HOT SPOTS: AND I AM NOT REFERRING TO NORTH CAROLINA WEATHER

                          
It is pretty steamy in North Carolina this June, and predictions are it will reach over 101 degrees this week. The flowers in my yard are still looking pretty good, especially the new crop of Asiatic Lilies.

Nearby, Duke Gardens is stunning no matter what the season. 

Taco Belle, my dog, prefers to be indoors and survey outdoor critters with the comfort of air conditioning.

 I can remember in Auburn, Alabama during my veterinary school days it could get pretty hot during the day. Most outdoor activities were pretty sticky. One evening, I had an invitation to go flying in a Piper Cub airplane to escape the daytime heat.

As my pilot friend soared over the loveliest village on the "plains" as it was called, I began a life time of adoration for pilots and flying. As mentioned in previous blogs, I did get my pilot’s license that year, but finances and time constraints kept me grounded. 

It was always an unexpected surprise to be caught by a cloud bank over terrain (I was flying visual/VFR) as a pilot does not like “surprises”. 

In a similar fashion, many clients this time of year are surprised by the sudden and unexpected odor, pain, and extreme discomfort of a nasty skin infection that is often called a HOT SPOT”.. 

WHAT IS A HOT SPOT?
Also called acute moist eczema, it is a TOPICAL skin infection that results when the normal skin bacteria multiplies rapidly and overcomes the skin’s defense system as a result of damage to the skin's surface. Pets aggravate the lesion by intense chewing at the site. These areas are oozing, wet, red, and sometimes blood-tinged when they are new.  Yet,  over time they become dry and quite “crusty or scabby.” They can be anywhere on the body, but most commonly they are on the face, neck, and rear end.

DO VETERINARIANS SPECULATE AS TO A CAUSE?
It is suggested that anything that causes irritation to the area (insect bite from fleas/flies/mosquitoes, allergies, accumulation of moisture from swimming/bathing, fur mats, thick coats in general, PAINFUL AREAS, and licking leading to saliva accumulation) contributes to the formulation of hotspots. Hot spots are  not a risk to spread to people with healthy immune systems. 

IS THERE A MOST COMMON BREED LIST AFFLICTED?
Newfoundlands, Golden/Labrador Retrievers, German Shepherds, and Bernese Mountain Dogs.

WHAT ARE THE STAGES?

-       The skin becomes DAMP, RED, ITCHY, and INFECTED. Odiferous pus is often found on the fur and the area is very painful. This then becomes encrusted in the fur. In many cases, hair loss and a raw, red skin are noted.

-      Hot spots can exponentially grow in size in a less than 24 hours. 

-      Although they are more common in dogs, they can also be found in cats. 

-      Hot spots can enlarge rapidly, so early diagnosis – before your pet’s hot spot involves a large area of the body – is important. Both dogs and cats can get hot spots, although dogs with dense undercoats are more likely to develop the problem than smooth-coated dogs or cats. Hot spots are more common during hot, humid weather, but can occur year-round, depending on the inciting cause.

WHAT ARE THE TREATMENT  STEPS?
-Clip the area to get air exposure and set up a perimeter (fire zone) to cut spreading.
-Wash the area with antibacterial soap, topical anti-inflammatory sprays/creams (after cytology)
-Many require an e-collar or tube around neck to distract and keep away from the area. Tranquilizers are sometimes prescribed.  

SUMMARY: KEEP YOUR PET FROM LICKING, UTILIZE DRYING AGENTS, AND CUT INFLAMMATION 

HOW CAN HOTSPOTS BE PREVENTED?
They are not always easy to prevent, but many clients will body clip  thick-coated retrievers in the spring to reduce moisture accumulation and clean ears well after swimming or bathing to dry the ear canal. In the early stages, shave at home as soon as a hot spot is suspected, and use either some apply cider vinegar or a warm tea bag for 3 to 5 minutes to dry the surface.

Betsy T. Sigmon DVM, Diplomate ABVP Canine & Feline
Hospital Director, Creature Comforts Animal Hospital
Cary, NC

The Red Eye

I recently had the privilege to travel to San Francisco and reconnect with a veterinary ophthalmology friend .

We took long hikes in coastal redwood forests,

walked the Golden Gate Bridge,

and participated in a walking tour of the Pacific Heights neighborhood (home of the rich and notorious). This was the home of Meg Ryan when she was married to Dennis Quaid.

One new diversion was Geocaching for little treasures using GPS coordinates in Coastal California Neighborhoods.

 I have to say it is a very dog-friendly area. When stopping at a local gas station, I found this owner had put his dog on the roof of his car to watch him pumping gas.

Public parks are the busy social place to have play dates and birthday parties for dogs and their pet parents. The Japanese Gardens are beautiful in Golden Gate Park. Pictured is a former sand dune converted to a park slightly larger than Central Park in NYC. 

I rode a Segway through the parks with stopovers at various sites such as the AIDS memorial garden.

As I walked with my friend, I asked, "In over 35 years of practice as a veterinary eye specialist, what has been the most common concern of owners when they come in?" She said, "The red eye." 

More specifically she added the painful red eyes, presenting as closed eyes, squinting and pain. With that background I wanted to "Segway" into common red eye conditions.

What are the most common causes of red eyes in pets?

Illness, Injury, Irritation, and Disease (local infection & some entire body)

In phone calls to our office, what are some of the comments mentioned?
Comments include worry over red and puffy lining, discharge, color change to the outer cornea of the eye, and partial to complete closure of the eyelids.

How does a client know if an eye problem is an emergency?

If the pet is holding the eye shut, pawing at the eye, the eye is bulging or is out of the socket,  along with a very red eye are all suggestive of an emergency.

Are their some historical questions that are helpful in the diagnosis? 

- How long has it been going on? Has it changed?
-Any new rugs, plants, carpet treatments, or exposures (smokers) introduced recently that could be irritating?
-Have any old, expired, or home remedies been tried?
-Is this the only pet exhibiting signs?
-Has this problem been treated elsewhere? (Bring the medications or home remedies)

What are the specific tests beyond the physical exam and utilization of the ophthalmoscope that are commonly utilized in eye exams?

- fluorescein stain for corneal ulcers
- pressure checks monitor  with a tonopen to see if pressure low, normal, or high (glaucoma)
- tear function test checking for dry eye (schirmer tear test)
-skin exam
-sometimes laboratory tests
-occasionally ultrasound of the eye itself to check for tumors

How are eye diseases treated?

It depends on the cause: topical and oral medications are often needed. In addition a soft e-collar is often needed to keep nails away from the eye causing further harm.

Statistically, what are the most common eye emergencies?

- excess pressure in the eye (glaucoma)
- falling forward of the lens leading to pressure changes and pain (lens luxation)
- penetrating objects/ sticks into the eye
- divots in the outer layer of the eye covering (corneal ulcers)
- bleeding within the eye (clotting disorders, detached retina)
It is late at night and I really do not want to see an emergency vet for my dog's squinting. Are there some basic tests I can check at home?

The eye will be difficult to assess if closed and thus needs the evaluation.

Betsy T. Sigmon DVM, Diplomate Canine and Feline Practice

Creature Comforts Animal Hospital

Cary, NC 

Feline Leukemia: Information from Dr. Google and Beyon

In the days prior to the Internet (and even now), hysteria and rumors overshadow public health facts concerning infectious diseases and vaccination. For example, Polio, also called infantile paralysis, is a viral disease spread by sneezing and fecal contaminated water that dates back to Ancient Egypt. In the sickest children, beyond being unable to walk, contorted spines, and shriveling leg muscles, the virus paralyzes the breathing muscles leading to suffocation.

 Until the 19th century many children were exposed during pregnancy and subsequent infancy to filthy hygiene practices and the virus. The mother’s antibodies protected them during these silent infections and children developed resistance to Polio subsequently for life. With improved public sewer and water filtration systems, children developed clinical disease later in life when their mother’s passive protection was gone. 

In July of 1916, an outbreak in Brooklyn, led to the mass gassing of over 72,000 cats as they were falsely believed to carry the virus. Armed gunmen manned exit and entry points from Manhattan into New Jersey towns as part of the hysteria of parents trying to flee the city with their children. 

As late as the 1940’s to early 1950’s more than 35,000 people got the disease each year. What is the point? Immunizations (vaccines) save lives.  I can distinctly remember going to Cary High School to have the oral sugar cube polio vaccine administered in the early 1960’s. The USA has been polio-free since 1979.

 It is important to review risk assessments and make informed choices with all vaccine programs.  Today’s blog features cats and specifically Feline Leukemia and vaccines. 

WHAT IS FELINE LEUKEMIA?

It is a contagious viral infection of cats, not transmissible to dogs or people, that can lead to anemia, tumors, and death. The populations at risk are cats younger than 1 year of age and over 10 years of age with exposure to other virus-positive cats.  There is no cure and it is most often fatal. 

WHAT ARE SOME OF THE SIGNS OF THIS DISEASE?

During the early stages of infection it is common for cats to exhibit no signs of the disease at all. However, over time—weeks, months, or even years—the cat's health may progressively deteriorate or be characterized by recurrent illness interspersed with periods of relative health. Common signs can include: loss of appetite, weight loss, pale gums, unthrifty coat, enlarged lymph nodes, pale gums, GI signs, seizures, eye problems, abortion of kittens by mother cats, fever, weakness, and severe respiratory disease. 

HOW IS IT SPREAD and DIAGNOSED?

Feline leukemia is spread from contact with an infected cat through saliva in bite wounds, shared food/water bowls, and from the mother while in the womb, nursing, or grooming. It is diagnosed through a blood test* available from most veterinarians (do not use the saliva based tests). It is estimated that two to three percent of the cat population in the United States has the disease. That number rises to greater than 13% in rescues, young kitten colonies, or sick populations of cats.  The  numbers have decreased in recent years due to rapid blood screening of cats at intake facilities and vaccines.

* No test is 100% accurate, and all positives should be re-tested at a later date. If negative with high exposure risk, once again, re-test in 30 days.

WHAT HAPPENS TO A CAT AFTER EXPOSURE TO FELINE LEUKEMIA (FeLV)?

1. Some cats will be resistant..-test negative
2. Some cats will develop a latent or hidden infection with no outward signs and no shedding of the virus.-test positive
3. Some cats will become infected,  pass on the virus in their saliva, and develop clinical disease later.-test positive

SHOULD CATS BE VACCINATED FOR FELINE LEUKEMIA TO LOWER THE RISK?

It is recommended that all kittens under one year of age (once tested negative OR their queen mother tests negative) that may slip out the door and all cats with potential exposure to outdoor cats should have the vaccine. It consists of two injections starting at 12 weeks of age, repeated in three weeks. Then repeat yearly for cats going outside. The vaccine does not interfere with testing results. 

ARE THERE OTHER STEPS?

 Keep YOUR cat indoors, or utilize an outdoor enclosure that lowers exposure to other cats, and adopt only FeLV infection-free cats.

WHAT DO I DO IF I DISCOVER ONE OF MY MANY CATS IS POSITIVE? 
Test all other cats in the household for FeLV to identify any carriers. Ideally, infected and non-infected cats should then be separated to eliminate the potential for FeLV transmission.

MY CAT IS FELINE LEUKEMIA (FE-LV) POSITIVE BUT SHOWING NO SIGNS. CAN I GET ANOTHER CAT? 

It is not recommended to adopt another cat unless the new addition is positive as well. 

http://www.vet.cornell.edu/fhc/Health_Information/brochure_felv.cfm

Betsy T. Sigmon DVM, Diplomate ABVP, Canine and Feline

Creature Comforts Animal Hospital

Cary, NC