Hyperadrenocorticism or Cushing’s disease in Dogs. This disease, also known as Cushing syndrome, is the most common endocrine disease in dogs and it is due to excess cortisol in the body. This excess cortisol can be derived from dogs own body or it can be as a result of treatment from corticosteroid medications. Dogs with excess production of cortisol, 85% of them have pituitary gland tumors and the 15% have adrenal gland tumors. In addition, it has been observed that 13.61%  of dogs with hyperadrenocortism will also have diabetes mellitus. This disease normally affects middle to old aged dogs from 7- 12 years. Symptoms of Cushing disease include increased thirst and urination, and this is the most common sign in 80 % of the cases. Other symptoms include increased appetite, obesity, pot belly with visible veins on the thin skin, recurrent skin and ear infections, muscle weakness and lethargy. Diagnosis of Cushing disease is based on the clinical signs, laboratory tests and diagnostic imaging. It is important for the veterinarian to know the causes of excess cortisol, especially if it is from endogenous origin, and differentiate Cushing from the pituitary or adrenal disease. This will enable veterinarians to formulate the most appropriate treatment protocol and determine an accurate prognosis.  Treatment Dogs with cushing disease are more commonly treated with drug therapy like Ketoconazole, Trilostane and  l-Deprenyl. Surgery is indicated in patients with adrenal tumors in the absence of predetermined complicating factors like uncontrolled diabetes mellitus. However, development of diabetes mellitus in dogs with Cushing disease presents poor prognosis. References

Pica in Dogs Stones from an xray in a puppy at The Andys Veterinary Hospital Dogs especially puppies love to chew lots of inedible things like shoes, rocks, just to mention a few, can bring deleterious health complications that might need urgent medical attention. This condition where dogs eat inedible items is called pica. It is common with puppies and to some extent, some breeds like the Labrador and dachshunds. Labrador are genetically inclined to be always hungry and would eat almost anything, and this predisposes them to pica. Among the items commonly consumed include plastic toys, rocks, soaks, maize cobs etc Pica can also be due to behavioral problems like boredom or habits that developed due to painful past experiences. Anxiety, stress, or lack of socialization will form harmful habits which pica is one of them. Food or poor nutritional quality that lacks essential minerals and vitamins will create deficiencies that will induce pica. Home made or poor quality dog food many times lack these essential macro and micro elements which predisposes dogs to pica. Pica can also be due to chronic health conditions, like the inflammatory bowel disease, iron deficiency, hypothyroidism and intestinal parasites. Some prescribed medications that increase appetite like steroids and Phenobarbital have been known to cause pica. Symptoms that your dog has eaten foreign body will include lack of appetite, vomiting, lethargy or depression, painful abdomen and breathlessness. Diagnosis of pica is made from the history and physical examination which will include ultrasound and x rays. Treatment of pica will depend on behavior or the underlying issue. Behavioral problems can be treated with training or anxiety reliving medications. Surgery is recommended where there is stomach or intestinal blockage.

Recommended guidelines for vaccinations in Dogs and Cats. One of the frequently asked question at our veterinary hospital is the one related to vaccinations. Many pet owners know that their pet’s need vaccinations, deworming and parasite control, however, the time of administering these preventative exercises becomes a bit hazy and they depend upon professional health care givers to provide correct guidelines. It is important to note that kittens and puppies can be infected with worms while still in the uterus or during nursing. Adult dogs get infected through the oral route or via skin by the worm larvae. The oral infection is through fecal contamination from the infected dogs or while grooming themselves, where fleas are the intermediate carriers for tape worms. In the coastal and lake regions, mosquito bite will transmit heart worm larvae which develop into worms that reside in the heart of dogs and cats. However, heart worm infection is more common in dogs. Common symptoms that kittens and puppies are infested with are worms are failure to gain weight, unthrifty coat, paleness, pot belly, labored breathing, diarrhea and vomiting. In extreme worm burden, they will void worms from vomiting or defecation. In many cases, opportunistic diseases will set in like bacterial and viral infections. Feline leukaemia virus in kittens and parvovirus in puppies are the most common. Therefore, kittens and puppies will require broad spectrum deworming tablets from the second week of life and every two weeks until they are 3 months. This is followed by monthly treatment until they are 6 months of age. Thereafter, every three months. It is recommended that dogs and cats get monthly Heart worm prevention medication in the affected geographical regions. Vaccinations should be a component of a comprehensive preventive health care plan based on the age, health status, breed, environment (previous cases of outbreaks), socialization habits and travel of the pet to some countries. Puppy and kitten vaccination programs should focus on vaccinations, parasite control, counselling on behavioral vices, zoonotic disease management and neutering. Most of the vaccines used in dogs and cats contain organisms that are attenuated to reduce or minimise virulence, this induces immunity by production of antibodies from the low-level infection without necessarily producing significant tissue pathology or clinical signs of infectious disease. The “memory” of the disease in the animals’ body will be through these antibodies which will help in fighting off the infections. In dogs and cats, these little ones are initially protected by the antibodies they receive from colostrum and milk. These antibodies, Maternally Derived Antibodies (MDA), initially interfere with the vaccinations and therefore most vaccinations start at 6- 8 weeks of life when MDAs have reduced. In some situations like in outbreaks, pups born from mothers that are not vaccinated or colostrum deprived pups from dams that have no milk or those that are hand reared, then vaccination can be started earlier. Vigilance should still be maintained by the owner allowing restricted exposure of puppies to controlled areas and only to other litter or adults that are healthy, and only after the puppies have been fully vaccinated. It is recommended that socialization classes should be held in venues away from the veterinary practice premises. Some breeds like the Rottweiler, Doberman and English Springer spaniels are suspected to be poor immune responders to vaccinations and have high susceptibility to canine parvovirus 2 (CPV2). Therefore, parvovirus vaccinations may be started as early as the fifth week, followed by booster vaccinations of up to 16 weeks is recommended. There is emergence of the new strain of parvovirus, CPV2c, which has raised questions on if the CPV-2 vaccines can provide protection against this new strain. However, it has been shown that the current available vaccines based on CPV-2 and CPV-2b will protect against all known strains of CPV, including the newer CPV-2c strain. The following is the core vaccination protocol for puppies and kittens in our veterinary hospital: Age Dog Vaccination Cat Vaccination 6 weeks Parvo virus Feline panleucopania virus (FPV), Feline calici Virus (FCV)  8 weeks Distemper, Hepatitis, leptospirosis and parainfluenza (DHLPPi) 12 weeks DHLPPi and Rabies Feline panleucopaniavirus (FPV), Feline calici Virus (FCV) and Rabies 16 Weeks Rabies ( DHLPPi in some breeds-Rottweiler,Doberman) Rabies The following is a summary of some of the diseases that are easily preventable by vaccinating your cat and dog. Rabies is one of the most devastating viral diseases that affect the brain and the spinal cords in mammals including dogs, cats and humans. The disease is passed though a bite from an infected animal. It can also be passed through an open wound or mucus membrane when it comes into contact with infected saliva. This virus progresses slowly and the average time of incubation from exposure to clinical signs is between 3 to 8 weeks in dogs, 2 to 6 weeks in cats, and 3 to 6 weeks in people. However, it has been reported that the incubation period is as long as 6 months in dogs and 12 months  in humans. Infected dogs and cats become hypersensitive to touch, light and sound. They may exhibit unusual biting of in animate objects or other animals and hide in dark places. This is followed by paralysis of the throat and jaw muscles, resulting in excessive salivation. Confusion and paralysis of the hind legs occur resulting in staggering and in coordination. Other signs of rabies include fear of water, loss of appetite, weakness, seizures and sudden death. Rabies vaccination is mandatory by law and is given at 12 weeks. Our vaccination protocol is that we repeat rabies at 16 weeks of age. Individual puppies and kittens have different vaccine induced seroconversion levels with higher risk of failing to reach protective antibody level of 0.5 IU /ml when young. It is advisable that dogs and cats that need sufficient antibody test result for the purpose of international travel, should be vaccinated twice with rabies vaccine and then regularly receive yearly booster. In dogs, canine distemper affects brain, gastrointestinal and respiratory tracts causing fever, vomiting,

Bladder stones in dogs and cats These are stones which vary in size from being microscopic sandy particles to large visible stones lodged somewhere along the urinary system in dogs and cats. These stones are formed as a result of minerals in urine that are clumped up together to form stones, also known as urinary calculi or bladder stones. The common cause for formation of these stones is contributed by the pH of the urine, which can be  influenced by bacterial infection, diet and some type of medications. These stones can be anywhere between the kidneys, ureter, bladder and urethra. Genetic plays a role, where in some dogs physiological processes produce substances that are precursors for stone formation more than in other dogs. Some breeds like the Dalmatians, English bulldogs and black Russian terriers are known to be genetically predisposed to the formation of urate crystals. This is due to decreased ability to oxidise uric acid to allantoin, which is excreted in the urine. Dalmatians also have a metabolic defect that is thought to result in an inability to reabsorb uric acid into the renal tubules for excretion. Bacterial infections tend to make urine more alkaline and this enhances formation of some specific crystals known as struvite. These bacterial infections also produce an enzyme called urease which creates a cascade of reactions which will eventually form struvite crystals. Feeding you pets with the wrong types of food especially those with high protein, magnesium and phosphates increase the chance of crystal formation in urine. The symptoms of bladder stones vary from observing blood in the urine, constant licking of the genitals, inability to urinate, Straining to urinate, and/ or increased frequency of urination, tender or abdominal pain, vomiting and if unresolved, death is imminent. Diagnosis involves physical examination after obtaining proper history of the pet from the owner, x-rays, urine analysis that will determine infection, type of the crystal and the urine pH. Treatment involves medical management or surgery depending on the location and type of the stones. Some stones like the struvite and ammonium urate are some of the stones that can be dissolved by dietary management, which eventually they will resolve. Medical management is also through treatment of infections where struvite stones are involved. In addition, struvite stones can be managed with medications that alters the urine pH from alkalinity to acidity. Some stones like calcium oxalate will only be managed by physically removing them either through surgery or urohydro-propulsion. Prevention of bladder stones involves increasing consumption of water by your pet by placing multiple bowls of water in the garden, and dietary changes through advise from your veterinary doctor, which will also depend on the type of bladder stone your pet is having. If your pet has regular bladders stones, it is important to have regular examinations by your vet to ensure that there are no recurrence. References Osborne, CA; Lulich, JP; Forrester, D; Albasan, H. Paradigm changes in the role of nutrition for the management of canine and feline urolithiasis. In Osborne, CA; Lulich, JP (eds.) Veterinary Clinics of North America Small Animal Practice: Changing Paradigms in Diagnosis and Treatment of Urolithiasis. W.B. Saunders Co. Philadelphia, PA; 2009 (January) 127-141 Sorenson, J.L and  Ling, G.V (1993). Metabolic and genetic aspects of urate urolithiasis in Dalmatians.J Am Vet Med Assoc :203(6):857-62.

FAQs at The Andys Veterinary Hospital When do dogs and cats get their first vaccination? Puppies and kittens get their first vaccinations at 6 weeks of age. This will follow with a series of vaccinations until they are 4 months of age. Thereafter, they are given annual boosters for the rest of their lives. When do they get their first rabies vaccination? We recommend rabies vaccination at 3 months of age and a booster shot one month after the primary rabies vaccination. My pet keeps shading a lot, what do l need to do? This can be likening to your own daily hair loss and shedding is also natural in some pets.  There are breeds of dogs and cats that naturally shed more than others. This can be reduced by daily combing or grooming your pet to get rid of the dead hairs and feeding the right diet. However, excessive shedding can be a sign of disease or illness that requires our attention. Why is my pet keeps dragging or rubbing its rear on the ground? Your pet may have full or impacted anal glands that need to be expressed. Tape worms also cause irritation of the bowel and this could be a sign that your pet needs to be dewormed. There may be other serious issues like anal furunculosis, foreign body, bite wounds and urinary problems that may need our attention. Please call us the clinic to make an appointment and It will be helpful if you could bring a fecal sample to your appointment for us to check for the presence of worm eggs. My dog keeps shaking his head and scratching his ears, what could be the problem? This could be mites, fungal or bacterial infection. Some breeds of dogs like the German shepherd have atopic dermatitis which is an allergic reaction triggered by food, mites and fungal infection. It also could be from aural hematoma which develops as secondary to the infections that have just been mentioned. It is worth investigating the cause of head shaking from the history, skin scraping and allergen test before treatment. Which days do you perform surgeries? We perform surgeries on every day of the week except on Sundays. However, emergency surgeries are handled any time of the day and week. What are the benefits of having my pet spayed or neutered? Spaying (Ovariohysterectomy) or neutering (Castration) your pets greatly reduces risk of developing some types of cancer like ovarian, uterine, mammary and testicular cancer. Spaying your animals eliminate the chances of your pets developing uterine infection, known as a pyometra, which is normally a life threatening condition.  In addition, aggressive behaviours towards other mates will be greatly reduced.  Spaying or neutering may also decrease or even eliminate unwanted behaviours such as aggression or running off from the homestead. Spaying or neutering pets is a responsible way of dealing with unwanted litters of puppies or kittens without placing an extra burden on animal shelters. What should l do when my pet is having surgery the following day? It is recommended that you provide food until about 10:00 PM the night before surgery. Do not restrict water intake and let your pet have access to water at all times. Your pet will be provided with food and water once they have fully recovered from anaesthesia. When should I pick my pet up following their surgery? This will depends on the type of procedure but for routine spay and neuter, We usually allow a patient that is neutered to go home on the same day the surgery is performed, but for any pet that is spayed, it is generally recommended that they spends the night at the clinic. In some circumstances, your pet may stay for much longer period depending on the type of procedure performed and the severity of the animal’s condition. At what age should my puppy or kitten be spayed or neutered? We generally recommend waiting until your pet is 6 months of age so that any urinary incontinence issues associated with spaying or neutering are avoided. It is recommended that your pets are spayed before their first cycle as this reduces chances of them having mammary tumours or pyometra. How do I know when my pet needs a dental check up? Foul or Bad breath, excessive drooling, inflamed gums, plaque or tartar build-up, and loose teeth are indications that your pets needs a dental check up. We also do dental check up when your pet comes for routine vaccinations. Schedule appointment for dental procedure as this is carried out under general anaesthesia. When should my dog be on heartworm medication?  Heartworm disease is common at the coastal and the lake regions. It is a specific parasite that is transmitted by a biting mosquito and affects dogs, cats, ferrets and other mammals. It is very easy to prevent but very difficult to treat and is normally a life threatening disease. It is important you provide a history if you are travelling to these heart worm risk areas and we recommend testing your dog for heartworm disease before starting on the preventative. Do you board animals at your clinic? We board quite a few animals, but we have limited space from our in patients and it will be ideal to call in advance so that you can book a space for your pet. Prepared by: Dr. Anderson Gitari, Bvm, Mvet Surgery The Andys Veterinary Hospital.