We Can-cer-vive Cancer! Meet Charlie!!!

Meet cancer survivor Charlie and learn how a team approach to health care is so important when it comes to your pet's health. 

Charlie is a very adorable 14 year old cat that was diagnosed with an ear canal cancer known as ceruminous gland adenocarcinoma. This type of cancer is one of the most common ear canal cancers seen in both cats and dogs. Clinical signs associated with this disease include excessive cerumen accumulation, discharge, swelling, itchiness, and recurrent infections. In order to obtain a diagnosis, advanced imaging such as a CT scan is usually required. 

Most commonly, ear carcinomas are locally invasive and have a low chance of spreading to other locations. The treatment of choice for this type of cancer is surgical resection, which involves completely removing the ear canal (TECA- total ear canal ablation). 


A TECA or in Charlie's case a TECABO is a Total Ear Canal Ablation or Total Ear Canal Ablation Bulla Osteotomy. This procedure involves the complete removal of the ear canal middle ear, leaving only the ear flap remaining. 


Although this type of surgery may sound like a lot for your pet to go through, they tend to feel so much better once it is performed and it gives them the best chance at achieving a long survival time. With successful surgery and no identified negative prognostic indicators, patients can live a long time after removal of their cancer. 

Charlie was initially evaluated by Dr. Irene Vazquez at our the Oncology Service and had a CT scan performed, which showed he had a mass within his ear canal. The mass was sampled and the results were consistent with carcinoma. Charlie was then evaluated by Dr. Andrea Clark at our Surgery Service and had surgery performed to remove his tumor. 

Charlie on his 5 month anniversary cancer free!

Since his surgery, Charlie has been doing great at home and is currently cancer free. He continues to come in for routine evaluations to make sure his cancer is not spreading and so far, he's been doing amazing! He is the sweetest boy and our hearts melt every time he comes in. 

We wish Charlie the best of luck and the longest survival time! Our VCA Hollywood family is SO proud of him 💙.


Contributors: Irene Vazquez, DVM and Andrea Clark, DVM

Charlie after surgery. 

Ear Canal Tumors

What are tumors of the ear canal?
Tumors of the ear canal are abnormal growths that can develop from any part of the ear canal (the skin, the glands of the skin that produce earwax and oil, and the underlying connective tissues, muscles, and bones). Ear canal tumors can be benign or malignant. Benign tumors do not spread, while malignant or cancerous tumors can spread to the surrounding tissues or even other areas of the body (metastasis). Tumors of the external ear canal are more common than tumors of the middle or inner ear.

In dogs, the most common external ear canal tumors are ceruminous gland adenomas (benign) and adenocarcinomas (malignant). Other tumors include inflammatory polyps, papillomas, sebaceous gland adenomas, and more.

In cats, the most common external ear canal tumors are nasopharyngeal polyps, squamous cell carcinomas, and ceruminous gland adenocarcinomas.

Lymphoma, fibrosarcoma, and squamous cell carninomas are occasionally seen in the middle or inner ear of dogs and cats.

What causes these kinds of tumors?
The reason why a particular pet may develop this, or any other tumor or cancer, is not straightforward. Very few tumors and cancers have a single known cause. Most seem to be caused by a complex mix of risk factors, some environmental and some genetic or hereditary. Although there does not appear to be a genetic or hereditary cause for ear canal tumors, chronic inflammation is believed to play a role. German Shepherds and Cocker Spaniels, for example, are at increased risk of developing these tumors. This may be related to the tendency of both breeds to have recurrent and severe ear infections.

What are the clinical signs of ear canal tumors?
horners_syndrome_dog_arrow_2018Initially, these types of tumors may appear as one or more pink, white, or purple nodular masses in the ear canal. If benign, they may grow to a certain size and may or may not be problematic. If malignant, they may grow, ulcerate (break open) and bleed, and nearly invariably become infected, causing recurrent or chronic ear infections. As they grow, they can narrow and even fill (and obstruct) the ear canal.

The most common clinical signs of pets with ear canal tumors include an inflamed, itchy and painful ear, persistent odorous discharge (that can be waxy, pus-filled, or bloody), head shaking, and ear scratching. Sometimes pets will shake or scratch hard enough to cause an ear hematoma (a blood blister). Occasionally draining abscesses may form just below the ear. If the middle or inner ear is involved, pets may experience head tilt, circling, loss of balance and coordination, nystagmus (darting of the eyes back-and-forth), Horner’s syndrome (see photo), facial paralysis (with facial drooping, salivation, and difficulty eating), loss of hearing, and other neurologic signs.
(Image via Wikimedia Commons / Joel Mills (CC BY-SA 3.0.)

How are these kinds of tumor diagnosed?
If deep in the ear canal, these tumors may be difficult to see and therefore diagnose. If the ear canal is severely inflamed, the inflammation may need to be alleviated first to more clearly see the mass. Once the mass is identified, it may (or may not) be possible to take a sample of the tissue, depending on the location. If the mass can be accessed, fine needle aspiration (FNA) or biopsy will be performed. FNA involves taking a small needle with a syringe and suctioning a sample of cells directly from the tumor and placing them on a microscope slide. A veterinary pathologist then examines the slide under a microscope. A biopsy is surgical removal of a piece of the tumor. The tumor tissue is then examined under the microscope. This is called histopathology.

If a diagnosis of malignancy is made from the FNA or biopsy, a CT scan of the head and neck region may be performed to determine how invasive the tumor is and plan a surgical approach. Staging (searching for potential spread to other locations in the body) is highly recommended for malignant tumors, as they tend to spread. This may include bloodwork, urinalysis, X-rays of the lungs, and possibly an abdominal ultrasound. If any lymph nodes appear to be enlarged or firmer than normal, samples may be taken to look for spread.

How do these types of tumor typically progress?
Benign tumors, such as inflammatory polyps, typically only grow to a certain size, but are often irritating and interfere with the ear’s normal function, resulting in waxy buildup and chronic infections. The biggest concern with malignant tumors (other than the possibility of metastasis) is local spread. If the tumor is not treated, it may continue to grow and invade the surrounding tissues, causing pain and increasing the risk of the more serious clinical signs and complications listed above.

What are the treatments for these types of tumor?
The treatment of choice for ear canal tumors is surgical excision. This is curative for benign tumors that are completely removed. Laser surgery may be an option. More extensive surgery is required for malignant ear canal tumors. One procedure, called total ear canal ablation and bulla osteotomy (TECA-BO), involves removing the outer and inner ear canal, as well as the tympanic bulla (the middle ear), leaving only the ear flap remaining.

If complete removal of the tumor is not possible, radiation therapy may be recommended to treat the remaining tumor cells. Radiation therapy may also be recommended for large tumors that cannot be surgically removed, to slow tumor growth or relieve pain. Chemotherapy may be an option if the tumor is highly malignant or if there is evidence of metastasis.

Is there anything else I should know?
It is important to recognize that tumors of the ear canal may grow without much outward evidence, only causing subtle signs in your pet. If your pet suffers from recurrent or chronic ear infections, or shows signs of pain or discomfort, rechecking with your veterinarian at frequent intervals may assist with early detection.

Contributors: Christopher Pinard, DVM
© Copyright 2018 LifeLearn Inc. Used and/or modified with permission under license.
https://vcahospitals.com/know-your-pet/ear-canal-tumors

Total Ear Canal Ablation and Bulla Osteotomy (TECA-BO)

What is a TECA-BO?
The term TECA-BO is an abbreviation for Total Ear Canal Ablation and Bulla Osteotomy. This surgery involves the complete removal of the ear canal and tympanic bulla (middle ear), leaving only the ear flap (pinna) remaining. Typically, this surgery is performed by a specialist, though some veterinarians in general practice may also perform this surgery.


Why would a veterinarian recommend a TECA-BO?
A TECA-BO is primarily recommended in cases of chronic, end-stage otitis (ear infections), in which medical treatment is no longer helping the patient. In some cases, this may be due to a bacterial infection that is resistant to antibiotic treatment; removing the bacteria may be the most effective means of dealing with the infection. In many cases, longstanding infection and inflammation have led to so much scarring and mineralization of the ear canal that the ear canal has narrowed and ear cleaning is no longer effective for removing accumulated debris. In either case, a TECA-BO allows the infected, abnormal ear tissue to be removed, reducing chronic pain and inflammation and giving the pet an improved quality of life.

A TECA-BO may also be recommended in dogs or cats who have neoplastic (cancerous) growths within the ear canal. If the mass is fully confined to the ear canal, a TECA-BO will allow removal of the entire mass.

What does the TECA-BO surgery entail?
Your dog will first undergo a pre-operative assessment. During a physical exam, the veterinarian will assess the extent of your dog’s ear abnormalities and assess the function of those nerves that run adjacent to the ear canal. Pre-anesthetic blood tests will be used to evaluate your dog’s internal organ function prior to anesthesia. Finally, imaging will be performed to evaluate the ear canals and bullae (middle ear). Although X-rays can be used to image the skull and bullae, advanced imaging such as CT scan or MRI are often performed to allow more effective visualization. This pre-operative assessment will assist the surgeons in planning your dog’s surgery.

Your dog will be placed under general anesthesia for surgery. The surgeon will create a skin incision surrounding the ear, then carefully cut through the underlying tissues so that the ear canal can be removed as one intact cylinder. The ear drum and the bones of the middle ear will also be removed. This will expose the middle ear cavity, also known as the tympanic bulla. Infected material will be removed from the bulla and submitted for bacterial culture. This culture will allow identification of the infection-causing bacteria, as well as a determination of the most effective antibiotics for treatment. The bone lining the bulla will be scraped clean and the incision will be closed. An external drain may be left in place at the surgical site, in order to allow remaining fluid/material to exit the incision.

What post-operative care will be required after TECA-BO surgery?

After surgery, your dog may be sent home with a drain still in place. There may also be bandages covering the surgical site. If this is the case, your veterinarian will give you information regarding the proper care and removal of these drains and bandages.

"As the incision is healing, your dog will be required to wear an E-collar (cone)."

Your dog will also go home with both pain medications and antibiotics. Antibiotics are typically continued for 2-4 weeks following surgery, depending on your dog’s overall health status and severity of the ear canal disease.

As the incision is healing, your dog will be required to wear an E-collar (cone). This will keep him from scratching at the surgical site, which could damage the incision and interfere with healing.

What complications are associated with TECA-BO surgery?
The primary risks associated with TECA-BO surgery are associated with the veins and nerves that run in the vicinity of the ear canal. Damage to the blood supply in this area may cause a partial loss of blood supply to the ear flap (pinna). If this occurs, tissue may begin to die along the edges of the ear flap and a second surgery may be required to trim away dead tissues to prevent infection. Damage to the facial nerve may result in paralysis of the affected side of the face. In many cases, this paralysis is temporary and will resolve without treatment, but in some cases the paralysis may be permanent.
Many pet owners expect their dog’s hearing to be reduced after surgery, due to the removal of the ear drum. This is definitely a possibility, but is not always the case. In many cases, the ear canal is so diseased by the time a surgery such as TECA-BO is being considered that owners notice little change in their dog’s ability to hear after surgery.

Some patients (approximately 3-15%) will experience chronic drainage from the incision, indicating the presence of residual infection. This drainage may be noted months to years after the original surgery. Although the drainage will often resolve temporarily with antibiotic treatment, a second surgery is often required for complete resolution.

Overall, the prognosis for pets receiving a TECA-BO is very good. The pet is relieved of a source of chronic pain and inflammation, while the pet owner is relieved of the odor and daily cleaning/medication associated with chronic ear infections.

Contributors: Catherine Barnette, DVM
© Copyright 2017 LifeLearn Inc. Used and/or modified with permission under license.

https://vcahospitals.com/know-your-pet/total-ear-canal-ablation-and-bulla-osteotomy-tecabo

A Team Approach to Cancer Care, VCA Pet Cancer Care Center!

A diagnosis of cancer is stressful for every pet owner. Helping owners learn as much as they can about the disease and the latest advances in treatment is key to managing fear, confusion, and helping them make an educated decision on their pet’s health.

Our mission is to provide an exceptional level of progressive and sensitive cancer care to the cancer patient through a team approach and ensure that our client is always well informed and comfortable with decisions made regarding their pet’s care.

Using the strengths and expertise of all specialists on site, including doctors from our Surgery, Internal Medicine, Cardiology, Dermatology, Radiology, and Emergency and Critical Care departments we tailor treatment protocols for each pet’s specific cancer and physical conditions to optimize the outcome and minimize side effects.

Our technicians have experience in caring and supporting cancer patients. They are knowledgeable and experienced in chemotherapy administration and treatment and they adhere to strict protocols to maintain the highest level of safety for the staff and patient. We emphasize support, education, and improving the quality of life for all animals, particularly those undergoing treatment.

Our Medical Oncology department utilizes chemotherapy to treat cancer.  Each tumor type has a different biological behavior. Depending on the tumor type, staging exams are usually performed prior to recommending treatment. Staging exams may include fine needle aspirates and/or biopsies, chest radiographs, an abdominal ultrasound and ultrasound guided aspirates, CT scan, etc. These can all be performed on-site and help us gain a better idea of the pet’s overall health.  Based on the tumor type and staging exam results, we may recommend surgery, chemotherapy, or a combination of both treatments. For some types of cancer, a curative intent treatment can be pursued. For others, a palliative intent treatment may be followed. 

 VCA Hollywood offers Medical Oncology Services
 with Dr. Irene Vazquez.
 Get to know Dr. Vazquez!

If something's bugging your pet, we can help!

Queen after 24 days of treatment.

"Queen", a 7 month old Shihtzu, presented to the VCA Hollywood Animal Hospital Emergency Service Department for an elevated temperature, lethargy, inappetence, erythema (skin redness) and crusty dermatitis. After hospitalization, advanced diagnostic, IV fluid and a course injectable and oral antibiotics, her temperature decreased into normal range and a consult with our Dermatology Department to further address her skin was prescribed.

When Queen presented to VCA Hollywood Animal Hospital Dermatology Department, Dr. Melanie Hnot, our Board Certified Dermatologist, diagnosed Queen with Demodex mites, as well as with a severe, deep skin infection.

Queen upon presentation to our VCA Hollywood Dermatology Service.

Demodex mites are mites that live in the hair follicle and dogs obtain them from their mothers. They are not contagious to other dogs or people. When a dog has suppression of their immune system, from medications, parasites, or malnutrition, they can develop demodicosis. Demodicosis is when the Demodex mites proliferate and lead to hair loss and skin infections. When Demodex mites live in the hair follicles, it predisposes dogs to superficial skin infections. If

the hair follicles rupture, then dogs can get deep bacterial infection, which Queen had.

The treatments for demodicosis include oral ivermectin daily, amitraz dips (only licensed treatment for demodex), oral milbemycin or Bravecto. Queen continued treatment for 6 weeks with antibiotics and Bravecto to kill off the Demodex mites and the results of her care are evident. 

Today, Queen is feeling much better. Her puppy personality is back as she is now wagging her tail and playing at home.

In 4 weeks, Dr. Hnot will perform additional deep skin scrapings hoping to reach 2 negative deep skin scrapings before approaching an "all clear" diagnosis. It can take months to treat dogs with

Queen after 10 days of treatment.

demodicosis and therefore treatment will continue one month past her second set of negative deep skin scrapings.

After treatment, Queen will need to be monitored for a recurrence of demodicosis. Certain medications can also increase the risk of demodicosis. Steroids can increase the risk of developing demodicosis so any oral, topical or injectable steroid should be avoided.

For now, Queen is feeling royal and she feels as good as she looks!  

Sarcoptic Mange in Dogs

What causes sarcoptic mange?

Sarcoptic mange is caused by a parasitic mite (Sarcoptes scabiei) that burrows just beneath the surface of the skin. It is important not to confuse sarcoptic mange with demodectic mange, which is caused by a different parasitic mite.

"Sarcoptic mange is a zoonotic disease or a disease transmissible from pets to people."

These mites bury into the skin of healthy adult dogs and puppies, and feed on material in and on the skin. Sarcoptic mange is also known as scabies and is zoonotic, which means it is a disease transmissible from pets to people.

What does it do to the dog?

The presence of the sarcoptic mite causes intense itching. The dog will chew and scratch its skin constantly. This leads to the loss of large amounts of hair, especially on the legs and belly. Eventually, the skin will become thickened and will darken.

Is it contagious?

Yes. Sarcoptic mange is highly contagious to other dogs and humans.

Although sarcoptic mites are not able to complete their life cycle on humans, they will cause severe itching until they die. Since the mite may be found in areas where infected dogs or foxes frequent, keep your dog away from these areas to attempt to prevent infection.

How is sarcoptic mange diagnosed?

Diagnosis is made by a skin scraping examined under the microscope. It is common not to see sarcoptic mange mites when performing a skin scraping. This is because the mites burrow deep into the skin and it takes only a few mites to cause significant itching.

Just because no mites are seen, does not mean your dog does not have sarcoptic mange. A presumptive diagnosis may therefore be made, based on clinical signs. Sarcoptic mange may occur in any dog at any age.

How is it treated?

There are several medications that are effective against Sarcoptes. Your veterinarian will discuss the best treatment for your pet's condition and lifestyle. Treatment varies from medicated baths and dips to injections and oral medications. Many pets will require a combination of treatments to resolve this infection.

Topical treatments may be divided into two categories:

1)   Dips. Some of the dips that are used to treat Sarcoptes include amitraz and lime-sulfur dip. Your veterinarian will provide you with information on how to use these dips.

2)   Topicals. Medication applied topically to one or two spots while the animal is dry. These medications are applied every 14-30 days or as your veterinarian recommends. Some examples of these topical medications include selamectin, imidacloprid and moxidectin, fipronil among many others.

Just like topical medications, there are a wide variety of oral medications available for the treatment of sarcoptic mange. These oral medications may be prescribed in the form of liquid, pill, or flavored chew, depending on the medication prescribed. Some of these oral medications include milbemycin (the active ingredient of Interceptor® and Sentinel®), afoxolaner (NexGard®), fluralaner (Bravecto®), and sarolaner (Simparica®). These medications are used 'off label' for the treatment of sarcoptic mange. The term 'off label' describes the use of a drug for conditions other than what it was approved for. Many of these medications are given for multiple treatments. To prevent re-infection, discard any bedding where your dog sleeps, or wash it frequently in diluted bleach solution (one ounce bleach in one gallon of water). If you dog is still scratching four to five days after treatment has started, please contact your veterinarian.

Can I get mange from my dog?

Yes. If any member of the family develops itching or a skin rash, contact your family doctor immediately. Tell your doctor that you may have been exposed to sarcoptic mange or scabies. In people, the mite cannot complete its life cycle so it will die in a few days. However, it may cause intense itching during that time and medical treatment is often recommended.

By Ernest Ward, DVM; Updated by Amy Panning, DVM

https://vcahospitals.com/know-your-pet/mange-sarcoptic-in-dogs

Contributors: Ernest Ward, DVM; Updated by Amy Panning, DVM © Copyright 2018 LifeLearn Inc. Used and/or modified with permission under license.

Demodectic Mange in Dogs

Mange is a parasitic skin disease caused by microscopic mites. Two different mange mites cause skin disease in dogs. One lives just under the surface of the skin (sarcoptic mange), while the other resides in the hair follicles (demodectic mange). Although both mites share similar characteristics, there are also important differences. It is important not to confuse the two types of mange because they have different causes, treatments, and prognoses.

What causes demodectic mange?

Demodectic mange is caused by Demodex canis, a parasitic mite that lives in the hair follicles of dogs. Under the microscope, this mite is shaped like a cigar with eight legs. Demodectic mange, sometimes just called ‘demodex’ or ‘red mange’, is the most common form of mange in dogs.

"As long as the body's immune system is functioning properly, these mites cause no harm."

All normal dogs (and many humans) have a few of these mites on their skin. As long as the body's immune system is functioning properly, these mites cause no harm.

Demodectic mange most often occurs when a dog has an immature immune system, allowing the number of skin mites to increase rapidly. As a result, this disease occurs primarily in dogs less than 12 to 18 months of age. As the dog matures, its immune system also matures.

Adult dogs that have the disease usually have weakened immune systems. Demodectic mange may occur in older dogs because function of the immune system often declines with age. Dogs who have a weakened immune system due to illness or certain medications are also susceptible to demodectic mange.

Is demodectic mange contagious?

No, demodectic mange is not contagious to other animals or humans. Demodex mites are transmitted to puppies from their mother during the first few days of life. Since the mite is found on virtually all dogs, exposure of a normal dog to one with demodectic mange is not dangerous, as the immune system must be depressed for mange to develop.

"Demodectic mange is not contagious to other animals or humans."

Why doesn't the immune system mature correctly in some dogs?

Development of the immune system is under genetic or hereditary control. An affected dog often has littermates that are also affected. Owners of littermates should be alerted to watch for the development of mange in their puppies. Because the disease is due to a genetic defect, affected dogs should not be bred, and the parents of the affected dog should not be bred again.

What does demodectic mange do to the dog?

Surprisingly, a dog with demodectic mange usually does not itch severely, even though it loses hair in patches. The hair loss usually begins on the face, especially around the eyes. When there are only a few patches of hair loss, the condition is called localized demodectic mange. If the disease spreads to many areas of the skin, the condition is called generalized demodectic mange.

How is demodectic mange diagnosed?

"Your veterinarian will take deep skin scrapings and examine them under the microscope to diagnose this disease."

Your veterinarian will take deep skin scrapings and examine them under the microscope to diagnose this disease. The finding of larger than normal numbers of Demodex mites in skin scrapings confirms the diagnosis. Occasionally, the disease will be diagnosed by means of a skin biopsy in dogs that have chronic skin infections that have not responded appropriately to treatment.

How is demodectic mange treated?

The localized form is usually treated with topical medication. The generalized form requires more aggressive treatment using special shampoos and dips, along with oral medication. Shampooing with special cleansing shampoos containing benzoyl peroxide helps to flush out and open the hair follicles prior to dipping. 

There are also several 'spot on' topical treatments, such as imidacloprid and moxidectin. These medications are used 'off label' for the treatment of demodicosis. The term 'off label' describes the use of a drug for conditions other than what it was approved for.

There is an injectable form of doramectin, which can also be used for off label treatment of demodex. Your veterinarian will discuss the benefits and risks of these medications with you.

In some cases, especially dogs with generalized demodectic mange, secondary skin infections complicate the condition, requiring antibiotic therapy. Because dogs with skin infections often have very red, inflamed skin, demodectic mange is often called ‘red mange’. Your veterinarian can help you determine whether or not your dog has a skin infection in addition to demodectic mange.

Are there any problems with topical treatment?

The dip commonly used for demodectic mange contains the insecticide amitraz. It must be used very carefully because it is a strong insecticide that can cause serious side effects, both to your dog and to you, if not used properly. Your dog may experience vomiting and sedation for twenty-four to thirty-six hours following each application. Most of these problems will resolve without medical intervention. If your dog reacts in this manner, you should dilute the next dip with 25% more water. If you are using a ‘spot on’ topical treatment, you may see drooling if your dog licks the medication.

"Amitraz must be used very carefully because it is a strong insecticide that can cause serious side effects, both to your dog and to you, if not used properly."

Since most dogs develop tolerance to the dip as they are repeated, your dog is less likely to have side effects with each subsequent treatment. After receiving two to three dipping treatments at seven-day intervals, skin scrapings should be repeated and examined for the presence of live mites or mite eggs. The results of these skin scrapings will determine whether further treatment is needed.

I heard that there is a drug that can be given orally for demodectic mange. Is that true?

Yes, under certain conditions.

Ivermectins are a class of drugs that are approved for prevention of heartworm disease in dogs and cats. Certain ivermectins are used to treat parasites on cattle. The cattle preparation has been used orally for demodectic mange in some dogs. However, ivermectin is not approved for use in treating dogs with mange, so its use to treat mite infestations in dogs is off-label.

Ivermectin is a very strong drug that can cause severe side-effects, including death, if it is not administered properly. It is extremely important to follow your veterinarian’s instructions and cautions carefully, as their directions may be very different from those on the label. Veterinarians do not generally recommend ivermectin for use in Collies, Shetland Sheepdogs, Australian Shepherds, Old English Sheepdogs, or any other herding breed because they are sensitive to the medication.

There are a few other oral medications that may be used off label in the treatment of the demodex mite. These include milbemycin oxime (the active ingredient of Interceptor® and Sentinel®), afoxolaner (NexGard®), and fluralaner (Bravecto®). Your veterinarian will help you decide which oral or topical medication is best for your dog.

What is the prognosis for my dog?

Treatment of demodectic mange is generally successful. However, if the immune system is weakened, neither the mites nor the infection may respond to treatment. With generalized demodicosis, successful treatment may take a long time, and may require regular skin scrapings to check the progress of the treatment.

Following successful treatment, is it likely to recur?

"It is important to treat as soon as a relapse occurs to minimize the possibility of developing uncontrollable problems."

Because the immune system does not mature until 12 to 18 months of age, a dog with demodectic mange may have relapses until that age. In addition, dogs with suppressed immune systems may be susceptible to relapse. It is important to treat as soon as a relapse occurs to minimize the possibility of developing uncontrollable problems. Relapses are usually recognized 3-6 months after treatment is discontinued.

By Ernest Ward, DVM; Updated by Amy Panning, DVM

Medical Conditions, Parasites, Pet Services

https://vcahospitals.com/know-your-pet/mange-demodectic-in-dogs

Contributors: Ernest Ward, DVM; Updated by Amy Panning, DVM

© Copyright 2018 LifeLearn Inc. Used and/or modified with permission under license.

We Can-cer-vive Cancer! #VCAHollywoodPetCancerCareCenter

Meet Apollo! This adorable 7 year old, Golden Retriever received his last chemotherapy dose last week. In October, Apollo was diagnosed with B-cell lymphoma.  

Lymphoma is one of the most common types of cancer seen in dogs. It is a cancer of the immune system that occurs as a consequence of uncontrolled and abnormal growth of lymphocytes, an important cell of the immune system. 

In general, dogs with lymphoma present with multiple enlarged lymph nodes throughout the body and they tend to feel well at the time of diagnosis.  Even though lymphoma is not considered to be a curable disease (curable in <10% of cases), it is highly treatable with chemotherapy and approximately 95% of treated dogs respond to treatment and enter complete remission. 

The treatment of choice for dogs with B-cell lymphoma is chemotherapy with the CHOP protocol. CHOP is an acronym that stands for 4 drugs: cyclophosphamide, doxorubicin (hydroxydanorubicin), vincristine (Oncovin), and prednisone. The total protocol duration time is 15 weeks. With chemotherapy, the survival time in dogs with B-cell lymphoma is approximately 1 year. 

Apollo did great throughout his chemotherapy protocol and we will miss seeing him and his wagging tail through our VCA Hollywood Oncology Department  but we wish him the best of luck and a very long remission duration time!

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News You Can Use- Bloat!

What is gastric dilation volvulus?

If you have seen the heart wrenching movie “Marley and Me”, you may be more familiar with the disease than you think. In the story, Marley was diagnosed with a condition referred to in the movie as a “stomach twist” which is medically known as gastric dilation volvulus. The movie gave us the notion that it is a very serious disease, but doesn’t really give us much beyond that. Today, we will dive into what happens behind the scenes in the case of GDV.

What is GDV?

Gastric dilation volvulus (GDV) is a life-threatening condition in which the stomach twists on itself and causes distension of the stomach. The stomach can twist anywhere between 90° and 360°. The torsion causes the outflow tract of the stomach (pylorus) and the esophagus (if the twist is greater than 180°) to close, kind of like twisting two ends of a Tootsie Roll. This means gas, solids, and liquids cannot enter or leave the stomach. This causes the stomach to bloat. The gas distended stomach occludes the blood vessels that lead to the heart which prevents proper blood flow and causes the pet to go into shock. If left untreated, GDV can lead to organ failure from lack of oxygen rich blood, heart arrhythmias, stomach rupture, sepsis, and death. Because there are blood vessels that connect the spleen to the stomach, the spleen is sometimes involved in the torsion.

What Causes GDVs

GDV most commonly occurs in large breed, deep chested dogs, such as the Great Dane and the Doberman. It tends to occur when dogs consume large amounts of food or water followed by exercise.

Signs to Watch For

It is assumed a dog experiencing GDV will look bloated. Though many dogs will be visibly bloated, some dogs’ stomachs are tucked up within the rib cage which would hide the bloat. Therefore, it is important to consider GDV if your pet fits the following characteristics and is showing the following signs.

●     Distended abdomen

●     Retching without vomiting 

●     Pain

●     Restlessness

●     Recently consumed a lot of food or water followed by exercise

●     Large breed and deep chested dog 

Diagnosis and Treatment

A confirmatory diagnosis is based on a right lateral (right side of patient on table) abdominal radiograph (x-ray). The radiographs will show a gas distended stomach that takes the shape of a smurf hat or Popeye’s arm.

Treatment

Decompressing the stomach and IV fluid therapy are the most important steps in treating GDV. Passing a stomach tube may be attempted, but if the esophagus is twisted, then passing a tube will not work. In those cases, puncturing the stomach with a needle (trocarization) can relieve the pressure until the surgery can be performed. Once the patient is stabilized, the dog is put under anesthesia for surgery. The stomach is first untwisted so that a stomach tube may be passed to clear the contents of the stomach. Then a procedure, called gastropexy, is performed in which the stomach is tacked to the left side of the body wall to decrease the risk of torsion in the future. 

Prevention

The gastropexy procedure mentioned above can also be performed prophylactically to decrease the risk of stomach torsion in large breed, deep chested dogs. It is actually a common procedure performed in military and police dogs. A gastropexy can be requested to be done at anytime if your pet is an at risk breed. It is often a procedure performed in conjunction with a spay or neuter.

Sometimes, It’s Not GDV

It is possible for dogs to experience bloat without torsion of the stomach in a condition called gastric dilation or simple bloat. This usually occurs in gluttonous dogs who have the tendency to eat too much, too fast. This condition, unlike GDV, is usually not life threatening. However, the pet should be immediately evaluated by a veterinarian because the symptoms are indistinguishable from GDV. As stated previously, radiographs of the abdomen can be taken for a confirmatory diagnosis.

Dr. Jalika Joyner

https://vcahospitals.com/hollywood/primary