Harry is a 4-year-old male Border Collie. He is a much-loved family pet whose passions include eating and chasing possums.
Recently Harry’s family became concerned when he started coughing and retchingoccasionally. He had chest x-rays at the clinic, which showed that his oesophagus was enlarged. This problem is known as ‘megaoesophagus’ and often occurs spontaneously for no reason. It is common for dogs with this condition to cough and retch, as it is difficult for food to pass through the oesophagus and into the stomach normally. The x-ray also showed evidence of aspiration pneumonia, which happened when food 'went down the wrong way'.
We assumed that the megaoesophagus was 'idiopathic' (meaning there is no underlying medical condition causing it) and asked the owners to feed Harry from an elevated position, as this often helps the food to 'go down the right way'. We also used a course of antibiotics to help resolve the pneumonia. Initially, he seemed to be improving, but then a couple of days later something strange happened. Just as he was starting to eat dinner, Harry became very stiff on all his legs, his back hunched up and he started to have tremors. Harry’s dad Neil was very concerned and brought him straight to the clinic.
At the clinic we did a full neurological examination and found that whilst Harry’s brain function seemed to be normal, his gait was not.He had a very short, stiff stride that seemed to get worse the more he moved.We became suspicious of a condition called ‘myasthenia gravis’ (MG), where signals between nerves and muscles are not transmitted properly. Usually this condition becomes more obvious when there are more signals firing, which would explain why he got worse with exercise and when he got excited at dinner time! MG can also sometimes result in megaoesophagus because nerve signals aren't transmitted properly to the muscle within the oesophagus. There was a reason for the megaoesophagus after all!
MG is a very rare condition and is difficult to diagnose without advanced equipment, so Harry was referred to the Veterinary Clinical Hospital at Werribee for evaluation by a specialist neurologist. At the clinic, they agreed that Harry’s clinical signs were consistent with MG, and performed a procedure called electromyography, or EMG. This measures electrical activityin the muscles, and is abnormal in dogs with MG. The results of this test were again consistent with MG, so we are now 99% sure of the diagnosis and have started Harry on medication to help alleviate his neurological signs.
We are awaiting results of a blood test in the United States to give us 100%confirmation of the diagnosis. We are hopeful that in about 6 months’ time, we will be able to start to taper off Harry’s medication and that it will remain in remission.Stay tuned!
Pippin, more affectionately known as Pip, is a 9-year-old Cavalier cross. He is a regular at our clinic, and refuses to walk past the door without coming in for a treat! At home, his favourite treat is toast with honey.
Images: Pippin enjoying a treat and sitting with Mum and Dad.
We saw Pippin in August 2011 for a 3-month history of difficulty urinating. His owner brought him into the clinic when he started to see a bloody tinge to the urine. On examination, Pip was painful towards the back end of his abdomen. When we examined his urine, we saw a type of crystal called struvite that can sometimes form stones in the urinary bladder. Suspicious that this was the cause of Pip's problems, we admitted him for an ultrasound to look for stones in the bladder.
Image: Pip's ultrasound
In this ultrasound image, the dark grey area towards the top represents the urinary bladder, and the bright white area represents the stones inside the bladder. Notice how the area beneath the stones is black? This is because the stones are so hard that they reflect all the ultrasound beams so that the deeper structures can't be visualised. This is called 'acoustic shadowing'.
Having confirmed that there were stones inside Pip's bladder, we recommended surgery to remove them. Pip's owner was happy to go ahead with this, so we went straight into theatre. During surgery, we removed a large number of small stones from Pip's bladder.
Images: Pip in surgery, Pip's urinary stones
Analysis from the lab revealed that the stones in Pip's bladder were a combination of struvite and calcium oxalate. This was most likely caused by a bladder infection. Pip has had a four week course of antibiotics to make sure we eliminate any residual infection, and is being transitioned onto a special diet designed to prevent the stones from forming again. Post-surgery, Pip has recovered beautifully. He is eating well and still enjoys coming into the clinic for his treats!
Georgie is a 13-year-old Irish Water Spaniel. She has a voracious appetite and can be quite cheeky, often wandering to the back of the clinic in search of food! She has a beautiful nature and is always up for a cuddle.
We saw Georgie for red, crusty skin lesions in July 2011. The lesions were very unusual in appearance and at first we were unsure what might be causing them. We were suspicious that they may be cancerous, but we started by prescribing a course of antibiotics to see if the lesions improved.
Images: Lesions on Georgie's back and belly
Two weeks later, the lesions looked slightly better but were nowhere near resolving. At this stage, we decided to take multiple skin biopsies to find out exactly what we were dealing with. While Georgie was under anaesthetic, we also found some lesions on her tongue.
Image: Georgie's tongue lesions
A couple of days later, we received a report from the lab confirming that Georgie was suffering from a cancerous skin disease called T-cell epitheliotropic lymphoma. The lesions on her tongue were part of the same disease process. This is quite a rare type of cancer so there is not a lot of information available on types of treatment and their success rates, but chemotherapy with a drug called CCNU had achieved improvement in skin lesions in about 80% of dogs in one particular study, with some dogs going into remission. We decided to give it a go!
First, we took x-rays of the chest and did a full blood analysis to check for any spread of the cancer to the lungs or abdomen. Fortunately, it was all clear and we were able to administer the first dose of CCNU. A week after the first dose of CCNU, Georgie's skin lesions had already started to shrink. By the time she was given her second dose three weeks later, her lesions were about half the size they had been and no longer looked infected.
Images: Lesions on Georgie's back and belly 3 weeks after the first dose of CCNU (chemotherapy)
Unfortunately, by the time Georgie was due for her third dose of CCNU, she had started to develop new skin lesions and her lymph nodes were enlarged. Samples from the lymph nodes showed that the lymphoma had spread. We decided to try one more type of chemotherapy drug, but it didn't make any difference and Georgie continued to develop new lesions. In the end, it was kindest to let her go. She will be greatly missed.