Skin Problems

We saw a patient by the name of Duke back in October of 2010.  He was emaciated, almost completely hairless, lethargic and his owners were considering having him euthanized because they had been to vet after vet with no consistent results

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With some labwork, skin tests and a culture we were able to figure out (at least partially) what was wrong with him.  His main problem is an underlying autoimmune condition initially brought on by an allergy to something, but now raging out of control.  This condition was causing his small intestines to not properly absorb nutrients such as B vitamins.  It also made the intestinal cells "leaky" so that protein that should have stayed in his body and blood was leaking out into his intestines.  Duke weighed 46 lbs when we first saw him because he could not take advantage of the food he was getting.

To make matters worse poor Duke was bombarded with a variety of secondary infections.  He had a

Pseudomonas aeruginosa in his ears   He also had a Staphylococcus intermedius (bacterial) and a Malassezia (yeast) infection on his skin.

The first bout of treatment for Duke included a topical ear medication for the external ear infection and eight weeks of oral Cephalexin for the Staph infection.  We also started him on medicated baths twice a week. Then we waited a few days for the blood work results to come back and found out he was hypoproteinemic (low blood protein levels) so we started him on Vitamin B injections and Prednisone.  About a week later the ear culture came back and we started him on an antibiotic that the Pseudomonas was susceptible to (Ciprofloxacin).  We saw him again on November 11, 2010 and he was already starting to grow some hair back.

That is when we started to treat him for the Malassezia (yeast) infection with Fluconazole (brand name is Diflucan).  By January he was growing some hair back and was up to 66lbs! 

We saw Duke again on July 25, 2011 and he was actually overweight at 88lbs! I am happy to say Duke is looking great though he now has some hair loss from the chronic use of Prednisone.  It is unfortunate that even the best of medications all have some side effects.  Prednisone is a medication that, especially with chronic use, can have some serious and severe side effects. 

 The next part of Dukes story will be balancing the dose of Prednisone to minimize his side effects, but yet maintain his skin and GI health.  There are some other medications that we can try but for now we are slowly lowering his dose and will see how he does.  With long term problems there are no quick fixes.  Duke has actually come a long way in a short time.

Vaccines Aren’t Everything.

            Veterinarians have spent the last 60 years drilling into people’s heads that their pets need to come in every year for their rabies vaccine.  Because the government required a rabies vaccine every year we never bothered to stress the importance of a yearly physical exam since we knew we would see them every year for their “shots”.  Now we have vaccines that are licensed for 3 years and the perception is that we now only need to see pets when they are due for vaccines.  As a vet I am kicking my proverbial mentors for not having talked about the importance of a physical exam.  The vaccines are important for pet health as well as for public safety, but they are not the “be all end all”.  A regular yearly physical exam while your pet is young and a biannual exam for senior pets is the most important preventative care you can offer your furry family member.

                I also hear many people say their pet does not need to see the vet because they are mainly living indoors. While it is true that an indoor pet is less likely to contract an infectious disease or become injured, it does not protect them from diseases such as obesity, diabetes, arthritis, kidney failure, heart disease, cancer, etc.  Dogs and cats are living longer which means we are seeing more cancers and organ failures.  The early signs of these diseases are very subtle and can be difficult to pick up unless you are trained on what to look for.

                A skilled veterinarian that takes the time to perform a thorough “nose to tail” physical exam and take a complete history can often discover the little clues that point to early disease.   In combination with lab work an early diagnosis can be made.  This is when intervention is most beneficial.  Once you as a pet owner notice signs such as increased urination, decreased appetite, vomiting, etc. the disease is often in the advanced stages and little can be done except to keep the pet comfortable.  This is especially true with cats that will hide illness until they are on death’s door. 

                Another important reason for regular check-ups is so that chronic conditions such as obesity, arthritis, dental disease, etc. can be addressed before they become debilitating.  It is much easier to get your pet to lose a pound or two than it is to try and get them to lose 30 pounds.  Once your pet is grossly overweight there is damage being done to the rest of the body which could significantly shorten his or her life.  Dental disease is also better addressed in the early stages when a simple cleaning can solve the problem versus having to extract several teeth.  Arthritis is a common ailment in both senior cats and dogs and it is not just something that your pet has to live with.  I have seen many pets for a euthanasia only to put them on some pain control and have them up and playing again in a few days.  If I had only seen those pets earlier on in the progression of their arthritis I may have been able to prolong their good quality life even more.

AAHA Feline Life Stages Guidelines