What is coccidiosis?
Coccidiosis is an intestinal tract infection caused by a one-celledorganism (protozoa) called coccidia. Coccidia are sub-classifiedinto a number of genera, and each genus has a number of species.Some six different genera of coccidia can infect dogs. They aremicroscopic parasites that spend part of their life cycle in the liningcells of the intestine. Most infections are not associated with anydetectable clinical signs (they are sub-clinical). Most clinicalinfections in dogs are caused by the species Isospora canis.Cryptosporidium parvum is another coccidian parasite that maycause diarrhea in some puppies.

How did my dog become infected with coccidia?
Oocysts (immature coccidia) are passed in the stool of an infecteddog. They are very resistant to environmental conditions and cansurvive for some time on the ground. Under the right conditions oftemperature and humidity these oocysts"sporulate". If the sporulated oocysts are ingested by a susceptible dog they will release "sporozoites" that invade the intestinal lining cells and set up cycles of infection in neighboring cells. Dogs may also be indirectly infected by eating a mouse that is infected with coccidia.

What kinds of problems are caused by coccidiosis?
Most dogs that are infected with coccidia do not have diarrhea or other clinical signs. When the coccidia oocysts are found in the stool of a dog without diarrhea, they are generally considered a transient, insignificant finding. However, in puppies and debilitated adult dogs, they may cause severe, watery diarrhea, dehydration, abdominal distress, and vomiting. In severe cases, death may occur.

How is coccidiosis diagnosed?
Coccidiosis is diagnosed by performing a microscopic examination of a stool sample. Since the oocysts are much smaller than the eggs of intestinal worms, a careful study must be made. Infection with some of the less common coccidial parasites is diagnosed with a blood test.

How is the coccidial infection treated?
The most common drug used to eliminate coccidia is a sulfa-type antibiotic. It is given for 10-14 days. Other drugs are also used if diarrhea and dehydration occur. If the sulfa-type drug is not effective, other treatments are available. Re-infection of dogs is common so environmental disinfection is important. The use of diluted chlorine bleach [1 cup (250 ml) of bleach mixed in 1 gallon (3.8 L) of water] is effective if the surfaces and premises can be safely treated with it.

Are the coccidial parasites of my dog infectious to humans?
The most common coccidia found in dogs do not have any affect on humans.However, less common types of coccidia are potentially infectious to humans.One parasite, called Cryptosporidium, may be carried by dogs or cats and maybe transmitted to people. This parasite has also been found in public watersupplies in some major cites. It poses a health risk for immuno-suppressedhumans such as AIDS patients, those taking immune suppressing drugs,cancer patients, or the elderly.Good hygiene and proper disposal of dog feces are important in minimizing risk of transmission of all canine parasites to humans, or to other animals.

General Information

Giardiasis is an intestinal disease of people, dogs, cats and other animals. It is caused by a microorganism called Giardia, which is swallowed when the animal eats contaminated stool, food or water. Giardia principally infects the upper small intestine. Infected individuals pass the infectious cysts in their stool, and the cycle begins again.

Diagnosis may be difficult; therefore, repeated microscopic examinations of multiple stool samples are often needed to find the cysts.

The most common sign of infection is persistent diarrhea with pale, greasy and occasionally blood-tinged stool. Giardia prevents proper absorption of nutrients, damages the delicate intestinal lining, and interferes with digestion.

Public Health Significance
Giardia is a relatively common intestinal parasite in people. Good personal hygiene should be practiced in homes where giardiasis has been diagnosed in a pet. Your pet's stool should be cleaned up and properly disposed of. Children should not be allowed to handle the stool.

Important Points in Treatment

1. Laboratory tests are often required to evaluate the patient's response during and after treatment.

2. Sun exposure and drying help eliminate Giardia from your yard.

3. Give all medication as directed. Call the doctor if you cannot give the medication.

Notify the Doctor if Any of the Following Occur:

* Your pet's diarrhea persists.

* Your pet's general health worsens.

Definition: Hypoglycemia--Low blood sugar

Physiology:
Glucose is the main source of energy for the body and the only source of energy for the brain. When most of the glucose in the blood is used up, the body responds by releasing glucose from the liver and by breaking down fatty acids and other energy sources. If no more stored glucose is available, the brain runs out of energy and can even be damaged beyond repair.

Causes:
“Puppy Hypoglycemia” is seen in toy breed dogs less than 5 months of age. These dogs have more brain mass per body weight compared to other breeds and therefore need more glucose for brain function. Other causes include excessive exercise in sporting breeds, liver disease, cancer, pregnancy, severe infection, prolonged starvation, and poor adrenal gland function.

Signs:
Weakness, loss of mental alertness, wobbliness, muscle twitching, seizures, and death.

Treatment:
Intravenous dextrose (a sugar) is needed for treatment of most severe cases. If the dog is seizuring at home, the owner can try rubbing corn syrup on the gums while transporting to the hospital. Large amounts should not be fed unless the dog can swallow. Sugars can also be absorbed through the rectum, so 50% dextrose could be given by enema until intravenous treatment is available. Once seizures are controlled, blood work and other diagnostic tests should be performed to determine the cause of the problem. Sporting dogs and toy dogs will need increased frequency of feedings and will need to have a meal a few hours before strenuous activity.

A portosystemic shunt (PSS), also known as a liver shunt, is a bypass of the liver by the body's circulatory system. It can be either a congenital (present at birth) or acquired condition.

Congenital PSS is a hereditary condition in dogs and cats, its frequency varying depending on the breed. The shunts found mainly in small dog breeds such as Miniature Schnauzers and Yorkshire Terriers, and in cats such as Persians, Himalayans, and mix breeds are usually extrahepatic (outside the liver), while the shunts found in large dog breeds such as Irish Wolfhounds and Labrador Retrievers tend to be intrahepatic (inside the liver).

Acquired PSS is uncommon and is found in dogs and cats with liver disease such as cirrhosis causing portal hypertension, which is high blood pressure in the portal vein.

Pathology:
Congenital PSS is caused by the failure of the fetal circulatory system of the liver to change. Normally, the blood from the placenta bypasses the liver and goes into circulation via the ductus venosus, a blood vessel found in the fetus. A failure of the ductus venosus to close causes an intrahepatic shunt, while extrahepatic shunts are usually a developmental abnormality of the vitelline veins, which connect the portal vein to the caudal vena cava. Thus in the juvenile and adult animal with PSS, blood from the intestines only partly goes through the liver, and the rest mixes into general circulation. Toxins such as ammonia are not cleared by the liver. Most commonly, extrahepatic shunts are found connecting the portal vein or left gastric vein to the caudal vena cava.

Congenital shunts are usually solitary. Acquired shunts are usually multiple, and are caused by portal hypertension in dogs with liver disease. This is most commonly seen in older dogs with cirrhosis, but may also be seen in younger dogs with liver fibrosis caused by lobular dissecting hepatitis.

Symptoms and diagnosis:
Symptoms of congenital PSS usually appear by six months of age and include failure to gain weight, vomiting, and signs of hepatic encephalopathy (a condition where toxins normally removed by the liver accumulate in the blood and impair the function of brain cells) such as seizures, depression, tremors, drooling, and head pressing. Urate bladder stones may form because of increased amounts of uric acid in circulation and excreted by the kidneys. Initial diagnosis of PSS is through laboratory bloodwork showing either elevated serum bile acids after eating or elevation of fasting blood ammonia levels, which has been shown to have a higher sensitivity and specificity than the bile acids test. Rectal portal scintigraphy using 99mtechnetium pertechnetate, a technique of imaging involving detection of gamma rays emitted by radionuclides absorbed through the rectum and into the bloodstream, demonstrates the blood vessel bypassing the liver. Surgery definitively shows the shunt if it is extrahepatic.

Treatment:
Surgical treatment is best, when it can be performed. Pressure within the portal vein is measured as the shunt is closed, and it must be kept below 20 cm H2O or else portal hypertension will ensue. Complete closure of extrahepatic shunts results in a very low recurrence rate, while incomplete closure results in a recurrence rate of about 50 percent. However, not all dogs with extrahepatic shunts tolerate complete closure (16 to 68 percent). Intrahepatic shunts are much more difficult to surgically correct than extrahepatic shunts due to their hidden nature, large vessel size, and greater tendency toward portal hypertension when completely closed. When surgery is not an option, PSS is treated as are other forms of liver failure. Dietary protein restriction is helpful to lessen signs of hepatic encephalopathy, and antibiotics such as neomycin or metronidazole and other medicines such as lactulose can reduce ammonia production and absorption in the intestines. The prognosis is guarded for any form of PSS.

Heredity:
The intrahepatic shunts found in large dog breeds are passed on in a simple autosomal recessive way, while the extrahepatic shunts of the small breeds are inherited on a polygenic basis.

Patella Luxation is common in Yorkies. It is therefore advisable
that breeders have their dogs and puppies tested by a vet.

What is it?
Luxating means out of place, or dislocated. The patella is the
equivalent to the human kneecap and part of the stifle structure,
and therefore a luxating patella is a kneecap that moves out of its
normal location. The patella normally moves up and down in
a groove in the lower femur bone called the trochlear groove. In
patella luxation the groove is often shallow and this shallow
groove prevents the patella from sitting deeply, predisposing it to
dislocation. A patella that is not stable but does not slip out of
joint is said to be subluxating, while one that comes out of joint
on its own is said to luxate.

There are two types of luxation, medial and lateral. Medial luxation
is the most common and is where the patella dislocates to
the inside of the knee. One knee can be more severely affected
than the other. This type of luxation is mainly congenital
(present at birth) and trauma is not usually associated with it.

With lateral luxation the patella dislocates to the outside of the
knee. Lateral patellar luxation can be congenital or the result of
trauma to the knee. In some cases the patella can luxate both
medially and laterally. Again, this disorder can affect one or both
knees and to varying degrees.

What are the Symptoms?
Signs of luxation may appear as early as weaning or may
go undetected until later in life. Signs include intermittent rear leg
lameness, often shifting from one leg to the other, and an
inability to fully extend the stifle. The dog may frequently stop to
stretch his rear leg behind him to allow the patella to pop back
into its normal groove. Mildly affected animals can have a
hopping or skipping action. This is due to the patella luxating
while the dog is moving and by giving an extra hop or skip the dog
extends its stifle and is often able to replace the patella until the
next luxation, when the cycle repeats.

Diagnosis:
A veterinarian can usually confirm diagnosis by manipulating
the stifle joint and pushing the patella in and out of position. This
can be done as early as 8 weeks of age to ensure that congenital
patella luxation is not present before the puppy leaves for his
new home. This type of examination is best left to the veterinarian,
as an overzealous examination can stretch the ligaments.
.
The degree of patella luxation is graded from 1 to 4 depending
on the relative ease with which the patella luxates. Grade 1 is
the mildest and grade 4 the most severe. With grades 1 and 2
patella luxation the dog may not show any symptoms and can be
incidental findings in mature dogs who have never been lame.
Grade 3 and 4 dogs are usually lame. Severe cases may develop
abnormal growth of the long bones of the leg or a non-functional
knee.

Grade 1:
Occasional carrying of the leg is seen, often described
as skipping or hopping, which may be transient, often
returning to normal by itself. Your veterinarian may easily luxate
the patella manually and return it to its normal position.
Pain may be evident only when the knee cap is luxated.

Grade 2:
The frequency of luxation increases, becoming more
or less permanent. The dog will usually carry its leg, but
will occasionally bear weight on it. When palpated by the
veterinarian, a dry, crackling sensation (crepitation) may occur
in the joint. A grade 2 luxation can increase in severity, and
if not surgically treated, can develop into degenerative joint changes.

Grade 3:
Permanent dislocation that occurs though weight bearing
may still be possible, however the stance will appear somewhat
crouching or bowlegged. Surgical intervention should not be delayed,
especially if this is found in a young, growing dog. Rapid growth of
abnormalities results in progressive deformities.

Grade 4:
Permanent luxation, with the affected limb always being
carried, creates a bowlegged / crouching stance. Early surgery is
strongly recommended at this stage for bone deformities of the
femur and tibia may occur.
.
What Causes It?

Patella luxation is strongly suspected of being inherited, but it can
also be caused by trauma.

When the luxation is from trauma, something has occurred that
has caused the knee to be forced out of normal alignment.
Usually the traumatic injury occurs when the dog's leg gets caught
somehow and he struggles to pull free. Or during an overly
enthusiastic playtime when the playmate grabs the foot and holds
tight while the excited puppy tries to get away. Any other
similar accident can permanently injure this small joint.

If the luxation is believed to be of a genetic nature, it is due
to an abnormal development of the leg. The possible mode of
inheritance is at present undetermined, but it is believed that it
may be polygenic. This means that any number of genes may be
involved, and that dogs are not "carriers" as such but it is merely
an unfortunate specific combination of certain genes from the
parents that produce patella luxation.

As with all polygenic traits, affected dogs should not be bred
from as the risk of producing puppies with patella luxation would
then be increased.

How is it treated?
Treatment is based on the severity of signs as well as the dog's
age and weight, and ranges from rest (decreasing your pet's
activity for 1-2 weeks) to surgical reconstruction of the knee joint.

Grade 1 luxations may respond well to anti-inflammatory therapy
and restricted exercise. These may or may not progress to
worsening grades.

Grades 2 through 4 luxations tend to require surgical corrections.
The worse the luxations the more reconstructive surgery
required to provide a functional joint.

“Trachea” is the scientific name for “windpipe,” the tube that connects the nose, mouth, and throat to the lungs. The trachea is meant to be a fairly rigid tube. It consists of muscle connecting a group of cartilage rings. The rings are actually not complete circles; they form a “C” with the open end of the “C” facing towards the animal’s back. This muscle covering the open end of the “C” is called the “tracheal membrane.”

When the diaphragm (the flat muscle separating the abdomen from the chest cavity) flattens and the intercostal muscles (the muscles between the ribs) move, air is sucked into the lung. The muscles move the opposite direction and air is pushed out of the lung. The trachea serves as a pipeline bringing air into the chest. Part of the trachea is in the throat but it extends into the chest as well so that we can look at the trachea as having an “intrathoracic” portion and an “extrathoracic” portion.

WHY WOULD A TRACHEA COLLAPSE?

Tracheas collapse due to a flattening of the “C” cartilage due to weak cartilage. When the “C” loses its curvature, the tracheal across the gets loose and floppy. Instead of being a tight muscle covering, the membrane moves as air passes through the trachea. When air rushes into the chest, the membrane of the intrathoracic trachea balloons outward and when air rushes out, the membrane of the intrathoracic trachea droops down into the “C” cartilage causing an occlusion. The tickling sensation of the membrane touching the tracheal lining generates coughing and if the obstruction interrupts breathing, the patient may become distressed. If the collapse is in the extrathoracic (also called the “cervical”) trachea, the opposite occurs; the collapse occurs during inhalation and the ballooning during exhalation.

Panting or rapid breathing for any reason makes the collapse and anxiety worse which unfortunately tends to generate more rapid breathing and a vicious cycle of distress.

Making things worse still, is the inflammation generated in the trachea. The collapse creates increased secretion and inflammation thus promoting yet more coughing which creates yet more inflammation Ultimately the tissue of the trachea changes and loses its normal characteristics and the condition gets
worse and worse.

The trachea may be collapsed along its entire length, only in the intrathoracic section, or only in the extrathoracic section. Most commonly the collapse is at its worse right where the trachea enters the chest.

WHAT ANIMALS ARE AFFECTED?

The victim is almost always a toy breed dog, especially poodles, Yorkshire terriers, and Pomeranians. The disease usually becomes problematic in middle age but can occur at any age. The cartilage defect that leads to the flattened “C” rings seems to be hereditary. Many dogs with collapsed tracheas do not ever show symptoms, however, until a second problem complicates things. Factors that bring out symptoms might include:

• Obesity

• Anesthesia involving the placement of an endotracheal tube

• Development of kennel cough or other respiratory infection

• Increased respiratory irritants in the air (cigarette smoke, dust, etc.)

• Heart enlargement (the heart can get so big that it presses on the trachea)
  

If a secondary factor such as one of those listed above should occur and make a previously incidental collapsed trachea a problem, often removal of the secondary factor (weight loss program, getting an air filter, etc.) may clear up the symptoms of the collapsed trachea.

TREATMENT:
The following steps are often helpful in long term management of the tracheal collapse patient:

• If any of the above listed secondary problems are of concern, they must be addressed. This may mean that the owner gives up cigarettes or that the dog goes on a formal weight loss program or other treatment to resolve the exacerbating problem.

• Dogs with collapsed tracheas become unable to efficiently clear infectious organisms from their lower respiratory tracts. Antibiotics may be needed to clear up infection.

• Cough suppressants such as Hydrocodone or Torbutrol may be handy.

• Corticosteroids such as prednisone and related hormones cut secretion of mucus effectively but are best used on a short term basis only due to side-effects potential. Long term use may promote infection and weaken cartilage further.

• Airway Dilators such as theophylline or terbutaline are controversial as they may dilate lower airways but not the actual trachea. By dilating lower airways, however, the pressure in the chest during inhalation is not as great and the trachea may not collapse as greatly.

EMERGENCY:
The patient’s distress can reach a level so severe that the normally pink mucous membranes become bluish and collapse can result. When this occurs, tranquilization is helpful to relieve the anxiety that perpetuates the heavy breathing and coughing. Oxygen therapy and cough suppressants also help. If the patient reaches the point where distress seems extreme or if collapse results, treat this a emergency and rush the pet to emergency veterinary care.

SURGERY?
If medical management does not produce satisfactory results, it is possible that surgery may be of benefit. Basically, a rigid prosthesis is placed and bonded around the trachea effectively creating a non-collapsible tube. This is largely effective as long as the portion of trachea which is collapsed is external to the chest. Should the intrathoracic trachea be involved, the surgery becomes far less successful, more expensive, and the prosthesis must be ordered according to the specific patient’s measurements.

In all surgery cases, the younger the patient, the more successful the surgery is likely to be with success dropping off in patients over age 6 years. Severity of the collapse prior to surgery is not a tremendous factor in obtaining a successful outcome.

This type of surgery requires a surgery specialist. If one is not on staff or cannot be scheduled, referral can be arranged.

There are several types of mites that can invade the ear canals of dogs, puppies, cats, and kittens. The same mite can affect both dogs and cats. In the puppy and kitten, the most common ear mite is Otodectes cynotis. It is not important in the diagnosis and treatment of ear mites to identify the exact scientific type of mite. Regardless of the exact mite species involved, we usually refer to mites of the ear canal simply as ear mites. Contrary to popular belief, however, is the fact that ear mites can live anywhere on the animal's body.
How are the mites transmitted?

Ear mites are extremely contagious. They can be passed from the mother animal to her offspring. Additionally, the mites are easily spread to other pets within the household including cats, dogs, rabbits, hamsters, gerbils, mice, ferrets, etc. Humans are not affected.

What are the symptoms?
Puppies and kittens with ear mites will scratch around their ears and/or shake their heads. The amount of scratching and shaking depends on the severity of the mite infestation. With more advanced infestation, the ear canals will bleed and either fresh or dried blood will appear inside the canal. Dried blood resembles coffee grounds. If you peer into your pet's ears and notice a build-up of a material that looks like 'coffee grounds,' then your pet probably has ear mites, although a bacterial and/or yeast infection is also a possibility.

Ear mites are very common, but still serious. Left untreated, they severely damage the ear canals and eardrum and can cause permanent hearing loss.

If mites spread out of the ears to other areas of the body, the animal may or may not scratch the area.

What is the management?
Various commercial ear preparations are available to kill the mites. These products contain an insecticide, usually pyrethrin. Ear products without an insecticide will not kill the mites. Ivermectin, fipronil (Frontline), and selamectin (Revolution) have also been used by some veterinarians. (Milbemycin (Interceptor) and Acarexx, a form of ivermectin have recently been approved for the treatment of ear mites in cats.) Depending upon the medication used, the ears may need to be treated two to four weeks until all mites are killed. As previously mentioned, many ear mites live all over the body, including the feet and tail. These areas should also be treated. Most products designed for fleas and ticks such as sprays, dips, and shampoos, which contain one of the above ingredients will be effective. Be sure to use products approved for use on dogs, and to treat the tail. This is because while sleeping, the tail is curled around the puppy's body where it lies in close contact with the ear. Because mites are very easily transferred between pets, it is best if all pets in the household receive simultaneous treatment. Most types of mites do not survive long off the pets, so the treatment of the house and yard is usually not necessary.

Can I get ear mites from my pet?
Ear mites are not considered to be a zoonotic disease (disease which can be transmitted from animals to humans).