Spinal cord injuries are common in dogs, and the most common type of spinal cord injury is a disc herniation.  Disc herniations can cause anything from minor discomfort to complete paralysis.  Rapid detection and treatment are often the difference between a full recovery and permanent damage.

As a pet owner, it is important to be able to recognize signs of a disc herniation or other spinal cord injury. Following are some common signs:

●    Arching of the back

●    Holding the neck stiff or refusal to turn or lift the head

●    Weakness of the legs (most often the hind legs, but any combination is possible)

●    Loss of coordination—dragging feet, walking on the knuckles, crossing the feet over, acting “drunk”

●    Holding a leg up in the air

●    Muscle spasms along the back, neck, or shoulders

●    Pain when touching along the back or neck

If you see any of these signs, your dog should be examined by a vet immediately.  Early signs of pain can progress to become worse injuries.  Any loss of function in the legs (loss of strength or coordination) should be treated as a true emergency, and you should try to take your dog to an emergency clinic if your primary vet is unavailable.  IF YOUR DOG HAS SIGNS OF A SPINAL CORD INJURY, IT IS IMPORTANT NOT TO WAIT.

If your vet suspects a spinal cord injury, they may prescribe anti-inflammatory or pain medication, or they may suggest advanced testing and treatment, depending on the severity of signs.

For severe disc problems, specialty care is necessary for the best chance of recovery.  Advanced imaging, such as MRI, can be used to diagnose the problem, and the most serious cases require spinal surgery.  Primary care veterinarians will typically refer you to a board-certified veterinary neurologist for such procedures.  A specialist can work with you and your vet to provide the best possible care for your pet.

The Internal Medicine Service at CARES is pleased to announce extended hours for new consultations!  In addition to providing Internal Medicine services during regular business hours, Monday through Friday, Dr. Murray and Dr. Adler are now available Tuesday and Thursday evenings and two Saturdays per month.  We hope that these extended hours will provide your clients with greater flexibility and convenience.  Appointments can be scheduled with our friendly reception staff.  As always, your phone calls with any questions are welcome!

Osteosarcoma Vaccine Study

Evaluation of a new cancer vaccine to stimulate anti-tumor immunity and prolong survival times in dogs with osteosarcoma

CARES is excited to announce that it is teaming with the University of Pennsylvania for an exciting new study into the treatment of canine osteosarcoma.  The study will combine the standard of care treatment (amputation and chemotherapy) with the addition of immunotherapy using a novel cancer vaccine.  You are welcome to contact the Oncology or Surgical Service to discuss the study or have the owners come for a consultation with their pet.

Osteosarcoma (bone cancer) is most commonly seen in large and giant breed dogs.  It is an aggressive cancer and despite amputation and chemotherapy many dogs will die from their cancer that spreads to the lungs. The purpose of this study is to determine whether a new biologic (vaccine) can 1) stimulate the immune system to attack tumor cells that may remain after amputation and chemotherapy and 2) prolong survival in dogs with osteosarcoma of their long bones.

The University of Pennsylvania’s School of Veterinary Medicine is conducting a pilot phase I dose escalation study to determine the dose of a L. monocytogenes expressing huHer-2/neu recombinant vaccine that can effectively stimulate an immune response against the tumor  and prolong survival in dogs with osteosarcoma. Only those dogs with a confirmed diagnosis of osteosarcoma by histopathology (either prior to or following amputation) and who have undergone standard of care limb amputation and chemotherapy (4 doses of carboplatin) will be eligible for inclusion in the study. Only those patients whose tumors express the target Her-2/neu will be eligible for inclusion in this study.

At enrollment (3 weeks following the last dose of carboplatin chemotherapy), all eligible dogs will receive basic clinical laboratory tests including bloodwork and urinalysis and a baseline evaluation of cardiac function by echocardiography.  Chest radiographs will be taken to determine whether cancer has spread to the lungs (metastases). Only dogs with no evidence metastases will be eligible for inclusion in the study.  At the time of enrollment, a blood sample will be taken to assess immune function and baseline levels of anti-tumor immunity.

All dogs will be vaccinated at the Matthew J. Ryan Veterinary Hospital at the University of Pennyslvania using a L. monocytogenes expressing huHer-2/neu recombinant vaccine; there is no placebo group. The first vaccine will be given three weeks after the last dose of carboplatin chemotherapy. Patients will receive a total of 3 vaccines given three weeks apart. Patients will stay in the hospital for 48 hours following vaccine administration for observation and bloodwork.

Benefits:

• Complete staging of disease at the time of enrollment  (blood work, urinalysis, immune function assessment, chest x-rays, cardiac evaluation)
• Three Listeria monocytogenes vaccines
• Hospitalization for observation
• Blood work, urinalysis and cardiac evaluation every three weeks for a total of 9 weeks
• Routine staging every 2 months following last vaccine administration (blood work, urinalysis, immune assessment, chest radiographs, cardiac evaluation)
• Four doses of carboplatin chemotherapy for dog’s whose tumors expresses Her-2/neu and who are eligible for inclusion in the study

There is no cost to participate in this study.  The cost of carboplatin will be covered for the eligible patients who enroll.   Initial diagnosis, amputation and related charges are not covered by the study.

Find us on Facebook at www.Facebook.com/CARESvet

Come visit CARES at two great events this weekend.  On Saturday we’ll be at the Mercer Regional Chamber of Commerce Pet Expo at Mercer County Waterfront Park from 10 a.m. to 4 p.m.  On Sunday we’ll be at Paws in the Park 2011 – Take a Bite Out of Canine Cancer.  That takes place at Neshaminy State Park from 10 a.m. to 3 p.m.  Hope to see you there!

To qualify for the study,

(1)    Patients must be dogs that have a confirmed diagnosis of sarcoma.  This includes tumor types such as hemangiosarcoma, osteosarcoma, and histiocytic sarcoma.

(2)    Patient should not have prior chemotherapy treatment within the past 2-4 weeks.

(3)    Treatment recommendations must include Doxorubicin (Adriamycin) chemotherapy treatment given once every 2 weeks for at least 4 treatments.

(4)    Patients must be healthy enough to undergo treatment.

Owners must be willing and able to

(1)    Understand and sign the informed consent.

(2)    Bring their pets to CARES for treatment appointments for approximately 10 weeks.

(3)    Give oral medications at home as per the study schedule.

(4)    Maintain a daily quality of life journal provided by the study.

Benefits of participation in the trial include financial compensation up to $690, standard-of-care treatment provided to the patient, the potential of benefit from the drug being evaluated, and the opportunity to improve the lives of future cancer patients who will benefit from the knowledge gained by this study.

To schedule an appointment to discuss participation and determine whether your pet qualifies, please call (215) 750-2774.

Shoo flea…don’t bother me!

Did you know that having a flea allergy is one of the most common causes of allergic reactions in cats and dogs?  It’s called flea allergy dermatitis and is a type I and type IV hypersensitivity reaction.  Dogs and cats are actually allergic to a component of the flea saliva, therefore, when the flea bites the animal, they inject the saliva into the skin which initiates the allergic reaction.  This type of allergy can occur at any age. The time of year we most commonly see flea allergy dermatitis in the Mid-Atlantic region is in the warm, rainy seasons.  However, depending on where you live in the country, flea allergy dermatitis may be a year round problem.  If your pet has a flea allergy it does not mean that the pet is infested with fleas.  It only takes a few bites from a single flea to initiate the allergic reaction.

So, how do you know your pet has a flea allergy?  It is actually uncommon to find fleas on your pet since it may only be one or two fleas causing the problem.  Also, a dog or cat’s grooming habits such as scratching or chewing may remove all visible fleas.  The most common areas of the body that can be affected by flea allergy dermatitis is the rump, lower back and tail region, however, any area of the body may be affected, especially in cats.  One of the most common manifestations in flea allergic dogs is the recurrent “hot spot.”  Other clinical signs of a flea allergy in cats and dogs includes moderate to severe itching, chewing, hair loss and a raised red rash.  Flea allergic patients may often have a secondary bacterial skin infection as well.

How is flea allergy diagnosed?
Flea allergy dermatitis is most commonly diagnosed by the patient’s history, clinical signs, and response to treatment.   The absence of fleas does not rule out a flea allergy in your pet and there are specific allergy tests which can definitively diagnose your pet with a flea allergy including serological (blood) allergy testing and intradermal (skin) allergy testing.

How is a pet with flea allergy treated?
The most important treatment for a flea allergic pet is strict, year round flea control.  There are several topical flea products which can be very helpful in preventing fleas from getting on your pet.  However, it is very important to get these products from your veterinarian or veterinary dermatologist or have a specific product recommended by your veterinarian since some over the counter flea products may be less effective or even toxic to your pet.  There are also two oral products which may be added into the treatment protocol for severe flea allergic pets which will kill a flea very quickly if it does bite the pet. Also, limiting your pet’s exposure to possible “flea rich environments” like the dog park, wooded areas, and boarding facilities can help keep your pet’s allergy under control.

Prognosis for a flea allergic pet?
The prognosis is good for these patients as long as they continue with strict flea prevention and avoidance.

If you feel your pet needs a dermatology consultation at CARES, please tell your family veterinarian.  They can provide you with a  referral to see our board certified veterinary dermatologist, Dr. Noel Radwanski.

Two of our Facebook fans recently asked some questions about pets and cancer.   So, our specialists from The Cancer Center at CARES answer these questions in today’s blog.

Katherine wrote:  I’d like to know what to ask my vet about cancer and how often to ask to make sure if my 10 year old dog gets it we catch it as early as possible.

That’s a great question Katherine!  Make annual or semi-annual visits to your veterinarian for a full examination and blood work.  If new lumps or bumps arise in the meantime, bring your pet into the veterinarian to have them evaluate.  Even if your veterinarian assures you they are benign, if they are rapidly growing, ulcerated, or doubling in size, return and ask for cytology or biopsy to be sure.   At home, the most important thing you can do is recognize changes in your dog.  Watch for any new lumps.  Notice weight loss or gain and any changes in appetite or eating habits.  Take your dog on walks and notice whether there is limping or exercise intolerance.  Changes that last for longer than a few days may be due to an underlying disease process.  You’re absolutely correct that early detection is key, so be aware of your dog’s habits and make sure you bring him to your veterinarian for evaluation if something changes, and be persistent if you still have concerns.

Halley wrote to us asking about cancer treatment options and signs and symptoms of the illness in pets.

Thanks for asking Halley!  Many treatment options exist these days.  A specific treatment is recommended based on a particular tumor’s behavior.  For example, if a tumor is localized and unlikely to spread to distant sites in the body, surgery may be the only treatment recommended.  If a tumor has spread to multiple organs, surgery is not usually a good idea. The main treatments recommended for cancer patients include medical treatment (also called chemotherapy), surgery, radiation and palliative care.  Palliative care is treatment used to help alleviate pain and improve the quality of life.  These treatments can include anti-nausea medication, appetite stimulants, pain medications, physical therapy, radiation, acupuncture, and even chemotherapy.  As for signs and symptoms of cancer, they often depend on the tumor type.  Symptoms that may indicate cancer include weight loss, exercise intolerance, the presence of masses in the skin or elsewhere, vomiting, diarrhea, decreased appetite,  lethargy, lameness, and fatigue.  Should your pet show progressive, concerning symptoms or have symptoms that last more than a few days, we recommend that you take your pet to your veterinarian for evaluation and diagnostics.

For more information on pet cancer and to learn about The Cancer Center at CARES, visit www.vetcares.com

June 9, 2011

Dogs, cats and even horses, like people, are affected by the pollen season or suffer from allergies.  Our animal patients may have food allergies, environmental allergies (to indoor and outdoor allergens), or insect/ flea allergies. Unlike most people with allergies that have hay-fever signs, our animal patients have itchy skin, hair loss or recurrent skin or ear infections with allergies. Only occasionally do we see pets with allergic symptoms of coughing, sneezing or runny eyes.

Meet Giovanni, a 6 year old male Cock-A-Poo from New Jersey

When CARES board certified veterinary dermatologist, Dr. Noel Radwanski first met Giovanni, he had a 3 year history of seasonal itching, paw licking and recurrent skin and ear infections.  Giovanni’s itching initially responded to steroids and antihistamines in addition to antibiotics for his secondary skin and ear infections.  However, at five years of age Giovanni’s allergies were becoming more severe.  He also continued to scratch his body, lick his feet and scoot his rear end on the ground into the winter months.  This was unusual since in the past years his allergies seemed to calm down after the pollen season was over.

At this time, Dr. Radwanski suggested allergy testing to determine what Giovanni was allergic to in the environment.  The testing concluded that Giovanni was allergic to almost all types of grass pollens, and two tree pollens (pine and sycamore).  Similar to people, we can formulate allergy vaccines for our canine and feline patients to help decrease their immune response to these types of allergens.   However, Giovanni’s diagnosed pollen allergies did not explain why he continued to be uncomfortable and lick or scratch in the winter.

Therefore, based on his age and non-seasonal clinical signs, Dr. Radwanski was suspicious that Giovanni had a concurrent food allergy.  Food allergy in canine and feline patients can either occur very early in life (less than 6 months of age) or as an adult (older than 5 years of age).  Like environmental allergies, patients with food allergies may also have itching of the skin and recurrent skin and/or ear infections.

How Giovanni was treated

Giovanni’s parents were shown how to give his customized allergy vaccines at home. Giovanni was also started on a hypoallergenic diet trial and was found to be severely allergic to chicken and duck.   Today, Giovanni’s itching, licking and recurrent skin infections have been well maintained with his allergy vaccine which are given every 21 days, daily antihistamines and a strict diet.

Update on Giovanni

Within the first six months of the allergy vaccines Giovanni’s allergies became much more manageable.  His itching steadily improved with every pollen season. Today, Giovanni’s seasonal allergies are very well controlled with his allergy vaccine and daily antihistamines.  His food allergies are well controlled on a diet free of chicken and other types of poultry.  Giovanni is a very happy patient who swims frequently in his family’s pool and enjoys long walks on the bike trails, even during the pollen season.

The steps Giovanni’s parents took to get him care

Giovanni’s parents have done a wonderful job keeping up with his care.  They understood that Giovanni’s immune system was better controlled with the use of allergy vaccines.  They also understood that many allergic dogs may have more than one type of allergy, as in Giovanni’s case with both environmental allergies and food allergies. In order to fully control an allergic patient, we must control or avoid all the possible allergens causing the patients symptoms.  Although it does take some time, patience and persistence, there is a lot that we can do for our animal patients to help improve their comfort and control their skin allergies with the aid of your local veterinarian and veterinary dermatologist.

Dermatology at CARES

Dr. Noel Radwanski of CARES

If you feel your pet needs a dermatology consultation at CARES, please tell your family veterinarian.  They can provide you with a  referral to see our board certified veterinary dermatologist, Dr. Noel Radwanski.

CARES’ Board Certified Veterinary Dermatologist, Dr. Noel Radwanski Tackles Allergy Season and What Pet Parents Need to Know

Allergy season is upon us and many areas across the country are experiencing high levels of pollen.  Like humans, dogs and cats can suffer from various issues including skin allergies; pollen being a top offender.  According to a survey by Veterinary Pet Insurance, the number one claim filed by pet parents is related to skin allergies.  There are a variety of skin allergens to be aware of, warning signs and ways to combat these ailments to make a pet comfortable and feeling its best.

Dr. Noel Radwanski, DACVD, is the board certified veterinary dermatologist at the Center for Animal Referrals and Emergency Services (CARES) in Langhorne.  She treats her four-legged patients for many types of skin allergies.  “This time of year allergens inhaled or absorbed through the skin can become serious.  It’s important to know what is treatable at home, when to bring your pet to the family veterinarian or when the issue has escalated to the point when a veterinary specialist is needed.”

Pets that swim, spend time near wooded areas, and outside during humid summer days are the most susceptible to skin irritations and allergies this time of year.  Some of the most common skin allergens a pet can suffer from are caused by flea bite hyper sensitivity, environmental and food-related allergies.  Dr. Radwanski offers some great tips during this allergy season and throughout the summer to keep a pet’s skin healthy.

Warning Signs- Excessive licking, scratching and chronic ear or skin infections are the most common signs there is a problem.

To Swim or Not to Swim- Some pets, especially dogs, enjoy a quick dip in the water to cool off from the heat.  Whether in a chlorinated pool or a local watering hole, it’s a good idea to rinse the dog off afterwards.

Sun Bathers Beware- SPF sunscreens may be needed in dogs with light skin, in hairless breeds or in dogs with certain skin diseases which may worsen with UV exposure.  Always consult with the primary veterinarian or a veterinary dermatologist to know if sunscreen is needed and what type to use.

Tub Time- For dogs with pollen allergies, high levels of pollen can get trapped on the skin, so bathing 1-2 times a week is recommended.  Otherwise, unless a pet has been rolling in the mud, just bath as needed.

Tick Toc- The creepy crawlies are out and about this time of year and an easy way to keep them at bay is to use a monthly combination flea and tick control.

If a skin allergy goes untreated it can cause severe trauma to the pet’s skin and secondary skin infections.  Seeing a veterinary dermatologist is a great way to help identify and treat what’s ailing a pet.

About the Center for Animal Referral and Emergency Services (CARES):

CARES is a full service specialty referral, 24 hour emergency and critical care veterinary hospital, located in Langhorne, PA.  Specialty cases are seen by referral from the primary care veterinarian.  Specialty services include: Cardiology, Clinical Pathology, Dermatology, Internal Medicine, Neurology, Oncology, Ophthalmology, Radiology, Surgery and Client Support.  The hospital also offers 24 hour emergency care.  For more information, visit www.vetcares.com You can also find CARES on Facebook at www.Facebook.com/CARESvet

About Dr. Noel Radwanski, DACVD:

Dr. Radwanski is a graduate of the University of New Hampshire, having earned her Bachelor of Science in 2001, and her Doctorate of Veterinary Medicine in 2006 from the University of Illinois College of Veterinary Medicine.  She participated in a rotating internship in Small Animal Medicine and Surgery at Long Island Veterinary Specialists in Plainview, NY and completed a three-year residency in veterinary dermatology at the University of Pennsylvania School of Veterinary Medicine.  She is board certified in veterinary dermatology and is a diplomate of the American College of Veterinary Dermatology.  Dr. Radwanski is a member of CARES’ full-time staff.

The CARES Team is excited to announce the addition of Neurology Services at our practice, led by Edwin Darrin, VMD, DACVIM (Neurology).  Dr. Darrin comes to us by way of the Chicago area, where he had been practicing Neurology in a progressive referral practice for the last three and a half years.  Dr. Darrin brings with him experience in general neurology, as well as experience with advanced imaging procedures (CT and MRI), electrodiagnostics, and both elective and emergency neurosurgery cases.

Dr. Darrin joined the staff at CARES on July 5, and has already become an integral member of our Team, working closely with our specialists in Surgery, Internal Medicine, Oncology, Radiology, Emergency/Critical Care, and other disciplines.  We’re looking forward to his ongoing interactions and contributions to our practice!

Welcome, Dr. Darrin!