Vomiting or Regurgitation-That is the Question.....

  "Ralphy" in his feeding chair  

Regurgitation is the passive process of bringing up contents from the mouth, pharynx, or esophagus.  It will often occur just like a simple burp or urp with no forewarning.  In contrast, Vomiting is the forceful and active process of bringing up contents from the stomach and upper intestine.  The most notable signs of vomiting are drooling and heaving.

It  is of utmost importance that the veterinarian distinguishes between the two as the differential diagnoses are vastly different.  This blog will focus on regurgitation.
The most common cause of regurgitation is Megaesophagus. Esophageal Strictures, sliding Hiatal Hernias, and Esophageal Tumors may also cause regurgitation.  Megaesophagus can be congenital or it can be as a result of Myasthenia Gravis, Addison's disease and possibly even Hypothyroidism.

Ralphy presented to our hospital with a complaint of regurgitation.  He was tested for megaesophagus by X-ray and barium swallow and the results were inconclusive.  However, we treated him as such and he responded. (Below is an image of a dogs chest with a megaesophagus.)

Part of the therapy for megaesophagus is to feed your pet upright so gravity helps keep the food down.  His owner was dedicated enough to have a feeding chair built for him.  As you can see he tolerated it very well!!!   (Watch the video above)
Ultimately it turns out that Ralphy most likely had an esophageal stricture secondary to esophagitis that caused his regurgitation. He no longer needs his feeding chair and is a happy boy!!


Dr. Kim Simons
West Boca Veterinary Center
www.westbocavet.com

                                             

Vestibular Disease in Dogs

                                                    "Ralphy" with old dog vestibular disease

The Vestibular System is part of the neurological system that is responsible for perceiving your body's orientation relative to the earth.  Basically the vestibular system determines if you are upside down, standing up, falling etc.  When this system is disrupted you won't know which way is up, whether or not you are standing up straight or slanted, and you'll feel dizzy.  Its like being on a constant roller coaster.
People often confuse/mistake vestibular disease with seizures or strokes.

The symptoms of vestibular disease are:
1.  Motion sickness
2.  Nystagmus-rapid eye movement---- http://www.youtube.com/watch?v=YeXT0Sss0Hg
3.  Circling
4.  Head tilt (like Ralphy in the picture above) http://www.youtube.com/watch?v=eqwW81CpUwE&feature=related
5.  Falling to one side
6.  Stumbling/staggering- http://www.youtube.com/watch?v=T1YNspRvdPE

The causes of vestibular disease are:
1.  Middle ear infection
2.  Brain lesion
3.  Unknown/idiopathic-Old Dog Vestibular Disease (what Ralphy in picture above suffered from)

In Ralphy's case he presented to our hospital with a sudden onset of staggering and falling onto his left side.  Within hours he was unable to walk and had rapid eye movement.  We diagnosed him with Old Dog Vestibular Disease and treated him for motion sickness.  Each day he progressively got better.  He is now walking but still has his head tilt (head tilts can persist up to 6 months and sometimes can even be permanent).  Below is Ralphy resting comfortably.  :)

                                                          
                                                        

Dr. Kim Simons
West Boca Veterinary Center
www.westbocavet.com

First FDA approved oral NSAID for cats

I am happy to announce that the FDA has finally licensed/labelled an oral NSAID (non-steroidal anti-inflammatory) for the use in CATS!!!
This is exciting news and the first of its kind in feline medicine.  For far too long, cats haven't had all the medicinal options as we have had for dogs.
This new drug is called Onsior (robenacoxib).  This drug is the equivalent to Rimadyl, Deramaxx, Previcox, or Meloxicam in dogs.  I am hoping this opens the door for more options for our feline friends when it comes to improving their quality of life and quality of medical care.

Dr. Kim Simons
West Boca Veterinary Center
www.westbocavet.com

Dog Ate What Foreign Object????

Dogs are notoriously known to eat just about anything.  In the past ten years of practice our hospital has removed corn cobs, underwear, Christmas ornaments...you name it. 
It is very important that owners "puppy proof" their homes in order to protect your pets from this dangerous problem. 

Below is a story about "Lena", a 6 year old mixed breed dog who we discovered ate a "linear foreign body".

"Lena" presented to our hospital with a history of lack of appetite and vomiting of 3 days duration.  In addition, when she drank water, she would vomit it right back up.  This are typical symptoms of a pet that has an obstruction or blockage from a foreign object. 
To help prove an obstruction x-rays were taken after a number of small x-ray visible beads were given to her to eat.  As you see below none of the beads move out of the stomach supporting the diagnosis of an obstruction.  (The dark areas behind the beads are intestines that are dilated and full of gas further supporting the diagnosis of obstruction.)

It was time for an exploratory surgery to find and remove the foreign object(s) from Lena's gastrointestinal tract.  Once in surgery we found a linear foreign object that was stuck and tangled in her stomach and went all the way down into her small intestines.  An incision into her stomach and two incisions into her intestines made it possible for us to remove the foreign object!!!

To this day, we do not know exactly what the object is, it appears to be a linear fabric like entity......
Lena is recovering nicely and feeling much better!!!

Kim Simons DVM

If you have any questions about this information or your pet, please give our office a call.
561-451-8838

West Boca Veterinary Center
www.westbocavet.com

Canine Influenza - Dog Flu

Canine influenza is a virus that poses a threat to the respiratory health of dogs in the U.S.

The virus is transmitted via direct contact, aerosol (via coughing/sneezing), and contaminated surfaces.

Symptoms include a persistent cough, runny nose, watery eyes, lack of appetite and lethargy.  The disease is usually mild however can progress to pneumonia in up to 20% of the cases.  The virus is fatal in up to 8% of infected dogs.

Those at risk are dogs that come from a shelter, rescue center, breeder or pet store.  Dogs that are boarded, attend daycare, training, dog parks or grooming facilities are at increased risk.

The flu vaccine has shown to be effective in decreasing the severity of clinical signs and the spread of the infection.  It reduces the duration of clinical signs, viral shedding, and protects against the formation/severity of lung lesions.  The vaccine is given twice, 2-4 weeks apart and then yearly as needed.

Should your pet become infected with the flu, there is no specific treatment/cure.  Those that are severely affected may require hospitalization and supportive care such as intravenous fluid therapy and antibiotics.

To date, there is no evidence that the dog flu can be transmitted to humans.



Kim Simons DVM
West Boca Veterinary Center
www.westbocavet.com

Heartworm Treatment Shortage

There is currently a shortage on heartworm treatment medication.  It is currently unavailable for purchase by hospitals until a dog is diagnosed with heartworm disease.  Once diagnosed it may take weeks to months to acquire the product as Merial, the company that produces Immiticide, is having to borrow the European equivalent product.  This ultimately leads to our patients being sick for extended periods of time potentially leading to disease complications.  Therefore, it is imperative that as dog owners we give our pets MONTHLY heartworm prevention.

Our practice continues to diagnose dogs with deadly heartworm infection each year.  Heartworm disease is transmitted by mosquitos and as Florida has a high prevalence of these insects our pets are at increased risk.  The cost of treatment for for a 50- pound dog can be $1,000 compared to 12 months of prevention for $95.

To protect your pet from heartworms, click here for coupon/rebate for Trifexis or click here for coupon/rebate for Heartgard Plus. 


Dr Kim Simons
West Boca Veterinary Center
www.westbocavet.com

Intestinal Parasites

Intestinal parasites are a common infection of dogs and cats.Roundworms are a type of  parasite that can infect our dogs and cats and also pose a threat to humans.
Roundworms are contracted a number of ways:

1.  Contaminated soil that harbors the parasite
2.  Via embryonic development while in utero (puppy contracts roundworms during pregnancy)
3.  Puppies ingest the parasite via the mothers milk

Roundworm infection can lead to vomiting, diarrhea, pot belly appearance, unthriftiness and pneumonia. 

Treatment with a number of available products is very effective in resolving the infection.

Human exposure is also a possibility.  The infection is more likely in children and pregnant mothers. Roundworm infection in humans can cause " visceral larval migrans".  This often leads to migration of the worm into the eyes causing blindness.

Prevention of parasitism is key for your pets health as well as your own. Your pet should be on a monthly heart worm preventative which also contains a intestinal parasiticide.  In addition your pets stool should be picked up and disposed of to keep the environment clean. 

West Boca Veterinary Center
Kim Simons, DVM