Posted on Leave a comment

Gastroesophageal Reflux Disease: Symptoms, Diagnoses and Treatment

Overview
    Add a header to begin generating the table of contents
    Scroll to Top

    What is Gastroesophageal Reflux Disease in Dogs?

    Photo Credit: VCA

    Gastroesophageal reflux disease (GERD) is a chronic condition in dogs in which stomach acid flows from the stomach to the esophagus. When the condition isn’t present, a valve referred to as the lower esophageal sphincter prevents this abnormal flow of acid. For dogs who experience GERD, the acid instead passes right through this valve and instead enters the esophagus.

    The stomach acid causes irritation once it enters the esophagus and can cause a great variety of clinical signs and mimics that of heartburn in humans. 

    What Causes Gastroesophageal Reflux Disease in Dogs?

    There are a few common causes of GERD including: 

    • Excessive acid production of the stomach leading to  fluid leaking back into the esophagus
    • Certain anesthetic procedures damage the esophageal sphincter’s ability to fully close the opening leading to reflux 
    • Chronic vomiting (commonly observed in dogs with abnormal liver and kidney function) 

    In some instances, the condition may be caused by an underlying congenital condition, such as hiatal hernia, which occurs when the upper part of the dog’s stomach bulges through the diaphragm into the chest cavity. This condition is often observed in Shar-Pei breeds and English Bulldogs. If a hiatal hernia or other underlying cause is present, your vet may recommend a surgical procedure to correct the issue, in turn correcting GERD.  

    Who’s At Risk of Developing Gastroesophageal Reflux Disease?

    As mentioned above, a congenital condition called Hiatal Hernia, is often observed in Shar-Pei breeds and English bulldogs, leading to GERD. 

    Additionally, younger dogs whose esophageal sphincters have not fully developed yet are at an increased risk of developing GERD. 

    What are the Symptoms of Gastroesophageal Reflux Disease?

    The most common symptoms of Gastroesophageal Reflux Disease in dogs include: 

    • Difficulty swallowing
    • Decrease in appetite 
    • Regurgitation following eating
    • Lip licking 
    • Change in bark 
    • Persistent coughing
    • Appearing general discomfort 
    • Restlessness 
    • Weight loss (observed in severe cases) 

    .

    How Can Gastroesophageal Reflux Disease in Dogs Be Prevented?

    While GERD may not be fully preventable, there are measures you can take to reduce the likelihood of GERD developing. Feeding your dog on a consistent, frequent meal schedule reduces the pressure on their gastrointestinal system.

    Additionally, if your dog is prone to acid reflux, softer dog foods can be beneficial as they decrease how much work the digestive enzymes must do to digest the food. 

    How is Gastroesophageal Reflux Disease Diagnosed?

    Photo Credit: BrindleBerry Acres

    Your veterinarian will likely diagnose GERD with a combination of a physical exam and various laboratory tests. 

    During the exam portion, your vet will search for pain and locate any abdominal masses, obstructions, or any other abnormalities that may be present. 

    A series of diagnostic testing will be performed. This includes a complete blood cell count lab test in order to assess your dog’s red blood cells, white blood cells, and platelets. Information will also be collected about how the internal organs, such as the liver and kidneys, are functioning. A urinalysis will also likely be done to examine your dog’s level of hydration and kidney function. 

    Finally, imaging such as radiography and ultrasound, will likely be necessary. Your vet will use these to examine your dog’s chest and abdomen for any signs of masses, infection, obstruction in the intestines, and any other abnormalities present. Since GERD symptoms can mimic many types of conditions, this imaging will help to rule out any other issues. 

    Dependent upon results of the exam and tests, your veterinarian may refer you to a veterinary specialist to continue to pursue further diagnostics. GERD is typically officially diagnosed based on an endoscopy. This procedure requires the patient to be anesthetized and a camera will be passed down the esophagus. The specialist will capture any inflammation in the esophagus, officially confirming the diagnosis of GERD. 

    What is the Treatment for Gastroesophageal Reflux Disease?

    A variety of different treatments for GERD. It is not unusual for your veterinarian to recommend a combination of treatments.

    In order to decrease stomach acidity, antacid medications are often prescribed. This class of medication includes famotidine, cimetidine, omeprazole, and ranitidine. While reflux can still occur on antacid medications, the damage and discomfort can be greatly reduced. 

    In addition to antacid medication, your vet may prescribe another medication to strengthen the lower esophageal sphincter by increasing muscle tone and decreasing the likelihood that stomach acid will enter into the esophagus. 

    A change in diet can also be beneficial to dogs with GERD. A low-fat prescription diet can reduce the production of stomach acid. Rather than larger, less frequent meals, feeding small frequent meals may help to reduce this reflux into the esophagus. 

    In most instances, even when all of these treatments are set into motion, it’s likely that some degree of reflux will still occur in your dog. A slurry called Sucralfate may be prescribed to coat the esophagus. The coating protects the esophagus’s fragile lining in turn reducing inflammation and progression of ulcers. 

    A variety of different treatments for GERD. It is not unusual for your veterinarian to recommend a combination of treatments.

    In order to decrease stomach acidity, antacid medications are often prescribed. This class of medication includes famotidine, cimetidine, omeprazole, and ranitidine. While reflux can still occur on antacid medications, the damage and discomfort can be greatly reduced. 

    In addition to antacid medication, your vet may prescribe another medication to strengthen the lower esophageal sphincter by increasing muscle tone and decreasing the likelihood that stomach acid will enter into the esophagus. 

    A change in diet can also be beneficial to dogs with GERD. A low-fat prescription diet can reduce the production of stomach acid. Rather than larger, less frequent meals, feeding small frequent meals may help to reduce this reflux into the esophagus. 

    In most instances, even when all of these treatments are set into motion, it’s likely that some degree of reflux will still occur in your dog. A slurry called Sucralfate may be prescribed to coat the esophagus. The coating protects the esophagus’s fragile lining in turn reducing inflammation and progression of ulcers. 

    Posted on Leave a comment

    Canine Stomatitis in Dogs: Symptoms, Diagnoses and Treatment

    Overview
      Add a header to begin generating the table of contents
      Scroll to Top

      What is Stomatitis in Dogs?

      Photo Credit: Veterinary Dental Center

      Canine Stomatitis is a condition of the mouth characterized by the irritation and inflammation of the soft tissues. In most instances, the condition causes ulcers to form inside of the dog’s mouth including the lips, tongue, gums, and back of the throat. Due to inflammation and ulcers, great discomfort and pain occurs, making it difficult for your dog to eat, drink, and even swallow in some cases. 

      What Causes Stomatitis in Dogs?

      Unfortunately, there is usually no single cause of stomatitis but is often associated with the development of dental disease. When dental disease develops, plaque accumulates along the gum line leading to swelling and irritation. Over time, bacteria multiply and the gums become infected. However, this is not always the case when it comes to Canine Stomatitis. Other possible causes behind Canine Stomatitis include: 

      • Hormone Disorders 
      • Kidney Failure 
      • Negative reaction to medications
      • Fungal or viral infections
      • Biting of toxic substance like certain plants or chemicals 

      Who’s at Risk of Developing Stomatitis?

      Canine Stomatitis is most commonly observed in certain breeds of dogs that are predisposed to the condition, including Cavalier King Charles spaniels, cocker spaniels, and Maltese.  Breeds that are at a higher risk of developing Gastritis include German shepherds, Rottweilers, and Shar-peis. 

      What are the Symptoms of Stomatitis?

      The most common symptoms of Canine Stomatitis include: 

      • Inflamed or swollen tissue in the mouth 
      • Odorous breath 
      • Ulcers in the mouth
      • Discomfort when eating or drinking
      • Excessive plaque on the teeth 
      • Increased saliva production and drooling 
      • Loss of appetite/weight loss

      How Can Stomatitis in Dogs Be Prevented?

      At-home dental care and keeping up with veterinary dental appointments is the best way to prevent stomatitis and other dental issues from occurring. A professional cleaning will reduce the build-up of tartar and plaque that leads to dental disease.

      How is Stomatitis Diagnosed?

      Diagnostic testing will likely be performed to rule out any other diseases or dental issues that look similar to Stomatitis. A biopsy will be taken and histology performed.

      What is the Treatment for Stomatitis?

      Photo Credit: DoctorVet-Laser Therapy

      Unfortunately, Stomatitis is difficult to completely cure and many dogs will experience repeated episodes of the condition. However, long-term treatment plans can help to ease your dog’s pain and discomfort. 

      Since the condition is very painful, your veterinarian’s first priority will be to get your dog’s discomfort under control so that they can carry out normal functions such as eating and drinking. Anti-inflammatory medications will likely be administered as well as antibiotics to heal the infection.

      Posted on Leave a comment

      Gastritis in Dogs: Symptoms, Diagnoses and Treatment

      Overview
        Add a header to begin generating the table of contents
        Scroll to Top

        What is Gastritis in Dogs?

        Gastritis is a condition that causes gastrointestinal inflammation or inflammation of the lining of the stomach. The condition can occur as a short episode which is defined as acute gastritis or have a longer duration which is defined as chronic gastritis. Chronic gastritis is often associated with other conditions such as allergy or parasitic infection. The condition often results in gastrointestinal upset including excessive vomiting. 

        What Causes Gastritis in Dogs?

        Acute gastritis actually occurs quite frequently in dogs. This is because many dogs are likely to eat unsolicited items such as garbage, spoiled food, foreign objects, grass, and table scraps. When acute gastritis occurs, most dogs recover within a few days when food is withheld. The likelihood of recovery is very good, even when the initial cause isn’t determined. There are many conditions and causes that are associated with gastritis in dogs including:

        • Severe allergies 
        • Parasitic infection 
        • Liver Disease 
        • Mast cell tumor 
        • Bacterial infection 
        • Foreign body 
        • Viral infection 
        • Kidney Disease 
        • Endocrine Disease

        Who’s At Risk of Developing Gastritis?

        Chronic Gastritis is most commonly observed in dogs under 5 years of age. Breeds that are at a higher risk of developing Gastritis include German shepherds, Rottweilers, and Shar-peis. 

        What Are the Symptoms of Gastritis?

        The majority of dogs that suffer from gastritis will experience excessive vomiting, often times the yellowish, foamy bile variety. In addition to this, you may observe signs such as: 

        • Blood or food in the vomit (especially if your dog has consumed something inappropriate such as a foreign object or table scraps) 
        • Gagging or breathing heavily following eating or drinking 
        • Tenderness around the stomach region
        • Loss of appetite 
        • Lethargy 
        • Dehydration due to persistent vomiting 
        • Hunching of the back (in an attempt to ease their abdominal discomfort)

        How Can Gastritis in Dogs Be Prevented?

        Whether or not Gastritis can be prevented is dependent upon the cause behind the condition. Oftentimes, Gastritis is the result of a change in diet, a new food allergy, or medication. When this is the case, it’s easier to prevent or stop Gastritis in its tracks. Many dogs will also develop Gastritis in response to getting into something they shouldn’t such as garbage, plants, or other foreign objects. Ensure that garbage and any other objects that pose a risk to your dog are not accessible in your home and yard. 

        However, if your dog’s case of Gastritis is associated with an underlying condition or disease, it is likely unpreventable. 

        How Is Gastritis Diagnosed?

        Tests for gastritis may include blood tests, urinalysis, fecal tests, abdominal X-rays, abdominal ultrasound, and endoscopy. In acute cases, only minimal diagnostics such as blood and urine tests are required.

        If the gastritis is chronic, more involved testing will be undertaken to determine the exact cause of your dog’s condition and symptoms. 

        What is the Treatment for Gastritis?

        Treatment for Gastritis is based on the specific cause. Most acute cases resolve without medical intervention. Non-medical treatment guidelines for acute gastritis typically include:

        • Withhold food for 24-48 hours 
        • Offer small amounts of water frequently during the first day  (if vomiting continues upon giving water, seek immediate veterinary treatment)
        • Once vomiting has subsided for 24 hours, feed half amount of typical food 
        • Resume feeding with small meals given frequently (usually about ½ of the normal daily amount of food, divided into 4-6 meals)
        • Over the next few days, gradually increase the amount of food offered 
        • if vomiting returns, notify your veterinarian and seek treatment 

        Medical treatment for dogs with gastritis may include:

        • Anti-vomiting medications
        • Fluid treatment if dehydrated 
        • Medications for ulcers if detected 

        What is the Prognosis for Gastritis?

        The prognosis is good for cases of acute gastritis. However, for chronic gastritis, the prognosis is dependent upon the underlying cause.

        Posted on Leave a comment

        Luxating Patella in Dogs: Symptoms, Diagnoses and Treatment

        Overview
          Add a header to begin generating the table of contents
          Scroll to Top

          What is a Luxating Patella in Dogs?

          A luxating patella is a painful condition that occurs when the knee cap moves out of its normal position in dogs.  

          Patellar luxation is classified into several degrees or classes, ranging from mild luxation, in which the kneecap only luxates when directly stressed, to moderate luxation, in which the kneecap sticks out on a regular basis, to extreme luxation, in which the kneecap has dislocated the majority of the time. In affected dogs, one or both kneecaps may luxate to varying degrees. Some dogs can live their entire lives with this condition and not be affected long term, whereas for others, the inner side of the groove in the femur may wear down and cause permanent, painful issues. There are four grades:

          • Grade l: Manual pressure causes the kneecap to dislocate from its natural position, but it quickly returns to its normal position when the pressure is relieved. 
          • Grade II: When subjected to manual pressure, the kneecap easily moves out of its normal position and remains displaced until manually corrected.
          • Grade III: The kneecap is frequently disjointed but can be moved back into place with manual pressure. However, once the manual pressure is removed, the patella begins to luxate on its own. 

          Grade IV: The kneecap is dislocated from its normal position 100 percent of the time and cannot be manually repositioned.

          What Causes a Luxating Patella in Dogs?

          The patellar ligament connects the large thigh muscles to a point on the tibia and is located beneath the kneecap. The force generated by these muscles is transmitted to the shin bone via the patellar ligament. This causes the knee to straighten or extend. The patella slides up and down in its groove (trochlear groove) during this movement, which helps keep the patellar ligament in place.

          A luxating patella in dogs can be caused by a traumatic injury, but it is more commonly caused by joint or limb structure abnormalities, such as the femur groove where the kneecap sits being too shallow, or the area where the kneecap attaches to the shinbone (tibia) being displaced.

          Who’s At Risk of Developing a Luxating Patella?

          Small and toy breed dogs such as Maltese and Chihuahuas, are likely to inherit a luxating patella. But in the end, all dogs can be at risk for a luxating patella.

          What are the Symptoms of a Luxating Patella in Dogs?

          The signs of a luxating patella may vary based on the grade of luxation. But the most common sign is a dog that suddenly skips while walking or run on three legs, and then the dog returns to normal. 

           

          Grade I is usually discovered by chance during a veterinarian’s examination and owners may not have noticed any physical signs of patellar luxation. With grade ll luxation, lameness can occur when the patella slips out of its normal position, and it can be uncomfortable and painful if the cartilage weakens as a result of repeated luxation. Grade lll causes gradual limb structure changes and/or cartilage damage from repeated luxation and causes increased pain, discomfort, and lameness in dogs. Grade lV symptoms include severe lameness, decreased mobility, and decreased limb function.

          How is a Luxating Patella Diagnosed?

          An orthopedic physical examination will be performed on the affected dog. Under sedation, the knee is palpated to assess ligament damage during this examination. X-rays of the pelvis, knee, and tibias will be done to assess the shape of the bones in the back leg and rule out hip dysplasia. A 3-D computed tomography (CT or CAT Scan) may also be done to provide an image of the entire back legs’ skeletal features In cases where the shape of the femur or tibia needs to be corrected. This advanced imaging technique usually assists the veterinary surgeon in planning the surgery.

          What is the Treatment for a Luxating Patella?

          The severity and grade of the luxating patella will determine the treatment options. Dogs with a grade l and ll luxating patella may be treated with pain and anti-inflammatory medications, exercise restrictions, weight management, and possibly physical therapy to rebuild strength. There are also braces that may assist in supporting your dog’s knee. Grade ll cases may also be treated with surgery due to the severe pain that is the result of cartilage damage. Both grade lll and grade lV are more often than not treated with surgery due to these grades severely affecting the dog’s quality of life. 

          The type of surgery varies based on if the correction is to either bony or soft tissue structures. But, the overall objective of luxating patella surgery is to realign the knee joint’s supporting structures so that the kneecap can move normally and stay in the femoral groove. Here are the most common strategies for luxating patella surgery:

          • Reinforcing the soft tissue structures of the knee joint.
          • Laterally shifting the joint that connects the kneecap to the shinbone.
          • Deepening the groove on the femur where the kneecap sits.
          • The tibial crest, which is the bony prominence below the knee where the patella tendon attaches, can be transposed to help realign the tendon, patella, and quadriceps.

          For recovery, your dog may need to wear a soft bandage or brace for three to five days and have their exercise restricted for four to eight weeks after surgery to allow the site to heal properly. During this time of recovery, your dog’s walks should be limited to short on-leash trips to the bathroom, and they may need to be crated or confined to a small room to limit activity. Physical rehabilitation can help reduce muscle mass loss on the affected limb and may allow some dogs to return to normal function sooner.

          How Much Does the Treatment for Luxating Patella Cost?

          The rehabilitation route can cost anywhere from $40 to over $100 per session depending on the exact treatment type such as hydrotherapy versus laser therapy.

          The cost of patella luxation surgery varies depending on where you live and who performs the procedure. General practitioners usually charge less than board-certified veterinary surgeons, who have more advanced training and experience with a variety of surgical techniques. The surgery can cost anywhere from $1,000 to $5,000.

          What is the Prognosis for a Luxating Patella?

          If surgery is performed, the prognosis is excellent and dogs should return to full use of their leg without pain. More than  90% of dog owners are pleased with their dog’s progress following surgery. In large dogs, the prognosis may be less favorable, especially when patellar luxation is combined with other abnormalities such as excessive long bone angulation or hip dysplasia. If your dog already has arthritis in the knee joint, he or she may experience intermittent pain in the leg and arthritis may progress. The possibility of recurrence of the luxated patella increases in higher grades but is not common.

           

          When it comes to non-surgical treatments, one study revealed that long-term outcomes for dogs with grade l and ll patellar luxations who have been treated non-surgically were less favorable than those for dogs who were treated surgically. In this study, 33% of the limbs in that study were treated without surgery. 86% had excellent to good results, while 14% had fair or poor results.

          Posted on Leave a comment

          Cranial Cruciate Ligament Tear in Dogs: Symptoms, Diagnoses and Treatment

          Overview
            Add a header to begin generating the table of contents
            Scroll to Top

            What is a Cranial Cruciate Ligament Tear in Dogs?

            Photo Credit: Good Vets

            The Cranial Cruciate Ligament, known as the CCL, is a connective tissue found in the knee of the dog that stabilizes the lower leg to the upper leg. The ligament connects the tibia, the bone beneath the knee, to the femur, the bone above. There are a number of CCL injuries that can occur in dogs. However, tears of the CCL are the most commonly observed.

            What Causes a Cranial Cruciate Ligament Tear in Dogs?

            CCL tears most commonly occur when the excessive internal rotation of the tibia takes place when the joint is partially flexed. Typically this is a result of exercise or running. One of the most common occurrences is when the dog is running and suddenly changes direction. This places the majority of the dog’s body weight on the knee joint, and excessive rotational force is placed on the cruciate ligament. The injury leads to the knee joint becoming unstable. 

            Who's at Risk of Developing a Cranial Cruciate Ligament Tear in Dogs?

            There are a number of factors that may contribute to a dog being at higher risk of developing a CCL injury: 

            Breed Type: Certain breeds are more prone to CCL injuries, including Labrador retrievers, Newfoundlands, German shepherds, rottweilers, and Golden retrievers. 

            Obesity: Overweight and obese dogs are four times more likely to tear or rupture their CCL than dogs at a healthy weight. Obesity can play a major role in CCL injuries. The extra weight causes additional strain on the dog’s joints and muscles, making the ligaments more prone to wear and tear. 

            Weekend Warriors: “Weekend warriors” are those dogs who don’t necessarily exercise on a regular basis, but partake in occasional strenuous exercise. 

            Previous Injury: Studies have shown that dogs who injure the CCL in one leg have a 50% greater chance of injuring the other side. This is because the dog will compensate and use the other leg more. More strain placed on the good side causes a risk of tearing or rupturing as well.

            What Are The Symptoms of a Cranial Cruciate Ligament Tear?

            Oftentimes, symptoms of a CCL tear come on gradually and will progressively worsen over a long period of time. However, in some incidents, there may be no obvious symptoms until the ligament actually ruptures.

            Symptoms of CCL injuries in dogs include:

            • Lameness or limping 
            • Favoring one leg
            • Stiffness after exercise
            • Swelling around the knee
            • Difficulty lying down or getting up
            • Pain or tenderness near the injured knee

            How Can a Cranial Cruciate Ligament Tear Be Prevented?

            There are a number of measures that can be taken to reduce a CCL tear from occurring in your dog: 

            • Maintain a healthy weight in your dog 
            • Provide proper warm-up for your dog before vigorous exercise 
            • Avoid “weekend warrior syndrome” – keep the amount of exercise your dog receives relatively consistent 
            • Provide the proper nutrients and vitamins needed to support joint health (ex. Omega-3 and healthy oils)

            How is a Cranial Cruciate Ligament Tear Diagnosed?

            A physical examination is necessary to diagnose a CCL tear. During your dog’s exam, your veterinarian will assess the affected leg by holding the femur in place while moving the tibia out. If it moves in a manner that can be compared to opening a drawer, the CCL is injured. 

            In addition to the physical exam, your veterinarian or orthopedic surgeon will order x-rays to assess the severity of the CCL injury and if there is fluid present in the joint.

            What Is The Treatment For a Cranial Cruciate Ligament Tear?

            Surgery is typically recommended for dogs with a CCL injury. However, this is on a case-by-case basis. Dogs weighing over 22 pounds usually require surgery in order to stabilize the knee. Smaller dogs weighing less than 22 pounds, may be able to heal without surgical intervention if severe restrictions are taken. 

            CCL surgery is very common and compared to that of an ACL surgery in a human. CCL repair surgery generally begins with an examination of the inside of the dog’s knee. When damaged or torn portions of the CCL are identified, they are removed during the procedure. There are a number of surgical methods that can be used to repair the injured CCL. There are four common surgical techniques executed to repair the CCL. These four techniques are Extracapsular Lateral Suture Stabilization, TightRope Technique, Tibial Plateau Leveling Osteotomy, and Tibial Tuberosity Advancement. Your veterinarian will discuss the pros and cons of each CCL surgery option and guide you and your dog in the right direction.