A:         A sarcoma is a malignant tumor that arises from one of the connective tissues of the body. They are very locally invasive tumors which makes them difficult to eliminate completely. They can also occasionally spread to other parts of the body, but this tends to be less of a problem.

The first step is to evaluate your cat’s overall health and check to see if there has been any detectable spread of the tumor. This entails doing lab tests, x-rays of her chest to evaluate the lungs, and an abdominal ultrasound to evaluate her internal organs. If there are no other underlying medical conditions and no evidence of spread, then she is a good candidate to consider pursuing some form of treatment. Cats can live a long time and 9 years of age is considered middle-age for cats.

As for treatment options, there are generally only three major options for most types of cancer: surgery, radiation therapy, and chemotherapy. The treatment of choice for sarcomas is surgery to remove the tumor. The difficulty arises from the fact that the mass is always more invasive than it appears to be. Therefore, a wide margin of normal appearing tissue always needs to be removed around the tumor to try to maximize the chances of removing all of the cells. This can be difficult when the tumor is on the leg, and sometimes amputation is necessary. If tumor cells are left behind after surgery, then the tumor will almost always grow back at the same site. Radiation therapy and chemotherapy are sometimes also indicated following surgery, but this is determined based on all of the findings for each individual case.

Unfortunately, it is impossible to predict life span without more information such as grading of the tumor, can it be completely removed, and has it spread. Consultation with a veterinary oncologist would likely be very helpful for you to start being able to answer some of these questions. Good luck with this very difficult situation.

Stephen Brenn, DVM, DACVIM (Oncology)

Dr. Brenn received his DVM degree from the College of Veterinary Medicine at North Carolina State University. He then completed an internship at the New Haven Central Hospital for Veterinary Medicine and remained in Connecticut to live and practice general medicine. He recently completed a three year residency in oncology at the Animal Medical Center in New York City. Dr. Brenn enjoys music, sports, and spending time with his two sons.

Answer:

It is indeed true that grapes and raisins are potentially toxic to dogs.  The mechanism of this toxicity is not entirely understood and the nature is idiosyncratic and not known to be dose related, with some dogs showing no signs after ingesting many grapes or raisins and others becoming very sick after just one grape or raisin.  The toxicity seen with grape and raisin ingestion may be characterized by vomiting, diarrhea, lethargy, anorexia, and acute renal failure.  Acute renal failure can lead to death, and therefore if you suspect your dog may have ingested raisins or grapes it is important to seek veterinary care right away.  Since it is unknown which animals will become sick from grape/raisin ingestion and at what dosage, treatment of all suspected intoxications is recommended to err on the side of caution.  Since digestion and absorption of grapes and raisins is slow, it is beneficial to induce vomiting up to several hours after suspected ingestion to get out as many grapes and raisins from the pet’s gastrointestinal tract as possible and therefore decrease risk of toxicity as much as possible.  Baseline and serial monitoring of kidney values and electrolytes via blood testing is recommended every 24 hours for up to 72 hours post suspected or known ingestion of the grapes or raisins.  It is ideal to put any dog that is suspected to have eaten raisins or grapes on IV fluids for 24 to 48 hours as it is unknown which patients will develop more serious renal disease.  Unfortunately there is no known antidote for grape and raisin toxicosis and prevention of exposure and a quick response to any suspected ingestion is the best medicine!

Anne Brodsky, DVM

Dr. Brodsky is a graduate of the Cummings School of Veterinary Medicine at Tufts University. She completed a year of internship training at Oradell Animal Hospital and is now a member of our Emergency/Critical Care team. Dr. Brodsky enjoys spending time with her husband Oscar and her cat Tigre. Her interests include hiking, traveling and reading.

A:  Loss of appetite is termed anorexia, different from the self image disorder in people termed anorexia nervosa.  If your kitty has a couple of “off” days, it is generally not a big problem as long as she maintains her hydration by drinking normally.  Try offering some canned food, along with giving your kitty a quiet place to eat not around any other household pets.  However, pet owners should seek veterinary attention soon if any another signs of illness occur such as vomiting, diarrhea, or lethargy or the anorexia continues into the third day.  Pets with a poor appetite may be ill, and if you wait until the appetite is completely gone it may be too late for recovery.  This is particularly true for cats.  As appetite fades, the pet must depend on stored fat for nutrients.  When large amounts of fats are mobilized to meet energy demands, they must be processed by the liver before being used for calories.  The feline liver is not designed to handle large amounts of fat may fail resulting in a condition called feline hepatic lipidosis.

Your veterinarian needs to examine your cat and may recommend diagnostic testing to help identify the cause of the anorexia.  Medications may also be prescribed that might be helpful in stimulating the appetite. Cyproheptadine and mirtazapine are two of the most popular medications used for this purpose.

There is absolutely no reason to stand around and watch your cat fail to eat.  If necessary, calories can be provided by syringe feeding to some cats. This can be messy especially if the pet is uncooperative and some sort of paper towel or cloth bib is probably a good idea. Be sure to ask your veterinarian what kind and how much of the food you are supposed to feed.

If this method is not working, your veterinarian may suggest hospitalizing your kitty to place a feeding tube, a procedure requiring a short anesthesia time.  Feeding tubes are the least stressful method of delivering nutrition by the pet owner at home.  The most popular and easiest to manage tubes are those placed directly into the esophagus (E-tube) through which a blenderized diet or a prescription diet can be administered.  Feeding through an E-tube does not require fussing with the cat’s face and allows her to also eat food normally when she is interested.  These tubes also serve as an easy method of administering medications.  A light bandage is placed and changed approximately once weekly.  When the cat is fully recovered and eating normally, usually in 2 to 3 weeks, the tube can be pulled and the hole seals up.  Feeding tubes are highly successful in speeding pets to recovery.

Remember, nutritional support is essential to proper recovery from whatever disorder may have caused the anorexia, and to make sure the pet does not suffer extra debilitation from malnourishment.  If you think your pet has a problem with inadequate appetite, do not wait until the problem is extreme; see your veterinarian for a proper evaluation promptly.  A Feline Assisted-Feeding Newsgroup is available and can be joined by going to: http://pets.groups.yahoo.com/group/Feline-Assisted-Feeding/

Mary Ann Crawford, DVM, DACVIM (Internal Medicine)

Dr. Crawford received her veterinary degree at the Ohio State University College of Veterinary Medicine in 1978. Dr. Crawford is board certified by the American College of Veterinary Internal Medicine. She has been board certified in internal medicine since 1985 and joined the Oradell Animal Hospital staff in 1986. Dr. Crawford was Professor and Head of the Medicine Department at Louisiana State University College of Veterinary Medicine before coming to Oradell Animal Hospital. She is also a past president of the American College of Veterinary Internal Medicine and a past president of the Northern New Jersey Veterinary Medical Association. Dr. Crawford was awarded "Distinguished Alumnus" from The Ohio State University College of Veterinary Medicine in 1995 and in 2004 "Outstanding Alumnus" from the Animal Medical Center in New York City. She is also the recipient of the 1997 Friskies Pet Care Award for Feline Medicine and Nutrition given for outstanding clinical research in the area of feline hepatic lipidosis. Dr. Crawford is involved in a number of clinical research projects and acts as a consultant for Antech Diagnostic Laboratories. In her free time she spends time with her family and enjoys biking and swimming.

Answer: First let me say that I am sorry to hear your dog has had a seizure.  Seizures are very hard to witness, but rest assured that your dog is not in any pain, and likely does not know what is happening to him.

Dogs and cats can have seizures for a variety of different reasons.  The most common reason for seizures in domestic pets is a condition called ‘idiopathic epilepsy’ which is when seizures occur due to chemical and electrical imbalances within the brain cells, but not caused by any structural abnormality of the brain.  This commonly occurs in young to middle-aged dogs and can affect cats of any age. Other causes for seizures can include abnormal liver or kidney function, imbalances in blood electrolytes (such as calcium, sodium or glucose), head trauma, ingested toxins, encephalitis, brain malformations and brain tumors.

If your dog just had his first seizure, the most important thing is to bring him to your veterinarian for evaluation.  She will likely perform blood tests to make sure he is systemically well, and perform an examination to look for any neurologic abnormalities.  Depending on his age and condition, referral to a neurologist for an MRI may be recommended.

Whether or not to start medications is very individualized to your pet.  In a young, otherwise healthy dog that has no abnormal neurologic symptoms other than the seizure, it is often times reasonable to wait to see if any more seizures occur before starting a medication except in the case of very long seizures or multiple seizures in one day).  If these have occurred, or if your dog is exhibiting other neurologic signs, then starting a medication sooner is usually recommended to help control the seizures as much as possible.

It is important to note, that while some dogs do become seizure-free on medications, many dogs will still experience occasional seizures even while being treated.  As long as they are short and infrequent they do not pose a great risk to your dog’s overall health.

Michaela Esteban, DVM, DACVIM (Neurology)

Dr. Esteban received her DVM degree from Cornell University School of Veterinary Medicine. She completed a one year medical and surgical internship at Oradell Animal Hospital and then she completed a 3 year residency at Cornell University School of Veterinary Medicine in Neurology and Neurosurgery. She is a Diplomate in the American College of Veterinary Internal Medicine in the specialty of Neurology. Dr. Esteban lives with her husband, and two dogs Naia and Caruso. In her spare time, she enjoys hiking, traveling, skiing and cooking.

Answer:

Dogs and Cats can receive transfusions just like people.  However not all veterinary clinics stock blood products.  Some veterinarians order blood products from animal blood banks that collect blood from dog and cat donors.  These blood banks separate the blood collected into different components for transfusion and then ship the products to veterinary clinics.  The most common blood components we use for dogs and cats are red blood cells and fresh frozen plasma.  At Oradell Animal Hospital we have feline and canine blood donors who donate blood on a regular basis.  This blood is stored at our hospital for up to a month and is utilized for patients in need of a transfusion.  We also order blood products from outside animal blood banks to supplement our supply.

Not all patients with a low red blood cell count (anemia) require a blood transfusion.  If the anemia is severe and the patient is having trouble breathing with an elevated heart rate and they are experiencing extreme weakness or collapse then they likely need a transfusion.  More importantly, this patient would need a full diagnostic work up to determine the cause of such a severe anemia.  A blood transfusion will make the pet feel better for a short time.  However, if the underlying cause for the anemia is not identified and treated the pet will begin to become sick again as the red blood cell count decreases.

Dogs and cats can become anemic for many reasons.  In general red blood cells can be lost from bleeding, be destroyed by the body, or there may be decreased production of red blood cells by the body.  At Oradell Animal Hospital some of our patients suffer anemia secondary to hemorrhage caused buy trauma.  Some are anemic from cancers and immunological diseases.  Others are mildly anemic from chronic diseases like kidney failure.  Some of these patients require transfusions while in our care and others are discharged without the need of transfusions.  Your friend’s veterinarian will be able to advise whether a transfusion is necessary and what tests need to be performed to determine the cause of the anemia.

Erica Swanke, DVM

Dr. Swanke graduated from the University of Illinois College of Veterinary Medicine. Upon completing an internship at the Cummings School of Veterinary Medicine at Tufts University she joined the emergency/critical care team at Oradell Animal Hospital. Dr. Swanke enjoys reading and spending quality time with friends, family and her pets.

A:  Demodicosis or Demodectic Mange occurs when there are excessive numbers of Demodex canis mites in the hair follicles.  The mites are generally obtained shortly after birth from the mother.  In most dogs the number of mites is very small and no clinical disease occurs. Demodectic mange is not contagious. Some dogs are genetically or immunologically susceptible to the proliferation of the mites which leads to the clinical signs. Certain breeds such as the pit bull terrier are predisposed to the disease.   As the mites accumulate in the hair follicles the skin becomes red with areas of hair loss.  Secondary bacterial infections are common and cause more severe lesions such as pustules and draining tracts. Lesions can occur anywhere but the face and the feet are most commonly affected.  When the secondary infections are severe and deep the dog may appear systemically sick. Demodicosis is diagnosed by doing skin scrapings.  A scalpel blade is used to collect a sample from the skin and the mites can be seen under a microscope.  Skin scrapings are also used to monitor the treatment. Juvenile onset demodicosis is when the disease began when the dog is less than eighteen months old. While the disease can still be very severe, most (but not all) of these dogs can be cleared of the disease.  Treatment may be needed for 6 months or longer.  When older dogs develop demodectic mange there may be an underlying cause which is weakening the dog’s own ability to keep the number of mites low.  Anything that weakens the immune system such as chemotherapy, cancer, hyperadrenocorticism, hypothyroidism, steroid therapy, internal parasites,or stress can lead to the development of demodicosis.  Therefore it is recommended to do diagnostic testing to see if a cause can be found and treated.  Unfortunately a cause can not be found in many cases and long term treatment is often required.  It is important to treat the secondary bacterial infections.  Long courses of antibiotics may be needed and culture and sensitivity testing are often necessary to choose the correct antibiotic.

Giving oral Ivermectin daily is well tolerated and can be effective in most dogs (80-85%).  Certain breeds of dogs such as Collies and other herding breeds do not tolerate the higher doses of ivermectin needed to treat demodectic mange.  Dogs can be tested for the genetic mutation which can help predict which dogs can safely take Ivermectin.  The dose of Ivermectin has a wide range and difficult cases will often require the higher end of the dose range.  Ivermectin is often started at a low dose and the dog is observed for side effects.  If there are no serious side effects the dose is increased gradually until an effective dose is attained.  Periodic examinations and skin scraping are done to monitor the progress.  Treatment is continued until there are no mites found on two skin scrapings one month apart.

Milbemycin is an oral drug in the same class as ivermectin.  It is tolerated by most dogs.  Unfortunately it is more expensive and currently unavailable

Mitoban dip can be used for dogs that do not tolerate Ivermectin.  Mitoban contains amitraz.  The dip must be diluted and applied properly in a well ventilated area.  Long haired dogs must be clipped prior to dipping.  The dips are done every 7-14 days for several months and can have a 60-80% cure rate. I would recommend that you bring your dog to see a veterinary dermatologist since demodectic mange can be a difficult and frustrating disease to treat.

Laura Bucklan, DVM

Dr. Bucklan graduated from The Ohio State University School of Veterinary Medicine. She is a member of our general practice group of fine veterinarians. Dr. Bucklan has a special interest in dermatology. Dr. Bucklan enjoys spending time with her family, aerobics and cooking.

Thank you, Madeline Hayden

A: Leptospirosis is a disease caused by spirochete bacteria similar to the bacteria that causes Lyme disease and syphilis in humans. It lives in water or warm, wet soil. It causes a variety of flu-like symptoms, but it can develop into a more severe, life-threatening illness that affects many organs, in dogs it primarily affects the kidneys and liver. It may cause serious life-threatening illness in dogs, other animals, and people throughout the United States and around the world.
The most common way dogs become infected with leptospirosis is by coming in contact with the urine of infected animals (often skunks or raccoons) – usually in water or on wet ground. Dogs become infected by swimming in or drinking contaminated water or by playing in areas where infected urine is present. Leptospires enter the body through the dog’s eyes, nose, or mouth, or through a break in the skin caused by a cut or scratch. If the infection reaches the kidneys and bladder, the dog may become a carrier of leptospirosis, spreading the bacteria each time it urinates.
The symptoms of leptospirosis in dogs are usually lethargy, depression, loss of appetite, vomiting, fever, and often times jaundice. Jaundice is noted by a yellow cast in the membranes of the mouth and whites of the eyes. At least 80% of the infected dogs develop serious kidney problems, with some developing acute kidney failure. The dog may also be reluctant to move due to muscle or kidney pain.
Your veterinarian is the best person to diagnose and treat leptospirosis because it can look like many other diseases. It is a challenge to diagnose quickly and may require numerous blood and urine tests. This process can be frustrating and costly. While waiting on the diagnostic test results, your veterinarian may recommend supportive treatment with a combination of intravenous fluids and antibiotics, as well as other supportive therapies.
You can try and to lower your dog’s risk of leptospirosis by limiting exposure to potential sources of contamination (stagnant water, rodents, damp ground in shaded areas), but the best way to protect your dog is with an annual vaccination that protects against the leading causes of leptospirosis. Currently vaccines protect against the 4 most common types of leptospires. Dogs have been vaccinated for this disease for many years, and the vaccines are almost always safe and well tolerated. Sometimes dogs experience tenderness at the injection site and/or lethargy, but that usually goes away very quickly.
Leptospirosis is a zoonotic disease, meaning that the potential is present for the bacteria to be transmitted from animals to humans. The major public health consideration is with the contaminated urine from infected animals. People with flu like symptoms who have been exposed to leptospirosis should notify their physician immediately so that appropriate therapy can be started right away.

Mary Ann Crawford, DVM, DACVIM (Internal Medicine)

Dr. Crawford received her veterinary degree at the Ohio State University College of Veterinary Medicine in 1978. Dr. Crawford is board certified by the American College of Veterinary Internal Medicine. She has been board certified in internal medicine since 1985 and joined the Oradell Animal Hospital staff in 1986. Dr. Crawford was Professor and Head of the Medicine Department at Louisiana State University College of Veterinary Medicine before coming to Oradell Animal Hospital. She is also a past president of the American College of Veterinary Internal Medicine and a past president of the Northern New Jersey Veterinary Medical Association. Dr. Crawford was awarded "Distinguished Alumnus" from The Ohio State University College of Veterinary Medicine in 1995 and in 2004 "Outstanding Alumnus" from the Animal Medical Center in New York City. She is also the recipient of the 1997 Friskies Pet Care Award for Feline Medicine and Nutrition given for outstanding clinical research in the area of feline hepatic lipidosis. Dr. Crawford is involved in a number of clinical research projects and acts as a consultant for Antech Diagnostic Laboratories. In her free time she spends time with her family and enjoys biking and swimming.

A: Dogs and cats with kidney disease do require special diets that are easier on the kidneys and help slow the progression of the disease. These diets are low in protein and phosphorus but your dog must consume enough of the food to fulfill all of his nutritional requirements and maintain an appropriate body weight. The first step is to talk to your veterinarian about different brands of diets specially formulated to help dogs with kidney disease. There are many different options available and another brand or another formulation (canned vs. dry) may be more palatable to your dog. The important thing to remember is to make sure your dog is feeling well and is not nauseous before starting to introduce the new food. Introducing a new diet when a pet is feeling poorly may cause a food aversion.  Also, be patient when introducing a new diet but ensure your pet is eating an adequate amount of food. If in doubt, ask your vet how much he should be eating each day. Try slowly mixing a new food into his diet over the course of several weeks or place a small amount of the new food in his regular food bowl and a little less of his current diet in a nearby bowl.  Slowly increase the amount of the new diet and less of his regular food every couple of days over the next several weeks and see how he tolerates it.  You may try warming or chilling a canned food to see if he prefers a certain temperature. Ask your veterinarian if you can flavor the food with a small amount of low sodium broth or honey. If these options do not work and your dog still won’t eat a formulated “kidney” or “renal” diet, consider a consultation with a veterinary nutritionist. There are a lot of options available including some home cooked diets, but they require careful balancing of nutrients such as vitamins and minerals.

Julianne Porter, DVM

Dr. Porter, originally from a small town in Sullivan County, NY, received her Bachelor of Science from Cornell University, followed by her Master of Arts at SUNY New Paltz and her Doctorate of Veterinary Medicine from Western University of Health Sciences. Her veterinary interests include Neurology and ER/Critical Care. Outside of work, Dr. Porter enjoys playing piano, teaching swimming, and getting involved in theater groups. She has two rescue-cats and loves to go hiking with her rescue-Staffordshire Terrier and Border Collie.