Eye Lid Tumors and Mocca's Story

There are several types of eye lid diseases that make your dog or cat look a little bizarre. Not all eye lid diseases will be mentioned in this blog, but among the most common ones that cause attention are: 

Eye Lid Tumors, at the top of my list,

 

Entropion, which is a rolling-in of the eyelid, 

Ectropion which is rolling out of the eye lid,

 

Distichiasis which is the abnormal growth of hair or eye lashes in inappropriate places, and

 

Prolapsed Third Eyelid Gland which is inflammation of the third eye lid to name a few. 

This blog will discuss the story of Mocca, a 14 year old Labrador with an eye lid tumor and what we did to treat it. When asked, the owners describe Mocca as the dog that “just keeps on living.”  Mocca came to Providence Veterinary Hospital as a puppy. He presented a few weeks ago with an eye lid tumor that he was scratching and rubbing and therefore his tumor would bleed occasionally. It was very unsightly and upsetting. 

 

Background 

To provide a little background, the eyelid is a common site of tumor formation in dogs. Most eyelid tumors occur in middle-aged to older animals. The vast majority of eyelid tumors in the dog are benign.


Mocca before surgery with eye lid tumor

 

Canine eyelid tumors often originate spontaneously from the glands located within the eyelid margin. Complete surgical removal is the recommended treatment and is usually curative.

 

Eyelid tumor enlargement can interfere with proper eyelid blinking and cause ocular irritation from rubbing of the tumor against the cornea, as was the case with Mocca.

Treatment 

Treatments for eyelid tumors may include one or more of the following:

 

• The recommended treatment for most canine eyelid tumors is surgical removal, using either a scalpel or laser. Complete excision is usually curative for the benign eyelid tumor.
• Large eyelid tumors may require surgical reconstructive techniques (plastic surgery) of the skin and tissues around the eyelid to preserve adequate protection of the eye after tumor removal.
• If the tumor is large enough, the entire eye and tumor are taken to protect the pet against tumor spread (metastasis) or further destruction of the globe. 

*

The owners and I discussed the plan of surgical removal of the eye lid tumor with the probable plastic surgery correction. After a careful evaluation of Mocca’s health, I proceeded to remove the growth by taking a “pie” wedge out of the lid. The lid just can't be sutured together without causing lid tension and distortion of the upper eye lid.

A sliding skin graft was performed similar to the diagram above to keep the original eye lid tension. After ten days, the sutures were removed and everybody, especially Mocca, was happy.                                                                                                                          

Home Care and Prevention

 If an eyelid nodule or swelling is observed, call your veterinarian promptly. Immediate evaluation of the eyelid lesion is very important if accompanying symptoms of ocular discomfort are observed, such as increased blinking, tearing and redness of the eye.

 

Gently wipe away any eye discharge with a warm moist cloth as needed to keep the eyelid area clean. Do not allow the pet to rub or self-traumatize the eyelids. After diagnosis of an eyelid tumor, lubricating or antibiotic ointments may be prescribed until the time of surgical removal.

 

There is no preventive care for most types of eyelid tumors. It is well known that squamous cell carcinoma develops more commonly in dogs with pink or white eyelid margins that have prolonged sun exposure. Reducing sun exposure in these dogs by always allowing them shaded area may help to reduce the risk of developing this type of tumor.                                                                                           Mocca 10 days after surgery

The Providence Veterinary Hospital Blog is a publication of Peter Herman, VMD, at the Providence Veterinary Hospital, 2400 Providence Ave. in Chester, PA. Contact Dr. Herman at 610-872-4000 or visit us at http://www.providencevet.com.                                                    

* Diagram from "Current Techniques In Small Animal Surgery I; M. Joseph Bojrab; Lea & febiger, Philadelphia

Fall and Your Pet's Safety

Fall is a beautiful time of year; especially in the northeast; especially in Pennsylvania. Fall also means colder, wintry weather – and the holidays – are just around the corner.

As temperatures drop and as dinners get prepared and decorations get put up for the holidays there is a mental checklist that you should go through to insure your pet is safe and secure. 

 

First, be sure to have a flea and tick preventive on your pet. Fleas and ticks can be found all year long.  One product that has worked well for us is Parastar flea and tick preventive for dogs and Easyspot for cats. I usually see at least 4-5 clients weekly that have been to the pet shop, or supermarket, or discount stores and still have a flea or tick problem. You are better off going to your veterinarian first. In the long run, it will be cheaper and more effective.
In the colder weather,  pets should have a warm place to sleep that’s off the floor and away from drafts. Wipe dogs’ legs and stomach when they come inside from the snow, sleet or ice. Don’t leave dogs alone in parked cars, as temperatures can fall quickly in a short period of time. 

• For the holidays, Thanksgiving, Hanukkah and Christmas ribbons, candles, tinsel, and wrappings can cause intestinal obstruction. The last thing you need is an emergency visit to your vet for an unscheduled surgical procedure. Also, keep in mind that holiday lillies, mistletoe and certain berries can be toxic to your pet.

Be sure your pet is always wearing a form of identification. Microchips are wonderful, if you register your pet with the number on your chip. The is no point in purchasing and installing a microchip, only to leave the registration form in your desk draw. If you buy a microchip, register it with the company the same day. Some companies require you to renew your registration annually.

The classic winter poisoning we see is antifreeze poisoning. If you are preparing your vehicle for the winter months and are changing the antifreeze, take caution in disposing properly and cleaning up any spillage. Many coolant products contain a chemical called ethylene glycol that is highly toxic to your pet. Ten teaspoons can kill a 20 pound dog, much less for a cat. Kidney failure and death can occur in as little as four to eight hours. Newer products that contain propylene glycol are generally considered safe. If you suspect your dog or cat has swollowed antifreeze, call your veterinarian or an emergency animal clinic immediately. 

Be sure to take a look outside. If your dog spends time outdoors in the winter, it is crucial to make sure he has clean warm bedding and shelter from the elements. A garage or a large insulated doghouse will make a big difference in the warmth and comfort of your outdoor pet. All outdoor bedding should be washed and treated for fleas and ticks before replacing it in the dog’s space.

We can't forget the mice and other rodents that are seeking warmth for the winter. You can't blame them, but they are still a nuisance. Take caution when using rodenticides around the home as these can be toxic to pets and can cause bleeding disorders that can be deadly. Consider using traps instead.

Be sure to have your pet scheduled for a therapeutic bath and grooming for the holidays. If you go to the trouble of preparing every little detail for your holiday celebration, shouldn't your pet look its best?

Many families will bring their pets with them when they visit friends and relatives. Be sure to have your pet up to date on all the appropriate vaccinations. Please check this by making a call to your veterinarian's office.

When it comes to all meals, but especially holiday meals:  they can  pose a medical threat for your pet. Chicken and turkey bones can get stuck or can pierce holes in any portion of the digestive tract. Rich foods can cause sudden pancreatitis or bloat. Keep holiday meals, leftovers and table scraps out of reach of your pet.

The Providence Veterinary Hospital Blog is a publication of Peter Herman, VMD, at the Providence Veterinary Hospital, 2400 Providence Ave. in Chester, PA. Contact Dr. Herman at 610-872-4000 or visit us at http://www.providencevet.com/.

 

 

 

 

Digital Dental X-Rays For Pets



I need dental care too!

You find your pet rubbing its face, following you around the house which is most unusual behavior, gulping or excessively salivating and you don't see a reason for these behaviors. You find your pet coming to breakfast with a swollen lump under the right eye and does not feel hungry. Your pet eats, but drops the food from its mouth.  How about the bad breath that makes you want to be in another room. Would you just hope for the behavior to go away without treatment?

All these symptoms are clinical signs of dental disease. Not only is treatment necessary, but first a diagnosis needs to be made. Before a diagnosis is made, an examination and dental x-rays need to be taken. 

Digital Dental X-Rays

This article is about digital dental x-rays. I wrote another blog about general dental care which can be found in the collection of blogs available. That blog was published 6/22/2011 and entitled Dental Care For Your Pets

Dental x-rays are the most vital tool in veterinary dentistry.  They are essential in most cases to make an accurate diagnosis.  The diagnosis is the basis deciding how to treat your pet.  Dental radiographs are essential in performing dental procedures, in evaluating procedural success and in documentation of dental and oral health.

It is virtually impossible to practice veterinary dentistry without dental radiographs!

Please check off the box asking for dental films when you admit your pet for an annual dental cleaning to the hospital. They are in and out usually in the same day. We provide a comprehensive oral health evaluation for your pet when the teeth are cleaned.  Dental x-rays with periodontal probing help with the assessment.  It makes no sense to place an animal under anesthesia to clean teeth and miss an important problem.  If you don't look (take x-rays), you most likely will not find problems that need attention.

One molar root is sitting in an abscess.
The tooth looks 100% normal in the mouth.

Did you know that two thirds of our dog's and cat's teeth are under the gums and are not visable?  Dental radiographs help in the evaluation.  They allow assessment of the teeth and the surrounding soft tissues, the joints and bone.  Dental radiographs can reveal under the gum foreign objects, cysts and tumors. Without the help of dental x-rays, 75% of problems could be missed.

Ok, maybe I convinced you dental x-rays are somewhat necessary. Then why digital dental x-rays?

Advantage Of Digital X-Rays

• Digital radiography in pet dentistry provides the veterinarian with the ability to store images on a computer. This provides two primary advantages over film X-rays:
• Digital X-rays can be viewed as full-screen images that can be enhanced and zoomed in on, aiding diagnostics and treatment.
• Digital technology allows our clinic to communicate images electronically for simpler referrals, record storing, and sharing.
• Digital x-rays are quicker, easier, and safer: Digital X-ray technology is in the best interest of our patients.

 The Sensor 

Intraoral radiographs are made using a small  digital sensor placed inside the patient’s mouth, and provide superior quality for examination of individual teeth or sections of the jaws compared with standard-sized veterinary radiographs. Because veterinary patients will not cooperate when a sensor is placed in the mouth, taking dental radiographs requires that the patient be anesthetized or sedated.



Resorptive lesions in a cat

Digital dental x-rays show us  root infections, bone loss and tumors that we might not be able to determine just by looking at and probing the teeth. Without digital dental x-rays, infected teeth may be left in the mouth, even after a thorough dental treatment!  Cats develop painful resorptive dental lesions, similar to cavities, below the gum line.  The only treatment for this condition is extraction of the painful tooth.  If we can’t see the lesion, don’t know it’s there, because we haven’t taken radiographs, we could leave our patients in pain!

This tooth tip fracture has an infected root.

Dental x-rays also tell us when we DON’T have to pull a tooth.  Tooth tip fractures are common.  If the pulp cavity of the tooth is exposed, the tooth should be either capped or extracted.  If the pulp cavity is not affected, the tooth can stay in place and just be “watched”. 

Digital xrays are an esstential tool in evaluating the mouth and all the dynamics involved with disease.

  The Providence Veterinary Hospital Blog is a publication of Peter Herman, VMD, at the Providence Veterinary Hospital, 2400 Providence Ave. in Chester, PA. Contact Dr. Herman at 610-872-4000 or visit us at http://www.providencevet.com/.

 

Heat Stroke - How to Save Your Pet

Every year we see two or three cases of heat stroke, a totally preventable ailment and cause of death. These dog and cat owners just don’t think through the consequences of leaving their dog or cat in a car with a temperature reaching 130 – 150 degrees. Certainly, these same people wouldn’t put their pet in an oven with a temperature at 200 degrees F.

Heat stroke is an emergency and requires immediate treatment. Because dogs do not sweat (except to a minor degree through their foot pads), they do not tolerate high environmental temperatures as well as humans do.

Common situations that can set the stage for heat stroke in dogs include:

·         Being left in a car in hot weather

·         Exercising strenuously in hot, humid weather

·         Being a brachycephalic breed, like a Bulldog, Pug, or Pekingese

·         Suffering from a heart or lung disease that interferes with efficient breathing

·         Being muzzled while put under a hair dryer

·         Suffering from a high fever or seizures

·         Being confined on concrete or asphalt surfaces

·         Being confined without shade and fresh water in hot weather

·         Having a history of previous heat stroke

Heat stroke begins with heavy panting and difficulty breathing. The tongue and mucous membranes appear bright red. The saliva is thick and tenacious, and the dog often vomits. The rectal temperature rises to 104° to 110°F. The dog becomes progressively unsteady and passes bloody diarrhea. As shock sets in, the lips and mucous membranes turn gray. Collapse, seizures, coma, and death rapidly ensue.

First Aid and Treatment:

 You must bring your pet to a veterinarian if you suspect heat stroke. Time is of the essence. You can try putting ice packs under the arms and groin areas while preparing to take him or her to the veterinarian or emergency clinic, but professional help is needed.

You may also try rapid cooling by spraying the dog with a garden hose or immersing him in a tub of cool water (not ice water) for up to two minutes. Monitor his rectal temperature and continue the cooling process until the rectal temperature falls below 103°F (39°C). At this point, stop the cooling process and dry the dog. Further cooling may induce the opposite effect and shock.

Do not try treating your dog for heat stroke without veterinary supervision. It is difficult to manage heat stroke in the veterinary clinic. Just imaging trying to treat it with the untrained eye!

Other consequences of heat stroke include kidney failure, spontaneous bleeding, irregular heartbeat, and seizures. These complications can occur hours or days later.

Another complication associated with heat stroke is dehydration. For mild dehydration, if the dog is not vomiting you can give him an electrolyte solution by bottle or syringe into the cheek pouch. Balanced electrolyte solutions for treating dehydration in children, such as Ringer’s lactate with 5 percent dextrose in water or Pedialyte solution, are available at drugstores and are also suitable for dogs. Gatorade is another short-term substitute to help replace fluids. Administer the solution at a rate of 2 to 4 ml per pound of body weight per hour, depending on the severity of the dehydration (or as directed by your veterinarian).

For more severe dehydration, IV fluids and electrolyte replacement are necessary and that is another reason to get to a qualified veterinary clinic ASAP.

At The Hospital:

Once an affected dog reaches the hospital, the veterinary team will take appropriate steps to try to safely bring the dog’s core body temperature into a normal range and resolve the hyperthermia. Room temperature intravenous fluid and electrolyte therapy may be used at shock rates depending upon the dog’s clinical condition. Oxygen supplementation may be used as well, either through a mask, a cage or a nasal catheter. Activity will be restricted and normally the dog will not be fed until it is medically stable. There are no specific medications to “treat” heat stroke. However, there are medications to help manage many of the complications associated with of heat stroke, which your veterinarian can discuss with you. Patients should be closely monitored around the clock during the first day or two of the cooling down process.

The prognosis for dogs that have heat stroke are highly variable and can be good to guarded to grave, depending primarily upon how quickly the condition was caught and treated.

The Providence Veterinary Hospital Blog is a publication of Peter Herman, VMD, at the Providence Veterinary Hospital, 2400 Providence Ave. in Chester, PA. Contact Dr. Herman at 610-872-4000 or visit us at http://www.providencevet.com

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Canine Cervical Disc Disease

Winston is a dog owned by Sarah W. They both recently moved from California. Winston is a very polite handsome five year old male Jack Russell mix breed weighing about 11 pounds. His main problem was he had occasional pain from time to time in some non specific area without any apparent cause. Since he was adopted just a few years ago, Sarah didn’t really know just how long this pain has been a problem. Winston knew but he wasn’t saying. Recently, Winston's pain got so bad, he wouldn't let a groomer touch his body. When an owner describes sudden “yelping”, with no apparent trauma or cause, I start thinking of cervical disc disease. Of course it could have been many other diseases, but after a routine and neurologic (nervous system) examination, I decided to take radiographs of the cervical vertebrae (the neck). The exam revealed that Winston’s head and neck appeared to be tense and stiff, and he tried to avoid lifting his head when I push the head up toward the ceiling. The radiographs confirmed the tentative diagnosis of cervical disc disease.

 Winston's x-ray showed calcification between two vertebrae and a narrow intervertebral space. Cervical (neck) lesions account for approximately one fifth of all intervertebral disc problems. Most patients experience neck pain as the first and most consistent clinical sign. "Yelping" or screaming often accompanies this pain. This occurs when there is a moderate disc rupture. The head and neck are held in a tense position with the patient reluctant to elevate the head and neck. Intervertebral disc disease is the most common neurologic syndrome seen in dogs. Disc degeneration has been reported in 84 breeds with particular susceptibility in certain small breeds. These breeds (Dachshund, Pekinese, Poodle, Beagle, etc.) have characteristic skeletal changes that predispose the discs to degenerate at a very early age. Intervertebral discs act as cushions between the vertebrae and function as the shock absorbers of the spine. A normal disc has two regions: a resilient gelatinous nucleus (center) and an outer fibrous ring that encircles the nucleus (see Fig.1). A degenerative disc loses its resiliency when its jelly-like center calcifies and develops a gritty, hardened consistency. No longer able to cushion the vertebrae, the center is predisposed to bulging and to rupture (see Fig. 1), resulting in pressure on the spinal cord, pain, and sometimes paralysis. Figure 1 Diagnosis A diagnosis of intervertebral disc disease is made based on the history and neurologic examination. Radiographs (x-rays) can reveal the presence of degenerative, calcified discs and may outline narrowed disc spaces with evidence of rupture and calcified disc material in the spinal cord. A definitive diagnosis may require a myelogram (a contrast dye study of the spine) to confirm and document not only the location of the ruptured disc but also the amount of spinal cord swelling. The myelogram is a common and safe diagnostic procedure when performed with care and under proper conditions. Because cervical discs by nature rupture slowly, the symptoms may come and go for some time. Early or mild cases are often treated medically. These medical treatments, which often include corticosteroids to relieve the cord swelling and pain caused by intense inflammation, become unrewarding as more disc material pushes against the spinal cord. The treatment of choice to reverse the symptoms and return the patient to a normal pain free life is surgical removal of the ruptured portion of the disc from its compressive position under the spinal cord. Treatment After radiographs and possibly a myelogram confirm the involved intervertebral site, a surgical decompression technique (a ventral cervical slotting procedure) is performed from an incision under the neck to remove all of the ruptured disc material. The architecture of the disc space is maintained to allow for a normal recovery. This is exactly what we performed on Winston. Sarah W with Winston - "going home". The remaining discs in the area undergo fenestration, a procedure which involves removal of the degenerative center of the other discs in the neck. This procedure includes up to five intervertebral discs and involves cutting a window in the outer fibrous rim of the discs followed by extraction of the calcified, degenerative centers. This prevents recurrence of any disc rupture, while allowing normal motion and pain free movement following surgery. As the resected center of the disc scars, there is little or no effect on mobility. Winston was operated on for cervical disc disease using the ventral cervical slotting procedure. The following day he allowed our groomer, Donna to handle him. He was groomed without any pain or objection.  That made Sarah very happy and Winston had an uneventful, painless recovery. The Providence Veterinary Hospital Blog is a publication of Peter Herman, VMD, at the Providence Veterinary Hospital, 2400 Providence Ave. in Chester, PA. Contact Dr. Herman at 610-872-4000 or visit us at http://www.providencevet.com  

Canine Hero

Never say you can’t teach an old dog new tricks.  This old dog, namely, Sebastian, a 12 year old Collie mixed breed, recently saved three lives and became a hero!

Sebastian

To keep the name of the owner private, we will just call him Mr. P from Somewhere, Pennsylvania. His dog’s name is really Sebastian. This is the story of Sebastian, Mr. & Mrs. P and how Sebastian saved their lives.

Mr. & Mrs. P were settling down for a peaceful night’s sleep and so was Sebastian. He usually slept at the foot of the bed. This particular night, however, Sebastian started to pace first to Mr. P’s side of the bed, then to Mrs. P‘s side. He wouldn’t stop.  Finally Mr P got up, thinking that Sebastian needed to go out.

After bringing Sebastian back in the house, every one settled down for the rest of the night.

It wasn’t two minutes and Sebastian started to pace again. First, he paced to Mr. P. and then to Mrs. P. After waiting about five or ten minutes, Sebastian still didn’t settle down. Mr. P got out of bed and checked the upstairs, then the main floor. Nothing abnormal.

Then Mr. P decided to check the basement. It’s the only place he didn’t check.

When he and Sebastian got down stairs, there was a faint odor of gas.

Mr. P called PECO and reported his findings. PECO came out in about ½ hour.

The PECO technician checked for leaking gas and sure enough found the problem. It was a leaking gas line leading to the hot water heater. He told Mr. P to treat this dog to anything he wants including a steak. He just saved your life, your wife’s life and your house. The gas leak could have ignited the entire house before morning.

How did I find out about it? Mr. P. was in to Providence Veterinary Hospital with Sebastian the other day, treating him to anything he wanted and told us the story. A TRUE STORY OF CANINE HEROISM!

The Providence Veterinary Hospital Blog is a publication of Peter Herman, VMD, at the Providence Veterinary Hospital, 2400 Providence Ave. in Chester, PA. Contact Dr. Herman at 610-872-4000 or visit us at http://www.providencevet.com