Hall Veterinary Surgery - Internal Medicine

Internal Medicine

When presented with a pet who is just ‘not right’, our task is to listen to your observations of your pet’s signs and perform a thorough examination to establish which body systems are in trouble. They can’t tell is how they feel or where it hurts, but indirectly we gather information about the function of the heart, lungs, liver, kidney, bladder, pancreas, gastrointestinal tract, reproductive tract, blood, lymphatics and brain. The detective work often requires more clues to shorten the list of suspect diseases and for this reason we may suggest appropriate diagnostic tests. Some of the more common problems we come across are mentioned below.

Heart and Lungs
By listening quietly to the heart and lungs and assessing the pulse and gum colour, we can learn a lot about the pet’s heart and lung function. Problems in these areas may manifest as a cough, abnormal breathing pattern, weakness or poor exercise tolerance. Radiographs (X-rays) of the chest and bronchio-alveolar lavage (the collection of cells from the airways for examination) are tests that help us establish what’s amiss and give appropriate treatment. Other tests used to assess the heart include ECG to find the cause of an irregular heart rhythm and ultrasound of the heart (echocardiography) to view the heart’s internal structure and measure how effectively it is pumping.

Liver, Kidney and Pancreas
Although we may gain a strong suspicion from our examination, blood tests and a urinalysis in our lab can often clarify the presence of problems in these organs that enable us to reach a diagnosis and start treatment.

Kidney failure is a common cause of thirst and weight loss in elderly cats. Management includes the use of prescription diets.

Liver problems may manifest as jaundice (yellow discolouration of the gums and whites of the eyes) or they may present with lack of appetite, vomiting or diarrhoea.

Pancreatitis also causes vomiting. A fatty meal may be all it takes to precipitate an attack. Early and intensive hospital care is often successful. Cats and dogs can also suffer from low-grade chronic pancreatitis.

If we are concerned about your pet’s response to treatment, we may suggest further procedures to give insight into the type of disease in that organ includings ultrasound, biopsy or exploratory surgery.

Bladder
An x-ray showing bladder stones in an enlarged bladder Straining or passing bloody urine are signs that need immediate attention. Apart from being very uncomfortable, some cats and dogs, especially males, can quickly become critically ill if a plug of tiny crystals obstructs the passage of urine. A thorough examination and urinalysis will often give us a diagnosis of bladder disease. Ultrasound and radiographs are helpful tools to complete the picture. As some animals age, urinary incontinence may become a problem. Many cases can be managed with medication.

Gastrointestinal Tract
A foreign body can often be detected by x-ray Vomiting and/or diarrhoea can be caused by infections, inflammation or blockages in the gut as well as with disease in organs like the liver, pancreas and kidney. Blood biochemistry tests can help us know if these organs are the problem or if the gastrointestinal tract is the cause. Feces can be tested for parvovirus, worms and other parasites. Radiographs of the abdomen help us to look for bowel blockages or foreign bodies. Even though that missing sock or macadamia nut may not show up clearly on the X-ray, we may see dilated loops of bowel that lead us to strongly suspect an obstruction and advise an exploratory surgery to check and correct the problem.

Reproductive Tract
The desexing of many of our pets greatly reduces the number of problems we see in this area. Female problems include uterine infections and breast cancers. Male problems include testicular cancers and prostate enlargement. The latter can result in constipation. Ultrasound is useful to diagnose uterine infections. Desexing may be required as part of the treatment for diseases of the reproductive tract.

I'm scruffy looking, but lots of fun! Blood and Lymphatic Systems
The most common group of blood diseases are the anaemias. The first sign of anaemia may be tiredness and pale gums. Blood tests tell us about the severity and cause of anaemia and whether the bone marrow is regenerating. Coagulate tests may be required for example after rat bait poisoning which reduces blood clotting ability. Sudden blood loss into the abdomen can alert us to ultrasound the abdomen to look for a tumor.

Many a pet’s life has been saved due to our generous nursing staff who have offered their own dogs' blood for a transfusion. Dorothy, the clinic cat, is one of our less impressed cat blood donors. Cross matching of blood can be carried out in our lab.

Swollen lymph nodes may just indicate an active defense system but can also occur with lymphoma. An aspirate or biopsy can give important information. ( photo blood collection/ transfusion)

Nervous system
Diseases of the nervous system are as diverse as are the parts of the body. Your input regarding you pet’s access to poisons or exposure to tick or snake habitats is invaluable when we are tracking down a neurological problem. Other problems include epilepsy, which manifests as occasional seizures in an otherwise healthy young dog. Blood tests help distinguish epilepsy from some other diseases causing seizures. Disc problems can result in a wobbly gait or even paralysis due to spinal compression, particularly in small breed dog with long backs. Thorough examination, both physical and neurological is our starting point. Radiographs of the spine may help diagnosis. Referral for specialist diagnostics and treatment may be appropriate

Endocrinology
Diabetes is a relatively common disease in our pets, particularly those who have been allowed to gain too much weight. Treatment is much less complicated in cases diagnosed early so let us know if your pet has started to drink more water recently. Most can be managed on twice daily insulin injections and we get to know these pets well due to regular monitoring. Thyroid gland disorders include a hyperactive thyroid in older cats. They will often come to see us because they are loosing weight despite eating more and respond well to a few treatment options. Dogs on the other hand can suffer from an under active thyroid which contributes to skin disease, weight gain and requires treatment with a thyroid hormone supplement.

To manage pets with thyroid and also adrenal gland disease, we rely on lab tests to monitor the response to treatment.

Cancer Treatment
Cryosurgery being used on a cat's nose It is best to have any lumps checked when they are small. Many are benign and we just ask you to monitor them. However, if surgery is required, it will never be easier than it is now. Fine needle aspirates can help us identify some commonly occurring tumors. If we are concerned about the possibility of a malignant cancer, we will offer histopathology to provide a definite diagnosis. We can then discuss all our options, depending on the type and location of the cancer. Chemotherapy can be used in some circumstances with fewer side effects than you may expect. Cryotherapy is a simple and effective way to manage small sun cancers on the pink noses of cats.

Next: Dermatology

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