Breathing Difficulties
My Partner and I recently got a Pekingese puppy. We have named him Foible. We purchased him from a breeder who assured us he is a pure bred. We didn't get any papers for him and don't know if the breeder is NZKC registered. The breeder said that Foible needed an operation to widen his sinus cavities and to alleviate breathing problems that are common to this breed.
The breeder said we needed to do it soon or it would be more expensive and painful for the dog if we left it until he was mature. He said that Foible was in good health and the operation was needed due to the breed type, not because of anything that Foible specifically had. We hadn't heard of this before and are seeking your opinion. Thanks for your time, David & Andrea.
Hi Foible and Family, we have never needed to perform that type of surgery with any of our client’s Pekingese here at VetCare so I’d say from my own experiences that the surgery is certainly not common for his, or indeed for any breed.
Although Foible does have a very short face like other brachecephalic breeds we use look at other factors like weight control and exercise for these little guys, rather than reaching for a scalpel. Of all brachecephalic breeds Bulldogs are most likely to have severe obstruction to airflow and sometimes need to go under the knife to shorten the soft palate tissues at the rear of the throat to prevent entrapment in their upper airways.
Not having papers is not a great concern, they’re only really required for showing dogs in competition and usually cost extra. The remarks made about his surgery are however a worry. To comment further I would need to examine Foible myself, which I would be more than happy to, as he may have something unusual going on with him specifically as an individual. I think the sooner the better.
Hyper - Hearts in cats (hypertrophic Cardiomyopathy)
Courtesy of Paws for thought magazine - by Chris Welland
Hyper-hearts is a common cat condition.
It is believed that as many as one in six cats have heart disease. Here Chris Welland looks at the symptoms and gives advice for owners if you suspect your cat may suffer from this condition.
It is believed that as many as one in six cats have heart disease. A high percentage suffer from a disorder called Hypertrophic Cardiomyopathy (HCM). A lot of cats will remain symptom free throughout their lives, some may develop congestive heart failure (CHF) and others can succumb to a devastating condition called arterial thromboembolism (ATE).
What is HCM?
HCM is a disease of the heart which leads to a thickening of the heart muscle and results in the heart not being able to relax properly. The disease is much more common in cats compared to people in which the estimated prevalence is only two in 1000. It is more frequently seen in male cats.
Gene mutations have been identified in Maine Coon and Ragdolls. Other predisposed breeds include American Shorthairs, Persians and Domestic Shorthairs. This disorder has been reported in cats from 3 months to 17 years of age. ATE is due to the tendency for blood clots to form on the lining of the enlarged heart. These clots often become free and end up blocking the blood supply to the hind legs.
What do owners see?
Many cats are free of symptoms. Some show a fast or difficult breathing pattern, can faint or become lethargic and have a decreased appetite. With ATE cats will often present with hind limb paralysis and will frequently cry in pain. Sadly sometimes the first sign may be the last sign – some cats can die suddenly with this disease.
What might your vet find?
Using the stethoscope, heart murmurs (abnormal heart sounds) or gallop rhythms (an extra heart sound that makes it sound like a galloping horse!) or an arrhythmia (abnormal rhythm) may be detected. Changes in the breathing pattern may also be found.
So how does my vet reach a diagnosis?
If your cat has signs of heart disease it should be checked out. It is vitally important to rule out other diseases that can thicken the heart muscle just like HCM. A blood test to check for hyperthyroidism, a blood pressure measurement and a red blood cell count (both anaemia and dehydration can affect heart parameters) should be undertaken early in the workup. In these disorders the heart muscle can remodel back to normal with treatment.
If these tests are normal the next step involves doing an ECG, chest x-rays, blood tests and most importantly an ultrasound exam (echocardiography or ‘echo’).
The ECG checks the electrical activity of the heart. Unfortunately highly variable and nonspecific results are often found.
Chest x-rays can be normal with mild disease. The heart may appear enlarged. Fluid in the chest or in the lungs appears with CHF.
Blood tests can help confirm the diagnosis of ATE. Overseas specific blood tests, referred to as biomarkers, have become available for use in cats. These have been used for some time in people. Potentially the most useful marker in cats is known as NTproBNP and is increased as the heart muscle gets stressed. This blood test may be useful to help confirm heart disease, as a screening test in ‘healthy’ individuals, to check whether the disease is progressing and to monitor whether medication is helping the heart. Like many blood tests, false positive and negative results and ‘grey area’ results will likely still be an issue.
Echocardiography is still regarded as the ‘gold standard’ test for HCM. An echo exam should always be undertaken after copy-cat conditions have been ruled out (see previous). The exam can usually confirm HCM, will reveal the form and severity of HCM and the findings will give a guide as to the risk for ATE.
Most cats seem to handle an Echo exam well (it is not a painful procedure), but occasionally ‘heart safe’ sedatives are given to calm an anxious feline.
My cat has HCM – do we need to treat?
- Due to the highly variable nature of the disease, your vet may consider the following:
- Ease of medication This is always top of the list! Most heart medications are tablets or capsules and in a lot of cases need to be given life-long.
- Echo findings Certain heart chamber measurements if exceeded can increase the like- lihood of ATE.
- Status of heart -whether your cat is in heart failure or not.
- Family history If you have owned a cat that has suffered from a complication of HCM then there will be the potential for an increased risk in related individuals.
- Serial echo exams / biomarker results If mild HCM is detected, your vet may recommend not treating at this stage. Rechecking the heart periodically (six monthly) may reveal any progression. Treatment may be started if the disease is advancing.
- Previous history If your cat has survived an episode of CHF or ATE, ongoing treatment is strongly recommended.
How do we treat?
Despite the high prevalence of HCM in cats, the ideal treatment strategy remains controversial. The same problem also exists in the prevention and treatment of cats at risk from ATE. The main focus of treatment of HCM is to try and get the heart muscle to ‘chill-out’ (to slow down and relax).
This has traditionally involved human drugs belonging to the classes of Beta blockers and calcium channel blockers. Drugs known as ACE inhibitors also improve forward blood flow. CHF is treated with a combination of drugs including diuretics to remove excessive fluid, and oxygen therapy. Treatment of ATE involves pain relief, sedatives and anticoagulant therapy (to prevent more blood clots).
Prevention of ATE has traditionally involved using low dose aspirin therapy. Recently drugs such as low molecular weight heparin (LMWH) and antiplatelet drugs such as clopidogrel are showing promise.
Is my cat going to be OK? A large number of cats will remain symptom free throughout their lives even without treatment. The long term prognosis for cats with CHF is guarded. Approximately one in three cats survive their initial episode of ATE. The average life expectancy of the survivors is approximately 1 year.
Should we screen for HCM?
With one in six cats in New Zealand potentially affected by HCM, screening is a good idea. There is a blood test available now in New Zealand to test for heart disease in cats and dogs DNA tests in the future may be able to rule out the disease lifelong in all cat breeds. Testing, either via echo or blood tests for biomarkers, will rule out significant HCM at this stage in your cat’s life. If HCM is detected, serial monitoring is useful to check whether the disease is progressing.
Note that many symptom-free cats will not need to be treated. However, cats are so good at masking disease that cats can have severe heart disease without owners noticing any signs.
The downside of screening is that it may reveal a disorder that may not ever be a problem for the cat but may cause undue anxiety in the owner.
Conclusion
Hyper-hearts in cats is a common, complex, confusing and controversial condition. Hopefully in the future we will have a better understanding of HCM and will reliably be able to prevent and treat the disease and its complications.
Diagnostic Plan
- History
- Physical Examination
- Blood tests
- to check for hyperthyroidism
- to check blood pressure
- to test red blood cell count
- ECG
- Chest x-rays
- Electrocardiography
- Echocardinology (ultrasound)
- Urine analysis
Therapeutic Plan
- Enforced rest
- Bronchodilators
- Oxygen therapy
- Removal of fluid from chest and abdomen
- Drugs that dilate blood vessels
- Aspirin
- Beta blockers
- Heparin
Dietary Plan
- A diet that avoids excess levels of sodium
Kennel Cough
Hi Dr Alex, I’ve got a gristly bone to grind with my usual kennel where Caesar, my beautiful Staffie stays whenever we go away on holiday. I went to drop him up there last week on our way out of town and they turned him away.
Fortunately I got a friend to take him at their home, so our trip wasn’t ruined but it was a really stressful experience. Although he had a nasal kennel cough vaccination 5 days prior they said this wasn’t good enough. We had that vaccination done especially at the kennel’s request because his annual shots were given 9 months before. What are they going on about? Confused in Ponsonby, Margaret.
Hi Margaret, this kennel cough scenario does my head in. I really sympathise with you. It is a disease which is a big risk when a large number of dogs are gathered in a small area, namely kennels. It’s caused by various combinations of 20 different bacteria and viruses.
The kennel cough vaccination blocks one of the worst of these, the annual shots includes protection against another of the worst respiratory viruses. The kennel cough vaccination gives 12 months protection, and is licensed for this having undergone stringent and well documented testing. Many years ago earlier versions of this vaccination did not have such a long effect.
Unfortunately for you and Caesar many kennels have refused to adopt this new information. The intra-nasal version of the vaccination that Caesar had actually works within 3 days to give faster protection than the standard type of jab which takes 1 week to reach full effect.
This is handy when travel plans are last Minuit. Caesar was as fully protected against kennel cough as you can get and he should have been taken in at your kennel. As educated clients of these pet accommodations you need to work together with the veterinary community to update information and change these unfounded demands.
Kidney Failure
Hi Alex, I’ve afraid I’ve got some issues with my Blue Heeler “Beema” and I’m somewhat confused and unsure where to go from here. I haven’t seen you for ages since I moved out of Grey Lynn and have been using another vet. They’ve taken her off her Metacam drops because of some kidney troubles starting up. As of a couple of weeks ago she was on no meds for her arthritis and she won't eat the special dog food with kidney medicines in it. So now she is actually getting no meds for either arthritis or kidney problems. I've been feeding her boiled chicken and rice and she's lost quite a bit of condition. What else could I be doing?? Regards, Jim.
Hi Jim, I’m really sorry to hear that. I’m glad they’ve taken her off the nsaids as they will play havoc with kidneys and gut lining if she started to dehydrate with the kidneys struggling to retain fluids. Instead we’ve got to reach for supportive arthritis treatments. I would go with glucosamine and green lip mussel extracts as either a powder or capsule. I’d also add fish or flax seed oil supplements for her joints. In addition it’s well worth trialling 4 injections (once weekly) of Cartrophen (a glycosaminoglycan) which supports joint surface rebuilding and then give a single dose once monthly if good improvement is observed. We are fortunate now at the many quality pet food brands that make a full range of kidney diets with different flavours and textures. Keep trying all types until you hit one she likes. Kidney medications I would use would include Famox tablets twice daily to settle gut lining and increase appetite (to assist our dietary modification). I’d also try an ace inhibitor to increase kidney blood flow and thereby function, reducing fluid, protein, mineral and water soluble vitamin loss. If we can get Beema eating and well hydrated she could do well for years to come. Kind regards, Dr Alex Melrose. VetCare Grey Lynn. 408 great North Rd. 09 3613500. www.vetcare.net.nz .
Sneezing
The reasons that your cat may sneeze can range from being extremely minor to being a serious medical condition.
A cat that is sneezing, intermittently may have simply inhaled an irritant in to their nasal passage during their investigation of something in their environment. Inhalation of dust & pollens can cause rapid sneezing, just like it does in humans.
Cats can also have allergies to mould & food, among other things. Mould is a common reason why your cat may be sneezing. Microscopic mould spores are very irritating to both human and kitty nasal passages. Larger objects like blades of grass can even become lodged in the back of cat’s sinuses, requiring extraction under anaesthetic.
Another cause of sneezing in cats can be complications from dental disease. If your cat’s gums & teeth become infected, this can also affect neighbouring nasal passages, extending dorsally into their sinus passages. Get your vet to check your cat’s teeth & gums for redness & swelling.
Commercial cleaning products in your house like air fresheners, perfume or cologne or many other aromatic common household products, even kitty litter dust can also contribute to your cat sneezing.
A very common cause for cat sneezing is ‘Feline Respiratory Disease’ this is a highly contagious disease causing conjunctivitis, sneezing, runny eyes and nose, and sometimes mouth ulcers and loss of appetite. In severe cases cats may die or be left with chronic respiratory infection. If a cat develops this disease it has a tendency to weaken the cat’s immune system, leaving the cats own natural abilities to fight infections and irritants weakened and they become more susceptible to aliments such as chronic sinus infections and asthma.
We recommend that you see your veterinarian to narrow down the possible causes and in case your cat does require medical treatment. They will take the time to investigate the situation and discover the root cause.
Snorring Operation
Hi Alex,
I have a 5 year old Chihuahua X Brussels Griffon who has the most INSANE snoring problem. It drives me and my partner absolutely bonkers, but we feel it would be unfair to remove him from the bedroom at bedtime since he's always been allowed to sleep on/in the bed (just like a small child).
His snoring appears to be getting worse the older he gets. When I first got him at 6 months old my vet mentioned there was an operation to fix this but unless it was particularly annoying he wouldn't recommend it as it's very expensive. Approximately how much would an operation like this cost?
He also has trouble breathing when he gets over excited and snorts like a little pig. The noise sounds like it's coming from his throat, rather than his nose though. His breathing is fine during walks so I'm not too concerned. It's just annoying!
Thanks and Regards,
Deborah
Hi Deborah.
I’ve got a 2 year old black Griffon myself who pulls out some pretty cool snoring sounds some nights from his elevated position sleeping on the bed, so I know what you’re talking about!
The deterioration in his snoring as he ages, and under heavy exercise is also pretty common, but can be caused by a few totally different scenarios.
With these cases we start with an examination of the throat under light anaesthesia, ideally using a scope. We are looking for narrowing of the nasal passages, benign polyps, partially collapsing larynx and (the most common) an elongated soft palate.
All short faced (brachycephalic) breeds are more prone to these airway problems with all those structures being squashed together genetically. Surgery can then be performed if required, polyps removed, nasal strictures released, larynx tied back and soft palate shortened.
All of these conditions will worsen with increased weight, and possibly with time as disrupted air flow puts pressure on surrounding structures.
The common occurrence of a soft palate being long enough to become entrapped in the epiglottis is what your old vet was previously mentioning. Surgery of this condition is only recommended when the dog shows difficulty breathing during moderate walks. The major complication with this surgery is creating a predisposition to aspiration pneumonia, i.e. a larger gap for food to be accidently breathed in.
We refer these operations to our specialist soft tissue surgeon at VSG, and costs would be in the order of $3,000.
Kind regards, Dr Alex Melrose.
