Friday, April 10, 2009

Feline Stomatitis



I just watched my associate finish a dental procedure on a very painful mouth that looked a whole lot like this one. Since I missed Pet Dental Health Month, (not yet blogging regularly) I wanted to share this with everyone so that hopefully your pet will not have to go through such a prolonged, painful course of disease before you seek treatment.



Feline Stomatitis, is a painful, inflammatory condition of the mouth. We are not sure why some cats get this condition. Some veterinarians think that there is a chronic viral infection with Calici virus. Others think it is from chronic poor dental hygiene. Still others think that it is an over reaction to the tarter, plaque and bacteria, found in the cat's mouth. One thing most veterinarians agree on is that there is some sort of immune system over reaction in the oral cavity. If recognized early, stomatitis can sometimes be controlled with frequent dental cleanings, anti biotics and a stringent home oral care program. Once the cat's mouth looks like the one in this photograph, the only treatment is surgical..

In the case of our kitty today, he was admitted for blood tests, general anesthesia, a good dental cleaning above and below the gum line and dental radiographs to evaluate the extent of dental disease. Then all affected teeth (most of the uppers as well as a canine_ were extracted. He will be sent home on anti biotics and some oral rinses and we will recheck him in two weeks. If we are lucky, the mouth will heal well and we can control this disease just by having the owners take care of the mouth at home.



To have success, we must make sure that radiographs are taken and no roots are left behind under the gum line. In many cases, this treatment is not aggressive enough and we have to go back surgically and remove all of the teeth and diseased bone. Long term anti biotics follow the oral surgery. There have been many reports of cats doing very well once all of the teeth have been extracted and the diseased tissue removed.



The most common objection I get from clients is their fear that their pet won't be able to eat with no teeth. In fact the cats do better after treatment as their pain has been alleviated. Some will still eat dry food, but we try to get most onto a diet of canned cat food.



You should check your cat's mouth regularly and call your veterinarian if you see any signs of redness, swelling or bleeding from the gums. If the cat chatters it's teeth when you are looking in, then the mouth is painful and needs immediate attention. Your veterinarian should examine your pet's mouth as part of the regular physical examination and let you know if anything needs to be done to keep the oral cavity healthy,



Dental health is a team project. Good nutrition, regular dental care, and home care with observation will keep your pet's smile intact and breath fresh and clean.



Keith Niesenbaum, VMD

http://www.thevetschoice.com/

http://www.crawforddogandcathospital.com/









Wednesday, April 1, 2009

Heartworm Infections in Dogs and Cats




The diagram to the left (still working on images on my posts but I seem to be getting better at it) shows the life cycle of the heartworm parasite in the dog. There is an important distinction between dogs and cats but we'll get to that later.


Remember posts ago, I said that I like to have my pets on year round parasite prevention. It's not for the heartworm, because as you can see, the vector/intermediate host is the mosquito and there are none around in the cooler months here in NY. Those of you in the south need to talk to your vets about heartworm season. We keep our pets on parasite control all year round because of intestinal parasites.


The infected mosquito bites our pet, our us (although people are rarely infected as our immune systems take care of the problem) and the parasite goes through development and matures to an adult. Males and females live in the heart and the large vessels of the lungs. They mate and baby worms (microfilaria) are released into the blood stream to be picked up by the next mosquito and the cycle continues. The time from infection to microfilaria in the blood is about 7 months, so when your pet is tested this spring (and the American Heartworm Society recommends testing all dogs yearly even if they are on preventatives) we are really looking for last year's infections. In cats, the worms do not really mature as well and we often see single sex infections or no adults at all, but in a moment we'll discuss why this disease is still important in our cats.


In dogs, the most common clinical signs that we see are those associated with congestive heart failure. Large masses of worms are in the heart and obstruct blood flow. I thought I could post a photo of a heart with worms, but It seems that if I try to upload more than one image per post it just stacks them at the top of the post and it doesn't look right.
In cats, we see respiratory disease or sometimes just sudden death. The syndrome was recently identified and named Heartworm Associated Respiratory Disease or HARD. Many cats with chronic coughs have had previous infections with heartworms.
In both species it is easier to prevent disease than to treat them. We have already reviewed different medications and your veterinarian can recommend one that he or she feels is best for your pet.
There is no treatment for cats. We have to wait for the parasites to die and hope that they don't kill the cat first. Seems like a good reason to put them on prevention. We did a massive screening test on our feline patients about 5 years ago, sponsored by Pfizer (the manufacturers of Revolution) and found several cats that had heartworm exposure and one that had active adult infection. Interestingly enough, indoor and outdoor pets were equally affected. I guess those screens do have some holes in them.
In dogs the treatment involves hospitalization and treatment with several injections of an arsenic compound. Some dogs cannot withstand the treatment and some are left with permanent damage to their hearts and lungs. If caught early, most will respond OK and go on to live happy lives. But it seems given all we have talked about concerning our options, that prevention is the way to go.
I'm going to try to post some interesting cases that I've seen in the next couple of weeks. However, you all know that I can get distracted. Until then, follow me on twitter at www.twitter.com/knvet and check out our web sites.
Keith Niesenbaum, VMD