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Pet First Aid: Responding to Pet Emergencies at Home

Working in emergency medicine, we get numerous calls from people wondering what they can do with their pet in an emergency prior to coming in to the office. While the majority of treatments on your pet should be done by a veterinarian or a member of a veterinary staff, there are some things you can do to help your pet prior to transport.

Preparing to Transport Your Pet
The most important thing to remember is that you should never do anything to assist your pet that will cause harm to yourself. Even the most gentle pet, when in pain, may try to bite and/or scratch you. The most frequent occurrence of this situation is after a pet is hit by a car — we often see clients who have been bitten by their pets while trying to tend to them and transport them. For dogs, placing a large blanket or towel over the head, with room for them to breathe, can help prevent injury to yourself. You can also use a towel with cats, and it’s a great idea to put on sturdy work gloves and a long-sleeved shirt prior to picking them up.

With an animal that has been hit by a car, it’s also helpful to slide the animal gently onto a board, blanket or sturdy piece of cardboard — this will help protect against possible trauma to their spinal cord or neck. It’s also important, especially in patients that are having trouble breathing, to keep your pet sitting up on their sternum (chest) — that will help them aerate both sides of their lungs and breathe more easily. You can place thick towels on either side of them to help keep them propped up in this position.

Getting Bleeding Under Control
When it comes to pet injuries, a bleeding pet typically leads to a frantic owner, so it’s important to stay calm and focus on helping your pet. To be prepared for such an event, having a first aid kit on hand for your pet — including gauze and materials needed to make a bandage — is a very good idea. One important initial word of advice is that if there is foreign material sticking out of the wound, do not try to remove it yourself. The foreign object could be pressing up against a blood vessel or penetrating an organ, and removing it could cause more harm than good. This includes foreign material sticking out of the eye.

For penetrating wounds (such as bites) and wounds that are bleeding heavily, apply firm pressure and place a firm pressure bandage over the wound. If the bleeding is on a limb, you can also try to raise that limb above the level of your pet’s heart to help slow the bleeding. For nose bleeding, apply ice to the bridge of the nose to slow it down, and try to keep your pet laying on their sternum (chest), as we discussed above.

One of the most common bleeding problems we see on an emergency basis is a bleeding toenail, which includes a toenail that has broken or has pulled out. This kind of injury can bleed profusely and run all over a floor or rug (I refer to this as “crime scene bleeding”). To help bring the bleeding under control at home, you can place the bleeding toe in some corn starch, a bar of soap or a stick of underarm deodorant containing zinc.

Dealing with Toxicities
Toxicities are also a common emergency we deal with here at Greenbrier Emergency. With so many different substances toxic to pets — and many substances you might otherwise not think of as toxic — always call a veterinarian if you suspect that your pet has gotten into something. In this kind of situation, many people consider trying to make their pet vomit to remove the toxic substance. But with some household products and medications, inducing vomiting in a pet can cause more harm than good. Your pet, if poisoned, may not be able to swallow correctly and end up inhaling some of its vomit, creating a whole new problem known as aspiration pneumonia. Also, some products can cause more irritation to the esophagus and mouth on the way back up than on the way down.

Because so many common plants are toxic to pets, I usually recommend that people keep a list of the types of plants they have in and around their house. Telling your vet, “they got into a big green one,” doesn’t help us pinpoint the exact toxic agent and resolve the problem.

For other common toxic household substances like rat poison, try to keep them stored in a place that is inaccessible to your pet. And if you smoke, don’t throw your used filters outside — nicotine is a toxic agent to pets, and any remaining tobacco, eaten by your pet in large enough quantities, can cause serious problems.

Call Ahead!
If you ever do have an emergency situation with your pet, if possible, please call a veterinarian or Greenbrier Emergency to let them know you’re on your way. That will help them get set up and be prepared to handle your pet’s specific problem and treat them as quickly and effectively as possible.

© 2010 Greenbrier Emergency Animal Hospital. All rights reserved.

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Parvovirus: Make sure your dog is protected!

A lot of you have probably heard of parvovirus, commonly referred to as just “parvo.” This disease is characterized by weakness, vomiting and extreme diarrhea (often with blood in it). Parvo is mostly found in young dogs, aged 6 weeks to 6 months, but it can be found in older adult dogs as well. Younger dogs are often more severely affected. Predisposed breeds include Rottweilers, Labradors, American Staffordshire Terriers and “pit bulls,” although any dog can be affected (I diagnosed this disease in a Shih Tzu earlier this year). Parvo is shed in the stool and has fecal-oral transmission — meaning that dogs become infected by eating infected substances (e.g., feces or grass with feces on it) or grooming other dogs with feces on their rears. And this little virus is hard to get rid of — once it is in your yard, it can last for up to a year.

What effects does Parvo have on your dog? In addition to the above-mentioned lethargy, vomiting and extreme diarrhea, this virus can do some truly awful things to your pup. Parvo is so debilitating that many pets have to be hospitalized for several days — if not weeks — with intravenous fluid support, antibiotics, anti-nausea injections, antacid injections and plasma transfusions. The virus can also severely decrease your pet’s white blood cell count and protein levels. And in rare instances, Parvo can even have effects on your pet’s heart or can create an obstruction in your pet’s intestines, causing the intestines to “fold in on themselves” and close off — an obstruction that requires surgery to fix. Although not all pets are this severely affected and some can be managed on an outpatient basis, some pets do die from this disease.

So what can you do to prevent this disease in your pet? Vaccines are available and are, for the most part, very effective. Occasionally a vaccinated pet can still get parvo, but in those cases the disease is often less severe than if they had not received the vaccine. Talk to your veterinarian about when to vaccinate and how many vaccines your pet needs — predisposed breeds often need more vaccines than other breeds. Also, do not take your pet to a place where there has been parvovirus within the last year. And if you yourself come into contact with a dog that has parvovirus, take care not to become a “fomite” &mash; when exposed, people can act as carriers and spread the disease to their own pets. After contact with an infected dog, Parvo can be found on your hands, clothes or shoes — so wash your hands, change your clothes and take off your shoes to help avoid bringing this disease home to your pet. Bleach in a 1:30 dilution with water can kill parvovirus on your floor and other surfaces, if you allow the solution to sit for approximately 10 minutes.

If you suspect your dog may have parvovirus, keep him/her away from all other dogs and take your pet to a veterinarian as soon as possible. Your veterinarian can perform a “snap test” to check for the virus. If your dog has been diagnosed with this disease, be sure to clean up all of his/her stool immediately, do not allow your pet to be around other dogs, and do not introduce another dog into your house without consulting your veterinarian first.

© 2010 Greenbrier Emergency Animal Hospital. All rights reserved.

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Grape toxicity and pets: Delicious but deadly

Grapes may be one of people’s favorite fruit-based snacks, but they are not a safe snack for our pets. While grapes don’t cause humans any harm, they can cause acute kidney failure in dogs, and even possibly in cats. Despite recent research, the exact agent in grapes that causes the toxicity is still unknown. It was previously thought that perhaps something related to pesticides or heavy metals in grapes was causing the problem, but that hypothesis has since been disproven. Current theories suggest that the fleshy portion of the grape, rather than the seed, is the toxic culprit. Thompson seedless grapes, the common green ones from the supermarket, statistically seem to create the highest number of problems in animals — however, this could just be because that variety of grape is the most commonly purchased. Other products made from real grapes, such as raisins, grape juice and grape jelly, have also shown to cause problems. And heated and fermented grape products, like those used in baked cookies and cakes with raisins, can also be toxic to pets. One notable exception is grape seed extract, which is found in some pet products and synthetic grape-flavored medications, and is not currently thought to be a pet hazard.

One of the most frustrating things for owners is just how small an amount of grape ingestion can be toxic. I have had people tell me, “Well, he only ate 2 or 3 grapes,” or “Well, he got into some trail mix with raisins, but there weren’t many in it.” Unfortunately, any known grape ingestion — regardless of the amount — could potentially cause a problem.

People also tell me, “I have been giving my pet grapes for years without a problem.” Regardless of what you may have given your pet in the past, that doesn’t ensure that your pooch won’t react badly to grapes in the future. In fact, some dogs that have eaten grapes in the past with no signs of toxicity ultimately may run into trouble with them. The consequences of grape toxicity can be severe, so why take the risk? To avoid these kinds of problems, we highly recommend not giving your pet grapes in any amount.

Like many other products that are toxic to animals, your pet may appear normal for up to 24 hours after they eat grapes or a grape product. Within 24 hours or so, you might start seeing them not wanting to eat, vomiting, acting like their abdomen is in pain or experiencing diarrhea. Within 48 hours after ingestion, they can start experiencing more serious problems, such as showing a decrease in the amount of urine they produce — or not producing urine at all. These are some of the signs of acute kidney failure.

And just like any toxicity, early treatment is the key. If you suspect your pet has eaten grapes, raisins or products containing them, bring your pet to Greenbrier Emergency Animal Hospital or to your regular vet as quickly as possible. Grapes can sit in the stomach for hours after being ingested, so your vet will most likely give your pet an injection to make them vomit. They may also be given what is known as activated charcoal to help bind up any additional grape products in the GI tract. Your pet will also likely be placed on intravenous fluids for 48 hours and have their kidney function checked daily for 72 hours via a blood test. The prognosis of any given case usually corresponds with how soon you realize that your pet has eaten the grapes — and how fast you react to get them the proper treatment.

© 2010 Greenbrier Emergency Animal Hospital. All rights reserved.

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Winter Hazards for your Pet

Now that the holidays are upon us, I thought it would be a good time to remind pet owners of the many common household items that can be hazards to pets during the winter season. I’ll start with a list of common food items that can present serious problems for pets. Many of these items have their very own blog entries, so please search our blog after you read this post if you’d like more detail. I am constantly surprised by how many people aren’t aware that these foods are potentially toxic to pets, so I don’t think we can list them too often.

Foods
Yeast bread dough: converts to alcohol, causes bloating
Moldy foods: contain toxins that can cause tremors
Macadamia nuts: can lead to weakness, depression, vomiting
Chocolate: GI and cardiac signs, can make pets hyper excitable
Onions, garlic, leeks, onion powder: can lead to anemia
Xylitol (contained in sugarless gum): causes low blood sugar, liver toxicity and blood clotting disorders
Grapes/raisins: can lead to kidney failure. For some dogs, it only takes a few.
Fatty foods: can cause pancreatitis

Plants
The following plants are toxic to pets:
Lilies: can cause kidney failure in cats
Holly: can cause gastrointestinal problems, lethargy
Mistletoe: can cause gastrointestinal problems and is a cardiotoxin
Poinsettia: can cause irritation to the mouth and gastrointestinal problems and is a mild toxin

Holiday-related items
Since many of the items below only come out seasonally, they can be a novelty — especially for those curious cats or puppies. Take care to pet-proof your holiday decorations!
Christmas tree water: can be laden with bacteria and/or pesticides; causes gastrointestinal signs
Ribbons/tinsel: cats especially love these, and they can cause linear foreign bodies requiring surgery
Liquid potpourri: can cause severe oral, ocular and dermal damage
Electric cords: can lead to electrocution, fluid in lungs

Other toxic items
Antifreeze: Extremely toxic to animals!! Lethargy, “drunk” behavior, kidney failure
Ice melt: irritating to skin, paws and mouth

Please keep your pets safe this holiday season. If you think your pet has ingested any of the above, please seek veterinary attention immediately. Many of these toxins can be mitigated with early veterinary intervention.

Dr. Elvira Hoskins

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Giardia…cha cha cha…

Diarrhea has a number of causes, but one that we saw quite a bit in our patients this summer is Giardia, a parasite that is transmitted in stool (Giardia can be transmitted to humans in this way, but people most often get this parasite from contaminated water). Once a pet is infected, it will typically take 5-12 days in dogs and 5-16 days in cats for the parasite to be found in the stool — however, diarrhea can occur before the parasite actually shows up in the stool.

To diagnose Giardia, your veterinarian will need a fresh stool sample from your pet. As this parasite cannot be detected by the naked eye, the doctor will examine the sample under a microscope. Sometimes the test may need to be repeated, as this parasite can shed intermittently — so while an initial test may come up negative, further tests may come up positive. A newer variety of test is the “snap test,” which tests for Giardia proteins in the stool. The snap test does help improve diagnosis; however, while almost all veterinarians have the capability to look at a stool sample under the microscope, the snap test is less readily available, and not all veterinarians will be able to offer it.

Treatment for Giardia involves multiple aspects of your pet’s life. Oral dewormers are given, as with many intestinal parasites. But with Giardia, bathing and hygiene are just as important as medication. This parasite can stick to your pet’s fur, and when the animal licks itself, he or she can be reinfected. You will also need to dispose of all stool immediately, and clean bedding and flooring regularly. Diluted bleach will kill this parasite on floors and in the laundry — however, killing Giardia on surfaces like grass is far more difficult, since it would require killing the plant life as well.

Other preventative measures include wearing gloves when handling stool and always washing your hands after handling stool or playing with your pet. There is a Giardia vaccine available, but this particular vaccine does not prevent infection. Instead it reduces the amount of the parasite shed in the stool, thereby reducing the amount of environmental contamination. This treatment doesn’t usually help animals that have already contracted the parasite, but it may be helpful in kennel situations and with pets that keep getting reinfected.

If your pet has diarrhea, please give your primary care veterinarian or Greenbrier Emergency Animal Hospital a call as soon as possible. We can help diagnose the cause and get your pet the treatment that he or she needs.

© 2010 Greenbrier Emergency Animal Hospital. All rights reserved.

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Cats and Abscesses: Don’t Let Them Go Untreated!

Abscesses are a serious condition that warrant treatment — and frankly, they are pretty fun to treat. At Greenbrier Emergency Animal Hospital, we generally see abscesses in our feline patients who spend time outdoors socializing with other neighborhood cats and creatures, since abscesses are usually caused by a bite from another animal. We tend see to them on the back part of a cat’s body, although they can occur anywhere. Typically, a cat will receive such a bite while running away from a predator — and trying to escape a potentially much more serious injury (or worse).

Because most cats are furry, a puncture wound or bite wound will typically be covered by hair, so it will be difficult to spot. And when your cat returns home, it likely will resume its normal activity (eating and sleeping), so you probably won’t suspect a thing. But after a bite, there’s often trouble brewing beneath your cat’s skin.

Bite wounds frequently cause small punctures where bacteria from the predator’s teeth are having a grand old time. The skin wound seals up, and the bacteria continue to multiply and fester below the skin surface. About four days after a bite takes place, you may start to notice that your kitty’s appetite is diminished, or that it doesn’t want to come out from under a bed. In short, your cat just may not be acting like its normal, happy self.

At this point, your cat needs to see a veterinarian. Most cats with an abscess will have a fever — and if left untreated, a simple ailment can spiral out of control and become a much larger, more serious medical issue. Dehydration is also common in these cases, since cats who are feeling crummy tend not to eat and drink as they should.

At Greenbrier Emergency Animal Hospital, in this kind of situation, a full physical exam will be performed on your pet, and an estimate will be presented to you before any treatments are carried out. Generally in this circumstance, your cat will need to be sedated for treatment, and the abscess will need to be lanced. The wound will be flushed out, and often a drain will be surgically placed so that the wound does not seal right back up. The wound will need to drain for 2-3 days, after which time the drain can be removed by your family veterinarian.

Antibiotics and sometimes pain medication will be dispensed to take care of the infection and treat your cat’s discomfort. We often offer an injectable antibiotic that lasts for 2 weeks, in order to keep you from the hassles of trying to get your cat to take an antibiotic pill or liquid at home.

Recovery from an abscess generally takes a few days, but your cat should perk up and want to eat and drink normally within 24-48 hours. If at that point your kitty still isn’t feeling up to snuff, a recheck exam should be scheduled as soon as possible.

© 2010 Greenbrier Emergency Animal Hospital. All rights reserved.

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Oh no!! My pet had a seizure!!

Seizures can have a number of causes, including toxins, low blood sugar, low calcium, kidney or liver problems, blood clots to the brain or “strokes,” infectious diseases, inflammation of or around the brain, cancer, epilepsy, and trauma. In pets that are predisposed to having seizures, stress and different medications can also cause seizures. In addition, stopping certain medications can cause seizures.

Both cats and dogs, along with our exotics, can have seizures. Seizures can be focal (isolated) or generalized. Although cats can experience either type of seizure, they more often have focal seizures, which may include symptoms such as facial twitching, dilated pupils and running into objects abnormally. Sometimes cats’ seizures can be so focal that they go unnoticed for periods of time.

Dogs can also have both generalized and focal seizures. Generalized seizures often involve severe muscle contractions, loss of consciousness and repeated jaw clamping. They may salivate, urinate and defecate as well. After the seizure subsides, your pet may be disoriented, start pacing, seem confused, be blind, or display other abnormal behaviors (e.g., aggression, fear, etc.). This period can last for anywhere from minutes to hours.

Seizure frequency is widely varied. Some pets have one seizure and never have another. Some have seizures more frequently (e.g., once every 6 months), but their seizures don’t significantly impact their quality of life. Others have more frequent episodes that do affect quality of life and therefore require medication. And still others have such severe seizures that medical management is ineffective.

So what should you do if your pet has a seizure? Bring him/her in to a veterinarian immediately. Your veterinarian can administer medications to help stop the seizures and will also likely recommend blood work to rule out potential causes of the seizure. Your veterinarian may also prescribe medications to help prevent further seizures, depending on their severity. Not all pets require long-term medical therapy, however.

Seizures that repeat more than once during a 24-hour period, seizures that happen one after another, and seizures that last more than 4 minutes are medical emergencies that need to be seen immediately. If your pet is having a seizure, do not place anything — especially your fingers — in his/her mouth! During a seizure, a pet does not know what is going on and can bite without intending to. They will not swallow their tongue. Keep them away from stairs and other places where they can injure themselves. If your pet has had seizures previously, keep a seizure log of what time the seizure started, how long it lasted, whether there was anything different about the environment (stress and thunderstorms can actually precipitate seizures), whether it was a focal or generalized seizure, and any medications given.

© 2010 Greenbrier Emergency Animal Hospital. All rights reserved.

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What did my dog get into … ivermectin?

Here at Greenbrier Emergency Animal Hospital, we’ve had two very interesting cases lately. This first one was a middle-aged dog who was disoriented. On examination, he was suddenly and completely blind! The second case was a 7-week-old puppy who was normal when the owner went to bed — but In the morning, when the owner woke up, the puppy couldn’t walk and was barely responsive. On examination, this puppy was also suddenly blind! What did these two cases have in common? They were both either on or near a horse farm. Ivermectin toxicity was suspected in both cases, and within a few hours (for the puppy) and a few days (for the older dog), they were completely back to normal.

Ivermectin is a drug commonly and safely used in many dogs to treat a variety of parasitic infections. This drug is also commonly used in cattle and horses at much higher doses — which can be toxic to dogs, if they are exposed to the medication. Certain types of dogs, including but not limited to collies and Australian shepherds, are also far more susceptible to the toxic effects of the drug.

Toxicity signs include depression, disorientation, nonresponsiveness, blindness, drooling, tremors, and walking like he/she is “drunk.” More severe signs, especially in the susceptible breeds, include low heart rate, low breathing rate, coma and death.

Treatment often is centered around supportive care, which may include intravenous fluid therapy, nutritional support and appropriate nursing care. Although ivermectin toxicity can be fatal in rare cases, many dogs do well and make full recoveries. Sometimes it just takes time. If your pet is displaying any abnormal neurologic behavior, or you suspect your pet has ingested anything toxic, bring him/her to your local veterinarian (or to Greenbrier after hours) immediately.

© 2010 Greenbrier Emergency Animal Hospital. All rights reserved.

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Diarrhea…cha cha cha…

No one wants to talk about it, but sometimes our pets get diarrhea. Diarrhea can range in consistency from soft to very watery, and in color from black to brown to bright red and bloody. Your pet may have large amounts of diarrhea, or small amounts with more frequent trips to the bathroom.

Two of the most common causes of diarrhea are parasites and dietary indiscretion, otherwise known as “eating something they’re not supposed to.” However, there are a lot of other causes, including bacterial overgrowths; viral diseases such as parvovirus; abrupt diet changes; food allergies; abnormal digestion and absorption diseases; stress; toxins; drugs; metabolic diseases such as diabetes and Addison’s disease; kidney, liver and pancreatic abnormalities; inflammatory diseases; and in our older patients, cancer. (This is by no means an all-inclusive list, however!)

If your pet has diarrhea, your veterinarian will likely want to start by running a “fecal,” which tests the stool for parasites. When you go to your veterinarian, you can bring a sample of the stool with you, if it is fresh, for them to test. Be sure to wear gloves when handling stool, and wash your hands directly after, as some parasites can be transmitted from pets to people! Depending on the age of your pet and the severity of the diarrhea, other tests that may be run include parvovirus tests and blood work. Chronic diarrhea may require further testing and colonoscopy with biopsy samples.

Treatment for diarrhea depends on its severity, cause and duration. Your veterinarian may put your pet on a bland diet. Parasite infections are often treated with deworming medication. Sometimes your pet will need antibiotics or fluids. For severe cases, your pet may need to be hospitalized and given intravenous fluids and injectable medications.

If your pet has developed diarrhea, bring him/her to your local veterinarian, or to Greenbrier Emergency Animal Hospital if it is after hours. They can decide on the appropriate treatment to help your pet feel better.

© 2010 Greenbrier Emergency Animal Hospital. All rights reserved.

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What’s in the pond water? Water-borne parasites

Ever worry about what your pet could be contracting when he/she stops and drinks out of a pond or other stagnant body of water? Many water-borne parasites can cause clinical signs that are anywhere from mild to severe. The most common parasites include, but are not limited to:

Giardia: Giardia is a protozoan that can live for a long time in stagnant water. It causes diarrhea, which is often watery but not bloody. It can be hard to detect on a regular fecal float at your vet, and often further testing is required. It is shed intermittently in the feces, making detection that much harder. The most common treatments are fenbendazole and metronidazole. There is a vaccine for giardia that does not prevent the infection, but does prevent shedding of the protozoan — making it useful in kennel-type situations. Is it transmittable to humans? Yes, humans can be affected by drinking contaminated water.

Coccidia: Coccidia is a single-celled organism that is transmitted by the fecal-oral route, meaning that it is passed in the stool of the host and ingested by another host. The most common form of Coccidia Isospora is species-specific and therefore is not cross-transmitted. Coccidia causes watery, voluminous diarrhea, with or without blood. It is easily passed to young animals with weaker immune systems but rarely affects adults. It is usually detected on a fecal flotation, but a very small amount of Coccidia can cause an infection, so it can be missed on a fecal flotation. Coccidia is commonly treated with Albon or sulfa drugs. Can it be passed to humans? The most common form is species-specific, but humans can contract the Coccidia toxoplasma from cats, which can be a risk for pregnant women.

Leptospira: Leptospira is a spirochete bacteria that affects dogs and rarely cats. It thrives in warm, stagnant water such as a marsh or muddy area and is usually shed in the urine of wildlife or rodents. It initially causes a fever; then the fever subsides, and the clinical signs progress to liver damage and kidney failure. Leptospira can be detected by a blood test. Many dogs are vaccinated for Lepto as part of their annual checkup. The vaccine is specific for certain serovars or strains of Lepto, so it is still possible to contract Lepto after being vaccinated. The treatment for Leptospira is supportive care and antibiotics, but the prognosis is poor.

Campylobacter: Campylobacter is a bacteria often found in water contaminated with feces. It mostly affects puppies less than 6 months of age, and rarely affects cats. It is often isolated from the GI tract of normal adult dogs, but can overwhelm the system in puppies, causing a high fever and watery, mucoid or bloody diarrhea. The diagnosis is made on a fecal wet mount. Animals that are positive for campylobacter and have an associated high fever are treated with antibiotics.

Cryptosporidia: Cryptosporidia is a protozoa affecting both cats and puppies usually less than 6 months old. It is usually found in water contaminated with feces. It causes watery diarrhea, weight loss, bloating, gas and nausea. It is hard to detect on routine fecal flotation, and usually is detected by sending a fecal out to a lab that uses special flotation solution. The clinical signs are usually self-limiting and rarely require treatment other than a bland diet for three days. If the diarrhea is severe, occasionally IV fluids and supportive care are required.

The majority of the water-borne parasites cause diarrhea, which is treatable in a healthy animals. An immuno-compromised or otherwise debilitated animal might have more severe clinical signs. Among water-borne parasites, Leptosporidia carries the poorest prognosis if it advances to liver and or kidney failure. The best prevention is to make sure your dog is vaccinated, to carry fresh water for your dog, and to try to discourage them from drinking from stagnant water.

© 2010 Greenbrier Emergency Animal Hospital. All rights reserved.

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