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.

Bites from non-venomous snakes should be treated the same as puncture wounds. Bacteria from the dog’s skin and the snakes’ mouth are delivered beneath the skin by sharp, needle-like teeth. Because the teeth are so sharp, the skin may seal quickly over the puncture. The bacteria may then reproduce and cause an abscess. It may rupture and drain several days later. A large amount of tissue may slough off that was damaged by the infection. Oral antibiotics are usually prescribed prophylactically for non-venomous snake bites.

Venomous snake bites are a different story. It is important to get treatment for the dog as soon as possible. Try to keep the dog calm, and keep the bite wound below the level of the heart. Do not attempt to remove the venom yourself by any means. Venom from different snakes act differently on the body, so identification of the snake makes it easier to determine the appropriate treatment protocol. Initial treatment is symptomatic. Shock is controlled with rapid IV fluid therapy and steroid injections. Antivenin is a serum that neutralizes venom, but it comes with its own set of risks, so it must be known whether the antivenin will benefit the dog. This will depend upon which type of snake caused the bite. Antibiotics, anti-inflammatory drugs, and pain medications are all indicated. Some venoms cause intravascular coagulation, some cause localized tissue destruction, and some cause neurological effects. The dose of venom determines the severity of illness, therefore, small dogs are more at risk than larger ones because they will receive a higher dose of venom per pound of body weight. In any case, a venomous snake bite is a life-threatening emergency, and veterinary care should be sought immediately.

There is a vaccine available for venomous snake bites. It may be useful for hunting and working dogs. It causes the body to produce antibodies to the venom making the dog somewhat immune. The vaccine appears to be safe, but its efficacy and duration is limited. Even a vaccinated dog should seek medical attention immediately after a bite from a venomous snake.

The first commercially produced NSAID was aspirin, or acetylsalicylic acid. It is a non-selective COX inhibitor. Isolated from tree bark (a folk remedy for headaches) in 1829, Aspirin was a miracle drug in treating minor pain without the risk of addiction to morphine. The side effects of aspirin include possible gastric ulceration and reduced platelet function. Because of the higher doses needed to achieve analgesia in animals, these side effects are even more pronounced in pets than in people. Aspirin was once the most commonly used NSAID in veterinary medicine, but alternative drugs have been developed that are safer for prolonged use.

A large group of NSAIDS called profens include selective and non-selective COX enzyme inhibitors. Ibuprofen (Advil, Motrin) is non-selective and carries the same risk of gastric damage as aspirin. It can be toxic to the liver; so, it is generally avoided as an analgesic for pets. Selective COX inhibiting profens include carprofen (Rimadyl), which is FDA labeled for use in dogs to treat pain. Carprofen can cause liver inflammation in some patients, and baseline liver values are measured before starting this and all NSAIDS. It should not be used in patients that have preexisting liver problems. Gastric ulceration is rare and is usually associated with over-dosage.

Other classes of COX-selective NSAIDS include the oxicams, arylalkanoic acids, and the coxib drugs. These drugs are less likely to cause stomach ulceration and bleeding than non-selective COX inhibitors in theory, however, the most common side effect seen with all of them is gastric irritation. Side effects are usually dose related. Meloxicam (Metacam), etodolac (Etogesic), deracoxib (Deramaxx), and firocoxib (Previcox) are all examples of these newer generation selective COX inhibitors.
NSAIDS are considered safe and effective for the treatment of pain when used according to directions. All of the drugs listed here, with the exception of aspirin and ibuprofen, are FDA approved for use in dogs. Cats do not tolerate most NSAIDS. There is only one drug approved for use in cats, and that is Metacam injectable. It is labeled for one time use only in cats. Other NSAIDS or the misuse of Metacam can be extremely toxic to cats. Never give a cat any pain medication that has not been prescribed by a veterinarian.
NSAIDS should never be combined with aspirin, corticosteroids, or other NSAIDS, as the risk of side effects will be greatly multiplied. Never give an extra dose or increase the dose without consulting a veterinarian. NSAIDS should not be given on an empty stomach.
All NSAIDS that are FDA labeled for use in dogs must display the following statement on their labels; “All dogs should undergo a thorough history and physical examination before initiation of NSAID therapy. Appropriate laboratory tests to establish baseline blood values prior to, and periodically during, the use of any NSAID are strongly recommended.”

One way to ensure your pet’s safety is to evaluate a blood chemistry profile before the surgery. This can detect compromised organ function, anemia, electrolyte imbalance, and bleeding disorders. Although it is impossible to screen for every possible disease process with one blood sample, the most likely problems that would preclude or complicate surgery can be ruled out.

Monitoring equipment used during surgery has greatly improved the safety and outcome of general anesthesia. In the past, the level of anesthesia could only be measured subjectively. Heart rate and respirations were observed to indicate the depth of anesthesia. Modern monitoring of blood pressure, blood oxygen saturation (pulse oximetry), and electrocardiogram (EKG) are much more accurate at assessing the patient’s wellbeing. The depth of anesthesia can be “fine tuned” using these parameters to improve safety and speed recovery.

The drugs used to induce and maintain anesthesia have become far safer as well. Induction agents and gas anesthetics are minimally metabolized by the body and are eliminated very quickly compared to older protocols. A rapid recovery reduces the chance of anesthetic injury to the kidneys and other organs. The pet is able to return to eating and drinking shortly after the procedure which prevents dehydration and boosts the immune system during healing.

A side effect of general anesthesia is lowered blood pressure. Intravenous fluids can be administered to normalize blood pressure and ensure adequate tissue oxygen perfusion. Life-saving drugs can be administered through an IV catheter in the case of an emergency.

Analgesia (pain control) is better achieved through the drug choices that veterinarians can utilize. It is a proven fact that pain suppresses the immune response, slows healing, and increases recovery times. Your pet will receive pre- and post-operative pain medications that will ensure their comfort and improve the outcome of surgery.

The veterinary staff will give you specific instructions to follow before and after surgery. The pet will need to fast for a period of time to reduce nausea during anesthesia. Vomiting while unconscious is very dangerous, and an empty stomach will avoid this problem. Be sure that you understand the fasting instructions. Withholding water for too long before surgery can lead to dehydration which may cause problems with recovery.

After surgery, you will be given aftercare instructions. Restricted activity, physical therapy, antibiotics, pain medications, rechecks, and scheduling suture removal are common follow up procedures to a surgery. You will want to monitor your pet’s appetite and attitude afterward and call the vet if there are any problems. An Elizabethan collar may be sent home to prevent the animal from chewing and scratching at the incision.

You should understand what will be done during surgery and the expected results. Discuss the procedure with the veterinarian and the nursing staff so that you are comfortable with your part in the follow up care of your pet.

Surgical repair is usually recommended for aural hematomas. Aspirating the blood with a needle and syringe can deflate the pinna, but this treatment is seldom effective. The hematoma will probably recur, and infection can occur if the hematoma is contaminated. Left untreated, the blood will reabsorb and form scar tissue, causing the ear pinna to shrink and deform. This is sometimes called a cauliflower effect, and can occlude the ear canal leading to increased risk of ear infections.

The window of opportunity to surgically repair an aural hematoma is typically within a week of its occurrence. The pet is administered a general anesthetic after pre-surgical blood work confirms that there are no contraindications precluding surgery. If an ear infection exists, the ear canal may be swabbed to send samples to a reference laboratory for culture and susceptibility testing. This can greatly expedite a successful resolution of the infection. Also, the ear canal may be flushed with antiseptic during anesthesia to facilitate a thorough cleaning before beginning topical treatments at home.

The ear pinna is shaved and prepped before an incision is made through one layer of skin over the length of the hematoma. The blood is drained, and the blood clots that would otherwise form scar tissue are removed. There are variations in technique at this point, but all achieve the same purpose. The Variation would be to tack the two sides of the ear pinna together leaving an opening to drain any residual bleeding that may occur. This will cause the two sides of the ear to scar together so that there will be no “pocket” to fill up with blood in the future. Some veterinarians will suture a piece of plastic to the back of the ear to help hold the pinna straight while healing. Local anesthetic may be infused into the pinna to help with pain control.

An Elizabethan collar is worn during healing to prevent the pet from scratching at the sutures, and sutures are removed after 14 to 21 days. Healing times are generally longer than spay or neuter surgery to ensure that the hematoma does not recur. Oral antibiotics and pain medications are sent home after surgery. Antibacterial / antifungal ear ointments are dispensed in the case of an ear infection.

More than half of cats with FLUTD under the age of 10 years will have an undetermined cause of their symptoms. Twenty percent may develop bladder stones or urethral blockage. Male cats have a tapering urethra, the tube that carries urine outside of the body. Because it narrows toward the opening, cells and mucous may dam up and form a blockage. This is called a urethral plug, and it is a life threatening emergency. The cat will usually howl or growl in pain while it strains to urinate, but it will be unable to do so or pass tiny drops of blood-tinged urine. Females rarely develop a blockage, but it does occur.

For cats over 10 years old with FLUTD, more than half will have a concurrent bladder infection and some degree of kidney dysfunction. Therefore, while extensive testing for a cause of symptoms may not yield results in younger cats, older cats with FLUTD should be screened for kidney failure.

Idiopathic cystitis describes a chronically inflamed bladder with an unknown cause. Cats may strain, urinate outside of the litter pan, and pass blood. No infection is associated with this condition.

When a cat presents with any of the symptoms listed above, a urinalysis is performed to categorize the type of urinary tract disease. Cells found in the urine sediment can allude to a bacterial infection as a primary or secondary factor. Antibiotics are prescribed any time a large number of white blood cells, the cells that fight infection, are observed. Sometimes, bacteria are obvious under the microscope. In this case, a culture and susceptibility should be run to determine the type of bacteria present and whether it has any antibiotic resistance. Most cats with FLUTD will have a large number of red blood cells present on urinalysis. Blood may be obvious to the owner, or it may be occult, revealed only on microscopic examination. X-rays and/or ultrasound of the urinary tract may be performed on all symptomatic cats to rule out bladder stones. Bladder stones are less common in cats than in dogs, but if they are present, symptoms will not resolve until they are removed surgically or dissolved with special diets. A chemistry panel, blood count, and electrolytes may be checked to discover other illnesses that may contribute to FLUTD.

Treatment for feline lower urinary tract disease depends on what is found during diagnostics. For the cat without infection, antibiotics are pointless. Cats diagnosed with idiopathic cystitis may be started on one or a combination of various medications which may include pain medications, antidepressants, and/or glycosaminoglycans. The exact mechanism by which these drugs work is unclear. Many cats respond well to amitriptyline, a tri-cyclic antidepressant that is given orally once or twice daily.

There are several reasons that may cause your dog to develop disc disease. In many cases, disc disease occurs due to a trauma, such as falling, jumping off of furniture, being struck by a car or even rough-play. Discs can also degenerate as a pet becomes geriatric.  Obese dogs are very prone to developing disc disease as well due to the extra pressure on the back caused by the fat. Certain breeds, such as Daschunds, Basset Hounds, Cocker Spaniels and other breeds with long backs can be more prone to developing disc disease especially if overweight.

The symptoms of disc disease are normally rather obvious. These signs will vary; however, depending on which disc is affected as this disease can occur anywhere on the spinal cord. For example, if your dog leaps from the bed and a disc in the middle back becomes slipped (known as a slipped disc), they will have greater pain in this area and the rear legs may be more affected. The abdomen may become rigid, the dog may tremble and in some cases they may even lose control of their bowel and bladder. In cases where a disc in the upper vertebrae around the neck is affected, the dog will likely have difficulty holding its neck and head up. In any case, the dog will be weakened and often lethargic. In severe cases, disc disease can also lead to paralysis.

If you notice any of the above symptoms in your dog, you should seek immediate veterinary attention. Your veterinarian will perform a thorough exam and will likely need to take X-Rays to further assess the health of your dogs vertebral column. If caught early, disc disease can be successfully treated with medications. Antiinflammatories, antibiotics, pain medications or a combination can be used to treat this condition. Be sure to closely follow your veterinarians instructions on how to administer these medications.

Treatment does not just involve giving medications. Your pets activity may need to be restricted and jumping and rough-play are definitely prohibited. This means no more leaping from furniture! If your pet is overweight, it will also be very important to begin a high quality diet that promotes weight loss. Your veterinarian will recommend a diet that is right for your pet. Once your pet has been cleared for increased exercise by your veterinarian, regular walks will greatly benefit your dogs weight and overall health.