Does your cat have high blood pressure?

                                                     

                                         

High blood pressure/ hypertension is a condition that is often undiagnosed in cats, unfortunately if not diagnosed early it can have devastating effects on the afflicted feline.
Hypertension in cats can be primary hypertension, where the cause is not known or secondary hypertension; in cats the most common ailments implicated in secondary hypertension are renal failure and hyperthyroidism. However this might be an oversimplication as hypertension can result in renal damage, often when the cat is presented for examination the cat has renal insufficiency and hypertension, so what came first, the chicken or the egg?
In my experience the most common presenting sign is sudden onset blindness or reduced vision. So generally a client will bring in a geriatric cat that has gone blind over a short period of time. On examination these cats will have acute ocular changes, generally retinal haemorrhages and/or retinal detachment. These patients respond well to treatment, so if you have an old cat that has gone blind, don’t attribute it to old age, get it to your veterinary surgeon fast( make sure they have the equipment to measure blood pressure). The sooner your pet is treated the better the prognosis and the greater the chance of it recovering its vision.
However these are not the only presenting signs, in summary if your cat presents with any of the following symptoms make sure you get its blood pressure checked:

Weight loss / Increased drinking-urination / lameness (hind limbs) / Blood in urine / Protein in urine / Heart murmurs / Blindness / Circling / Seizure / Haemorrhage in eye / Dilated pupils / Disorientation / Enlarged thyroid glands.

One of the most common ailments of the geriatric feline is renal disease, if your cat is suffering from this or is diagnosed with this then it is important that its blood pressure is measured too to make sure that this is not a complicating factor.

Measuring your cat’s blood pressure is a non-invasive procedure normally done during a standard consultation. However if your cat is very agitated or nervous you must take this into account when taking a reading and take this into consideration.

• 150/95 – at this reading or below, there is minimal risk and treatment is not recommended
• 150/99 to 159/95 -- intervention is routinely not recommended at these readings
• 160/119 to 179/100 -- treatment should be sought to limit the risk of organ damage
• 180/120 -- immediate treatment should be sought to limit the degree of other more severe complications

Another very useful tool frequently used is the measuring of urine protein, when blood pressure is high proteins are ‘pushed through’ the kidney filter system , so high protein in the urine can be a great aid in the diagnosis of hypertension and also useful as a prognostic indicator.

Early diagnosis is ideal, if caught early before any further organ damage then simply dosing your cat once a day with medication can be enough to prevent any further deterioration and will extend your cat’s life substantially.

High blood pressure is not a condition to be ignored, if you have an aging cat, from the age of 10 + then ask your vet to take its blood pressure and ideally provide the vet with a urine sample. Managed well hypertension is easily controlled and your cat will lead a normal life, left untreated and it will eventually cause irreversible organ damage and will shorten your pet’s life.

Get Your Dog’s Spleen Checked!!!!

Your dog’s spleen is an organ in the abdomen that has several functions; it’s most vital functions are the production of lymphocytes, a type of white blood cell and also the storage of blood. Therefore it is a very vascular organ, it has a thin capsule and it sits on the left hand side of the abdomen but it is not fixed tightly like the kidneys or the liver allowing it to expand and contract so that it can fulfill its functions.

The spleen is one of those organs that is commonly forgotten, it sits quietly performing its functions hidden away in the abdomen. One of the main reasons that the spleen is so mobile is to actually protect the organ. As it is a very vascular organ with a relatively delicate capsule it is susceptible to blunt trauma that could result in its rupture. It sits tucked in the abdominal fat that also provides it with a degree of protection.

Unfortunately its structure does predispose it to problems, and more often than not they are veterinary emergencies.  

In the older dog, usually from 8 years of age onwards, the spleen is very susceptible to vascular tumours because of its highly vascular structure heavily interlaced with immunomodulating regions. These tumours tend to grow slowly and in my experience tend to be benign at the start of their development. However as they grow their structure changes and they become malignant, they become haemangiosarcomas in the majority of cases. These growths are extremely vascular and grow rapidly. The dog will be totally asymptomatic during this phase in the majority of cases, clients often attribute a slightly larger ‘tummy’ to the dog getting fatter as it ages. I have removed tumours weighing up to four kgs where the owner as been oblivious to the existence of the mass. This is because of the mobility of the spleen, so expansion will be into the peritoneal cavity in the abdomen and nobody is none the wiser that this monster is growing inside your pet.

What happens is the expanding haemangiosarcoma stretches the thin capsule of the spleen until it ruptures, often with the most innocuous of traumas e.g. jumping on a sofa. This is usually the point that the animal is presented to me for examination, the dog is usually in loads of abdominal pain and it is pale and weak as the animal bleeds out into its abdominal cavity. As I mentioned previously these tumours are really vascular so once the mass ruptures the blood loss is rapid. Unfortunately in most cases the owner is unaware that their dog is bleeding out as there is no external signs of blood loss.

Early diagnosis and emergency surgery are necessary for a successful outcome, often there is no time for niceties, no time for blood tests etc, and aggressive surgical intervention is required to stop the bleeding. The quicker the diagnosis, the quicker the surgery the better the chances of your pet’s survival.

Unfortunately once the mass has ruptured and even after successful surgery the chances of the tumour reemerging in another part of the abdomen are very high. The rupture releases millions of cancer cells into the abdomen, so despite abdominal flushing and irrigation it is very probable that one of these cells will settle on another abdominal organ and regrow. The time taken for the cancer to reoccur does vary between different animals and obviously the degree of malignancy of the original tumour, it can vary from approximately 3 months to a year.

So early diagnosis of a splenic growth is vital, this can be done using an ultrasound of the spleen, an experienced veterinary surgeon will be able to detect early changes in the organ’s structure. I have removed spleens from dogs with early changes, and these animals live for many more years and pass away from unrelated conditions. If you have an elderly dog then get that spleen checked, you could save your best friend’s life .

Cystitis, how serious it is?

Cystitis is inflammation of the bladder wall; it is multi-factorial in origin, it can be caused by a simple bacterial infection, bladder stones, tumours, polyps. The cause of the problem very much decides its prognosis, I shall try to go through the symptoms and its treatment bearing in mind that it can be a medical emergency in certain cases.

The most common symptom that patients present with is increased straining and frequency of urination. The animal in question has the urge to go to the toilet more frequently because of the bladder irritation, therefore clients notice behaviour changes, often these animals are very clean animals that have never had an accident in the house, but as a consequence of the cystitis they cannot control the urge to urinate. It is important that they are not told off when this happens, they cannot control the need to urinate, and scolding the pet could actually compound the problem. Often there is blood in the urine and the animal may spend excessive time licking their genital areas.

In the more elderly animal a bacterial cystitis is more common, usually as a result of an ascending infection; therefore a short course of anti-inflammatories and antibiotics is usually sufficient to treat the condition. However if the problem starts to recur then it is important that the condition is worked up properly as one of the other causes might be a factor.

Another common cause of cystitis in dogs and cats are urinary calculi, these are crystals that are formed in the urine that often coalesce to form larger stones. These crystals can be formed as a result of a metabolic anomaly in the patient or secondary to a primary infection. In the male dog and the tom cat this can lead to a medical emergency, the male urethra is narrower than in the females therefore as a direct result of this a urinary stone can cause an obstruction. If this obstruction is not removed then the animal will deteriorate rapidly, develop kidney failure and die a slow agonising death. This problem is seen more commonly in cats, so if your cat is spending excessive amount of time on the litter tray then it is important that you get him to a vet immediately.

The most common cause of cystitis and urethral obstruction in cats is stress related, so if there are any changes in the cat’s environment then be aware that this may set off a bout of cystitis and often a urethral obstruction too.

Polyps are seen infrequently, but bladder tumours in dogs are seen more commonly, transitional cell carcinoma is seen relatively frequently and unfortunately carries a very poor prognosis, it tends to affect most of the bladder wall so surgical excision is not an option, they can only be managed medically.

If you have your dog or cat presenting with symptoms of cystitis then get it treated promptly. Personally I ultrasound all of my patients, an ultrasound tends to be used as the first diagnostic tool, it is better at picking up stones,(some stones do not show up on x-ray). The ultrasound is also better at accessing the bladder lining, therefore polyps and tumours can be picked up earlier   and treatment can be implemented and therefore the prognosis will be improved.

In summary cystitis in your pet can be treated easily in the majority of cases but can become complicated if ignored and may carry a poor prognosis if the underlying cause is serious or the condition is not treated promptly and efficiently.

Does your pet have bad breath???

Sometimes halitosis can be an indication that all is not alright with your best friend, it is not a condition to ignore as there could be treatment that might help and keep your pet healthy.

The most common causes of halitosis are tooth decay, gingivitis and periodontal disease. This is particularly common in the smaller breeds of dogs, in Gibraltar the breeds most commonly afflicted are the Yorkshire terriers and Chihuahuas. Just take a couple of minutes to check your pet’s mouth, but don’t just check the incisors, firstly pull his gums back and have a look at all the teeth, right up to the last molars, obviously check both sides and upper and lower teeth. Then open your pet’s mouth and have a look at the biting surfaces and the inside surface of the teeth. If there is any reddening of the gingiva, and bleeding from gums or a lot of plaque on the teeth, get them checked out. Just because your pet is young does not exclude him from developing dental problems.

Neglected teeth with tooth decay over a protracted period time can have serious repercussions to your pet. What happens frequently is that bacteria from infected teeth embolise into the blood and lodge in the liver, the liver can usually cope with this but if the liver is subjected to a protracted challenge of embolised bacteria it can be damaged, resulting in decreased hepatic function and in very advanced cases can cause death.

The heart can also be affected by the bacterial emboli, these have a tendency to adhere to the heart valves and form vegetative lesions. Once this happens there is permanent damage to the valves, even if the bacteria are cleared with antibiotics the valves are irreversibly damaged and with time the animal will develop heart failure.

Other less common complications directly linked to dental disease are kidney failure and haemolytic anaemia.

In cats halitosis and gingival disease are one of the most common symptoms of FIV (Feline Immunodeficiency Virus), cats also suffer quite badly from immune based diseases that affect the gingival margins, causing severe inflammation and infection.

As in most other medical conditions, prevention is better than cure and the sooner you start looking after your pet’s teeth the easier it will be to keep them healthy. Cleaning your pet’s teeth is usually not very successful, pets don’t often tolerate this very well and we all lead very busy lives. So the best way is to get your dog to clean his own teeth!! From an early age get your dog used to hard chews, buy a selection of tough chews that your pet will spend a long period of time gnawing at.  If you buy a product that is gobbled away in a matter of minutes then don’t purchase these, all they will do is make your dog get fat.

Unfortunately if your pet has bad teeth and gingival disease then it will need a dental, I always give the dog or cat a course of antibiotics before a dental, primarily to stop bacteria embolising into the blood and causing complications. At the practice we have invested heavily in dental equipment to offer our clients the best dental care possible, with ultrasonic descalers, polishers and dental drills.

Halitosis can also be an indicator of internal disease, when waste products cannot be cleared effectively from the body then they can taint the smell of expired air, most commonly seen in animals with renal disease and diabetes. These diseases can be treated, the sooner they are diagnosed the better the prognosis.

In summary if your pet has a smelly mouth do not ignore it!!!