<![CDATA[Pet Scan: Mobile Veterinary Ultrasound Service - PET SCAN Blog: The Inner Pet]]>Tue, 02 Dec 2025 08:16:51 -0800Weebly<![CDATA[RECALL: Brutus & Barnaby “Pig Ears Natural Treats for Dogs” for salmonella health risk]]>Mon, 02 Sep 2019 14:35:05 GMThttps://www.azpetscan.com/pet-scan-blog-the-inner-pet/recall-brutus-barnaby-pig-ears-natural-treats-for-dogs-for-salmonella-health-riskBrutus & Barnaby of Clearwater, Florida is recalling all size variations of our Pig Ears for Dogs because it has the potential to be contaminated with Salmonella. Salmonella can affect animals eating the products and there is risk to humans from handling contaminated pet products, especially if they have not thoroughly washed their hands after having contact with the products or any surfaces exposed to these products.

Healthy people infected with Salmonella should monitor themselves for some or all of the following symptoms: nausea, vomiting, diarrhea or bloody diarrhea, abdominal cramping and fever. Rarely, Salmonella can result in more serious ailments, including arterial infections, endocarditis, arthritis, muscle pain, eye irritation, and urinary tract symptoms. Consumers exhibiting these signs after having contact with this product should contact their healthcare providers.
Pets with Salmonella infections may be lethargic and have diarrhea or bloody diarrhea, fever, and vomiting. Some pets will have only decreased appetite, fever and abdominal pain. Infected but otherwise healthy pets can be carriers and infect other animals or humans. If your pet has consumed the recalled product and has these symptoms, please contact your veterinarian.
Bags of our Pig Ears were distributed throughout all states via Amazon.com, Chewy.com, Brutusandbarnaby.com and the brick and mortar Natures Food Patch in Clearwater, Florida.

The product is identified by our trademarked logo  and says “Pig Ears 100% Natural Treats for Dogs”.  These were available in 4 different sizes:

  • 8 Count
  • 12 Count
  • 25 Count
  • 100 Count

Brutus & Barnaby has ceased the production and distribution of the product as FDA and the company continue their investigation as to what caused the problem.

Consumers who have purchased Brutus & Barnaby pig ears are urged to destroy any remaining product not yet consumed and to contact the place of purchase for a full refund. Consumers with questions may contact the company at 1-800-489-0970  Monday-Friday 9am-5 PM EST.
Source: FDA
]]><![CDATA[Blue-green algae isn't the only danger lurking in water]]>Fri, 16 Aug 2019 16:44:27 GMThttps://www.azpetscan.com/pet-scan-blog-the-inner-pet/blue-green-algae-isnt-the-only-danger-lurking-in-waterLeptospira bacteria live in standing and moving water and can harm the kidneys and liver of animals that drink contaminated water, says veterinarian Mark Finkler. A vaccine prevents leptospirosis, infections respond to antibiotics and untreated infections can cause death.

Source: WSLS-TV
]]><![CDATA[5 Senior Dog Diseases You Need to Know]]>Tue, 28 Jun 2016 16:06:01 GMThttps://www.azpetscan.com/pet-scan-blog-the-inner-pet/5-senior-dog-diseases-you-need-to-know5623155Life passes quickly, especially when you’re a dog. The frolicking puppy brought home from the humane society just a few short years ago matures into a mellow senior in what seems like the blink of an eye. Fortunately, as veterinary medicine has improved, so has our ability to identify and manage some of the most common health conditions associated with aging in dogs.

As veterinary medicine has improved, so has our ability to identify and manage health conditions. Here are 5 senior dog diseases you need to know.


When is my Dog a 'Senior'? Although the common wisdom tells us a dog’s age times 7 equals their equivalent age in human years, the truth is dogs age at different rates depending on their size. Giant breeds like Great Danes may have a life expectancy of less than 10 years, while an eight pound Chihuahua may live past 18. A more specific rule of thumb is that a dog can be considered a senior during the last quarter (25%) of his or her expected life span.

1. Osteoarthritis: Joint disease goes hand in hand with aging, as the cartilage that protects joint surfaces wears down with time. Although this process cannot be reversed, owners have plenty of tools at their disposal to reduce the impact of aging on joints and arthritis in dogs.

First, make sure your pet is at a healthy weight. Overweight dogs carry significantly heavier loads on their joints. This has an effect on dogs of all breeds, but is most pronounced in large breed dogs who may already have a genetic disposition to conditions such as hip dysplasia. Second, make sure your dog receives regular examinations to catch the early signs of joint disease. Familiarize with the signs of joint disease, too — reluctance to climb stairs, stiffness especially in the morning, and limping to name a few. Last but not least, ask your veterinarian about therapeutic dog food. Some diets are formulated specifically to improve mobility and joint health.

2. Dental Disease: One of the most commonly diagnosed conditions in dogs, dental disease occurs in all breeds and sizes of canines. Left untreated, periodontal disease can lead to pain, tooth loss, and bacteria in the bloodstream that can damage internal organs.

Home care such as tooth brushing and dental treats can help reduce tartar on the teeth, as can specialized foods meant to promote dental health. Once dental disease has developed, however, a fully anesthetized dental cleaning at the veterinary clinic in needed. Start early, before severe periodontal disease develops.


3. Obesity: More than half the dogs in the United States are classified as overweight or obese, and many owners don’t even realize it. Even worse, overweight dogs are susceptible to a litany of secondary problems such as joint disease, diabetes, and respiratory illness.

Exercise and calorie control are the keys to managing a pet’s weight. Senior dogs are often less active than their younger counterparts and have different caloric needs. Diets designed for seniors can help provide nutrients in the proper balance, often with different ratios of fat and protein than you would find in a standard adult dog food. Regular gentle exercise is beneficial even for dogs with health issues. Consult with your veterinarian to come up with a diet and exercise plan that is right for your pet.

4. Hypothyroidism: Overweight dogs that are following a vet-approved weight loss plan with little to no success may be suffering from hypothyroidism, a common condition in dogs that results in a sluggish metabolism. Fortunately, hypothyroidism can be diagnosed with a simple blood test and responds readily to medication.

5. Cancer: Sadly, dogs are susceptible to many of the same cancers seen in humans. Hemangiosarcoma, lymphoma, and mast cell tumors are just a few of the neoplasms commonly diagnosed in dogs via ultrasonography. Although there is a strong genetic component in some dog breeds like Golden Retrievers and Boxers, cancer can develop spontaneously in any breed. Early detection and diagnosis is the key to surviving dog cancer, so don’t skip those annual veterinary exams.]]><![CDATA[Case Spotlight: Vomiting Cat]]>Thu, 17 Mar 2016 18:07:08 GMThttps://www.azpetscan.com/pet-scan-blog-the-inner-pet/case-spotlight-vomiting-cat
Picture
A five-year-old neutered male Domestic Shorthair cat was presented with an acute history of anorexia and vomiting. Physical examination revealed a painful cranial abdomen. A complete blood count and blood chemistry profile were normal, and abdominal radiographs were unremarkable.

Findings
Abdominal ultrasound revealed a spastic duodenum (Figure 1), an enlarged, irregular, hypoechoic pancreatic body (Figure 2) and a hypoechoic left pancreatic lobe (Figure 3), as well as hyperechoic surrounding mesentery which surrounded the body and left pancreatic lobe. 

Differential Diagnosis
Pancreatitis
Acute gastroenteritis
Inflammatory bowel disease
Gastrointestinal obstruction
Peritonitis
Acute renal failure​

Diagnosis
Pancreatitis

Discussion
The cat responded well to medical management of pancreatitis with intravenous fluid therapy, famotidine and pain medication.

Pancreatitis is inflammation of the pancreas and it can be acute (sudden) or chronic (recurrent) in nature.  It is associated with a range of clinical signs that vary in severity, often overlapping with signs of acute gastroenteritis, inflammatory bowel disease, gastrointestinal obstruction, peritonitis, or acute renal failure.  Therefore, ultrasound is a very useful diagnostic tool to help differentiate among these similar presenting conditions.

The cause of pancreatitis in dogs and cats is usually unknown.

Source: soundvet.com
]]><![CDATA[Case Spotlight: Older Cat with Blood in Urine]]>Fri, 06 Nov 2015 19:17:32 GMThttps://www.azpetscan.com/pet-scan-blog-the-inner-pet/case-spotlight-older-cat-with-blood-in-urine
Picture
This is a case is a 13-year-old female spayed domestic short haired cat with history of hematuria (blood in the urine).

Findings
​The right kidney is markedly enlarged, with a rounded shape. It is distorting the abdominal wall on the v/d projection and displacing the ascending and transverse colon medially and ventrally. The left kidney also has an abnormal shape, with reduced length and increased width.
​
There is also spondylosis deformans at the L5-6 intervertebral disc space, which is an incidental finding.
On ultrasound images, both kidneys were surrounded by large cystic structures filled with echogenic fluid. There are fine septae visible in the pseudocyst surrounding the left kidney. Drainage of both collections of fluid were clear and colorless except for the last 15 ml from the right kidney, which was hemorrhagic. Both kidneys were small and irregular with poor corticomedullary distinction.

Differential Diagnosis
  • Perinephric pseudocysts
  • Hydronephrosis
  • Chronic renal disease
  • Subcapsular hematoma
  • Lymphosarcoma

Diagnosis
Bilateral perinephric pseudocysts and chronic renal disease.


Discussion
Perinephric pseudocysts are associated with chronic renal disease, but are often asymptomatic. The association between the pseudocysts and this cat’s hematuria is unclear. The hematuria may have been due to pressure from the pseudocysts, or idiopathic in nature.

Source: veterinaryradiology.net / Allison Zwingenberger
]]><![CDATA[New Research May Help Control Brown Dog Ticks]]>Mon, 08 Jun 2015 20:00:31 GMThttps://www.azpetscan.com/pet-scan-blog-the-inner-pet/new-research-may-help-control-brown-dog-ticksNew research may lead to more effective ways to control the brown dog tick, a species that can cause major problems for dogs and their owners.

University of Florida scientists say they found that the brown dog tick is resistant to permethrin, a widely used anti-tick chemical. They also found that carbon dioxide seems to be an effective way to lure ticks to bug traps.

Unlike other ticks, the brown dog tick can complete its life cycle indoors. One female brown dog tick can lay up to 5,000 eggs in its lifetime, the researchers said.

The bugs hide in hard-to-reach places. Some dog owners take desperate steps to be free of these ticks. These steps may include giving away their dogs, fumigating their homes, throwing out many possessions, or even moving, the researchers said.

"They're particularly troublesome for people who have cluttered homes, and they drive some homeowners to desperate measures in search of ways to control the tick," Phil Kaufman, an associate professor of veterinary entomology at the University of Florida, Gainesville, said in a university news release. "Eliminating places where ticks live and breed is one of the best practices for tick control."

Because the researchers found that the ticks are resistant to permethrin, pet owners and pest control companies should use the chemical fipronil. This anti-tick chemical should work in most cases, the researchers said.

However, dog owners should watch for loss of effectiveness with fipronil. An indication that fipronil isn't working is seeing ticks that appear to be alive and swelling within the month after treatment, the researchers said.

In addition to using pesticides, the researchers said vacuuming can help control ticks, too.

The finding on carbon dioxide suggests it may be possible to lure ticks from their hiding spots in nooks and crannies throughout the house to one location. This makes it easier to control them, according to Kaufman.

The results were published recently in the Journal of Medical Entomology.

Source: University of Florida, news release, May 19, 2015 / Robert Preidt

]]><![CDATA[Valley Fever (Coccidioidomycosis)]]>Thu, 16 Apr 2015 18:44:53 GMThttps://www.azpetscan.com/pet-scan-blog-the-inner-pet/valley-fever-coccidioidomycosisSan Joaquin Valley Fever, now called Valley Fever for short, was named because of an outbreak among farm workers in the well known San Joaquin Valley of California. The condition is caused by inhaling dust or dirt contaminated with a fungus called Coccidioides immitis. The fungus is inhaled into the lungs where it may simply cause a low grade chronic cough and calcification (mineralization) of local lymph nodes or, if the immune system is weak, it can cause pneumonia or even disseminate throughout the body.

About the Fungus

The fungus lives only in one area: the Lower Sonoran life zone. This area includes the southwest United States, Mexico and Central America as well as parts of South America. In these places, soil is sandy and alkaline. There is little rainfall. Summer is hot and winter is cold. Fungal spores, called arthroconidia, are released from the ground after a rainfall and are carried by the wind. Earthquakes or high winds or even crop harvesting have led to outbreaks of this infection as both conditions stir up fungal spores. Once the spores are in the air, they can be inhaled and set up infection.

Getting Sick

It has been estimated that 60% of animals and people that become infected with this fungus never get sick. It is only when antibodies indicating past infection show up on a blood test that infection is discovered.

But the other 40% do get sick. It only takes 1 to 3 weeks from the inhalation of fungal spores before coughing starts. Fever, weight loss, and appetite loss accompany the cough, which can be dry or productive. If the fungus escapes the lung and travels out elsewhere in the body, the infection has disseminated and prognosis is much worse. On the average, several months pass between the initial cough (which may be so mild as to have gone undetected) and signs in another organ system. There is an order by which the fungus disseminates in that it appears in certain organs before others. After the lung, the fungus spreads to bone, then eyes, heart, testicles, brain, spinal cord, and abdominal organs. In cats, the pattern is a bit different with the usual disease picture being draining skin lesions with fever, weight loss and poor appetite. The respiratory phase is rarely noted in feline patients.

An animal or person who is sick is not contagious; infection is only through inhalation of a fungal spore released from dirt, but only a few spores are necessary for infection to occur.

Testing

There are several diagnostics that can be helpful with this condition.

  • Radiographs
    The patient with a cough is likely to have x-rays taken of the chest. Findings will not be specific to Valley Fever; large lymph nodes and lung infiltration will likely be found. The point is to rule out other conditions that are more readily identifiable on radiographs such as heart disease, tracheal collapse, or more localized forms of pneumonia.
  • Cytology
    If some sort of tracheal wash or lavage is performed, where samples of lung fluid are collected for analysis, it is possible to capture some fungal spores. If this occurs, the diagnosis is confirmed, as Coccidioides immitis has a fairly characteristic large size and appearance.


  • Blood testing
    Blood testing is by far the least invasive way of diagnosing Valley Fever. Antibodies against the fungus are measured in a blood sample using one or even several different methods (tube precipitin, complement fixation, latex agglutination, gel immunodiffusion, or enzyme linked immunoassay). As mentioned, many patients are exposed to this fungus and do not get sick. These patients will absolutely have positive antibody tests so it is important not to treat an animal with a positive antibody level (also called an antibody titer) and no history of symptoms of any kind.
Treatment

A general rule with any fungal infection is that it takes a long time to clear. Valley Fever is no different and a year of medication administration is fairly common. Treatment continues until the clinical signs have resolved, the radiographs look normal, and the antibody level has stabilized (note antibody levels may never fully drop to zero). Ketoconazole, itraconazole,  and fluconazole are the usual drugs to treat this condition. Monitoring liver enzymes is important with all of these, particularly since long treatment courses are common.

Lufenuron, the active ingredient in the flea control product Program, was developed to inhibit the development of chitin (the crunchy exterior material of the insect body). The idea was that a flea larva who had fed upon blood pellets (flea dirt) from a pet treated with oral lufenuron would be unable to properly pupate into an adult flea. It turns out that the shell of Coccidioides immitis is also rich in chitin and that lufenuron at specific doses may be helpful in clearing this infection. This is still an experimental use but it may be worthwhile to ask your veterinarian about this product.

If the disease is limited to the lung, prognosis is felt to be good. The most severe form of infection appears to involve bone and when multiple bones are infected, complete recovery is unlikely unless amputation is possible. Eye involvement is painful and very difficult to clear short of removing the eye (enucleation). Obviously, a patient with any internal fungal infection should avoid immunosuppressive drugs for other conditions as their use could lead to a disastrous fungal dissemination.

Source: Veterinary Partner

]]><![CDATA[Immune Mediated Hemolytic Anemia (IMHA)]]>Fri, 20 Mar 2015 17:37:06 GMThttps://www.azpetscan.com/pet-scan-blog-the-inner-pet/immune-mediated-hemolytic-anemia-imhaImmune-mediated hemolytic anemia is a condition where the patient’s immune system begins attacking her own red blood cells. What occurs on a microscopic level is that the branch of the immune system that produces antibodies begins to direct them against the patient’s own red blood cells. The red blood cells quickly become coated with tiny antibody proteins, essentially marking these red blood cells for destruction. When too many red blood cells are destroyed the patient is said to be anemic and will feel cold and weak. Because the red blood cells are being destroyed internally (and not lost through bleeding), the patient will become yellow-tinged (jaundiced) rather than pale (see picture below).

Removing old Red Cells/Recycling Iron: The Normal System

Red blood cells have a natural life span from the time they are released from the bone marrow to the end of their oxygen-carrying days when they become too stiff to move through the body’s narrow capillaries. A red blood cell must be supple and flexible to participate in oxygen delivery and carbon dioxide removal, so when the cell is no longer functional the body destroys it and recycles its components.

When old red blood cells circulate through the spleen, liver, and bone marrow, they are plucked from circulation and destroyed in a process called extravascular hemolysis. Their iron is sent to the liver for recycling in the form of a yellow pigment called bilirubin. The proteins inside the cell are broken down into amino acids and used for any number of things (burning as fuel, building new protein etc.) The spleen uses immunological cues on the surface of red blood cells to determine which cells are plucked out of circulation. In this way, red cells parasitized by infectious agents are also removed from circulation along with the geriatric red cells. When the immune system marks too many cells for removal, problems begin.

The jaundiced/icteric pet has a yellow color in the gums and whites of the eyes.The spleen enlarges as it finds itself processing far more damaged red blood cells than it normally does. The liver is overwhelmed by large amounts of bilirubin and the patient becomes jaundiced (icteric), which means her tissues become a yellow/orange color.

Making matters worse, a protein system called the complement system is activated by these anti-red cell antibodies. Complement proteins are able to simply rupture red blood cells if they are adequately coated with antibodies, a process called intravascular hemolysis. Ultimately, there aren’t enough red blood cells left circulating to bring adequate oxygen to the tissues and remove waste gases.  A life-threatening crisis has emerged; in fact 20-80% mortality (depending on the study) has been reported with this disease.

Signs you Notice at Home
 
The jaundiced/icteric pet has a yellow color in the gums and whites of the eyes. Illustration by Wendy Brooks.Your pet is obviously weak. She has no energy and has lost interest in food. Urine is dark orange or maybe even brown. The gums are pale or even yellow-tinged as are the whites of the eyes. There may be a fever. You (hopefully) brought your pet to the veterinarian’s office as soon as it was clear that there was something wrong.
 
The Tests Show Anemia

Part of a general evaluation includes blood testing. If your pet seemed obviously pale or jaundiced (yellow-tinged), right off the bat your vet may run a test called a packed cell volume. This test can be run in most veterinary clinics and involves spinning a small amount of blood in a small glass tube at high speed to separate the red blood cells from the serum (the blood’s liquid phase). By comparing the blood tube to a chart, it will become obvious if your pet has a low red blood cell count. If your pet has hemolytic anemia, the serum will be bright orange instead of its normal off-white color.

The anemia may be seen on a full blood panel sent to a reference laboratory. These laboratories perform a test called a hematocrit, which is slightly different from a packed cell volume but essentially measures the same thing: the percentage of blood volume made up by red blood cells. This number should be 43 - 59 for dogs and 29 - 50 for cats.

Anemia is the condition where one’s red blood cell count is low. Anemia can be mild or severe and can represent bleeding, red blood cell destruction (as in IMHA), or simply lack of red blood cell production. Once a patient is found to be anemic, it is important to determine why.

The Tests Show Responsive Anemia

Anemia due to poor red blood cell production by the bone marrow is called a non-responsive anemia. Such anemias are caused by chronic inflammatory diseases (like inflamed skin, infected teeth, or other long standing irritations), kidney failure, cancers of various types, or certain drugs (especially agents of chemotherapy).

Normally when red blood cells are lost, the drop in blood oxygen that results causes hormonal changes leading to increased production of red blood cells by the bone marrow. These are called responsive anemias because the bone marrow is responding. Bleeding and immune mediated red blood cell destruction are both responsive anemias.

There are several ways to determine if the anemia is responsive or not from the blood panel results. Most blood panels run by reference laboratories include a portion called a complete blood count, or CBC, which reviews red blood cell count, size, shape, and maturity as well as white blood cell types and ratios. A patient with a responsive anemia will have an active bone marrow. Red blood cells will be released early leading to a variety of sizes and redness of red blood cells circulating in the blood (less mature red blood cells are larger and paler than mature cells). Further, red blood cell precursors called reticulocytes are released. (These may be thought of as red blood cells so immature they can’t truly be called red blood cells yet.) If the bone marrow stimulus is especially strong, red blood cells may be released still containing cell nuclei.

These findings indicate the anemia is responsive. This means either red blood cells are being lost through bleeding, possibly internal bleeding, or they are being destroyed by the immune system.

Which is it?

The Tests Suggest Immune-Mediated Destruction rather than Bleeding

There are several clues in blood testing that tell us if our patient is bleeding or destroying red blood cells. You might think it would be obvious if the patient were bleeding but if the bleeding is internal it may not be so obvious.

Icterus (also Called Jaundice)
We have mentioned this but let’s recap. Icterus is the yellow color that is taken up by a patient’s tissues when the liver is overwhelmed with bilirubin, the iron-containing by-product of red blood cell destruction.  Normally red blood cells are removed from the circulation when they become old and inflexible. Their iron is recycled in the liver. With so many red cells being destroyed, the liver is overwhelmed and bilirubin (a yellow pigment) spills out everywhere, coloring urine, gums, skin, and the eyes orange.

Is immune-mediated red cell destruction the only cause of icterus? Absolutely not. Liver failure also leads to icterus when the diseased liver cannot process normal amounts of bilirubin. In cats especially, bacterial endotoxin (the toxic cell walls of certain types of infecting bacteria) can lead to icterus. Usually, however, a responsive anemia together with icterus, suggests immune-mediated red cell destruction.

Spherocytes

A normal red blood cell is concave on both sides and shaped like a disc. It is slightly paler in the middle than on its rim. After a portion has been bitten off, it re-shapes into a more spherical shape with a denser red color. The presence of spherocytes indicates that red blood cells are being destroyed.

Autoagglutination
In severe cases of immune-mediated hemolytic anemia, the immune destruction of red cells is so blatant that the red cells clump together (because their antibody coatings stick together) when a drop of blood is placed on a microscope slide. Imagine a drop of blood forming not a red spot but a yellow spot with a small red clump inside it. This finding is especially foreboding.

Leukemoid Reaction
Classically, in IMHA the stimulation of the bone marrow is so strong that even the white blood cells lines (which have little to do with this disease but which also are born and incubate in the bone marrow alongside the red blood cells) are stimulated. This leads to white blood cell counts that are spectacularly high.

More Tests Needed

Coomb’s Test (also Called a Direct Antibody Test)
This test is designed to identify the antibodies that are coating red blood cell surfaces. This test is the current state of the art for the diagnosis of IMHA but, unfortunately, it is not as helpful as it might seem. It can be erroneously positive if there is any inflammation or infectious disease (which might lead to harmless attachment of antibody to red cell surfaces) or in the event of a prior blood transfusion (ultimately transfused red cells are removed from the immune system). The Coomb’s test can be erroneously negative for a number of reasons as well. If the clinical picture fits with IMHA, often the Coomb’s test is skipped.

Remember, not all causes of hemolysis (red blood cell destruction) are immune-mediated.  Onions in large amounts, and possibly garlic, will cause a toxic hemolysis. Zinc toxicity, usually caused from swallowing a penny minted after 1983 or from licking a zinc oxide ointment applied to the skin, will cause hemolysis as well. In a young animal, a genetic red blood cell malformation might be suspected.

Once there is a diagnosis of IMHA, efforts to determine an underlying cause should be made. 

Treatment and Monitoring During the Crisis

The patient with IMHA is often unstable. If the hematocrit has dropped to a dangerously low level, then blood transfusion is needed. It is not unusual for a severely affected patient to require many transfusions. General supportive care is needed to maintain the patient’s fluid balance and nutritional needs. Most importantly, the hemolysis must be stopped by suppressing the immune system’s rampant red blood cell destruction. We will review these aspects of therapy.

Transfusion
There are several products that may be helpful in treating the IMHA case. If the patient is in a crisis and needs immediate therapy, artificial blood may be a good choice. Artificial blood (Oxyglobin®) is made from hemoglobin harvested from cow’s blood. Because the patient does not receive actual red blood cells, the artificial blood does not further stimulate the immune system. Artificial blood does not require refrigeration and is likely sitting on the shelf ready to use at your veterinarian’s office. The disadvantage of artificial blood is that it does not last in the body like a well-matched blood transfusion does. The body begins removing artificial blood immediately so that the entire transfusion is probably gone in 48 hours or so. In IMHA, this may buy some time but since IMHA tends to have a long treatment course, it is likely that the patient will be back where they started from at that point. If a compatible donor is not readily available, sometimes an artificial blood transfusion buys enough time to find a compatible donor

Well-matched whole blood or packed red cells (a unit of whole blood with most of the plasma, leaving only a concentrated solution of red blood cells) may last longer. Compatible blood can last a good 3 to 4 weeks in the recipient’s body. The problem, of course, with IMHA is that even the patient’s own red blood cells are being destroyed so what chance do donated cells have? Cross matching of red cells is ideal but still may not lead to a good match given the hyperactivity of the patient’s immune response. For this reason, it is not unusual for several transfusions to become necessary during treatment.

Immune Suppression
Corticosteroid hormones in high doses are the cornerstone of immune suppression. Prednisone and dexamethasone are the most popular medications selected. These hormones are directly toxic to lymphocytes, the cells that produce antibodies. If the patient’s red blood cells are not coated with antibodies, they will not have been targeted for removal so stopping antibody production is an important part of therapy. These hormones also suppress the activity of the reticuloendothelial cells that are responsible for removing antibody-coated red cells.

Corticosteroids may well be the only immune suppressive medications the patient needs. The problem is that if they are withdrawn too soon, the hemolysis will begin all over again. The patient is likely to be on high doses of corticosteroids for weeks or months before the dose is tapered down and there will be regular monitoring blood tests. Expect your pet to require steroid therapy for some 4 months; many patients must always be on a low dose to prevent recurrence.

Corticosteroids in high doses produce excessive thirst, re-distribution of body fat, thin skin, panting, predisposition for urinary tract infection and other signs that constitute Cushing’s Syndrome. This is an unfortunate consequence of long-term steroid use but in the case of IMHA, there is no way around it. It is important to remember that the undesirable steroid effects will diminish as the dosage diminishes.

More Immune Suppression

If no response at all is seen with corticosteroids, supplementation with stronger immune suppressive agents is necessary. The two most common medications used in this case areazathioprine and cyclophosphamide. These are serious drugs reserved for serious diseases. Follow the links above to read more about specific side effects, concerns, etc.

Cyclosporine is an immune-modulator made popular in organ transplantation technology. It has the advantage over the two above medications of not being suppressive to the bone marrow cells. It has been a promising adjunctive therapy in IMHA but has two major problems: first, it is extremely expensive and second, blood level monitoring is necessary to ensure that the dosage is appropriate. This adds dramatically to the expense of treatment but ultimately may provide results not possible with other drugs.

Leflunomide is an immuno-modulator that is meant for patients with immune mediated diseases when corticosteroids either do not work or cannot be used. It is expensive (approximately $600 per month) but we may be hearing more about it in the future.

Human gamma globulin transfusion is a treatment that is reserved for patients for whom more traditional methods of immune suppression have been ineffective. The gamma globulin portion of blood proteins includes circulating antibodies. These antibodies bind the reticulo-endothelial cell receptors that would normally bind antibody-coated red blood cells. This prevents the antibody-coated red blood cells from being removed from the circulation. Human gamma globulin therapy seems to improve short-term survival in a crisis but, unfortunately, its availability is limited and it is very expensive.

Why did this Happen to your Pet?

When something as threatening as a major disease emerges, it is natural to ask why it occurred. Unfortunately, if the patient is a dog, there is a good chance that there will be no answer to this question. Depending on which study you read, 60-75% of IMHA cases do not have apparent causes.

In some cases, though, there is an underlying problem: something that triggered the reaction. A drug can induce a reaction that stimulates the immune system and ultimately mimics some sort of red blood cell membrane protein. Not only will the immune system seek the drug but it will seek proteins that closely resemble the drug and innocent red blood cells will be consequently destroyed. Drugs most commonly implicated include penicillins, trimethoprim-sulfa, and methimazole.

Drugs are not the only such stimuli; cancers can stimulate exactly the same reaction (especially hemangiosarcoma).

Red blood cell parasites create a similar situation except the immune system is aiming to destroy infected red blood cells. The problem is that it gets over-stimulated and begins attacking the normal cells as well.

There is some thinking that vaccination can trigger IMHA. Insect bites have also been implicated. Both have been temporally associated with the development of autoimmune hemolytic anemia. The relationship between recent vaccination and IMHA development is one of the factors that has led most universities to vaccinate dogs with the standard DHLPP every three years rather than annually.

Dog breeds predisposed to the development of IMHA include: cocker spaniels, poodles, Old English Sheepdogs, and Irish setters.

In cats, IMHA generally has one of two origins: feline leukemia virus infection or infection with a red blood cell parasite called Mycoplasma hemofelis (previously known as Hemobartonella felis).

Complications of IMHA

Thromboembolic Disease
This particular complication is the leading cause of death for dogs with IMHA (between 30-80% of dogs that die of IMHA do so due to thromboembolic disease). A thrombus is a large blood clot that obstructs (occludes) a blood vessel. The vessel is said to be thrombosed. Embolism refers to smaller blood clots spitting off the surface of a larger thrombus. These mini-clots travel and obstruct smaller vessels, thus interfering with circulation. The inflammatory reaction that normally ensues to dissolve errant blood clots can be disastrous if the embolic events are occurring throughout the body.

Heparin, a natural anticoagulant, may be used as a preventive in hospitalized patients or in patients with predisposing factors for embolism.

*Four to seven days are required for the bone marrow to generate a response. If hemolysis occurs suddenly there may not have been adequate time for a response. When this occurs, if there is any question about the responsive nature of the anemia, continued monitoring of the complete blood count will show a clear response in an appropriate time period. It should also be noted that in an especially unlucky patient, the red blood cell destruction may extend to the pre-red blood cells (reticulocytes, nucleated red cells and other precursors) within the bone marrow. If these cells are also destroyed, the condition is especially dangerous and it will take weeks rather than days to begin to see a response to treatment. The lack of circulating immature red cells will lead this anemia to test as non-responsive.

The 2002 study by Drs. Anthony Carr, David Panciera, and Linda Kidd at the University of Wisconsin School of Veterinary Medicine reviewed 72 dogs with IMHA looking for trends. Their findings are:

  • The only predisposed breed they found was the cocker spaniel.  
  • Most patients were female.  
  • The mean age was 6.8 years.  
  • Timing of vaccination was not associated with the development of IMHA.  
  • 94% of cases had spherocytes on their blood smears. 
  • 42% showed autoagglutination.  
  • 70% also had low platelet counts.  
  • 77% were Direct Coombs' positive.  
  • 58% were suspected of having disseminated intravascular coagulation.  
  • 55% required at least one blood transfusion.  
  • Mortality rate was 58%.  
  • Of those that died, 80% had thromboembolism present on necropsy (autopsy).

Prognostic Factors for Mortality and Thromboembolism in Canine Immune-Mediated Hemolytic Anemia. A.P. Carr, D. Panciera, L. Kidd. Journal of Veterinary Internal Medicine. 2002; 16: 504-509.

Another study
The 2005 study looking for trends by Drs. Tristan Weinkle, Sharon Center, John Randolph, Stephen Barr, and Hollis Erb at Cornell University reviewed 151 dogs with IMHA. They found:

  • Cockers spaniels and miniature schnauzers were both overrepresented (i.e., felt to be predisposed). These breeds, however, showed the same mortality rate as other breeds.  
  • Unspayed female dogs were overrepresented.  
  • Neutered male dogs were more commonly affected than unneutered male dogs (begging the question of whether male hormones might have some protective effect).  
  • The chance of survival either long term or short term was significantly enhanced by the addition of aspirin to the treatment protocol, especially when combined with azathioprine.  
  • Adequate vaccination information was not obtained for enough patients to comment on association with vaccination.  
  • 89% of affected dogs showed spherocytes on their blood smears.  
  • 78% showed autoagglutination.  
  • 70% of patients required at least one blood transfusion.  
  • Of the 151 dogs studied, 76% survived, 9% died, and 15% were euthanized. Survivors were hospitalized an average of 6 days. Non-survivors were hospitalized an average of 4 days.  
  • 100% of dogs that died or were euthanized showed thromboembolism on necropsy (autopsy).  
  • Of the dogs that survived 60 days or more, 15% experienced relapse. Most dogs treated with corticosteroids, azathioprine, and ultra-low dose aspirin did not experience relapse.

Source: Veterinary Partner]]><![CDATA[High Blood Pressure in Cats]]>Fri, 30 Jan 2015 20:25:29 GMThttps://www.azpetscan.com/pet-scan-blog-the-inner-pet/high-blood-pressure-in-catsSystemic Hypertension in Cats
Hypertension, more commonly referred to as high blood pressure, occurs when the cat's arterial blood pressure is continually higher than normal. When it is caused by another disease, it is called secondary hypertension; primary hypertension, meanwhile, refers to when it actually is the disease. Hypertension may affect many of the cat's body systems, including heart, kidneys, eyes, and the nervous system.

Symptoms and Types
The following are just some of the more common symptoms displayed by cats with high blood pressure:

  • Seizures
  • Circling
  • Disorientation
  • Blindness
  • Dilated pupils
  • Retinal detachment
  • Hemorrhage of the eye
  • Blood in the urine
  • Protein in the urine
  • Bleeding from the nose
  • Swollen or shrunken kidneys
  • Heart murmurs
  • Weakness, either on one side of the body or in the legs
  • Involuntary oscillation (rolling) of the eyeballs
  • Palpable thyroid gland (when hyperthyroid)

Causes
The cause of primary hypertension in cats is not known. However, it may have a genetic component. So how prevalent is this form of hypertension? Studies have varied, but one study found that 65 percent of cats with chronic renal failure and 87 percent of cats with hyperthyroidism had mild high blood pressure. Ages of cats with hypertension ranged 4 to 20 years old.

Secondary hypertension, which accounts for 80 percent of all hypertension cases, may be due to a variety of factors, including renal disease, hormonal fluctuation, and hyperthyroidism.

Diabetes may also be a cause for hypertension, although it is uncommon in cats. If you suspect that your cat is suffering from hypertension, bring it in so that your veterinarian may provide a proper diagnosis.

Diagnosis
Blood pressure is often measured in pets in the same manner as in humans. An inflatable cuff will be placed on the cat's paw or tail, and standard blood pressure measuring instruments will check the pressure. It is important to keep the cat still long enough to get an accurate reading.

The standards for cat blood pressure are:

  • 150/95 – at this reading or below, there is minimal risk and treatment is not recommended
  • 150/99 to 159/95 -- intervention is rotuinely not recommended at these readings
  • 160/119 to 179/100 -- treatment should be sought to limit the risk of organ damage
  • 180/120 -- immediate treatment should be sought to limit the degree of other more severe complications

Five to seven measurements are generally taken. The first measurement will be discarded, and the cat's excitement level during the procedure will be taken in account. If the results are in dispute, the procedure will need to be repeated.

Treatment
The underlying cause of the high blood pressure will be treated first. Otherwise, the cat will probably be on medication to control the blood pressure indefinitely. The medication of choice is either a calcium channel blocker or a beta-blocker. As to cat's diet, the veterinarian may recommend food that are lower in sodium.

Blood pressure should be checked regularly, and some lab tests may be ordered by your veterinarian to measure your cat’s reactions to the medication.
Source: PetMd
]]><![CDATA[New feline kidney disease research offers hope for earlier detection and improved quality of life]]>Fri, 30 Jan 2015 20:17:58 GMThttps://www.azpetscan.com/pet-scan-blog-the-inner-pet/new-feline-kidney-disease-research-offers-hope-for-earlier-detection-and-improved-quality-of-lifeFoundation For Feline Renal Research, the only 501(c)(3) nonprofit foundation dedicated exclusively to the understanding and treatment of feline kidney disease, is pleased to announce a $20,000.00 grant to the Royal Veterinary College, London, in support of their groundbreaking study "Unravelling The Genetic Basis for Blood Pressure and Kidney Function In the Cat". This important work, which is starting now, will be led by Dr. Rosanne Jepson, BVSc (Dist) MVetMed PhD DipACVIM DipECVIM MRCVS and Dr. Jonathan Elliott, MA, Vet MB, PhD, Cert SAC, Dip ECVPT, MRCVS.

Kidney disease is one of the biggest killers of companion cats; it causes great pain and suffering, and there is no cure. As many as one in three cats will ultimately develop the disease. The goal of this study is to isolate and analyze genes that influence renal disease and hypertension (the two diseases often go hand in hand).

According to Dr. Jepson, "Kidney disease is one of the most common conditions that we see in ageing cats. Some of these cats also develop high blood pressure (hypertension) which can result in damage, particularly to their eyes, and can lead to blindness. We know that, in human medicine, there are genes that are involved in both kidney disease and hypertension. At the Royal Veterinary College we have been studying these conditions for over 20 years. Thanks to the funding provided by Foundation For Feline Renal Research, we are now in a position to use newly developed cutting edge technology to look for gene associations in almost 1000 cats. As far as we know, this will be the first and largest study looking at genes associated with kidney disease and blood pressure in older cats. It's really exciting to be starting new work that we hope will expand our knowledge of both of these important conditions."

This humane study utilizes DNA from blood samples obtained for diagnostic purposes from companion cats during the course of their regularly scheduled veterinary visits. The samples, after being used for the necessary diagnostic purposes, were preserved for use in this study with the consent of the cats' human companions.

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