Laurie Anne Walden, DVM Photo by Anya Prygunova on Unsplash In recent years, monoclonal antibodies have been approved to treat some common medical conditions in animals:
More monoclonal antibodies are likely to become available for dogs and cats. Monoclonal antibodies are used in humans to treat infections, autoimmune disorders, cancer, and other conditions, and they’re being investigated for similar uses in dogs and cats. How Monoclonal Antibodies Work Monoclonal antibodies are in a therapy class called biologics, meaning therapies made from living sources like animal cells, plant cells, or microorganisms. Biologics are large molecules that interact with receptors on the outer surfaces of cells; they don’t enter cells. In contrast, most traditional drugs are small molecules that work inside cells. Monoclonal antibodies are similar to the natural antibodies produced by the immune system. When the immune system detects an antigen, different immune cells release lots of different antibodies that tag different sites on that antigen. (An antigen is anything that triggers an immune response.) Once the antibodies have tagged the antigen, other components of the immune system arrive to destroy it. Monoclonal antibodies are cloned in a laboratory from just one antibody made by one type of immune cell (mono means “one”). They tag only a single site on an antigen. Monoclonal antibody therapy can be very precise because it directs the immune response to a narrow target. In addition to tagging invaders like viruses, monoclonal antibodies can be engineered to tag a receptor on an animal’s own cells. The monoclonal antibodies that relieve pain in dogs and cats, for example, block production of a protein that’s partly responsible for the pain sensation. After monoclonal antibodies have activated the immune system, they’re broken down in the body the same way that natural antibodies are. Unlike small-molecule drugs that enter an animal’s cells, they aren’t cleared through the liver or kidneys. Administration Monoclonal antibodies are given by injection at a veterinary clinic. They can’t be given by mouth because they’re proteins and would be destroyed by digestion. Their effect lasts a few weeks (4-8 weeks for Cytopoint, 4 weeks for Solensia and Librela). These therapies are species specific: monoclonal antibodies for dogs work only for dogs, not for cats. Benefits The monoclonal antibodies that are available for dogs and cats generally work well for their approved uses. They are less likely than some traditional drugs to cause adverse effects because they have a narrow target of action and don’t enter cells. Because they are not cleared through the liver or kidneys, they can be safer than other drugs for animals with liver or kidney disease. Injections given every few weeks might be more convenient for pet owners than pills given multiple times a day, especially if their pets resist oral medication. Adverse Effects Monoclonal antibodies have fewer adverse effects than many traditional drugs. An antibody injection can cause an allergic reaction, although this is rare. Manufacturers might recommend precautions for individual monoclonal antibody products. Image source: https://unsplash.com/photos/a-dog-wearing-a-baseball-glove-E3K7xyAvQ8M Laurie Anne Walden, DVM Photo by Kanashi on Unsplash Vestibular disorders cause problems with balance and coordination. Animals with vestibular disorders typically have a head tilt along with stumbling, walking in circles, and possibly vomiting.
Vestibular problems that start suddenly can look scary to pet owners. The signs can be mistaken for stroke. Some conditions that cause vestibular problems are serious, even life-threatening; others are relatively minor. One of the most common vestibular disorders in dogs is a benign condition called idiopathic vestibular syndrome (idiopathic means “of unknown cause”). This condition is not serious and gets better on its own with time. Idiopathic vestibular syndrome most often affects senior dogs, so in dogs it’s also known as old dog vestibular disease. Cats can also develop idiopathic vestibular syndrome. Causes The vestibular system includes the brainstem, cerebellum (part of the brain), inner ear, and nerves that conduct signals between the inner ear and brain. Anything that affects any part of this system can cause vestibular signs. Vestibular disorders are either central (related to the brainstem and cerebellum) or peripheral (related to the inner ear and surrounding nerves). Central vestibular disorders are usually much more worrisome than peripheral vestibular disorders. Idiopathic vestibular syndrome is a peripheral vestibular disorder. The exact cause in dogs isn’t known. Similar conditions in humans are caused by inflammation of the inner ear or surrounding nerves, viral infections, and benign positional vertigo (an inner ear problem). These same causes are possible but not proven in dogs. Some of the other causes of vestibular disease in animals are deep ear infections (common), cancer, drug adverse effects, toxins, systemic disorders like hypothyroidism, meningitis, and other neurologic disorders. Signs These are the typical signs of a vestibular disorder:
Idiopathic vestibular syndrome usually affects older dogs and cats. It begins suddenly and then starts to improve within a few days. The signs are most pronounced on the first day and don’t get worse with time. In most animals, the signs disappear after a couple of weeks, although the head tilt can last much longer. Other diseases that affect the vestibular system cause signs of their own. For example, a central vestibular disorder might cause seizures or changes in consciousness. Vestibular signs that get worse with time are a signal that the animal has something other than idiopathic vestibular syndrome. Diagnosis Idiopathic vestibular syndrome is a diagnosis of exclusion: it’s diagnosed after other possibilities are ruled out. Diagnosis begins with a neurologic examination, eye and ear examinations, baseline bloodwork, and usually a thyroid function test and urinalysis. Depending on the results, the animal might need referral to a veterinary neurologist and advanced tests like magnetic resonance imaging of the head or cerebrospinal fluid analysis. Treatment For idiopathic vestibular syndrome, the goal of treatment is to make the patient comfortable until the condition resolves on its own. Most animals receive prescription antinausea medication; some also need appetite stimulants or fluid therapy. Home care includes making sure they can eat and drink and protecting them from falling down steps or bumping into things like furniture corners. Physical therapy and postural maneuvers that are used to help people with vertigo aren’t commonly used in animals. Prognosis Most animals with idiopathic vestibular syndrome recover completely, although some have a permanent head tilt afterward. Some animals have more vestibular episodes later on. For vestibular signs that aren’t caused by idiopathic vestibular syndrome, the prognosis depends on whether the cause is treatable. Sources
Image source: https://unsplash.com/photos/brown-and-black-german-shepherd-Xy7SLX9zuVM Laurie Anne Walden, DVM Photo by Anna Shvets on Pexels Home dental care is a crucial part of keeping dogs’ and cats’ mouths healthy. But many pet owners are reluctant to brush their pets' teeth (and brushing is not safe with animals that might bite), so the market is full of products that claim to clean teeth or freshen breath without brushing.
Some home dental care products work pretty well, some don’t work at all, and a few pose safety risks for pets. Here’s how to choose dental products for your pet. The Point of Home Dental Care The goal of cleaning your pet’s teeth at home is to remove plaque. Plaque, a sticky biofilm that contains millions of bacteria, attaches to tooth surfaces. Dental disease in dogs and cats is caused by plaque under and at the edges of the gums, not by tartar (hardened plaque) that you can see on tooth surfaces. Like humans, pets need a combination of professional dental cleanings and home dental care. Home dental products can’t remove tartar or treat dental conditions like periodontal disease. Some products make gum inflammation worse. Tartar and dental diseases require a dental procedure with general anesthesia at a veterinary clinic. When to Use Dental Products If your pet has smelly breath, visible tartar, bleeding gums, loose teeth, missing teeth, or signs of mouth pain, this is not the time to go shopping for dental products. This is the time to take your pet to the veterinarian and then schedule a dental procedure if your veterinarian recommends it. The time to start home dental care is when it will be effective and not painful for your pet, which means before your pet develops dental disease or after dental disease has been treated. It’s ideal to train puppies and kittens to have their teeth brushed while they’re young so they will build positive associations with dental care. If your pet has dental disease, talk to your veterinarian about the timing of home care; it’s usually best to start about a week after a dental procedure to give the gums time to heal. Active vs Passive Plaque Removal (How Much Work You Have to Do) Home plaque removal products fall into 2 categories: active and passive. With active plaque removal, the pet owner cleans the teeth with toothbrushes, toothpaste, or dental wipes. Passive plaque removal relies on chewing and doesn’t directly involve the pet owner; these are products like dental diets, treats, and chews. Many of us would love to use only passive dental care because tossing a treat to a dog is easier than brushing the dog’s teeth. (This is why the dental care aisle of the pet store has about 3 hooks for toothbrushes and 20 linear feet of toys and chews.) But passive dental care alone isn’t enough to keep a pet’s mouth healthy. Passive dental care products are best used along with professional cleanings when tooth brushing isn’t appropriate. Active plaque removal products have been shown to be most effective on the front teeth (the teeth the owner can easily reach). Passive plaque removal is generally most effective on the back teeth (the teeth used for chewing). Therefore, your veterinarian might recommend that you use more than one dental care product. Look for Veterinary Oral Health Council Seal Products that have the Veterinary Oral Health Council (VOHC) seal of acceptance have been shown to be effective for plaque or tartar control. The VOHC doesn’t test products; they review data submitted by product manufacturers. Some products that work, like most toothbrushes, haven’t been submitted to the VOHC, so lack of a seal doesn’t necessarily mean that a product is useless. However, looking for the VOHC seal is a good place to start. You can find lists of accepted products on the VOHC website: https://vohc.org/. Product Types Toothbrushes and toothpaste:
Dental rinses:
Dental chews, toys, diets, and treats:
Water additives:
Sources
Image source: https://www.pexels.com/photo/person-using-a-toothbrush-on-dog-with-shower-cap-4588018/ Laurie Anne Walden, DVM Photo by Jonny Neuenhagen on Unsplash The prostate gland grows and develops in response to testosterone and related male sex hormones. Almost all prostate disease that we see in companion animal practice is in intact (not neutered) dogs.
In male animals, neutering means surgical removal of the testicles (castration). Some prostate diseases can affect neutered animals, but these are rare. Most pet male cats in the United States are neutered, so prostate disease is much less common in cats than in dogs. Benign Prostatic Hyperplasia Because the prostate can keep growing as long as it’s exposed to testosterone, most intact male dogs eventually develop enlargement of the prostate, or benign prostatic hyperplasia (BPH). About half of intact male dogs have microscopic evidence of BPH by the time they’re 4 years old; more than 90% have it by the time they’re 8. Most dogs with BPH have no signs of the condition and don’t need treatment. Signs can include blood in the urine, straining to urinate or defecate, and constipation. BPH can reduce the fertility of breeding dogs. In some dogs, an enlarged prostate can be detected with rectal palpation. Ultrasonography is used to measure the prostate and make the diagnosis. Depending on the dog’s signs and test results, samples of prostate fluid or prostate cells might be sent to a laboratory to rule out other prostate disorders. For dogs whose prostate enlargement is causing a problem, the treatment is to eliminate exposure to testosterone, typically with castration. Medications that block the effects of testosterone on the prostate are available for breeding dogs that need to keep their testicles. Prostatitis Dogs with BPH are prone to develop prostatitis, which is infection of the prostate. Prostatitis is fairly common in intact male dogs and rare in neutered male dogs. The signs of prostatitis depend on whether the condition is acute (has just begun) or chronic (has been going on for a long time):
Prostatitis is suspected in any intact male dog with compatible signs—especially if rectal palpation is painful—or repeated urinary tract infections. Diagnostic tests include blood tests, urinalysis, ultrasonography of the prostate, and culture of prostate fluid. Some dogs with prostatitis also have abscesses of the prostate, and these can be seen with ultrasonography. The treatment for prostatitis is several weeks of antibiotics along with treatment of the underlying BPH, which means castration for most dogs. Dogs that are ill with acute prostatitis sometimes need to be hospitalized. Abscesses of the prostate might require surgical drainage. Prostate Cancer Prostate cancer is rare but unfortunately very serious in dogs. The types of prostate cancer that dogs get aren’t linked to testosterone level, so castration does not protect dogs against prostate cancer (it’s actually more common in neutered dogs for unknown reasons). The screening tests and treatments for prostate cancer that are used in men don’t work in dogs. Prostate cancer in dogs tends to be aggressive, is metastatic (spreads through the body), and is usually diagnosed at a late stage. Treatment options other than palliative care are limited; a veterinary oncologist is the best source of advice for an individual dog. Sources Christensen BW. Canine prostate disease. Vet Clin North Am Small Anim Pract. 2018;48(4):701-719. doi:10.1016/j.cvsm.2018.02.012 Palmieri C, Fonseca-Alves CE, Laufer-Amorim R. A review on canine and feline prostate pathology. Front Vet Sci. 2022;9:881232. doi:10.3389/fvets.2022.881232 Image source: https://unsplash.com/photos/black-and-white-short-coated-dog-tKtYHZ13yls Laurie Anne Walden, DVM Photo by Sofia Shultz on Unsplash Cases of infectious respiratory disease in dogs have received media attention in the last couple of weeks. We don’t yet know what’s causing these illnesses or whether the reported cases are true outbreaks. However, there is no doubt that dogs can be exposed to a variety of infectious organisms, mostly affecting the respiratory and gastrointestinal (digestive) systems, when they’re around other dogs.
Take steps to reduce your dog’s risk if your dog goes to group settings like these:
Dogs in animal shelters are at especially high risk because incoming animals are likely to be carrying infections, overcrowding is common, and stress can blunt the immune response. Infectious disease agents—viruses, bacteria, parasites, and so forth—are spread in 5 main ways: by direct contact, through the air, by mouth, by vectors (mosquitoes, ticks, and other animals), and on objects (water bowls, shoes, etc). Dogs in group settings can be exposed through any of these routes. Infectious Respiratory Disease Canine infectious respiratory disease complex, also called kennel cough, is caused by a wide range of viruses and bacteria, like canine parainfluenza virus, canine influenza virus, and Bordetella bronchiseptica. These infectious agents are carried in respiratory secretions and transmitted by direct contact with an infected dog, through the air, or on contaminated objects. Symptoms include coughing, sneezing, and runny nose. Most dogs have mild illness and recover, but some develop pneumonia. Vaccines are available for some of the agents that cause respiratory disease. Infectious Gastrointestinal Disease Canine parvovirus is highly contagious among dogs. Infection is often fatal but can be prevented with vaccination. A number of other viruses, bacteria, and protozoa that cause gastrointestinal disease are contagious among dogs. These agents are shed in feces, so transmission is generally by direct contact, by mouth, or on contaminated objects. Symptoms are related to the digestive tract: vomiting, diarrhea, loss of appetite, and so forth. Raw meat is a source of bacterial infection (E coli, Salmonella, Campylobacter, Listeria, etc). Dogs that eat raw meat can shed these bacteria in their feces without showing any symptoms, and other dogs that have contact with the feces can become infected. Parasites Intestinal parasites—most often hookworms and roundworms—are common in dogs that aren’t receiving regular parasite prevention medication. These worms are contagious to other dogs (and people) through feces. External parasites like fleas and ticks are vectors that spread infectious diseases to dogs and people. Some of these diseases, like bartonellosis, Rocky Mountain spotted fever, and Lyme disease, can be quite serious. Dogs can also catch fleas and mange mites directly from other dogs. How to Reduce Your Dog’s Risk
Image source: https://unsplash.com/photos/black-and-tan-german-shepherd-and-brown-and-black-german-shepherd-mix-dogs-on-brown-field-Z-lEcNOfWMI Laurie Anne Walden, DVM Public domain photo by Alan Levine on flickr Palliative care and end-of-life hospice care for animals focus on improving quality of life, not curing disease. The decision to begin these types of care can be difficult for pet owners. Whether palliative care is right for an individual pet depends on the needs and capacity of the family as well as the medical needs of the animal, so the decision is specific to each pet and each caregiver.
Animals that are candidates for palliative and hospice care typically fall into one of these categories:
Palliative care is treatment that minimizes an animal’s pain and distress (without curing disease) at any time, not just at the end of life. The term hospice care more specifically refers to care near the end of life. Hospice care generally includes palliative care for the animal and support for the human caregivers. The biggest difference between human and animal hospice care is that euthanasia is a legal and humane option for animals. Hospice-assisted natural death is possible for some animals. However, choosing to let pets “die on their own” without any relief of pain and distress is unethical. Some veterinarians are specialists in palliative and hospice care. End-of-life care for animals might involve a team including veterinary staff members, specialists (like grief counselors) to support the humans, and the pet owners themselves. Tips for Pet Owners The American Association of Feline Practitioners recently published hospice and palliative care guidelines for cats and has very helpful suggestions for pet owners (not just cat owners). Here’s a summary; for more details, see the Cat Friendly Homes website.
If you know your pet is nearing the end of life, it can be very helpful to plan in advance for your pet’s death. Options might include euthanasia at your veterinarian’s office, home euthanasia (if available in your location), or hospice-assisted natural death (if appropriate and available for your pet). Ask about the euthanasia procedure and the cremation and burial options. For More Information
Image source: https://www.flickr.com/photos/cogdog/25256183337/ Laurie Anne Walden, DVM Photo by kevin turcios on Unsplash The differences between heartworm prevention products can be confusing. Some products protect pets from other parasites in addition to heartworms. Your veterinarian can recommend products for your own pet according to risk factors like your pet’s lifestyle, environment, and geographic location.
Heartworm preventives should be given all year round. If your pet’s heartworm preventive doesn’t also cover for fleas and intestinal parasites like roundworms and hookworms, your pet should receive a second product or have regular parasite tests (your veterinarian can advise you about this). Heartworm preventives labeled for dogs and cats are available in the United States only by prescription. Some products that target fleas, ticks, and intestinal parasites are prescription products; others can be sold without a prescription. If you find a flea/tick product or a dewormer for dogs or cats that can be bought without a prescription, it won’t protect your pet against heartworm infection (unless it’s being sold illegally or possibly from outside the United States). These are the parasites most often covered by parasite preventives for dogs and cats:
Heartworm Preventives New products come on the market regularly. Products within the same brand line that have different ingredients (for different parasite coverage) tend to have nearly identical names, so check labels carefully. The following is a summary of currently available heartworm preventives for dogs and cats, listed by route of administration and active ingredient. This list is from the American Heartworm Society website, which shows the product names and their parasite coverage in an easy-to-read chart. For an updated list of heartworm preventives for dogs, cats, and ferrets, please see the American Heartworm Society website: https://www.heartwormsociety.org/preventives Products for Dogs Tablets or chews given by mouth once a month:
Injectable product given every 6 or 12 months:
Topical products applied to the skin once a month:
Products for Cats Tablets or chews given by mouth once a month:
Topical products applied to the skin once a month (except Bravecto Plus):
Image source: https://unsplash.com/photos/rls2bfqYh8E Laurie Anne Walden, DVM Photo by Alexandre Debiève on Unsplash Most dogs and cats cope very well with vision loss. They rely more on the sense of smell than on the sense of sight. Blind animals can have happy, comfortable lives with some help from their owners.
Pets with gradual vision loss often adapt so well that their owners don’t realize their pets are having trouble seeing until they’re completely blind and bumping into things. Animals with sudden blindness can take longer to adjust. Safety and Navigation Use gates and other barriers to block a blind animal’s access to stairs, swimming pools, fireplaces, and other dangers. Use foam cushioning (child safety equipment) to pad furniture corners. Keep the floor clear of trip hazards like toys and laundry. Keep blind animals in a crate or other secure space whenever they’re unsupervised, at least while they’re adjusting to their loss of vision. This space can also become a safe, familiar retreat. Blind animals can have a hard time navigating stairs, especially descending. Be patient and use a harness and treats to show blind dogs how to manage stairs. Consider covering short runs of steps with a ramp. Nonslip strips applied to stair treads might make a blind pet feel more secure. Dogs and cats that sleep on furniture might need a ramp or steps so they don’t have to jump up and down. To help blind pets learn their way around the house, don’t pick them up and carry them; let them walk on their own. Different floor surfaces (mats or rugs) can help them identify specific areas like doorways and the location of food and water bowls. A radio left on at all times in one room and scents applied to furniture at the pet’s head height can also help orient them inside the house. Face whiskers help animals feel obstacles, so don’t have their whiskers trimmed at grooming appointments. Vests with circular extensions around the head or chest (halo vests) are available for blind dogs who keep bumping into things. Exercise and Mental Health Blind animals need exercise just like every other animal, but they shouldn’t go outdoors unsupervised. Even a small fenced yard can have holes and fallen branches that would pose a risk to a blind pet. If you don’t have a fenced yard that’s safe and familiar to your dog, keep your dog on a leash. When walking your blind dog, attach the leash to a harness instead of a collar in case you need to pull your dog away from a hazard. Teach your dog verbal cues like “left,” “right,” and “stop.” An unexpected touch can frighten a blind dog, so warn people who approach that your dog is blind. Consider using a dog vest with the words “Blind dog” or “Do not pet.” Be very careful if another dog approaches while you’re walking your dog. A blind dog can’t read other dogs’ body language. If you let your dog interact with another dog, be sure that the other dog is friendly and that your dog is comfortable with the interaction. Provide toys that stimulate senses other than sight. Use toys with bells (with supervision—bells can be a choking hazard), catnip toys for cats, and tracking games for dogs who enjoy following scents. For some animals, playing contact games like tug of war might be easier than chasing toys by sound or scent. Some animals experience anxiety while they’re adjusting to vision loss. Keep your pet’s routine consistent, stay positive around your pet, and provide a safe retreat like a crate. Behavior changes like hiding, reluctance to walk or play, growling, barking, and snapping can all be signs of anxiety. Contact your veterinarian if your pet has any of these changes or seems to be having trouble adapting. Some pets benefit from short-term or long-term prescription anxiety medications. For more ideas, see the ACVO Vision for Animals Foundation website: https://www.visionforanimals.org/coping-with-a-blind-dog/ Image source: https://unsplash.com/photos/SEX4KAz9ExQ Laurie Anne Walden, DVM Photo by Edson Torres on Unsplash Treats are fun to give and are useful for training. But in large enough quantities, treats and table food can contribute to weight gain and throw off the nutritional balance of a pet’s diet.
Keep these points in mind:
If you live with other people, you probably aren’t the only person giving your pet treats. Talk to your veterinarian about a realistic nutrition plan that will work for your household, especially if your pet is overweight or has special nutritional needs. Calories The calories in treats and table food can add up quickly for a small animal that needs only a fraction of the calories that a person eats. To find out how much your pet should eat in a day, start with your pet food manufacturer’s feeding guide or use a calorie calculator. Your pet’s individual requirement might be higher or lower than the estimate from a feeding guide or calorie calculator, so keep an eye on your pet’s body condition and adjust the amount fed as needed. Here’s how to find your pet’s daily calorie requirement:
Nutritional Balance A balanced diet has the right proportions of vitamins, minerals, protein, and fat for an animal’s species and life stage. For example, cats need a higher percentage of dietary protein than dogs do, and growing animals need more calcium than adults do. Pet foods sold as complete and balanced diets must meet nutrient requirements set by the Association of American Feed Control Officials (AAFCO). The packaging will include a statement that the product meets AAFCO standards for a certain species and life stage. Products sold as treats don’t have to meet these nutrient requirements. As long as the treats make up less than 10% of the daily calorie intake, their nutrient content isn’t that important. But if treats account for more than 10% of the daily calories, they can unbalance the diet. Treat Ideas These treats don’t contain many calories and are safe for healthy dogs and cats. If your pet has a food allergy or a medical condition, ask your veterinarian about appropriate treats.
Image source: https://unsplash.com/photos/hjzs2nA4y-k Laurie Anne Walden, DVM Photo by iezalel williams on Flickr Many dogs and cats need eye medication at some point in their lives. Pets with chronic eye diseases might need more than 1 eye medication given multiple times a day for years. With practice and positive reinforcement, giving eye medication to an animal can be quick and drama free.
If your pet doesn’t need eye medication yet, you can train them for it in advance. This training will reduce your pet’s stress when they need medication later on. Go through the body positioning and head handling steps listed below and give yummy treats at each stage. Large dogs can be trained to rest their head on your knee to receive eye medication. Handling Eye Medication
Giving Multiple Medications
Preparation
Administering the Medication
Watch for Unwanted Effects Some eye medications are a little uncomfortable for the first few applications. It’s common for animals to blink more than usual or squint for a minute or two after an eye medication is applied. If your pet’s eye seems uncomfortable for more than a few minutes or if this response continues for more than the first few doses, contact your veterinarian. Image source: https://www.flickr.com/photos/181765699@N08/48298582227/ |
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November 2024
The contents of this blog are for information only and should not substitute for advice from a veterinarian who has examined the animal. All blog content is copyrighted by Mallard Creek Animal Hospital and may not be copied, reproduced, transmitted, or distributed without permission.
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