The emergency occurs when gas can not escape the stomach, and it becomes overly distended. The normal contractions in the stomach wall cease, and the entire organ rotates in the abdomen. Since each end of the stomach is stationary, the blood supply is cut off by the twisting or torsing effect. The tissue quickly loses viability as it is starved for oxygen. As the stomach enlarges, it puts pressure on the diaphragm causing respiratory distress. Cardiac output may also be reduced by restriction of the abdominal arteries. Shock quickly ensues, followed by death if not immediately managed.

Factors that may contribute to the onset of GDV include over-eating or ravenous eating, once a day feeding, and exuberant activity after a meal. Older males are more likely to develop GDV than other dogs.

Dogs with GDV will have a distended painful abdomen and may be retching, hyper-salivating, gasping for breath, or comatose. An x-ray can help to visualize the gas that is trapped in the stomach, but symptoms and predilection are usually diagnostic. Shock should be treated with rapid IV fluid replacement and oxygen supplementation. Comatose dogs will be intubated to provide artificial respirations if necessary. A stomach tube will be passed in an attempt to deflate the stomach and restore blood circulation. Medical treatment of heart rhythm abnormalities, electrolyte imbalance, and sepsis is performed as required. Surgical repair of damaged stomach tissue and gastropexy, tacking the stomach to the abdominal wall, is performed as soon as the patient is stable enough for anesthesia.

Complications after surgery include relapse of all symptoms, cardiac arrhythmias, necrosis (death of tissue) and perforation of damaged organs, and peritonitis (sepsis of the abdominal cavity). The prognosis of any GDV patient depends on how soon the animal receives treatment and the extent of damage to the tissues involved. Follow up therapy will include antibiotics to prevent infection, IV fluids until the dog can eat normally, and pain control.

GDV is a serious emergency that requires immediate medical attention. If you suspect your dog is experiencing gastric bloat, it is always better to err on the side of caution and seek veterinary advice.

When a cat appears with related symptoms, it should be examined by the veterinarian as soon as possible. A urinalysis, blood panel, and x-ray are performed as an initial diagnostic profile. A urine sample is collected by the veterinarian in order to perform the urinalysis (UA). Care should be taken to avoid contaminating the sample with artifact. The “cleanest” method of collection is called a cystocentesis – passing a very fine needle through the abdominal wall directly into the bladder. Less ideal respectively are passing a urinary catheter and collecting a voided sample, since contaminate may be introduced from outside of the body.

The urine sample is analyzed for blood, inflammatory cells, bacteria, and crystals. A specific gravity measures urine dilution caused by increased water consumption or kidney dysfunction. A reagent dipstick tests for nitrite (bacterial metabolite), pH, glucose (to screen for diabetes), and bilirubin (produced by the liver). A portion of the sample is centrifuged to separate solids from the urine such as cells, casts of the renal (kidney) tubules, bacteria, and crystals. This material is called urine sediment. Bacteria observed in the sediment are diagnostic for infection but are not always observed.

The urine may be sent to a reference laboratory for a culture and susceptibility (C&S). The sample is incubated in a special agar or broth, a food medium to grow bacteria. When bacterial growth is present, the organisms are isolated and tested to determine their species. Then they are exposed to a battery of antibiotics on a susceptibility disc. This information will tell the doctor which antibiotic to prescribe and what dose will be effective. Also, the C&S will give some idea as to how the infection will respond to treatment.

Abdominal x-rays are taken to check for the presence of bladder and kidney stones, especially if crystals are found in the urine sediment. If bladder stones are discovered, they must be removed or dissolved if possible. The stones will harbor bacteria and make resolution of the infection impossible. X-rays can also reveal a congenital defect in the bladder wall called a persistent urachus. This is a remnant of the tube that connected the bladder to the umbilicus before birth. It can also harbor bacteria and make the infection persist despite antibiotic therapy.
A blood count and chemistry panel will help determine whether the bladder infection is secondary to underlying organ dysfunction. Kidney disease is very common in older cats.

When your veterinarian prescribes an antibiotic for your cat’s bladder infection, is critical to give it as instructed. Antibiotic resistance is a real problem in bladder infections. Also, a urinalysis should be repeated at the end of the treatment period to gauge the response to the antibiotic. If time lapses between treatment and rechecking, the infection may recur, causing the need to repeat diagnostics.

When you take your dog in for a wellness exam, the veterinarian will want to know about any changes you’ve noticed in your dog’s behavior. Changes in water consumption, appetite, activity, loose stools, and amount of urine production are all very important to discuss with the doctor.

Weight loss or redistribution of weight is very common in older dogs, even when no changes in appetite have been noticed. Underlying disease processes that can contribute to muscle wasting and weight loss include diabetes, renal (kidney) failure, and hyperadrenocortisism (Cushing ’s disease). These illnesses are all associated with increased water consumption, urine production, and incidence of infection. Dogs with Cushing’s disease will lose muscle mass despite an increase in appetite.

Weight gain occurs with Hypothyroidism. The reduction in circulating levels of thyroid hormone causes slowed metabolism and an increased susceptibility to skin infections and alopecia (hair loss).

Inflammatory Bowel Disease (IBD) is more common in older dogs as well. Symptoms begin with an increased frequency in bowel movements, followed by straining, diarrhea, and weight loss. Intermittent or persistent fresh red blood on normal stools is a common early indicator of IBD.

Other common diseases seen in older dogs include cardiomyopathy (heart disease), arthritis, degenerative disc disease, and periodontal infections. These problems are much more easily managed and treated when detected early in their progression.

Along with a thorough history and examination, your veterinarian will recommend routine screening for age related diseases. Blood chemistry panels include measurements of kidney and liver function, thyroid levels, and indicators of metabolic disorders like diabetes and adrenal gland disease. EKGs and blood pressure readings, as well as chest x-rays, can also reveal underlying disease.

When you take your cat in for a wellness exam, the veterinarian will want to know about any changes you’ve noticed in your cat’s behavior. Changes in water consumption, grooming, activity, frequency of vomiting, loose stools, amount of urine production, and appetite are all very important to discuss with the doctor.

Anyone who has owned a cat for its lifetime is familiar with the appearance of the “skinny old cat”. It is not normal for an older cat to lose interest in food and drop in body weight. In fact, by the time weight loss is observed, significant changes are already occurring. Usually, other symptoms preceded the weight loss. In some cases, the cat is still eating normally, or even ravenously, but they continue to lose weight. When a ten pound cat sheds two pounds, or twenty percent of its normal weight, that is the equivalent of a 200 pound man losing 40 pounds!

Some of the ailments and organ dysfunctions seen in older cats that can be treated, delayed, or prevented are listed here along with the symptoms associated with them. The symptoms alone are not a diagnosis of disease. Examinations, blood-work, and radiology are used in conjunction with history to confirm a disease.

Whipworm infection may be diagnosed when a veterinarian performs a fecal flotation. Eggs are floated in a salt solution and observed under a microscope. Because there are typically so few eggs present, a negative test is not a rule out for suspected whipworm infection. The veterinarian may choose to prophylactically de-worm your pet if intermittent lethargy and diarrhea persists. De-worming is repeated at three weeks and again in twelve weeks because of the long lifecycle of the whipworms.

Viable, infective whipworm eggs can persist in contaminated soil for years, so stools should be removed from the pet’s environment.

Other indicators of a poor quality of life include incontinence and immobility. Pets may be in so much pain that they urinate or defecate where they lie. This causes shame and worry to a potty trained animal as it would any person. It is unhealthy and unfair to the pet, and the burden that it causes on the household must be considered. Stress on the family is also felt by the animal, and it is not unreasonable to factor this into the assessment of quality of life.

When it is time, euthanasia should be absolutely humane and painless. Discuss euthanasia with your veterinarian until you fully understand and are comfortable with the procedure. Ask if there are any other treatment options available for your pet’s condition. Admit your concerns; the doctor is there to address them. Veterinarians schedule extra appointment time for these difficult times. There are slight variances in the specific procedure and drugs used for euthanasia, but the goal is to avoid any pain and suffering. Anesthetic agents will be given to ensure that the animal is completely unconscious. Then a drug is given intravenously to stop heart and brain function. The entire procedure is very rapid and completely painless.

During this emotional time, you can take comfort in the fact that you have provided your pet with a happy and healthy lifetime. We’ve always known that one day we would have to say good-bye, but our pets provide many cherished memories that remain with us long after they have left our sides.

Reproductive hormone (estrogen) responsive urinary incontinence is rarer in cats than in dogs. The cause of estrogen responsive urinary incontinence is not completely understood, but the fact that it occurs in spayed females and responds to estrogen supplementation leads us to believe that the mechanism involves reduced levels of the hormone or reduced estrogen-receptor function. Urine is kept in the bladder by a sphincter muscle at the top of the urethra, the tube that carries urine outside the body. In older spayed female cats, this sphincter muscle loses tone, and urine begins to leak. During rest and sleep, the muscles especially relax, leading to complete incontinence. Obesity further complicates this condition, probably from excess weight pushing on the bladder. Not all spayed female cats will develop urinary incontinence; therefore, the exact role that estrogen plays is uncertain.

When uncomplicated urinary incontinence is diagnosed, treatment with synthetic estrogen (diethylstilbestrol – DES) may be prescribed. DES has a wide margin of safety in cats; however, over-dosage can result in serious side effects, and long term usage can cause bone marrow suppression, reducing the cat’s white blood cell count. Blood counts should be measured periodically on cats that take DES. Reduced availability of the drug has caused veterinarians to seek alternative therapies.

Phenylpropanolamine (PPA) may be used as an alternate drug to DES. It is a neuro-stimulant that improves bladder muscle tone and is safe for use in healthy cats. It must be used with caution in kidney and heart failure patients, and those with high blood pressure. Side effects are dose dependant; so the amount may be reduced, but efficacy in controlling incontinence may diminish. A low-dose combination of DES and PPA may be a good solution for cats who do not tolerate therapeutic doses of either drug. If symptoms suddenly worsen, or if inappropriate urination occurs outside of sleep, a bacterial infection or other disease process should be considered.

Both the male and female dog should have a complete physical examination before breeding when possible. They should be screened for heritable conditions such as hip and shoulder dysplasia, demodecosis (predilection for mange), hernias, and cryptorchidism (un-descended testes). Dogs with any of these traits should not be bred. The female should be tested and de-wormed for intestinal parasites that can be transmitted to the litter. Both dogs should be current on vaccinations.

Pregnant and nursing dogs should be fed 4 to 5 meals daily with a high quality puppy food to provide the extra protein, fat, and calcium they will require to raise a healthy litter. Fresh water should always be available. A whelping bed can be made from a large box with warm blankets. Be sure it is large enough for the mother to arrange and groom her puppies when they are delivered. A heating pad is not recommended because the newborn pups will not be able to cool themselves by moving away from the heat source.

During a natural delivery, it may be necessary to assist the mother in caring for the newborn puppies. Generally, she should be left alone during labor, as anxiety can stop contractions. However, if she cannot tend to the pups in a timely manner, the birth sacs should be removed with a soft washcloth to prevent the pups from suffocating. There will be amniotic fluid in the puppy’s mouth and lungs that can be aspirated with a bulb syringe or gently shaken out. Stimulate the puppy fairly vigorously until it begins squirming and crying, then allow the mother to finish grooming it. If the puppy is slow to respond, it should be gently “slung”. Cradle the puppy in both hands with its head pointing away from you. Be very careful not to drop it, as it will be very slippery. Gently sling it downward two to three times to force fluid out of the lungs. This will also stimulate the puppy to gasp for air.

Phone numbers for an after hours veterinarian should be obtained in case emergency care is needed. Labor usually lasts a couple of hours. If more than 20 minutes of contractions elapse without delivering a puppy, or if a partial birth occurs and is not completed after 10 minutes of contractions, this is an emergency situation that requires immediate veterinarian intervention.

Factors that exacerbate symptoms of a collapsed trachea are heat and humidity, obesity, heart failure (which can be secondary to collapsed trachea), inhalant allergens like cigarette smoke, respiratory infection, and anxiety. These can increase the coughing and tracheal deformation to the point of suffocation. The dog may pass out from anoxia – lack of oxygen to the brain. In fact, dogs with collapsed trachea may have elevated liver enzyme tests from chronic oxygen deprivation.

Breed predilection and x-rays confirm a diagnosis of a collapsed trachea, and treatment begins with cough suppressants and bronchodilators. Secondary heart failure will be treated with specific drugs, although the health of the heart may improve by controlling the airway disease. A weight loss program should be started for obese dogs. Avoidance of irritants like smoke is very important. As the disease progresses, surgery may be an option. Not all collapsed tracheas can be repaired however. If the weakness in the cartilaginous rings is in the throat, synthetic rings can be sutured in place. If the defect is in the chest, surgery may not be corrective or even possible. Many dogs with a collapsed trachea have a weakness in the walls of the bronchi, the main branches of airway into the lungs. For these pets, symptomatic treatment is the only option.
Because a collapsed trachea is heritable, affected dogs should not be bred.

Arthritis is very common in older dogs as an aging process. It can be very painful, cause limping and lameness, and lead to muscle atrophy (wasting) from reduced exercise. This condition is called degenerative joint disease and is a consequence of wear and tear on the cartilage that pads the bones from rubbing together. Inflammatory joint disease is an arthritic process that is not related to aging. Instead, infection or immune-mediated disease is the cause of joint stiffness and pain. Tick-borne diseases such as Lyme and Ehrlichia are common causes of this painful joint condition. Treatment for pain is indicated, but the underlying illness must be treated as well.

Hip dysplasia is a common cause of limping in dogs. It is not a disease, but a mal-formation or a poor confirmation of the hip joint. The femur bone in the rear leg is topped with a ball that fits into the acetabulum (socket) of the pelvis. In this heritable condition, the ball can slip around or completely out of the socket causing discomfort. Over time, arthritic changes occur as abnormal wear occurs. An x-ray can confirm hip dysplasia, but it may not predict the severity of symptoms that may arise as a result. Hip replacement and a “salvage” surgery called a femoral head ostectomy are recommended when pain is not controlled with joint health supplements and medications.

It is important to have any persistent limping checked by the veterinarian to determine the cause and provide pain relief.