An interesting case of stones in the bladder

The other day a 6 year old Cocker spaniel bitch was brought to our clinic with the history of  - “can’t hold its urine”, increased frequency of urination and  painful urination. Apart from the presenting symptoms, the animal appeared normal. 

The blood reports and the urine examination did not reveal any significant finding either and no urinary tract infection could be established.

However, the Xray report revealed the presence of stones in the bladder. An operation was carried out to remove the urinary stones and the bitch had an uneventful recovery.

Nice to know   

Stones in the urinary tract are technically refereed as “Uroliths”. The term “urolith”  is derived from the Greek “Ouron” meaning Urine and “lithos” meaning stone. (Remember the Paleolithic and the Neolithic age that we read about as kids !). These stones are primarily made up of minerals and can be lodged at one or many places in the urinary tract. 

When present in the bladder it is called a cystolith, in the kidneys (nephrolith) and when present in the urethra it is called a urethrolith.

Luckily, the disease is infrequently seen in dogs. Roughly about 3 per cent dogs presented to the veterinary clinics are found to be suffering from the disease. Depending upon the location where it is lodged, varied symptoms are presented by the animal. Diagnostic imaging viz Xrays and Ultrasound are normally employed to arrive at a confirmatory diagnosis.   

Rapid strides have been made in the treatment of the disease. Generally, when the stones are fewer in number and smaller in size attempts are made to dissolve the same. This is what is referred to as the Dissolution Protocol.  Normally it helps. When it doesn’t surgical intervention is carried out. The surgery can be specialized or simple surgery.

Radiograph showing white (radio opaque) stones in the bladder

Cystoliths removed after open surgery

  

Interesting Facts : Ticks And Diseases Caused by Them in Dogs

Ticks, fleas and mites are the most common external parasites found on the body of dogs. However,  ticks are perhaps the most notorious of the three as they are responsible for causing a number of debilitating diseases.  

Actually, ticks kind of lay an ambush hiding in vegetation waiting for prospective hosts to pass by whereupon guided by their body heat, they attach themselves to the body. Thereafter, the tick utilizes its specialized mouth parts to pierce the skin and starts its blood meal.

(Image Courtesy : http://pets.webmd.com )

A tick does not detach itself till its meal is complete. Apart from being blood suckers, ticks are also responsible for transmitting a large number of diseases to their hosts. Interestingly, these diseases are caused by other microbes and not by ticks themselves. As a matter of fact, the ticks harbour these microbes and transmit it to the host. That is why the ticks are referred to as vectors of various diseases.

 Table 1 : Diseases transmitted by Ticks in dogs

Ser No	Name of Tick	Disease transmitted by tick  (vector)	Transmitted to Man
1.	Deer Tick (Ixodes scapularis) also known as black legged tick	Vector for 02 diseases viz. Lyme Disease, a  disease caused by a bacteria (Borrelia burgdorferi) & Anaplasmosis, a disease caused by Anaplasma phagocytophilum	Yes (for both diseases)
2.	Brown Dog Tick (Rhipicephalus sanguineus)	Vector for 02 diseases viz. Ehrlichiosis – caused by an organism called Ehrlichia & Babesiosis – caused by an organism called Babesia	Yes (for both diseases)
3.	Lone star Tick (Ambylomma americanum)	Rocky Mountain Spotted Fever -  caused by an organism called Rickettsia rickettsii	Yes
4.	American Dog Tick (Dermacentor variabilis)	Vector for 02 diseases Rocky Mountain Spotted Fever & Babesiosis	Yes

American Dog Tick  (Dermacentor variabilis)

(Image Courtesy : Jerry Kirkhart via Wikimedia Commons)

Brown Dog Tick  (Rhipicephalus sanguineus)

(Image Courtesy : CDC Public Health Image Library)

Deer Tick  (Ixodes scapularis)

(Image Courtesy : Public Domain Graphic, Agricultural Research Service, USDA)

Lone Star Tick  (Ambylomma americanum)

(Image Courtesy : CDC Public Health Image Library)

COPING WITH CANINE PANCREATITIS

If your dog is suffering from marked loss of appetite, vomition, diarrhoea, fever, lethargy, dehydration and has a painful abdomen, it might be suffering from Pancreatitis. 

The pancreas is an inverted “V” shaped, pink colored glandular structure located just below the stomach adjacent to the duodenum. Duodenum is a part of the small intestine. The Pancreas has two functions. Firstly, it secretes insulin and glucagon – hormones that are responsible for sugar metabolism in the body. An abnormality in this function leads to Diabetes mellitus. Secondly, the pancreas also secretes digestive enzymes (amylase, protease, lipase) through an opening in the duodenum where in partially digested food coming down from the stomach is further digested with the help of these enzymes.

 (Image Courtesy : http://www.vcahospitals.com/main/pet-health-information/article/animal-        health/pancreatic-lipase-immunoreactivity-in-dogs/363)

                               

Simply put, an inflammation of the pancreas is referred to as Pancreatitis. In this condition, the pancreas greatly swells up and the mechanism by which these digestive enzymes normally get liberated in a calibrated way gets disturbed and these enzymes start destroying the pancreatic cells. This triggers a vicious cycle and the cascading effect goes on. In severe cases, the kidneys and liver may also get affected. Thus the disease progresses and if timely remedial measures are not instituted it may lead to shock and death.   

  

Causes

Trauma due to accidents, post – surgery, tumours, certain medicines (chemotherapy agents, antibiotics, anti- epileptics), high fat, low carb diet, sudden gorging on high fat diet, obesity etc are often attributed to Canine Pancreatitis. Breeds like Miniature Schnauzer, Miniature Poodle are more predisposed to the ailment.  

Miniature Poodle

(Image Courtesy :http://www.dogbreedinfo.com/miniaturepoodle.htm)

Miniature Schnauzer

(Image Courtesy :https://en.wikipedia.org/wiki/Miniature_Schnauzer

Diagnosis

Traditionally, diagnosis is based on the clinical signs and by measuring the levels of two enzymes viz amylase and the lipase in the serum. Higher levels are suggestive of Pancreatitis. However, it is worth noting that the levels of these enzymes will also be found high in conditions other than Pancreatitis viz kidney diseases, prolonged use of corticosteroids etc.  

To circumvent this problem a new approach is to measure the level of pancreas specific lipase. Pancreas specific lipase, as the name suggests, is an enzyme that is only secreted by the pancreas and the detection of it in the serum or the blood confirms that that the pancreas specific lipase has been leaked by the pancreas. This test is referred to Specific Canine Pancreatitis Lipase Test and today is the most definitive diagnosis of Canine Pancreatitis. It is a rapid test and results can be obtained within 10 minutes.  However, other techniques like Ultrasound and X-rays are also employed with varying success.

(Image Courtesy : http://www.idexx.com.au/smallanimal/inhouse/snap/cpl.html) 

Treatment

The approach towards the treatment is primarily symptomatic. Generally, in cases where the vomition is very severe, feed and water are not offered to the dog for 24 -48 hours. Instead, the dog is administered intravenous fluid to negate dehydration, meet energy requirements, facilitate blood circulation. Anti vomition drug, appropriate pain killers are also administered intravenously / intra muscularly to make the dog comfortable and manage the vomition. The traditional approach towards withholding the feed and water orally is primarily aimed towards making the irritated digestive system settle down.

When the feeding eventually commences, care should be taken to offer a fat free or a low fat diet. As a matter of fact, it is actually advisable to manage the dog on a fat free diet for its life to prevent re-occurrence of the condition. 

7 TIPS FOR ENSURING A COMFY TIME FOR YOUR DOG THIS WINTER

It’s that time of the year when the days are becoming chillier and there is  just a  hint of fog in the mornings and late nights. Indeed, your woolens have started coming out! However, are your things in place so that your pooch has a comfy time this winter? Here are seven tips that will help you take care of your dog this winter.

1.         Preliminary Check up

Schedule an appointment with your vet especially if you have an old dog at home. He will examine the dog for arthritis and other ailments and suggest what needs to be done. Remember that dogs with long hair and furry coats fare better in winters as compared to their small haired cousins.

2.         Sort out the Sleeping arrangements

Ensure that there is a rug, a small dog – bed, suitable bedding available for your dog especially during the night when the temperature dips sharply. The extent of sleeping arrangements made for the dog should be in consonance with the severity of the winter.  In no case, the dog should be allowed to sleep on the floor as it will not only be uncomfortable for the dog but may also predispose it to other ailments.  The dog’s bed should be carefully placed so that it is not exposed to wind / draft.

3.         Watch the calories intake  

In winters, a dog spends more energy in keeping itself warm. It is therefore a good idea to increase the quantity of feed just a little during the winters to enable it to compensate for the energy loss. However, take care that your dog doesn’t become overweight. 

4.         Walking the dog

After walking the dog, wipe the paws clean and ensure that there is no moisture or dirt in between the toes as these predispose the dog to pododermatitis – a painful skin infection. Remember, that the grass is wet in winters and the moisture and the dirt rapidly lead to pododermatitis. Applying a bit of Vaseline on the paws before commencing the walk and after cleaning the paws subsequent to the walk is a good idea to keep the paws healthy. 

5.         Invest in a Dog Coat

Buy a dog coat of the correct size and a nice color. Gradually, make your dog acquainted with it by making it wear for small periods of time. Slowly, it will get accustomed to it and actually start enjoying wearing it. Besides, a  dog with a smart coat at heels walking with its dashing owner is a wonderful sight on wintry mornings and can bring a smile on the most reticent souls in your block.  

6.         Beware of the heating arrangements  

Take adequate precautions that the dog doesn’t come to any harm due to the fireplace, electric / kerosene heaters and the quaint little bukharis still very much in vogue in the quaint little hilly towns of India.

7.         Monitor the water intake  

Often indoor heating arrangements make our premises extremely dry and lower the humidity to such a level that the dog may become dehydrated. Ensure that your pooch has easy access to clean drinking water at all times.

Implement these tips and be assured of a great time this winter with your healthy and happy dog!

Anal Glands - everything you need to know!

Anal glands, also referred to as anal sacs are two small paired glands located at 4 O' Clock and 8 O' Clock position on either side of the anus. They are found in a large number of mammals including dogs and cats.

These glands secrete a liquid in a small quantity which remains inside the sacs and when the dog poops, the sacs get compressed and the liquid comes out with the stool. It is believed that this helps in lubricating the faecal mass and thus helps in its expulsion. Another school of thought believes that the liquid helps the dogs in marking their territories. Hence, these glands are also called as Scent glands. 

Normally, all goes well but sometimes the glands / sacs are unable to express themselves and the liquid inside them slowly becomes thick and viscous resulting in pain and discomfort to the dogs. The pain is manifested by the dogs in many ways like whimpering, attempting to bite the anal region, awkward sitting posture, fever etc. However, the classical symptom that goes with the problem is "scooting" by the dog. The dog actually rubs its posteriors on the floor, carpet or any hard object to relieve itself. More often than not, this is the stage which draws the attention of the unsuspecting owner. This condition is called as the impaction of the anal sacs.

Now, almost all dogs suffer from this problem one time or the other. Though, smaller breeds tend to suffer more commonly. However, the good news is that it generally responds well to the line of the treatment. Unfortunately, if the condition progresses further without any veterinary intervention then infection may set in or there may be abscessation and ultimately it may lead to the rupture of the sacs.

Generally, the treatment commences with the expression of the anal sacs. It can be done by the dog's handler, veterinary groomers, veterinarians, just about any body (read no rocket science).  It is a simple non invasive procedure that barely takes a minute and the dog feels immensely relieved. In this procedure, the thumb and the index finger are placed strategically near the anal glands and squeezed which leads to the anal glands getting compressed and thus getting expressed. This results in a foul smelling, viscid, pasty substance being voided out. The procedure almost instantly gives relief to the dog. 

Occasionally, a dog may have a relapse. In such a case the anal sacs are expressed again and a course of antibiotics or steroids may be required to be given. However, the best way to avoid such a situation cropping up is by ensuring periodic expression of the anal glands say once a week or may be fortnightly. Increasing the fibre content of the dog also helps as it increases the volume of the poop thus compressing the glands and allowing them to express.

A word of caution though! The discharge of the anal sacs is pretty stinky and while trying to express them many an uninitiated souls have their faces smeared by it! So better watch out!

(Photograph from the kind courtesy of - http://www.dummies.com/how-to/content/how-to-empty-your-dogs-anal-sacs.html)

Ear Infections in Dogs

Ear problems are one of the most common problems encountered in dogs. Quite often, it starts with a mild discharge from one of the ears which quickly goes on to develop into a foul smelling thick discharge. It is often noticed by the owner while playing (and patting) with the dog. Many a times, the condition is discovered when the owner notices that the dog is moving with its head tilted on one side.

Let me briefly touch upon the salient aspects of the disease. 

Just like us, the ear of a dog also secrets ear wax. The ear wax is a complex secretion secreted in the ear canals of the mammals. It lubricates the skin in the ear canal besides acting as a barrier to the entry of microbes, dirt and water. As the ear wax is produced in the ear canal, it tends to push out the previously produced ear wax. However, since the ear of the dog is "L" shaped, quite often there is a problem in expelling out the ear wax. The problem gets compounded owing to poor grooming and soon there is a growth of a large number of unwanted microbes (bacteria, fungus etc). This is how the disease occurs.

Sometimes, ear mites, allergies are also responsible for causing the disease. 

crusted ear wax in a dog with ear infection

Regular attention to ears while grooming will ensure that the ears are clean. However, if one suspects an ear infection a visit to the vet is warranted. More often than not the vet will clean the ears with medication and prescribe some ear drops. However, if the disease has advanced it would entail a different approach towards it. 

It is also worth mentioning that occasionally one encounters cases where in the ear infection has a tendency to recur. It is an annoying and a frustrating experience and in certain cases desired results are achieved after months. However, the early the case is presented to the vet, better are the chances of the recovery.

Heart Worm - the silent killer

Heartworm is a fairly common and often fatal disease of dogs if not diagnosed and treated. Actually, it is a global disease of the dogs.  Unfortunately the average pet owner has little knowledge about the disease. Quite often, the disease sets in insidiously and eventually leads to the death of the dog.  Here are the salient aspects of the disease.

 Cluster of Heartworms in the pulmonary artery & right ventricle

What is heartworm ?

As the name suggests, it is a worm about 12 inches to 14 inches in length and about 2-3 mm in thickness. This worm gains entry in the dog’s body owing to a mosquito bite. Yes, you read it right ! This disease is indeed transmitted by a mosquito. This at least theoretically means  that the disease can occur at every place that has a mosquito population. More specifically at all places that are host to the mosquitoes responsible for transmitting the disease.

So what is the bad thing about the disease?

It’s serious and complex. The adult heartworm lodges itself in the pulmonary artery in the heart. It gets its nourishment from the blood that courses through the artery. The number of worms  can be from a few to about 100. The presence of the worms cause mechanical obstruction in the flow of the blood besides causing inflammation. Sometimes the blood may even clot. In general, higher the number of worms, severe is the disease.

What are the symptoms ?

Unfortunately, initially, there are no symptoms. However, as the number of the worms increase most dogs will develop a cough. They will get winded easily (exercise intolerance). In severe cases abnormal lungs sounds can be heard. Dogs with heavy heartworm load may collapse and die if they are subjected to strenuous exercise. Often the symptoms manifest six months after the mosquito bite.

What is the treatment ?

Generally, the treatment is planned after assessing the severity of the disease. Further, a diseased dog may have adult worms, only immature worms (microfilariae) or mixed population of adult and immature worms. Drugs (ivermectin and related drugs ) are available in the market that kill the immature worms. Now, killing the adult heart worms is a different ball game. Presently, there is only 01 drug (Milbemycin Oxime) that is supposed to kill the adult worms. Unfortunately, it is not available in India. Further, an adult heartworm that has been killed by the drug runs the risk of floating around the blood vessels. In certain cases after confirming the worm load by radiological aids the adult worms are also extracted out by surgical means.

What is the prevention ?

Monthly administration of ivermectin tablets / injections to dogs residing in endemic areas keeps the disease away.

Technical Stuff

Technically inclined visitors may watch the video "Davey's Gift from Dr Garner" at You tube where in 86 adult heartworms have been shown being extricated from the jugular vein of Davely a golden Lab. 

A visit to www.marvistavet.com and then reading the entire info on the disease is highly recommended. The info is actually fascinating. Professionals in the field and fellow vets must visit the same.