Pancreatitis is inflammation of the pancreas, an organ in charge of producing enzymes to help break down food in the intestinal tract. It can come on suddenly, known as acute pancreatitis, or it can be a long-term, chronic problem. Cholangitis is inflammation of the gallbladder and bile ducts. It is sometimes termed cholangiohepatitis when the liver is also inflamed. The gallbladder makes bile, which helps break down fatty foods in the intestinal tract. The ducts or passageways for the pancreas and gallbladder open into the intestines in the same place, so when that area of the intestines is inflamed, infected, or diseased, the pancreas and gallbladder have a higher chance of being injured as well.

IBD is a chronic condition of the intestines in which inflammation leads to a poorly functioning GI tract. Causes are numerous and include overactivity by the immune system, food allergies, abnormal bacteria in the gut, and genetics  ̶  often occurring in some combination together.

How is Triaditis Diagnosed?

In cats with triaditis, the most common sign is vomiting or throwing up. Decreased activity level, diarrhea or loose stool, poor appetite, and weight loss are also frequently seen. Occasionally, fever, tummy pain, a yellow tinge to the skin (known as icterus),and swelling of the belly may occur.

Your veterinarian will want to do a thorough physical examination to assess for other causes of these signs. They will also run tests on the cat’s blood, such as a complete blood count (CBC), chemistry panel, and pancreatic lipase immunoreactivity test. X-rays and an abdominal ultrasound may also be needed. If a bacterial infection is suspected, a culture and sensitivity may be run on fluid or tissues from the affected organs. All of these tests will help point the veterinarian in the right direction for diagnosing triaditis.

However, to get an official diagnosis, a biopsy of the pancreas, intestines, and gallbladder or surrounding liver is needed. While this sounds like a lot of tests, keep in mind that triaditis is really three different diseases happening at the same time, so it can be difficult to get the diagnosis right. Thank goodness kitties are so tough!

Treating Triaditis

In order to treat triaditis effectively, all three diseases will need to be managed together. Pancreatitis treatment may include pain medication, treatment for nausea, and hospitalization and fluid therapy for dehydration. Triaditis treatment is similar, although liver and gallbladder protective medications such as ursodiol, samE, or Denamarin may be used to help encourage healing. Antibiotics may be given if a bacterial infection is occurring. IBD treatment includes managing the cause of GI disease. This management can mean a special diet, medications to suppress the immune system, and vitamin B supplementation when needed.

Additional treatments needed will depend on the complications or effects of triaditis on the pet. Bleeding disorders, gall stones (known as choleliths), severe infections such as abscesses or septicemia, calcium deficiencies, and electrolyte imbalances are some of the complications that may occur, especially if treatment is delayed. For cats that won’t eat, sometimes feeding tubes are necessary.

Triaditis is a complex disease, but your veterinarian will be able to give you a good idea of what is needed for your cat and help you get them back to health. The prognosis can vary depending on the severity of disease.  Luckily, many cats with triaditis recover well with treatment.

True VKH syndrome is a human disease, well described for nearly a century. A similar disease in dogs has been described but since we do not know the relationship between the canine and human disease, we are hesitant to call the canine version VKH syndrome as well. Until we know what is really going on in dogs, we will leave it at VKH-LIKE syndrome or, more accurately, uveodermatologic syndrome.

A syndrome is a collection of symptoms. In humans, VKH syndrome consists of the following:

1. Deep inflammation of the eye tissues (a process called uveitis) leading to at least partial blindness. Approximately 70% of people with VKH syndrome become blind and it is usually the inflammation in the eyes that appears as the first sign of VKH syndrome.
   
2. Premature whitening of the hair (present in 90% of affected people). 
   
3. Whitening of the skin (present in 50% of affected people).
   
4. Inflammation of the membranes of the nervous system (a process called meningitis). This leads to deafness in about half of the people affected with VKH syndrome.

Affected people are typically of Mediterranean, Hispanic or Asian descent. There are numerous links for more information regarding this condition in humans.

The syndrome in dogs includes:

1. Uveitis leading to blindness that, as in humans, is usually the first sign to show. The owner would notice that the eyes seem painful and/or bloodshot. The patient may bump into things and show diminished vision. The pupils are classically constricted and the eye may seem cloudy or may seem to change color from normal. 
   
2. Whitening of the coat, sometimes confined to the face (present in 90% of affected dogs) This typically begins 3 to 6 months after the eye disease has started. 
   
3. Whitening of the skin, usually most obvious on the nose, lips, eyelids, footpads, and scrotum (occurs in 50% of affected dogs).

Unlike the human disease, deafness or meningitis is not a feature. The most detrimental part of the syndrome is blindness.

What Causes this Syndrome?

Uveodermatologic syndrome is an immune-mediated disease where the body inappropriately attacks its own melanocytes (the pigment-producing cells). These cells seem most prevalent in the skin, retina, and uveal tract of the eye. It is speculated that the immune reaction is initially triggered by a virus though research is ongoing.

1. Male dogs are affected more than female dogs. 
2. Akitas and Nordic breeds are primarily affected. (Actually, 80% of reported cases involve Akitas and as many as 4.1% of Akitas are affected.)

How is the Diagnosis Made?

The best way to confirm this diagnosis is by a skin biopsy (the lip is said to be the best location). Treatment, however, is focused on the eye disease as this has the most serious outcome ‒ blindness ‒ while skin disease is generally cosmetic.

Uveitis is most literally inflammation of the uveal tract of the eye. The uveal tract consists of the iris (the colored portion), the ciliary body (the area inside from which the lens is suspended), and the choroid (the vascular coating of the inside). The treatment for uveitis due to a VKH-like syndrome is the same as for other causes of uveitis.

At the initial evaluation, 36% of dogs had glaucoma (increased eye pressure) and 57% were blind in both eyes. Some dogs were able to regain vision and 50% of subjects could see in at least one eye at the end of the study. Of the dogs that ultimately became blind in both eyes, blindness came on over 13.5 months (median). At least 10 eyes had to be removed in order to provide long-term comfort.

When dogs or cats develop masses protruding from their vaginas, it can be alarming for an owner. Fortunately, they are not common and are rarely seen in spayed pets.

Is it hyperplasia, swelling, prolapse, or a mass?

Many of these can look similar – a pink, fleshy mass in the cat or dog’s vaginal area. Although vaginal hyperplasia, swelling, and prolapse are similar and often related, they are not the same. Keeping it simple, hyperplasia means that there’s more tissue than there should be due to more cells being present.

Technically, this is different from swelling, which occurs for reasons other than an increase in the number of cells, such as an increase in the amount of fluid in between cells. A prolapse is where the vagina is everted (turned inside out) of the body. Imagine something from the inside of the body pushing the vagina outward, like turning a sock inside out. The tissue will often swell when combined with a prolapse.

Vaginal hyperplasia is more uniform than a mass. Think of vaginal hyperplasia as the difference between a thin cotton sock and a thick wool one. The “walls” of the wool sock (the vagina) are thicker than that of the cotton sock. If the sock couldn’t stretch outward for some reason, perhaps tight shoes, it would lessen the amount of room inside the sock for your foot, and the sock would feel tight.

Now, if that hyperplasic vagina should prolapse, a round, tongue- or doughnut-shaped mass may be easily seen; it’s often more in the neighborhood of “you can’t miss it” because the dog is paying so much attention to that area. The prolapse generally starts out smooth and shiny but eventually dries out a bit, after which cracks called fissures develop. It’s basically caused by an overreaction to estrogen and tends to occur just before she goes into heat (proestrus) or while she’s in heat (estrus).

Generally speaking, it only happens in dogs and cats who have not been spayed because spayed dogs and cats do not have enough estrogen to cause it. That said, if a spayed pet is exposed to estrogen from outside of her body, like what can happen to a dog that licks estrogen cream off her owner’s arm, there is the possibility of a prolapse developing then as well. Occasionally, difficult labor and delivery may lead to a prolapse, such as if the vagina everts outward as part of the pressure and forces involved in giving birth. Due to a slight increase in estrogen prior to the date of labor and delivery, it occasionally will happen then, too.

During delivery of a litter, if you can see any type of abnormal vaginal protrusion, it is a medical emergency.

Vaginal hyperplasia can interfere with sex while breeding; before the hyperplastic vagina prolapses outside the body, a reluctance to breed or difficulty urinating may be the only signs.

Occasionally, the discomfort continues throughout pregnancy or just recurs when the puppies are born.

Breeds predisposed to vaginal hyperplasia and prolapse include the boxer, English bulldog, mastiff, German shepherd dog, Saint Bernard, Labrador retriever, Chesapeake Bay retriever, Airedale terrier, English springer spaniel, American pit bull terrier, and Weimaraner. Because it tends to run in some family lines, it’s best not to breed dogs if they have had a prolapse even though the genetics and heritability of the condition are not fully worked out yet.

A mass is a collection of cells.  Sometimes, masses will form inside a dog’s (or, rarely, in a cat’s) vagina and grow into a larger mass that eventually pushes itself outside the vagina.  Vaginal masses, whether benign or malignant, are not common in cats and dogs, particularly if spayed.  Continuing with our sock analogy, imagine a burr inside your sock, where the burr is like a vaginal mass.  The burr protrudes into the middle of the sock where your foot sits.  You’re wearing your sock as usual.  If you stick your finger inside your sock, you can feel the burr. 

If it’s a really big burr or you turn your sock inside out, you will see it when protruding from the sock.  Masses can be pedunculated or sessile. If pedunculated (on a stalk) they are nearly always vaginal polyps, which occur more commonly in intact vs spayed bitches but can occur in both. Usually, the bitch is older. Polyps can be single or occur in groups. If the mass is sessile it is more likely a leiomyoma or leiomyosarcoma, which are differentiated by an incisional biopsy.  Occasionally, other neoplasms can occur in the vaginal vault.

Growths called Transmissible Venereal Tumors may sometimes cause vaginal protrusions in dogs.

Treatment for Vaginal Prolapses

With vaginal prolapses, unless the prolapse is extreme, it will generally resolve on its own as the dog’s heat cycle moves along or after the dog is spayed. In minor cases, the dog only needs cleaning and an ointment to keep the tissue moist, so it doesn’t dry out.

If minimal tissue damage has occurred, your veterinarian can push it back in with a gloved hand. It is first cleaned appropriately, and swelling is reduced by applying hypertonic dextrose or sugar. Sutures can then be put in to keep it in place.

If the tissue is dead (necrotic), it has to be removed surgically. Spaying her will prevent another occurrence and can be done at the same time as removing the dead tissue.

Dogs with difficulty delivering litters due to the protrusion will likely need a C-section.

Sometimes supportive therapy involving an E-collar to prevent self-trauma, a diaper with a lubricated pad, and hormone treatment can be given to make ovulation occur faster. However, dogs don’t generally have a good response to hormones, and it’s ineffective if given after ovulation, so it’s not usually helpful.

After treatment, the intact dog should be monitored in case of a relapse.

The only prevention is spaying.

Treatment for Vaginal Masses

Treatment for any kind of mass in the vagina will depend on many factors including the type of mass it is (such as a benign mass or cancer), the exact location, the extent of it, and whether or not it has metastasized to any other location.  If your pet has a vaginal mass, talk with your veterinarian to discuss treatment options.

In summary, if you notice a pink mass protruding from your cat’s or dog’s vagina, notify your vet. If your cat or dog seems to be in discomfort or having trouble urinating, contact your veterinarian or a veterinary emergency clinic right away.

Why does my pet need this medication? 

High levels of FAS can have negative effects in many ways.  It isn’t healthy for your pet.  Elevated stress hormone levels can suppress the immune system, change lab work results, and over the long term may even shorten your pet’s life.

Every time your pet is in a stressful situation such as going to the veterinarian, they learn to associate it with feeling anxious or scared.  That means that each time they go back to the clinic or a groomer, or you try to do something that they find scary, they get more and more scared.  They also anticipate something bad happening, so the anxiety starts sooner and sooner.

If they stay at a high level of FAS, your pet may learn that the only way to make people stop doing the things that scare them is to be aggressive.  This adaptation could result in a situation where your pet is sick or injured and making sedation risky but necessary because of aggression due to repeated negative experiences.  This risk can limit your veterinarian’s ability to provide necessary medical care to your pet.

My pet isn’t aggressive, can’t you just do what they need?

Physically we might be able to do these things, but it would have a negative impact on your pet’s mental health.  We don’t want them to learn to be more afraid at the vet’s office or start being afraid of strangers or you or in other situations.

He didn’t need medication last time, why are you saying he needs it now?

FAS often increases because of memories of bad experiences.  Giving medication to lower FAS also changes what your pet is learning so they don’t continue to become more and more anxious or aggressive. 

What if my pet is still fearful after taking these medications?

The medications you give at home may not be enough for your veterinarian to do full procedures but may allow injectable sedation to be given without causing undue stress.  If they don’t need urgent care, you may need to try a different combination of medications or different doses. 

What else can we do to lower my pet’s FAS?

Happy visits

If your pet travels in a carrier, use treats so they’re happy about going in and out of the carrier at home and take them for car rides in it so it isn’t a scary thing. Take your pet to the clinic when nothing is needed so they can learn that it’s a good place to be.  Start out just giving treats in your car or out in the parking lot.  Call ahead; if it’s a quiet time, staff may be able to come out and give your pet treats or have them come inside for some.

Home exams

If your dog or cat is fearful at the veterinarian’s, but is not aggressive or extremely fearful at home, you can get a pulse and respiratory rate and take their temperature at home.  You can also take pictures of their teeth in case they need to be muzzled, in which case teeth can’t be examined.

Basket muzzle training for dogs

For the safety of your clinic staff and ultimately of your dog, many fearful dogs require muzzles.   If the muzzle is introduced properly, your dog will associate it with treats and good things, so it will lower anxiety when worn.  If it is not introduced properly, putting a muzzle on a fearful dog can increase anxiety and aggression. 

Uveitis is an inflammation of the dark tissues (uvea) of the eye.  The uvea includes the iris, the ciliary body behind the iris, and the choroid in the back of the eye behind the retina.

Uveitis can be acute or chronic in onset, and anterior (iris and ciliary body) or posterior (choroid and retina) in location. Occasionally, all uveal tissues are involved (panuveitis). 

Uveitis has many different causes, including infectious diseases such as bacterial, viral, fungal, rickettsial and protozoal infections. Penetrating trauma, bleeding into the eye, long-standing cataracts, ingestion of fatty foods, immune-mediated diseases, generalized systemic diseases, and cancer of the eye are also potential causes. Occasionally, a cause is never identified.

Any age, sex or breed of dog or cat can develop uveitis. The underlying causes, however, can be influenced by the pet’s age, sex, breed, the geographic region in which it lives, and the environment.

Diagnosis

Figuring out why a pet has uveitis can be challenging. Unless the cause is obvious on the eye exam (such as a cat scratch, tumor, hypermature cataract), a thorough physical examination is required to search for evidence of disease elsewhere in the body. Numerous tests (complete blood count, biochemistry profile, serology for infectious diseases), x-rays (chest, abdomen), and possibly an abdominal ultrasound may also be needed. If the front of the eye is so cloudy that the structures in the back of the eye cannot be seen, then an ultrasound may be recommended. Ophthalmology requires specialized equipment, and your veterinarian may refer your pet to a veterinary ophthalmologist.

Treatment

The goal of treatment is to resolve the uveitis and any underlying causes.  Immediate priorities are to relieve pain, prevent glaucoma, maintain the normal internal structure of the eye and preserve vision. Treatment usually involves topical eye drops and systemic medications. Therapy is often required for weeks or months. Occasionally, treatment is lifelong. Surgery to remove the eye is rarely required; that is most often indicated for eyes that are permanently blind and painful, have a tumor, or when the inflammation cannot be controlled.

Monitoring

Because pets that have uveitis are at risk for vision problems and treatments often must be tweaked, close monitoring is important. Monitoring involves frequent ophthalmic examinations, including eye pressure measurement to check for glaucoma. Repeated laboratory tests may be required, depending upon the underlying cause and the therapy used.

Prognosis

Prognosis is good to guarded depending on the underlying cause, severity, extent of damage caused by the inflammation, duration of inflammation, response to therapy, and development of negative aftereffects. The best outcome occurs when uveitis is diagnosed early, treated promptly and aggressively, and the underlying cause is responsive to therapy.

An umbilical hernia is a condition in which abdominal contents (fat, intestines, etc.) protrude past the abdominal wall at the location where the umbilical cord was attached to the fetus. Congenital umbilical hernias are more common in puppies than in kittens.

The umbilicus, or belly button, is where the umbilical cord attaches when the puppy or kitten is in the womb. The umbilical cord carries nutrition and oxygen from the mother to the fetus, and waste products and carbon dioxide from the fetus to the mother. Normally, after the puppy or kitten is born, the cord breaks, and the connection at the umbilicus closes up.

An umbilical hernia occurs when the hole doesn’t close correctly. When this happens, skin is the only barrier between the abdominal organs and the environment.

Umbilical hernias are diagnosed on physical examination.

Small hernias do not usually cause any problems, and are often left untreated.

Large hernias should be repaired surgically, because there is a risk that the abdominal contents inside the hernia sac could become damaged or strangulated. Strangulation of intestinal loops can cause blood flow restriction to the intestine, intestinal blockage, etc. Strangulated hernias can become life-threatening; signs can include a large, warm hernia sac; vomiting; abdominal pain; lack of appetite; and depression. Radiography or ultrasonography may be necessary to help diagnose a strangulated hernia.

As long as the hernia isn’t causing problems for the puppy/kitten, the herniorrhaphy (hernioplasty, hernia repair surgery) can be delayed until the scheduled ovariohysterectomy or neuter. However, if strangulation occurs, the surgery becomes an emergency procedure.

The exact cause of congenital umbilical hernias is unknown, but it is generally thought to be a hereditary condition.

These bacteria are anaerobic, meaning that they grow in conditions where there is no oxygen (such as a deep bite wound or puncture). Clostridia are soil bacteria, meaning that they live in dirt so it should be easy to see how a puncture contaminated with dirt would be a classical tetanus-yielding wound. Such wounds are particularly common on farms where there might be nails or bits of wire on the ground, ready to pierce a human or animal foot, but there is nothing special about rusted metal in predisposing to tetanus. The puncture can come from any pointed object. The pointy object provides the puncture (an anaerobic wound) and contamination with dirt provides the Clostridia. A fight involving a bite wound and rolling around in dirt might similarly offer an opportunity for tetanus.

Different animal species have different sensitivity to the tetanus toxin. Horses, humans, and livestock are more sensitive while cats are quite resistant and almost never get infected. We will be confining our discussion primarily to dogs.

The Course of the Disease

The tetanus toxin is called tetanospasmin. It is produced by the bacterium Clostridium tetani in a wound. The toxin binds to local nerves and migrates up into the central nervous system where it interferes with the release of glycine and GABA, both of which are inhibitory neurotransmitters. The result of this loss of inhibition is painful muscle over-activity, spasms and rigidity. In severe cases, the patient cannot breathe because of the rigid paralysis of the respiratory muscles and a mechanical ventilator is required. As a human disease, tetanus has been known and described since ancient times. In the modern world, human death is unusual and is mostly limited to infants and to the elderly, but even in these groups mortality is only 10-15 percent.

Dogs with ears that hang down may actually develop ears that stand up straight, and the facial muscles pull back in such a way as to create what is called the risus sardonicus or sardonic smile. In more advanced stages, the patient can no longer walk and stands stiffly in what is called a sawhorse stance.

In an advanced state of disease, the patient cannot walk or even sit up and is at risk for aspiration of saliva or food contents. If the jaws are locked, feeding may be impossible and if the respiratory muscles become involved, the patient will not be able to effectively breathe.

In dogs, a localized tetanus is more common than the generalized (whole body form) and only the limb nearest the original wound becomes rigid or will tremor. This is an easier form to treat compared to the more generalized; however, the localized form can spread and become the generalized form.

In the generalized form, initial signs seem to pertain to the eyes and can easily be mistaken for eye disease in the early stages.

Testing

There is no test for tetanus in the way you might hope: no blood test or unique finding. The diagnosis is generally made based on the appearance of the animal and history of a wound. It is possible to measure antibody levels against the tetanus toxin but this has not been widely used in the clinical setting. Attempting to culture Clostridium tetani from the wound is generally not successful.

Therapy

The first step in treatment is antibiotics to kill the Clostridia. Happily, unusual antibiotics are not needed: penicillin works quite well for this classical gram positive rod. Clindamycin and metronidazole are also felt to be effective. Improvement is usually obvious in the first week of treatment.

Sedation is necessary to control the spasms and/or seizures. Acepromazine and chlorpromazine have been recommended to control the sensitivity to light and noise. The patient will need a darkened quiet room and may need his eyes covered to reduce stimulation. These medications can promote seizures in other sets of circumstances, but tetanus is the exception. Injectable pentobarbital, phenobarbital, propofol, methocarbamol, diazepam, or midazolam can be used to control the muscles stiffness.

Patients for whom respiratory compromise is a concern (when the respiratory muscles are affected or if there is larynx spasm) may actually need days of general anesthesia, an endotracheal tube (tube in the windpipe to keep an airway open) or even a mechanical ventilator.

The decision on whether or not to include tetanus antitoxin is more controversial. Antitoxin is an antibody solution (a blood product) generated by either a horse or human to bind and destroy the tetanus toxin. It cannot remove toxin already bound to the patient’s nerves but can inactivate new toxin not yet bound. Toxin that is already bound to nerves simply has to unbind in time on its own.

There is a risk in using antitoxin because it is a blood product of another species and highly inflammatory to the immune system. Antitoxin can be given under the skin or in the muscle but can take up to 3 days to reach a therapeutic level this way. Giving it by IV is more rapid but also more dangerous in terms of inducing an anaphylactic reaction. Skin testing is commonly used to see how reactive the patient might be. It is potentially helpful in early stages of disease only.

Tetanus toxoid is the tetanus shot most of us have had at one time or another. It is a vaccine against the tetanus toxin and it is part of a horse’s regular vaccination set, just as it is part of a human’s vaccination set. Because dogs and cats are much more resistant to tetanus than horses and humans, regular vaccination against tetanus is not recommended for them.

Nursing care requires a darkened room with minimal stimulation even if the pet no longer requires hospitalization. Clenched jaws can be problematic for feeding so expect a liquid diet or slurry to be needed. Soft bedding to prevent bedsores is a must.

Improvement is generally noted within the first week of therapy but complete recovery can easily take a month.

Some Tetanus Statistics

Most of the information in this article has been gleaned from a study by Burkitt et al published in the Journal of the American Veterinary Medical Association in January 2007 where 35 cases of canine tetanus seen at the University of California Veterinary Teaching hospital were reviewed for analysis.

Severity Classes

For the purposes of the study mentioned above, cases were classified by the severity of their signs into four groups. It is important to realize that a dog’s initial classification could easily change (in this study 17 dogs that were normal or in Group I at the beginning of the study ended in Group III or IV).

Group I	The dog was able to walk but also demonstrated constricted pupils, risus sardonicus, erect ears, inability to open its jaws, sunken eyes, and/or sensitivity to light.
Group II	All of the above plus erect tail, sawhorse stance, difficulty swallowing, walking stiffly with difficulty.
Group III	All of the above plus muscle tremors or spasms, inability to walk, and seizures.
Group IV	All of the above plus any of the following: heart rate below 60 beats per minute, heart rate above 140 beats per minute, high blood pressure, low blood pressure, or respiratory arrest.

Study Results

The minimal amount of time it takes for an attached tick to transmit disease is not known. The time it takes to transmit diseases is affected by the type of disease organism, the species of tick, etc. However, in general, if a tick is removed within 16 hours, the risk of disease transmission is considered to be very low. Therefore, owners can usually prevent disease transmission to their pets by following a regular schedule to look for and remove ticks.

The Tick Life Cycle

During the egg-laying stage, ticks lay eggs in secluded areas with dense vegetation. The eggs hatch within two weeks. Some species of ticks lay 100 eggs at a time, while others lay 3,000 to 6,000 per batch. Once the eggs hatch, the ticks are in the larval stage, during which time the larvae move into the grass and search for their first blood meal. At this stage, they will attach themselves for several days to their first host, usually a bird or rodent, and then fall onto the ground. The nymph stage begins after the first blood meal is completed. Nymphs remain inactive during winter and start moving again in spring. Nymphs find a host, usually a rodent, pet, or human.

Nymphs are generally about the size of a freckle. After this blood meal, ticks fall off the host and move into the adult stage. Throughout the autumn, male and female adults find a host, which is again usually a rodent, pet, or human. The adult female feeds for 8 to 12 days. The female mates while still attached to her host. Both ticks fall off, and the males die. The female remains inactive through the winter and in the spring lays her eggs in a secluded place. If adults cannot find a host animal in the fall, they can survive in leaf litter until the spring.

What are the best ways to deal with these blood-sucking parasites?

Outdoor Environmental Control

Treating the yard and outdoor kennel area with acaricides (tick pesticides) is an important tool in the arsenal against ticks. Some products can be used to spray the outdoor area. However, you should not rely on spraying to reduce your risk of infection.

If you have health concerns about applying acaricides, check with local health or agricultural officials about the best time to
apply acaricides in your area, identify rules and regulations related to pesticide application on residential properties, and consider using a professional pesticide company to apply pesticides at your home.

You can also create a tick-safe zone in your yard by using some simple landscaping techniques that can help reduce tick populations:

1. Remove leaf litter.
2. Clear tall grasses and brush around homes and at the edge of lawns.
3. Place a 3-ft wide barrier of wood chips or gravel between lawns and wooded areas to restrict tick migration into recreational areas.
4. Mow the lawn frequently.
5. Stack wood neatly and in a dry area. (This discourages rodents who would be used as tick hosts.)
6. Keep playground equipment, decks, and patios away from yard edges and trees.
7. Discourage unwelcome animals (such as deer, raccoons, and stray dogs) from entering your yard by constructing fences.
8. Remove old furniture, mattresses, or trash from the yard that may give ticks a place to hide.

Indoor Environmental Control

If ticks are indoors, flea and tick foggers, sprays, or powders can be used. Inside, ticks typically crawl (they don’t jump) and may be in cracks around windows and doors. A one-foot barrier of insecticide, where the carpeting and wall meet, can help with tick control.

Any spray insecticide labeled for use on clothing should not be sprayed directly on pets.

Powders are fairly easy to apply, but they can be messy. (Avoid topical powders if your pet has a respiratory condition.) Shampoos are useful only for ticks that are already on your pet. A tick collar might be somewhat more water-resistant than a residual insecticide, so if your dog likes to swim, the collar might be a better choice. Flea combs can be used to help remove ticks and wash your pet’s bedding frequently.

Finding and Removing Ticks

The best way to find ticks on your pet is to run your hands over the whole body. Check for ticks every time your pet comes back from an area you know is inhabited by ticks. Ticks attach most frequently around the pet’s head, ears, neck, and feet, but they are not restricted to those areas.

There are several tick removal devices on the market, but a plain set of fine-tipped tweezers will remove a tick quite effectively.

How To Remove A Tick With Tweezers

1. Use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible.
2. Pull upward with steady, even pressure. Don’t twist or jerk the tick; this can cause the mouth parts to break off and remain in the skin. If this happens, remove the mouth parts with tweezers. If you can’t remove the mouth easily with clean tweezers, leave it alone and let the skin heal.
3. After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water.
4. Dispose of a live tick by submerging it in alcohol, placing it in a sealed bag/container, wrapping it tightly in tape, or flushing it down the toilet. Never crush a tick with your fingers.

Risk of disease transmission to you, while removing ticks, is low but you should wear gloves if you wish to be perfectly safe. Do not apply hot matches, petroleum jelly, turpentine, nail polish, or just rubbing alcohol alone. These methods do not remove the ticks and they are not safe for your pet. Rubbing alcohol could be used to disinfect the area before or after removing the tick.

Watch for Infection and Diseases

After you pull a tick off, there will be a local area of inflammation that could look red, crusty, or scabby. The tick’s attachment causes irritation. The site can get infected; if the pet is scratching at it, it is more apt to get infected. A mild topical antibiotic, such as over-the-counter triple antibiotic ointment, can help but usually is not necessary. The inflammation should go down within a week. If it stays crusty and inflamed longer than a week, it might have become infected.

Various diseases can be transmitted by ticks including anaplasmosis, babesiosis, ehrlichiosis, Lyme disease, tick paralysis (or tick toxicosis), and others. Not all species of animals (pets or not) are affected similarly by every tick-borne illness.

Although ticks can transmit diseases contracted from a previous host to pets and humans, they are usually nothing more than a nuisance. The best approach is to prevent them from embedding and once embedded, to remove them quickly. If you notice your pet experiencing signs of illness or acting differently after a tick bite, it is always best to see your veterinarian. If you stay on top of the situation, your pets should cruise right through the tick season with no problems.

Dogs are often brought in for tremoring or shivering episodes. The patient can be any age or any size. Tremors can involve only certain muscles or body areas or the entire dog. Finding the reason behind tremors is tricky as tremoring occurs for many reasons.

The first step is to consider normal reasons for shivering. The patient is:

1. cold
2. frightened
3. asleep and dreaming.

Usually, these can be excluded from being a disease by providing a blanket or sweater, comforting the anxious patient, or rousing the sleeping patient.

Elderly dogs with muscle atrophy tend to suffer muscle fatigue and muscles will shake when over-worked. This type of tremoring is often pretty easy to distinguish as the patient is elderly and the tremors begin when the patient has been standing longer than they would prefer. When a muscle becomes fatigued, tremoring helps release stored glycogen/glucose to permit continued muscle contraction. Tremoring generally stops when the muscle is allowed to relax and the patient rests.

Mild shivers are rarely a significant symptom; it is the more violent involuntary tremors and twitches that indicate neuromuscular disease.

Conditions When Only Certain Body Parts Tremor

If only certain body parts tremor, there are some neuromuscular diseases to consider.

Intention Tremors

Diseases involving the cerebellum of the brain will lead to tremors when the patient directs his attention to a task. The patient may sit quietly without tremors, but if a bowl of food is put out, tremors of the neck and head erupt when the patient reaches for the food.

This sort of tremoring generally goes way beyond what might be described as shivering or even twitching. A classic example of cerebellar intention tremors is seen in kittens born with cerebellar hypoplasia, a neurologic condition stemming from the mother becoming infected with or vaccinated for feline distemper during pregnancy.

Cerebellar disease certainly does not have to be congenital. Any damage to the cerebellum (trauma, tumor, infection, etc.) can produce an intention tremor. An intention tremor is highly suggestive of disease in the cerebellum, though, and diagnostics should be pursued to uncover the nature of that disease. See a video of these wobbly kittens.

Idiopathic Head Tremors

No one really knows why this occurs but some dogs have episodes of head bobbing (usually up and down but can be side to side). Breeds that seem over-represented are Boxers, English bulldogs, beagles, and Doberman pinschers. This condition is totally unresponsive to seizure medications and the best way to curtail an episode seems to be to focus the dog’s attention on a toy or treat. Episodes tend to get milder with age. See this boxer’s head tremors.

Distemper Myoclonus

Dogs that survive a canine distemper infection may suffer from seizures, paralysis, or muscle twitching long term. Often a young dog is adopted from the shelter or rescue, and her history is unknown. Distemper myoclonus appears as involuntary twitches of muscle groups anywhere on the body. Multiple areas can be involved. These twitches are not seizures and do not respond to seizure medications. Numerous medications have been used with inconsistent results. The most successful treatment has involved injections of cosmetic Botox® into the muscle group involved, but this therapy is expensive and many dogs do not seem particularly inconvenienced by their myoclonus. The black dog is showing myoclonus of his jaw and neck muscles.

Orthostatic Tremors

This condition is observed only when the dog is standing and involves tremors of the leg muscles. The patient is typically a young, very large-breed dog (Great Dane, mastiff, Weimaraner). The condition tends to progress in severity over time and may come to require treatment. It is generally responsive to phenobarbital and/or to gabapentin.

Conditions When the Whole Body Tremors

If the entire dog is shivering and shaking, then we must consider diseases that involve the entire dog. Normal muscles rely on oxygen, nutrients, and electrolytes from the bloodstream as well as normal electrical stimulation from the nervous system.

We need to look at problems with these systems:

1. Hypocalcemia (low blood calcium, especially if nursing puppies)
2. Hypoglycemia (low blood sugar)
3. Toxins (especially snail bait and insecticides)
4. Little White Shaker Dog syndrome (which does not actually require that the patient be a white dog), is also called non-suppurative meningoencephalomyelitis or steroid-responsive tremors.
5. Seizures/epilepsy.

Severe tremors can elevate the body temperature dangerously and cause brain damage. Patients for which tremoring is an emergency are generally clearly mentally distressed by the involuntary motions or disoriented from the underlying neurologic disease.

Many toxins can cause twitches and involuntary muscle tremors, so it is important to let your veterinarian know what products are in your home. What flea products do you use? Do you have pesticides in the garden? These products are frequently neurotoxins that produce seizures and twitching. Snail baits containing metaldehyde are particularly common, as are permethrin-based flea products (generally safe for dogs but cats are uniquely sensitive). Tremors are a notable feature of chocolate toxicity. Obviously, poisoning is an emergency so you will need to see your veterinarian or local emergency service right away.

Brain diseases can produce seizures that can manifest as persistent but fine tremoring or more violent convulsions. Metabolic diseases, such as low blood sugar or low blood calcium, can lead to tremors and even seizures. Muscle diseases such as tetanus can lead to involuntary muscle contraction. Twitches and tremors may be intermittent and are certainly not always emergencies; however, blood testing and possibly advanced neurological testing may be needed.

Your first step is going to be an evaluation with your veterinarian to narrow down the search and complete the necessary basic tests. Not all veterinarians are comfortable diagnosing neurologic disease, so discuss with your veterinarian whether referral to a specialist would be best for you and your pet. The best treatment plan can be made from there.

The small white dog in this video has White Shaker syndrome. It is generally controlled with immune-suppressive doses of corticosteroids. The prognosis (outlook) is generally good.

A dog with arthritis around that joint or who has or has had a jaw fracture may chatter their teeth in response to that pain. Teeth can rub together if the jaw is clenched or from grinding the teeth. Imaging such as X-rays or computed tomography (CT) (both done under anesthesia) may be recommended to help your veterinarian better visualize what is happening in the jaws or mouth.

Even though the most common cause is somewhere in the mouth, the source can be elsewhere, including the gastrointestinal tract, or involving a neurologic disease. In some greyhounds, and likely in some other breeds, it’s a relatively common sign of anxiety and often ends as the cause of anxiety ends, such as a veterinary appointment.

Generally, the first step in treatment is a tooth-by-tooth exam under anesthesia with dental imaging, either X-rays or a CT scan.

Tooth Resorption

Tooth resorption is when the dentin, or the harder outside of a tooth, is inflamed and disintegrating. Teeth need to be evaluated closely for any tooth-resorbing lesions, as oral lesions may not be visible even on dental radiographs.

Identifying tooth resorption can be difficult, and choosing which teeth to pull requires experience and judgment. You and your veterinarian should discuss whether referral to a veterinary dentist is in your pet’s best interest.

Gastrointestinal Issues

With some gastrointestinal issues, dogs may become nauseous, vomit, drool, or have gastroesophageal acid reflux. Lab work and imaging, such as ultrasound or endoscopy (a camera scope fed into the GI tract) or surgery, might be recommended. In cases caused by gastrointestinal issues, medications may help stop the chattering within the first week.

Focal Seizures

Focal seizures are sometimes a neurological cause of teeth chattering. A focal seizure is a type of seizure that only affects a certain area in one half of the brain, not both halves. A dog with focal seizures may chatter their teeth or display what may be referred to as “fly-biting behaviors,” where they snap at the air as if chasing an insect. However, unlike other causes of teeth chattering, a dog experiencing focal seizures will not respond to you as they normally would when you call them by name, make noise, or so on, and they may seem to stare off into space.

Before this type of seizure, your dog may act unusual, such as walking back and forth or clinging to you. If your dog stops chattering their teeth during a short trial of anti-epileptic drugs, the cause of the chattering is likely related to the seizures.

Other less common causes of teeth chattering exist, such as pain in other parts of the body or even hormonal changes. A physical examination and consultation with your trusted family veterinarian, along with appropriate testing, can help pinpoint the cause of chattering and help guide treatment.

Additionally, taking videos for your veterinarian and listing all signs can be helpful to get them started on the best diagnostic path for your pet.