Heartworm Medication Importance

Heartworm disease is a serious and potentially fatal condition caused by parasitic worms living in the arteries of the lungs and occasionally in the right side of the heart of dogs, cats and other species of mammals, including wolves, foxes, ferrets, sea lions and (in rare instances) humans. Heartworms are classified as nematodes (roundworms) and are filarids, one of many species of roundworms. Dogs and cats of any age or breed are susceptible to infection. Learn more...

Where is Heartworm Disease?

Heartworm disease has been reported in all 50 states. The map below shows particularly endemic areas based on the number of cases reported by clinics.

History

The first published description of heartworm in dogs in the United States appeared more than 100 years ago in an issue of "The Western Journal of Medicine and Surgery."¹ Heartworm in cats was first described in the early 1920's.^{2, 3}
Since then, naturally acquired heartworm infection in cats and dogs is identified as a worldwide clinical problem. Despite improved diagnostic methods, effective preventives and increasing awareness among veterinary professionals and pet owners, cases of heartworm infection continue to appear in pets around the world.
¹ Osborne, TC. Worms found in the Heart and Bloodvessels of a Dog; Symptoms of Hydrophobia. The Western Journal of Medicine and Surgery, 1847.
² Riley, WA. Dirofilaria immitis in the heart of a cat. J Parasitol 1922;9:48
³ Travassos, LP. Notas Helminthologicas. Brazil-Med. An. 1921;35 2(6):67

How Heartworm Happens: The Life Cycle

First, adult female heartworms release their young, called microfilariae, into an animal's bloodstream. Then, mosquitoes become infected with microfilariae while taking blood meal from the infected animal. During the next 10 to 14 days, the microfilariae mature to the infective larval stage within the mosquito. After that, the mosquito bites another dog, cat or other susceptible animal, and the infective larvae enter through the bite wound. It then takes a little over 6 months for the infective larvae to mature into adult worms. In dogs, the worms may live for up to 7 years. Microfilariae cannot mature into adult heartworms without first passing through a mosquito.

What Are the Signs of Heartworm Disease?

For both dogs and cats, clinical signs of heartworm disease may not be recognized in the early stages, as the number of heartworms in an animal tends to accumulate gradually over a period of months and sometimes years and after repeated mosquito bites.
Recently infected dogs may exhibit no signs of the disease, while heavily infected dogs may eventually show clinical signs, including a mild, persistent cough, reluctance to move or exercise, fatigue after only moderate exercise, reduced appetite and weight loss.
Cats may exhibit clinical signs that are very non-specific, mimicking many other feline diseases. Chronic clinical signs include vomiting, gagging, difficulty or rapid breathing, lethargy and weight loss. Signs associated with the first stage of heartworm disease, when the heartworms enter a blood vessel and are carried to the pulmonary arteries, are often mistaken for feline asthma or allergic bronchitis, when in fact they are actually due to a syndrome newly defined as Heartworm Associated Respiratory Disease (HARD).

How Do You Detect Heartworm Disease?

Heartworm infection in apparently healthy animals is usually detected with blood tests for a heartworm substance called an "antigen" or microfilariae, although neither test is consistently positive until about seven months after infection has occurred.
Heartworm infection may also occasionally be detected through ultrasound and/or x-ray images of the heart and lungs, although these tests are usually used in animals already known to be infected.

Prevention

Because heartworm disease is preventable, the AHS recommends that pet owners take steps now to talk to their veterinarian about how to best protect their pets from this dangerous disease. Heartworm prevention is safe, easy and inexpensive. While treatment for heartworm disease in dogs is possible, it is a complicated and expensive process, taking weeks for infected animals to recover. There is no effective treatment for heartworm disease in cats, so it is imperative that disease prevention measures be taken for cats.
There are a variety of options for preventing heartworm infection in both dogs and cats, including daily and monthly tablets and chewables, monthly topicals and a six-month injectable product available only for dogs. All of these methods are extremely effective, and when administered properly on a timely schedule, heartworm infection can be completely prevented. These medications interrupt heartworm development before adult worms reach the lungs and cause disease.
It is your responsibility to faithfully maintain the prevention program you have selected in consultation with your veterinarian.

Treatment

Heartworms in the heart of a dog

Usually, all but the most advanced cases of heartworm disease can be successfully treated in dogs. Currently, there are no products in the United States approved for the treatment of heartworm infection in cats. Cats have proven to be more resistant hosts to heartworm than dogs, and often appear to be able to rid themselves of infection spontaneously. Unfortunately, many cats tend to react severely to the dead worms as they are being cleared by the body, and this can result in a shock reaction, a life-threatening situation. Veterinarians will often attempt to treat an infected cat with supportive therapy measures to minimize this reaction; however it is always best to prevent the disease.

Heartworms in the Pulmonary Artery of a dog

Adult heartworms in dogs are killed using a drug called an adulticide that is injected into the muscle through a series of treatments. Treatment may be administered on an outpatient basis, but hospitalization is usually recommended. When the dog is sent home, exercise should be limited to leash walking for the duration of the recovery period, which can last from one to two months. This decreases the risk of partial or complete blockage of blood flow through the lungs by dead worms.
Re-infection during treatment is prevented by administration of a heartworm preventive. These preventives may also eliminate microfilariae if they are present. Dogs in heart failure and those with caval syndrome require special attention.

Affects of Fleas and Ticks on You and Your Pet.

Where Did My Pet Get Fleas and Ticks?
     You probably won’t even notice that your pet is already suffering from a flea infestation because you’d seldom see them scratching at first. But as time goes by, the insects that are living in your pet’s fur multiply. Soon, you’ll not only notice excessive scratching, but you’ll also see skin irritation. Furthermore, such insects cannot be contained. If you allow your pet to roam inside your house, then the fleas and ticks will find their way to other food sources, which will be you and your family.
So, how did your beloved cuddly companion get infected?
It’s actually quite easy for your pet to get fleas or ticks. For one, stray dogs or cats easily spread these bloodsucking insects. Other wild animals, such as raccoons, which just passed by your neighborhood can distribute the eggs of such ectoparasites too. Once the eggs hatch, the insects will just be waiting to jump on your canine or feline companion as it frolics in your yard. Ticks also crawl up on shrubs or grass so that it’ll be easier for them to leap onto a possible host.
 Flea and Tick Effects on Animals
 When ticks and fleas feed on animals, they inject foreign substances that cause skin irritation. So, it’s very common for animals to experience skin irritation. Flea allergy is a more serious condition wherein the infected animal bites and scratches until its skin becomes raw and its hair falls off.
Pets can also get tapeworms and other dangerous conditions from such bloodsucking insects, such as canine anaplasmosis, canine hepatozoonosis, as well as anemia. Other tick-borne diseases that can severely affect humans, such as Lyme disease, babesiosis, and ehrlichiosis, can also be fatal to animals. But not all disease-causing organisms affect dogs and cats the same way. For instance, cats don’t get Lyme disease but they can contract tularemia. Hence, once you notice fleas and ticks on your domestic furry companions, act immediately to get rid of the pests.
Also, visit your vet if you believe that your animal is sick because of a pest infestation. Flea and Tick Effects on People Just like bed bugs, fleas can transmit pathogens that cause tapeworms, murine typhus, cat scratch fever (bartonella henselae), and also the rare but serious bubonic plague.
As for ticks, there are different species that transmit organisms that cause Lyme disease, Rocky Mountain spotted fever, and tularemia, to name a few. The most common condition that people experience from fleas and ticks is skin irritation. The bite of such creatures can be extremely itchy and overly scratching the affected area can injure the skin. Once the skin is injured, it’s easier for other organisms to cause infection. Call us at 940-855-0451 today to assure your pets and you are protected against theses pesky insects.

Flea and Tick Prevention

Flea and tick prevention is an important part of taking good care of your cat or dog. That’s because pets can get a variety of diseases from fleas and ticks. And flea and tick bites can make your pet (and you!) very uncomfortable. But flea and tick preventives contain substances that can be harmful if not handled properly, so it’s important to know how to use these products safely.

When to Use Flea and Tick Control Products

When should you treat your cat or dog with flea or tick products? It depends on where you live. Fleas are worst during warm weather months, but they can live inside all year long. Spring and summer can also be the worst time for ticks. In some areas of the U.S., they survive year-round. If you see signs of fleas or ticks on your pet, be sure to treat them right away. Otherwise, start treating at the beginning of flea or tick season.

Types of Flea and Tick Prevention

Many products are available for flea control in cats and dogs. Some products also prevent ticks or other pests. The most popular products for their effectiveness at A Caring Heart Veterinary Hospital are: Vectra, Trifexis, Preventic Collars, Ovitrol, Siphotrol and Knockout.

Flea and Tick Prevention: Medication Safety Guidelines

1. Check with your vet before using flea and tick products, even if you purchase them over the counter. This is especially important for elderly or sick pets, puppies or kittens, pets who are on other medications, or pets who are pregnant or nursing. For these and pets that have had reactions to tick and flea products, your vet may suggest using a flea comb instead to pick up fleas, eggs, and ticks. Deposit them in hot, soapy water.

2. Read and carefully follow instructions when using flea and tick products. Do not use dog products on cats or cat products on dogs. Cats are very sensitive to insecticides – a few drops of a spot-on treatment designed for dogs can be fatal to a cat. Only apply the amount needed for the size of your cat or dog. Never double up on products – applying powders in addition to spot-on products, for example.

3. Wear gloves or wash your hands with soap and water after applying a flea and tick preventive. Be sure to follow the instructions for proper storage and disposal of packaging.

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4. When applying spray or spot-on flea and tick preventives, keep pets separate while the product dries. This will keep them from grooming each other and swallowing the chemicals.

5. After applying a product, watch your cat or dog for signs of a reaction, especially if it’s the first time you’re using it. Call your vet if your pet has symptoms such as:

• Poor appetite
• Vomiting or diarrhea
• Excessive salivation
• Depression

If you cat or dog has a bad reaction to flea and tick products such as spot-ons, sprays, or powders, immediately bathe your pet thoroughly with soap and water and follow any instructions from the package insert. Call your vet at 940-855-0451 and report problems to the National Pesticide Information Center at 1-800-858-7378.

Pet Arthritis

Arthritis can have a variety of causes. Prior trauma, degenerative disease, developmental disorders, and infection are just some of the most common causes for a painful joint. Although most people think “old dog” when they hear the word arthritis, it affects all sorts of pets, of all ages. What are the symptoms? The signs of arthritis are many and often subtle, and may go unnoticed until well into the disease process. Pets with arthritis don’t tend to cry out in pain, leading many people to think that their older pet is “just slowing down” instead of having a medical problem that can be helped. Owners may notice slowness when the pet rises from the floor or a seated position, especially in the morning; being a little cautious on the stairs; a subtle but persistent limp. Cats are even more subtle in their disease symptoms, which may be nothing more than reluctance to jump onto a counter or bed. Once your veterinarian confirms the diagnosis of arthritis, there are many treatment options that can help your pet age gracefully and feel more spry and limber well into his or her golden years. Treatment options: Many people come into my clinic and tell me, “Oh, he’s slowing down, but he’s just getting older,” thinking nothing can be done. Nothing could be further from the truth! Here are a few of the possible treatments I go over with people in my clinic: 1.Heat therapy: There are lots of choices to help pets through the cold winters. Sweaters and heated pet beds are some of the most common choices. There are heating pads on the market specifically made for dogs, with pet-friendly fillings and Velcro straps to help the pad stay on a canine hip. Ask your vet for recommendations so you don’t unintentionally cause burns to your pet with a heating source she can’t get away from. 2.Prescription medications:The most well-known choice for arthritis treatment, medication can be a lifesaver for many dogs and cats. Non-steroidal anti-inflammatory drugs (NSAIDs) are the most commonly used, though other options are available. Products such as Rimadyl, Deramaxx, Previcox, Metacam, and Zubrin are some of the most popular options.While it’s tempting to just ask your vet for a prescription, there are a few things you need to keep in mind, as NSAIDs are not without side effects. Your veterinarian will want to monitor your pet regularly and will likely require blood work to make sure his liver and kidneys are functioning well. Pets with other medical conditions may be best served by other treatment options. Do not give your pet any over-the-counter human medications! They are not as effective in pets as in people, and carry the risk of some very serious side effects. Just ask the Rottweiler I treated who had a perforated gastrointestinal ulcer after taking Aleve. 3.Dietary supplements such as glucosamine and chondroitin sulfate: So-called neutraceuticals that support joint function and help reduce inflammation are very popular with both people and pets. While usually not strong enough to be the sole treatment in later-stage disease, they are an excellent addition to other treatments and can help slow down the degenerative process in inflamed joints. There are many brands in various forms, from flavored pills to liquids, and most are available over the counter. 4.Adequan injections: Adequan is a cartilage component, given as a series of injections, that provides building blocks for damaged cartilage in addition to slowing down the enzymes responsible for degeneration. This is an FDA-approved product that, like glucosamine and chondroitin sulfate, can be used in conjunction with other treatments. 5.Acupuncture: Lots of people may chuckle at the idea of a dog relaxing on the exam-room floor with needles sticking out of his head, but those who have seen the results aren’t laughing — they’re smiling. Acupuncture has been shown to reduce pain and increase endorphin release in arthritic pets, often reducing and sometimes eliminating the need for prescription medications. This can be a boon to pets who are unable to use NSAIDs due to underlying renal (kidney) disease or other medical conditions. Acupuncture can be performed in combination with other treatments. 6.Weight control: Without question, the pain and inflammation of arthritis is worsened by carrying extra weight. Owners who have spent hundreds of dollars on medications are often amazed at the difference in their pet when they finally give in and commit to a weight-loss regimen for their overweight pet. Arthritic dogs don’t like to exercise, leading to more weight issues, leading to more arthritis — it’s a vicious circle. But low-impact exercise such as walking combined with a diet is extremely beneficial to arthritic pets. The bottom line is, there are many approaches to managing arthritis, and the most successful ones combine more than one of the above treatments. With your veterinarian’s guidance and your own commitment, you can do a great deal to improve the quality of life for your arthritic pet!

Top 10 Reasons To Spay and Neuter Your Pet

The top 10 reasons to get your pet spayed and neutered. 1.Your female pet will live a longer, healthier life. Spaying helps prevent uterine infections and breast cancer, which is fatal in about 50 percent of dogs and 90 percent of cats. Spaying your pet before her first heat offers the best protection from these diseases. 2.Neutering provides major health benefits for your male. Besides preventing unwanted litters, neutering your male companion prevents testicular cancer, if done before six months of age. 3.Your spayed female won't go into heat. While cycles can vary, female felines usually go into heat four to five days every three weeks during breeding season. In an effort to advertise for mates, they'll yowl and urinate more frequently—sometimes all over the house! 4.Your male dog won't want to roam away from home. An intact male will do just about anything to find a mate! That includes digging his way under the fence and making like Houdini to escape from the house. And once he's free to roam, he risks injury in traffic and fights with other males. 5.Your neutered male will be much better behaved. Neutered cats and dogs focus their attention on their human families. On the other hand, unneutered dogs and cats may mark their territory by spraying strong-smelling urine all over the house. Many aggression problems can be avoided by early neutering. 6.Spaying or neutering will NOT make your pet fat. Don’t use that old excuse! Lack of exercise and overfeeding will cause your pet to pack on the extra pounds—not neutering. Your pet will remain fit and trim as long as you continue to provide exercise and monitor food intake. 7.It is highly cost-effective. The cost of your pet's spay/neuter surgery is a lot less than the cost of having and caring for a litter. It also beats the cost of treatment when your unneutered tom escapes and gets into fights with the neighborhood stray! 8.Spaying and neutering your pet is good for the community. Stray animals pose a real problem in many parts of the country. They can prey on wildlife, cause car accidents, damage the local fauna and frighten children. Spaying and neutering packs a powerful punch in reducing the number of animals on the streets. 9.Your pet doesn't need to have a litter for your children to learn about the miracle of birth. Letting your pet produce offspring you have no intention of keeping is not a good lesson for your children—especially when so many unwanted animals end up in shelters. There are tons of books and videos available to teach your children about birth in a more responsible way. 10.Spaying and neutering helps fight pet overpopulation. Every year, millions of cats and dogs of all ages and breeds are euthanized or suffer as strays. These high numbers are the result of unplanned litters that could have been prevented by spaying or neutering. Call 940-855-0451 to schedule your appointment.

Kidney Failure in your Pets

What Happens When A Pet’s Kidneys Fail? First, you need to know something about the work of the kidneys. Kidneys keep your pet’s body free of the wastes that accumulate during metabolism. They are continually scrubbing the blood free of excess salts, water and metabolites. The actual removal of wastes occurs in tiny systems within the kidneys called nephrons. There are almost one million of these structures in a single human kidney. Each nephron contains a small sieve-like filtering structure called a glomerulus. These glomeruli (plural form) keep normal blood proteins and cells in the bloodstream, while allowing extra fluid and wastes to pass through to end up in the pet’s urine. A complicated chemical exchange takes place, as waste materials and water leave the blood and enter the urinary system. The kidneys also regulate the body’s acidity and, through regulation of body salt content, they help control blood pressure. Cells associated with healthy nephrons produce an important hormone called erythropoietin and and enzyme called renin. Erythropoietin is necessary for the pet’s body to produce and maintain red blood cells while renin activates another hormone (angiotensin) to helps control blood pressure. In addition, healthy kidneys are required to process vitamin D into calcitriol to preserve calcium for bones and for normal calcium balance in the body In chronic kidney disease these glomeruli are scarred and lost, or plugged up with proteins and inflammatory cells. Without enough functioning glomeruli, none of the processes I have mentioned work normally. But My Pet Is Still Producing Plenty Of Urine – More Than Before ! The animal body is marvelous in sensing when it has a problem. In an attempt to keep the body waste-free, your pet’s kidneys work overtime, using their small remaining capacity to remove waste. This accounts for the excess thirst and urination you have seen in your pet. For a while, this compensation keeps it’s body clean enough of wastes to function, but gradually, the pet can not consume enough water to keep waste levels in check. By the time your pet experiences weight loss, anemia, and abnormal blood work results, over half of its kidney glomeruli have been lost. You pet can not replace them. What Are The Signs Of Kidney Disease In My Pet? The first sign that there is a problem is when your pet begins to drink water and urinate excessively. At first, it is normal for owners to ignore this. It might just be that your dog wakes you up during the night to be let out or that your cat’s water bowl had to be filled more than it used to. But with time, the pet begin to loose weight and become a more finicky eater. About this time, the pet’s energy levels tend to decrease. They play less, romp less and sleep more. Generally, their coat lacks the luster it once had. This is often when pets are first taken by their concerned owner to see their veterinarian. In advanced kidney disease, pets will no longer eat. They often have digestive disturbances such as nausea, retching and diarrhea. Their water intake decreases and they become dehydrated. They may stand over their water or food bowl without attempting to eat or drink. These pets have developed uremia – an intolerably high level of nitrogen-containing metabolic waste products in their blood. Because these toxic waste products all contain the azo-molecular grouping of nitrogen, another term for uremia is azotemia. Why Did This Happen To My Pet ? Veterinarians know the things that make a pet’s kidneys fail suddenly. We are much less certain why they are more likely to fail gradually. Many causes have been discussed that seem logical – but few of them have been proven to be true. Regardless of the cause, all cases of chronic kidney disease develop the same signs and pass through the same stages. Usually, your veterinarian will just tell you your pet has CRF. This is because, in most cases, there is no way for the veterinarian to determine the cause. The Wear And Tear Of Time There was a time – not so long ago – when infectious diseases and dietary deficiencies ended the lives of dogs and cats early. But with advances in pet nutrition, antibiotics and sophisticated surgery, our pets now live much longer. Nothing lasts forever and every organism has its weakest link. Cells of the kidney cannot replace or regenerate themselves as they do in the liver, lungs, bone and skin. Once a glomerulus ages and is lost, it is lost forever. This is probably the most common cause of kidney failure in dogs and cats. Polycystic Kidney Disease Some cats and dogs were destined from birth to loose kidney function too early in life. These pets inherited genes that cause fluid-filled sacks (cysts) to form within their kidneys. As these cysts gradually grow in size, they crowd out and destroy the functional tissue (glomeruli) within the pet’s kidneys. This is an inherited problem in certain purebred cats. It is much less common in dogs, but it does occasionally occur in them – particularly in terriers and beagles. Chronic interstitial Nephritis Chronic interstitial nephritis is the most common form of kidney damage in older dogs. It occurs less frequently in cats. Nephritis is a term for inflammation of the kidneys. The tissue that surrounds the nephron filters is called the interstitial tissue. It is the matrix that suspends the nephrons - much like stars are suspended in space. Pathologists that examine kidney tissue from pets with failing kidneys have noticed that many have a higher than normal number of inflammatory cells invading this area. This low-grade, chronic inflammation is thought to cause scaring that eventually destroys most of the nephron filters. Acute (sudden) nephritis can occur in dogs that are infected with leptospirosis. Leptospirosis is diagnosed less frequently in cats. After the acute phase of this disease, the organism responsible sometimes lingers for long periods of time in the pet’s kidneys, causing a chronic nephritis. However, most dogs with chronic interstitial nephritis show no evidence that they were ever infected with leptospirosis. Pets suffering from chronic interstitial nephritis have small, shrunken, hard kidneys due to scarring. If the pet is not too chubby, it is often easy to palpate and identify these shrunken firm kidneys during a routine veterinary exam. Chronic Over-stimulation Of The Pet’s Immune System Your pet’s kidney glomeruli act as a sieve, straining and filtering blood as it passes through it. Very large molecules in the blood have a tendency to collect there and appear to slowly damage the kidney’s filtering-ability. Some of these large molecules are antibodies combined with antigens (immune complexes). Many chronic infectious and auto-immune diseases produce immune complexes. These include lyme disease, chronic skin infections, chronic intestinal disease, overactive adrenal glands and diabetes. Chronic gum disease (periodontal disease) is associated with kidney damage in humans. It is associated with heart disease in dogs. We do not yet know if it is a risk factor for kidney disease in pets. A type of destructive protein sometimes accumulates in the kidneys. It is called amyloid (amyloidosis). In some cats, this is a genetic disease. But it is also know to occur subsequent to long-term over-stimulation of the immune system. Abyssinians and Siamese cats, shar pei and akita dogs all have a higher than normal incidence of amyloidosis which can lead to kidney failure. A similar form of kidney damage in pets occurs in auto-immune diseases that are similar to lupus in humans. In this disease, run-away antibodies are produced against the pets own body. In some cases, these antibodies are directed at the pet’s kidneys themselves, in others, they may only accumulate there causing physical damage. Hyperthyroidism In Cats And High Blood Pressure An overactive thyroid gland or hyperthyroidism has become a very common problem in older cats. You can read an article on this problem here to see what some of your options are. We are uncertain why it is occurring more frequently, but we know that it often occurs concurrently with kidney disease. Hyperthyroidism often masks the signs of kidney failure, and it is only when your veterinarian resolves your cat’s thyroid problem that it becomes apparent that the cat’s kidneys are failing. We know that hyperthyroidism may cause your cat’s blood pressure to be abnormally high. We also know that high blood pressure leads to kidney failure. This is probably why hyperthyroidism and kidney failure go hand-in-hand in cats. Lower Urinary Tract Disease Feline Urological Syndrome (FUS) is another disease that has become very common. In this condition, a pasty grit (struvite crystals) irritates and sometimes plugs the cat’s urethra, preventing normal urination. When the urethra is partially or completely plugged and the cat cannot pee, urine pressure builds up in the bladder, up the tubes to the kidneys (ureters), and into the kidneys themselves. Abnormally high urine pressure in the kidneys slowly destroys them. The condition is called hydronephrosis. However most cats that loose their normal kidney function do not show the kidney changes associated with hydronephrosis. In dealing with FUS, cats are often placed on diets that are very acidic, in an attempt to prevent struvite crystals from forming. Some veterinarians believe that the acid urine these diets produce is unhealthy for the kidneys and may be one reason that they fail. The pH of these diets has recently been adjusted upward to take this into account. How Will My Veterinarian Diagnose Kidney Disease In My Pet? The history you give your veterinarian, your pet’s age and the veterinarian’s physical examination of your pet may make your veterinarian suspect a chronic kidney problem. As kidneys scar, they become hardened, small and lumpy. In lean pets, they have a characteristic feel when felt through the abdominal wall. In these cases, and when a diagnosis is unclear, your veterinarian will run tests. Blood and urine tests that warn of kidney damage are included in all standard laboratory examinations. When your pet feels poorly and the cause is uncertain, these are the first tests your veterinarian will run. For normal results, see my article on normal blood values. Urine Specific Gravity When your veterinarian asks you to bring in a urine specimen from your pet, its specific gravity will be checked. This tells your veterinarian how concentrated the urine sample is. Pets that have weakened kidneys cannot produce concentrated urine. The lower the specific gravity, the more serious the kidney problem is likely to be. However, anything that causes your pet to drink excessively will also lower urine specific gravity. That is why it is wise to collect your pet’s urine specimen as soon as possible after it rises in the morning and before it has consumed water. For certain analysis, it is better if the veterinarian collects the sample. Urine Protein Content And Microscopic Urine Examination Failing kidneys leak blood proteins into the urine. Most of this protein is albumin. A high urine protein content is often an early sign of sudden or long-term kidney damage. The presence of white blood cells and debris in the urine help veterinarians tell the difference between sudden (acute) and chronic (long-term) kidney disease. Blood Urea Nitrogen (BUN) Blood urea nitrogen, a waste product of metabolism, rises in the blood of pets with failing kidneys. It’s level stays within a relatively narrow range in the blood of healthy pets. BUN level in the blood of ill pets begins to rise when not enough healthy kidney tissue remains to excrete it into the pet’s urine. The higher its level in the blood - the more serious the kidney problem is likely to be. Blood urea nitrogen and creatinine levels are the prime way veterinarians decide if their treatment of kidney disease in your pet is working. You will have many of these tests run on your pet during therapy. Blood Creatinine Level Creatinine is a protein metabolite of muscle that tends to rise and fall in tandem with BUN. Creatinine-determination is a more sensitive test for kidney disease then BUN-determination because blood levels of creatinine fluctuate less than urea nitrogen in response to a pet’s being dehydrated or consuming a high-protein meal. So BUN and Creatinine tests are almost always run together. The results are often expressed as a BUN:Creatinine ratio. Blood Phosphorus & Calcium Determination Phosphorus is one of the mineral constituents of blood. The foods your pet consumes are very high in phosphorus. It's failing kidneys have difficulty excreting sufficient phosphorus into the urine. An elevated blood phosphorus level is another sign of failing kidneys. As the ratio of phosphorus to calcium in the blood becomes abnormal, the pet’s bones will weaken. This is why pets in kidney failure need to be fed diets low in phosphorus. Pets with kidney damage may also loose their ability to produce calcitriol. When this occurs, they can no longer absorb sufficient calcium from the foods they eat. Potassium Proper internal levels of potassium are very important to your pet's well being. When a pet’s kidneys fail, its body potassium levels rise. This problem, called hyperkalemia causes generalized fatigue, nausea and an irregular, slow heartbeat that can be life threatening. However, when pets with advanced kidney disease loose their appetites, their blood potassium level can fall dangerously low. Packed Cell Volume (hematocrits, Hct, PCV) Your pet’s packed cell volume is a measure of possible anemia. When a pet with kidney failure has a PCV that is abnormally low, it is not manufacturing sufficient red blood cells. One of the hormones involved in red blood cell manufacture is produced in the kidneys. It is called erythropoetin. When your pet’s kidneys deteriorate, not enough of this hormone is produced. Blood Pressure You veterinarian may also measure your pet’s blood pressure. It is common for pets with chronic kidney disease to also have abnormally high blood pressure. It is unclear if the high blood pressure is part of the cause of kidney damage, or the result of kidney damage. High blood pressure is known to damage the kidneys – but kidney disease is also known to elevate blood pressure. This is called secondary hypertension. What Treatment Options Do I have For My Pet? In the future, we may be able to regenerate failing organs. But for now, there is no known way to mend damaged kidneys. What veterinarians can do is to try to slow the rate at which your pet's kidney tissue is lost and deal with the side effects of the loss. Kidney failure is progressive – that means that with time it will get worse. The key to gaining time for your pet is to use the its remaining kidney tissue as efficiently as possible. We try to do this through diet, medications and, when necessary, fluid injections (diuresis). A Special Diet Commercial diets, designed for kidney failure are considerably lower in protein (1/3 - 1/2 the amount) and sodium than ordinary pet foods. They also have added omega 3 and omega 6 fatty acids and compounds like potassium citrate to counteract body "over-acidity" and they are drastically lower in phosphorus. But your pet's health on protein restricted diets needs to be monitored carefully. Blood tests need to be done periodically to be sure that its blood protein levels have not dropped too low and that the pet's body weight remains stable. When you do that, and the pets BUN and Creatinine levels drop or remain stable, protein restriction is a very positive step. But there are periods in a pet's ongoing fight with renal disease when restricting protein might not be a good thing to do.For example, when 7/8th of its kidney's filtering apparatus has been lost. Cats do not tolerate low protein diets as well as dogs. And they do not metabolize added carbohydrates as well. It may be wiser to depend more on added fat and fiber for dilution of the cat's protein consumption rather than a large amount of added plant carbohydrates. (Higher fat diets can be beneficial to kidneys. Ketoacids, as sold through body building outlets, can also act as a substitute for dietary protein in certain instance. Always make your pet's dietary changes gradually. No matter what you decide to feed, we always want to limit your pet's consumption of phosphorus. The foods naturally highest in phosphorus are the common high-protein foods, meat, poultry, fish, dairy products, peas and beans. Limiting the amount of sodium your pets ingests is also wise when its kidneys are failing - so commercial-prepared kidney diets limit the amount of sodium-rich ingredients in their foods. They also add omega-3 and omega-6 fatty acids that are found in cold-water fish and fish oils combined with flax seed. In advanced kidney disease, when your pet's BUN is over 60 mg/dl, most vets believe that moderately restricting protein in your pet's diet does become important. Vitamin Supplements Pets with kidney problems often have poor appetites, weight loss and anemia. They may suffer digestive disturbances as well that could limit the absorption of vitamins. So B-vitamins are often given as appetite stimulant and to ward off any deficiency. ACE Inhibitor Medications An organ as basic as the kidney does not appear to vary much between mammals. Experiments in kidneys disease are most acceptable to animal welfare advocates these days when they are done in rats. The cells that researches zero in on in declining kidney function are the podocytes , cells in the kidney's filtering apparatus that underlies its blood-cleansing abilities. Once podocytes loss begins, like a tree, bent to a severe angle by a storm - it will continue to slowly fall even after the wind ceases even though the remaining filers "super nephrons" enlarge (hypertrophy) and work harder. There is considerable evidence that medications called ACE inhibitors can slow that loss. In fact, ACE inhibitors might actually restore or aid in renal (kidney) repair. The ones most often chosen in pets are benazepril. and enalapril If your pet is placed on an ACE inhibitor, it is wise to be sure that its blood creatinine levels do not increase. In later kidney failure when the remaining kidney filters (glomeruli) are filtering way above their normal capacity, ACE inhibitors occasionally drop the kidney's internal pressure so low that the pet's uremia actually worsens. The best monitoring test in those situations is a 24 hours creatinine clearance test or another test that estimates the pet's GFR. The most common side effect of ACE inhibitors in pets are stomach/intestinal upsets, constipation and weakness do to too low a blood pressure. In those cases, the dose needs to be reduced. Sometimes these side effects can be lessened if you begin these medications at a low dose and gradually increase them to the desired dose. Phosphorus binders Certain compounds called phosphate binders can block the absorption of phosphorus from your cat's foods while it is still within its digestive system. At one time, aluminum hydroxide was suggested. Dieticians now think that more modern products that are free of aluminum are safer. Some common ones are calcium acetate (PhosLo) and sevelamer (Renagel). Calcitriol Since pets with advanced kidney disease may not produce adequate amounts of active vitamin D in their kidneys, the preformed compound, calcitriol, can be given to them. It is generally given when blood calcium/phosphorus levels and ratios become abnormal. Potassium Supplements Potassium supplements (Tumil K, etc.) help when the pet’s blood potassium level drops too low. This sometimes helps combat the listlessness and weakness that accompanies advanced kidney failure. Erythropoetin – Red Blood Cell Growth Factors Sold as Epogen, Betapoietin or Eporel, these compounds encourage your pet to produce red blood cells and so combat anemia. Because these compounds were engineered for humans , dogs and cats eventually cease responding to them. But they often do raise the pets PVC for a time. There is a danger in giving this product. When the pet's immune system decides to attack human erythropoetin as a foreign protein, it not only destroys the human erythropoetin that was given - it also destroys the pets natural erythropoetin. So it can make the anemia even worse. It should only be used as a last ditch effort. Fermentable Fiber Fermentable or soluble fiber, when added to a pets diet, also helps remove toxins from its body. Because of this, it is often an ingredient in commercial diets sold to manage kidney failure in pets. In these diets, the source is sugar beet pulp. It is sold in quantity to stables as a horse feed additive. Fluid Administration There comes a time with all pets when they no longer drink enough water on their own to fully utilize their remaining kidney capacity. Early in this period, you can give your pet additional fluids orally or add additional liquid to its food. When that is no longer sufficient, the fluids needs to be give periodically under the pet’s skin by injection. The effect is called diuresis. Its effect in flushing out lowering blood toxins from your pet can be dramatic. Many owners learn how to administer these subcutaneous fluids at home. In most cases, there is no benefit in giving them intravenously. Pets with failing kidneys do need emergency intravenous fluids when they are presented severely dehydrated to veterinarians. How Long Will My Pet Live? That is completely dependent on the level of toxins in your pet’s blood. Pets with blood creatinine levels below 2.8 mg/dl usually do well for long periods. Pets with blood creatinine levels of up to about 4 mg/dl have also survived happily for many years with appropriate treatment. But when your pet's creatinine levels exceed 5, its quality of life has become quite poor. Level of 5 and above mean that 80-90% of their kidneys have been destroyed. It is possible to keep these pets alive – but I question the kindness of doing this. Your pet loves you very much. But it is a two way street - it is relying on you to end its life peacefully and humanely when the right time comes. Kidney Transplants Kidney transplants are an option for pets if you are fortunate enough to be able to afford them. They are much more successful in cats than in dogs. Currently, a little more than half of the cats that have kidney transplants survive six months. Of those that do, many have lived an additional three years. Success rates for transplant surgery generally go up as specific veterinary centers gain more and more experience with procedures. Transplantation surgery in cats is still in its infancy. Success rates vary from one veterinary center to another. It is not just the expertise of the surgeons that accounts for this. Some Centers are willing to try transplant surgery on pets that are already seriously ill. In those cases, the overall success rate will be lower than at Centers that confine their surgery to more healthy pets. Dogs do not fare as well with kidney transplants. The biggest obstacle to kidney transplantation in dogs is rejection of the new kidney. Powerful immunosuppressive drugs must be given to the dog for the rest of its life. These drugs have serious side effects of their own. Centers that once performed the procedure on dogs have ceased to do so. But others are always begin programs that attempt to get around the hurdle of rejection in novel ways.

Winter Tips for your Pet!

Winter's cold air brings many concerns for responsible dog owners. Keep the following precautions in mind: •Don't leave your dog outside in the cold for long periods of time. Wind chill makes days colder than actual temperature readings. Be attentive to your dog's body temperature, and limit its time outdoors. •Adequate shelter is a necessity. Keep your dog warm, dry and away from drafts. Tiles and uncarpeted areas may become extremely cold, so make sure to place blankets and pads on floors in these areas. •Be extra careful when walking or playing with your dog near frozen lakes, rivers or ponds. Your dog could slip or jump in and get seriously injured. •Groom your dog regularly. Your dog needs a well-groomed coat to keep properly insulated. Short- or coarse-haired dogs may get extra cold, so consider a sweater or coat. Long-haired dogs should have excess hair around the toes and foot pads trimmed to ease snow removal and cleaning. If you do the trimming, take care not to cut the pads or other delicate area of the foot. •Feed your dog additional calories if it spends a lot of time outdoors or is a working animal. It takes more energy in the winter to keep body temperature regulated, so additional calories are necessary. •Towel or blow-dry your dog if it gets wet from rain or snow. It is important to dry and clean its paws, too. This helps avoid tiny cuts and cracked pads. A little petroleum jelly may soften the pads and prevent further cracking. •Don't leave your dog alone in a car without proper precautions. If the car engine is left on, the carbon monoxide will endanger your dog's life. If the engine is off, the temperature in the car will get too cold. Health Tips Dogs cannot talk to us when they are sick. As a responsible dog owner, it is important to pay special attention to your dog's well-being during the winter season. Remember the following health concerns: •Antifreeze, which often collects on driveways and roadways, is highly poisonous. Although it smells and tastes good to your dog, it can be lethal. •Rock salt, used to melt ice on sidewalks, may irritate footpads. Be sure to rinse and dry your dog's feet after a walk. •Provide plenty of fresh water. Your dog is just as likely to get dehydrated in the winter as in the summer. Snow is not a satisfactory substitute for water. •Frostbite is your dog's winter hazard. To prevent frostbite on its ears, tail and feet, don't leave your dog outdoors for too long. •Be very careful of supplemental heat sources. Fireplaces and portable heaters can severely burn your dog. Make sure all fireplaces have screens, and keep portable heaters out of reach. •Like people, dogs seem to be more susceptible to illness in the winter. Take your dog to a veterinarian if you see any suspicious symptoms. •Don't use over-the-counter medications on your dog without consulting a veterinarian.