Clinton Veterinary Hospital’s Blog
Dogs can become lame or limp for a various number of reasons. Unlike when we hurt ourselves though, they can’t tell us how they injured themselves or where it hurts. That is why taking your pet to your veterinarian when you see limping is important. Of course, there are different types of limping or issues that can cause these injuries and not all are emergencies. There can be acute vs. chronic types of limping and having your vet examine your pet can help narrow down why that limp is occurring. In general, if your pet has a more gradual, intermittent issue, this might be a more, chronic condition like hip dysplasia or arthritis. If your pet injures a paw or fractures a bone, you will see sudden limping. If you see a gradual onset limp or even an acute limp that doesn’t seem to be bothering your pet—these can most likely wait for normal veterinary hours and don’t need to be rushed to the emergency hospital. If your pet suddenly injures itself and exhibits signs such as swelling, dangling limbs, obvious fractures, ataxia or stumbling—these are more serious issues and should be addressed immediately.
There are many causes of limping in dogs and limping can range from chronic conditions to acute trauma. We will go through five common causes of limping in dogs.
Injuries of the Paw:
Dogs have a very thick, specialized tissue on their paw pads but they can still get injuries to those areas. Foreign material such as glass, thorns, and nails, can become lodged into the paw pads and cause injury. Also, lacerations or burns to this area can cause acute limping as well. Injuries such as broken nails, infection from lacerations or wounds, or even issues like frostbite or sensitivity to salt on the ground during the winter can cause the paws to be sensitive and uncomfortable to walk on. You may see your pet holding up his paw or licking that area constantly and there may be blood or pus if the area is infected. These are all signs that your pet should be seen, they may need antibiotics and pain medications or wound cleaning/bandaging.
We can also see limping or gait abnormalities when we are dealing with systemic illnesses such as tick-borne infections like lyme or autoimmune disease. These tend to be more gradual in onset, but we can see an acute onset as well. We frequently see other signs such as lethargy, decreased appetite, swelling of joints and fever.
Joint/Soft tissue Injuries:
Some conditions that cause lameness can be due to injuries to the musculoskeletal system. Gradual wear or tear of ligaments or tendons or injuries within joints themselves can cause joint pain which leads to limping. Dogs can also have issues with the development of the elbow joint, specifically the cartilage in that joint. These tend to lead to arthritic changes within that joint. Even more common injuries involve the soft tissue structures of the joint. Dogs can get cranial cruciate ligament tears (like human ACLs), meniscal tears and luxating patellas (kneecaps). These injuries are seen daily in veterinary practice. With these injuries your dog will have hind end limping. They may be seen toe-touching with that hind foot or not fully bearing weight on the injured leg. An entire blog on one or two of these specific injuries will be available in the future since they are so very common.
There are also diseases that affect the actual bones in your dog. Young, rapidly growing large breeds can have conditions such as panosteitis or hypertrophic dystrophy. Panosteitis can cause pressure within the bone and cause stimulation of pain receptors on the outside aspect of the bone. This leads to acute, limping in younger dogs that may shift from one leg to the other. Hypertrophic osteodystrophy can be seen in the front limbs of dogs. This is a non-infectious inflammation of the bone which can lead to swelling or bony growth in that area. There is bilateral swelling of front limb joints and this can be very painful. Limping in older dogs that involve the bones tend to be either osteoarthritis or bone cancer. Osteoarthritis affects the joints/cartilage and we can see chronic inflammation that can lead to a gradual lameness. Bone cancer such as osteosarcoma tends to a gradual onset with increasing pain in that certain limb.
Traumatic injuries tend to be the most obvious causes of limping. These are the ones you see occur or can pinpoint the cause; car accidents, sports injuries, pets falling off the bed, etc. With these injuries, we see anything from fractured bones to soft tissue injuries. If you see your pet injure themselves and become lame after, keep them quiet and calm and wait a few minutes. If after a half hour your pet is still non-weight bearing or limping, you should bring them in to be seen by their vet. If an injury seems to be improving by itself, you can continue to monitor it and it may resolve without needing medical attention, but make it a point to strictly monitor your pet during that time.
Sometimes the cause of the limping is glaringly obvious—glass in a paw pad or broken limb that is at an odd-angle and other times the cause is unknown. Your dog may need radiographs to help identify fractured bones, joint disease or other skeletal issues. Other tests like biopsies or joint fluid collection and blood tests to rule out tick illnesses or systemic issues may be needed.
The treatment for all these different conditions varies greatly, which is why bringing your pet to the veterinarian is important. The treatment could be as simple as a few days rest with pain medication or it could require surgery, further imaging or testing or months of rehabilitation and recovery. Which is why in most limping cases, the sooner you bring your dog to see a vet, the better the prognosis!
Is your pet limping? Have more questions? Give us a call to schedule an appointment today. 860-669-5721
Peeing outside the box? 5 tips to avoid urinary problems in cats.
One of the most common complaints we get from cat owners is that their cat is peeing outside the litter box. Inappropriate urination can be a sign of serious health problems in cats. So how do you know when peeing outside the litterbox is a problem and what can you do to fix it? In this blog, we are going to offer 5 tips to create litterbox harmony for your cat!
- The golden rule for litterbox happiness is to take your # of cats and add 1, this is the # of litterboxes that should be present in your house! If you have 3 cats, you should have 4 litter boxes. Even if you only have 1 cat, you really should have 2 litter boxes to avoid issues. If your cat is urinating outside the box this is the first place to start. Add additional litter boxes. If space is an issue I am a big fan of litterbox “furniture” such as the enclosures below. They allow you to hide the litter boxes and put them in areas where you may not want a litterbox visible.
- Clean the boxes every day! This is extremely important. At my house, it is the first thing I do every morning before I even have a cup of coffee. I let the dogs out and then clean out all the litter boxes. Cats are usually fastidious creatures and they prefer clean litterboxes. Many cats won’t use a litter box if it is dirty or smells bad. I also recommend completely emptying and bleaching out litterboxes every 3-4 weeks. This helps decrease odors and keep litter boxes clean. Cleaning the litter boxes every day also allows you to notice changes or trends. If your cat has not used the litterbox in a day, or if there are suddenly larger or smaller piles or urine this should prompt further investigation.
- Figure out what type of litter your cat prefers and stick with it. Sometimes people switch out litter types all the time or buy whatever is on sale and this can be a major stressor to cats and lead to litterbox avoidance. I use Arm and Hammer clumping litter, and I am also a fan of crystal litter. I have tried the corn and pine-based litters and my cats won’t use them so I stick with what they like. If you are going to try a new litter, always offer it side by side with the old litter. Don’t just change it out. This will allow you to determine if your cat will use it or not and won’t force them to use a litter they might not like.
- Make sure your litter box is large enough for your cat. Cats should be able to stand up and turn around in their litter box. For some larger cats, they will need a large or oversized litterbox. Two of my cats have a history of urinary tract problems and for them, they need a litterbox with high walls to avoid them peeing over the edges of the box. Some cats prefer covered boxes, but make sure that they can get in and out easily. For older cats finding a box that has a low side that is easy for them to step in and out of is critical.
- If your cat is suddenly peeing outside of the box or in inappropriate places around the house and you have addressed all the issues above consider trying to figure out what has changed and what might be stressing them out. Often times peeing outside the litter box is a behavioral issue that is triggered by stress. It can also be triggered by changes in the household such as new dogs, new cats or a new household member. It can also be triggered by cats outside the house who might be near windows where your cat can see them. Be mindful of all these things if your cat’s litterbox behavior changes.
If stress is a trigger for inappropriate urination pheromones such a Feliway can help. Feliway is a natural pheromone that cats secrete when they are happy and relaxed. You can buy collars with the pheromones in them or diffusers. I recommend placing some of the diffusers around the house, particularly in areas where cats spend a lot of time.
Last but not least, if your cat is suddenly urinating outside the litterbox have them checked out by your veterinarian. Crystals and other bladder problems may require medication or special diet changes and your veterinarian can help determine if these are needed. Have additional questions? Call us today- we are happy to help answer any litterbox questions you might have. 860-669-5721.
WHAT IS PANCREATITIS?
The pancreas is a very important organ that is located on the right side of the abdomen next to the stomach. The pancreas produces enzymes to help break down food and hormones such as insulin, which helps regulate blood sugar. These enzymes are activated when food is ingested. When pancreatitis occurs, the digestive enzymes are activated before they reach the intestines and cause problems to the surrounding organs. Pancreatitis in our pets can be acute or chronic and can cause mild to severe clinical signs. If your pet has chronic pancreatitis, we see flares of these episodes; where a pet will have symptoms, respond to medications and then recur months later.
WHAT CAUSES PANCREATITIS?
Most cases of pancreatitis in pets are idiopathic; meaning we don’t find the reason your pet develops this disease. Pancreatitis can be triggered by fatty meals or foods, certain medications such as steroids, endocrine diseases such as cushings or diabetes and/or trauma. There is a genetic link in specific breeds such as miniature schnauzers, where they have a genetic predisposition to developing the disease.
WHAT ARE THE CLINICAL SIGNS OF PANCREATITIS?
Vomiting, nausea, decreased appetite, diarrhea, painful abdomen and lethargy are the most common symptoms. Some animals may present in a “prayer” position. In some severe cases some dogs and cats may need to be hospitalized due to the severity of the disease. In some cases pancreatitis can be fatal if not treated right away.
HOW TO DIAGNOSE PANCREATITIS?
There are a few blood tests that can be run to help diagnose pancreatitis. A complete blood cell count (CBC) can be done and may reveal an increase in the white blood cells. This is not 100% diagnostic though, since we can see this elevation due to other things as well. A chemistry panel that shows elevations in the pancreatic enzymes may be the most helpful test we perform. In some cases though, these enzymes may not be elevated. In this situation if we suspect pancreatitis may be the cause or want to have confirmation, an additional test can be done. This test is called the pancreas-specific lipase test. This test is very specific to pancreatic lipase and can be elevated in cases of pancreatitis. Also, ultrasound can be used to diagnose pancreatic inflammation or peritonitis (inflammation of the tissue in the abdomen). Sometimes though, even with all this testing, it may be difficult to diagnose pancreatitis and the diagnosis may be based on clinical signs and history.
HOW IS PANCREATITIS TREATED?
The severity of the disease and symptoms dictates the treatment. For more acute, less severe cases, getting animals on gastrointestinal medications, a bland diet, and some pain medication may be all it takes. This allows the pancreas to “rest” by not overwhelming it with fatty foods and protecting it with specific medications. For more severe cases, more extreme measures may need to be taken. Some animals will need to be hospitalized on intravenous fluids to rehydrate and correct electrolyte imbalances. They will be given intravenous medications to help with the inflammation and analgesics to help with the pain. Certain animals will need to be hospitalized anywhere from 2-4 days or even longer if patients are in systemic shock.
WHAT IS THE PROGNOSIS?
Dogs that have less severity of disease and respond well to the medication prescribed should have a good prognosis. If the disease process is severe and patients don’t respond well to treatment or need to be hospitalized, the prognosis can be more guarded; especially animals who present in shock from the disease process. Overall though, most pancreatitis cases respond and do well. Dogs and cats that have recurrent bouts of pancreatitis are often put on a low fat prescription diet to minimize the risk of future flare ups. It is very important to bring your pet in if there is any change to their normal behavior at home. If you notice vomiting, lethargy, decreased appetite or any of the clinical signs listed above, bring your furry friend in!
How do you prevent pancreatitis?
Make sure you don’t feed your pet high fat meals and stick with your pet’s normal diet. People don’t realize that feeding your pet left over trimmings from Christmas dinner, foods with high butter content or any food that is a different fat content can affect them. Even though we feel we are giving them this as a treat or to show our love to them, it can be harmful. Love your pet with affection via brushing, snuggles, hiking/walks, throwing the ball or giving cat nip, but not by feeding them fatty human foods. This is a great way to keep your furry friends happy and healthy!
You might be thinking, what is leptospirosis and how does it affect me or my pet? Let me explain.
As the seasons change, your dog or cat’s skin may change as well. You may notice they have increased itching, biting at their feet/legs or overall seem more uncomfortable. We see atopy-or environmental allergies-in dogs quite frequently. The clinical signs range from a simple ear infection to major hair loss, scabs all along the body and them being severely uncomfortable. Atopic dermatitis is the inflammatory and chronic skin issue that’s associated with allergies. These allergies can be brought about by things in the environment that normally would be harmless—pollen, spores, molds, dust mites, etc. During certain seasons, we see these allergies intensify and see the clinical signs associated with them. The most common areas we see affected in our canine friends are; between their toes, ears, groin/inguinal region and sometimes across their backs. Environmental allergies can be genetically linked and even though we can see them in all breeds, there are specific breeds who tend to be affected more. We start to see these develop in dogs from 6 months and up. They have mild reactions when they are younger and we can see these intensify as they are older.
We also see some dogs who have food allergies. Food allergies are less common than environmental allergies and any breed can develop them. We see food allergies manifest when dogs are younger and we see the same type of skin issues from these allergies as well. With food allergies we don’t see a change in symptoms with the season changes. The most common food allergies we see are to protein sources—with beef, pork and chicken being the top allergens.
There are steps we can take to make your dog more comfortable and try to identify what is causing these reactions. Allergy testing can allow us to identify the specific allergens bothering your pet and help us come up with a plan for immunotherapy. Immunotherapy helps slowly build up your dog’s tolerance to these allergens and hopefully eventually decrease their reaction to them. If food allergies are suspected there are specific diets that we may start your pet on. Other things we can add to make your pet more comfortable on a daily basis are medications to helps with the itch, fatty acid supplements and adding antibiotics when we are dealing with a skin infection that flares up. It’s all about managing the itch from many different angles!
A few medications to help with itch are apoquel, which is an oral medication and cytopoint which is an injection. Apoquel helps stop cytokines involved in the itch process and will provide relief against inflammation associated with atopic dermatitis. Cytopoint is the first long acting antibody injection that helps against atopic dermatitis. When or which medication we start with will depend on each individual patient. Both will help your pet with their itch! Also starting an omega 3 supplement helps protect the skin barrier against environmental allergens.
If your are noticing signs of allergies and itchiness at home with your pet, make an appointment and lets discuss the next steps to make your pet less itchy. We can come up with a plan to help manage your dog’s allergies and make sure they are comfortable all year long!
It’s time to think about your cats! Most people adopt kittens or young cats from shelters or friends. That is the perfect time to bring them into the vet and start a habit of veterinary care for them. Bringing your kitten or young cat in begins a positive relationship and allows the start of a discussion for future health care. This is the perfect opportunity to educate yourself on vaccine protocols, behaviors at home, interactions between multiple household cats and much more. This is also a great time to get your cat used to the carrier. Most people don’t bring their cat in until they are much older so being placed in a carrier and in the car and then arriving at a new place is an anxiety filled experience. If there is a reoccurring practice of coming in for multiple kitten vaccines and a positive interaction when they are younger, this will make any future experience to the vets easier. This is also a good time to discuss lifestyle of your cat. Are they going to be indoor or outdoor or even both? Most people believe since their indoor cat does not go outside, they are not exposed to fleas, ticks or mosquitoes. This is not true. So having even your indoor cat on monthly preventatives is important. These are just some examples of what could be discussed at an early vet visit to make sure your cat has a healthy, long future.
People tend to think of cats as smaller versions of their canine friends. However, cats interact with us and each other much differently than dogs. Dogs are more social, pack animals who crave attention while cats are more independent. Dogs will be happy being walked or being allowed to sniff around outside while cats love high perches where they can have the vantage point, and tight spaces where they can be alone. Don’t get me wrong, there are some cats who love to be walked outside to sniff around as well! There are specific behavior cues such as inappropriate urination or marking behaviors which may indicate stressors in the environment. Multi-cat households should have multiple liter boxes–one more than the number of cats. Cleaning out the boxes daily is also a good way to decrease stress in the household. This is also a good time to bring your cat in to discuss these issues to rule out any medical reasons for that inappropriate elimination. Some cats who are older and may being dealing with arthritic issues, may have inappropriate elimination just due to height and location of the litter box. The box may be in a place that is difficult for them to get to–going down flights of steps to the basement for example. Or if the box itself has higher edges, this may be difficult for your cat to comfortably get into, hence the elimination outside the box. Also, just paying attention to daily eating/drinking and elimination habits can tell you a lot about your cats health. If your cat misses a few meals this could lead to serious issues whereas if your dog missed a meal, they could recover quickly. So being aware if your cat is eating and drinking normally and having normal urinary/bowel movements is very important.
Also, spaying or neutering your cat when they are younger can help eliminate behavior issues at home. This alteration will decrease aggression issues, marking behaviors and perhaps decrease persistence to escape outside. Having environmental stimuli and toys for them to play with will also help keep them at a healthy weight and keep them stimulated so we don’t see certain behaviors. A link is listed below that lists some tips for environmental stimulation:
Sadly, we as veterinarians don’t always see cats until they are older and their health issues are too severe. We tend to see them when they are sick and owners are ready to put them down. We don’t want to just see your cat at end of life, we want to see them every year! If cats were brought in on an annual basis so we could track weight, body condition, discuss new or odd behaviors at home this would allow us to intervene much quicker and hopefully extend your pets life. There has to be a change with how we view and value our feline pets. Since they can be more independent, stoic and easily left to their own devices, it can be easy to overlook medical/behavioral issues that may be occurring. If we understand that yearly exams and blood work (as they become older) are important tools to help diagnose and keep track of future issues, then making those yearly appointments makes more sense. That way, we as a veterinary family can make sure your feline family members are the healthiest they can be.
You may notice lumps or bumps on your furry friend that happen to pop up. If so, it’s always a great idea to have those bumps checked and make sure they are nothing serious. It’s a good idea to keep track of when they first appeared, the size of them and if they have changed at all. This will help us start to categorize the masses. Once you bring your pet in, the next step is to take samples of the mass. We do this by needle aspirates. We take samples of the tissue that make up the mass and apply these to a glass slide. We stain the slide and then can view the different cells under the microscope. Looking at the different cells allow us to see if they are normal skin or fat cells or are different cells which could indicate cancer. We will go over a few of the more common skin masses we tend to see.
- The most common skin mass we see are lipomas. These are benign masses that are made of fat cells. They usually occur in older dogs but we do see them in younger pets as well. Most of the time these masses are right under the skin but some can be deeper and adhered to the muscle layer. The majority of these do not pose a problem but they can continue to increase in size. If they are in a location-like under the armpit-this could affect how your pet walks. So at times it is a good thing to remove them if they continue to grow. The pictures below were taken from surgery on a patient who had a large lipoma on her chest that was continuing to increase in size. The second picture shows what they look like once removed.
- We also tend to see a lot of cysts as well. There are many types of cysts. The more common ones we see are follicular and sebaceous cysts. Sebaceous glands are under the skin and they produce sebum which lubricates the hair follicles. These glands can become inflamed and cause cysts that are sacs under the skin. Most of the time they are not an issue but they do have the tendency to rupture and leak material. If this is something that keeps on occurring, surgical removal of the cyst is needed to keep the area clean and healthy. The follicular cysts tend to be smaller and the individual hair follicle can become inflamed. These are not an issue if we can monitor and keep the area clean, but if your pet continues to lick or scratch at the area and causes marked inflammation/bleeding you may want to get them removed.
- Another common skin mass we see in practice is a mast cell tumor. This is the most common malignant mass we see on our patients. Mast cells are a normal part of the body. They are commonly found in most tissues; especially the skin, lungs and digestive tract. They are an important part of the body’s immune response to stimuli. They release histamine which can help during times of allergic reaction, but can be dangerous if released in excess from a tumor. These tumors can look like anything from ulcerated, bleeding masses to flat masses right under the skin. Which is why if you are finding anything new on your pet, have it checked! There can be subcutaneous and cutaneous mast cell tumors. Once a mast cell tumor is identified, it is best to remove the mass as quickly as possible. Surgically removing it when the tumor is small helps us get better surgical margins. For more information: https://www.animalreferencepathology.com/canine-mast-cell-tumors.pml
- A fourth mass we see is something called a histiocytoma. These typically occur in young dogs (less than three years old) and are benign. These tumors will typically become ulcerated and then will regress on their own. You will see these masses start out looking like a skin tag, then they can increase in size, become very inflamed and ulcerated. They do tend to visually look worse before they start to regress. These do not need to removed, we just need to monitor them to ensure they don’t become infected.
- We do also see melanomas. Melanomas of the skin may be either benign or malignant which is why it is important to have these checked out and removed. They are darkly pigmented masses, and they can range from small to medium sized. Correlation between location and if these masses will spread can be seen. Melanomas of the mouth and arms/legs can have a greater potential for spread than those on the body.
After removal most masses are sent for histopathology where the pathologist conclusively states what that mass is and the next steps. If the mass is benign–histocytoma, cyst, lipoma then there are no next steps. The pet is in the clear. For malignant masses, there may be follow-up which can differ depending on the type of mass. The five masses listed above are just a few we can see. The main thing is to know if something changes or is new on your pet and make an appointment for that mass to be checked. If we work together, we can hopefully stay on top of any new masses that appear!
There has been a lot in the news recently about grain free dog foods and how they might be contributing to heart disease in dogs. The FDA has issued a warning and is looking into grain free diets, particularly those containing legumes, peas, lentils and potatoes. These ingredients are most common in grain free foods.
Here is what I think you should/need to know.
1.) Most veterinarians do not like grain free foods. “Grain Free” is a marketing strategy designed by the multi billion dollar pet food industry to make you feel like you should be feeding this to your dog. You shouldn’t. Not one of the 3 doctors in our practice feed a grain free food to their dog.
Why don’t we like grain free? First- most dogs do not have a wheat allergy. Most allergies in dogs are to a protein source such as beef, pork or chicken. Second- a lot of the grain free diets are higher in fat and certain minerals. This makes patients more prone to GI issues such a vomiting and diarrhea and pancreatitis as well as bladder stones. Third- these diets may actually be harming our patients. While we do not fully understand the link between heart disease and grain free foods yet, I think it would be wise to pay attention.
2.) Here is what we do know so far about the link between grain free foods and heart disease.
There are several reported cases of Dilated Cardiomyopathy in breeds that are not genetically predisposed to it. There was a sharp increase in cases that caused veterinary cardiologists to pause and try to determine what might be causing this rise. The common link so far is that all the dogs were eating grain free foods that were high in peas, legumes, lentils and potatoes. These ingredients are usually found in grain free foods.
At first it was thought that taurine, an essential amino acid for heart health, might be causing the issue. However, some of the dogs are taurine deficient and some are not, further complicating the issue.
3.) One of the questions/statements I have heard a lot recently is- “wild dogs didn’t eat grains?”
No they didn’t. However, they weren’t eating legumes, peas, potatoes or barley either. Also, you don’t have a wild dog sleeping in bed with you. You have a domesticated dog who has been bred to be a companion animal, and thus, their nutritional needs are vastly different than those of a wild animal.
4.) Why do people think that corn and wheat are such a bad thing for pets?
Both corn and wheat, which a lot of people seem to think are bad for their pets are good sources of fiber. They are also low in fat and easy to produce and test for quality control and safety. Things like oatmeal, and brown rice are grains and they are good ingredients in pet food.
5.)What should you do if you are concerned about your pet or want to switch foods?
Contact your veterinarian! We are happy to talk to you about diets that might be a good fit for your pet. We do not make any money from our recommendations, nor do we even sell any of the diets! Our only wish is to keep your pet as healthy as possible. We want to help, not harm your pet.
If you do want to switch foods, do it slowly. Mix 25% of the new (hopefully non grain free food) in with 75% of the old food and gradually increase the amount of the new food over the course of 1-2 weeks.
Want more information on what foods might be appropriate or what the best food is for your pet? Check out the Tufts Veterinary School’s nutrition service. They have a lot of helpful resources on their page and you can trust their info.
Don’t believe them? Read the FDA press release on their investigation:
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