Rappie

A total ear canal ablation and bulla ostectomy is the better surgery for chronic infection because they can be so deep seated. Often the structures of the ear are so damaged that even if infection is resolved, they will still be prone to infection as the self defence mechanisms have been obliterated. A lateral ear canal resection might only be of more use if there was an anatomical reason for the infections to develop and the middle ear was not involved - however most chronic otitis cases have some degree of otitis media occuring. It's definitely a job best done by a specialist surgeon, but there may a few very skilled general practitioners around that have done several before. There are certainly risks involved regardless of who performs the surgery due to the proximity of the important neurovascular structures.

I gather phosphorus levels are important too Rappie? I think K/D is 14% protein. I try to feed treats lower than that. For the older boy in my house, he loves Dentasticks and they are 10% protein or thereabouts. They are his daily treat. :) Yes they are - my comment was just about the protein, as it's often mentioned that diets must be low protein but it's not exactly the case

Just a point to keep in mind with protein and kidney disease - the focus is not so much on restricting protein to low levels but ensuring there is not a 'surplus' for the kidneys to deal with. It's also important that it is good quality protein.

They sound like the kind of ears that I would treat with some systemic medication first, the continue with appropriate topical treatment. If he has not had any investigation and work up previously then that is certainly warranted for a recurrent infection.

You're welcome :) If you have any questions just let me know, I'm mostly hanging out in off topic at the moment.

The single treatment with the most impact on chronic kidney disease is dietary modification. It is most easily achieved with the commercial diets but there are recipes for home prepared. The other thing to be conscious of is that dogs (and cats) with kidney disease cannot compensate for fluid loss so it is important to watch any symptoms od illness such as vomiting or diarrhoea carefully. Just a comment about Fortekor (drug name is benazepril) - it is only indicated in cases of chronic kidney disease where there is a significant level of protein in the urine. This needs to be tested with a urine protein : creatinine ratio rather than a dipstick (though high levels will show up on a dipstick) and a urine culture should also be carried out.

These are all strong reasons to consider a plateau levelling procedure (TPLO / TTO / TTA / TWO etc). A DeAngelis procedure is better than no surgery but it wouldn't be my first choice. Conservative management tends to have the best results in dogs under 10-15kg but it is an option for larger dogs that don't lead active lifestyles. In a large breed dog with significant laxity in the joint though I would consider surgery. I'm sure you've come across the statistic in your reading but remember that about 50% of cases will injure the opposite cruciate ligament, often within 12 months. The supportive treatment options like physio, acupuncture, hydrotherapy etc are all useful things even pre-op to try to maintain muscle tone and mobility.

The antibiotics themselves wont make the sin worse, but you certainly can get a flare up in the few weeks after starting treatment for the mites. Dead and dying mites cause irritation to the hair follicles and it is not uncommon for skin to look worse before it looks better.

I would suggest starting with a second opinion with a specialist surgeon. I normally refer to David Lidbetter for orthopaedic cases but also have regular contact with SASH. There are also referral hospitals in Homebush (Animal Referral Hospital) and the North Shore. Depending on the grade of MLP surgery may or may not be required. If you are particularly concerned about the anaesthetic then SASH does have a consultant specialist anaesthetist on staff. I know that Karen Hedberg is a well respected vet but for the purposes of this conversation, while she is experienced with particular breeds she does not have a specialist qualification.

Looks great!

That's great progress for the time frame so far - hope it keeps going that way :)

Ok, I've pulled the articles I have on mammary tumours... Elise+Hudson: I actually have a textbook chapter that references the original article. The chapter is in Small Animal Clinical Oncology (2007), Withrow and Vail, pp619-636. The statistics quoted for the risk of malignant tumours in desexed dogs (as compared to intact dogs) is: 0.05% if before the first oestrus, 8% after the first oestrus and 26% after the second oestrus. (Reference quoted here is: Schnieder R, Dom CR, Taylor DON - Factors influencing canine mammary cancer development and post-surgical survival. J Natl Cancer Inst 43:1249-1261, 1969. Certainly not a recent article). Other relevant points from the same chapter: - late ovariectomy may reduce the risk of benign tumours - one study in Beagles (can get reference if needed) showed a lifetime risk of 63% for development of any mammary hyperplasia or tumour and 23% for development of a malignant tumour - suggestion that small dogs have a higher incidence of benign tumours compared to large breeds (25% malignant in small breeds as opposed to 58% in large breeds). In another articles I have: (Effect of ovariohysterecomy in bitches with mammary neoplasms. Morris JS, Dobson JM, Bostock DE, O'Farrell E; Vet Record (1998) 142, 656-658). - in bitches with benign tumours, OVH at the time of tumour removal did not influence the future risk of mammary tumours. - in bitches with malignant tumours, OVH has no effect on progression of an established tumour, and even with removal of the primary tumours death occured in 60% of cases with invasive tumours within 2 years, and 24% of those with well defined tumours. - the more malignant tumours do not have high degrees of oestrogen receptor positivity - the strongest promotional effect of hormones is exerted in the first 1-2 years of life, the effect is lost after two or more cycles (this is referenced back to the Schnieder article above).

Since you have the scientific name you could try calling one of the emergency hospitals. Many of them will have a book called "Poisonous 2 Pets" which is a great resource for toxic plants. Maybe someone on the forum has a copy - we have one at work but since I'm on maternity leave, I suspect another 6 months is too long for you to wait!

It's good to hear that the results are more normal. However, both an increase in urine pH and crystal formation are something that can occur with time and storage of the urine. Crystals are also a normal feature of highly concentrated urine, but in some circumstances and clinical presentations their presence can imply that there may be an underlying problem. Unless there was a UTI, the fact that they have cleared with antibiotic treatment may be coincidental. The most important thing is that that your dog is improving.

Glad to hear it :)

It's not usually separated if it's being sent for histopathology as it is important to see the location and orientation of the mass, and sometimes there just really isn't a lot of spleen to see. As for the diet, from the perspective of colitis and a providing a fibre source you can also use pumpkin or some sweet potato if the rice is not going being accepted. It is also really important that in a stressed dog (post surgery so I refer here to stress on the body, not necessarily 'mental' stress) with gastrointestinal problems that the Metacam is ONLY given if the dog has eaten. If they are not eating or there is any vomiting, you must tell your vet and preferably an alternate pain relief drug can be used in the interim.

Has it actually been established that the dog has a urinary tract infection to warrant the change in antibiotics? Although UTI can be associated with a higher pH of urine and struvite crystals it is certainly not a definite assumption positive ID requires a urine culture, or at a minimum examination of the stained sediment from a sterile urine sample. What has the concentration of the urine been like? Have super fresh samples been examined?

As far as I remember from the product info, Plaque Off is not recommended for animals that already have thyroid problems but the daily dose should not be a problem for normal animals.

Sorry I just realised I wrote that backwards - pregnant and tired, lol. I meant to say that the conjunctival patch is more like to resolve in lesions located near the edge, compared to centrally - so it's more likely in your case :)

That looks like a good healing response at this stage. The white spot on the eye is like a 'band aid' - so it looks disturbing but it's a normal change. In severe injuries this can leave a scar, but it will often resolve once it's no longer needed, especially in cases where the injury is more central (where this one is much closer to the edge of the cornea). I can go through it with you in more detail via PM if you like.

If you have a link to the paper these are from, or any details I would really appreciate them! As a vet I know I mostly see one side of these things, but it certainly has made me much more aware for the day when I will own entire bitches. I think I have the article these stats are from, but I don't remember the 75% lifetime risk aspect of it - more so that after the 4th heat there isn't a significant benefit from speying at that time (although there is a reported small protective benefit against malignant tumours at any time. Happy to see if I can find the article and get the reference for you.

Dorothy runs some of her Canine Kindy classes from our hospital - she's a lovely woman and the clients and pups that attend always seem to have a good time. We have worked jointly on a few patients as well - I'm happy with her approach to training and behavioural modification.

A couple of bites without a resident flea can cause a lot of itching and scratching which in turn leads to scabs. You're right that the base of the tail is a common spot. If you've got a Capstar on hand now then use it but at least for the next month or so use a flea treatment that kills adults in the longer term. A luke warm bath and a good skin massage might help to relieve some of the itching.

Scrotal ablation is not routine in Australia. The only time I have had reason to perform it is when removing scrotal skin tumours where castration is also required. Not performing it is certainly not an 'error'. The scrotal swelling may be a normal post op occurence, or could perhaps reflect a scrotal haematoma if there were inadequate control of any bleeding either from the ligatures or even from skin oozing (older dog castrations may be quite messy this way). Unless it's infected, or getting significantly bigger over successive days it should resolve with time and the scrotal skin will shrink.

I am not familiar with the specialist options in Victoria, but are there clinical signs that mean that conservative management is not an option at all? (Like urinary retention, absence of deep pain response etc etc)