Showing 106 posts tagged with "ask dr larry"
Love is a word that gets used a lot. In fact, it is thrown around so carelessly much of the time that it loses its true meaning for many of us. Genuine love is more rare. That's the love that comes with no strings attached. It's unconditional.
That's the kind of love Chris and I were so lucky to see between our good friends Mike and Ellie and their special dog, Cedar.
Cedar lost his battle with cancer late last week. Some of you first got to know Cedar with a post I did a couple of years ago, and some of you knew Cedar through more recent updates on his fight with squamous cell carcinoma.
We knew he would eventually lose that battle, but still we were not prepared to see him go. It happened too fast. It seems that he was just diagnosed, although that happened last summer. Love always tries to look on the bright side.
Looking back, Cedar had a life most dogs would envy. Heck, he had a life most people would envy.
He had the best of everything, including the best people in the world. He gave the best, too. He was there for Mike and Ellie through the good times and the bad, when Mike was sick and when he got well. Cedar helped Ellie care for Mike and in the end they returned the favor. 
Over the last month, Ellie made the six hour drive to Santa Fe to see the oncologist several times even though the prognosis was grim. What else could she do? There was never, ever, any question about that. They would do what ever Cedar needed. They would be there for him as he had been there for them his whole life.
It's a tough time now. There's not much to do except deal with the loss and remember the good times. We should all be so lucky to have a dog like Cedar. If you are lucky enough to be in that boat please give your dog a big hug in honor of Cedar and Mike and Ellie.
On today's Scratchings and Sniffings Out Loud podcast Dr. Grace and Dr. Larry discuss a serious but often manageable disease: diabetes. Interestingly enough, November is National Diabetes Month. As you can see on this CDC page for Diabetes, this disease is a "leading cause of kidney failure, blindness" and worse! What you might not know is that it affects dogs and cats, too.
Today, on our podcast, we will cover what it is and what to watch for. Next week, we will have Part II - with information on how to manage diabetes if your cat is diagnosed with it by your vet.
Our dog's eyes are very similar to ours. Like us, they have a lens in the front part of the eye that focuses light on to the retina in the back of the eye.
Some people use a camera analogy for that process where the lens is like the lens in a camera and the retina is like the film. Without the ability to focus, the image on the film will be blurred. If the lens remains closed, no image at all will appear on the film.
A cataract is something that forms in the lens that interrupts the flow of light to the retina and results in impaired vision. Depending on the severity of the opacity, a cataract can result in blurred vision or blindness.
Most cataracts in dogs are hereditary. There are upwards of forty different breeds that have the potential to inherit cataracts. Other causes are secondary to metabolic diseases like diabetes, eye trauma and injuries or the result of other primary diseases of the eye like uveitis.
If you notice some clouding of your dog's eye or if your dog starts bumping into things or maybe starts to hesitate to go down stairs, he could be developing a vision problem. Your veterinarian can examine your pet's eyes to determine whether a cataract is forming fairly easily. She can also run tests to determine whether the cataract is secondary to another condition or disease of the eye.
This is really important because the customary treatment for cataracts is surgical removal. Many dogs with hereditary cataracts are good surgical candidates but dogs with cataracts secondary to another eye disease may not be surgical candidates. In those dogs, resolution of the primary problem is the first step in treating the eye. And dogs with diabetes are not good surgery candidates unless their symptoms are well controlled.
Vision can be restored in many dogs with cataracts following surgery and there are even prosthetic lenses available for both dogs and cats that can return vision to almost normal.
There is a condition that occurs in many older dogs that can look like cataract formation. This condition is called either nuclear sclerosis or lenticular sclerosis and is very common in older dogs. The lens does appear to be cloudy in these dogs but their vision usually remains quite good and there is no real treatment needed. 
Darcie had nuclear sclerosis for several years before she passed away. She was deaf as a post but she could see pretty well at the end. Your veterinarian can tell the difference between cataract formation and age related changes in the eye.
There is no consistent way to prevent the development of cataracts, but there is an organization called CERF, or the Canine Eye Registry Foundation that helps breeders determine which dogs to breed. You can have your dog certified free of major heritable eye disease through this group. It's well worth it if you have one of the breeds involved with this and other hereditary eye diseases. Selective breeding is one way to limit the spread of these conditions.
Since I seem to be on an eye kick we might as well talk about the big kahoona of hereditary eye disease; Progressive Retinal Atrophy. I'll do that next week.
I did a post on glaucoma over on the pet insurance blog last summer. It was basically an overview of the disease process and potential treatment options. Interestingly, I got an e-mail from a reader with a dog that has glaucoma. It was thought provoking and merits general discussion.
There are two broad classifications with glaucoma. Primary glaucoma is due to a defect in the eye's drainage system and tends to be inherited. Secondary glaucoma is also the result of poor fluid drainage from the eye but the defect is due to some other issue. For instance, a tumor may be present that disrupts the outflow of aqueous humor and the resulting increase in intra ocular pressure is secondary to the presence of the tumor.
Another form of secondary glaucoma is due to something called lens luxation. The lens is the structure in the eye that helps us focus. Cataracts form in the lens resulting in clouding and loss of sight. The lens is held in place by fibers that attach to the inside of the eye. In certain breeds these fibers break down 
prematurely and the lens is no longer anchored in place. In some cases it flops around in the front part of the eye and it can interfere with the drainage system resulting in secondary glaucoma.
Lens luxation can be the result of trauma but more commonly, it, too, is an inherited defect. Lens luxation is more common in Border Collies, Brittany Spaniels, and many terrier breeds. In fact, our reader has a Wheaten Terrier that has glaucoma secondary to lens luxation.
She had been to see a veterinary ophthalmologist and he had recommended surgery to remove the lens to correct the glaucoma. Her dog was receiving medical treatment for the pressure build up and she wanted to know my opinion on the surgery.
It's really a matter of timing and the potential for preserving some sight in the 
eye. High intraocular pressure can do irreversible damage in as little as a few hours.
My assumption, in this case, is that the ophthalmologist assumed there had not been irreversible damage due to the glaucoma. In that case the surgery is really the only hope. If you don't remove the cause of the outflow problem you don't have a real chance of preserving the eye and some vision. It doesn't make much sense to treat a problem medically when the cause is a physical blockage that could be removed surgically.
There are no guarantees. though. All surgery involves risk and the outcome is not guaranteed. In this case it seems that the risk of surgery is justified.
I just watched an awesome video. It's a video on dealing with kidney disease for cat owners and it's available on the Partners In Animal Health website. The video is by the Cornell Feline Health Center and made possible by a grant from Purina Veterinary Diets.
This video can be an excellent companion to the several posts we've done on feline kidney disease including the Podcast Yvonne and I did with Dr Grace Long just last September.
This video is broken down into five chapters, each dealing with a certain aspect of kidney disease. It takes about twenty five minutes to view the entire video but if you have a cat afflicted with kidney disease it will be time well spent.
The first chapter covers diagnosis of kidney disease. This chapter features real life stories from cat owners and covers the early warning signs that you might see in a cat developing kidney disease. You'll also learn about the various diagnostic tests and procedures your veterinarian might perform to determine whether your cat might actually have kidney disease.
The second chapter is about kidney disease in general. They do a great job of explaining normal kidney function and demonstrating what goes wrong in the diseased kidney and how that translates into some of the signs you may see in your cat.
The third chapter is about therapy options. They cover the role of diet and explain why a change in diet helps slow the progression of kidney disease. They describe the alterations in key nutrients that make up a good kidney diet and explain how these different nutrient levels affect kidney function.
The diet they use in the video is Feline NF, one of the Purina Veterinary Diets available from your veterinarian. They also discuss the various medical therapies available to manage kidney disease and why each one might be effective.
The next chapter covers what you can expect if your cat has to be hospitalized to treat an episode of renal insufficiency. You'll learn about the role of intravenous fluid therapy and why and how we "flush the system" with a procedure known as diuresis.
And finally, the last chapter gives some hands on instruction in how to manage a chronic renal failure patient at home. At some point you may have to give your renal failure patient sub cutaneous fluids and this chapter does an excellent job of showing the proper way to administer this important fluid therapy.
This video is a must for cat owners dealing with this all too common problem. I'm sure you'll find it very informative and you'll come away with a lot of knowledge about how a normal kidney functions too. My friend Edwenna is really going to like this. I'm going to give her a call right now.
