Heart Disease in Dogs and Cats
Heart disease affects as many as 60% of our older canine patients and although it is very hard to know the extent of heart disease in cats, it is estimated to be present in up to 15% of them. The reason it is so hard to get a more accurate statistic in cats is that it often goes undiagnosed. Heart disease is also estimated to affect about 15% of young dogs.
Unfortunately heart disease can be very difficult to diagnose in both dogs and cats. They can not tell us when they are feeling bad or lethargic or if they are having any unusual pains in their chest. That is why this disease is often undetectable until they are showing signs of heart failure, at which point treating is less beneficial because the disease is not reversible.
There are some breeds that are more prone to heart disease. These include but are not limited to the Cavalier King Charles Spaniel, Chihuahua, Poodle, Dachshund, Doberman pinscher, German Shepherd, Golden Retriever, Great Dane, Weimaraner, and Boxers.
Although it is quite complex, heart failure occurs when the heart is unable to pump out the amount of blood it is receiving, therefore supplying inadequate amounts of oxygenated blood to the body. The problem can be attributed to valves that become leaky, allowing blood to flow through the heart in the wrong direction, or because the muscle itself becomes weak and stretched over time. The end result is the same however with fluid “leaking” from vessels into the lungs or abdomen, depending on which side of the heart is affected. This buildup of fluid causes obvious symptoms of difficulty breathing (if fluid is accumulating in the lungs) or abdominal distension (if fluid is accumulating in the abdomen). Other symptoms that may or may not be present early in the disease process include exercise intolerance, reluctance to play, and general lethargy. Many times, signs of heart disease are so mild that the owner doesn’t even realize there is a problem. It is easy to attribute “slowing down” to old age. Your veterinarian may detect a heart murmur or abnormal rhythm during your pet’s physical exam and discuss further diagnostics with you.
Once heart disease is suspected your veterinarian will probably recommend chest radiographs to determine if the heart is enlarged and if there are any changes present in the lungs. This may help stage the heart disease somewhat and help the doctor determine a treatment protocol and prognosis. There are more extensive diagnostics such as an electrocardiogram or echocardiogram that may be indicated as well. These things may have to be done multiple times through the course of the disease to monitor progression and response to treatment.
The goal of treatment is to help the heart function more efficiently. Medications are available to allow the heart to contract more strongly thereby pushing more blood out and through the body. Diuretics may be needed as fluid starts to accumulate in the lungs or abdomen.
There are also congenital heart anomalies that can occur in puppies and kittens. Examples include Patent Ductus Arteriosis (PDA), Ventricular Septal Defect (VSD) and Pulmonic Stenosis, just to name a few. Many of these can be corrected surgically by a board certified veterinary surgeon.
Cats too can be affected by heart disease. Hypertrophic cardiomyopathy is a condition that occurs most often in young cats. They may often be asymptomatic until it is very end stage. At this point they may have acute respiratory distress or sometimes they pass away suddenly without warning.
Routine visits to your veterinarian will give your pet the best chance at detecting this disease and starting a treatment protocol before they are symptomatic. Frequent monitoring will ensure that they are responding well to treatment and have the best quality life possible.
Thanks for reading!
Dr. Stephanie Bradley
Oh no, my pet is limping! Now what…
Hey everyone! Just thought we would give you a couple of pointers about limping in pets.
Pain when walking or “lameness” is a very common ailment seen at our hospital. There can be many different causes of lameness in your pet and there are many different considerations that your veterinarian will use when determining the underlying cause. In many cases, the species (canine or feline) and specific breed are significant factors when investigating the type of lameness we see in your pet. Many of you are familiar with diseases like hip dysplasia and luxating patellas and the breed of dog in which these diseases are seen are pretty consistent. To keep things simple, I will break down some of the most commonly seen issues that pertain to lameness.
In many cases, the degree of lameness is a good clue as to the severity of the injury. Anytime your pet is unable to use a limb at all or you can clearly see an odd angle or in some severe cases, a dangling limb, these can all be indications of a fracture or dislocation and your pet should be taken to the vet right away.
If you have a pet that suddenly started limping on a front or back leg while running or playing always look for sharp objects wedged in the foot pads first and if not seen, a sprain or strain may be the culprit. Sprains and strains are commonly seen in both growing dogs and adults. Its always a good idea to try and rest your pet if you see them start to limp abruptly. Take them out on a leash for potty breaks and keep the activity to a minimum while in the house if possible. If your pet is crate trained, keep them in their crate if they start to get too rambunctious. If the issue does not resolve in a day or two, call your veterinarian and schedule an exam.
For larger breed puppy owners, hip dysplasia is a biggie when considering causes of lameness but there are also other diseases like elbow dysplasias, osteochondrosis, joint luxations and nutritional imbalances to keep in mind. If the lameness is in the back end, radiographs or xrays should be taken to assess for hip dysplasia. Hip dysplasia is a fancy term for hip joints that are malformed which eventually leads to arthritis and loss of function. This disease is most commonly seen in German shepherds, St. Bernards, Labrador and Golden Retrievers and Rottweilers but can also be seen less commonly in cats such as Maine Coons.
Elbow dysplasia is a collective term for 3 major diseases that can be seen in the elbow of some large breed puppies and is one of the most common causes of limping in the front limbs. Your veterinarian will need to take xrays to determine if these diseases are present and they usually require surgery to correct.
Osteochondrosis dissicans is a disease of cartilage formation and will cause limping in both the front and hind limbs depending on where the lesion is located. This can be difficult to diagnose as cartilage is not readily seen on radiographs but is a cause of persistent lameness and should be evaluated. In many cases, this issue will require surgery to remove the diseased flap of cartilage causing the problem.
As far as nutritional imbalances are concerned, as long as you are feeding a good quality large breed puppy formula, these issues should not arise providing there is no outside supplementation.
Lameness in adult dogs can be the direct result of the above mentioned disorders but can be from other causes as well. Cranial or anterior cruciate ligament rupture (CCLR or ACLR) is the same disease you hear about in professional atheletes with an ACL tear. Our pets can also develop this disease and unfortunately it eventually affects both back limbs. This disease occurs as a result of instability within the knee joint (stifle) which leads to arthritis and eventually a weakened cruciate ligament. The weakened ligament tears or partially tears when playing or running around doing normal things. This is a pretty straight forward diagnosis and nearly always requires surgery to lessen pain and to preserve function in the limb.
Luxating patellas is another common disease that we see mostly in our smaller patients such as Yorkies, Maltese, Poodles, etc. This disease occurs when the kneecap (patella) moves abnormally toward the inner or outer knee and can cause significant arthritis and pain. The patella can even become “locked” in that abnormal position over time which permanently changes the normal conformation of the limb and prevents normal function. This condition is correctable surgically if caught early.
This is just a brief overview of the most common causes of limping that we see in the hospital. I could go on forever about each of these topics and others relating to lameness but for the sake of keeping this relatively painless, we’ll stop here and if any of you have any additional questions please feel free to call us anytime.
Thanks for reading!
Dr. Jessica Zink
Environmental Enrichment for CATS:
Environmental Enrichment for CATS:
“Cats are NOT small dogs” was the first sentence on the first day of feline medicine lectures by my professors in Veterinary school. And how true this has proved to be over the years. There are lots of similarities but some of the most notable differences of cats from the canines is behavior. So as more cats are living together indoors it is more important to be aware of their living conditions and to improve their health and welfare by making sure their needs are met in the environment.
There are several areas that can be of concern to our cats that are often not obvious to us but can become behavioral problems exhibited by unacceptable actions (i.e. urinating outside the litter box). One of the most important areas is access to the three basic resources (food, water, and litter box). These should be located in quiet area (not next to washing machine), semi private area (low foot traffic area), and in multiple sites (especially in multi-cat household where one member “guards and teases” others at the resource for “fun or spite”). A key point with “litter box etiquette” is to always have the same number of litter boxes as the number of cats in the household “plus 1”. For instance, if you have 3 cats there should be 4 or more litter boxes available in the home.
Another important area to consider is structures for the cats within the environment. This includes scratching posts, places to climb, perch, rest and hide. There are several commercially made “cat condos” which most cats like and we encourage clients to start kittens early so they know it’s “theirs”. Some cats like to explore so owners could also hide toys for them to search for.
Social contact (with the owner as well as other cats in the household) is a very important area as well. Cats are nomadic by nature and do not form packs or groups in the wild. So when put indoors some have a harder time adjusting to this closeness. Therefore each one should be observed and if necessary be separated for a while if need be. A lot of cats enjoy alone time too. If they are being a bully then a time-out in a spare bedroom is good to give the others a break. Remember just because you love them does not mean they will like each other (very few people would let their ex-spouse rent a room from them no matter how cordial their relationship).
One area that will be different for every cat is their human interaction. Most cats will play games (feather on a stick, laser pointer light chasing, small fake mice, etc). Some prefer the petting or grooming (brushing) interaction. Our job is to see what they enjoy the most and to avoid interactions that may stress them (i.e.: chasing the cat). For those of you that have kitties that tend to bite when being petted, keep in mind that to many cats petting should be on their terms. Most cats will not object to petting that stays around the head and neck region. When you go beyond that “magic line” between the neck and shoulders, some cats will consider that too much and give you a little warning nip. That will be your cue that this particular cat prefers a “less is more” approach to contact.
Also consider audio, visual and olfactory areas too. These are things like a radio or television playing while the owner is away. Access to a window or fish tank can be very beneficial as well. Cats often will like catnip or pheromones which are commercially available.
Lastly, it is a good idea to rotate toys on a regular basis (weekly) to provide some novelty.
Dr. Joe
Subtle Signs that Could Indicate your Pet has a More Serious Disease
Last week we saw an older German Shepherd that had an extremely large tumor in its abdomen. After speaking with the owner and gathering a history, it seemed that this tumor had been growing for the past 2-3 months. There were a few very subtle signs that he noticed in retrospect, however he didn’t recognize the seriousness of these seemingly minor changes. Many times animals can have serious disease and unfortunately we don’t realize until it’s too late. It is an animals instinct to show no signs of weakness, even in our domesticated pets. It is that reason, coupled with the fact that they can not tell us when they feel bad, that many things get overlooked. There are some little things that we can look for in our older pets however to help us recognize and diagnose diseases earlier in the process and hopefully help them live a longer life. Fortunately for our patient mentioned earlier, we were able to successfully remove the mass and he has recovered amazingly well. Below, I will outline some of the things that could indicate an underlying disease and some things that should not be ignored.
1.) Excessive water consumption (polydypsia) and excessive urination – I think this is probably the most common clinical sign owners describe to us in older animals, especially cats. While some animals may consume a lot of water just because they really like it, others may begin to drink more as they get older because of an underlying disease. Things such as hyperthyroidism in cats and kidney disease are a very common cause of this. Other common causes are diabetes and hyperadrenocorticism (Cushings disease). There are other less common things including some cancers that can cause this as well. If you notice that you are filling that water bowl more frequently, cleaning large amounts of urine from the litter box, or letting your dog out to urinate more often, then possibly you should have your veterinarian check over your pet.
2.) Change in eating habits (lack of appetite or a ravenous appetite) – While people like a lot of variety in their diet, animals do not really seem to care if they eat the same food day in and day out for years at a time. When I hear that an older dog or cat has suddenly lost interest in their food then I get a little concerned. Many times owner will tell me that their pet didn’t seem to like their food anymore so they switched types and then they ate it ok for a few weeks then lost interest in that one as well. A lot of times this is a very non-specific indicator that something else is going on. We would have to dig a little deeper to determine the cause. All that being said, I will say that occasionally I run across a little dog or cat that is just extremely picky and really does like a little variety. These animals have usually been like that their whole life but it is when an animal suddenly develops this pickiness that it is a concern. On the other side of the coin is the animal that can’t seem to eat enough. This also can lead us to suspect certain endocrine diseases.
3.) Sudden weight loss – this usually goes along with the change in eating habits. If your pet is not eating great and you notice weight loss then you should definitely take it in to see the doctor. Just because your pet is older it should not lose a significant amount of weight quickly. If your animal has lost 10% of its body weight in just a few months, that is significant. Just because your pet is older doesn’t mean it should lose weight. Now, of course as an animal ages it will very gradually lose weight and muscle but we are concerned when this happens fairly quickly. Some diseases, such as diabetes and hyperthyroidism, can cause weight loss even though they seem to have a ravenous appetite.
4.) Change in body shape – Sometimes although the scales may indicate that your pet weighs the same it may look “different”. The belly may be bigger and rounder or you may be able to see the spine better than you ever have before. Muscle atrophy can cause them to look much thinner. Sometimes this happens in the muscles of the back causing the spinal column to be more prominent and easily seen and sometimes this happens on the head and face. This is something else that can happen slowly as patients age, but shouldn’t be ignored if it comes on quickly. Some disease processes can cause a pot belly appearance and that may be one of the only clinical signs you notice. The german shepherd I mentioned earlier with the abdominal mass had a “bloated” looking abdomen. The owner said some days the abdomen looked bloated but other days it looked ok. If something seems to get better but comes back again it is best to check it out.
5.) A lesion on the skin that doesn’t seem to be getting better – I often see pets that have a red or ulcerated area on the skin that the owners thought was just a scrape and have been treating topically with neosporin or something similar. Sometimes it will get better and reappear and sometimes it just doesn’t heal up like it should. These things should be looked at because sometimes there are skin tumors that can be difficult to distinguish from a “hot spot”. If your doctor determines that it is a mass or if they suspect it could be a malignant tumor, it is always best to have these things taken care of sooner than later.
6.) Sudden change in behavior – Any change in behavior is an important sign. If your animal has always been very active and suddenly doesn’t feel like running after the ball, going on walks or joining the family as it usually does then maybe it is because something just isn’t right.
These are just a few things that may help you pick up on a problem a little sooner. No one knows your pet like you do and if you feel like something just isn’t quite right then trust your gut and if nothing else call your veterinarian to seek some guidance. As our pets become geriatric, which can be as early as 7-8 years old in large breed dogs, it is a great idea to have an exam at least once a year. We also recommend yearly blood work which includes a CBC, chemistry profile and thyroid level. Many times the blood comes back completely normal which is excellent. However, sometimes this blood work picks up some abnormalities before your pet even exhibits any clinical signs of illness. Early detection can be the difference between a happy pet and a very sick pet sometimes.
Please feel free to call any of us at Heritage Veterinary Hospital if you have any concerns about your pet!
Dr. Stephanie Bradley
What is that Loud Smelly Thing That is Ruining My Life
Everyone always told me “just wait until you have kids. . . your dog will take the backseat and won’t get near as much attention as she gets now”. It’s not that I didn’t believe that human children would require more attention and obviously there is a different kind of love for a human over an animal, but my dog was truly my baby. I have noticed, as a veterinarian, once our “regulars” have babies we don’t see them as often as we did before. Still, I just didn’t see that happening to me and my dog. I was going to be different and give my little Lexi the same amount of attention as she was used to getting. I could snuggle with a dog and a baby at the same time!
I got Lexi as a gift from my family about 8 years ago after I graduated from Veterinary School, several months before my husband, Kyle and I got married. She is a Cavalier King Charles spaniel and was about the cutest puppy in the world! I treated her like my child. My friends actually liked to tease me for this very reason. She went everywhere with me. I took her to training classes and taught her every trick I could think of. She had a necklace and dressed up occasionally, especially on OSU game days. She had an OSU t-shirt she wore to show her support for our cowboys. She is very smart and I’m pretty sure she can understand a lot of what I say to her. She was my little shadow and there was a permanent place on the couch next to me.
You may have noticed that I am talking a lot in past tense here, not because Lexi has died but because I now have 3 children. Luke and Logan are my 2 year old twins and Leighton is my 6 month old baby girl.
My twins were born in October 2009. It started out not too bad (for Lexi that is). I think she was a little curious at first about these two loud, crying babies. That probably quickly changed from curiosity to annoyance as her sleep was interrupted nightly. Since she sleeps in my bed, she was disturbed each time I had to get up and tend to the babies. But, her life was truly ruined (in her eyes) as these babies (not just one but two) became mobile and started crawling around, grabbing fists full of long ear and tail hair. At first she was able to escape to the safety of the couch, but it wasn’t long before they were pulling up and able to reach her even there.
So, this brings me to a more serious note of protecting your babies and your pets from each other. I get this question a lot as a veterinarian. “How should I introduce my dog to my new baby?” First of all, NEVER trust any animal 100%. Even the nicest dog or cat in the world is still an animal. If annoyed enough or pushed to their limit by hair pulling and toy stealing they may act instinctively and their only defense mechanism is growling or sometimes nipping or even biting. I consider Lexi one of those super nice dogs. There have been a few times though that one of my boys has grabbed some hair and before I could get to her to help her she has turned around and sort of nipped at them. She was not trying to bite them but merely trying to get loose and stop the painful attack on her ear. When introducing your pet for the first time to your new little bundle, make sure you are in a calm, quiet, familiar environment. If you are really concerned that your dog may be too hyper or react badly you can have it on a leash so you have better control. Also, make sure to never leave your baby unattended with your pet. Have a crate or a gated off area where your dog can go to get some peace and escape from your child if needed. There were many times when my twins first discovered how fun it could be to chase my dog and cat that I had to take the animals to my room for a break from the kids. When it comes to feeding your pets, keep their food in a place the kids can’t get to. This is for your pets, and for your sanity as well. Kids love to play in the water bowl and eat the dog food. I have had to dig some dog food from my son’s mouth on more than one occasion. He has probably eaten more dog food than I’d like to admit. More importantly, many dogs are very food aggressive or protective over their food and their treats and toys. This seems to be when most accidents and injuries occur to children.
Cats are a little easier because they tend to be pretty good at staying up and out of the way. My cat actually thinks it is fun to tease the kids and get just close enough to where they think they can get her, and then she runs away. There have been a few times that she was too slow and got dragged a little ways by the tail. She didn’t come back to play for awhile after that one. With cats, you will need to make sure that the litter box is in a place where the kids can’t get to it. The food and water can be put up where the kids can’t reach it, but the cat can hopefully jump up easily enough to eat and drink. Personally, my biggest concern with my cat and my babies was that she might snuggle them to death. She is a super sweet kitty and loves to lay right by your side. I was afraid that she might jump in their crib at night to snuggle and the babies wouldn’t be able to move, causing them to suffocate. Luckily, this wasn’t an issue but they do make netting to put over cribs for this very reason if needed.
You all know your furry babies better than anyone else and many of you may have absolutely no concerns about how they will react when you bring a new baby home. Some, however aren’t so lucky and have problems with the transition. There are even a few who are never able to make it work out. We are always here to answer any of your questions and to help counsel you through difficult times or decisions you may have to make.
As far as Lexi goes, she is still my little 4 legged baby but does not, unfortunately, get the attention she once did. I feel guilty sometimes when I see her laying off to the side watching, while I play with the kids. I try to give her extra attention in the evening once the boys are in bed, but even that is hard since I now have a 6 month old that would like some one-on-one time without her brothers around. Not to mention that once everyone else is asleep is the only time that the laundry gets done, toys get picked up and other house cleaning gets taken care of. Life is not all bad for her. She still gets to go on walks, still comes to work with me everyday and she gets a lot more treats now. The boys have found out that it is fun to share their food with Lexi and they drop a ton on the floor. I’d say mealtime is Lexi’s favorite time of day now. I know that as the kids get older she will have some fun little playmates!
Happy New Year!!
Dr. Stephanie Bradley
Tis the Season for. . . .Chocolate!!!
http://blog.jezrose.co.uk/will-dogs-die-from-eating-chocolate.html
Christmas is a wonderful, fun time of the year…. until your dog eats an entire stocking full of Hershey kisses, Tootsie Rolls, M&M’s, Peanut Butter cups and then finishes up with your box of Russell Stovers’s mixed chocolate assortment and a few Lindor Truffles just for good measure. Now, you are at the emergency veterinary hospital, Christmas just got a little more expensive and you are definitely not enjoying the holidays anymore! At this point, you are just hoping that your dog survives this Christmas and lives to see another.
Chocolate contains theobromine and caffeine, both of which are toxic to dogs and cats. There are varying amounts of these toxic ingredients in different types of chocolate. Baking chocolate and dark chocolate have a much higher concentration than milk chocolate and white chocolate.
If you are lucky, your dog will feel nauseated from eating all this chocolate and throw up. The messy chocolatey vomit will definitely not be pleasant to clean up, but at least most of the chocolate will be out of your dogs system. If you weren’t this lucky then definitely call your veterinarian first. Many times our sneaky little pets gobble up all these goodies when we aren’t home and its hard to tell how much time has elapsed since it was initially ingested. Usually, our first bit of advice is to induce vomiting with hydrogen peroxide. Then, depending on size of the dog, amount that we think was eaten, clinical signs, and time elapsed we may have to see your pet for hospitalization and observation.
Clinical signs that may be observed with chocolate toxicity include nausea, vomiting, panting, weakness, ataxia (a neurological condition where they appear to be drunk when they walk), diarrhea, hyper-excitement, muscle tremors, and seizures. It can also cause hyperthermia, an increased, rapid heart rate, and cardiac arrhythmias. Chocolate can even cause death due to prolonged cardiac arrhythmias and respiratory failure several days later.
Treatment is aimed at 1.) decreasing further absorption by inducing vomiting and possibly administering a compound called activated charcoal to help adsorb some of the toxins. 2.) increasing the excretion of the toxins. This is done by administering fluids to increase blood flow through the body and kidneys. 3.) providing symptomatic relief. We can give drugs to calm muscle tremors and rigidity and stop seizures. There are medications to calm nausea and vomiting. We also have medications to slow the heart or correct cardiac arrhythmias.
Fortunately most cases of chocolate toxicity end happily and do not require extensive hospitalization. However, it has the potential to be very serious and even deadly so be aware of this tasty toxin and take the precautions necessary to keep your pets safe during the holidays!
Merry Christmas from everyone here at Heritage Veterinary Hospital!
Dr. Stephanie Bradley
Buster Man, quite the swimmer…
http://animals.nationalgeographic.com/wallpaper/animals/photos/monkeys/spider-monkey/
Hello all!
The inevitable finally happened over the weekend. Buster was outside, I was standing at the back door watching him. He started walking very near the pool. I called his name…he looked in my direction…his foot slipped…into the pool he went! I’ve always wondered what my plan would be in this particular situation. I’ve gone through the scenario multiple times in my head. Some involved grabbing the pool skimmer and scooping him up and out of the pool. Some involved a glorious swan dive and powerful butterfly stroke that eventually resulted in his dramatic rescue.
It wasn’t so graceful as all that.
My husband compared my immediate rush into the pool to a crazed “spider monkey”. Let me tell you, a foray into the Polar Bear Club was not on my Christmas list this year. That was some VERY. COLD. WATER!! Luckily, Buster was saved quickly and hopefully has learned not to follow the sound of flowing water in the backyard…
At this point, its probably pretty obvious that he has not regained much vision but I’m happy to report, his glaucoma is successfully managed. It was going so well in fact, his opthalmalogist and I attempted to try to wean him down on his glaucoma meds. “Attempted” is the key word. Unfortunately, he was not quite ready and his pressure started to creep up again so it was quickly determined that we had to go back to his old med schedule. (I was REALLY hoping to decrease the frequency of meds as he is currently on 7 different ones and they must be given at least 5 minutes apart 3 times a day). Oh well, thank goodness for small favors right?
Thanks so much to everyone that has been following Buster’s harrowing adventures. Your kind words and prayers have been very much appreciated this holiday season. I hope everyone has a very Merry Christmas and a Happy New Year!
Jessica Zink, DVM
Buster Man snoozing in the break room
Update on Buster
Buster today
Hello all! It has been a bit of a rollercoaster over the course the week. Buster’s pressure has flucuated a great deal and despite 3 emergency efforts to reduce it which were only briefly successful, I think we have finally achieved a good, steady pressure level. Unfortunately, this may be more optimism than is really appropriate as the pressure has only been reliably down for around 24 hours. Nevertheless, I’m going to maintain this positive outlook because he has been unable to maintain a decent pressure for even this amount of time.
The details of this week are pretty scary and pretty remarkable at the same time. The emergency procedures I am referring to involve giving a medication called Mannitol which is typically used in head trauma cases to remove excess pressure on the brain. This medication is a concentrated salt solution and causes fluid to shift away from normal tissues quickly and by itself comes with its own amount of risk. For this reason it is typically reserved for the most critical of cases and unfortunately Buster fit that criteria. He had Mannitol on Tuesday m0rning and his pressure was reduced a great deal pretty quickly but went back up by the next day so had to be repeated. Unfortunately, the second time the pressure was only reduced for a few hours and went right back up into the mid 60 range. As a reminder, normal intraocular pressure should be under 20 and humans have described pressures in the 40-60 range as the most excrutiating migraine pain they have ever experienced. At that point, I became extremely worried and so with the help of his opthalmalogist, Buster was anesthetized and fluid was physically removed from the front chamber of his eye using a small syringe. This is not a commonly performed procedure but with a pressure as high as Buster’s was and without the ability to administer more Mannitol safely, it was our only remaining option to hopefully preserve vision in that eye. After having gone through all that, poor Buster again had very high pressures the following day. At that point, the opthalmalogist and I discussed the last and final option to preserve the eye. Cryotherapy was his recommendation.
Cryotherapy is a procedure that freezes portions of the structures that produce fluid (the ciliary bodies) in the front portion of the eye. This procedure has many potential complications. It nearly always causes a great deal of inflammation within the eye (uveitis) which by itself can cause many problems that may have future consequences on the ability to retain vision. Another set of potential issues is if too much of the ciliary body is damaged, the eye is unable to keep filled and retain its shape and if too little is damaged, there is still too much fluid being produced and the glaucoma is not resolved. The good news is that approximately 70-75% of animals will have function following this surgery despite the potential for complications. I was still very nervous as it would involve yet another round of anesthesia for Buster and given his previous poor luck, I was concerned that Buster may again be in that 25-30% range. I made plans to leave the office early to make a trip out to the surgeon’s office and then, miraculously, something happened. Buster’s pressure started dropping. Neither myself nor Buster’s ophthalmologist are quite sure as to what may have changed to drop his pressure after previous efforts had failed but after arriving at his office, Buster’s pressure was still just under 10 so we decided to postpone the surgery. I am happy to report that his pressure this morning was 11 and seems to be holding. I am still unsure as to whether he will retain his ability to see as his pupil has been very constricted this entire time which prevents vision and I have also been unable to assess the health of his retina, but at least the excruciating pain has passed and that is something to celebrate. I will keep updating as things progress but for now, I will just enjoy his happier attitude and hope for the best.
Jessica Zink, DVM
The Joys and Struggles of Cataract Surgery: From an Owner and Veterinarian’s Perspective
http://www.childhoodcataracts.org.uk/medical/howeyeworks.html
My old man, Buster, is one week out after having cataract surgery. Let me give you a little background on him. Buster is a 14 year old Rat Terrier that started developing cataracts about 5 years ago. Cataract is a collective term that, at its most basic definition, describes a loss of transparency of the lens that is usually hereditary and eventually leads to blindness. Not all opacities in the eye are the result of a cataract. A common cause of cloudiness seen in the eyes of an older pet is nuclear sclerosis. Nuclear sclerosis is the result of normal aging changes that cause stiffening of the lens and do not affect vision. Your veterinarian can make the distinction between the two.
Ok, back to Buster. For starters, this little guy has been the apple of my eye since he was 6 weeks old. He has had issues with anesthesia in the past which prevented me from having the procedure done earlier. It was only his recent major loss of vision and the fact that I have a pool in my backyard that made me finally come to the decision for him to have the surgery. The surgery to which I am referring is termed a Phacoemulsification. In this procedure, a veterinary opthalmologist makes an incision into the eye at the junction of the sclera (white part) and cornea (clear part). An instrument is then inserted into the lens capsule (the tissue surrounding the lens) and using high-frequency ultrasonic waves, the lens is shattered and removed. Many surgeons will place an intraocular lens implant in the remaining lens capsule to aid in vision correction. Buster had an implant placed during his surgery and upon recovery was able to see quite well that day.
According to current literature, approximately 95% of patients will have useful vision and relatively low complication rates. Unfortunately, Buster is in that 5% category. The most common complications associated with a surgery of this nature are uveitis (inflammation within the eye) and glaucoma. Buster is currently struggling with what was previously moderate glaucoma the day after surgery and has recently become full blown severe glaucoma. Glaucoma is increased intraocular pressure or increased pressure within the eye. Signs of glaucoma are cloudiness of the cornea, red sclera, and a bulging eye. Unfortunately, this by itself will cause blindness.
Let me start by saying that cataract surgery is the best way to improve vision in a pet that has developed cataracts and subsequently, vision deficits. It is a surgery that I have observed multiple times and I know it to be very safe and tremendously helpful to those pets whose quality of life is suffering due to issues with vision. I have recommended the surgery on numerous occasions to clients and have seen great successes. Unfortunately, my own experience has been more challenging and thankfully I am a veterinarian and am able to monitor Buster for rapid changes that jeopardize his recovery. It is still very touch and go, his pressure today is 63 where normal intraocular pressure is under 20. This has been a rapid development and he is under therapy but it is very painful both for him and for me. He is disoriented because he can’t see and glaucoma can be very painful all by itself. I am hopeful that the treaments received today will greatly decrease that pressure to a more normal level but the question remains, how long will it last?
Cataract surgery is not for every pet. Many pets will do very well with decreasing vision, even to the level of blindness as it is typically a slow progression, unless induced by diabetes which can cause rapid development of cataracts. The point to focus on is that many pets will adjust to declining vision and cope nicely. I will always advocate for the surgery if it is within your means to provide it, even with the difficulties I have experienced with my own dog. I will keep you posted as to Buster’s condition and hope that everyone has a happy, healthy holiday season.
Buster man post-op, evening after surgery
Jessica Zink, DVM
Heritage Veterinary Hospital
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