What You Need to Know About Allergic Reactions in Your Pets

Picture this scenario: you let your dog out in the backyard, and when you let him in his face is swollen severely.  You of course suspect a bee sting, and the response your dog has shown is a form of anaphylaxis, but now what?

Anaphylaxis or an anaphylactic reaction is an allergic/hypersensitivity reaction to a foreign substance.  These substances can include vaccines, food proteins, insect bites, medications, chemicals, etc.   The pet must have had previous exposure to one of these substances in order for an anaphylactic reaction to occur.  The body’s immune system over-reacts to the substance, causing the reaction. 

With spring starting, we usually start to see an increase in insect bite reactions, with bees being a primary concern.  Vaccine reactions are also a potential—speak to your veterinarian for more information.  Clinical signs of an anaphylactic reaction can include itching, red skin, hives, a swollen face, vomiting, diarrhea, pale or blue gums, or collapse, with potential for death if not treated.  If your pet experiences any of these symptoms, especially if after a known insect bite, vaccination, new medication, exposure to a chemical, etc, it is important to seek immediate veterinary attention.  Anaphylaxis is serious and requires treatment.  In some situations the allergic response may be treatable with an antihistamine, but it is always recommended to see your veterinarian first to ensure your pet is not having a serious anaphylactic reaction. 

With each exposure to the substance, the reaction will worsen.  Therefore, once it is known to cause a reaction, the goal is to prevent future exposure. 

 

Modifications made by Kristen Ferguson, DVM, from “Anaphylaxis in Dogs” Ernest Ward, DVM © Copyright 2009 Lifelearn Inc. Used and/or modified with permission under license.

Heart Disease in Pets

Heart disease is frequently seen in both dogs and cats.   There are many types and causes of heart disease and they can occur from birth to old age.  Like many other illnesses, it is important to diagnose and treat heart disease as early as possible to ensure our pets live without symptoms of illness for as long as possible.

Inherited or Congenital Heart Disease

Heart disease in dogs and cats can be congenital/inherited or acquired.  Congenital disease can cause malformations of the heart which impairs function and can be present at birth.   Hereditary disease can cause congenital problems or increase the likelihood of adult-onset heart disease, particularly heart muscle diseases in both dogs and cats.

Your pet’s breed may have increased chances of having inherited diseases.  Some cat breeds that are predisposed to heart disease include the Maine Coon Cat, Siamese, British Shorthairs, and Persians.

Examples of dog breeds with increased chances of heart muscle disease are Cocker Spaniels, Boxers, Doberman Pinschers, and other large to giant breed dogs.

Acquired Heart Disease

Other kinds of heart disease can occur later in life related to other illnesses such as hyperthyroidism (particularly in cats), long term untreated dental disease, bacterial infections, and cancer.

What is the structure of the heart and how is it affected by heart disease?

The heart can be divided into 4 functional components:

1.      The heart muscle which pumps the blood around the body

2.      The heart valves which act to prevent the blood going in the wrong direction

3.      The pericardium which is a tough membrane surrounding and protecting the heart

4.      The electrical conducting system which acts to initiate and transfer electrical impulses around the heart allowing it to contract or “beat” in a systematic and coordinated fashion

Any or all of these parts can be affected by heart disease. 

What are the signs of heart disease in cats?

Most cats do not display any clinical signs until the disease is advanced. Unlike humans and dogs with heart disease, cats rarely cough if they have heart disease. Exercise intolerance does occur but can be difficult to recognize since cats rarely go for walks or engage in sustained physical activity with their owners. With advancing disease and declining exercise tolerance, cats tend to become more withdrawn, hide under furniture and sleep more.

The most common signs of heart disease in cats are:

• poor appetite
• weight loss
• lethargy
• increased respiratory rate and effort
• sudden collapse
• sudden hind leg paralysis accompanied by pain
• stunted growth (kittens)

Common signs of heart disease in dogs

The most common clinical sign of congestive heart failure (CHF) is persistent coughing accompanied by difficulty breathing. This is due mainly to pulmonary edema or the accumulation of fluid in the lungs. The enlarged heart will also push against the trachea, causing irritation that can induce a cough. Many dogs with CHF will fatigue more easily, have reduced stamina and not engage in playing or walking as they once did. Coughing when at rest or sleeping, excessive panting, persistent loss of appetite, a swollen belly, and pale or bluish gums are also signs associated with heart failure. The dog will develop generalized weight loss and muscle wasting due to the effects of CHF on other body systems. If any of these signs develop in a pet with a heart murmur, notify your veterinarian immediately.

How is heart disease diagnosed?

As mentioned above, early diagnosis is very important, since our patients hide signs of illness until the heart has advanced disease.  Regular examinations are very important to detecting heart disease early.  Puppy and kitten exams, yearly adult exams, and twice yearly senior (over 7 years old) exams are very helpful in diagnosing and treating patients before too much damage has occurred.

With any heart problem, diagnosis involves several tests: 

Auscultation or listening to the heart with a stethoscope is the first step in diagnosing heart disease. Heart murmurs are detected by auscultation; the murmur’s location and intensity helps determine its significance. The heart rhythm is assessed, and if there are concerns, the veterinarian may simultaneously palpate or feel the pulse to determine its strength and rhythm. Finally, the lungs are assessed, looking for evidence of changes associated with heart failure.

Chest x-rays are taken to evaluate the size and shape of the heart and look for lung changes such as the presence of fluid as in CHF.

Blood and urine tests are performed to give an indication of any other disorders in the body. Liver and kidney function are often impaired in patients with heart disease.

An electrocardiogram (ECG) measures the electrical activity of the heart and allows accurate determination of both heart rate and rhythm. Any abnormal rhythms (arrhythmias or dysrhythmias) can be detected and evaluated.

Ultrasound examination (echocardiogram) utilizes ultrasound waves to evaluate the heart. The size and thickness of each heart chamber can be evaluated, and the effectiveness of the heart’s contractions can be directly observed. Measurements can be taken to evaluate the heart’s pumping efficiency.

Can’t you treat my dog without these tests?

Accurate diagnosis gives us a much better guide to the type and extent of treatment necessary. Today there is a wide selection of heart medications that can be used to treat congestive heart failure and treatment regimes must be tailored for each patient. Without these tests, your veterinarian is unable to determine the optimal treatment for your pet, and may inadvertently cause more harm than good. With proper treatment, many dogs are able to live a normal life for many months to years.

Ernest Ward, DVM © Copyright 2009 Lifelearn Inc. Modified by Dr. Clouse with permission under license.

Hospice Care and Your Pet: A General Overview

Hospice care for pets is pretty new in veterinary medicine, but more and more doctors are starting to have discussions with owners and then implement some form of hospice care for their geriatric pets.  If you have a pet that has been diagnosed with a chronic or terminal illness, or if you are interested in what goes on with hospice care in general, then this post is for you.

 

What does the term ‘hospice care’ mean?

Hospice care is supportive care that focuses on palliation (end of suffering, or keeping as comfortable as possible) to patients at the end of their lives/at the end stages of terminal diseases.  The goal with hospice care is to have the quality of life of the patient be the best it can be with whatever time is left in the patient’s life.  This is achieved by forming a plan with a doctor and having other medical professionals (such as nurses, physician assistants), volunteers, and family members implement it.

 

Where does hospice care take place?

Hospice care can be put in place anywhere, and often is performed in the home.  For veterinary patients, the at-home hospice approach is most used for a pet’s end-of-life care.   The hospice goal for pets is to allow the pet to be comfortable in its own home (especially because the hospital setting can be very frightening and overwhelming for many pets) with the family members by its side, either until death comes naturally or a humane euthanasia is chosen.

 

What are the differences between pet and human hospice care?

Pet hospice care is essentially the same as human hospice care with one important difference: veterinarians have the ability to provide humane euthanasia when the pet’s quality of life deteriorates.

 

As with dying humans, pets with diseases that cannot be cured benefit from having a system that measures their quality of life day-to-day (see the link at the end of the blog for an online hospice journal).  With your veterinarian, you can discuss what the baseline quality-of-life-measurement will be for your pet, and how often re-evaluations should occur.

 

When do pets need to enter hospice care?

If a life-limiting disease is diagnosed in your pet, it is time to have a discussion with your veterinarian about what options are available for treatment and comfort as your pet nears the end of its life.  Many of these diseases can be treated aggressively and managed in some of these pets, including diabetes, degenerative joint disease, and some cancers.  Treatment options depend on the disease process, how advanced it is, and the pet.  Your veterinarian will work with you on what options are best for your pet.  Your veterinarian will also help you feel comfortable in implementing the plan at home.

 

How do you know when hospice care should end?

Your veterinarian will discuss quality of life indicators for your pet.  In general, we want to see the pets free from as much pain as possible; control of vomiting, diarrhea, and infections; eating and drinking normally; etc.  Some quality of life indicators for one pet may be different for another, depending on what the owners are comfortable doing at home.  For instance, one owner may be comfortable expressing the bladder of his or her pet that has a neurologic disorder, whereas another may indicate that not being able to urinate on their own is an important quality of life indicator.  These standards of what is going to determine whether hospice care is continued for that pet need to be set before hospice care is implemented.

 

Additionally, planning early on how the euthanasia will take place (if death does not come naturally) can make things easier when it comes time to make that final decision.

 

If after reading this post you are interested in learning more, please discuss hospice care with your veterinarian.  The following website may be a useful tool for day-to-day detailing of your pet’s progression:

http://www.pethospicejournal.com/

 

 

 

Excerpts taken from Hospice Care for Pets –Overview, Part 1 and 2, by Robin Downing, DVM, CVPP, DAAPM, © Copyright 2012 LifeLearn Inc. Used and/or modified with permission under license.  Modifications by Kristen Ferguson, DVM.