Transcript Endocrinopathies of Dogs and Cats Diabetes mellitus

The First Visit to the Veterinarian
dr. Ákos Máthé
Department of Internal Medicine
A golden chance
• To examine the new patient
• To bond a new client to your practice
~ Health examination - congenital defects
~ Vaccination programs
~ (Parasites: flea control and deworming)
~ (Nutritional management)
Health examination
• History
~ For how long has the owner the puppy/kitten?
~ How and where did she/he acquire it?
~ Information about littermates, parents
~ Previous vaccinations, flea control, deworming
~ Patients appetite, any abnormality
Health examination II.
• General physical examination
~ Clinical impression: behaviour, grooming,
nutritional state etc.
~ Rectal temperature
~ Skin, ears, eyes, parasites
~ Lymph nodes, mucous membranes
~ Respiration and circulation
~ Mouth and abdominal palpation
~ Testicles
~ Movement, skeletal deformities
Common congenital and inherited problems
discovered by physical examination
•
•
•
•
•
Heart murmurs
Abnormal bite
Problems with dentition
Umbilical hernia
Cryptorchidism
Congenital heart murmurs
• „Innocent murmurs”
~ Healthy pups/kittens
~ Left craniodorsal heartbase, 1-3 degree
~ Varies with body position
~ Usually disappears at 14-16 weeks of age
• Pathologic murmurs
~ 4-6 degree with precordial thrill (fremitus)
~ Cyanotic mucosae +/-, abnormal pulse +/-
Most common congenital heart
abnormalities
• Patent ductus arteriosus
~ Poodle, collie, German shepherd, Siamese, Persian
• Pulmonic stenosis
~ Beagle, English bulldog, fox terrier
• Subaortic stenosis
~ Newfoundland, boxer, golden retriever
• Atrioventricular valve dysplasia
~ Great Dane
• (Persistent right aortic arch - history with regurgitation)
~ German shepherd, Irish setter
Abnormal bite
• Normal bite: lower incisors are just behind upper
incisors, mandibular canine occludes in interdental space
between lateral upper incisor and maxillar canine
• Brachygnathic bite (short mandible)
~ Lower canines may occlude at level of upper canine
~ Can cause palatal trauma  orthodontic techniques
recquired
• Prognathic bite (long mandible)
~ Normal in brachycephalic breeds (Bulldogs, Boxers,
Persian and Himalayan cats)
~ Mild form: level bite (excessive wearing)
• Rostral crossbite
Dentition problems
• Anodontia
~ Absence of one or more teeth
• Retained deciduous teeth
~ Increased plaque formation  parodontal
disease
~ Abnormal positioning of permanent teeth
~ Removal necessary as early as possible
~ Yorkshire terriers
• Supranumerary teeth
~ Crowding
Umbilical hernia
~ Failure of normal closure of umbilical ring
~ Contains part of the omentum, sometimes
intestinal loop
~ Airedale terriers, Pekingese, pointer
~ Usually does not cause health problem
Cryptorchidism
• Testicles are not in the scrotum by 8 weeks of age
• Unilateral > bilateral
• Testicle is in the abdominal cavity or in the
subcutis of inguinal region
• Hereditary, probably autosomal recessive
• Poodles, Yorkshire terriers, chihuahua, Pekingese,
Maltese, Persian cats
• In dogs risk of neoplasia in cryptorchid testicle
• Should be castrated!
Vaccination - general considerations
• Only vaccinate animals in good health
• Always take temperature
• Owner should keep puppy/kitten indoors until basic
vaccinations are completed, and have taken effects!
• Select protocol based on patients planned lifestyle
~ Cat: - outgoing or indoors?
- breeding and show animals
~ Dog: - frequent walks/hunts in forrests?
- access to rodents
- dog kennels
Vaccination - general considerations II.
• Use as few antigens as necessary for patient
profile
• Use multivalent vaccines rather than combine
vaccines yourself
~ multivalent vaccines are tested for antigen
interference  they are safe and effective
• If you use more than one vaccine at once never
mix them, and inject to multiple locations
Causes of vaccination failure
• Host
~ Maternal antibody interference
~ Immune deficiency/suppression
~ Incubating disease at time of vaccination
~ Breed: Rottweilers, Staffordshire terriers,
Dobermanns, German shepherds are more
susceptible for parvovirus
Causes of vaccination failure II.
• Human error
~ Improper vaccine handling, storage
~ Skin disinfection used
~ Early exposure of patient to virulent strain
~ Use of passive immunization within 3 weeks
~ Wrong vaccination protocol
Postvaccinal complications
• Immunologic
~ Type I.: urticaria, anaphylaxis
(Leptospira, rabies, FeLV, feline
respiratory diseases)
~ Type II.: cytotoxic reaction - IHA, AITP
(parvovirus, distemper)
~ Type III.: immune complex deposition - uveitis
(attenuated CAV-1)
• Local granulomas or sarcomas (cats)
(Leptospira, rabies, FeLV)
Postvaccinal complications II.
• Fever
~ Any modified live virus (MLV)
• Abortion, congenital malformation
~ Any MLV, especially parvoviruses
• Clinical disease
~ Cat: calicivirus, herpesvirus
~ Dog: parainfluenza virus, distemper
Vaccination program for puppies
(having colostral immunity)
•
•
•
•
•
8-9 weeks:
12-13 weeks:
(14-15 weeks:
15-16 weeks:
<1 year:
D, A, Pv, (Pi, CoV)
D, A, Pv, (Pi, L, CoV, Ly)
may go to street/park)
Ra, (D, A, Pv, Pi, L, CoV, Ly,)
Ra
• D = distemper
A = CAV-1 or CAV-2
Pv = parvovirus
Pi = parainfluenza virus
CoV = coronavirus
L = Leptospira
Ly = Lyme disease
Ra = rabies
Remarks for dog vaccinations
• Use high titer potentiated MLV Pv vaccines in puppies
• Give additional vaccination for Pv to Rottweiler,
Staffordshire terrier, Dobermann, German shepherd
puppies at 15-16 weeks of age
• Only give CoV if owner asks for it or wants „complete
protection”
• Do not give CoV and L simultaneously if possible
Remarks for dog vaccinations II.
• Boosters: D, A, Pv, (Pi, L, CoV, Ly) yearly,
Ra every 1-3 years depending on law
• Do not use MLV-s in pregnant bitches
• Colostrum deprived puppies
~ Vaccinate at 3, 6, 9, 12 weeks with D, A, Pv using
inactivated Pv first, then potentiated MLV Pv
~ (Pi, L, CoV) are optional at 9, 12 weeks
Vaccination program for kittens
(having colostral immunity)
• 8-9 weeks:
• 12-13 weeks:
• 15-16 weeks:
P, Rh, C, (Ch, FeLV)
P, Rh, C, (Ch, FeLV, FIP, Ra)
(P, Rh, C, Ch, FeLV, FIP)
• P = panleukopenia
Rh = rhinotracheitis
C = calicivirus
Ch = Chlamydia
FeLV = Feline leukaemia virus
FIP = Feline infectious peritonitis
Ra = rabies
Remarks for cat vaccinations
• If inactivated P is used, give it 3 times, MLV P is enough
twice
• P, Rh and C also exist as intranasal vaccines
~ but parenteral P is more effective
~ intranasal Rh and C are more effective, but may cause
mild disease
• Give inactivated P, Rh, and C to pregnant queens and
immunosuppressed cats (FeLV +, FIV +)
• FIP is intranasal, only useful for seronegatives
Remarks for cat vaccinations II.
• There is no benefit and no harm if you give FeLV
vaccine to a positive cat
• FeLV vaccination does not provide complete protection
• FeLV vaccination does not cause test positivity
• Boosters: P, Rh, C, (Ch, FeLV, FIP) yearly
Ra every 1-3 years
• Colostrum deprived kittens:
~ P, Rh, C at 3, 6, 9, 12 weeks (use inactivated P for
first time)
~ (Ch, FeLV) at 9, 12 weeks
~ (FIP, Ra) at 12, 15 weeks
Microsporum canis vaccine
• Killed vaccine
• Useful as part of treatment regimen against
ringworm
• Three times with 3 weeks intervals
• Only IM to dogs, IM or SC to cats
• Local reactions