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Keratoconjunctivitis Sicca Syndrome (KCS) or Dry Eye

What is KCS?
This disease is characterized by an absence or decrease in the formation of tears. The most common cause of KCS in dogs is immune-mediated destruction of the lacrimal (tear) gland. Certain breeds are predisposed to develop this condition, including the Bulldog, Lhasa Apso, Shih Tzu, West Highland White Terrier, Pug, American Cocker Spaniel and Pekingese.

When the watery layer is not being produced in an adequate amount, the eye will become dry. Most commonly, you will notice a copious sticky yellow or green discharge on the lids. Usually, the discharge is more severe in the morning. It is important to clean it away, since it can result in a secondary bacterial infection. It also is irritating for your dog to have these crusts present, and they will be more likely to scratch or rub the area, which can result in injury to the eye. Use a soft towel or cotton balls wet with warm water to wipe away the discharge from the eyes.

A Schirmer tear test is a simple test in which a strip of paper is placed in between the eye and the eye lid. The distance tears travel down the strip of paper indicates the overall tear production. Normal tear production is 20-25 millimeters or greater in dogs. This test will be repeated periodically during the treatment of KCS to determine the efficacy of the medication.

How is KCS treated?
The goals of treatment are to stimulate tear production and to substitute lubrication using tear-like substances. Products available are ointments, drops and medications which combine the characteristics of each. Initially, your dog may need to be on a topical antibiotic to control any bacterial infection.

The most commonly utilized medications to stimulate new tear production are Optimmune ointment or topical cyclosporine drops. They can take a while to become effective (up to 3- 4 months), so in the meantime, lubrication is needed. Commonly used products include Celluvisc or Refresh drops, Puralube, Lacrilube or AKWA-Tears ophthalmic ointment and artificial tears. The lubricants are available over-the-counter without a prescription at any drugstore and some grocery stores. As a rule, the liquid medications will need to be used more frequently than ointments.

Can KCS be cured??
It is important to remember that, with few exceptions, dry eye is a disease that cannot be cured. Lifelong medical therapy will be needed, and it is important that treatment be continuous. Without treatment, KCS can lead to corneal ulcers, discomfort, and eventually blindness. We will adjust medications based on your dog’s needs


Feline Herpesvirus

What is Feline Herpesvirus?
Feline herpesvirus is caused by a virus called Feline Herpesvirus type 1 (FHV-1). The virus infects the tissues lining the eyes and respiratory tract. The virus generally causes signs of upper respiratory infection such as sneezing, nasal and ocular discharge. There are instances where the virus can lead to an ulcer on the cornea of your cat's eyes which results in squinting, pain and discomfort. Occasionally cats develop corneal sequestrums as a result of slow-healing defects of the cornea. This results in a brownish to black discoloration of the cornea. Surgery is sometimes necessary to correct this condition. A few cats develop KCS (dry eye) and require lifelong treatment with lubricating ointment to increase their tear production. Cats can also develop eosinophilic keratitis, a condition in which eosinophils (a type of white blood cell) are deposited on the cornea producing a white, fluffy plaque on the surface of the eye.

Where did my cat get herpes?
FHV-1 is widespread in the cat population of the U.S. Some studies show approximately 90% of cats are infected. The typical cat vaccination program addresses FHV-1; however, if a cat is exposed to the virus before vaccination, they can become infected with the virus and become a carrier for life. Kittens typically show signs of infection in both eyes as well as the upper respiratory tract. Adult cats, however, can show signs of infection in one or both eyes with or without obvious signs of upper respiratory disease.

How can my cat be treated?
Topical antiviral medication (idoxyuridine) is the treatment of choice in severe disease. Adult cats with herpes virus should receive 500 mg of L-lysine by mouth or in their food twice a day for life. Because FHV-1 is a virus, antibiotic drugs are ineffective in treating this disease. They are sometimes used to control secondary bacterial infection, but have no impact on the virus itself. Good preventative medicine and avoidance of stress are the best ways to decrease the incidence of disease. If you notice your cat squinting either eye, an exam will need to be performed and the cornea stained to look for an ulcer. If a corneal ulcer is present, topical eye medications will be prescribed.

Can Herpesvirus be cured?
No, once infected the cat will have the infection for life. There is no cure, just supportive care as mentioned above.

How do I protect other cats in my home?
L-Lysine can be given to all cats in a household where one cat is infected with FHV-1. For an adult cat, give 500 mg by mouth or on the food twice daily. Frequent hand washing to decrease transmission from cat to cat is important. Any cat who is showing signs of disease should be isolated from other cats in the household. New cats should always be vaccinated and isolated before introduction into the household. Can I get the infection from my cat? No, you cannot get this infection from your cat. Can my dog get the infection from my cat? Dogs have their own type of herpesvirus which is very rare. The feline herpesvirus is only spread between cats.

Dr. Jennifer Fernandez

For: Exotic Animal Corner
From: Dr. Zoe Forward
WHAT DO I FEED MY RABBIT?

Rabbits are very special in their dietary needs. There is much confusion over what to feed pet rabbits, and often petstore advice is incomplete, or incorrect. Incorporated here are the current recommendations to keep your pet rabbit healthy.
In general a rabbit's diet should consist of four things:

  1. HAY- Most of a rabbit's diet (70-80%) should be a high quality GRASS hay such as Timothy, available for the rabbit to eat 24 hours a day. The hay should smell fresh and have a green color. Moldy or dusty hay should not be fed. Do not feed large quantities of alfalfa hay, because it is too high in calcium for a rabbit.
  2. PELLETS - A lower percentage (10-20%) of the diet should consist of rabbit pellets that contain a minimum of 18-20% fiber and a maximum of 14-16% protein. Do not buy rabbit food that contains seeds, nuts or starch-rich cereal kibble mixed in (fiesta mixes). You want food that just has green pellets(e.g., Oxbow Bunny Basic, Kaytee Forti-Diet). Feed approximately 1/4 cup of pellets per 4 pounds of body weight of rabbit per day. Pellets should be fresh. Do not purchase more than 6 weeks worth of pellets at a time, because it may spoil. Make sure the expiration date on the rabbit pellet bag is still valid or the pellets may not have enough vitamin content remaining.
  3. FRESH FOODS - The rest of the diet should consist of fresh, well washed, dark green and yellow vegetables such as parsley, kale, carrot tops, etc. (see list of recommended vegetables below). Stay away from beans and rhubarb. Feed a small salad each day. You can feed fruit daily, but feed no more that 1-2 ounces (2 tablespoons) per 6 lbs. of body weight per day (because high in calories).
  4. WATER - Water is an extremely important part of your rabbit's diet. Without a constant clean, fresh source of water, your rabbit can die. Sipper water bottles are ideal for rabbits because they do not spill and the rabbits cannot soil the water.

Feeding this diet rather than an all pellet diet or fiesta mix diet reduces the likelihood of hairballs, diarrhea, kidney disease and obesity. Occasional grains, cereals or breads can be offered, but be aware that these foods in excess are associated with fatal diarrheas.

Recommended vegetable choices:

Alfalfa, radish and clover sprouts
Basil
Beet greens (tops)*
Bok choy
Broccoli (mostly leaves/stems)*
Brussel sprouts
Carrot and carrot tops*
Celery (leaves/stem)
Clover
Collard greens*
Dandelion greens & flowers (no pesticides)*
Endive
Escarole
Green peppers
Kale*?
Mint
Mustard greens*
Parsley*
Peppermint leaves
Radicchio
Radish tops
Raspberry leaves
Romaine lettuce (No iceberg orlight colored leaf lettuce)
Spinach*?
Watercress*
Wheat grass

*= Contains vitamin A. Vitamin A is a dietary necessity. Choose one each day from the list that contains Vitamin A.
? = Use sparingly. Healthy, but high in either oxalates or goitrogens and may be toxin in accumulated quantities over a period of time.

Food Supplements? In addition to the above recommended foods, the addition of one papaya enzyme extract tablet (e.g. Oxbow Papaya tablet) daily is recommended to help prevent hairballs.

Supplementation with digestive enzymes (proteases, amylases), acidophilus, or vitamins on a daily basis is unnecessary, if you feed the recommended diet items. There is no evidence that healthy rabbits produce insufficient levels of these enzymes or require probiotic supplements on a regular basis.

Treats? Your cute little bunny is hard to ignore, especially when he sits up and looks so deserving of that special treat. Pet stores sell a selection of rabbit treats, but be careful. Many so-called treats are non-nutritious junk that can cause potential harm to your rabbit. Commercial treats fall into several categories: processed cereal kibble, mueslix (dried seed/fruit/veggie mixes), cereal/veggie blends, and candies/sugars. None confer an advantage over the fresh vegetable, high fiber pellets, and unlimited hay diet! The best snack is fresh vegetables or fruit. When feeding commercially available treats, moderation is the key. One treat a day won't hurt, but if fed too many or if fed only treats, problems will arise.

Processed Cereal kibble diets/treats- These range from "crunchy puffs" to shaped products designed to substitute for pellets. Some contain expensive extras that serve no benefit to your rabbit, such as plant or herbal extracts and freeze dried bacteria. As was mentioned above, supplementation with "digestive enzymes" from treats is unnecessary. The kibble treats tend to be low in fiber and high in fat. They are extremely expensive and come with feeding recommendations destined to give a spayed or neutered house rabbit obesity. The variety of colors and shapes are more for pleasing the human buyer than the rabbit. Again, fresh vegetables, restricted high fiber pellets, and unlimited hay are healthier and easier on your budget.

Mueslix (dried seed/fruit/veggie mixes)- These are diet mixes made of seeds and grain. The bottom line is that these diets are extremely unhealthy for a rabbit and not recommended. These diets are extremely high in fats and carbohydrates (sugar) and usually low in fiber, which is exactly the opposite of what you need to feed your rabbit. Rabbit metabolism is geared for a low fat diet. Rabbits appear to be more sensitive to fat than are humans and in addition to obesity, the excess fat can accumulate in your rabbit's liver and arteries (atherosclerosis). Rabbits fed seed-rich diets are at high risk for fatty liver disease (hepatic lipidosis), which is often fatal. Manufacturers claim that seeds and grains satisfy "the chewing urge". While this is true, it is far safer and cheaper to satisfy that urge with baskets, untreated wood, and cardboard boxes.

Cereal/veggie blend- These are grain products which may be supplemented with dehydrated vegetables, and shaped into a form which mimics the vegetable product. There is no advantage to feeding these over real vegetables. The main ingredient of these products is often not vegetables, but cereal. These treats/diets are too high in carbohydrate content and rob your rabbit of important fiber. These products also tout the vitamins that are added back (due to processing); real vegetables will supply as much if not more, and it's less expensive.

FOR ADDITIONAL INFORMATION ON RABBITS: Visit the House Rabbit Society of America website: http://www.rabbit.org

*Special thanks to the House Rabbit Society (www.rabbit.org), Ohio State University College of Veterinary Medicine and the Ohio State College of Veterinary Medicine for providing information that was used to compile this information.


MICROCHIPS

You look around and suddenly realize that your dog is gone. She was there just a moment ago. You can feel your heart racing as you call her and look everywhere-you miss her smiling face and wagging tail as she comes back to you. You walk the neighborhood calling her name and asking friends to watch out for her.

Then you go into functional mode. First, call the animal shelter; anyone who finds a lost dog should contact the shelter. Was she stolen? It happens, right here in our area. Did she wander far away to the next county? Is she hurt? Did someone take her to a veterinarian?

Someone asks you "is she microchipped?" Oh yeah, you've heard of that, it's a small rice grain size device painlessly implanted under her skin that can be read by scanners in all animal shelters and veterinary hospitals. The chip enables an owner to be found anywhere in the country. It can't be lost like tags on a collar.

You say- "no, she's not microchipped". But you remember when your veterinarian discussed this with you. You were in a "hurry that day" or it seemed like "just another thing to do" or "the cost didn't seem worth it". What would you give right now to relive that decision? Your best friend is lost and you want her back safe with you. You would do anything to have her head in your lap tonight.

I have witnessed this moment many times. My clients, friends and even staff members have lived this experience. I have also seen many pets reunited with their owners, weeks or months after they were lost, hundreds of miles away, when the only thing that could have made this miracle happen was the microchip. Owners and staff have shed tears of joy in my veterinary hospital, when a pet and their people are in each other's arms again.

Don't live to regret this particular moment of decision, ask our staff about microchipping for your dog or cat. Do it today.

Wally Diehl, DVM

For more information visit:
www.24petwatch.com


WHY THE CONCERN ABOUT RABIES?

--Eight rabid raccoons in Orange county between March-April 2005!
--Two stray cats test positive for rabies in Durham county between September-November 2004!

Rabies virus infects the central nervous system in all warm-blooded animals and people, causing encephalopathy and ultimately death. Early symptoms of rabies in humans are nonspecific, consisting of fever, headache, and general malaise. As the disease progresses, neurological symptoms appear and may include insomnia, anxiety, confusion, slight or partial paralysis, excitation, hallucinations, agitation, hypersalivation, difficulty swallowing, and hydrophobia (fear of water). Death usually occurs within days of the onset of symptoms.

Rabies is transmitted by the saliva of an infected host to an uninfected animal, usually through a bite. All domestic pets are susceptible to rabies, but most especially dogs, cats, and ferrets. Our beloved pet can acquire rabies from a bite from a rabid pet or wild animal. The wild animals of primary concern include raccoons, skunks, bats, foxes and coyotes. If unvaccinated and then bitten by a rabid animal, our pet would incubate the infection over a period of several days to months before showing any signs if illness. Once signs of illness are present in our pet, it is contagious and could then transmit rabies to us or other animals. Most animals die within 5 to 7 days of showing any sign of rabies.

Common signs of rabies in an animal: 1)daytime activity when normally active only at night (e.g., a raccoon or bat out in the daytime); 2) staggering, weakness, or paralysis; 3) inability or reluctance to eat or drink; 4) drooling or frothing at the mouth; 5) abnormal behavior, obvious neurological derangement, or seizures.

The only way to confirm rabies infection in an animal is post-mortem (after the animal is dead) by a test that requires brain tissue (direct fluorescent antibody test). There are no blood tests available to confirm an active rabies infection before death in animals. There is no cure for this disease. This disease can be prevented through regular vaccination.

There are several things you can do to protect your pet from rabies. First, we recommend a thorough annual physical examination and keep the rabies vaccination up to date! It is the law that all dogs, cats, and ferrets must be vaccinated in North Carolina. Second, keep your pets under direct supervision, especially when outdoors. All ferrets should be housed indoors. Third, spay or neuter your pets to help reduced the number of unwanted pets that may not be properly cared for or vaccinated regularly; and making your intact male or female pet less likely to wander away from home in search of a mate. Finally, report all stray animals to Animal Control since these animals may be unvaccinated or ill.


For more information on rabies please visit the CDC website: http://www.cdc.gov/ncidod/dvrd/rabies/Ques&Ans/q&a.htm

To report a stray animal to Animal Control phone:
Carrboro 918-7418
Chapel Hill 967-7383
Orange County 245-2075
Durham County 560-0630


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