CNA Diagnostics and Ethos Veterinary Health Enter Strategic Partnership to Develop Suite of Diagnostic Tests for the Companion Animal Market

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CNA Diagnostics Inc. (“CNAD”) and Ethos Veterinary Health (“Ethos”) are pleased to announce the parties have entered a strategic partnership to develop and distribute a suite of molecular diagnostic tests specifically designed to serve the companion animal market.

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Dangers of Pet Obesity

Obesity in dogs and cats

  • 30-50% of adult dogs and cats are clinically obese with one study reporting 63% of cats being obese.
  • Most cases of obesity arise from simple over eating and lack of physical activity – just like people
  • Check with your family veterinarian and ask the following questions: Is my pet a proper weight and is he/she on the proper diet?  A Veterinarian’s role is to counsel pet owners on pet nutrition.

Clinical consequences and why you would need to see a specialist:

  • Poor quality and quantity of life: lifetime study showed that leaner dogs live 1.8 yrs longer than their overweight counterparts and the slimmer dogs had a delayed onset of chronic illness.
  • Chronic arthritis or osteoarthritis: as little as 6-8% weight loss has led to significant decreases in subjective and objective lameness scores.
  • Back disease or a slipped disc: in a study of 700 dogs it was shown that being overweight increased the risk for disc disease.
  • Metabolic and endocrine conditions such as pancreatitis and diabetes.
  • Heart disease, hypertension and respiratory disease.
  • Reduced immunity.
  • Association with cancer.

Management of obesity (reduced calorie intake and increased physical activity).

  • Nutrition.
  • Well-designed program by health care professionals to promote appropriate weight loss
  • 1% weight loss per week is a good target that is safe with caution in cats regarding weight loss due to the potential for this species to have fatty liver syndrome.
  • Life style changes (increased physical activity).
  • Drug therapy:  medications such as dirlotapide (Slentrol) can also be used to promote weight loss.
  • Life stage feeding in health is well suited to dogs and cats and has become a very popular way to council pet owners on nutrition.
  • Clinical nutrition in disease is an extremely important part of disease management and multiple pet food companies have prescription lines of food that have undergone a lot of research and development.

Prevention

Benjamin Franklin’s quote, “an ounce of prevention is worth a pound of cure” may keep you from having to see a specialist to manage conditions that occur because of obesity.

Endoscopy

Upper gastrointestinal (GI) endoscopy or esophagogastroduodenoscopy (EGD) is an important diagnostic technique for diseases of the upper GI tract.

There are numerous indications for upper GI endoscopy including vomiting, regurgitation, diarrhea, lack of appetite, weight loss, evaluation of masses (tumors) and ulcers. Upper GI endoscopy can also be used therapeutically for removal of GI foreign bodies, dilation of esophageal strictures and removal of polyps in the stomach.

The video endoscopy unit is a state of the art piece of equipment with many components. The scope itself is a long, flexible tube which sends and receives light, and transmits the image onto a high resolution television screen. This enables the doctor to see inside the animal’s gastrointestinal tract. The scope has channels for biopsy forceps, retrieval forceps, and other accessories. In addition, the scope has capabilities for suction, and air/water instillation which allows the lens to be cleaned of debris. The scope is placed through the mouth into the stomach and small intestine. The doctor views the anatomy as the scope is passed, looking for any abnormalities. The doctor checks to see if the mucosal lining is of normal color and texture. The biopsy forceps are passed through the channel of the scope and tissue samples are taken from the stomach wall and different sites in the intestinal tract. If the doctor is removing a foreign object, retrieval instruments are passed through the scope or along side the scope to grasp objects and remove them from the GI tract.

An endoscopy technician will be monitoring the anesthesia as the doctor performed the procedure. Endoscopy requires that your pet receive an intravenous catheter and be placed under a general anesthetic. The animal’s heart rate is monitored using an EKG telemetry monitor, which evaluates cardiac rhythm. The technician monitors respiratory rate visually and additionally uses sophisticated blood pressure and pulse oximetry monitors to monitor blood oxygen level to assure the animal is receiving proper ventilation. The technician stays with the animal following the procedure until the pet is fully recovered from anesthesia.

The endoscopic procedure lasts approximately 30-60 minutes. Recovery from anesthesia is approximately another 15-20 minutes. We will usually keep your pet for the day to monitor for any post-procedural complications. If all has gone well with recovery, the animal can usually go home that evening. The biopsy samples are placed in formalin to preserve them during transport to the lab. They are sent to the Texas A&M GI Laboratory where the samples are evaluated by pathologists with special expertise in GI pathology.  Biopsy results are available in approximately 5 working days. Upon discharge of your pet, discharge orders are sent home with you giving instructions for care until biopsy results come back.

The Veterinary Specialty Hospital invites you to call us at any time if you have questions concerning your pet’s health.

Elbow Dysplasia in Dogs

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common elbow diseases of dogs

Osteoarthritis of the elbow joint is the most common cause of foreleg lameness in dogs. Most of the arthritic diseases of the elbow are considered forms of developmental elbow malformation (dysplasia).

Elbow dysplasia refers to a group of congenital diseases of the elbows of dogs, which include:

  • Fragmented coronoid process (FCP)
  • Medial compartment disease (MCD)
  • Osteochondrosis dessicans (OCD)
  • Ununited anconeal process (UAP)
  • Incomplete ossification of the humeral condyle

FCP and Medial Compartment Disease

Fragmented coronoid process (FCP) is the most common form of elbow dysplasia in dogs. In this disease, a fragment of bone and cartilage of one of the bones of the elbow joint (ulna) is broken off. The rest of the joint may be normal or there may be additional cartilage damage, including OCD or severe full-thickness cartilage loss. This is termed Medial Compartment Disease and unfortunately can occur in dogs as young as 1 year of age.

FCP and medial compartment disease are best diagnosed and initially treated with arthroscopy. Arthroscopy is the fastest, most effective, and least invasive method for fragment removal. Advanced medical options for treatment of Medial Compartment Disease include joint injections with Hyaluronan or autogenous Stem Cells (link to stem cell page).

Advanced surgical treatments of Medial Compartment Disease include Sliding Humeral Osteotomy (SHO) and total elbow replacement. Sliding Humeral Osteotomy was developed in the Orthopedic Research Laboratory of the University of Californita by Dr Schulz and is currently in clinical trials with very positive results. For more information on this procedure please see our handout on Sliding Humeral Osteotomy

For additional information about Elbow Dysplasia download PDF

Osteochondrosis Desiccans

Osteochondrosis dessicans (OCD) is an abnormality in the development of cartilage that leads to a cartilage flap. In the elbow this occurs on the humerus and can usually be detected on radiographs.

Treatment of elbow OCD involves removing the loose cartilage flap by arthroscopy. Removal of the cartilage flap may enable the underlying bone to heal with fibrous cartilage tissue, stopping the irritation of the opposing cartilage surface. OCD is best treated by elbow arthroscopy.

 

Ununited Anconeal Process

The anconeal process is the top part of one of the bones of the elbow called the ulna. In some dog breeds, especially German shepherds, this fragment of bone may fail to unite with the rest of the ulna during a puppy’s growth in the first year of life. When this occurs, the loose fragment contributes to joint instability and inflammation.

Diagnosis of ununited anconeal process is easily made with x-rays in dogs older than 6 months. Treatment involves surgical techniques to either remove or stabilize the bone fragment. The key to successful surgery of ununited anconeal process is early diagnosis when the osteoarthritis is not yet severe and the body is still able to heal the fragment to the remainder of the bone.

Incomplete Ossification of the Humeral Condyle

Incomplete Ossification of the Humeral Condyle (IOHC) is an uncommon disease of the elbow joint seen most often in Spaniel breeds. In this disease two of the parts of the humeral bone fail to unite. The end result is a permanent crack in the upper bone of the elbow joint. IOHC is very difficult to diagnose on x-rays because the crack in the bone is very narrow. The crack is however easily seen by arthroscopy. Treatment of IOHC is to place a screw across the bottom of the humerus (humeral condyle) and the bone crack to stabilize the bone and prevent future fracture.

Arthroscopic Surgery at Peak Veterinary Referral Center

Arthroscopy at Peak is performed by a highly experienced and caring team who prioritize your pets welfare. Dr Schulz has been performing arthroscopy for over 15 years and is an author of the only textbook on small animal arthroscopy. In many cases surgery may be performed the same day as your initial appointment and because arthroscopy is minimally invasive, many patients may go home the same day.

Dr Schulz served as chief of surgery at the University of California and has published over 60 manuscripts in canine orthopedics. He is the author of several books including Small Animal Surgery, Small Animal Arthroscopy, and the Pet Lovers Guide to Joint Problems and Osteoarthritis.

At Peak we understand the importance of your pet to your lives. Our philosophy is to educate owners and help them make the best decisions for their pet and their family.

Case Study: Progressive Behavior Change in a Cat

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Tammy L. Stevenson, DVM, Diplomate ACVIM (Neurology)

HISTORY:
Chandra, a 14 year old, DSH, was presented for a 5 month history of a slowly progressive behavior
change, urinating outside the litter box, withdrawing from client, vocalizing without apparent
purpose, and a tendency to walk in circles to the left. Prior to referral, a CBC, serum chemistry
panel, urinalysis, serum T4 concentration, and a Cryptococcus titer were obtained which were
unremarkable. She was started on prednisone at 0. 5mg/kg BID, and there was initial dramatic
improvement. However, the signs would recur whenever the
medication was tapered, and now she is not responding as well to
the BID dose.

ABNORMAL EXAM FINDINGS:
Iris atrophy, nuclear sclerosis, dental disease, BCS 7/9.
Mentation: Obtunded
Cranial Nerves: absent menace on the right, others normal.
Gait: Ambulatory, tendency to circle to the left.
Conscious Proprioception (CP): unable to assess CPs, but hopping was slower on the right than the
left. The remainder of the neurological examination was normal.

NEUROANATOMIC LOCALIZATION:
Left Cerebrothalamic.

DIFFERENTIAL DIAGNOSIS:
Neoplasia, inflammatory, less likely infectious, other.

DIAGNOSITCS:
Three view thoracic radiographs—No gross evidence of metastatic disease
MRI of the brain—uniformly contrast enhancing mass associated with the meninges and
compressing the left cerebral hemisphere.

PLAN:
Left rostrotentorial craniotomy. The mass was removed and Chandra recovered uneventfully. She
was discharged within 3 days of surgery on prednisone 0.5 mg/kg BID x 7 days, then 0.5mg/kg SID
until time of recheck. The biopsy was interpreted as a psammomatous meningioma. She had an
inconsistent menace OD and an otherwise normal neurological examination at the two week
recheck.

DISCUSSION:
Meningiomas are the most common type of brain tumor in the cat. These tumors do not invade
adjacent brain tissue and typically “pop” out easily at the time of surgery. Obviously, attempting to
get clean tumor margins is not possible with brain surgery. Surprising to most clients and
veterinarians is that follow up radiation and/or chemotherapy is usually not necessary with most
feline meningiomas. Since these tumors are so slow growing, and these modalities depend on
dividing cells, they do not increase survival time. Generally, these are elderly patients that either die
of another disease process prior to regrowth, or the clients can elect to pursue a second surgery in 1-3
years if they become clinical again for their brain tumor. Clients who elect not to pursue a second surgery are usually grateful for the high quality, “bonus” time they have had with their cat. About 15% of feline meningioma patients have more than one meningioma at the time of diagnosis. Not all are surgically accessible, but removing the largest tumor can often afford clients a significant amount of quality time with their cat.
Unlike dogs with brain tumors where seizures are the most common presenting complaint, cats
are most commonly presented for behavior changes. Since the clinical signs can be very gradual in
onset and can progress slowly over several months, clients will often mistakenly interpret them as
old age and don’t bring their pet to the veterinarian until they are significantly affected. The signs
may be as subtle as lethargy, withdrawing/hiding, and sleeping a lot, or as severe as blindness,
head pressing, and compulsive pacing/circling, with or without seizures. A good response to
prednisone may further delay a definitive diagnosis and treatment. Since surgery for meningiomas
in cats is often extremely successful, motivated clients should be encouraged to seek a diagnosis.
So if presented with an elderly cat patient with behavior changes, meningioma should be on the
differential list.

 

Download the PDF for this case study here: behaviorchangeincat

CT Scan and Rhinoscopy

When your pet presents for nasal signs, your internal medicine specialist may recommend a CT scan and rhinoscopy to try to determine the cause for your pet’s signs. A CT scan and rhinoscopy is a diagnostic procedure and the patient’s problem will not be fixed or improved following the procedure.

Only in very rare cases, such as foreign objects and abnormal strictures in the nose, is a treatment for the problem performed simultaneously.

There are many signs that your pet may have,  and these are not specific to any one particular disease process, but are very similar across all diseases that affect the nose. These signs may include sneezing, nasal discharge of any type (bloody, mucoid, clear), nasal congestion, snorting, gagging, or swelling of the nose or head. Occasionally cats will present with significant increase in respiratory effort when their nose is congested as they rarely open their mouth to breathe.

Diseases that can affect the nose include nasal cancers, fungal infections, anatomic abnormalities (both congenital and acquired), immune-mediated inflammation, foreign material in the nose, severe dental disease, allergic inflammation, viral infections, and rarely bacterial infections. Nose bleeds can occur in dogs and cats related to diseases outside the nose, so your veterinarian will likely recommend diagnostics such as clotting times, platelet count, blood pressure, and certain infectious disease testing prior to recommending a CT scan and rhinoscopy. Cats should have a blood test for Cryptococcus, a common fungal organism that affects the nose.

Basic health screening blood and urine tests will be recommended, as the procedure requires general anesthesia. Occasionally chest radiographs (x-rays) or an echocardiogram may be recommended as your pet’s condition dictates. General anesthesia carries some uncommon risks, including death, esophageal strictures, aspiration pneumonia, and strokes while under anesthesia. These are extremely uncommon and the highest quality monitoring is provided for your pet by a qualified veterinary technician. Our anesthesiologist is available on an as needed basis for critical patients requiring anesthesia.

A CT scan is an advanced imaging technique that allows for detailed three dimensional evaluation of boney (and some soft tissue) areas that are difficult to otherwise image. It allows the radiologist and internist to determine not only where in the nose is the problem located, but also gives some general idea of what the problem is. After the CT scan, if a space occupying mass (typically a cancer, but sometimes a fungal mass) is seen, a blind biopsy is performed with guidance from the CT scan so that the biopsy instrument is placed in the mass in order to get the best representative sample. If there is not a mass seen, or if the mass is in the very back of the nose, rhinoscopy will be performed to evaluate the nose and obtain samples of the nose. Rhinoscopy is performed with a small flexible fiberoptic scope and occasionally a small rigid scope that can be advanced through the nasal cavities of all but the smallest patients. The back of the nose is examined with the flexible scope, and then the throat is packed off with gauze sponges. The scope is then advanced through the nasal structures in a systematic fashion. In order to facilitate visualization through the mucous and blood that are inevitably, a constant running saline flush is utilized. Foreign material can be removed using a small grasping forcep, or may be flushed out during the examination. After a thorough evaluation, nasal biopsies are obtained.

After the procedure it is common to have some increased nasal congestion and bleeding due to biopsies and the presence of the scope. Nasal bleeding is not uncommon for several days following the procedure. Occasionally patients will spend the night to allow their family peace of mind and to keep the carpets clean. Patients can also be discharged that same night if the family would prefer.

Keep in mind that our procedures are scheduled with several services, and thus are subject to time change/delay. We will always try to keep to a scheduled time; however we may not have control over the start time. We will do our very best to keep you informed of significant delays in your pet’s procedure.