Well, never, if you’re a retired Human Dentist because human dentists are veterinary experts now, because they read an article.
But the facts are only half-presented in her diatribes against the whole world who wants to spay and neuter animals. (See here) Continue reading When To Spay or Neuter a Dog
See also: Kidney Results
When you get blood work back on a pet (Cat), it’s about nine years old and it shows kidney failure it’s not always clear what’s going on. There’s another test or two that you’d run on a dog and there are some tests you could run on a cat. Actually, there are ways to spend thousands. Or, treat the treatable? Give this a listen.
The above does not constitute advice or replace the necessary input of your regular veterinarian within the confines of a VCPR. The above is as much a ‘document’ for the benefit of a particular client I sent to this, as it is to others who may face the same situation.
Diabetes for Fractious Pet Owners
Diabetes mellitus (DM) is a disorder where the body is unable to regulate its blood sugar level. Continue reading Diabetes
This is a well written description of how to give an insulin shot. It discusses “the bubble” and how to load the syringe. It doesn’t have doses but it does have “my favorite” type of dosing syringes etc. Continue reading Diabetes II: How to Give an Insulin Shot
A mask may be necessary. Racing muzzles are pretty easy to put on. There are lots of kinds of masks.
Some people are like “Nuts to this, I know she has a right to complain but I’m not getting bitten over this” and let their dogs go. Depending on the ‘battle’ it is, I could be aligned to that thought process.
But…. Continue reading Diabetes III Insulin for a Fractious Pet
So, I put together 39 pages of information on Cushing’s Disease, which is overactive Adrenal Glands. The body produces way too much Cortisol and the impact is insulin antagonism, and hunger and thirst, weight gain, thinning skin, premature aging. And increased vulnerability to infections.
Actually, a lot of the same symptoms (besides thirst and elevated liver enzymes) of Hypo-Thyroidism.
And, so that I don’t look totally stupid when I walk into the exam room with my Cushing’s Cases, I put together THIS DOCUMENT to leaf through over my lunch.
There’s the diagnostic algorithm, and the numbers you want to see, and then treatments are discussed and my favorite (because it hedges itself against Addisonian Crisis) is the Utrecht Method of medicine.
Long ago, traditional Chinese medicine derived that Black Bear gall bladder contents was therapeutic for numerous diseases (link) and disorders. I wasn’t even born at that point and my exposure to TCM is limited. Fast forward to the Vietnam War when military personnel were exposed to large amounts of Agent Orange and suffered severe liver damage. When they came back from the conflict, one of the medicines they found effective in their treatment was Urso. At the time, called Actigall.
When you’re presented in clinics with a dog or cat with elevated ALK lab values it can be assessed that there’s some stress on the liver. Either acterial showers via the bloodstream from the teeth and, or, the presence of some chemical or medicine that’s taxing the liver. ALKPhosphatase is a ‘stress’ or ‘overexertion’ enzyme from the liver under most practical instances.
Another enzyme from the liver is ALT, (alanine amino-transferase) and I’ve seen this elevated more commonly in cases of actual liver DAMAGE. So when I see this, I interpret it in light of a CBC for infection, cirrhosis, inflammation, or other damaging process. If the exam, signalment, or more bloodwork doesn’t illuminate this, and the values are high – an ultrasound of the liver is almost always rewarding.
Urso is ‘in play’ for me whenever I see elevations in ALKPhos because historically, Urso ameliorates these values to normal in 80+% of cases.
Urso causes gallbladder contraction, which drastically reduces sludge in the gall bladder and prevents the formation of stones (or more stones) and it boosts the enterohepatic cycle of pigments, nutrients and microbial ‘players’ in and out of the liver.
Other research says that ursodehydrocholic acid is actually trophic to liver cells. They can actually metabolize it? As a nutrient? I don’t know much about this.
But this relatively affordable medication is indicated (at least by me) for the normalization of the liver’s stress enzyme, AlkPhos with a recheck of that value in 2-3 weeks. I have found the compound less rewarding in elevations of ALT because it would seem, the pathophysiology of ALT elevations is different and tbh, more serious.
This article separates a couple kinds of Addison’s from the typical kind which has signs referrable to glucocorticoid *AND* mineralocorticoid lack.
But, the “atypical” HoAC doesn’t have electrolyte disorders (low sodium and high potassium) and may be managed with nothing but Prednisone at a dose low enough to manage the glucocorticoid deficiency say, 0.15mg.lb once or twice a day.
Atypical HOAC
Therapy for atypical HOAC consists of replacement of cortisol, usually with prednisone, given at 0.1–0.25 mg/kg/day, as directed for patients with classic HOAC. The goal is to give enough prednisone to control the clinical signs of HOAC, while not causing side effects of prednisone administration.
Additional prednisone (twice normal) is recommended during times of stress.
Dogs with atypical HOAC sometimes develop signs of mineralocorticoid deficiency (electrolyte abnormalities) weeks to months after the initial diagnosis (usually within 1 year). It is impossible to predict which dogs will develop electrolyte abnormalities; therefore, reevaluation of the electrolytes is recommended at 1 and 3 months following initial diagnosis and then every 6 months thereafter.
This document is for my clients who have pets that have been diagnosed with kidney issues. There’s a ton of information to take in when you get that ‘news’ and so I put together this one-page handout to refresh your memory after we talk. Interpretation of your pet’s Creatinine levels is of key import. How we manage kidney cases is presented.
https://drjohnson.com/wp-content/uploads/2019/09/Kidney-Cats-and-Dogs.pdf
Cushings Disease is a condition wherein the dog’s adrenal glands produce too much cortisol. When this happens a dog may exhibit signs like you’d see in Diabetes, namely increased thirst and appetite, except you also see weight gain and NOT weight loss. It’s treatable but it’s not cheap to diagnose and treat. Johnson Vet prefers the Utrecht method. This can be explained in person.
https://drjohnson.com/wp-content/uploads/2019/09/Hyperadrenocorticism2016.pdf
By Doc Johnson
Besides extremely expensive, (and risky) liver biopsies, ultrasounds, radiographs and bile-acids-tests – – there are seven ways to interpret liver health. All of these come from the bloodwork.
*ALT* – Alanine Amino Transferase: This is a “damage” enzyme and it’s typically elevated when the liver is being damaged in some way, by bacteria, viruses, or mechanical issues like duct obstructions or even cancers. ALT may also be elevated for other reasons. So, elevations in ALT aren’t dread-harbingers unless there are other clinical signs and bloodwork problems that suggest it.
*ALK* – Alkaline Phosphatase: This is a ‘stress-leakage’ enzyme that comes up whenever the liver is ‘overworked’ metabolizing drugs, germs, cellular debris, toxins, and sometimes during bone changes in rapid growth or decline (puppies).
*t.BIL* – Bilirubin is supposed to be removed from the bloodstream by the liver. If the liver falls-down-on-the-job the Bilirubin backs up and shows up high, in the blood work.
*BUN* – Blood Urea Nitrogen. A liver function assessment: The liver turns the bodies protein-by-products (ammonia) into Urea Nitrogen, which the kidney can get rid of. If the liver fails, the Ammonia is NOT converted into BUN (Urea Nitrogen) and the value for BUN drops off while the ammonia skyrockets, sometimes the BUN can fall all the way to zero and the kidney isn’t the problem. Dogs die of Ammonia poisoning.
*tPROT* – The liver makes all the bodies’ protein. So the “Total Protein” is a number that assesses how well the liver is processing amino acids, and making vital proteins. In liver failure or liver shunts, the Proteins will be reduced by the liver’s lack of production.
*Albumin* – Albumin is just one of the proteins the liver makes. If the Albumin is normal, it speaks well to the liver’s ability to make it.
*Globulin* – Similarly to Albumin, this is a bloodstream protein and the liver makes all the bodies’ protein.
Doc Johnson
.
.
.
.
