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    Hi! from a new guest expert
    Ann Hohenhaus, DVM, DACVIM posted:
    I am very excited to be a part of the AVMA's partnership with Web MD pet health site as a guest expert. My roots in veterinary medicine are deep, as I grew up in a rural veterinary family. My father was a mixed animal practitioner, predominantly caring for dairy cattle. I had my first Tingley rubber boots at age 2. Today, my professional role is much different than at the start. I work at The Animal Medical Center in the middle of urban New York City. Although I am board certified in both oncology and internal medicine, I still provide routine health care to the pets whose owners I met as an intern. As you might guess, the challenge of managing a complex pet illness is what I love, but I am also interested in the impact of pet health issues have on the humans in the family. I look forward to the challenges message board participants' questions will present.
    buster219 responded:
    could sodium have an adverse affect to dogs?
    i own six dogs we usually feed them purina dry
    plus cornish chickens w/rice. my husky has allergies
    which i believe was from the dry food i fed her. causes dry skin above her eyebrows and forhead. it usually only shows during the spring to fall seasons. so i started to feed all of the dogs with pinnacle and blue buffalo dry food. I also gave them cream of chicken soup instead of the cornish hen. i know soups have high conentration of sodium, and was wondering if it would pose any problems in the dogs.
    KittyKatJenn responded:
    Welcome! It is good that there are those who love to help us with pets and their complex issues. I have a cat with severe asthma. Talk about complex!
    Ann Hohenhaus, DVM, DACVIM replied to buster219's response:
    Good question. Some diseases result in a really high or really low sodium. Either of these diseases can be life threatening, but these diseases are not caused by dietary sodium. Hypertension does occur in dogs, but rarely is sodium a causative factor. Veterinary cardiologists may recommned a low sodium diet for certain heart conditions. If your pet is a cardiac patient, ask if a low sodium diet might help control the heart disease.

    If you are at all concerned about your pets health, sodium levels in the blood and blood pressure can easily be tested in an office visit with your veterinarian.
    srstephanie responded:
    Hi Dr Hohenhaus,

    Welcome! I'm just a simple pet (cat) owner but enjoy learning what I can about feline medicine. It is a real gift to us pet owners to be able to ask questions and learn from some of the top veterinary specialists. It says a lot about the dedication of the vets here who give their time and share their expertise freely with us.

    I can't resist asking a question or two of a board certified oncologist. My beloved cat, Macrina, died in Dec 2008 from pancreatic cancer that spread to her lymph nodes. I had a terrific Internist (DACVIM) who continues to be a friend ... and like you, when she took a job 2 yrs ago at the Univ of Montreal vet school, she had it put in her contract that she could retain a few of her long time clients (and she is extending that to me with my new kitten).

    My kitty, Macrina, died at age 18.5. She had the usual geriatric problems: Hyperthyroidism, heart murmur (poss HCM but probably hypertrophy secondary to hyperthyroidism), Hypertension, Chronic Kidney Disease (early IRIS stage 3 when she died), pancreatitis, probable IBD (or poss lymphoma), probable cholangitis (dilated bile ducts), moderate gingivitis and arthritis (DJD). She sounds like a wreck but thanks to her great doctors she was doing very well until the last 2.5 months. Before the final decline when the cancer was diagnosed, she was a healthy 12.5 to 13 lbs with good muscle mass. For her final three years I used to feed her small meals of canned food with added water every 3 hours around the clock.

    A year or so before she died, she was diagnosed with pancreatitis via ultrasound and a positive fPLI at Texas A&M. Her Internist always left adenocarcinoma on her differential list and she noted a "mass effect" in the pancreas but felt it could be a result of pancreatitis ... and we really didn't think it was cancer because she was doing so well. We decided against biopsies because we didn't want to put her under anesthesia or heavy sedation to do it. In Sept 2008, she got very sick (vomiting, anorexia, fever) and was hospitalized for three days on fluids, pain medication and antibiotics. Another ultrasound was done and aspiration of her lymph nodes which found pancreatic cells.

    Just wanted to share the background of my questions. One is wondering if you have seen many cases of pancreatic cancer in cats. While pancreatitis is popular at vet conferences, I haven't heard talks about pancreatic cancer. I should probably mention that my "hobby" is listening to recordings of talks from vet CE conferences (e.g. NAVC, CVC, AAHA). I think one reason we didn't consider it seriously was that it seems so uncommon.

    A second question is about the relationship between inflammation and cancer. We will never know but it is likely that Macrina had concurrent pancreatitis and pancreatic cancer. I wonder if pancreatitis could "progress" or lead to cancer. I've been struck by the relationship between inflammation and cancer elsewhere. I have an interest in vaccinology and understand that vaccine associated sarcomas are caused by inflammation that leads to a mutation of the p53 gene (a tumor suppressor gene) that results in a fibrosarcoma. I recall a talk a couple years ago about the challenges of diagnosing IBD vs intestinal lymphoma, and some think that IBD might progress to lymphoma. It just looks to me like there may be a link in cats between inflammation and cancer in various areas. I have heard quotes of Dr Dennis Macy (an Oncologist from CSU who has studied VAS) where he has said very technically that "cats don't do inflammation well". Just wondering what your thoughts are about the connection between inflammation and cancer in cats. Do you see a connection or am I jumping to conclusions?

    I can't resist asking if you attended the ACVIM Forum in Montreal last year? I live in Montreal and the ACVIM graciously let me attend the talks. I had an incredible experience! I wish I could be at the Forum this week.

    Stephanie in Montreal
    Ann Hohenhaus, DVM, DACVIM replied to srstephanie's response:
    Wow! you have just synthesized what it has taken scientists years to discover - cancer and inflammation are linked. Injection site sarcomas are likely the best known animal cancer linked to inflammation, but inflammation from the fracture healing process, chronic presence of a foreign object - like a piece of glass, chronic trauma all have been linked to cancer. These are fairly uncommon. More importantly fat is considered a big producer of the cellular stubstances that lead to inflammation. There are already some studies linking obesity to cancer. Another good reason to slim your pet down. PS - pancreatic cancer is very uncommon and I don't believe it has been linked to pancreatits - but it is totally possible there is a link yet undiscoverd. Ann Hohenhaus
    srstephanie replied to Ann Hohenhaus, DVM, DACVIM's response:
    Hi Dr Hohenhaus,

    It is easy to propose a theory ... and very hard and time consuming for scientists to find evidence to support or refute it. :-)

    Yeah, I do remember Dr Richard Ford (NCSU ... I've learned a ton from him on vaccinology) mentioning one of the early examples of a fibrosarcoma from inflammation was inflammation from an ocular injury. I know Dr Lappin at CSU likes to put the emphasis on the genetic predisposition of the cat in its response to any amount of inflammation ... whereas most of the others prefer to work to limit the amount and duration of inflammation caused by vaccines, hence recommend avoiding Killed Virus vaccines which contain adjuvants whose sole purpose is to produce inflammation (often long-term chronic inflammation).

    I'm intrigued by the discovery that in cats inflammation can cause a mutation to the p53 gene which results in a sarcoma (hope I have that right). Is it the same etiology for other types of inflammation induced cancers ... i.e. inflammation resulting in a gene mutation?

    I'm also very interested in the connection of fat to cancer. My Macrina wasn't overly obese but she was on the heavy side ... her ideal weight was probably closer to 12 lbs, though she was normally around 12.5 lbs. With her various problems (pancreatitis, IBD, poss cholangitis), about a year before she died we put her on low dose prednisolone (1.25 mg once a day) and chalked up a weight gain to it when by 5 months later it had gone up to about 13.5 lbs (where it stayed until her final 2 months). At that point (at 13.5 lbs) her Internist put her at a 3.5 on the 5 point BCS scale (I'd estimate 7.5 on the 9 point BCS scale) and noted she had good muscle mass. She was naturally a large, big-boned cat. Though a bit heavy, both her vet and Internist did not recommend putting her on a diet, feeling she may need the reserves later.

    I mention it because about 8 months before she died, she seemed sensitive to touching or palpating her belly. Her Internist re-evaluated her and noted that she seemed painful on palpation of her subcutaneous fat. She didn't mention it in her report but I recall her saying the fat layer felt bumpy. In her report she put "possible pansteatitis/steatitis of unknown etiology." It was a mystery to me because she ate almost no fish ... just an occasional few bites of tuna along with some tuna water (not packed in oil). It couldn't have been more than about 3% of her diet. We tried giving some Vitamin E but she vomited it up (she had in the past vomited when given Omega 3 capsules ... her tummy just didn't like oil). A pancreatic mass and possible cancer was on the differential list but we didn't really think it was cancer at that point.

    I have since wondered whether what seemed to be pansteatitis or some type of irregularity and sensitivity in her subcutaneous fat layer could be related to the pancreatic cancer. I was sure that a few months after Macrina died, that I ran across an article on a possible connection between fat abnormalities and pancreatic cancer ... but I've searched my computer and can't find it ... so maybe I dreamed it. Do you think what seemed to be steatitis might have a connection to her cancer? However, the "mass effect" in her pancreas was noted months before she became sensitive in her subcutaneous fat layer. Makes me wonder which came first ... fat leading to the pancreatitis/pancreatic cancer ... or, pancreatic cancer causing abnormalities in her abdominal fat ... or no connection at all. Any thoughts?

    Another odd thing about Macrina was when we tried giving her SQ fluids in 2005, twice she had an extreme reaction of apparent cellulitis ... spiked fever to 104F, major pain to touching anywhere on her body (she literally screamed), but resolved within 24 hours. We stopped the fluids. I've wondered if that reaction to the SQ fluids was related to her later fat irregularities/steatitis?

    Stephanie in Montreal
    lchancey responded:
    my vet thinks my dashund needs his anal glands removed since they keep getting impacted and cant be expressed well.
    what does this entail and what is the usual outcome. Is it safe?
    grannycf responded:
    Am trying to get help for my Border Collie-Siberian Husky mix she is 4 yrs old. She weighs 77-80 lbs. covered in patchy lesions and very red in her underlegs on legs and feet and around eyes and middle down her nose. She started getting really bad last year before that she just had a crust on her nose and we just thought it was from nosing in the dirt for moles. She also now has a very bad body oder and sometimes has a soild stool then a real runny one, the last had some blood in like she strained real hard.
    Sandy Willis, DVM, DACVIM replied to lchancey's response:
    Dear Ichancey,
    Anal glands sit on either side of the rectum. Particularly in dogs, they can get infected, plug up, and become abscessed. This can be a painful condition and we recurrent infections, we tend to like to remove them.

    If they are intact and not ruptured, they can be gently dissected away from the surrounding muscle and removed. This is done under general anesthesia. Usually recover is uncomplicated.

    Removing them certainly prevents a recurrent infection and a recurrence of this painful condition.

    These are excellent questions. Talk to your veterinarian about the specifics, short and long term care (which is usually minimal) so you can make an informed decision.

    Dr. Sandy
    Sandy Willis, DVM, DACVIM replied to grannycf's response:
    Dear Grannycf,

    Sounds like you Border Collie-Husky mix may have a couple of problems.

    The skin problem sounds like it is spreading. This may be due to mites or possibly fleas (is it ichy?), a skin infection and/or skin allergy. Sometimes there is more than one problem involved. The smell may be a skin infection or a greasy skin condition.
    Her hard stool, straining with some blood may be constipation or a colitis.
    Diet may be something that your veterinary will try for both conditions, but they probably will also do a skin scraping looking for mites, empirically do flea control, and may send you home with a shampoo for a skin infection. They may even try some antibiotics.
    There are some conditions such as allergies that respond best to steroids but we generally try that last after ruling out infections and parasite problems.

    I would start wiht your veterinarian to give you and your dog some relief.

    Hope this helps. Let us know what you find out.

    Dr. Sandy
    etzela1986 responded:
    Lately, when my cat shakes his head I can hear a distinct watery sound coming from his ear. I can't visibly see anything wrong but I can tell it bothers him when I touch his ear. The noise went away for a while but now it's back. Could this be serious? Should I take him to the doctor or might this be something that will go away on its own?
    An_220811 responded:
    When I read that you grew up in a rural veterinary family setting, I realized that you might be the person to help us.
    My husband has two pigs -- one female, one male. The female can't have bowel movements. We've done everything we can think of -- glycerin suppositories, Fleet, warm/soapy water, Milk of Magnesia, fed her fruit. Nothing has worked.
    What do you think could be causing this and what should we do next? She is not expecting piglets and weighs about 70 pounds.
    She is eating a little and drinking fluids.
    The appearance of the anus is swollen/blocked by something other than stool.
    Democat responded:
    Like others, I'm glad to find online sources who can give us input on concerns that might not necessarily lead to a vet's visit. Right now I'm awaiting food allergy results for my 8 year old Bichon whom I adopted from our local pound last summer. He's a delightful fella, but eats fitfully - but suddenly has vomiting & diarrhea, and ended up with really high liver enzymes. The vet put him on Purina's EN food, which he ate with vigor until they changed the formula - and then, he wouldn't eat it at all.

    Until results are received, I'm feeding him beneful dinners in tubs, which he will only eat if I add cooked meat to them...any insights?


    toni4187 responded:
    Good morning, Ann. Welcome! We're glad to have you. May I ask a question on behalf of Ruby, my 9 year old German Shepherd mix dog? She was limping on and off for the last 2 months, and my vet gave me chondroitin chewables. She takes them for the most part (sometimes she hides them & pretends she ate it). I am in the beautiful mountains of Boone, NC for the weekend, and it rained all day yesterday & it is much cooler here than were we live in Durham, NC. She has developed a very pronounced limp, since she's been here and today she looks like she's in so much pain it's killing me. I heard that we can give dogs baby aspirin. Is that true? How much would I give her. She weighs around 65 pounds. Thank you!

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