a log, so that any undesirable trends or adverse events noted during anesthesia can be avoided in future procedures, ensuring the safety of the patient. Commonly used monitoring equipment includes:

– An electrocardiogram (EKG) to monitor the heart rhythm for arrhythmias

– A pulse oximeter to monitor the oxygen saturation of the blood, which should remain close to 100%

– A blood pressure monitor

– A machine (capnograph) to monitor the respiratory rate and carbon dioxide level

Another concern many pet owners have is the cost of anesthesia. As you can see, modern anesthesia involves a lot of equipment and expertise when performed safely, and unfortunately this costs money. Cutting corners by not performing pre-anesthetic blood screening, not intubating patients, not keeping patients warm, or skimping on pain medications and monitoring can save money, but the price is decreased comfort and safety for your pet. At The Pet Hospitals, we strive to provide the highest standard of care for your pet to ensure that they remain healthy and happy.

Dr. Christie Taylor

The Pet Hospitals- Lakeland

 

Feline Heartworm Disease

August 3rd, 2016 by Audrey Parker

Cats can get heartworms, too!  The disease presents itself very differently from canine heartworm disease. The cat is NOT the typical host and most worms in cats do not survive the adult stage. The prevalence of heartworm disease in cats versus in dogs is much lower. Cats that do have adult worms normally only have 2-3, but many cats never end up having adult worms. Immature worms in cats can wreak real damage by causing a condition known as heartworm associated respiratory disease. mosquito

As in the dog, the mosquito is what transmits heartworms to cats. The mosquito bites an animal already infected with heartworms, where an immature heartworm is then transmitted to the mosquito. The baby heartworm will then mature in the mosquito over 10-14 days. At this point, when the mosquito bites another animal, the larvae are deposited under the skin. It takes 6 months for the larvae to mature into adult heartworms.

Signs of heartworm associated respiratory disease in feline patients can be subtle or dramatic. They can include coughing, asthma-like attacks, periodic vomiting or weight loss. In some cases, the only sign is sudden collapse, or even sudden death.heartworm

Testing in cats is also more difficult. A blood test is most commonly performed, but we could use radiographs or ultrasound to try and detect these parasites as well. Treatment for feline heartworm disease is unavailable so instead we just manage their symptoms.

Although mosquitoes are more prevalent in the summer months, the best way to prevent this disease in cats (and keep them dewormed against intestinal parasites) is to use a monthly heartworm prevention on them year round. Ask your veterinarian what product would be best for your cat!

Dr. Karen Gant

The Pet Hospitals- Collierville

Demodex: A Mitey Problem

July 27th, 2016 by Audrey Parker

 

We’ve all heard of mange. The term probably brings to mind a pitiful, skinny, bald little shelter animal in one of those heart-wrenching Sarah McLachlan ads on TV. Before you reach for the tissues, fear not! We can deal with mange! It’s not such a mighty problem! But it is a MITEY problem. There are several types of mange (like scabies, or sarcoptic mange), but demodectic mange is the most common type. The microscopic bugs, or demodex mites, that cause this condition are not contagious. They actually live on all dogs, but in low numbers. Here is a picture of the adorable little rascals!: demodex mite

Cute, right? Not so much.

Luckily it is usually only in puppies or immunocompromised animals that the mites multiply and cause a problem. Some breeds, like pit bulls and shar peis, appear to be predisposed, so there is likely a genetic component to the immune system that leave some dogs more susceptible than others. Most cases of demodex mange are not a terrible, full body affair, though. Many dogs just get a few small patches of hair loss, often on the face,  feet, and limbs. To test for these mites, your vet will perform a skin scraping. This is not a pleasant test, but most dogs tolerate it just fine. I always warn owners that the spots where I test are going to look like an angry hicky, and apologize in advance! If we see mites under the microscope, it’s a home run! Sometimes, though, we can’t catch the little guys in the act even if they are present. Hence the saying, we can rule mites in, but we can’t rule them out with a negative scrape test.lily after

Treatment for mites varies by case. Very mild presentations may go away as a puppy ages. More significant cases require more aggressive care. Take Lily Bug:

Lily came to me as a 3 month old puppy that a very nice lady rescued from the lot next to her apartment complex, and boy did Lily look a little rough! We did a scrape, found a ton of mites, and started treatment. We needed to kill the mites, get rid of the secondary bacterial skin infection they had caused, and flush out the hair follicles where the mites lived. To kill the mites, we used to use a very high dose of a drug called ivermectin, but this medication can be dangerous to some dogs at the elevated doses needed to kill demodex. And, that drug had to be given EVERY DAY. Nowadays, I typically reach for a 3-month flea and tick pill called Bravecto (fluralaner). This medication is only labeled for dogs 6 months and older. It has been tested and found to be very safe in younger puppies, but puppy metabolisms are cranking so fast that they burn through the drug faster than adult dogs, so it might not last the whole 3 months. But, one pill typically cures a case of demodex, even one as bad as Lily’s!  We also used antibiotics to get rid of Lily’s secondary bacteria, and a medicated, folicular flushing shampoo to clear all the debris out of her pores and follicles. In a couple months, Lily looked a heck of a lot better! lily DEMODEX

She’s even smiling to show off her spotted tongue! There are other treatments available, including medicated dips and off-label, high frequency administration of certain heartworm preventatives. But since its arrival on the market, Bravecto has been the easiest and most reliable treatment for me.

So don’t fear! If your dog has demodex mites, it’s not such a mighty problem. New treatments and some consistent care will get your puppy back to her cute and comfortable self.

 

Dr. Katie Morrill

The Pet Hospitals- Poplar at Massey

How to acclimate your cat traveling in a cat carrier

July 21st, 2016 by Audrey Parker

 

How to acclimate your cat to traveling in a cat carrier

A common concern for feline owners is the stress associated with car rides and veterinary visits, which can often deter a client from bringing their cat in for check ups. Because early detection and intervention are paramount to successful treatment of chronic disease, regular veterinary check ups are very important for feline patients. Stressed kitties also make examination and treatment very difficult for veterinarians. With the help of your veterinarian, there are many tips and tricks for training cats to become more comfortable traveling in their carriers, making car rides and trips to the veterinary clinic far less traumatic and stressful. With a little preparation, and patience, you can improve your cat’s comfort level with traveling, as well as our ability to care for your cat appropriately. Here are some tips to help you lower the stress level of your cat:

Steps to improved cat carrier acceptance

1) Introduce the carrier as early as possible. Starting carrier training while your kitten is still young will teach your cat that the carrier is just another fun hiding place, or play area, as opposed to a confined space that is only used for transportation. When purchasing a carrier, choose one that loads from the top, or comes apart in the middle, so that your veterinarian can take the top off and begin their examination with the cat sitting comfortably in the bottom portion of the carrier. Be sure to place the carrier in your cat’s favorite room, perhaps a sunny location, with a soft piece of bedding to encourage exploration and voluntary use. Young kittens are extremely curious, and will happily enter the carrier, which will help them to acclimate to the carrier much faster than an older cat.cat carrier 2

2) Encourage daily usage of the carrier. Each day, please a piece of kibble or a yummy treat in the carrier. When the cat enters the carrier and eats the treat, calmly praise and pet the cat, and offer a few more treats. If the cat doesn’t accept the treat right away, just walk away. Don’t try to persuade the cat, or they will become suspicious. It might take a few days, but the cat should start to eat the treats willingly, although it might be when you are not watching.

3) Gradually close the door. Once your cat happily enters the carrier when you are around, gently close the door, offer a treat, and then open the door so that the cat does not feel trapped.

4) Extend the door-closure period. After several days of closing the door with positive reinforcement, leave the door closed and walk out of the room for several seconds before returning and offering another treat. Gradually increase the time spent in the carrier, and work up to moving the carrier to another place in the house with the cat still inside.

5) Begin car rides. After a week of daily training sessions with the door closed, move on to placing the carrier in the car, and then work up to short car rides. Then take a trip to the veterinary clinic for a “happy visit”, and ask the staff to provide positive reinforcement in the form of petting and treats. If at any point your cat becomes nervous, go back a step and give treats until your cat is more comfortable. cat carrier car

6) Cover the carrier when traveling. A helpful tip is to cover the carrier with a blanket or towel while in the car. This will help your cat to feel safer while traveling.

7) Add toys, treats or bedding into the carrier. If your cat has favorite toys, treats brushes, or bedding, please bring them to the clinic when you visit (both for training visits, as well as actual visits). This will create a more familiar and comfortable environment for your cat, by surrounding him/her with familiar smells and textures.

8) Consider using Feliway just before traveling. Feliway is a feline-appeasing pheromone product that produces a calming effect in cats. This pheromone can be found in many forms – plug-in diffusers, sprays, and towelettes. Prior to your car trip, prepare the carrier by spraying with Feliway spray or wiping it down with Feliway wipes, and allow it to sit for 10 minutes before introducing your cat. With especially nervous cats, Feliway can help with the initial training steps as well.

By following these steps, use of a carrier will become routine for your cat, and he/she will be much more comfortable with trips to the veterinary clinic and traveling in general. However, some cats, despite your best efforts, will still become afraid of confinement or travel. In these cases, your veterinarian may consider prescribing additional anti-anxiety medications to help alleviate stress. The ultimate goal should always be keeping the experience as peaceful and pleasant as possible for everyone involved, including yourself and the veterinary staff.

 

Dr. Christie Taylor