Dermatology    

    & Allergy

Scooch is a very handsome 14 year old Labrador Retriever. He is one of our most favorite patients at Gulf Coast Veterinary Specialists; in fact, he has been seen by almost all of the services here at one time or another!  

 Scooch started seeing us in 2009 when we noticed some increased liver values on his bloodwork. The only significant finding was a coarse liver on abdominal ultrasound in addition to an early gall bladder condition. The gall bladder appeared to improve with time and medications, thus surgery was not needed to remove the gall bladder. His biggest issue was vomiting and diarrhea. We obtained a liver biopsy and also endoscopic biopsies of his GI tract. Because he was also panting a lot and drinking more water than normal, he was tested for hyperadrenocorticism (Cushing's disease). Cushing's disease is a condition in dogs where the adrenal glands produce too much steroid. As result, these pets often eat excessively, drinking excessively and pant excessively. His test for Cushing's returned positive and so he was started on trilostane therapy to control his steroid levels. Typically, Cushing's disease is caused by a small pituitary tumor. However, sometimes this tumor can become large and cause behavioral or vision problems. When this happens, it is called a macroadenoma. Because Scooch still has some residual behavioral issues which continued even after treatment with trilostane, we obtained an MRI to make certain that everything was normal and thankfully, it was.

Scooch did well and would see Dr. Karin Beale in dermatology for an occasional yeast infection on his feet or severe ear infections. Because he remained on trilostane she would routinely re-test him with an ACTH stimulation blood test to make sure he was on a good dose of medication. His testing began to show that he no longer needed trilostane and we were eventually able to stop the medication! Abdominal ultrasounds were done on Scooch pretty frequently during these recheck visits to keep an eye on his liver and gall bladder since he had a history of issues with them in the past.

In December 2010, Scooch began losing weight. He had a complete workup which showed a dynamic hiatal hernia and surgical repair was recommended. A hiatal hernia is a condition where a portion of the stomach is pushed up through the diaphragm muscle into the chest. It can lead to vomiting, gagging and some discomfort. In Jan 2011, Dr. Hottinger did his surgery. Not only did he have his hiatal hernia repaired, but he also had his gall bladder removed and intestinal biopsies were obtained to find out why he was losing weight. The intestinal biopsies showed inflammatory bowel disease and lymphangetasia (a condition in the small intestines that impairs protein and fat absorption). He was started on a course of steroid to help with these conditions.

Shortly after surgery, Scooch had his first bout of pneumonia. Thankfully, it resolved with antibiotic therapy and he seemed to bounce back. However, in July 2011, we began noticing that he seemed much weaker in the back legs and his GI signs (vomiting) returned. In November, he developed his pneumonia again and required hospitalization, but eventually recovered. We re-tested him for Cushing's, looking for something that would explain why he was so prone to developing pneumonia and his test was positive. He was started on trilostane and seemed to have some more energy which was great news.

Just when Scooch seemed to be on the right track and feeling OK - his breathing became really loud. A sedated oral examination showed that he had developed laryngeal paralysis. This is a condition that affects many older dogs, especially Labradors. It occurs when the nerve to the laryngeal fold does not work properly and as a result, the laryngeal folds flutter when breathing-creating a loud stridorous, roaring sound. Once again, Dr. Hottinger performed surgery and like a champ, he did great!

This January, we saw Scooch again for a recheck and at that time, his weakness seemed to really be bothering him. Dr. Beale in orthopedics evaluated him and felt excessive joint fluid. X-rays were obtained and once no bone abnormalities were seen, the joints fluid was sampled and revealed an immune mediated, inflammatory joint condition called polyarthritis. Typically this condition would be managed with steroids, but because of Scooch's Cushing's disease, we are having to hold off on treating him right now. Once we have his Cushing's disease under better control, he will consider some steroids, but for right now, doxycycline seems to be helping him get around pretty well.

Scooch is am amazing boy. He has never missed a beat here are Gulf Coast! Although he is very nervous when here, he ALWAYS enjoys his belly rubs by everyone who stops to give them! He has a lot of complicated medical issues and requires a lot of medications and veterinary care, but thanks to his family - Annette and Paulette, he takes it all in stride! Way to go Scooch!

Chocolate Toxicity 

Melissa Garcia-Lacaze, DVM, DACVECC

Valentine's Day is a special day for many reasons, but it can also mean trouble for your pets if they accidentally get into the candy stash!  

Chocolate contains a toxin called theobromine.  The amount of theobromine differs depending on what type of chocolate is ingested.  Milk chocolate contains the least amount of the toxin, while dark chocolate and baker's chocolate contain considerably more theobromine levels.  White chocolate is not toxic to pets because it is made from milk, sugar and cocoa butter, but does not actually contain any chocolate.  However, white chocolate can still cause considerable GI upset with vomiting and diarrhea and should not be fed to cats or dogs.

Theobromine is a potent toxin similar to caffeine.  It causes the release of catecholamines or stress hormones in the body.  Dogs that have ingested large amounts of theobromine will often appear to be hyper-excitable with fast heart rates, increased activity and panting.  In severe cases we can even see heart arrhythmias, tremors, seizures and in the worst case scenario, coma.

If you are worried that your pet ingested chocolate, it is important to contact your veterinarian or veterinary emergency center as soon as possible to determine if your pet was exposed to a toxic amount of theobromine.  Animal Poison Control can also be contacted at 1-888-4-ANI-HELP (1-888-426-4435).  Based on how your pet is acting, the time lapsed since ingestion and the amount ingested, they may recommend that you induce vomiting at home.  If a significant amount of chocolate has been ingested or your pet is showing clinical signs of chocolate toxicity, veterinary care with IV fluids and medications may be necessary.

The best way to avoid ending up in the emergency clinic on Valentine's Day is to keep the chocolate in places where your pet doesn't have access to them.  If you have any questions or concerns regarding chocloate toxicity in your pet, please don't hestiate to contact your family veterinarian or one of the doctors at Gulf Coast Veterinary Specialists.

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

713-693-1144   fax- 713-693-1145

Cardiology ~ Critical Care ~ Dermatology & Allergy 

Diagnostic Imaging ~ Internal Medicine ~ Nutrition

Medical & Radiation Oncology