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Wednesday, May 16, 2012

What is a FORL?


What is a FORL?

Well, you guessed it, it has something to do with your cat's teeth.  


Feline Odontoclastic Resorptive Lesions (FORL)

What are Feline Odontoclastic Resorptive Lesions?
Dental health is a very important aspect of general health in both our canine and feline patients.  Cats are particularly susceptible to painful dental disease known as a “feline odontoclastic resorptive lesion” (FORL), previously known as caries, cervical neck lesions, or root resorptions.  This condition is an inflammatory disease whereby the tooth resorbs and eventually breaks.  Studies have shown that more than half of all cats over the age of three will have at least one tooth affected by resorption.

The cause of FORL’s is not completely understood, but the involvement of odontoclasts, cells normally responsible for absorbing deciduous (baby) teeth, is seen at a microscopic level.  It is likely that these cells are triggered by an autoimmune response, meaning the tooth is most likely being destroyed by the cat’s own immune system.

FORL’s can be very painful as the protective outer layer of the tooth, the enamel, is worn away, exposing the sensitive dentin and pulp.

How do I know if my cat has a resorptive lesion?
During your cat’s physical exam, the doctor will closely examine the mouth, looking for obvious signs of resorption, often found along the edge of the tooth at the gumline, as well as evidence of pain or sensitivity.  Pain may manifest as jaw trembling, drooling, bleeding, or a decreased appetite. Cats, however, do not often show outward signs of oral pain.  A complete examination and oral evaluation require anesthesia, assessing the mouth with a probe similarly to a human dentist, cleaning both above and below the gumline, and radiographs (x-rays) of the entire mouth. According to the American Veterinary Dental College, intraoral radiographs are the required to properly evaluate this condition.

How do you treat my cat’s resorptive lesion?
All of the information above combined allows for development of an accurate, complete treatment plan.  Because teeth suffering from resorptive lesions are being destroyed by the cat’s own immune system, continued breakdown is inevitable and the only treatment available is extraction of the affected tooth. 

During extractions, our standard of care involves a multimodal approach to pain management including nerve blocks during the procedure, pain medication before and after the procedure, and pain medication to go home.  Further, teeth are extracted surgically, a post extraction x-ray is taken to ensure the complete removal of the tooth, and the gums are closed with absorbable suture material.

Written by:  Stephanie Kotas, DVM

Friday, January 27, 2012

Case Study: Why Maddy's tail didn't wag that day


“Maddy” is a bouncy, outgoing 5 year old Cavalier King Charles Spaniel.  Her very worried family called us in late October because she had lost her spunk.  In addition, she refused to eat breakfast, which never happens with Maddy!  They had seen blood in her stool that morning as well.


When “Maddy” presented for her examination, she really felt bad-not even a tail wag. 
The reason quickly became apparent, as seen below:


“Maddy” had developed an anal gland (sac)  abscess, which ruptured externally.  Anal glands are glands located on either side and slightly below the anus.  Their sole function is to deposit a pungent, fishy discharge, usually after bowel movements, as a way to mark her territory.  The glands can become infected with bacteria, which causes the duct leading from the gland to the outside of the body to become blocked.  The gland continues to make new secretions, but they can’t leave the gland due to the blocked duct.  The gland becomes bigger and bigger until it pops…much like an over-filled balloon.  



This is what “Maddy’s” gland looked like after the area was cleaned up:


Although “Maddy” did not display typical signs of anal gland discomfort, dogs with anal gland disease will usually lick at the anal area and may scoot.  In addition, they may becomed depressed, stop eating and act like are painful in the hind end, with reluctance to raise their tail or wag.  Treatment centers around pain control-as you can imagine, this is a very painful condition!  Antibiotics and anti-inflammatory medications are also prescribed. 

“Maddy”, 14 days later:


Moving forward, it will be important to make sure “Maddy” doesn’t have another abscess.  Frequent anal gland emptying, every 1-3 months, will help keep her enthusiastic and bouncy!


Written by:  Wendy Hauser, DVM

Friday, December 23, 2011

Holiday Safety Tips: Topic #3 - Christmas Tree Dangers


Christmas Tree Dangers

O Christmas Tree, O Christmas Tree, How dangerous you can be……

If you are anything like me, I love to trim the tree right after Thanksgiving. This way I can enjoy it as long as possible.  My pets, especially my cats, seem to enjoy the tree just as much as I do.  All those shiny ornaments and draping garland make such great toys.  I have at least one ornament that doesn’t make it to see the next holiday season.  Live tree or artificial, there are several hazards to be aware of with this splendid piece of holiday décor (yes…I love Christmas trees!).

Christmas tree water –
If you have a live tree, this is real hazard.  The water can contain fertilizers which can cause stomach upset.  It is also considered stagnant water and can be a breeding ground for bacteria.  Bacteria can lead to vomiting, nausea, and diarrhea, if ingested. 
Safety suggestions:  1. Use a covered tree base.  2. Switch to an artificial tree.  3.  Keep the tree in a room that your pet is unable/not allowed to enter. 4. Place a pet/baby gate around your tree so you pets are unable to get to tree water. 

Electric cords
Exposed electric cords can look like string and toys to your pets.  If they are chewed this can lead to electrical burns and even electrocution.  Cover cords to help prevent your pet from chewing on them. 
Safety suggestions:  1. Cover the cords with plastic guards (available at most electronic stores).  2. Keep the tree in a room that your pet is unable/not allowed to enter.  3. Place a pet/baby gate around your tree so you pets are unable to get to decorations.  



Ribbon, tinsel, and ornaments
These bright and shiny decorations are very attractive to inquisitive and playful pets.  A cat playing with a piece of tinsel might seem innocent, but this can lead to ingestion of the tinsel, ribbon, or ornament.  Ingesting of any type of decoration can lead to an obstruction (a blockage in the intestine) which requires surgery to correct.  Obstructions can be life threatening.  Glass ingestion (by way of glass decorations and ornaments) can be particularly dangerous due to the possibility of the glass cutting the esophagus and intestines.  Do not allow your pet to play with any decorations. 
Safety suggestions:  1. Keep all breakable ornaments at a high point on your tree out of reach.  2. Switch to shatter proof/plastic ornaments.  3. Place a pet/baby gate around your tree so you pets are unable to get to decorations.  4. Do not use decorations (like tinsel ‘icicles’) that can easily fall off or be removed in small pieces. 

Batteries
These are often found under your tree.  Batteries contain corrosive material.  If a battery is chewed, these corrosive materials can leak out and cause ulceration to the mouth, tongue, and the rest of the gastrointestinal tract.  In addition, there is also a danger of obstruction (a blockage to the intestine) if a battery is swallowed by your pet. 
Safety suggestion:  1. Do not place gifts under the tree until it is time to open them, especially gifts with batteries.  2. Do not leave unopened gifts under the tree.  3. Place a pet/baby gate around your tree so your pets are unable to get to gifts.  4. Keep batteries out of reach of your pets at all times.

Potpourris
The holiday season is one of the most popular times for household fragrances.  Liquid potpourri can be exposed to your pet through direct ingestion from simmer pots or spills, by rubbing against leaky bottles or simmer pots containing the potpourri, or from spilling the containers.  Tissues in the mouth become exposed following one of these events from the pet grooming themselves.  Exposure to potpourri can result in severe damage to their mouth, tongue, skin, and eyes.  With dry potpourris, there is the added risk of possible obstruction (a blockage to the intestine) or toxic plant ingestion.
Safety suggestions:  1. Keep potpourris in a safe location where pets can not nock them down, spill, or disturb them.  2. Use other forms of household fragrances like plug in diffusers or room sprays to fragrance your home over the holidays. 
DO NOT use any scented fragrances if you have birds in your home.

We hope that these tips can help prevent a potentially scary and stressful event for your pet and your family.  The best thing you can do is try and prevent an exposure and be prepared. 

What to do if your pet has been exposed to a holiday hazard:

  1. Gather information about the exposure – What, When, How Much
    1. What were they exposed to
    2. When were they exposed to it
    3. If applicable, how much were they exposed to/how much they ingested
  2. Call your veterinarian – Have a hospital contact sheet handy
    1. Coal Creek Veterinary Hospital – 303-680-2200 (we have FREE hospital magnets for this purpose, please ask for yours today).
  3. If it is after hours or a holiday, call your local Pet Emergency Clinic
    1. Animal Emergency and Specialty Center - 720-842-5050 (we have FREE magnets for this purpose that include a map, please ask for yours today).
  4. Remain calm and follow directions from your veterinarian or pet emergency clinic.

We hope no pet owner ever has to go through a pet being exposed to these hazards.  Please use good judgment and keep your pets in mind when decorating your home this holiday season.

Written by:  Jamie A. Davis, CVPM

Tuesday, December 13, 2011

Is your pet’s food contaminated with Salmonella?


Is your pet’s food contaminated with Salmonella?

Salmonella is a bacteria that is most often spread through ingestion of food or water contaminated with fecal material.  Salmonella contamination has recently been implicated in pet food recalls and concerns over exposure to pets and humans alike have increased.  Pet food, supplements, and treats may all carry a risk of contamination directly or can be infected by cross contamination in facilities that handle these products.

Illness from Salmonella most often affects the young and old and the immune compromised in both animals and humans, but the bacteria can be carried by apparently healthy individuals.  There are a reported 1.4 million reported cases of salmonella-related illness and 400 related deaths per year in the United States.  To protect both your two-legged and furry family members, it is important to take precautions to avoid exposure or continued contamination by Salmonella bacteria.

Here are some important guidelines from the American Veterinary Medical Association to prevent the spread of Salmonella in your home:

  • Avoid feeding raw diets, commercial or homemade, to your pets which can habor the bacteria if precautions are not properly taken during processing, handling, and storage.
  • Purchase individually packaged pig ears, rather than buying from bulk bins—more than 50% of pig ears tested from bulk bins have been found to be contaminated with Salmonella. (Note: Coal Creek Veterinary Hospital does not generally recommend pig ears as treats because of the risk of tooth fracture).
  • Make sure packaging of pet food products are in good condition and return if they appear tainted, discolored, or smell abnormal.
  • Discourage children, the elderly, and immunosuppressed people from handling food and treats.
  • Wash hands thoroughly with soap and water before and after handling pet food, treats, and nutritional products.
  • Use a clean scoop to dispense food and regularly wash water and food bowls with hot water in sink other than the kitchen or bathroom to prevent spread of the bacteria.
  • Avoid feeding pets in the kitchen.
  • Make sure to save the original food packaging materials including date code and product code in case your pet’s food is recalled.


Written by:  Stephanie Kotas, DVM

Thursday, December 1, 2011

Daisy's story of what lies beneath.

Meet Daisy.  She is a sweet, 3 year-old Mastiff that had a run-in with the TV on Wednesday.   

One of her family members pulled a sharp object out of her neck that evening and everything seemed to be just fine.  They cleaned the area with some hydrogen peroxide just to be safe.  The next day, her guardians noticed that there was swelling on the left side of her neck, and Daisy just wasn’t acting like herself.  She seemed agitated and her energy was off.  She wasn’t painful when the site was touched, but they were concerned and brought her in for an examination.

To get a closer look, the area was shaved, revealing a small (1/4 inch) puncture wound, and some bruising.  While Daisy was being distracted, Dr. Fein aspirated the area with a needle, and got pinkish, milky fluid.  This pus is characteristic of an abscess.  The skin appeared to be healed, but underneath the skin, bacteria had begun to grow, forming an abscess.  Left untreated, abscesses can cause a fever, making our pets feel under the weather.
Daisy was treated with pain medication and antibiotics.  An incision was made to drain the infected material from the abscess.  The area was flushed with a sterilizing solution until it flushed clear instead of milky pink.  Daisy had a drain placed, to allow the wound to heal from the inside-out, and to prevent the skin from closing over again.  If the skin is allowed to close, another abscess can form.

Here is a picture of the drain that was placed: 


It took her a couple of days for her energy and appetite to return to normal, and we were able to removed the drain 5 days later.  Here is what the area looked like when the drain was removed:

The most important thing was that there was no more infected discharge.

Just 2-3 days later, this is what the area looked like:
 
Daisy made a full and speedy recovery.

Written by: Karyn Fein, DVM

Monday, November 28, 2011

Holiday Safety Tips: Topic #2 - Plants. What plants are dangerous to my pets?

What plants are dangerous to my pets?

Whether you are a seasoned gardener, or a black thumb like me, there are times in our lives that plants find their way into our home and even our yards.  House warming gifts, flower arrangements, and holidays seem to bring them into my home.  It is hard to believe that some of these beautiful plants and flowers can be dangerous to our pets.  Remember that the plant kingdom is just as cunning in making the most beautiful plants the most dangerous.  Here are a few of the holiday plants that might find their way into your home this holiday season and what precautions you should take.

Poinsettia - A holiday favorite in its bright colors and thick foliage.

Toxicity:  Toxic to Cats and Dogs.
Signs/Symptoms:  Irritation to the mouth and stomach and sometimes causing vomiting.


Holly (American) – A rich green plant seen in flower and plant arrangements during this time of year. 

Toxicity:  Toxic to Cats, Dogs, and Horses
Signs/Symptoms:  Vomiting, diarrhea and depression


Mistletoe (American) – This plant known to bring kisses is also a very dangerous plant if ingested by your pets. 

Toxicity:  Toxic to Cats, Dogs, and Horses
Signs/Symptoms:  Gastrointestinal disorders, cardiovascular collapse, difficulty breathing, abnormally low heart rate, and erratic behavior.  Vomiting, diarrhea, low blood pressure is possible, but rare.


Lilies – A favorite in many bouquets in a vast variety of types such as Tiger, Asian, Japanese Show, Easter, Stargazer, and the Casa Blanca.   

Toxicity:  Toxic to Cats
Signs/Symptoms:  Vomiting, not wanting to eat, lethargy, kidney failure, and death is possible.


The biggest asset we can have is awareness.  The best is to assume that every plant you have in your home can pose a danger for your pet unless specifically bought our supplied to your pet (cat grass, etc.).  Keep all plants up and away from pets.  Use of a closed window box or rooms not accessible to pets is best. 

If your pet decides to ‘taste’ a plant, have the following information on hand.

  1. The Phone Number to Call
    1. Your Veterinarian’s phone number (Coal Creek Veterinary Hospital 303-680-2200)
    2. Your local veterinary emergency clinic number (Animal Emergency and Specialty Center 720-842-5050)
    3. Animal Poison Control (1-888-426-4435) - $65.00 case fee may apply.
  2. The plant ingested – either the name or a sample of it.
  3. The details around the ingestion – when and how much was eaten/chewed on.

If you want to learn more about the plants in your home or if you have a question on what plants are safe for your home, go to www.aspca.org/apcc for a search-able database of toxic and non-toxic plants.  

Written by:  Jamie Davis, CVPM

Wednesday, November 9, 2011

Holiday Safety Tips: Topic #1 - Chocolate Toxicity. Why chocolate is so bad for your pets.

Chocolate Toxicity

Why is chocolate so bad for my pet?
Chocolate contains a compound called theobromine which is toxic to pets.  The theobromine comes from the cacao beans used to make chocolate.  There are three components resulting from processing cacao beans – chocolate liquor (liquid), cocoa butter (fat), and cocoa powder (solid).  Different types of chocolate have different levels of these ingredients and therefore different levels of theobromine.  The higher the level of theobromine the more dangerous it is to your pet if consumed.

Theobromine levels (highest to lowest):
Unsweetened Cocoa Powder
Unsweetened Baking Chocolate
Semisweet & Dark Chocolate
Milk Chocolate
Chocolate flavored cakes or cookies

What do I do if my pet eats chocolate?
If you know or believe that your pet has eaten chocolate, you should determine what type of chocolate was eaten (see list above or have product information), how much (in ounces), and approximately when you think it was eaten.  Then call your veterinarian’s office, veterinary emergency center, or animal poison control (see end of article for these resources).  Recommendations based off the above information will determine what needs to be done for your pet. 

What happens to my pet if they’ve eaten chocolate?
There are two main concerns with chocolate ingestion.  One is due to the high fat content in chocolate; the second is the toxin theobromine.  Chocolate can be very high in fat depending on what was eaten.  A sudden high fat meal (like your pet eating a whole stick of butter) can cause a serious condition called pancreatitis.  This is a metabolic condition in pets caused by an inflamed pancreas and can results in vomiting, diarrhea, and abdominal pain.  This can be a reversible condition, if treated, and can be life threatening if left untreated.  The ingestion of the toxin theobromine can cause vomiting, diarrhea, hyperactivity, tremors, seizures, racing heart rhythm progressing to abnormal rhythms, and death.

What is the treatment for my pet?
It takes nearly 4 days for the effects of chocolate to work its way out of an animals system.  However, conditions caused by the ingestion can last much longer and require follow-up care.  If your pet has just recently eaten chocolate (less than two hours) then vomiting can be induced to attempt to remove as much of the chocolate (and often wrappers/packaging) as possible.  Your pet will also receive supportive care like hospitalization, IV fluids, and lab work to watch for effects of the theobromine.  There is no quick fix for chocolate ingestion except for keeping chocolate away from your pets. 

What can I do to make sure my pet doesn’t get into chocolate?
It sounds simple, just keep it out of reach, but with very ‘crafty’ pets that learn to open cupboards and doors, get into trash cans, and just do things we never thought they would, it can become a bit harder to do this.  Here are a few ideas. 

#1 – Do not leave chocolate at reachable levels, including lower cabinets or kitchen counters. 
#2 – Keep chocolate in tight closing containers on high shelves in your pantry or a cabinet. 
#3 – Do not put chocolate candy in open candy dishes that be easy tipped over or reached. 
#4 – When disposing of left over chocolate or chocolate that is no longer wanted, place in tied up garbage bags in outdoor garbage cans with lids.  This will prevent animals who love to explore trash from getting into the chocolate or other harmful trash.   

I would like to share a bit of my own experience that helps me remember that I need to remember how important it is to think about my pets during the holiday season…

I was living in Florida at the time with my fiancé (now husband) and our four dogs.  Two boxers, one American Bulldog, and one English Bulldog.  It was the holiday season and I was preparing to make truck loads of cookies and treats for my friends and neighbors.  I carefully planned my grocery shopping list for the ingredients and braved the holiday crowds to get everything I needed.  Our agenda for the day was full, and we wanted to drop off the ingredients at the house before we went on to the next event.  I quickly rushed the bags in the house and mindlessly placed them by our pantry (I’m sure can tell where this is going).  We then quickly left the house again to then return several hours later to this…..

This is Celest, one of my Boxers.  She found multiple bags of flour from that purchase and pulled them to various parts of the house, ripped the bags open, and spread out the flour.  She wore her guilt well (the only one mind you…my three other dogs were clean as a whistle).  I remember how mad, and how lucky I felt that day.  Those bags were filled with various types of chocolate and other dangerous things she could have eaten.  I had never left shopping bags on the floor like that, and she never got into things…all until that day.  I have learned to think hard before I do something, especially over the holidays, and how it might affect my fur-babies.  And yes, I do laugh about it now, but if the outcome where different it would have been a preventable tragedy.  

If you have questions or if your pet has eaten chocolate, please call our office:
Coal Creek Veterinary Hospital 303-680-2200

If we are closed, please call:
Animal Emergency and Specialty Center at 720-842-5050
ASPCA Animal Poison Control Center at 888-426-4435 (consultation fee applies)

Written by:  Jamie Davis, CVPM