Callie is a 13 year old female domestic shorthair cat who was presented to us in Aprilfor vaccines and a senior wellness blood screen. At this time Callie had some weight loss, but otherwise was looking healthy. When results returned from the senior wellness blood work, we discovered that her liver values were elevated.
The liver is an important organ in the body, contributing to the detoxification of metabolites, protein synthesis, and the production of bile, which is necessary for digestion. Because of the varying functions, we were unsure as to what exactly caused the increase in her liver values. We prescribed Clavamox, an antibiotic, to treat for a possible bacterial infection. This antibiotic was also used to help rule out Cholangiohepatitis, a common condition of liver disease that causes inflammation of the liver and bile duct. When we ran a follow-up blood panel, however, it showed little improvement in her liver values.
We continued to pursue a diagnosis with additional testing, as well as a liver supplement. Abdominal X-rays were taken to check for size or mass abnormalities, and a liver function test was performed. When both tests came back normal, Callie was referred to the University of Missouri Veterinary Hospital for an ultrasound. The purpose of the ultrasound was to provide a different method and image of any abnormalities in the size or shape of the liver, but all findings were, again, normal. Throughout this process, liver values were continuously checked, to no avail, and Callie continued to lose weight.
Since the origin for Callie’s elevated liver values was still a mystery, a different antibiotic was prescribed in hopes of a more effective response than with the Clavamox. Minimal improvements were observed with this antibiotic, however, and so a biopsy was suggested to determine a definite diagnosis.
Dr. Forbes performed biopsies of both the liver and intestines, and the samples were sent to multiple labs across the country. The examination of the biopsied tissues reported back with findings consistent with small cell malignant hepatic LSA, or lymphosarcoma. Also known as lymphoma, lymphosarcoma is a cancer of the lymphatic system, which is a network of vessels, organs, ducts and nodes found throughout the body. This system’s job is to transport lymph and help rid the body of toxins, waste, and other unwanted materials. Callie presented an interesting case of lymphoma, as it usually occurs first in the small intestines. However, the malignant cells were only found in her liver.
We are thankful that Callie’s owner decided to do a senior wellness blood screen, as that is what helped us distinguish a problem in the first place! She has begun chemotherapy to destroy the cancerous cells.
Written by Maggie
Congratulations to Serenity, our August pet of the month!
A simple walk in the evening with a friend turned out to be a little more than a stroll with a bit of casual conversation. Emily (one of our techs) and her friend decided to go for a walk in the area and while out they found a dog in the neighbor’s pasture that was extremely malnourished and loaded with fleas. As with all of the employees at Rock Bridge Animal Hospital, our mentality goes into help mode.
The dog was brought home to Emily’s house and separated from all of the other pets. She was bathed to try and help get rid of the fleas. The dog was so weak from lack of food that when she shook to get the excess water off she fell over. She was soon put on a bland diet of boiled chicken and rice and as soon as she was tolerating it well she progressed up to balanced diet of dry food.
It was common knowledge from the beginning she could not keep the new pet, but wanted her in optimal shape so she would be a great addition to someone else’s family. So on July 2nd, she was taken to Rock Bridge Animal Hospital for an exam, vaccinations, wormer and flea and tick protection. At that time she was weighed in at 25.5 pounds. She was given her first round of Distemper and Parvo vaccines and also was given a vaccine for Rabies along with Nexgard for fleas and ticks. Emily took her home and started her on a feeding schedule of 4 – 6 feedings per day. She soon was flourishing and on her next vet visit, which was a week later, she was up to 35.5 pounds. On August 3rd, she was taken for her vaccine boosters and a final weigh in and I am happy to announce she weighed in at 44.7 pounds and was given a clean bill of health!
As an employee of Rock Bridge Animal Hospital and a pet lover myself, I cannot express the importance of taking care of your pets. Ownership of a pet usually consists of over 12-14 years (and sometimes more) which include vaccinations, proper food and clean water, exercise and mental stimulation as well as providing a healthy environment.
Serenity is available for adoption by contacting Emily at Rock Bridge Animal Hospital 1-573-443-4501. She does well with other dogs and cats. She barks at new people, but only because she is excited and is still in the process of learning manners. She loves toys, especially ropes and tennis balls.
Written by Kim
Has your pet started acting differently as he gets older? Seemingly forgetting where he is, or staring at the wall? Maybe he’s started staying awake all night or losing his house training. Many subtle symptoms of Canine Cognitive Dysfunction (CCD) such as these get written off as old age, but there are things we can do to help slow the progression of this disease and get your friend back.
CCD is a chronic disease that is comparable to Alzheimer’s disease in people. It develops via a number of pathways, but ultimately there is oxidative stress to the brain cells, particularly the mitochondria, leading to their dysfunction and abnormal protein deposition in the brain. The dysfunction of these cells and abnormal protein deposits disrupt normal electrical signaling in the brain, leading to what we see as behavior changes. There is likely a genetic component that will predispose some pets to developing CCD.
Common behavioral changes include:
• Sleeping more, or sleeping all day and staying awake at night
• Overall decrease in activity level
• Forgetting basic obedience training, or apparent deafness
• Decreased interest in their surroundings
• Confusion or disorientation (staring at the wall, pacing, forgetting where he is)
• Difficulty navigating the environment (going to the wrong side of the door, running into things)
• Inability to recognize familiar people
• Increased thirst
• Increased panting
• Difficulty eating, or decreased interest in food
• Loss of bladder or bowel control
• Changes in vocalization
If you think your pet may be exhibiting some of these symptoms please let your vet know. There are many other diseases that can cause similar symptoms that need to be ruled out before arriving at a diagnosis of CCD.
As of now, there is no cure for CCD, however there are several options for slowing the progression or even temporarily reversing some of the symptoms. Because there are many pathways that lead to CCD, treatments that work for one patient may not work for another, so there may be a period of trial and error.
Lack of exercise, lack of sensory input, lack of rest which can be seen with excessive pacing or abnormal sleep patterns, excess calorie intake, obesity, high carbohydrate or high fat diets, and certain nutritional deficiencies can all contribute to progression of CCD. Some of these things are easy to address. You can certainly increase how much exercise your pet gets by going on more frequent walks. Getting out and experiencing different sights/sounds/smells can address the sensory input as well. This activity will also help with obese pets in burning more calories, however measuring their food daily is a major component of weight control. You can revisit basic house training and obedience training to help your senile pet remember what they’re supposed to be doing when.
Discuss with your vet which supplements or medications might be appropriate to address other symptoms. There is even a veterinary diet designed specifically for senile pets which contains an appropriate balance of proteins, fats, and carbohydrates, as well as specific supplements to address brain aging. Your vet may also want to revisit medications your pet may be taking for other health conditions, as some can worsen CCD symptoms. Hopefully with a little help your pet can get back to his normal self for a while.
Mia is a 6 year old Retriever Lab mix who presented on April 11, 2016 for blood in her urine. Her owner was very worried as he was preparing to leave for China the next day and would be gone for 3 weeks. During the initial exam, it became apparent that she was bleeding extensively. When she stood up from where she sat, there were clumps of clotting blood on the floor which are not typical in a urinary tract infection. We ran a blood panel which showed that her white blood cells were elevated, indicating an infection. Radiographs showed a very enlarged uterus, which should not normally be seen on x-rays. All of these findings led to a diagnosis of pyometra. A pyometra is an infection of the uterus and can occur in any unaltered female dog and is life-threatening. We decided to rush her into emergency surgery.
The safest and preferred method of treating a pyometra is to surgically remove the uterus via an ovariohysterectomy, or spay. Most pyometras occur 4-6 weeks after the female’s last heat cycle due to the hormonal and physical changes occurring at that time. Older females are at a greater risk but a pyometra can occur at any age and after any heat cycle. If bacteria find its way into the uterus during or directly following the cycle, a pyometra may occur. Symptoms may not be as severe as the blood coming out of Mia, but may range from excessive licking of the hind end, vaginal pus or discharge, swollen abdomen, vomiting, lethargy, dehydration and eventually collapse or death via septic shock (infection affecting multiple organs or parts of the body).
After putting Mia under anesthesia, we began surgery to carefully remove her uterus. Throughout the procedure, we made sure that there were no tears or openings in the uterine wall where infection could have leaked into her abdomen from the infected uterus. After her uterus was carefully removed, we examined her abdomen and determined that there were no signs of peritonitis, (infection of the abdominal cavity) and then carefully stitched her up. After she awoke from surgery, we placed her on broad spectrum antibiotics to kill any residual infection in her body and she was given pain medication to help her recover from surgery. The next few days we struggled to get her to eat much of anything until we found out she liked canned tuna with some baby food on top. We continued to administer her antibiotics and pain medications while she stayed with us for the following two weeks. After her stay with us, she went to be with a family friend until her owner returned from China. We were updated on her a couple weeks ago and she is doing great with no residual problems and no sign of infection. We are so happy she was brought in quickly and we were able to get her fixed up without additional complications.
Written by Emily
When Titus’s owners brought him in for an exam due to a lack of appetite, the last thing they expected was that Titus would be in need of emergency surgery. Titus lost his appetite and began showing signs of discomfort about four days before his appointment. He didn’t want to drink anything either, so his owners had been using a dropper in an attempt to keep him hydrated. An exam confirmed that Titus was extremely uncomfortable and painful in his abdominal region. In addition, the owners’ normally sweet, loveable cat had become extremely irritable due to pain, and even began hissing and striking out at staff due to his discomfort.
Dr.Forbes knew there was a big possibility that Titus’s behavior and discomfort was rooting from something very serious. A foreign body was suspected and X-rays confirmed that there was definitely something blocking Titus’s intestinal tract. Surgery was needed to remove the object from Titus’s small intestine, and it needed to be done soon. After explaining the findings to Titus’s owners, they consented to surgery. After making an incision and carefully navigating Titus’s abdomen, Dr.Forbes found that a large portion of Titus’s small intestine was plicated. This means that it was bundled together like a scrunchie over a rubber band. The intestinal plication was caused by dental floss that Titus had gotten into and eaten 2 weeks prior. The floss had embedded itself in his small intestine, requiring that almost 9 inches of the small intestine be removed.
The problem was that this portion of small intestine included about 90% of Titus’s illium, which is the only part of the intestines that absorbs B vitamin. Depleting such a large portion of his small intestine also put Titus at risk for chronic diarrhea, which could make keeping Titus hydrated and nourished a constant struggle. Fortunately, B vitamin could be supplemented by injections, and there was a good chance Titus’s stools would regulate themselves with time.
Titus made a grand recovery and after only a few days in our hospital we were able to reunite him with his loving owners. They took him home and after watching him closely for a couple weeks were able to report that Titus was feeling great, and the B vitamin injections seemed to be working just fine. Titus is now back to feeling like himself again, and as long as he stays away from dental floss, should live a long, happy, healthy life.
Written by Alicen
Weiner, a 15 year-old Dachshund, came to the clinic one morning after getting in a tussle with the family Yorkie. Weiner sustained multiple lacerations, including a serious puncture wound on his right inguinal (groin) area, and injury to the upper palate of his mouth. When we first saw Weiner, things were not looking good. He was very lethargic and could not stand on his own. His parents were very worried about him, as he has been a part of the family since he was just a puppy. They wanted to make sure Weiner had the best shot at a full recovery, so he was taken into surgery right away.
Dr. Sappington stitched up some of the more superficial lacerations on his flank, then got to work on the wound in his inguinal region. She cleaned the wound thoroughly and removed some necrotic, or dying, tissue. Because this area of the body is prone to movement and moisture, Dr. Sappington did not simply just close the wound, but instead placed a Penrose Drain to allow any excess fluids produced to drain out of the body.
When it came to Weiner’s mouth, three upper incisors and one upper canine tooth had to be extracted. The teeth were very loose and just barely attached to the gums. The surgery ended up going well; however, this was not the end of the road for Weiner quite yet.
Following the initial surgery, Weiner had to return to the clinic for numerous rechecks. The large puncture wound ended up opening further due to infection. Dr. Sappington decided to leave the wound open until the infection was cleared up. This meant Weiner had to come back every day for several days and be sedated for a bandage change each time. We were finally able to close the wound completely with sutures. A few weeks later, all of Weiner’s sutures have been removed and he has gone back to living a normal, happy life. However, Weiner’s parents have now made it a point to keep him away from their Yorkie!
Whether a cat should be kept indoors or let out has become a bit of a controversy in recent years. Most cats love going outside to explore, but there are many risks in the great outdoors that can be avoided by keeping them in. There are also concerns about their effect on the environment, as many cats are avid hunters and will kill prey regardless of how well fed they are. Whether your cat goes outside is up to you, but here are some considerations to keep in mind when making that decision.
The outdoors can be a dangerous place for cats. They can get hit by cars, or attacked by wildlife or roaming dogs. They are more likely to get into cat fights, resulting in injuries that may require veterinary attention. Your cat could pick up diseases from other cats he meets outside, such as Feline Leukemia (FeLV), Feline Immunodeficiency Virus (FIV), and upper respiratory tract infections. Your cat will also be exposed to parasites such as fleas and ticks, which both carry their own variety of diseases, some of which are very serious (Cytauxzoonosis is a prime example). Even the rodents your cat may bring home can cause infections, most notably tapeworms. All that being said, cats love going out and exploring. If they’re miserable staying indoors, you have to consider their overall quality of life. It would be much safer if I stayed inside all the time too (no car accidents, muggings, lightning strikes), but what kind of life would that be? Just be sure to carefully consider the environment around your home before deciding whether to let your cat outside.
Indoor cats generally are exposed to much less risk, however they are more likely to be overweight due to inactivity, and some may develop behavior problems due to a lack of mental stimulation. Indoor cats need more than just food, water, and a warm lap to sleep on. They should have perches on several levels, hiding spots to hide or explore, and a variety of toys that you can rotate to keep your cat interested. There should be numerous scratch posts or pads, and enough litter boxes for every cat in the house (plus 1 extra). Ohio State has a great list of ways to keep your indoor cat happy and satisfied.
Cats are natural hunters, and as such they need an outlet for their hunting instincts. This is important both for physical activity as well as mental health. Some of these hunting activities can be simulated for the indoor cat, by hiding their food in small amounts around the house so they can go on a scavenger “hunt”, or using food puzzles and various toys. Outdoor cats, no matter how tame, can be very efficient hunters. Studies have suggested that outdoor cats kill huge numbers of wildlife, particularly songbirds, even when they are well fed at home. And they typically bring home less than 25% of what they kill. If you want to let your cat go outside but also protect local wildlife, there are a few collar options to make your cat a little less stealthy. The easiest is a bell on the collar, though some cats do learn to walk so that it doesn’t jingle. This collar* can make your cat easier for birds to spot.
A screened porch can be a good compromise for the cat that really wants to be outside. They can enjoy the sights, sounds and smells of the outdoors, and still be safely confined. Alternatively, you can get cat “proof” (I never trust that word) fencing* for your yard. You can even build elaborate catwalks* for your cats.
Let your vet know whether your cat is indoor or outdoor, as this may change which vaccines and preventatives they recommend. It can also affect what disease processes your vet needs to rule out if your cat gets sick. And if you do opt to let your cat roam outdoors, please make sure they have a microchip (and your contact information is up to date with the microchip company) as well as a collar with contact information so they can make their way back home to you!
*The products listed here are not endorsed by RBAH, they are simply listed to demonstrate the variety of products available for the outdoor cat.
Dora is a spunky little 11 year old Dachshund that was referred to us from an outlying clinic in Linn, Missouri. When she went in for a routine dental cleaning the veterinarian noticed some areas of gingivitis and pus around her canine teeth. She probed the area and found an oronasal fistula. Unfortunately, Dachshunds are very prone to developing this condition.
An oronasal fistula is an opening between the oral cavity (mouth) and the nasal cavity (nose) that is abnormal. These pockets result from dental disease. As tartar builds up on our pets teeth, bacteria adhere to the tooth surface. This bacteria moves under the gum line and creates infection in the gums and ligaments. When the infection worsens, it begins to eat away at the underlying tooth roots and bones, eventually creating a hole into the sinus cavity. Debris begins to collect in these openings and causes serious infection. The treatment for an oronasal fistula involves extraction of the diseased teeth, cleaning out the pockets, and suturing the gums over the opening. There is a high risk for breakdown of these incisions because every time the pet breaths through its nose, it pushes on the tissues.
Dora’s veterinary office was not equipped to do such an extensive oral surgery, so they contacted us for help. We set her up for surgery and took X-rays of her mouth to assess all of her teeth. It turned out she had quite a few other teeth with periodontal disease as well. We removed all the diseased and painful teeth and cleaned what was left.
Many times, it is hard to tell when a pet is having dental pain. That is why it is important to schedule routine dental cleanings and X-rays to evaluate their oral health. Several owners report great mood and energy changes after their pet’s diseased teeth are removed. Dental care is just one type of preventative care that helps our pets live much happier, healthier lives. Miss Dora is a lucky girl to have a family so on top of her care. Without veterinary visits, her infection may have gone unnoticed. Her mouth healed without any complications. She is back to her sweet, lovable self and she is feeling good as new!
I get this question more often than you might think…When do you say goodbye to the little furry friend you’ve loved for years? The decision is never easy, whether the circumstances that lead to that question occur suddenly, or you’ve known it’s been coming for months. It is a highly personal decision, one that must consider not only the pet’s comfort and quality of life, but also what you, the owner, are able and willing to afford and endure.
Taking care of an elderly pet can become hard work. That pet may start losing their house training, either due to mental confusion or a medical condition. They may have a tough time getting up off the floor because of their arthritis, and require extra help just to go get a drink. They may start getting any number of medical conditions that require daily medications or treatments, and the pet may or may not cooperate for them. For many people with busy schedules, these inconveniences get to the point where they just cannot provide their pet with the increased care they need, despite their best efforts. In those instances, the pet suffers, and the owner is distressed because of it.
For a pet with declining health, it can be tough to be objective about their quality of life. One great day may make you forget about the week of listlessness prior to it. They may get so excited about dinner at the end of the day that you don’t want to think about how much trouble they had getting up to go outside that morning. If you find yourself contemplating whether it is time to say goodbye, talk to your vet. While we can’t decide for you, we can certainly help guide you in making your decision. Knowing what is going on with your pet and what to expect as things progress can make the decision much easier.
Bring your pet in for an exam as well. Even if your pet’s condition is something that cannot be fixed, there are many options for treating symptoms to keep your pet comfortable for as long as possible. Treatments do not always have to be invasive, and can be tailored to fit your pet’s needs as well as your own. Hospice care for pets has become more and more common in recent years. It can be very beneficial in improving quality of life as well as strengthening the bond between you and your pet.
For chronically ill pets, it’s a good idea to keep a journal of good days and bad. Is your pet still doing things he enjoys? Is he still going on walks, or exploring around the house? Does he still seek attention from the family or does he isolate himself? Keeping track will make it easier to look back and see if things are really getting better or worse for your pet. The Association for Pet Loss and Bereavement has an excellent quality of life scale you can fill out to help with this process.
In the end, this decision, as hard as it is, belongs to you and your family. For many people who have already made that call, their biggest regret is waiting too long because they were too attached to say goodbye. They felt that their pet suffered too long because they couldn’t let go. Looking at the big picture, as objectively as possible, can help make sure that you are making this decision in the best interests of your beloved pet.
Rainbow Bridge Poem
When our hospital first met Walden in late September, it was clear the sweet boy was in some substantial discomfort. He was actively vocalizing his feelings about the situation, and his owner reported to us that he had been more lethargic than normal and his bathroom habits seemed a little “off” the past couple of days. As Dr. Sappington, along with our staff, began the initial examination, the diagnosis was clear: Walden had a urinary blockage.
Urinary blockages in cats most often occur in males from 1-10 years of age. A male cat’s urethra is longer than a female’s, and narrows as it reaches the outside world, creating a bottleneck effect as urine leaves the body. In this “bottleneck”, obstructions can occur due to inflammatory material, mucus, crystals, or even small stones from the kidneys.
The same day he came to see us, Walden underwent an emergency surgical procedure to remove his blockage and to insert a catheter to be worn overnight. Walden also had a complete blood panel ran to check his current kidney function. Although his procedure went well and his bladder had emptied overnight, Walden was not out of the woods yet.
Because a blockage does not adequately allow toxins to leave the body, Walden had a buildup of these toxins in his blood stream. Dr. Sappington set up Walden with a few days of hospitalization and monitoring to make sure he was eliminating normally on his own and his body was flushing out the toxins.
While spending a few days in the hospital getting IV fluids, seemingly using the litter box normally, and winning over the hearts of all the staff, Walden’s blood work was rechecked. All of his levels were thankfully back to normal and Walden was set for discharge!!
Walden’s owner was so thankful to have him back home and it was bittersweet for the staff to have the sweet boy leave. Little did we know, it wouldn’t be for long.
After Walden settled in at home, he must have decided he missed his new friends at Rock Bridge and has periodically had to come in for rechecks when he starts urinating more frequently. Fortunately we have been able to keep him comfortable with medications and have not had to unblock him again. In general, most blocked cats do not need to be on long term medications after a successful surgery, and we are hopeful that Walden can soon join them.
Walden’s owner’s quick action to get him in to see us, along with her willingness to provide Walden with the best care possible has all been integral in allowing Dr. Sappington and the rest of the staff at Rock Bridge Animal Hospital to get Walden happy and healthy again.