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Goddard Veterinary Group
Wanstead Veterinary Hospital
84 New Wanstead
Wanstead
London E11 2SY |
Tel: +44 (0) 20
8989 7744
Fax: +44 (0) 20 8532 2821 |
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Common Medical Conditions |
Diabetes mellitus
Diabetes Mellitus is a condition usually found in middle-aged bitches, or middle-aged neutered male cats. It is a problem with the production of insulin from special cells in the animal's pancreas.
There are two hormones, insulin and glycogen, that work together to keep the balance of sugar in blood. After eating a meal the gastrointestinal tract works to break down the food particles into readily available nutrients. These are soon passing across the gut lining, into the blood supply. Once the liver has filtered out any potential toxins this nutrient-rich blood then starts its passage around the body.
The high levels of blood sugar trigger an automatic regulating response from the pancreas - to release insulin.
The insulin then acts to lower the blood sugar to safe levels by allowing the sugars to pass into cells. The sugar is transformed into glucagon in the cells.
Sometime after feeding, when the nutrients (and sugars) have all been distributed around the body the blood sugar level will start dropping. If this drops below an acceptable level and the body does not receive any more food then another regulatory response occurs.
The pancreas secretes the hormone, glucagon, which acts on the stored glycogen in the tissue cells, forcing them back into the blood circulation.
An animal becomes diabetic when the insulin it produces is not sufficient to match the sugar level (obesity), if the pancreas should fail to produce insulin (cell exhaustion or disease / inflammation) or produces defective insulin which does not work at the receptor sites on the cells. In very rare cases insulin antibodies are formed by the body which render the insulin ineffective.
Signs of diabetes mellitus
Excessive thirst with increased urination
Over-eating with weight loss
Repeated urine infections
Sudden clouding of eyes
Treatment of diabetes mellitus
Your vet will need to perform a number of blood tests sometimes requiring your pet to be an in-patient overnight and some tests on the animal's urine. These will help the vet determine whether this is the diagnosis. As you will see in this section many very different diseases have similar symptoms.
Once a diagnosis of Diabetes Mellitus has been reached your vet will organise a routine that includes the following:
Regular health checks - probably every three months then six monthly once stabilised.
Daily or twice daily injections of insulin. You will be taught how to give these.
A regular exercise routine to suit you and your pet. This exercise routine is an important part of the treatment and should be stuck to.
A special diet that releases its nutrients slowly, over a longer period of time compared to normal foods. This allows the insulin to work better and prevent the animal from experiencing high peaks of nutrient (sugar) rich blood.
Your pet will need to stay on this routine for the rest of its life.
Cushings Disease
This is a problem with over-production of cortisol, a natural steroid from the animal's adrenal glands Production of cortisol from the adrenals is controlled by the pituitary gland in the brain. The adrenal glands are situated close to the kidneys.
Cushings disease can occur for a number of reasons:
If there is a tumour of the glands, leading to excess production of the cortisol
A tumour in the pituitary gland in the brain. The pituitary gland controls the adrenal glands - when there is a tumour present in its structure it over-stimulates the adrenals. This is the most common form of Cushings
Signs of Cushings
Excessive drinking (polydipsia) and increased urination (polyuria)
Increased appetite (polyphagia)
Saggy, pot bellied appearance
Loss of hair on both sides of flanks (bilateral alopecia)
Some cases will see a change in coat colour, muscle weakness and wasting or hardening of the skin.
Your vet will need to perform some blood tests during a stay at the surgery. If these lead to a diagnosis of Cushings disease the following treatment maybe recommended:
a. If the tumour is based in the adrenal gland then normally just one of the two glands will be affected. Surgical removal usually results in the healthy one returning to full function.
b. If the tumour is found to be at the pituitary gland then a drug therapy course will be started. The drug works to suppress the adrenal glands and control their production of cortisol.
Regular health checks, especially for the pituitary-centred disease, will be requested by the vet so that the condition may be closely monitored.
Kidney (Renal) Disease
The everyday functions of the kidneys are filtration, excretion and re-absorption.
 The blood vessels to the kidney supply blood under pressure. The design of the kidney is such that particles are forced out of the blood circulation into the structure of the kidney (at the glomerulus - see diagram).
This is indiscriminate and many useful items, such as water and electrolytes like sodium and potassium are pushed out.
Regulatory controls are exerted on the kidney structure (convoluted tubules and Loop of Henle) which then carefully takes back in or keeps out of the circulation the various minerals and waste products. The animal's water requirement is also balanced here by complicated hormonal controls leading to either loss of water (weak urine) or retained water in the body (concentrated urine). When kidney disease is present these complicated mechanisms fail.
Acute kidney disease affects the animal suddenly. It may occur with a urinary tract infection or an inflammatory disease. Your vet would start a course of supportive treatment, including intravenous fluids, to help the animal overcome the problem.
Chronic kidney disease is where the problem has slowly progressed and is a long-term problem. Animals with chronic kidney disease are able to cope with the problem up to quite an advanced state of damage, as the other areas of the kidney compensate. An affected animal will appear normal until the disease has progressed beyond the point of compensation - usually when ">60% of the kidney is diseased and damaged.
Some chronic kidney patients are able to cope very well with their problem until something tips them over the edge, i.e. not having enough to drink on a hot day, then their kidneys will crash and the animal suddenly becomes ill with the problem.
When the kidneys are no longer able to work efficiently they are unable to perform their key functions and so waste products are not efficiently excreted. Urine concentration is lost and useful elements in the blood are excreted in the urine. Other elements which should be excreted efficiently start to build up in the blood e.g. urea and creatinine. It is these secondary effects of kidney disease that make the animal feel so ill and not the actual presence of kidney disease.
Signs of kidney disease
Excessive drinking and increased urination
In appetence (anorexia)
Weight loss and lethargy
Vomiting
Bad breath (halitosis) and mouth ulcers.
Treatment
Intravenous fluids
Supplementation of vitamins and potassium lost in high volumes in urine (usually supplemented in the intravenous fluids or the diet)
Feeding a special diet that reduces the workload on the kidneys, thereby slowing the progression of the disease and that has the right kinds of foods and supplements to make the animal feel better.
The intravenous fluids dilute the waste products retained in the blood circulation and help to keep the kidneys flushed through. Useful supplements, otherwise lost in the increased volumes of urine, can also be delivered to the animal in the fluids.
Diets, specifically designed for dogs and cats with kidney disease, attempt to slow the progression of the disease (there is no cure) and make the animal feel better by controlling the kinds of waste products provided in its diet (and therefore needing excretion by the kidneys). This comes from high quality, balanced proteins, fats and carbohydrates that are easily digested to provide excellent nourishment with little left over as waste.
The diets are also supplemented with the vitamins and minerals important to ill animals and ones that are likely to be flushed out of the body too quickly by the increased urine production.
Many animals diagnosed with chronic kidney disease are managed well with a good quality of life for several years on the special diet routine with regular health checks to monitor the progression of the disease and to check its effects on the animal.
Chronic Liver Disease
Like the kidney, the liver has an ability to compensate for damage and disease to its tissues. There is often considerable damage sustained before signs are seen i.e. around 70% of the liver tissue can be damaged before obvious signs can be picked up by the owner.
Liver disease may caused by a number of factors, such as infectious disease, some drugs, inflammatory disease, cancer or following injury such as during a road accident.
 Signs of liver disease
Vomiting
Weight loss
Diarrhoea
Abdominal pain
Jaundice (yellow coloured mucous membranes e.g. lips, gums and mouth. Sometimes the whites of the eyes are yellowed.)
Swollen belly (ascites - fluid accumulation in abdomen)
Pale faeces
Your vet will need to take some tests to make a full diagnosis and these include blood sampling and radiography. The vet may also need to take some x-rays and perform a biopsy, perhaps during an ultrasound examination.
As with kidney disease there is sometimes no cure but there are diets available that can make the animal feel better.
Bladder stones - urolithiasis or crystals / stones in urine
No one fully understands why these form in dog and cat urine (and humans and other animals) but there are different types which form in different urine - alkaline or acidic. They are made up of minerals, the most common being the STRUVITE crystal which is made up of magnesium and phosphates and grows in an alkaline urine.
It is most commonly seen in animals that are lazy, sleep a lot and therefore have long gaps between emptying their bladder. This means that when an animal is prone to getting the problem and has the right collection of minerals the problem has a chance to develop.
The kidneys produce an almost constant stream of urine into the bladder. The lazy ginger cat sleeps on the sunny windowsill for most of the day and ignores the call of nature. The right collection of minerals, in increasing quantities, then sits in the bladder, clumping together as a crystal with plenty of time to increase in size. The cat then finally gives in and has to urinate. One of two things then happen: either the crystal is now so large that it does not pass into the urethra and it stays in the bladder continuing to expand to become a bladder stone or it just fits into the urethra but causes irritation along the way and probably gets stuck part way down (especially in male dogs and cats).
This then leads to an irritated urinary tract (cystitis) and possibly the urgent situation of urethral obstruction, which can be fatal.
Signs of lower urinary tract disease
Straining whilst passing urine
Passing blood tinged urine
Repeated frequent attempts to urinate, often passing little of nothing
Crying out when urinating
Bloated abdomen
WARNING - TAKE CARE
If you are suspicious that your cat or dog has a problem, especially if you notice that it has not passed any urine after considerable effort, then seek IMMEDIATE veterinary advice, HOWEVER, be extremely careful when you pick up the animal. If it has a blocked urethra then it will probably have a full to bursting bladder - a serious risk.
Treatment of lower urinary tract diseaseIf there is a urethral blockage then the animal should be treated as an emergency - you should inform the receptionist. The vet will admit the animal and relieve the blockage - usually by passing a catheter. Sometimes this is not possible and surgery may be required.
The normal course of treatment may include intravenous fluid therapy or surgery to remove large crystals and stones.
Few urinary tract problems are as a result of infections therefore your vet will probably not prescribe antibiotics.
You will be asked to ensure your cat increases its drinking water intake as this will increase its need to urinate. If it urinates more frequently then it is less likely to have crystal formation. Special diets assist this, as well as controlling the minerals present in urine and changing the pH (Acidity/alkalinity) of urine to lessen the likelihood of the problem recurring.
You will probably have to keep your pet on a special diet for the rest of its life, although it is possible to control some animals by providing them with a regular canned diet with a little added water.
Diarrhoea
Acute diarrhoea: sudden onset
Chronic diarrhoea: long-term problem over two weeks in duration
Acute diarrhoea
Most acute diarrhoeas are due to the animal eating something it shouldn't have. This may be the result of scavenging from bins while out on a walk in the park or a sudden change in diet, especially from a cereal-based to a meat-based diet.
The balance of the gastrointestinal tract becomes upset in diarrhoea cases. Temporary and mild damage occurs in the gut lining and the body acts to get rid of the problem by reversing the water pumps in the gut lining, it speeds up the passage of the offending product and gets it out of the body. A protective layer of mucous can also be produced, which will be seen as a jelly-like substance.
Because diarrhoea is carried through so quickly, much of the original fat is still present when it reaches the lower end of the gut. This overfeeds the bacteria present in healthy gastrointestinal tracts and produces lots of gas. As well as this, the lower gut does not have time to remove some of the water and so more is lost with the faeces - hence the fluid nature of the diarrhoea.
Simply withholding food from the animal for 12 - 24 hours will give the gut lining time to repair the damage. A further couple of days with a mild diet, consisting of chicken, white fish and rice will gently put the gut back into action and ensure quality nourishment is supplied whilst the gut fully heals.
Chronic diarrhoea
This is much harder to treat.
Your vet may need to perform a number of diagnostic tests to clearly identify the problem, including blood tests, radiography, endoscopy and biopsy analysis.
Some chronic diarrhoea cases occur as a result of tumours, problems with production of enzymes vital to nutrient digestion e.g. with pancreatic insufficiency or as a result of worms or a bacterial infection.
Diarrhoea is sometimes seen as part of another problem entirely such as with liver disease.
If a dietary intolerance is identified and the particular foodstuff is avoided then the problem should be controlled.
In the case of dietary allergies, where there is an immune system allergic response to a certain food, the animal needs to follow a strict diet programme - initially to identify the foods it can and can't eat and thereafter to prevent recurrence of the problem.
Ear Problems
Foreign bodies
Whether these are grass seeds or stones they are likely to result in intense irritation and discomfort or pain.
The animal will suddenly start shaking and pawing at its head/ear, perhaps calling out in pain. It may rub and scratch the ear, holding its head down to that side. Relief is achieved when the foreign body is removed, often necessitating a general anaesthetic.
Stings
Wasps, bees or nettles will make an ear-flap tingle. Some animals may experience an allergic reaction but this is uncommon. Most will allow you to bathe it with cool water but some may need to visit the vet for an anti-inflammatory injection.
Haematoma
This is collection of blood within the layers of the ear flap (pinna). It is usually caused by persistent shaking of the animal's head when a foreign body or allergy is present.
Treatment usually involves performing a small surgical procedure to drain the ear under general anaesthetic or possibly injection of a drug into the blood clot.
Skin disease and allergies
 Dogs and cats with skin disease and an allergic condition called ATOPY are often prone to ear disease as the outer ear is simply a twisted tunnel made up of skin. Some animals get severe ear disease even affecting their middle and inner ears.
These conditions are usually incredibly painful for the animal and unpleasant for the owner as the animal suffers from various aural discharges and aromas.
 Treatment is usually mixed between treatment of the chronic skin disease - often by visiting a veterinary skin specialist and treatment of the ear disease. It may mean long-term medication or surgery.
Parasites
Dogs, cats and rabbits get ear mites. These little creatures live in the ear canal existing on the debris and skin. They can cause extreme irritation to the bearer - they are easily treated with anti-parasitic drugs.
Skin disease
The most common cause of itchy pets is fleas. Some animals are particularly sensitive to the presence of fleas and are extremely irritated by their presence. Animals with a FLEA ALLERGY suffer an intense all-over reaction every time a flea bites them even with just a single bite from just one flea. These animals need a careful regime to ensure they remain flea free. Working closely with your vet should allow these animals to live comfortably.
Some animals have problems with skin infections, cyst growth, tumours in the skin or immune-based skin problems.
Many skin diseases are hard to diagnose and require a referral to a skin specialist to resolve the problem. The Goddard Veterinary Group is able to offer these referral appointments.
Arthritis
The shoulder, elbow, hip, knee and toe joints are all called "articular" joints because they articulate to allow a range of movement in a number of directions. To smooth this movement the inner surfaces of the bones, within the joint, are covered with a smooth layer of protective cartilage. Over time or with high impact damage (e.g. as experienced by humans during running on hard surfaces in poor quality shoes) or an injury such as an accident or ligament problem this smooth protective layer gets damaged. Rheumatoid arthritis may affect a number of limbs. It may be constantly present or it may come and go, even in different joints at different times.
Treatment involves controlling the symptoms and discomfort felt by the animal by use of medication prescribed by the vet caring for the animal. In some cases, certain types of hip disease may be operated on surgically and can even involve a hip replacement in some cases. Frequent short periods of exercise throughout the day can prevent the joints stiffening up and may make the animal more comfortable along with the provision of soft padded bedding.
Heart Conditions
The most common heart conditions currently seen in cats and dogs in the UK are:
Heart murmurs (faulty valves)
Congestive heart disease
Enlarged heart muscle (hypertrophy)
Birth defects (congenital)
Faulty, leaky valves are the most common heart condition. It often poses little or no threat to the animal's health - depending on its severity. Your vet may pick up an irregularity during a routine health check, such as at a puppy check, during a vaccination appointment or when assessing an animal for another procedure e.g. radiography. Further tests may be needed to assess the severity of the problem. Depending on the extent of the problem you may be given some treatment or may simply be advised to let the animal live normally but to avoid excessive strain on the pet such as becoming overweight or irregular exercise.
Congestive heart disease and Hypertrophy are two symptoms of diseases of the heart. They occur as a result of the heart's inability to do its job efficiently. Blood is backed up as it approaches the heart (right side) which causes fluid collection in the lower areas of the circulation e.g. abdomen (ascites) or the heart muscle becomes thicker as it has to work harder due to an inefficient left side, which pumps the blood out of the heart around the body.
Birth defects include murmurs and more rarely PATENT DUCTUS ARTERIOSUS, where a vessel used in the circulation as a foetus should close down as birth approaches but remains open after birth and causes a loop of circulation of blood to the lungs. This causes the puppy some difficulties and requires open-heart surgery to allow the puppy to mature.
Bloat / Gastric torsion / Gastric dilatation (volvus) GDV
This is an emergency condition requiring immediate urgent veterinary attention. The animal's stomach is overfull of gas, possibly with a twist to prevent gas escape.
This is a potentially fatal condition usually seen in deep-chested large dog breeds such as Irish Setters, Irish Wolfhounds, Rottweillers and Great Danes. Some animals are prone to the problem but other causes include feeding one large meal daily and exercising soon after a meal. As the food is digested and fermented, gas builds up but has no means of escape either because of some anatomical problem or because the full stomach has flipped over, twisting the entrance and exit ports. Pressure builds up within the stomach and abdomen making the animal increasingly uncomfortable and affecting its breathing and blood circulation as its chest cavity becomes squashed. Rapid relief is urgently needed to prevent the animal's death. Emergency veterinary attention is required. The vet or nurse will attempt to relieve the pressure by passing a stomach tube, followed by techniques which may involve surgery under general anaesthesia. Important steps to avoid re-occurrence will be provided by the vet.
Anal glands
Many animals have problems with these scent glands.
The anal glands are two small pockets either side of the anus that contain a pungent fluid mixture that lubricates faeces. If these pockets become inflamed or infected they may become blocked. This causes the animal pain and discomfort. Clinical signs include sudden calling out in pain and sniffing its behind, sudden sitting down or dragging its bottom along the floor.
The vet can manually empty the anal glands but may recommend surgical treatment if the problem returns frequently, or if it progresses to an abscess.
Hyperthyroidism
This is a condition usually associated with older cats. The thyroid glands are found in the neck, either side of the windpipe (trachea).
The affected cat usually loses weight, drinks more and urinates more (polydipsia/polyuria); sometimes the enlarged glands can be palpated. Other signs may alert your vet and blood samples are likely to be taken for analysis. Treatment includes drug therapy or surgical removal of the affected gland. Sometimes, both sides of the gland are affected.
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