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VetHQ Newsletter
News and information for wellcare of our pets

Spring Wellbeing

 
It has been a great quarter for us at Vet HQ. We have had many wins that make our days so successful. To mention a few, Cassius, the one year old boxer, who has undergone 19 weeks of chemotherapy and is bouncing off the walls and looks great and is we are happy to say at this stage in remission. We also have seen Hermes recover from a nasty dog attack that saw him have a diaphragmatic hernia, abdominal hernia, pneumothorax and  severe spinal muscle damage. He underwent an epic surgery at Vet HQ with very successful results. JP has had seven skin tumors in 3 surgery’s removed and at this stage looks clear from any further disease. I have joked with his owner that like at your local café, I will give him JP’s 10th skin tumor surgery free. 
 
Unfortunately with the highs we have to also experience the lows and we have said good bye to 17 of our pets. Most from old age but some prematurely and we hope to see all those people who have lost their pets again soon under better circumstances.  For those of you who would like to remember your pets we have a memorial section on our web site and if you would like to provide us a photo we will remember them forever on the www. 
 
Recently,  I have been reflecting on my beginnings in this profession. In the last quarter I have visited several schools, talked at the Uni to the vet students and had several Work Experience students and Vet Students asking advice (and in some cases offering advice). I started Veterinary School in 1994 at Sydney University. I was lucky enough to pick up a Vet Nursing job at North Randwick and Lane Cove as a student. I remember the two nurses that were my boses. One of which was Kate, who is my head nurse now. I remember never being able to get everything done that would satisfy them. I remember wondering is this the right job for me? It is not the cleanest, nicely smelling or even well paid jobs in the world. However, as a profession, and what we can achieve on a daily basis, it has fulfilled all my ideals and goals. 
 
Tammy is having September off and we congratulate her on her thoroughness to detail and her exceptional knowledge that she has gained in the 2 years since graduating. Nikki one of our vet students is graduating this year and we wish her all the success she deserves in her years as a Veterinarian. To the rest of theVet HQ team, well done and congratulations on continuing to provide the highest quality of veterinary care and creating close bonds with our pets and clients. 
 
To you the clients, see you soon….but not too soon (as you all say to me!) 
 
Geoff 
 
 
Important Dates for the diary:
 
Christmas Breakfast in the park:   Saturday 8 December 8.30am
Last day of Dog Day Care: Friday 21 December. 
Christmas Hours: We will close at 1pm on December 24. We will be open as normal 27-30 December and we will again close at 1pm on 31 December. We will be open as normal from Wednesday 2 January. 
 
 

Itchy?

 
I will tell you a little story about Dino. Dino is now a 9 month old Rhodesian Ridgeback. He is a beautiful dog as you can see but suffered from allergies. After a few courses of antibiotics, antihistamines and some skin moisturiser cream we finally got his skin under control. About 1 month later it all came unstuck and Dino got worse again. After some careful history taking we realised that the Dino was being walked by a dog walker and in the preceding month until 3 days ago he had not been taken to a particular park Astrolabe park in Pagewood. 3 days ago he went to Astrolabe park and the rest is history. (It should be noted that Dino reacted to something in the park and plenty of dogs go to that park, so it is not the park that is at fault it is Dino’s immune system not being able to cope). 
 
There are many things that can cause itchy skin. Fleas, mites, infection (bacteria and fungus), food, endocrine disease, contact allergens (grass, materials, chemicals including shampoo’s, plants airborne particles), moulds and dust mites, and finally behaviour problems. Getting to the bottom of the ‘Itchy Pet’ can sometimes be very difficult and challenging and takes time. A dog that is only itchy in Spring/Summer is often an easier diagnosis where as a case that is itchy all year round can be very hard. 
 
Atopic dermatitis is a disease in which there is an inherited tendency to develop IgE antibodies in response to exposure to allergens that are inhaled or absorbed through the skin. This extremely common allergic skin disease is second only to flea allergy dermatitis in frequency, and affects about 10 percent of dogs.
 
Atopy begins in dogs 1 to 3 years of age. Susceptible breeds include Golden Retrievers, Labrador Retrievers, Lhasa Apsos, Wire Fox Terriers, West Highland White Terriers, Dalmatians, Poodles, English Setters, Irish Setters, Boxers, and Bulldogs, among others, although any dog may be affected. Even mixed breeds may suffer from atopy.
 
In early canine atopy, itching is seasonal and the skin looks normal. Dogs scratch at the ears and undersides of the body. The itching is often accompanied by face-rubbing, sneezing, a runny nose (known as allergic rhinitis),watery eyes, and licking at the paws (which leaves characteristic brown stains on the feet). In many dogs the disease does not progress beyond this stage.
 
When it does progress, an itch-scratch-itch cycle develops with deep scratches (called excoriations)in the skin, hair loss, scabs, crusts, and secondary bacterial skin infection. These dogs are miserable. In time, the skin becomes thick and darkly pigmented. A secondary dry or greasy seborrhea with flaky skin often develops in conjunction with the skin infection.
Ear canal infections may accompany these signs, or may be the sole manifestation of atopy. The ear flaps are red and inflamed, and the canals are filled with a brown wax that eventually causes bacterial or yeast otitis.
 
Canine atopy diagnosis can be suspected based on the history, location of skin lesions, and seasonal pattern of occurrence. Skin scrapings, bacterial and fungal cultures, skin biopsy, and a trial hypoallergenic test diet should be considered before embarking on an involved course of treatment for atopy. It is important to treat and eliminate fleas. The majority of dogs with canine atopy are allergic to fleas and may have an associated flea allergy dermatitis complicating the picture.
 
Treatment: The most effective long-term solution is to change the dog's living circumstances to avoid the allergen. The atopic dog is usually allergic to many different allergens, however, and often it is not possible to avoid exposure to them all. This has been the example of Dino where by avoiding the park has barely had an itch. 
 
There are a variety of treatments available to dogs that suffer allergic skin disease or atopy. It is important to talk to us first to discuss this before embarking on treatment. Food allergy although low down on the list as a cause of itching, is an easy one to change. We have also discovered that dogs allergic to house dust mites often react with grain mites and will benefit from diets with no grain. At Vet HQ we use a combination of fish oils, antihistamines, and topical medications and shampoos as our first line of defence. Every case is potentially a little different and so it is important to consult with us prior to commencing treatment. Occasionally Corticosteroids may have to be used to control the itch, however these are used sparingly and long term use is defiantly not advised. 
 
Dogs who do not respond to medical treatment can be considered for immunotherapy with hyposensitization. This involves skin testing to identify the allergen(s) and then desensitizing the dog to the specific irritants through a series of injections given over a period of 9 to 12 months or longer. Some dogs will require periodic boosters during times when allergens are heavy.
 

Lumps and Bumps on the Skin

 
Have you ever been giving your dog a bath and while shampooing them up found a lump on the skin you have never felt before? 
 
Imagine your pet sits in your lap and your fingers stumble upon a skin lump - what do you do? 
  • Panic? 
  • Cry? And think cancer.
  • Ignore it…. It’s not very big….yet?? 
  • Feel it every day and worry that it’s getting bigger? 
  • Rush down to the clinic as an emergency? 
 
Ideally, follow the following:
 
1.  Have you been in a tick area? If there is any concern that the lump may be a paralysis tick, please visit a vet ASAP. Ticks can be embedded into the skin and easily appear a new lump. 
 
2. Get the lump checked, its size and location documented. Remember not all lumps are equal: 
 
The size of the lump has no bearing on its severity. The lump in the picture below is a very serious type of tumour that has the potential to spread throughout the body. It is called a mast cell tumour. 

 
The lump in the picture below is a harmless lipoma. It may look dramatic but it is a fat lump.

 
Being on the surface of the skin does not make it less dangerous than being under the skin. Some lumps are true tumours while others may be misplaced normal tissue such as a hernia. This picture shows a rectal hernia from straining as a result of severe diarrhoea. 
 
However, you can’t tell what a lump is just by looking at it and feeling it. A fine needle aspirate is a technique that can be used to help identify the type of lump.  When performing a fine needle aspirate, a needle is placed into the skin and cells are removed. The needle is moved about within the lump and cells are withdrawn from many different levels. These cells are stained and looked at under the microscope. Sometimes these samples are sent to specialist pathologists for the cells to be identified. Occasionally a section of the lump – known as a biopsy is sent to laboratory.
 
 
The benefit of a fine needle aspirate is that the sample can be taken without a general anaesthetic. It will also give you some peace of mind. Even if the news is bad, then something can be done about the lump. Surgical resection is sometimes required and this is best performed early on in the life of the lump. If the news suggests that the lump is a benign mass then watchful waiting can be done. The lumps size, position and texture are closely monitored. All changes mean that retesting is required. 
 
The morale of the story is lumps should be checked and identified. The sampling can usually be done during a consultation. Just call us to make an appointment.  It’s always better to be “safe than sorry”. 
 
 

Harry the 17 year old and nothing will stop him. Not even cancer!

 
Harry is a 17 year old poodle crossbreed and presented for ear discomfort (shaking head and scratching) of the right ear only. The ear was found to be full of a waxy residue, and the ear pinnae surface had wax crusted onto the internal surface.
 
The ear canal was examined, cleaned and he was commenced onto medicated ear drops which target both bacteria and yeast. These both exist on the skin in normal healthy dogs but can become a problem when humidity or trauma to the skin allows them to proliferate into larger populations – causing itching and discomfort.
 
He returned 1 week later for a follow up appointment – the ear looked much improved but still not 100% as there was still a little residue inflammation. The inflammation is a result of infections – and it reduces the ability of the ear to rid itself of the waxy discharge. 
 
The following week another appointment was made to check the ear, but it had regressed and lots of purulent (pus –like )discharge was found in the ear canal. The follow appointment (after a week had lapsed) Harry was treated with a long acting antibiotic injection (convenia) as his skin had a generalised infection and the ear was resolving, although much slower than anticipated.
 
Cerumen is a natural lubricant and protector of the ear canal, and overproduction can be due to breed predisposition, inflamed ear canals, polyps or growths in the ear canal. In Harry’s case, there was no evidence of cerumen gland disruption in the left ear, and no obvious growths or polyps could be seen in the ear canal. 
 
Harry was started onto a more potent steroid ointment topically onto the ear pinna surface, in addition to the previously prescribed ear ointment. 
 
Some improvement was seen over the course of the following month but as soon as the topical ointments were stopped (even with a step down measure of reducing to every other day dosing), the ear discharge and crusting returned almost immediately.
 
At this point, a small bleeding mass was identified on otoscopic examination. The mass appeared to be adjacent to the tympanic membrane (ear drum) and fresh blood was seen as well as mucoid discharge. This was likely to be the cause of the ongoing ear disease (as it had been slowly growing in the ear and had only just grown large enough to be seen with the otoscope).
 
Harry was admitted into hospital for the day to undergo a general anaesthetic and have his right ear cleaned and suctioned and to biopsy the mass from the ear to decide what further treatments could be offered to rid his ear of the ongoing disease.
 
Under anaesthetic the right ear was able to be visualised completely and the remaining crusted discharge could be evacuated from the ear. The mass (approximately 7 mm in diameter and irregular in size and shape) was then easily seen. Forceps were used to grasp the mass to sample for histopathology and de-bulk it. With several attempts, the mass was largely removed and placed into formalin pots to send for laboratory analysis.
 
Once it had been removed, it was possible to see that the mass was likely growing through the tympanic membrane as its integrity was now compromised. 
 
Harry was recovered from anaesthetic and sent home with the topical ear drops as the anti-inflammatory component would help with the swelling and irritation. The histopathology results revealed that Harry’s right ear mass was a ceruminous gland carcinoma – a relatively uncommon diagnosis in dogs though usually patients are between 9-11 years of age. Secondary infections and ulcerations are commonly seen and can cause more discomfort than the primary lesion.  
 
To completely remove the mass, a total ear canal ablation would need to be performed. This is a major procedure with high risks for an older patient. 
 
Harry is currently being treated conservatively with topical medications into the ear to prevent the area developing secondary infections and ulcerations, and to reduce the growth rate of the mass.
 
If you pet has an irritated ear (or two) or has an unsavoury smell, please contact us at VetHQ to make an appointment to check their aural health.
 

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October 2012
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