Dermatology    

    & Allergy

Jake is an AMAZING 16yo Beagle. He was initially seen at Gulf Coast in November 2010 for vomiting. At that time, bloodwork showed elevated liver values. An ultrasound was done to evaluate further and at that time, he was diagnosed with a liver tumor. This tumor was in a bad place, very close to a large blood vessel near the heart, and so surgery was not recommended. We decided that the best course of action would be to monitor the liver mass serially with ultrasound.

We did not see Jake back until January of 2011 at which time he had recently been diagnosed with atypical Cushing's disease. This is an endocrine condition where the adrenal glands make too much steroid. He was being treated with medications and had been responding well. This recheck ultrasound showed that there was no change in the liver mass and so we were all thankful to see him doing so well.

In May 2011, Jake presented for another recheck ultrasound. His liver mass had become a little bit larger, but nothing that indicated a change in our current treatment plan. However, Mom noted that he was coughing more. Chest x-rays showed some inflammation around the airways and an ultrasound of Jake's heart showed increased pressures in the lungs called pulmonary hypertension. Pulmonary hypertension can be very serious and cause pets to have decreased activity levels in addition to coughing or being exercise intolerant. He was started on Viagra to treat the pulmonary hypertension and seemed to be on the fast track to feeling better.

In July 2011 we saw Jake for a serious and life threatening emergency. He was admitted to the emergency clinic for acting lethargic. They were able to diagnose a significant anemia (low red blood cell count) in addition to fluid in the abdomen. Unfortunately, further evaluation revealed that the fluid in his abdomen was blood. The tumor that had been slowly growing in the liver had ruptured a blood vessel and was now bleeding. After he was stabilized, he was taken immediately to surgery. The liver mass was wrapped around the caudal vena cava (the vessel that brings blood to the heart), but with gentle dissection, the surgeons were able to remove the majority of the mass and stop the bleeding. He also had the urinary bladder masses removed. Jake did remarkably well post operatively and was sent home shortly after his surgery. The liver mass returned as hepatocellular carcinoma, which is a slow growing tumor of the liver. However the urinary bladder mass was more concerning. It returned as a transitional cell carcinoma which is typically an aggressive tumor of the urinary system. In most patients with this tumor, the median survival time is about 6 months once diagnosed. However, in Jake's case, we were hoping for a better survival time because of the location of the tumor and the fact that it was caught and removed early, before it could affect the other structures of the urinary system.

Jake continued to do well and was enjoying life until recently when we saw him on emergency for vomiting, diarrhea and acting uncoordinated. He was seen by the Urgent Care service and we were concerned about a neurological condition affecting his balance. This type of condition, vestibular disease, can be caused by a peripheral middle ear infection or a primary brain mass. Unfortunately, Jake's ears looked good and so because of that, in addition to the type of neurological signs we were seeing, we strongly suspected a right brain stem lesion. We opted to treat him symptomatically for his condition and focus on giving him a great quality of life for as long as possible. True to Jake's previous stays, he rallied and recovered much sooner than any of us anticipated.   We even celebrated his 16th birthday in ICU-complete with cupcakes and candles and even a memorable rendition of "Happy Birthday" from the ICU nurses and doctors who have come to know and love Jake so much.

Jake still visits us from time to time as he does have some hiccups in his health ranging from not eating well to diarrhea and ongoing tremors. However, overall, he is thrilled with life and thrilled to be hanging out with his Mom and Dad who do an AMAZING job taking care of Jake! We love Jake so much here at Gulf Coast and are excited to have him be our patient of the month for the New Year!  

Shock in Your Pet

Melissa Garcia-Lacaze, DVM, DACVECC

Shock is a life threatening condition that is defined as lack of perfusion or blood flow to the organs in your pet's body. Without adequate blood flow, the organs cannot get oxygen needed to maintain normal body function. Shock can be seen with a number of conditions, most commonly traumatic events such as hit by car or dog/cat fights. However, some other causes of shock include severe vomiting and/or diarrhea, unmanaged diabetes and internal bleeding.

There are two main stages of shock in the dog: compensatory (early) and decompensatory (late). Unfortunately in cats, we often do not see the compensatory or early stage of shock. The sooner your pet's shock is identified and treated, then better chance for a complete and rapid recovery.

Compensatory (early)shock can be difficult to recognize. A lot of times, these pets are felt to be stable because they "look" so good. Their gums are pink, they are active and alert and they don't seem to be sick. However, these patients are not as stable as they seem outwardly. Their heart rates are often extremely elevated which in turn allows them to maintain an adequate blood pressure and keep the pink color to their gums. However this masquerade is very energy consuming and dogs cannot keep this up for long. Without intervention, dogs will no longer be able to compensate and their shock will progress to the decompensatory or late stage. If your pet has been in a traumatic event or has had any major fluid losses (vomiting/diarrhea being the primary examples), it is strongly recommended to have them evaluated by a veterinarian as this early stage of shock can be very hard to recognize at home.

If your pet's shock is not recognized and treated, the condition will progress. The heart rate begins to fall and as a result, the blood pressure drops and these patients no longer look as good. They are often quiet and lethargic. The gum color may pale pink or grey and it is very difficult to find pulses. At this stage, immediate care by a veterinarian is recommended. Often, an intravenous catheter will need to be placed to deliver fluids to replace the fluid that has been lost.

The cat responds to shock much differently than the dog. They do not typically exhibit an early stage and often present to veterinarians in decompensatory/late shock. Cats are extremely good at hiding their illness. Often they will withdraw from the family and can be found hiding in strange places. When cats present in shock, they often have a low body temperature, low blood pressure and a low heart rate - very different than the dog's presentation. Although IV fluid administration by a veterinarian is still needed to reverse the signs of shock, the amount and types of fluid given may be very different compared to what is done in the dog.

Your veterinarian has a lot of choices in regards to the type of fluids used to correct your pet's shock. Typically we use the same types of fluids used in the human emergency rooms-physiologic saline or a balanced replacement fluid. However if your veterinarian suspects fluid losses due to bleeding, a blood transfusion may be recommended. In addition, if your pet has lost a lot of protein in addition to fluid, they may need to use a synthetic protein fluid in addition to the typical fluids used to manage shock. Your veterinarian will need your help in obtaining a complete history and then will perform a complete physical examination and some labwork to help determine the most appropriate type of fluids needed for your pet.

Just like with children, pets often present a challenge to us as pet owners and doctors because they cannot talk to us to let us know how sick they are. If your pet is not acting right or has been sick for more than 24 hours, it is strongly recommended that they be seen by a veterinarian. It is always easier to prevent shock and treat conditions as early as possible.

  Nutritional Differences Between Cats and Dogs  

Dogs and cats are different for obvious reasons - dogs are more active than cats, most cats sleep more than dogs, and there really is no such thing as an "athletic" cat.  Dogs and cats also have different nutritional needs.  

Cats are true carnivores (primarily eating meat), meaning they need a lot of protein and less dietary carbohydrates.  While some quantity of carbohydrates is safe for cats, in general, their digestive tracts are less able to digest and absorb carbohydrates than the gastrointestinal tracts of dogs or people.  Instead of using glucose for energy like humans do, their bodies are more equipped to use protein.  Dogs, on the other hand, are more omnivorous (eating meat and vegetables) than cats and can tolerate higher levels of dietary carbohydrates.    

There are other nutritional differences as well.  Cats need dietary taurine, which is an amino acid that is essential for heart function, vision, and digestive function.  Dogs are able to make taurine from another amino acid, so we rarely worry about dietary taurine for dogs.  Cats are not able to synthesize taurine and thus it is considered an essential amino acid for them and needs to be provided in their diet.  Cats also need arachidonic acid (a fatty acid) and retinol (a specific form of vitamin A) in their diet because their bodies are not equipped with the enzymes that dogs and humans use to make these important nutrients.  These nutrients are found in animal tissue, which is another reason we consider cats to be true carnivores. 

Despite the fact that cats are carnivores, an all-meat diet is not safe for any animal.  Meat is not complete and balanced as a sole source of nutrition due to vitamin and mineral excesses and deficiencies.  Feeding a commercial pet food or a homemade diet specifically formulated to be complete and balanced for your pet the best way to ensure that your pet receives proper nutrition.

1111 W. Loop South, Suite 140  Houston, TX 77027

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Cardiology ~ Critical Care ~ Dermatology & Allergy 

Diagnostic Imaging ~ Internal Medicine ~ Nutrition

Medical & Radiation Oncology