Excess weight is a serious health problem for dogs and cats and is common in many countries. The two main causes of obesity are too much food and too little exercise. Other contributing factors can be due to hormonal influences, certain genetic factors, and other disease processes. If you pet is carrying extra weight, it can: Increase the risk of heart disease by forcing the heart to work harder. Increase the risk of arthritis as extra weight can stress the joints, cause joint pain, and make it harder for your pet to move around comfortably. Obesity can cause breathing problems, skin and hair coat problems. Especially in cats, obesity frequently leads to diabetes. All of these problems can make your pet uncomfortable and limit the way they interact with you and other family members. Treatment is to rule out and treat any medical causes, such as hypothyroidism. Reducing caloric intake and increasing exercise can help your pet successfully lose weight. Lifestyle changes and a weight loss program are essential. Your veterinarian can help determine if your pet is too heavy and provide guidelines for achieving their ideal weight. Slentrol is an oral weight loss drug for obese dogs that are not able to lose weight by other means.

There are many types of mites that infect dogs, cats, and other animals.  Mites are microscopic arthropod parasites that, for the most part, infect the skin or mucous membranes.  Mites can even be present on birds and reptiles.  The most common mites that infect dogs and cats are ear mites, Demodex, scabies, and Cheyletiella. Ear mites are very common on cats and are occasionally seen on dogs.  They live primarily in the ear canals and can cause severe irritation.  They are easily transmitted between pets, so if they are found in one pet, all pets in contact should be treated.  A different species of ear mite can infect rabbits. Demodex is a mite that all dogs are exposed to, but only a small percentage of dogs develop skin problems. In young puppies, it usually causes small areas of hair loss especially on the head and front legs.   Adult dogs tend to show more generalized symptoms, and usually have more red, itchy skin lesions.  Adult dogs that develop Demodex usually have another disease such as hypothyroidism, Cushings, or cancer that suppresses the immune system and allows the Demodex to increase in numbers and cause lesions.  It is now recognized that cats have their own species of Demodex, but the disease is much more rare in cats. Scabies is a skin disease in dogs or people caused by the mite Sarcoptes.  Most dogs with this disease are intensely itchy.  Scabies is highly contagious, but not all dogs in contact are as itchy.  People also have their own species of Sarcoptes; most of their cases are due to the human scabies mite, but it is possible for people to develop lesions from the dog scabies mite. Cheyletiella species of mites can be seen in rabbits and dogs.  It is especially seen in puppies as large flakes of scale and is sometimes called “walking dandruff”. There is no one treatment that will kill all the types of mites discussed here.  Your veterinarian can advise you on the various treatments for each problem.

Luxating patella is a condition where the kneecap (patella) moves out of its normal position.  Luxating patella is one of the most common knee joint abnormalities of dogs, but it is only occasionally seen in cats.  It may affect one or both of the knees.   In some cases it moves (luxates) towards the inside of the knee, and in other cases it luxates towards the outside of the knee.  Luxation to the inside of the knee is the most common form seen; it is most commonly seen in the small or miniature breeds of dogs such as Poodles, Maltese, Yorkies, and Chihuahuas.  Luxations towards the outside of the knee are seen less frequently.  It can be present in many breeds, but is seen especially in Newfoundlands. There are four grades of patellar luxation: Grade I- the kneecap can be manually luxated but the kneecap returns to its normal position when the pressure is released. Grade II- the kneecap can spontaneously luxate out of position with just normal  movement of the knee. Grade III- the kneecap remains luxated most of the time but can be manually reduced into the normal position. Grade IV- the patella is permanently luxated and can not be manually repositioned Dogs frequently start with a Grade I or Grade II and worsen over time to a Grade III or IV. Many people are not aware their pet is affected, but a luxating patella can cause pain.  Owners may see the pet limp on a rear leg, or they may see them shake a rear leg to try to snap the kneecap back into place. A serious consequence of patellar luxation is that it predisposes the dog to a rupture of a ligament inside the knee called the anterior cruciate ligament (ACL).  ACL ruptures are very painful, at least initially, and usually the dog doesn’t bear weight on the affected leg. Surgery is indicated for any case that is causing lameness or pain.  Owners may also elect corrective surgery as a way to prevent an ACL.

A liver shunt is also named a PSS, portosystemic shunt, portacaval shunt or portosystemic vascular anomaly. This abnormality occurs when a pet’s venous blood from the intestine bypasses the liver. In the normal pet, blood vessels pick up nutrients from ingested material in the intestine and carry it to the liver to be processed. In the case of a shunt, an abnormal blood vessel carries this blood around the liver and dumps the nutrients directly into the general circulation. Toxins build up in the bloodstream as a result. The pet can be born with the shunt (congenital) or can develop it later (acquired). Breeds at increased risk for congenital shunts include Cairn Terriers, Yorkshire Terriers, Maltese, Irish Wolfhounds, Himalayan and Persians. An acquired shunt can develop in any breed and is usually caused by liver problems due to toxins, hepatitis, infections, inflammation, etc. Symptoms of a liver shunt include stunted growth, weight loss, vomiting, diarrhea, lethargy, unresponsiveness, seizures, disorientation, poor skin and coat, excessive drinking and urination. Some pets will have a single sign and some with have several. The diagnosis is made with blood tests, urinalysis and imaging tests (radiographs and/or ultrasounds). A liver function test called bile acids is usually very suggestive for a liver shunt when the values are very high. Another diagnostic test that can be performed is nuclear scintigraphy, which must be done at a referral specialty facility. Yet another possible diagnostic test that can be performed is a CT scan. The treatment and how well the pet responds are dependent on many things including the location and severity of the shunt. Some pets will do well for long periods of time with medical management only. Medical management includes a low protein diet, antibiotics and lactulose. Surgical repair is commonly done for congenital shunts and again the success is dependent on the location and severity of the shunt.

Leptospirosis is a serious, life-threatening disease caused by a spiral shaped bacteria.  Dogs, cats, other animals and even people can be infected through exposure to urine, bite wounds, ingestion of infected flesh, or contact with contaminated soil, water and even bedding.  Certain environmental conditions can favor the bacteria: standing water, rain, floods and warm moist weather. Pets living under these conditions, especially those who live primarily outdoors or are used for activities like hunting or herding are at a higher risk of being infected. The bacteria can quickly spread through the body causing symptoms like fever, joint pain, excessive drinking and general malaise. Eventually the bacteria settle in the kidneys or liver where it rapidly multiplies leading to organ inflammation, organ failure and possibly death. People infected with Leptospirosis show the same symptoms as pets: fever, joint pain, excessive drinking and general malaise.  Most often people contract the disease when their mucous membranes or open wounds come into contact with the urine or other bodily fluids of an infected animal. Repeated blood tests 2 to 4 weeks apart are recommended for diagnosis.  This test detects the presence of antibodies the body produces after being exposed to the disease.  Recent vaccination against leptospirosis can make diagnosis difficult as vaccines stimulate the body to create similar antibodies. New technology has made rapid tests available and sometimes urine can be used although this test is less sensitive. Samples of kidney tissue can be used but this is rarely done due to the need of an invasive procedure. Fortunately, leptospirosis can be treated with a combination of antibiotics. If kidney function becomes seriously impaired, patients may need kidney dialysis; some patients need this only temporarily while others will need it for life. Supportive care is crucial for pets that become extremely debilitated by the disease.  Intravenous fluids help maintain blood flow through the damaged organs.  Special precautions should be observed when cleaning up any urine or bodily fluids from an infected patient. Leptospirosis is a zoonzotic disease and vaccinations are available. Unfortunately the leptospirosis vaccine has been linked to a high level of vaccine reactions and while reducing the severity of a dog’s illness will not prevent them from becoming carriers of the disease.  Therefore this vaccine is given only when deemed necessary after consultation with your veterinarian.

Hypothyroidism is the natural deficiency of thyroid hormone and is the most common hormone imbalance of dogs. This deficiency is produced by several different mechanisms. The most common cause (at least 95% of cases) is immune destruction of the thyroid gland.  It can also be caused by natural atrophy of the gland, by dietary iodine deficiency, neoplasia (primary or metastatic) of the thyroid gland or (rarely) as a congenital problem. Hypothyroidism is most common in medium to large breeds of dogs that are middle aged (4 to 10 years) but can occur in any dog. Hypothyroidism is extremely rare in cats and is most commonly seen in cats following bilateral thyroid removal or radioactive iodine therapy for hyperthyroidism.  This is often transient and usually does not require therapy.  Rarely cats can have congenital hypothyroidism. Thyroid hormone serves as a sort of volume dial for metabolism.  Since virtually every cell in the body can be affected by thyroid hormone it is not surprising that reduced levels of thyroid hormone can lead to symptoms in multiple body systems. A recent published survey of hypothyroid dogs showed the following percentages of symptoms: 88% had some kind of skin abnormality 40% had hair loss (often on the tail or on both sides of the trunk and flanks ). 22% had skin infections 14 % had dry brittle coats with hair that could easily be pulled out 49% were obese 48% were described as lethargic or listless at home 36% were anemic 80% had an increase in blood cholesterol Hypothyroidism is treated with the oral administration of thyroid hormone, usually given twice daily for the life of the dog. Periodic blood testing is recommended; it is important to know if the medication dose is too low or too high.  Thyroid supplement is a safe medication but if it is not given in sufficient doses the patient will not be adequately treated. If the dose is too high excessive water consumption, weight loss, and restlessness can result.  Once a pet is started on thyroid supplementation, it is recommended to check a T4 level in two to three weeks, with the blood draw between 4 to 6 hours after the morning dose. Once the correct dose is found, it is recommended to perform a T4 every six to twelve months. Hyperthyroidism in Cats This is a very common disease of the middle aged to older cat.  A tumor (97% are benign) on the thyroid gland starts producing too much thyroid hormone.  Symptoms are usually weight loss in spite of eating well and vomiting.  Other signs you might see are diarrhea, a dull and flaky hair coat, and personality changes.  This disease usually can be easily diagnosed with a blood test, although occasionally we need a special test called a technesium scan to diagnose the early, borderline cases. There are three basic methods of treatment:  radioactive iodine, surgery, or an oral medication called methimazole (Tapazole).  For most cats, the best treatment is radioactive iodine.  In 97% of the cases, it is a one -time treatment.  The biggest disadvantage is that the treatment needs to be done at a special facility, and the cat needs to be hospitalized for usually 5 to 10 days.  In the past, surgery was a common treatment, but it is performed less frequently as the problem seems to recur on the other gland.  Treating with Tapazole is also common, but has the disadvantage that it is life long and the cat needs blood tests to monitor the thyroid level and to check for adverse effects. The disease of hyperthyroidism can actually help the kidneys.  If the cat has both kidney disease and hyperthyroidism, it is not a candidate for radioactive iodine and the dose of Tapazole may need to be adjusted.  Kidney tests are also monitored when a cat is being treated for hyperthyroidism.

Hookworms are small, thread- like parasites of the small intestine where they attach and suck large amounts of blood. These parasites are found in almost all parts of the world, being common in dogs, and occasionally seen in cats. Symptoms are usually diarrhea and weight loss. The parasites can actually suck so much blood that they cause pale gums from anemia, and black and tarry stools. Young puppies can be so severely affected that they die. Infection can be by ingestion of breast milk from an infected mother, by ingestion of infective eggs, or by skin penetration of infective larvae. Since the adult parasites are so small, they are rarely seen in the stool. Diagnosis of these parasites is by the veterinarian or laboratory finding the microscopic eggs in the stool. There are a variety of medications that can kill hookworms. The important point to know is that there is no one medicine that will kill all the types of intestinal parasites that exist. Some of the monthly “heartworm preventatives” will also work to treat hookworms. People exposed to hookworms can develop a rash called cutaneous larval migrans. Infective larvae, usually from contaminated yards, can penetrate human skin and cause red tracts.

Hip dysplasia is a congenital disease that, in its more severe form, can eventually cause lameness and painful arthritis of the joints. It is caused by a combination of genetic and environmental factors. It can be found in many animals and, rarely, humans, but is common in many dog breeds, particularly the larger breeds. In the normal anatomy of the hip joint, the thigh bone (femur) joins the hip in the hip joint, specifically the caput ossis femoris. The almost spherical end of the femur articulates with the hip bone acetabulum, a partly cartilaginous mold into which the caput neatly fits. It is important that the weight of the body is carried on the bony part of the acetabulum, not on the cartilage part, because otherwise the caput can glide out of the acetabulum, which is very painful. Such a condition also may lead to maladaptation of the respective bones and poor articulation of the joint.  In dogs, the problem almost always appears by the time the dog is 18 months old. The defect can be anywhere from mild to severely crippling. It can cause severe osteoarthritis eventually.

Heartworm has been diagnosed in dogs in all parts of the world and is actually very common. This may be due to the fact that heartworm has a virtual 100% prevalence rate in unprotected dogs living in highly endemic areas. Heartworm, also known as Dirofilaria immitis, is transmitted by mosquitoes. The mosquito injects a microscopic larvae which grows into an adult worm six to eighteen inches long inside the heart of the affected dog. The worms can cause mild symptoms, such as coughing, but with time, more severe symptoms such as congestive heart failure, weight loss, fluid build up in the abdomen, fainting spells, anemia, collapse, and death usually occur. Luckily we have several excellent medications which can prevent heartworm if given as directed. There are oral medications which need to be given monthly, and which also help protect against some intestinal parasites. There is one topical medication which is also applied monthly. An injectable medication, ProHeart, which is administered every six months, is back on the market after being withdrawn for several years. Even if a dog has been given preventatives, it is still important to have annual checkups for heartworms by doing a blood test. Many people are not totally compliant about giving the preventive medication on time, and no medication works perfectly. If a dog has heartworms and it is given a dose of preventative, there can be a reaction that is detrimental to the dog, even deadly. Heartworms were once thought to be rare in cats. Now we know the incidence is anywhere from 10% to 50% of the canine rate. Heartworm disease in cats is different than in dogs. Cats usually test negative on the routine blood test done in the hospital, the worms are smaller and usually do not produce microfilaria which are like baby heartworms that circulate in the bloodstream. Veterinarians have to do different tests, sometimes more than one, to diagnose heartworms in cats. The symptoms in cats are different also. Cats usually have asthma signs or cough, even vomit. Cats can die acutely. The treatment for adult heartworms in dogs is expensive and potentially harmful to the dog. This is why it is much better to just prevent them in the first place. There is not a treatment for adult heartworms in cats. Many veterinarians are now recommending monthly heartworms preventative for cats in addition to dogs, since heartworm can be such a serious problem.

Gastric Dilation Volvulus (GDV) is a life threatening, acute condition that requires immediate medical attention.  Certain breeds are more prone to this condition: Boxers, Great Danes, Standard Poodles, Saint Bernards, Irish Setters, Dobermans, Weimaraners and Gordon Setters.  These breeds are considered deep-chested (large chest and narrow waist) but any similarly shaped dog can be at risk. Diagnosis of GDV is made based on physical examination, history and abdominal x-rays.  Often GDV happens when a pet eats a large meal and then becomes very active.  Initially the dog may become restless, try to vomit or retch continuously but is unable to produce any vomit.  This is because the stomach has twisted, preventing anything entering and exiting the digestive system.  The pressure inside the stomach starts to increase and the dog may salivate and pant excessively.  As the patient’s condition progresses they become lethargic, have a swollen stomach and eventually collapse.  If not treated, the internal organs can be damaged and without timely treatment this condition is fatal. The goals of treatment are to reduce the pressure in the stomach and return the stomach to its normal position.  During the surgery, the stomach and internal organs are examined for damage and then the stomach is attached to the body wall to prevent a reoccurrence. Prophylactic suturing of the stomach is sometimes advised in breeds predisposed to GDV during abdominal surgeries for other causes.  Other preventative measures include restriction of exercise before and after feeding.  Feed twice a day instead of once a day and not to elevate food/water bowls.