Veterinary Medicine - December 2007 - (Page 780)

2007 Highlights O Central Practical advice from the presentations Practical ideas for managing common internal medicine problems The following tips—5 each for dogs and cats—are easy to implement and will improve your patient care. Kenneth R. Harkin, DVM, DACVIM (small animal internal medicine) I ’ve compiled these tips to help practitioners deal with common problems or situations in a manner that will help improve a patient’s outcome, simplify the diagnosis, and minimize complications in daily practice. You may already use many of these tips, but you may also find new ones to help you with long-troublesome problems. DOGS In dogs with a recent onset of urinary incontinence, rule out polyuria and polydipsia as possible causes before initiating drug therapy. Some clients may not be aware that polyuria and polydipsia can be linked to urinary incontinence, so they may not report the polyuria and polydipsia. Polyuria can overwhelm the capacity of the sphincter in dogs with marginal sphincter function, resulting in urinary incontinence. Correcting the underlying cause of polyuria and polydipsia usually resolves the incontinence. #1 Perform a urine culture, regardless of urinalysis results, in any dog that presents with polyuria #2 and polydipsia, signs of urinary tract disease, or an endocrinopathy. The urinalysis may not show marked signs of inflammation, and bacteria may not be seen, in many disease states. This situation is particularly true with diseases that cause dilute urine production, suppress immune function, or otherwise inhibit the normal urinary tract defense mechanisms, such as diabetes mellitus and hyperadrenocorticism. In addition, occult pyelonephritis may cause polyuria and polydipsia. It is acceptable to not perform a culture in a dog that is experiencing its first episode of lower urinary tract signs consistent with cystitis. But perform cultures if subsequent episodes occur. Manage hypoglycemia in toy breeds or puppies by administering L-carnitine. Hypoglycemia in toy breeds or puppies can be frustrating since the most popular recommendation is to provide frequent feedings, Kenneth R. Harkin, DVM, DACVIM (small animal internal medicine) which may or may not resolve the problem. Some human infants with fatty acid oxidation disorders respond to L-carnitine, which helps move fatty acids into the mitochondria for energy production. 1 I use L-carnitine (50 mg/kg orally twice a day) until the puppies are 9 to 12 months old. In my experience, the hypoglycemic episodes diminish or disappear, the puppies are more active, and weight gain is more rapid. When supplemented with L-carnitine, these puppies don’t seem to need the intensive feeding schedules recommended for managing hypoglycemia in toy breeds, and most do fine with twice-daily feedings. L-carnitine tablets and liquids are available at health food stores. Treat dogs with chronic vomiting for Physaloptera species infection before doing extensive work-ups. For otherwise healthy dogs with chronic low-grade vomiting (one Department of Small Animal Internal Medicine College of Veterinary Medicine Kansas State University Manhattan, KS 66506 #3 #4 780 December 2007 VETERINARY MEDICINE ©iStockphoto.com/Michael Pettigrew

Table of Contents Feed for the Digital Edition of Veterinary Medicine - December 2007

Veterinary Medicine - December 2007 Contents Letters Editors' Guest Thanking Our Valued Reviewers The Veterinary Medicine Interview: Dr. Joseph Harari Clinical Exposures Idea Exchange Answers to Three Commonly Asked Questions About Lyme Disease Practical Ideas for Managing Common Internal Medicine Problems A Tip for Interpreting Leptospira Species Titers Investigating Proteinuric Kidney Disease Counseling New Puppy Owners: Normal Play vs. Aggressive Tendencies 11 Guidelines for Conservatively Treating Chronic Kidney Disease CE Form Product Preview Advertiser Index Marketplace/Classifieds Mind Over Miller Merial Insert

Veterinary Medicine - December 2007

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