Internal Medicine: 703.330.8809
Surgery & Behavior Medicine: 703.361.0710
 

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Cruciate Ligament Injuries in Dogs—Rarely in Cats

A Cranial Cruciate Ligament (CCL) injury is one of the most common orthopedic problems in dogs and is the most common reason for hind limb lameness in dogs. In people the CCL is called the Anterior Cruciate Ligament (ACL).

The CCL attaches the back of the femur to the front of the tibia and is responsible for stabilizing the knee joint. Dogs are susceptible to CCL injuries due to the natural slope of the knee that causes instability. CCL injuries occur in dogs of all breeds, ages, and sizes but they are especially common in Labrador Retrievers, Newfoundlands, Rottweilers, and Pit Bulls.

A CCL can be partially or completely torn. A partial CCL tear can cause symptoms that resolve over time, but the ligament can NOT repair itself. Eventually a partial CCL tear will eventually lead to a complete tear. The longer a CCL rupture is present the more arthritis forms and therefore, the pain and lameness increase. The majority of dogs who injure their CCL will also injure their meniscus that is the cartilage-like structure that is responsible for shock absorption and weight bearing. Due to the risk of degenerative changes it is advisable to seek veterinary care as early as possible.

Symptoms of a CCL injury include:

  • Lameness in a hind limb
  • Non-weight bearing on a hind limb
  • Trouble rising from sitting or lying position
  • Decreased activity
  • Hopping on three legs
  • Sitting with legs out to the side instead of under the body
  • Loss of muscle mass
  • Pain

Diagnosing a CCL injury can be as simple as palpating the knee and observing the dog as it walks. X-rays are usually taken to confirm the presence of fluid in the joint which occurs with injury, the degree of arthritis, and to rule out any other injuries such as a fracture or dislocation. The CCL and meniscus cannot be seen on x-rays.

Two important steps should be taken when treating a CCL injury:

  • Surgical repair
  • Medical management of arthritis

Many surgeons consider the TPLO (Tibial Plateau Leveling Osteotomy) surgery to be the gold standard for CCL injuries.

Keep Your Pets Safe at Halloween!

Follow these tips to ensure your pets have a safe and Happy Halloween.

Treats
Make sure your pets only receive pet-specific treats. Candy is unsafe for pets. There are two kinds of candy that are extremely dangerous for your pets.

Chocolate: In all forms chocolate can be toxic to your pet—dark chocolate and baking chocolate are the most potent and are the most dangerous forms for your pet. Symptoms of chocolate toxicity include, but are not limited to:

  • Vomiting and diarrhea
  • Excessive thirst and urination
  • Panting and restlessness
  • High heartrate
  • Severe cases can include
    • Muscle tremors
    • Seizures
    • Heart failure

If your pet has ingested a large amount of chocolate, especially dark and baking, take your pet to your regular vet or emergency hospital immediately.

Xylitol: This is an ingredient in sugar-free candy. Dogs and cats can’t process Xylitol like we can—even a small amount can be very toxic. If you think your pet has ingested Xylitol it is important to get them to your veterinarian or emergency hospital right away. Symptoms of Xylitol poisoning include, but are not limited to:
• Weakness/lethargy/collapse
• Vomiting and/or black tarry stools
• Tremors and seizures
• Loss of consciousness/coma

Safety: It is best to bring your pets inside before the trick or treating starts. The chaos, costumes, and surrounding activity can be overwhelming for them. Sadly some people take Halloween as an opportunity to do aggressive and mean things to pets. If your pet becomes agitated from repeated knocking on the door you can set up outside to pass out candy.

Decorations: Pumpkins, corn, hay, candles, and candy make for festive decorations. Be careful where you place them around the house. Pumpkins, although non- toxic, can cause upset stomachs if eaten in large volumes. Large chunks of pumpkin and especially corn can get lodged in the stomach or intestines making for an extremely dangerous blockage which would require immediate surgery. Don’t leave lit candles in places that could be easily knocked over. If you have particularly adventurous or playful pets it may be best to use outside decorations only.

Happy Halloween!

Veterinary Referral Center of Northern Virginia Applauds Our Licensed Veterinary Technicians During National Veterinary Technician Week

Our Licensed Veterinary Technicians (LVTs) play an essential role in the exceptional care we provide to our patients. They provide excellent nursing care, treatments, patient monitoring, and diagnostic assistance. They intubate patients, place IV catheters, draw blood, assist with ultrasounds, x-rays, and endoscopic exams, and provide laser therapy. Our LVTs assist in surgery and monitor anesthesia. They provide behavior medicine services. During National Veterinary Technician Week—we extend our sincere thanks to each and every one of our LVTs for all they do for our patients and our practice!

Iliopsoas (Groin Muscle) Strains in Dogs

The iliopsoas muscles are the major hip flexor muscles located in the groin. Strains of these muscles in dogs are an easily overlooked diagnosis. Agility dogs or dogs with knee injuries often have iliopsoas strains. Also, they are not uncommon in dogs that recently had orthopedic surgery.

Iliopsoas strains can present as a knee injury due to a one-sided limb lameness. Patients can be toe touching like a dog with a cruciate ligament injury. X-rays are not usually diagnostic for this condition. Diagnosis can usually be made by direct palpation of the area.

The following treatment protocols are used:

  • Rest is indicated to prevent further injury to the muscle.
  • Gabapentin and/or NSAIDS may help with the pain and inflammation.
  • Laser therapy has been shown to promote healing of iliopsoas strains.

Fall Allergies

Fall has arrived. The bright colors, brisk air, and the crunching leaves make it perfect for outdoor time. There is nothing like walking your pet on a crisp fall evening and letting them jump and chase the leaves. As wonderful as it sounds, fall brings allergies for some pets. Seasonal allergies significantly detract from your pet enjoying this wonderful season.
Pet do not typically absorb allergens through the nasal cavity like humans. Occasionally your pet can have similar symptoms such as sneezing and coughing, but most pet allergens are absorbed through the skin causing topical symptoms. Some allergy symptoms include:
  • Itchy skin which results in constant scratching, head shaking, and chewing at paws.
  • This can cause pink or red discoloration of the fur at chronically licked areas, especially paws, because of the saliva.
  • Constant scratching can also cause hair loss and open wounds. The soft hairless belly is a great way to check for lesions—red crusty spots on the stomach often are signs of a skin infection.
    • Reoccurring ear infections.
    • Red eyes and chronic watery discharge.
Although allergies can manifest with different symptoms, the skin issues stated above are our number one way of telling whether your pet is suffering from allergies or not. Some pets suffer from year-round allergies while others are worse in the fall or spring.
If you think your pet is having seasonal allergies, we recommend a visit to your veterinarian to get your pet some much-needed relief. Mild cases of allergies that last a couple of months can be treated conservatively. In some cases, if the allergies are more severe or a skin infection has begun, your pet may need more medical treatment. Treatments are prescribed on a case-by-case basis and include but are not limited to:
  • Anti-itch shampoos
  • Antihistamines
  • Ear medicine
  • Eye drops
  • Steroids
  • Antibiotics
  • Allergy shots (Allergy shots are provided for severe cases following extensive allergy work ups—allergy testing and a pet dermatologist are available if needed)
No one likes to be itchy and miserable when they are supposed to be enjoying outside time in the cooler temperatures. Make sure to obtain relief for your pet if you notice any signs of allergies so they can have a fantastic fall!

Lyme Disease

Lyme disease is a bacterial infection that travels through the blood and can affect joints, organs, or give an overall feeling of illness. Ticks, particularly deer ticks, are carriers of Lyme Disease.

The tick needs to be attached to your pet for 24 to 48 hours before the disease can be transferred. Adult ticks are not killed off by frost and will often just lie dormant for a warmer day. Therefore, ticks present a health concern year round.

Symptoms for Lyme Disease include but are not limited to:

  • Fever
  • Loss of Appetite
  • Lethargy
  • Lameness—which can be intermittent, reoccurring, or shifting from joint to joint
  • Stiffness, Discomfort, and Pain
  • Swelling of Joints

 

There are two different blood tests that can be used to check for Lyme Disease. There is an in-house blood test available with results in ten minutes. There are more in-depth blood panels that can be sent out if Lyme Disease or other tick-borne diseases are suspected.

If discovered early, Lyme Disease can be treated with a short dose of antibiotics. More difficult cases, which have affected the organs, may require more extensive treatments. Lyme Disease may also lay dormant for a while and occasionally reoccur and need another course of antibiotics.

There are simple ways you can help prevent Lyme Disease in your pet:

  • Year round flea and tick prevention is available through your veterinarian, online or local participating retailer. It is best to administer your pet’s flea and tick prevention year round since adult ticks are active almost all year.
  • Check your pet after playing outside and immediately remove any ticks found.
  • Avoid letting your pets play in higher grasses and thickly wooded areas.
  • You can do treatments for your own yard to protect against ticks.
  • Yearly blood tests are recommended to catch any possible positive results that are asymptomatic.
  • Lyme Disease vaccines are available through your veterinarian as well. They can be started at any age. An initial injection is followed up with a booster two weeks later with a yearly vaccine recommended.

Urinary Issues in Cats

Feline Lower Urinary Tract Disease (FLUTD) and Feline Urologic Syndrome (FUS) are not just one problem, but a myriad of clinical symptoms involving the cat’s urinary system. It is very important to address these with your veterinarian promptly. Symptoms include:

  • Painful or more frequent urination
  • Prolonged squatting in the litter box
  • Increased visits to the litter box
  • Bloody or cloudy urine
  • Dribbling urine
  • Excessive licking at the urinary opening
  • Excessive water intake
  • Inability to urinate

 

FLUTD and FUS can have many different causes which include:

  • Cystitis (inflammation of the bladder)
  • Bladder stones, crystals, or debris
  • Urinary tract blockage
  • Trauma to the urinary tract
  • Congenital abnormality
  • Tumor
  • Cancer

 

Male cats are more prone to urethral blockage due to their narrow urethras which is the tube that carries the urine from the bladder. Urinary blockage can lead to rupture of the bladder and/or kidney failure.

Urinary problems can be very serious and potentially fatal if left untreated. If you notice any of the symptoms listed above—seek immediate veterinary care for your cat or kitten.

The Importance of Heartworm Prevention

The importance of heartworm prevention cannot be overstated. Heartworm disease is caused by the bite of a mosquito that is a carrier of the disease. Heartworm is not spread from pet to pet—it is only caused by the bite of a mosquito. Heartworm disease causes lung disease, heart failure, damage to other organs, and death in dogs, cats, and ferrets. It has been reported in all 50 states, but is prevalent along the Atlantic and Gulf Coasts.

Your pet is at risk for contracting heartworm disease even if he or she lives inside or only goes outside briefly. Mosquitos do get into homes and can be found in our area throughout the year. This puts your pet at constant risk. Year round prevention is strongly recommended!

Your pet should be tested for heartworm disease before a preventive treatment is started. This can be done in minutes at your veterinarian’s office. If your pet is negative for heartworm disease—a preventive treatment should be started immediately. There are many options available for heartworm prevention. These include chewable and non-chewable tablets, topical liquids that are applied to the skin, and injectable products. Ask your veterinarian which is the best choice for your pet.

If your pet is diagnosed with heartworm disease the treatment is not easy on the pet physically or on the owner’s finances. The treatment includes an injection with an arsenic-containing drug, exercise restrictions, other oral medications and/or topical medications. Treatment can be very toxic to the pet and can cause serious complications including blood clots in the lungs. It also requires multiple veterinary visits and possibly hospitalization. The cost for treatment can add up quickly.

For the sake of your pet’s health please talk with your veterinarian about using a heartworm preventive. It could save your pet’s life and save you a lot of money in the long run.

Diabetes

Diabetes in pets is common in the veterinary world. Genetics, certain breeds, obesity, and underlying diseases can be factors for diabetes. Most pets with diabetes will need to be managed and monitored for the rest of their lives. In some cases, diet and weight loss can cause a remission of the disease.

What Are the Symptoms?

Early Stages/Uncomplicated

  • Increased thirst and urination
  • Increased appetite
  • Increased possibility of infections, such as urinary tract infections

Severe/Ketoacidosis

  • Depression
  • Vomiting
  • Severe weight loss
  • Trouble breathing
  • Coma/loss of consciousness

If early signs of diabetes are present, the testing is often simple. There are two ways to check for diabetes. Both are quick and these tests can be run in the hospital for immediate results:

  • Bloodwork is run to check blood glucose levels. Depending on when your pet last ate, glucose levels should range from 80-120. New unmanaged diabetics often have numbers in the 200s to 300s.
  • Urine is also collected and checked for Ketones or sugar. When the blood glucose is over 180 the kidneys are unable to filter the sugar and it is released into the urine. When both blood and urine sugar is positive, a diagnosis of diabetes is made and insulin should be given immediately.

When starting to care for a diabetic pet, most hospitals will provide owners with an in-depth diabetic consult. This includes showing owners how to administer insulin, providing them with safety tips, noting the symptoms to watch for, and providing other important diabetic disease information. This consult gives the pet owner the knowledge and confidence to manage their pet’s diabetes at home.

After starting insulin more blood testing is done until the appropriate dose of insulin is found. Your pet might have to make several day trips to the vet until blood glucose levels are regulated. Diabetes can then be managed from home with the owner’s vigilance with regard to administering insulin and observing the patient for any changes. At-home glucometers can be purchased through your veterinarian. They can enable owners to check levels immediately in case of a potential emergency.

Diabetes can be a daunting diagnosis at first but with your veterinarian’s help—your pet can live comfortably and happily for many years.

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Laryngeal Paralysis

Laryngeal Paralysis, a common condition in middle- to old-age dogs, is usually seen in large breed dogs such as Labradors, Golden Retrievers, Saint Bernards, Newfoundlands, and Pointers. In hot, humid weather or with strenuous exercise—the symptoms can snowball leading to respiratory distress and collapse.

The larynx, located at the back of the throat over the opening to the trachea (wind pipe), opens when the dog is breathing and closes when the dog is eating or drinking. With this condition the larynx remains closed leading to difficulty in breathing. In most cases this condition is idiopathic, meaning there is no underlying cause.

  • Early symptoms include noisy breathing, dry cough, and voice changes
  • Progressive symptoms include difficulty breathing during exercise, easily fatigued, and cough or gag when eating and drinking
  • Symptoms may progress for months or even years before becoming a problem
  • The surgery most commonly performed is called laryngeal tie back
  • The laryngeal tie back procedure carries the risk of aspiration pneumonia
  • A tracheostomy can be performed as a last resort

With the pet owner’s diligence after surgery, a good quality of life can be achieved.