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The Itching Pet
Excessive licking, chewing, and scratching can make a pet’s life miserable for month after month, even year after year. For rapid relief of itch and inflammation, nothing matches the corticosteroids. There are some animals that seem unable to live with any degree of comfort without these medications. Unfortunately, corticosteroids have widespread and potentially dangerous actions throughout the body when they are used for inappropriately long periods and it is generally desirable to minimize their use if possible. Ideally, corticosteroids are used for a few really tough itch weeks and other forms of itch management are used for general itch maintenance. The following list includes assorted non-steroidal methods for relieving itch and reducing the amount of corticosteroid hormones needed. Antihistamine Trials - Diphenhydramine (Benadryl), Clemastine fumarate (Tavist), Hydroxyzine (Atarax), Chlorpheniramine (Chlor-Trimeton) Histamine, a biological chemical, is the chief mediator of inflammation in humans. Histamine is not the major mediator of inflammation in the dog, thus these medications are not as reliable for dogs as they are for us. Antihistamines are not free of side effects; they are notorious for drowsiness in some individuals. Still, this is vastly preferable to the systemic disruption caused by the corticosteroid group. In cats, antihistamines are substantially more reliable than in dogs so that the chances of a given antihistamine working are usually pretty good. For both cats and dogs, using antihistamines together with a corticosteroid hormone will decrease the amount of corticosteroid hormone needed to control the itching (i.e., less hormone is needed to get the job done if it is given with an antihistamine). Fatty Acid Supplementation - Fish oil provides essential fatty acids, particularly omega-3 fatty acids, which have natural anti-inflammatory benefits. While this finding has primarily been utilized in the treatment of itchy skin, many arthritic dogs and cats have also benefited from supplementation. While there are no toxic issues to be concerned with, these products require at least one month to build up to adequate amounts. Effects are not usually dramatic but can be helpful. Flaxseed oil is the best nonanimal substitute for fish oil. Cyclosporine (Atopica) - Cyclosporine is an immune system modulating drug originally developed for use in organ transplant patients, but which is also useful in other immune-mediated diseases. Since allergy is an immune-mediated condition, cyclosporine was investigated as an alternative to corticosteroids and found effective for most patients. Topicals - Colloidal Oatmeal Shampoos/Crème Rinses, Sprays, Lotions, Lime Sulfur Dip, Humilac Spray, Witch Hazel, 100% Aloe Vera Gel. When using any dip on inflamed skin one should be aware that the use of cool water is considered much more soothing than warm water. Ten minutes or more of skin contact is the minimum requirement for any medicated shampoo, premature rinsing will not allow for the therapeutic benefit to be realized. Herbal Formulations - Treatment with herbal formulations is aimed at cooling the heat that rises to the surface, clearing the wind that causes the itching and strengthening the Yin to balance the original condition. Because of the intensity and duration of the situation, it may be a slow process to rebalance all the organs involved. Severe itching amounts to a reduction in life quality. It is important not to develop the mindset that corticosteroids should be avoided at all costs. This would not be fair to the itching pet. Steroids are valuable tools in the relief of pain and suffering and have an important place in the therapy of the itchy pet. The goal is not to avoid steroid use if possible but to avoid long term dependence on steroids if possible. Despite all of the above management tricks, some pets will still require long term steroid use to achieve any reasonable comfort. There are monitoring protocols in place for such cases. It should also not be forgotten that underlying allergies and recurring skin infections can be addressed specifically and that as these conditions are managed, the itch is also managed. Steroid hormones have many side effects and, as helpful as they are for allergic skin diseases, it is best to reserve them for only the itchiest episodes. ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ As always, we recommend that you check with your veterinarian for your pet’s immediate health needs and concerns. If you have questions about your pet’s health, care, and well-being, email your question to: NtTAskOurVet@aol.com |
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Polysulfated Glycosaminoglycan
A joint consists of articulating bones, a fibrous capsule enclosing the joint, and slippery lubricating joint fluid to facilitate the gliding of the two bones across each other when the joint is flexed. The bones are capped by cushions of cartilage to facilitate frictionless gliding. Cartilage consists of what is called matrix (which makes up 95% of cartilage, the other 5% being chondrocytes, the cells that secrete the matrix). Cartilage matrix consists of collagen (tough structural fibers) and proteoglycans (water absorbent molecules). The function of a proteoglycan is to soak up water thus creating a cushion, sort of like a water bed, to absorb the pressure exerted on the joint as it works. Over years, either through injury or poor conformation, cartilage wears down or is damaged and arthritis results. The body must then make more matrix and will require the raw materials to do so. Polysulfated GAGs may be injected into the body where they will be distributed to any joints currently effecting cartilage repair. It turns out, however, that polysulfated GAGs represent more than just building materials. They have anti-inflammatory properties of their own that help slow down the actual damage to the cartilage. They also promote enzyme systems that facilitate other aspects of joint repair beyond simply making more matrix. They help the joint create more lubricating fluid as well. The active ingredient in Adequan® is polysulfated GAG, which is mostly chondroitin sulfate, extracted from cow tissue (the trachea, to be exact). In treating arthritis, injections are given twice a week for 4 weeks for a maximum of eight injections. Injections are given intramuscularly. Dogs, cats, and horses are the usual patients. Adequan may be combined with NSAIDs and with glucosamine and chondroitin sulfate. There is another more controversial use for this medication and that is in the treatment of feline lower urinary tract disease. One of the theories of this very complicated syndrome is that the GAGs that line the urinary bladder and help protect the bladder tissue from the irritating urine become depleted. By giving a GAG injection they may be restored, thus helping to resolve the urinary discomfort associated with this syndrome. ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ As always, we recommend that you check with your veterinarian for your pet’s immediate health needs and concerns. If you have questions about your pet’s health, care, and well-being, email your question to: NtTAskOurVet@aol.com |
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The normal canine eye receives its tear film from two lacrimal (tear-producing) glands. One gland is located above the eye, and the other is fo Fleas are the most common external parasite of companion animals. Flea allergy dermatitis is the most common skin disease of dogs and cats! Flea control has always been a challenge for veterinarians and pet owners because the adult fleas cause the clinical signs, yet the majority of the flea population (eggs, larvae and pupae) are to be found off the pet in and around the home. The ideal flea control program utilizes products that target the various stages of the flea life cycle, not only the adult fleas on the pet. Eggs are laid in the hair coat and are designed to fall off the host. They are resistant to insecticides, but susceptible to various insect growth regulators. Larvae develop in the host’s environment and feed on adult flea feces (blood) that fall out of the hair coat of the pet. Larvae are susceptible to traditional insecticides, borates and insect growth regulators. Larvae eventually spin cocoons (often within carpet fibers) for pupation. Pupae are resistant to freezing, desiccation, and insecticides. Pupae can lie dormant for many months; they are stimulated to expupate as emergent adults by vibration, warming and increased carbon dioxide. Normally, expupation occurs when a host is near and the new flea finds the pet within seconds of emergence. Emergent fleas are fairly mobile and can survive a few days without a host, if in a suitable environment. New fleas begin feeding within hours of finding a dog or cat. Once a blood meal has been taken, the flea can survive only a short time if it is dislodged from the host. New fleas experience very high mortality on healthy adult hosts. Most fleas do not survive 72 hours on an animal that is itching and able to groom itself. Unfortunately, limited egg production does occur even on allergic animals. The entire life cycle of C. felis can be completed in as few as 16 days! For the flea allergic patient, continuous excellent flea control is required to remain symptom free. Even very minimal exposure may be sufficient to perpetuate itching in a hypersensitive patient. In the past, veterinarians and pet owners always had to try to control fleas by treating the environment of the animal for the immature stages of the flea. Today, veterinarians have some great flea control products in our arsenal. There are now several highly efficacious, long lasting and very safe new products to choose amongst: Program® and Sentinel® (Lufenuron), Nylar® (Pyriproxifen), Advantage® (imidacloprid), K9 Advantix® (with permethrin), Advantage Multi® (with moxidectin), Frontline® Spray, Frontline Plus® and Frontline Top Spot® (fipronil), Revolution® (selamectin), Capstar® (nitenpyram), Comfortis ® for Dogs (spinosad), Promeris for Cats® (metaflumizone), Promeris Duo for Dogs® (metaflumizone/ amitraz), Vectra 3-D for Dogs® (dinotefuran, permethrin, pyriproxifen), Vectra for Cats® (dinotefuran, pyriproxifen).
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The normal canine eye receives its tear film from two lacrimal (tear-producing) glands. One gland is located above the eye, and the other is found within the animal's third eyelid. The gland of the third eyelid contributes a significant portion of secretion to the tear film. In the smaller breeds -- especially Boston terriers, Cocker spaniels, bulldogs and beagles -- the gland of the third eyelid is not strongly held in place. The gland prolapses (slips out) to where the owner notices it as a reddened mass. Out of its normal position, the gland does not circulate blood properly and may swell. Historically, the prolapsed gland was treated like a small tumor and was simply removed. That was before the full significance of the gland was realized. If the third eyelid's tear gland is removed, it cannot be put back in place. If the other tear gland (the one above the eye) cannot supply adequate tears, which is not an uncommon phenomenon in older small breed dogs, then the eye becomes dry and uncomfortable. A thick yellow discharge results and the eye develops a blinding pigment covering for protection. This condition is called simply dry eye, or more scientifically keratoconjunctivitis sicca, and daily medical treatment is required to keep the eye both comfortable and visual. Not only is dry eye uncomfortable for the pet, its treatment is often frustrating and time-consuming and there is expense involved. We would like the dog to maintain the greatest amount of tear producing tissue possible, thus removing the gland for cosmetic reasons is not an acceptable treatment method. The only acceptable treatment of cherry eye is replacement of the gland in its proper location. Harmful complications from cherry eye surgery are unusual but recurrence of the cherry eye is common. If a cherry eye recurs, it is important to let your veterinarian know so that a second surgery either with your normal veterinarian or with an ophthalmology specialist can be planned. An owner should expect some postoperative swelling after cherry eye repair but this should resolve and the eye should be comfortable and normal in appearance after about a week. If the eye appears suddenly painful or unusual in appearance, it is important that it be rechecked as soon as possible. ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ As always, we recommend that you check with your veterinarian for your pet’s immediate health needs and concerns. If you have questions about your pet’s health, care, and well-being, email your question to: NtTAskOurVet@aol.com |
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The adrenal gland is so named because it is located just forward of the kidney (renal means kidney). The center of the gland is called the medulla and the outer area is called the cortex. While both areas produce hormones, Addison's disease concerns the hormones produced by the cortex; these hormones are called corticosteroids. Corticosteroids are the hormones that enable us to adapt physiologically to stress. They gear the metabolism towards the preparation of burning (rather than storing) fuels so as to be ready for a fight or flight situation. The mineralocorticoids influence the electrolytes: sodium and potassium. As a general biological rule, where there's sodium or salt, there's water. When the mineralocorticoids circulate as part of the fight or flight preparation, sodium is conserved in anticipation of blood loss so that there will be extra fluid in the vascular compartment (spare blood). When sodium is conserved, potassium is lost as part of the biological balance. The fight or flight preparation is far more complex than can be reviewed here but the bottom line is: Corticosteroid hormones are needed to adapt to stressful situations and without these hormones, even small stresses could lead to physiologic disaster. In animals with Addison's disease, there is a deficiency of the corticosteroid hormones. Patients are usually young (age 4-5 years) female dogs. At first signs are very vague - listlessness, possibly some vomiting or diarrhea. Ultimately, the disease results in a phenomenon known as the Addisonian crisis. The animal collapses in shock. The patient may not survive this episode. Corticosteroid hormones are needed to adapt to stressful situations and without these hormones, even small stresses could lead to physiologic disaster. Because of the numerous symptoms Addison's disease can be present with, Addison's disease has earned the medical nickname "the Great Imitator." The only definitive test for Addison's disease is the ACTH stimulation test. A lack of response is diagnostic for Addison's disease. The most important aspect of treatment for hypoadrenocorticism is the replacement of the missing mineralocorticoids hormones. ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ As always, we recommend that you check with your veterinarian for your pet’s immediate health needs and concerns. If you have questions about your pet’s health, care, and well-being, email your question to: NtTAskOurVet@aol.com |