COMING THIS SUMMER, THERAPY LASER WORKSHOP

It has been well over a year since we introduced the concept of Laser Therapy.  Laser Therapy has been an overwhelmingly positive experience for nearly all our cases.  We are so excited about the relief we are seeing in our patients, we want to introduce as many people as possible to this treatment for their pets. 

This summer we will be holding a one day Free Clinic for Laser Treatments.  We will devote this entire time to treating your pets that may be suffering with arthritis, hip dysplasia, ear infections, wounds, or any other inflammatory condition that does not involve the eye. 

Mark your calendar for:

Saturday, June 11, 2011

10:00 am – 2:00 pm

 

Call our office and we will put your pet on the schedule.  You can estimate your exam and treatment to take 20 minutes.  We will have me and two veterinary students administering the treatments.  Veterinarians are welcome to come as well.  If you are wondering if your pet’s symptoms can benefit from this treatment, come by for a brochure that explains the possibilities.  Or you may feel free to call us and we can discuss it with you. 

These treatments will be available not only to new friends and neighbors, but also to any of our clients that have been considering laser therapy.  If your pet is currently receiving treatments, bring them by also.  This one is on the house.  Tell your friends. 

Give us a call!  We look forward to seeing all of you this summer at our Free Clinic for Laser Therapy Treatments! 

Dr. Keith A. Bailey

SouthwestVeterinaryHospital

(on the corner of 71^st & Elwood)

316B W. 71 St.

918-446-7838

Ear Infections – April 2011

 

In the spring we commonly see an increase in ear infections in dogs.  Often it is worse when it rains and may become excruciatingly painful.  In chronic cases the ear canal may start to ossify, that is, the cartilage may gradually turn to bone.  In order to understand what is going on let’s examine the anatomy, physiology, and pathology of the ear. 

In addition to the ear flap, or “pinna”, the ear is composed of three basic regions, the outer, the middle, and the inner ear.  Unlike people, most ear infections in the dog are “otitis externa”, or outer ear infection.  The outer ear is composed of a canal which is shaped like an “L” with a vertical portion and a horizontal portion, with the ear drum, or tympanic membrane, at the end.  The canal is lined with epithelial tissue composed of glands called ceruminous glands.  These are the wax producers of the ear.  When they are inflamed they swell up and increase the production of wax.  The wax, along with the narrowing of the canals, restricts air circulation and sets up an environment which is ideal for a number of organisms, both yeast and bacteria, to thrive.  In some extreme cases the canals may even swell shut. 

What starts this inflammation in the first place?  The vast majority of ear infections are secondary to an allergy.  This explains why we often see an increase in ear problems in the spring.  Since the lining of the ear canal is an extension of the skin, it is a common place for skin allergies to be manifested, and is often the only sign of the allergy.  Left untreated, the ear drum may rupture leading to middle, or even inner, ear infections.  The signs of this may vary from extreme pain sometimes with nausea and vomiting, to head tilt, stumbling, or even seizures. 

Obviously, when ear infections have a recurrent nature, it is very important to address the underlying allergies in addition to treating the ear infection itself.  Reducing the inflammation may be accomplished with laser therapy or steroids.  This helps reduce pain and open the canal so that medication may reach the infection.  Testing is commonly done to identify the specific organisms involved so the proper medication may be chosen, but the allergy, too, must be addressed.  This may range from symptomatic control, especially when it has a seasonal occurrence, to allergy testing and hyposensitization.  Even then you may find that a combination approach is necessary, and in severe cases recurrence is possible even with the best of care.  These occasional flare-ups will need to be specifically addressed.  

Remember, in the case of allergy-induced ear infections, we are trying to achieve control rather than expecting a total cure.  No two patients are alike and each case must be approached individually.

Wow! What a Winter! – March 2011

I was beginning to think we were not going to have a winter, to speak of, when POW!  It hit with a vengeance.  We broke several records including snowfall and cold temperatures.  But was it enough to have a mild spring bug problem?  Sorry, but it takes at least three weeks of the temperature not rising above twenty degrees to make much of a dent on the parasite population. 

So, now that we have overcome more than a foot of snow and the cabin fever that goes with it, we are once again faced with the problems of spring. 

Thunderstorms are a lot of fun when we have a pet that is afraid of them.  Of course it is too late to hyposensitize them to thunder this season but there are a few things we can use to help us cope, ranging from herbal therapy to antianxiety drugs. 

While heartworms are always a concern they are more readily transmitted due to the higher mosquito burden we are now faced with.  Remember it is now recommended to have both cats and dogs on year-round heartworm prevention. 

If we let them, our pets will wander about more and thereby be exposed to a greater number of risks, including injury by automobile or other animals, parasite exposure, including both ectoparasites (fleas, ticks, mosquitoes, and various mites) and endoparasites (worms and protozoans), and infectious diseases (such as parvovirus, distemper, leptospirosis, and kennel cough).  For their own safety, pets should be in a fenced yard or on a leash. 

Allergies are always a concern with many pets but often increase with the bloom of many plants in the spring.  Trees and grasses commonly show up on our allergy panels, along with a myriad of other offenders.  Control of this frustrating problem may range from simple to extremely complex and must be tailored to each individual patient. 

While we have mainly spoken of the down side of spring, we can appreciate the disappearance of the huge mounds of snow and ice along the roadside.  The longer days and warmer temperatures also make us feel better and we can get out and enjoy God’s creation, running and playing with our friends, soaking up the sun’s rays, and working in the gardens.  Oh, yes … and we get to start mowing.

Heartworm Disease – February 2011

In the dog, heartworms are long, spaghetti-like parasites found mostly within the right side of the heart.  This is the side that pumps blood to the lungs to pick up oxygen to be carried throughout the body.  Here, the worms occupy precious space, thereby decreasing the effective volume of the pump (that is, the heart).  They interfere with the proper closure of the valves within the heart and actually cause damage to the lining of the heart.  They may become dislodged and go to the lungs to cause a condition called thromboembolism.  This is a blockage interfering with the flow of blood to the lungs and therefore decreasing the oxygen supply to the body.  This may be fatal. 

In the cat, the heartworms usually don’t make it to the mature (L-5)stage, rather they die off in the earlier forms.  In addition, they usually don’t stay in the heart, but go to the lungs where the dead or dying larvae cause much damage.  Cats may have signs of respiratory distress (difficulty breathing), lethargy, or may show no signs at all.  Often the only sign is sudden death of the animal.  Testing for these parasites is much less accurate in cats and there are many false negatives, regardless of the test.  There are certain things that may be seen on radiographs (X-rays) to strongly suggest that heartworms are (or were) present. 

      Heartworms differ from most other worms in that they do not lay eggs.  Instead they shed microscopic larvae called microfilaria.  Microfilaria are released by the adult female heartworm within the dog’s heart.  They are rarely present in the cat, since, as previously stated, heartworms rarely mature.  Once released, the tiny larvae are free to roam with the blood throughout the animal’s body.  While these larvae may cause damage to the kidneys and other parts of the body, the real danger is that they may be picked up in the blood by mosquitoes.  Inside the mosquito microfilaria undergo further development into “infective larvae” which the mosquito is capable of transmitting to several other dogs or cats. 

      The mosquito deposits the infective larvae into a susceptible animal.  These larvae burrow into the skin and gradually mature as they migrate to the heart to start this cycle again.  All this takes months to occur.       

Typically, the first hint of heartworm disease in dogs is a slight cough.  The animal may simply be slower, appear unthrifty and have a dull, unresponsive hair coat.  In later stages there may be a “pot-bellied” appearance and marked difficulty breathing.  These signs may worsen until they become irreversible.  

      If there are just a few worms the dog may not ever become ill.  After years, these worms will eventually die and be broken down and absorbed by the body.  However, one cannot accurately predict how many worms are present and if you wait until the animal becomes ill before deciding to treat, the risk factor greatly increases.  A positive dog acts as a continuous reservoir of microfilaria for the mosquitoes in the environment, so the disease should always be treated.  If the patient is too ill to be treated, there are ways to limit the microfilaria with less risk to the dog.

Cherry Eye – January 2011

Q.  My one-year-old Cocker Spaniel has suddenly developed a bulging red mass in the corner of his eye.  A friend referred to it as a cherry eye.  Can you explain what this is and what we need to do about it? 

A.  Dogs have a “third eyelid” just under the other two eyelids.  It starts at the corner of the eye nearest the nose and comes across the eye when the eyes close.  This third eyelid (or membrana nictitans) contains a tear producing gland which is responsible for 30 to 50% of the tears.  A true cherry eye occurs when this gland prolapses, or turns outward, causing it to be exposed and inflamed.  

No one really knows the exact reason this happens but it usually occurs in young dogs, age six months to two years.  It is thought to be caused by congenital weakness of the tissues attaching the gland to the underlying areas.  It is common for the other side to eventually prolapse or for it to be bilateral. 

Medication may decrease the inflammation some and have the appearance of improving it but the only way to resolve it is with surgery.  Other conditions having a similar appearance include an everted cartilage of the third eyelid (it contains a “T” shaped cartilage which holds its shape) or even a Neoplasia, or tumor. 

Years ago the treatment was to actually remove the gland, but occasionally that led to a condition called keratoconjunctivitis sicca, or “dry eye” because of the removal of 30 to 50% of the tear production.  Now there are a couple of surgical procedures that are used to replace the gland to a more normal position.  It is recommended to operate on the cherry eye to decrease the likelihood of damaging the gland or causing corneal ulcers since the eyelids don’t close all the way.  After surgery an Elizabethan collar (cone) is often used to prevent damage to the freshly operated tissues by self-trauma from head rubbing or pawing.  Recurrence is not uncommon and re-replacement of the gland is advised.

He Can’t Hit the Box – December 2010

Q. My three year old spayed female cat has always urinated in her litter box but lately she has not only missed it, but may go anywhere.  How may I convince her to do her duty properly? 

A. First, we must determine if there may be a medical reason for the abnormal behavior.  Have her examined by her veterinarian and be prepared to answer such questions as: How long and how often has she been exhibiting this change of habit?  Does there appear to be an “urgency”?  Have you noticed blood in the urine?  How does she act otherwise?  Have there been any changes in her diet or environment?  Be prepared for tests or procedures the doctor deems necessary, if any. 

Once you have ruled out a medical cause then consider, again, the environment.  Have your own habits changed?  If the problem has been determined, to the best of your ability, to be purely behavioral, and if a specific correctable environmental difference cannot be found, then there are a few other thing you may try. 

If she normally uses a litter box, consider the cleanliness of the box itself.  Some cats are fastidious and prefer the box to be very clean, while others will not use a box unless it has the scent of urine or feces on it.  That does not mean it needs to be filthy, rather, it should not be thoroughly scrubbed and disinfected every day.  The odor of disinfectant may be the culprit.  Having ruled these factors out, try to determine just where she goes the most and set the box in that spot.  If she uses this then gradually move it a few feet each day back toward its usual location.  This is not always as simple as it sounds and much patience must be exercised.  I also realize that it poses a hardship at times to carry this out, especially when you try to explain to family and friends just why a litter box adorns your living room.  

Cats are free willed animals.  When attempting to alter a behavioral pattern it is of little use to inflict physical punishment on them.  Nor can you merely reason with an animal that has no ability (or desire) to perceive your point of view.  The goal of behavioral therapy with a cat is to cause him or her to come up with the idea of change on his own.  Therefore the altered behavior is “his own idea”, that is to say he “chooses” to do what he ought.

Winter Warnings – November 2010

It is once again time to winterize our thinking.  As we check or even change our antifreeze in our automobiles we need to be thinking about any that may be spilled on the driveway.  Ethylene glycol antifreeze is extremely poisonous and even a very small amount can be fatal if ingested.  It needs to be carefully disposed of when changing fluids.  Even a small amount spilled onto the driveway may be fatal if ingested so it should be rinsed with copious amounts of water.  If you think your dog or cat may have gotten into it you need to rush him to his doctor, as, by the time there are clinical signs of illness, it is too late to help. 

Be sure to “slap” the hood before starting the car because cats seek warmth wherever it can be found, including hiding inside the engine compartment of recently driven autos.  They may be struck by the fan blade or get wrapped into a fan belt and be severely injured or killed. 

Other holiday hazards include the seasonal gluttonous feasts we enjoy.  Fatty foods can lead to GI upset or even pancreatitis when the turkey and ham trimmings are slipped to the critters.  Believe it or not, raw bread dough not only causes a tummy ache, but can even lead to alcohol toxicity as it ferments within the tract.  Avoid giving your pet chocolate, raisins and grapes, and anything sweetened with xylitol.  Make sure they can’t steal these from the table or convince an unsuspecting family member that they need a bite. 

Dogs and cats are known to become electrocuted while chewing on cords from tree lights or to pull the Christmas tree over onto themselves.  More than once has an animal had to be opened up to remove foreign bodies, such as tree ornaments, tinsel, wrapping paper, tiny “gifts”, turkey bones or plastic toys.  And playing among wrapping paper and boxes, they may go unnoticed and become stepped on in the excitement of the moment. 

A number of dogs are poisoned each winter with rodenticides (mouse and rat poisons) as people responded to these varmints seeking the warmth of their homes over the cold icy fields.  If these products must be used, please be sure they are inaccessible by your animals.  Unfortunately, most of the cases we see are from neighbors using baits without thinking of the neighborhood pets which may enter their property uninvited.  They are not supposed to be off  leash but escapes do happen. 

As long as we are alert and take the time to properly prepare, the holiday season may be safe and enjoyable for our family members of all species.

Radial Nerve Paralysis

Response to Laser Therapy

A Case Study

Keith A. Bailey, DVM

Laser therapy has been found to increase cellular respiration and enhance neovascularization as well as reverse inflammatory processes, hence accelerating healing.  A variety of wavelengths between 600 nm and 1100 nm have beneficial effects on tissue.  The lower end of that spectrum is more useful superficially while the higher end can penetrate deeper tissues as well, with those between 700 nm and 800nm having less benefit. 

This case involved the use of the Companion® Therapy Laser by LiteCure.  It operates at 980 nm wavelength and is variable in power from one to ten watts.  This is a Class IV laser and, as such, must be handled properly, with all the laser safeguards outlined by the American National Standards Institutes in the documents, ANSI 136.1 and ANSI 136.3.  More on safety and training, as well as available publications may be found at www.laserinstitute.org. 

Craig: 

Craig, a three-year-old male Mastiff weighing ninety-seven pounds, presented with right forelimb lameness.  It had appeared suddenly, two days earlier, with no known incident of trauma.  Upon examination it was noted that there was a non-weight-bearing lameness of the right forelimb.  Carpus was knuckling under and elbow carried low.  Limb was edematous and painful from the elbow down.  Deep pain was present but there was no withdrawal response.

                                

Radiography revealed only soft tissue involvement.

The limb, from the shoulder to the carpus, was treated with 2000 Joules of energy at eight watts continuous wave.  Two days later his demeanor was much better.  The limb was still edematous but there was no pain on manipulation.  He was still dragging it and there was no withdrawal response. 

At this time the same treatment regimen was applied.  On day four, the edema had nearly resolved and he was not painful.  Other than the motor deficits, he acted and appeared normal.

A slightly different approach was taken at this time.  We treated only the subscapular region, using the massage ball head, which allows deeper delivery of energy while massaging the tissues and placing the limb through passive movements.  Ten watts of power and continuous wave were used.  The delivery was aimed all the way around the perimeter of the scapula, from the axillary region to the dorsal midline.  Gentle pressure was maintained as the tissue was massaged. 

Seven days later (day eleven) Craig was presented for evaluation.  He was using the limb with barely any perceptible limp.  All motor and sensory function appeared to be intact on examination and his owner reported that their lives had returned completely to normal.

Radial nerve paralysis is one of the most common forms of nerve injuries in dogs.  Avulsion of some of the nerve roots of the brachial plexus is a much worse scenario and the two may be difficult to differentiate. 

The degree of damage and prognosis for recovery depends on which form of paralysis occurs.  The first form is called neurapraxia and holds the most favorable chance of full recovery.  In this case, the fibers have been tweaked or stretched but not ruptured.  Often, deep pain remains while motor and tactile sensory functions are diminished or absent. 

Axonotmesis is the second form.  Here the axon and myelin sheath are damaged but the connective tissue remains intact, allowing regeneration of the axon distal to the injury.  This, too, may allow for recovery but holds a less favorable prognosis. 

Finally, neurotmesis involves complete severing of the axon, myelin sheath and supporting connective tissues.  Prognosis here is poor and amputation may be the only option.

So, Now That We’re Getting Older … October 2010

Q.  I have noticed that the muzzle on my lab is starting to grey.  Until now, I really hadn’t thought about her getting older and am concerned.  Is there anything I can do to help insure her quality of life stays high? 

A.  Like us, as our pets age they begin to be more prone to many age related conditions.  Among these are arthritis, dysplasia, cataracts, endocrine disorders, internal organ malfunction, cognitive dysfunction (senility), heart failure, and many, many more. 

As a colleague of mine told me decades ago, as I was contemplating adding in-house laboratory equipment, “If you don’t look, you won’t find it.”  Sometimes we are reluctant to run those tests or take those radiographs because we don’t want to spend our client’s money.  This may be dangerous thinking as our patients can’t tell us exactly how they feel.  It is far better to have normal or negative test results than to wish we had looked earlier, when the condition was treatable. 

An elderly pet should, as a matter of course, have a geriatric laboratory screening performed periodically.  This may vary from clinic to clinic and patient to patient, but may include such things as a chemistry and electrolyte profile, complete blood count, radiographs and urinalysis.  Occasionally during a routine screening there is something found which needs to be addressed, or, at least, monitored for progression. 

Animals on long term medication may need periodic screening to assess any potential side effects warranting a change of direction or dosage.  This will be tailored to the specific medications in question. 

Often animals may benefit from certain nutritional supplements to help slow down the arthritic process or to enhance the health of the skin and internal organs.  Sometimes pain is difficult to evaluate, especially in cats, and we don’t really appreciate the effects it has until it is brought under control.  The use of pain medication or laser therapy may enhance the comfort level in the aging pet. 

Your veterinarian is trained and equipped to evaluate any age related issues and to formulate a plan to help your pet enjoy an enhanced quality of  life, which, in turn, will allow you to have less stress in your own life.

Dermatitis – September 2010

Q.  My dog has a skin infection and my veterinarian will not prescribe antibiotics for him without an examination.  Is this absolutely necessary? 

A.  Inflammation of the skin may have many causes.  Some start with allergies.  This can be from contact with something the animal is allergic to.  Usually multiple causes are present and they have an additive effect to overwhelm the immune system. Allergies may also be from inhalation or ingestion of pollens or dust borne particles, or anything the animal is sensitive to.  Even the food can be to blame.  It is not at all uncommon for it to be a combination of all of the above. 

The doctor may choose to do skin scrapings, impression smears, or fungal and bacterial cultures to make sure there is not a secondary (or even a primary) infection or parasitic infestation of the skin.  Each case is considered as an individual and seldom do we treat any two animals exactly alike.  If infection or infestation is present, these need to be addressed as well in order to resolve the issue. 

If the incident is seasonal, then control may be relatively simple using a combination of antihistamines, sprays, and shampoos along with supplementation with omega three fatty acids.  In worse cases, very small doses of corticosteroids may be used to control a seasonal flare-up.  There are side effects possible, so your veterinarian will be very careful when and how they are used.  

With longer term issues, it is common to use an immunosuppressant called cyclosporine.  This is safer than corticosteroids but may be more costly, and recently there have been availability issues.  A few cases call for allergy testing for regional allergens (things animals are commonly allergic to in your specific region).  This may be accomplished with either skin patch testing or serology.  Both have their advantages and disadvantages.  With a specific diagnosis of the things your pet is allergic to, a treatment set may be formulated which is custom made for the individual. 

It becomes readily evident, when we look at these things, that skin issues are potentially complex.  We haven’t even discussed the subject of hormonal conditions which may affect the skin.  It is for these reasons that we don’t always grab for the antibiotics.  In fact there are specialists in the area of veterinary dermatology as it is beyond the scope of a general veterinary practice to be fully knowledgeable and adept at everything that may possibly go wrong with the largest organ of the body, the skin.