Diagnosing and Treating Hyperglycemic Hyperosmolar Syndrome in Dogs and Cats

Hyperglycemic Hyperosmolar Syndrome (HHS) is an uncommon form of a diabetic crisis that can occur in dogs and cats that has the following characteristics: Severe hyperglycemia (>600 mg/dl) Minimal to absent ketones Increased serum osmolarity (> 350 mosm/kg – normal ~ 300) Like diabetic ketoacidosis (DKA), HHS is caused by a lack of insulin with increased counter-regulatory hormones (glucagon, epinephrine, cortisol, growth hormone).  Unlike DKA though it is believed that there is not lipolysis so…

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Nutrition for the Critical Dog and Cat

Lack of adequate food intake is a substantial problem in any veterinary intensive care unit (ICU).  This is because the diseases our patients have are often associated with significant anorexia or even an inability to eat.  Additionally, we schedule diagnostics or surgical procedures that lead us to withhold food from our patients.  We are all guilty of writing NPO on a treatment sheet because diagnostics MAY be done that MAY necessitate a fasted patient and…

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IDEXX Diagnostic Challenge: Lethargy & Skin Nodules

Take the IDEXX Diagnostic Challenge: Lethargy & Skin Nodules Porter, a 6-year-old male mixed breed dog, presented with a history of lethargy, inappetance, and coughing. On physical examination, skin nodules were noted on the pinna and head. Below are Porter’s diagnostic test results. Review the slides and diagnose Porter’s disease. Porter’s Diagnostic Tests Tracheobronchial lymphadenopathy was identified on thoracic radiographs Abdominal ultrasonography revealed abdominal lymphadenopathy Fine needle aspirate cytology of an abdominal lymph node (Figure…

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Blastomycosis in Dogs: What is the Best Drug Treatment?

Blastomycosis is a fungal infection that is being seen more commonly in our pet population, with dogs being more commonly infected than cats. Blastomyces dermatitidis, a dimorphic fungal organism, is the causative agent and is most commonly seen in the Ohio, Mississippi, and Missouri River Valleys, as well as mid-Atlantic states. Infection is caused by inhalation of spores that settle in terminal airways as well as inoculation of wounds. Once infection is established, the organism…

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Utilization of Video Capsule Endoscopy (VCE) in Dogs

Video capsule endoscopy (VCE) can provide yet another means of noninvasive diagnostics in evaluation of gastrointestinal tract disease in medium to large breed dogs. Minimally invasive diagnostics are an emerging and needed trend in both human and veterinary medicine. When evaluating acute or chronic gastrointestinal tract disease, endoscopic evaluation of the upper and lower gastrointestinal tract is the most common minimally invasive diagnostic currently utilized. Although endoscopy is an excellent diagnostic tool in the majority…

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