Adrenal Gland Yin and Yang

March 5, 2014

puppy-yinyangLast week was a big week for adrenal gland disorders at The Animal Medical Center. Not one, but three dogs were admitted by The Animal Medical Center’s 24-hour Emergency Service with a diagnosis of Addison’s disease, or hypoactivity of the adrenal gland. Additionally, I evaluated two of my patients for adrenal gland hyperactivity, or Cushing’s disease.

Small but Mighty
Adrenal glands are tiny organs, one sits atop of each kidney. The normal width of a dog’s adrenal gland is less than half an inch. In cats, adrenal glands are half that size. Small compared to the liver or kidneys, these glands are powerhouses pumping out an array of hormones critical to maintaining normal homeostasis. Because the adrenal glands produce so many different hormones, either condition hypo- or hyperactivity can cause a wide variety of serious clinical signs. The hormone most important in Cushing’s and Addison’s disease is cortisol.

Poodle Problem
Two of last week’s ER patients with Addison’s disease were poodles. This was no coincidence. Addison’s disease is inherited in the Standard Poodle and also the Portuguese Water Dog, Nova Scotia Duck Tolling Retriever and the Bearded Collie. Cats very rarely develop Addison’s disease. What is strange about the dogs at AMC is the diagnosis of Addison’s disease in three dogs in one week, since the prevalence of the disease in dogs is thought to be 0.6-0.28% of all dogs. Dogs with Addison’s disease have vague, nonspecific clinical signs such as vomiting and diarrhea. One reason your veterinarian performs blood tests when your dog has vomiting and diarrhea is to identify the characteristically low blood concentrations of sodium and chloride and the high concentration of potassium, classic for a diagnosis of Addison’s disease. The consequences of missing a diagnosis of Addison’s disease are dire. Dogs become progressively dehydrated and the potassium climbs to levels which can stop the heart from beating. The AMC ER has a machine which can test blood concentrations of sodium and potassium in minutes, speeding the diagnosis of Addison’s disease.

Too Much Water; Too Much Pressure
The adrenal glands of dogs with Cushing’s disease produce too much of the hormone cortisol, either because of an adrenal tumor or because the pituitary gland in the brain forgets to tell the adrenal glands to stop producing cortisol. The two patients I evaluated for Cushing’s disease had different medical problems. One dog had an increased amount of protein in her urine, high blood pressure, and an elevated liver test. All three disorders are known to occur as a result of Cushing’s disease. The other dog was drinking too much water and having accidents in the house — two more signs of Cushing’s disease. Neither dog had hair loss, but it is another common problem we see in dogs with an overactive adrenal gland. Cushing’s disease, like Addison’s disease, is rare in cats.

Giving and Taking Away
Treatment for these two opposite diseases is opposite! For Addison’s disease we give hormones, and for Cushing’s disease we take the hormones away by suppressing the adrenal glands. Dogs with Addison’s disease respond rapidly to either oral or injectable forms of the missing adrenal hormones. Treatment of dogs with Cushing’s disease takes a month or two, while oral medications are adjusted to individualize the dose for each dog.

Recognizing the Yin and Yang of Adrenal Gland Disease in Your Dog
Even though Cushing’s disease is more commonly seen than Addison’s disease, both diseases can be readily diagnosed with blood tests. Your veterinarian will suggest testing if your dog is showing the following signs:

Cushing’s Disease

  • Excessive drinking and urinating
  • Hair loss on the trunk
  • Elevated liver tests
  • High blood pressure
  • Protein in the urine
  • Pot-bellied appearance

Addison’s Disease

  • Waxing/waning vomiting and diarrhea
  • Poor appetite
  • Weight loss
  • Anemia
  • High blood potassium
  • Low blood sodium and chloride

Small Dog Safety

March 12, 2012

Kimba

I was recently at the Pet Socialite “Home, Garden and Safety” Pet Product Media Showcase, organized by my friend Charlotte Reed. Everyone was enjoying themselves speaking with vendors about the advances in fun new products for pets. Our enjoyment abruptly stopped when the shrieking of a three-month-old Chihuahua puppy pierced the air. I got called to take a quick look at the puppy and could easily see one of the front legs was broken. Kimba was rushed to The Animal Medical Center to have the broken leg repaired. Here you can see him with a faint resemblance to a martini glass after the leg was repaired.

Fragile as a procelain teacup

Kimba is not the only dog with a broken leg from a jump out of his owner’s arms as a puppy. My patient, Handsome, an eight-year-old pug, has three screws in his back leg from a fall he took as a puppy. Because small dogs can be as fragile as a bone china teacup, the littlest trauma can induce a fracture. The AMC’s Critical Care and Emergency Service cared for an Italian Greyhound who, while struggling to get out of a sweater he did not like, fell off the bed and broke both front legs.

Dog owners prone to worrying may read these vignettes and resolve to never carry their small dog again, but their worries may provoke other problems, such as the risk of their tiny dog being bitten by a larger dog or getting stepped on in a crowd. Exercise is equally important for small and large dogs alike. Carrying your small dog too frequently will keep him from getting adequate exercise to burn off all his exuberant energy. Common sense should dictate whether or not your dainty dog can safely walk on the ground or be carried. In either case, putting a harness and leash on your dog will help you control unexpected behavior and possibly break a fall.

Manners matter

For their safety, and that of their family members, small dogs need obedience training as much as large dogs do. Small dogs like Kimba, who are frequently out in public have a greater opportunity for social interaction with strangers. These dogs need impeccable manners regarding biting behaviors and must be well socialized through obedience training.

Being small can be a big problem

Because of their compact size, situations handled easily by a large dog have greater potential for danger in small dogs. Take chocolate, for example. If your 60-pound Golden Retriever helps herself to one chocolate from the Valentine’s Day box, it is not likely to cause a problem. If your six-pound Toy Poodle raids the box, the problem is 10 times worse due to his small size.

Little dogs get colder faster since they have a larger surface area to body mass ratio and, therefore, have a greater ability to loose body heat. Their greater potential for loss of body heat puts them at greater risk for hypothermia.

Finally, when I see small dogs mixing with big dogs at my local dog run, I worry about the safety of the small ones. One of my favorite NYC parks, Carl Schurz Park, has a run dedicated to small dogs. For more NYC dog run information, click here.

For some additional ideas about keeping small dogs safe, check out what our friends at the American Kennel Club included in their e-newsletter on small dogs.

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This may also be found in the Tales from the Pet Clinic blog on WebMD.com.

For over a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.


Making a Pet First Aid Kit

January 7, 2009

animals-header2

Every pet owner should put together a pet first aid kit – a handy, easily created resource that will help a pet owner think and act quickly in the event of an emergency. 

Pack the listed items in a clear container to facilitate finding them quickly.  Include an emergency telephone list inside the kit, or you might even tape it to the outside of the container.  Having these numbers on hand will allow the first response to an emergency to be a telephone call to the appropriate emergency information source.  The telephone list should contain:

• Your veterinarian’s telephone number and address
• The telephone number and address of the closest veterinary emergency facility
• The number of your local animal ambulance or transportation service
• Animal Poison Control: 1-888-426-4435*

*The advice is well worth the Animal Poison Control user’s fee.  If you call, be sure to record your case number and give it to your veterinarian who can contact them for additional consultations about your pet.

First aid kit items:

  1. Muzzle: Should be of the appropriate size for you pet.  Injured pets are likely to bite even their owners due to pain or fear.  Muzzling protects the person caring for them in an emergency.
  2. Tweezers: For splinter or tick removal
  3. Nail trimmer: Ask your veterinarian for the style of trimmer right for your pet.   For cats, my personal favorite is the $1.29 one available at the checkout counter of your local drug store.
  4. Blunt-tipped scissors: Handy for hair clumps and trimming out foreign material like burdocks and plants.
  5. Pre-packaged povidone-iodine cleaning pads: Use to clean off first-aid-kit1cuts and wounds.  Follow cleaning with a clean water rinse to remove the soap.
  6. Saline solution: Regular human contact lens saline solution can be used to flush out dirt, sand or other irritants – just squeeze the contents directly into the eye.  The nozzle tip of these bottles makes it very useful to direct the saline into a cut or scrape to flush out sand and dirt.
  7. Triple antibiotic ointment: To place directly on a cut after it has been cleaned with povidone-iodine and water.
  8. Sterile petroleum jelly: Put ¼ inch in each eye to protect it from soap or povidone-iodine if cleaning a wound around your pet’s eyes.  Works well if you’re bathing your pet, to prevent soap and water from getting in the eyes.
  9. Sterile nonstick pads: Sticky bandages and fur don’t mix. Wrap the wound with the pads before placing a bandage on your pet.
  10. Bandage material: Elastic bandages or gauze, which can be used to hold a nonstick pad in place.
  11. Peroxide: To only be used to induce vomiting when Animal Poison Control instructs you to do so.  You should call Animal Poison Control when your dog or cat has consumed something from the pet toxins list.  Peroxide should NOT to be used for cleaning wounds, as it slows healing.
  12. Leash: In case the accident happens when you don’t have one available. Use only if the pet is able to walk.
  13. Towel: A big, clean cotton towel to dry the pet off, to keep him/her warm, to cover a cut or to use when applying pressure to stop bleeding.

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