Situations where an ultrasound machine might be used are numerous. Imaging can be made of the entire urinary tract to diagnose bladder and kidney stones, defects in the bladder wall and ureters, and prostate disease. The machine may have Doppler capabilities that measure blood flow to the liver and kidneys. Ultrasound is used to diagnose tumors and abscesses of the liver, spleen, and pancreas. A procedure called an echocardiogram employs an ultrasound to measure the heart chambers and valves, assessing cardiomyopathy or heart disease. A specialist usually performs advanced ultrasound techniques.

Unlike an X-ray that takes a still image of the body, the ultrasound gives real-time visualization of the organs. Blood flow through arteries and urine production from the kidneys can be seen as it occurs. X-rays produce radiation that carries certain risks with long term exposure. Ultrasound is not associated with the ionizing effects of radiation.

An ultrasound is a powerful tool available to veterinarians that can assist in diagnosing diseases, abscesses, and cancers that would go undetected without exploratory surgery. It is a wonderful advancement in medical technology that allows non-invasive assessment of the internal workings of the body.

The veterinarian will confirm prostatitis by rectal palpation of the gland to feel for enlargement, asymmetry, obvious masses, or fluctuant areas (soft spots). Lab work should include a complete blood count, chemistry panel, and urinalysis. These tests are used to categorize the prostate disease and rule out other systemic illness. An x-ray or ultrasound of the urinary tract will help to visualize the degree of enlargement or masses associated with the gland. Urine sediment analysis may reveal increased numbers of red and white blood cells which are not found in healthy urine. Bacteria may be seen which would warrant a culture and susceptibility test. This would be indicative of primary or secondary bacterial prostatitis.

The most common type of prostate disease in dogs and man is benign prostate hyperplasia. This simply means non-cancerous enlargement. It is associated with changes in the male sex hormone levels as the dog ages. Neutering can reduce the chance of BPH significantly. Studies indicate that neutering at less than one year can all but eliminate BPH in male dogs. The treatment for BPH is in fact, neutering. This type of prostatitis is almost always chronic and recurrent if the dog remains intact. Secondary bacterial infection is common with BPH because the normal antibacterial secretions from the prostate are diminished and red blood cells provide food for the organisms.

Acute or chronic bacterial prostatitis occurs in both intact and neutered male dogs. Usually the bacteria has ascended the urethra from the outside world. Broad spectrum urinary tract specific antibiotics are prescribed while the results of a culture and susceptibility test is pending. Bladder stones and other urinary tract disease may be associated with bacterial prostatitis.

Prostatic neoplasia is the rarest of the prostate diseases comprising about 5% of all cases. Neoplasia means new growth and refers to cancer. In humans, there is an antibody specific to prostate cancer that can be measured in the blood. Unfortunately, there is no reliable blood test for dogs at this time. The prognosis for prostate cancer in dogs is poor. The cancer is aggressive and has likely metastisized to other organs by the time of diagnosis. A needle biopsy and histopathology report can help to diagnose prostatic neoplasia. Poor response to other treatments and progression of disease usually verifies cancer as the diagnosis.

Biopsy by endoscopy3 or exploratory laparotomy is the only definitive way to confirm the presence of inflammatory cells within the stomach and intestinal wall. A general anesthetic is administered to facilitate tissue collection. An endoscope3 is a narrow tube with a camera and forceps attached at the end that is passed through the esophagus to obtain upper GI tissue biopsies, or through the colon to harvest lower GI tissue samples. It is not always possible to collect diagnostic samples using an endoscope. So exploratory laparotomy, though obviously more invasive, is sometimes necessary. After surgery, the tissue samples are sent to a pathologist for examination.
Some patients will improve during a food trial with a prescription hypoallergenic diet. There are two basic types of food available by prescription for IBD: novel protein, novel carbohydrate formulas and hydrolyzed protein formulas. Whichever type of food is used, the most important factor in realizing their effectiveness is to eliminate all other sources of calories. This includes treats, table scraps, rawhides, even flavor-infused chew toys as they all may contain ingredients to which the pet is allergic.
Oral medications are used to treat patients who do not respond to food trials. These include antibiotics, antiemetics, and corticosteroids, often prescribed in combination with each other. Because there is no cure for Inflammatory Bowel Disease, long-term use of these drugs is used to control symptoms. There are possible side effects from chronic steroid use, so your veterinarian will usually prescribe a tapering dose regimen to determine the minimum dose required to alleviate symptoms. Prednisone (prednisolone) is the steroid of choice, although a safer drug called budesonide, which is less systemically bioavailable, may control some IBD patients. Prednisone should not be used in patients suspected of having intestinal lymphoma, as diagnosis and remission can be difficult or impossible to achieve. Antibiotics used include metronidazole, sulfasalazine, and tylosin. These drugs are used for their anti-inflammatory effect on the colon as well as to normalize the bacterial flora in the gut. It is important to use a therapeutic dose of antibiotic so that bacterial resistance is less likely. Sulfasalazine is used on a short term basis because of a risk of KCS (reduced tear production)4, and it may be toxic to cats because of its aspirin content. Antiemetics are medications that control vomiting. Metoclopramide is an antiemetic that also increases peristaltic contractions, making it a good choice for IBD treatment.
While not considered a drug, probiotic may be useful to reduce the dose of steroid necessary and improve symptoms of Inflammatory Bowel Disease. Probiotic is a dormant form of beneficial bacteria that normally resides in the healthy intestine. In-vitro studies show that it may have anti-inflammatory effects by blocking the enzymes produced by white blood cells in the gut wall. The most common probiotic is called Lactobacillus Acidophillus. It is available over the counter as well as in pet products specifically made for the treatment of diarrhea.
It should also be noted that Omega 3 fatty acid supplements may be of benefit in the IBD patient.
1. 4. Food Allergies
2. 26. Understanding Giardia Infections
3. 25. Endoscopic Procedures
4. 39. Dry Eye (KCS)

Rarely, an allergic reaction to nylon or plastic food bowls may cause feline acne. It is always worth a try to switch to stainless steel bowls to see if there is improvement. A shampoo or acne medication containing 3% benzoyl peroxide is used to break down the oils that clog the comedones and kill bacteria. Oral antibiotics may be prescribed if there is secondary infection or deep dermatitis. Never use over the counter topical acne products without first consulting a veterinarian as the cat may consume the medication while grooming.

Tests that are used to rule out other skin conditions that may mimic feline acne include skin scrapings, fungal cultures, and biopsy. These diagnostics may be recommended in the case of deep dermatitis or extreme self-trauma.

Supplementation with omega fatty acids may help prevent feline acne. The anti-oxidant activity of these supplements protect the skin cells from damage that may lead to comedones. Food allergy is a possible contributor to feline acne when there are other associated symptoms present. A hypoallergenic diet food trial may be in order.

Poor grooming as a cause of acne may be a sign of underlying disease. If the cat has recently changed its grooming habits, a physical exam and blood chemistry profile should be performed.

Routine cleaning of the chin with astringent pads can help reduce breakouts in cats that are prone to feline acne.

There are many sizes and varieties of endoscopes, but there are two basic types: flexible and rigid. Which one the surgeon uses is a matter of preference and depends on the surgery.

The kinds of procedures that may be performed using an endoscope are numerous. A biopsy of the stomach wall or colon is obtainable without the need for a laparotomy, or opening of the abdominal cavity. A very small incision through the abdominal wall however, will allow a surgeon using a scope to biopsy the liver and other organs easily. A smaller incision means less chance of introducing infection. Arthroscopy is a surgical method of using a very small scope to visualize the inside of the joints. Exploration of the thorax is possible without artificial respiration.

Ultimately, the endoscope is a remarkable advancement in surgical technique. It reduces the size of incisions, minimizing bleeding and risk of infection. It speeds healing times greatly, allowing pets to return to normal activity much more quickly than after conventional surgery. The use of an endoscope also reduces pain associated with surgery since less trauma is caused to body tissues during the procedures. There are situations where the use of an endoscope is not ideal, but usually the endoscope offers superior results to the scalpel.

When cats become sick for any reason, it is common for them to stop eating. The body switches metabolic modes to start burning fat stores, and it is not in a cat’s design to do this properly. The liver, which should break the fat down into lipoproteins for energy, instead becomes infiltrated with fat and begins to fail. This is called hepatic lipidosis. Liver cells erupt and release the enzymes alkaline phosphatase (SAP) and alanine aminotransferase (ALT) into the blood stream. Bilirubin cannot be metabolized and excreted through the bile duct, causing jaundice of the mucous membranes. These enzymes will be elevated on blood tests. A biopsy will confirm the fat deposits in the liver if the cat is a candidate for surgery. Many times they are too sick to risk anesthesia, so an ultrasound-guided fine-needle aspirate of the liver may be taken to provide a definitive diagnosis. Diagnosis can also be based on history, clinical signs and laboratory results if neither of these diagnostic procedures is available. Hepatic Lipidosis can be reversed if treatment is aggressive and instituted before complete liver failure occurs. If anorexia was the only cause of the hepatic lipidosis, then the prognosis for recovery is good. Other underlying disease should be investigated if the reason for anorexia is unknown.

Hepatic lipidosis can occur in any cat that stops eating; although, typically the cat will have been overweight and reduced its caloric intake by one half or more for a period of two weeks. This can be difficult for an owner to realize (especially for free-choice feeders), and sometimes the history of anorexia is unclear.

The goal of treatment is to reverse the starvation state of metabolism. This is accomplished by giving a calculated amount of a high-protein, high-calorie diet to the cat by one of several methods. If the cat tolerates it, force feeding semi-moist canned food can be attempted. Meatballs of the food can be forced down the throat in the same manner that a pill is given. The problem with this technique is that most cats will fight it, the process is slow, most of the food ends up on the floor, and not enough calories are consumed to be effective. Just enough food may be given to keep the cat alive, but the liver will continue to fail in many cases.

Another method of delivering calories is by inserting a nasogastric feeding tube. This usually does not require anesthesia. A small diameter rubber tube is passed through one nostril, down the esophagus, and into the stomach. Liquefied food can be administered through this tube several times a day. An Elizabethan collar is worn to prevent the cat from removing the tube with a paw. Drawbacks of this method are that the food must be watered down, and thus is not calorie-dense. Also, the tube can be vomited up. When this occurs, the cat will chew off the end of the tube that is hanging out of the mouth, and the owner may not be aware. During the next feeding, liquefied food is squirted into the throat instead of the stomach; and there is a risk of aspiration into the lungs. Sometimes a nasogastric tube is used for a couple of days in order to stabilize the cat before more aggressive therapy can be started.

An esophagostomy / pharyngostomy tube is a better alternative to the nasogatric feeding tube, but it does require anesthesia to place. It is a larger bore tube that can accept blenderized food (more calorie-dense), and it is passed into the esophagus through an incision from the side of the neck. The tube is sutured and bandaged in place and is generally well tolerated. It can be left in place for weeks. This type of tube can also be vomited, so the same risk of aspiration exists as with a nasogastric tube. Also, infection can occur at the incision requiring removal of the feeding tube.

The best type of feeding tube is called a percutaneous endoscopic gastrotomy (PEG) tube. It also requires the cat to be anesthetized for placement. An incision is made through the abdominal wall and directly into the stomach. A balloon-like cuff on the end seals the tube to the stomach wall, preventing leakage of food into the abdomen. Unlike other feeding tubes, it cannot be vomited and the risk of aspiration is much lower. A PEG tube can remain in place for a year or more.

An important consideration to factor in the treatment options for hepatic lipidosis is the length of time it generally takes to reverse the starvation state and heal the liver. This typically requires three to six weeks of tube feeding. Also, the cat must begin eating on its own before supplemental feedings can be stopped. If a tube is surgically implanted, it is advised to leave it in place for several days after the cat begins eating just in case of relapse.

Around 85% of uncomplicated hepatic lipidosis cats will recover when treated aggressively.

There may be numerous causes of EGC, and the exact mechanism of their formation is not completely understood. Eosinophils are white blood cells that are involved in allergic and inflammatory responses. They phagocytize (consume) antigens contained in bacteria, parasites, and viruses. EGC is thought to be immune mediated, and may occur in response to hypersensitivities to insect bites (mosquitoes), food allergies, and inhalant allergies. The lesions can mimic many other dermatologic conditions, and because treatment will include the use of immunosuppressive drugs, other disease processes must be ruled out. The presence of large numbers of eosinophils on a biopsy, and a typical clinical appearance of the lesions confirm a diagnosis.

Indolent ulcers, misleadingly nicknamed rodent ulcers, most often occur on the inside of the upper lips. They are not associated with rodents at all. The tissue will be inflamed, raised, and smooth. The ulcers can occur on one or both sides of the mouth. In the case of indolent ulcers, biopsy is usually not diagnostic, but it is used to rule out neoplasia (cancer) when non responsive to treatment.

Eosinophilic plaques can occur anywhere on the skin, but are most often found on the inner thighs and groin. They appear as raised, round, bright red, and hairless masses that are especially itchy. The lesions are ulcerated from self-trauma and may become secondarily infected by bacteria. The circulating eosinophil count in the blood stream will probably be elevated.

Eosinophilic granulomas are found between the toes, on the tongue, and on the roof of the mouth. These ulcerative lesions are raised and crusty on the skin, and erosive in the mouth. They are bright red and may bleed easily. They are not thought to be itchy, but cats may cause self-trauma from over grooming the skin lesions and may stop eating if the lesion is in the mouth. Eosinophils will be elevated in circulation and prevalent in the biopsied tissue.

Treatment for EGC begins by ruling out and treating any underlying disease that may be a contributing factor. Secondary bacterial infection is addressed with oral and topical antibiotics. An Elizabethan collar may be used to prevent self trauma. Immunosuppressive drugs like prednisone and other steroids are prescribed specifically for EGC, and may be given for weeks until response is seen. A tapering or pulse dosing is sometimes required to prevent recurrence of the lesions.

For EGC that responds poorly to steroid therapy, immuno-modulating drugs may be used. Certain antibiotics have this effect, and may be prescribed for 2 to 4 weeks. Chlorambucil is the most common immuno-modulator drug used in refractory EGC.

Omega fatty acid supplements may also improve lesions to some degree. They may reduce the steroid dose required during treatment, decreasing the chance of side effects from these drugs.

In very young cats, EGC lesions may spontaneously resolve without treatment. The prognosis for older cats is more guarded, and they may require on going steroid therapy to keep the lesions in remission.

There are many symptoms to watch for that might indicate your pet has developed a cancer. It is important to realize that many of these symptoms can be related to several other illnesses, so do not assume your cat has cancer until he has been officially diagnosed by a veterinarian. Unexplained weight loss, abdominal distention, respiratory distress, difficulty swallowing, changes in bowel consistency (diarrhea or constipation), blood or mucous in the stool, unusual bleeding or discharge, lameness, growths that can be felt through your pets skin and any areas of skin discoloration should be reported to your veterinarian. Remember that these symptoms are merely indicators that you should bring your cat to see the veterinarian.

Unfortunately, there are no blood tests to determine whether or not cancer is present in our cats. Therefore, acquiring a sample of the tumor through biopsy is often necessary and this sample is normally sent off to a specialized pathologist for microscopic examination. Many cancers can be cured if caught early enough and if the lump is small enough to surgically remove. Even after a lump is removed, your veterinarian may wish to send the sample to a pathologist to ensure that the margins of the growth are cancer free.

If your cat is diagnosed with cancer, many of the same treatment options available to humans are also available for pets. Chemotherapy and radiation therapy for pets is offered at most veterinary specialty practices in major metropolitan areas. Your veterinarian will be able to share more information about these treatment options with you. It is important to understand that these therapies are costly and some forms of cancer are more easily treated than others. If chemotherapy and/or radiation therapy are not an option, your cat can be treated symptomatically, and depending on how aggressive the cancer is, your cat may be able to live for several months to a year. Other medications and therapeutic options will be outlined by your veterinarian.

There are steps that can be taken to avoid cancers. Having your pet spayed or neutered will drastically decrease the chances of various reproductive cancers. Feeding your cat a high quality diet and keeping him at a healthy weight will also help to prevent certain cancers. Obesity is a major cause of many cancers in pets. It is impossible to prevent all cancers and genetics also play a role in this disease. If you have any additional questions about a specific cancer or are concerned about your cat, please do not hesitate to discuss this with your veterinarian.

There are many symptoms to watch for that might indicate your pet has developed a cancer. It is important to realize that many of these symptoms can be related to several other illnesses, so do not assume your dog has cancer until he has been officially diagnosed by a veterinarian. Unexplained weight loss, abdominal distention, respiratory distress, difficulty swallowing, changes in bowel consistency (diarrhea or constipation), blood or mucous in the stool, unusual bleeding or discharge, lameness, growths that can be felt through your pet’s skin and any areas of skin discoloration should be reported to your veterinarian. Remember that these symptoms are merely indicators that you should bring your dog to see the veterinarian.

Unfortunately, there are no blood tests to determine whether or not cancer is present in our dogs. Therefore, acquiring a sample of the tumor through biopsy is often necessary and this sample is normally sent off to a specialized pathologist for microscopic examination. Many cancers can be cured if caught early enough and if the lump is small enough to surgically remove. Even after a lump is removed, your veterinarian may wish to send the sample to a pathologist to ensure that the margins of the growth are cancer free.

If your dog is diagnosed with cancer, many of the same treatment options available to humans are also available for pets. Chemotherapy and radiation therapy for pets is offered at most veterinary specialty practices in major metropolitan areas. Your veterinarian will be able to share more information about these treatment options with you. It is important to understand that these therapies are costly and some forms of cancer are more easily treated than others. If chemotherapy and/or radiation therapy are not an option, your dog can be treated symptomatically, and depending on how aggressive the cancer is, your dog may be able to live for several months to a year. Other medications and therapeutic options will be outlined by your veterinarian.

There are steps that can be taken to avoid cancers. Having your pet spayed or neutered will drastically decrease the chances of various reproductive cancers. Feeding your dog a high quality diet and keeping him at a healthy weight will also help to prevent certain cancers. Obesity is a major cause of many cancers in pets. It is impossible to prevent all cancers and genetics also play a role in this disease. If you have any additional questions about a specific cancer or are concerned about your dog, please do not hesitate to discuss this with your veterinarian.