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Dog Owner Seeking Health Information about Neutering and Constipation

Dr. Laci Nash Schaible, DVM

Dr. Laci Schaible, DVM

Dr. Laci: Hi, how can I help you?

Mary: Hi, good evening. yes, I have some questions about my dog that just got neutered.

Dr. Laci: Okay, I am Dr. Laci Schaible and I will be answering your questions today and helping you with your dog. What is his name and what questions about his neutering do you have?

Mary: Well, I took Sam in yesterday in the morning to get neutered and picked him up in the evening. He was wagging his tail and seemed pretty normal when I picked him up. maybe a little less bouncy than usual but the vet said that was how I was supposed to keep him.

Dr. Laci: It sounds like you did the right thing, and I agree with Sam’s veterinarian. Keeping a patient quiet after an operation is important to help the body recover and prevent complications (delayed healing, for instance if he were to jump up and pull out a suture). It is also common for pets to be a little sleepy or slower after anesthesia but they should be able to walk normally with 100% coordination by the time they leave the hospital.

Mary: Good. Yeah, he could walk fine. The vet told me to give him a small dinner, I don’t remember why, but lots of water. He seemed so hungry after I gave him 1/2 his food so I gave him the other half. he threw up right afterwards, and it was pretty much the whole dog food pieces, just moist and bigger.

Dr. Laci: Did he throw up more than one time? Was there any blood or dark bits resembling coffee grounds in his vomit?

Mary: no, it was just the once, and it was just the food.

Dr. Laci: Good. That sounds like a common side effect after anesthesia. As long as Sam doesn’t throw up again, and he is otherwise normal, it is okay and nothing major. Unfortunately you learned yourself why your veterinarian recommended a small meal, but no harm is done and there is no reason to feel bad.

Mary: well he’s been bouncing off the walls today. I’m trying to keep him quiet but it’s not easy.

Dr. Laci: I understand. I sometimes have trouble keeping them calm in the hospital after surgery. Some dogs back bounce so quickly, like the operation never even phased them.

Mary: I have another problem though.

Dr. Laci: Okay, let’s hear it and see if I can help you.

Mary: He hasn’t gone to the bathroom since yesterday. Do you think something could have happened with the surgery or the vomiting?

Dr. Laci: He has urinated or had a bowel movement either?

Mary: Oh yeah, he’s peeing fine he just hasn’t pooped. I called my vet today and they said to bring him in but I just paid over $200 there and I don’t have the money to bring him back in. it’s after hours and their fees are more at night.

Dr. Laci: Mary, when was Sam’s last bowel movement, and was it normal in appearance?

Mary: It was the day before his surgery when I let him out in the evening. I didn’t see it so I don’t know what it looked like.

Dr. Laci: Okay to summarize and make sure I have everything straight: Sam had a bowel movement 2 days ago, had surgery yesterday and threw up once at home, today was normal energy appetite and urination, just no BM. Right?

Mary: right.

Dr. Laci: Did he have dinner the night before his surgery, or did his vet order no food that evening?

Mary: well, they told me not to feed him dinner, but I did give him a couple treats, but nothing after 10pm.

Dr. Laci: It sounds like there are a couple reasons for Sam’s constipation, and the good news for you is you don’t have to rush him to the ER or worry at this point. Constipation is very common after surgery. One of the primary reasons for this is pain medications. Another is decreased intake: no food or water the night before Sam’s surgery, no water the next day (unless they used IV fluids–always a good idea), water and food that night, but it was all thrown up. The combination of little fluid and food intake work’s against the body’s natural elimination.

Dr. Laci: During anesthesia, not only was Sam “asleep” his muscles were also asleep. His intestines weren’t pushing along food they way they normally do.  Again slowing down digestion and the formation of stool.

Dr. Laci: Also, with less fluid, feces are drier and harder to express. Something that you can do at home to try and help is add a bit (2 or 3 tablespoons) of canned pumpkin (the pureed kind, not pie filling) to his food. It is full of fiber and is a natural way to help relieve constipation.

Mary: I think I have some here at home. Wonderful! How long are dogs normally constipated after surgery?

Dr. Laci: Some dogs it takes 2-3 days, and others experience no problems. Limited exercise also keeps the intestines moving the food along more slowly, so the inactivity that is encouraged also encourages constipation.

Mary: That makes sense. thank you so much for your help.

Dr. Laci: You’re very welcome, and thank you for doing your part to help control animal overpopulation by neutering Sam. Do you have any other questions that I can help you with?

Mary: no, that is it for now. thank you again doctor and have a good night.

Dr. Laci: You too, and best of luck with Sam. He is lucky to have a concerned owner like yourself.

Cat Owner with Concerns about Weight Loss and

Abnormal Gait and Stance

Question: I have a 12 yr old neutered male cat.  He used to be overweight, but seems to be losing weight over the last year.  My question is, he has recently started walking and sitting kind of half-way down on his back legs.  He doesn’t seem to be in any pain, and he didn’t break his legs in any way.  He doesn’t meow or cry when I touch them, and he seems otherwise normal.  Do you think this could be anything to worry about, or is he just probably getting old?  Thanks!

Answer:  It sounds like your cat is likely suffering from diabetes mellitus.  Walking lower on his hocks, exactly as you describe, is probably a result of having too high of blood sugar, resulting in a dysfunction or one or both tibial (back leg) nerves.  This is called a diabetic neuropathy, and is causing his plantigrade stance.  Other signs indicating it likely is diabetes is overweight, male neutered cat over the age of 10, and recent weight loss.

Increased drinking and increased urination, along with decreased energy are other common clinical signs.

Fortunately, this abnormal stance (and the other dangers of diabetes) will likely resolve with the regulation of his diabetes. Supplementation with Methyl-B12 (a specific type of vitamin B12 that gets absorbed into the spinal fluid) will also help restore your feline’s normal stance.

Cat with diabetes and plantigrade stance

The cat on the right is in a plantigrade stance

You can give him a pill, or crush the medicine into wet food (have your veterinarian help you select a new food specific for diabetic cats.  Some cats with milder diabetes can be controlled with only a food switch.  Others may need insulin injections or oral medications to control their sugar levels.)

A standard recommended dose of Methyl-B12 is 3 mg daily, but if you can only find 5 mg pills that will work, as the vitamin is water-soluble and the excess will be excreted out in the urine.  Make sure to find a pill that is not supplemented with glucose flavoring, as this will be bad for your hyperglycemic patient.

Remember, diabetic crises from both too high or too low blood sugar levels can be fatal, so please bring your feline friend into the veterinarian as soon as possible to diagnose and begin treatment of the diabetes.

Does your guys walk/stand something like this picture on the right?

Left untreated, the altered stance will make jumping difficult for your guy. Eventually his legs may even seem to slip out underneath

him, rendering him almost unable to walk.

It sounds like you have caught the disease earlier rather than later, which means you have a better chance at restoring your kitty’s full health.  Please let me know if you have any additional questions or answers; it is a lot of information to digest, and the more reading you have done to understand the disease prior to the appointment the more you will get out of it.  Here are some links for additional information:
Pet Diabetes Neuropathy Link

Article summarizing diabetes in cats (veterinary conference proceedings)

Thanks and best luck,

Dr. Laci

Ferret Owner Seeking Health Information and Options

for an Expensive Surgery

Question: My ferret Debbie was diagnosed with an adrenal tumor last week! I am freaking out because the veterinarian said she needs to get surgery before she dies from all the hormones.  The only problem is that I don’t have the $1100 dollars that I was quoted for the surgery and I think there will be meds and stuff too.  What do I do?  Is there a rescue that pays for this kind of thing?  I don’t know what to do.

Answer: I am sorry to hear about Debbie.  Let me first tell you more about the disease and then I will tell you what can be done under your financial constraints.

Adrenal gland disease, called Hyperadrenocorticism, is common in ferrets and is one of the most easy to recognize diseases in ferrets due to its specific classical signs. In this disease, an adrenal tumor secretes estrogens and androgens.

Females, like Debbie, usually show signs of enlarged vulvas, hair loss, etc.  Diagnosis is usually made by recognition of clinical signs, then palpation of the gland by the kidney. Abdominal ultrasound can be used to observe the mass and determine if it if one or two adrenal glands are involved.  Some veterinarians confirm the diagnosis with a hormone blood panel.  Occasionally, the tumor may also be secreting insulin that regulates blood glucose, so you should be sure to know that and your vet can test the glucose with a cheap and simple blood test.

There are several treatments that ferret vets can employ and the GOOD NEWS is that surgery is not the only option!  You need to be sure that your veterinarian has done a lot of adrenalectomies and is familiar with all of the newer medical options.   The surgery is very difficult, especially if the right adrenal gland is the culprit.  This is because the right adrenal gland is attached to the wall of a huge vessel called the venal cava, and if it is ruptured, that can very bad news if they don’t know what they are doing.   Furthermore, not all ferrets take well to anesthesia.  In my wife’s veterinary school, she witnessed a survival rate that was less than ideal and that was an exotics surgery department. Complications after surgery can be hypoglycemia, trouble thermoregulation, hypotension, anemia, and Addison’s disease if too much adrenal gland was removed.
Picture of adrenal gland of a ferret

You need to ask your vet, or preferably a ferret/exotics vet, about medical management.  Medical management can be very effective in many ferrets and involves a monthly injection of Lupron® (leuprolide acetate).  This drug stops the production of two hormones (LH and FSH) due to negatively feeding back on its production.  The process is called “desensitization” and the drug should be done monthly for at least three months.  After that, it is possible to reduce the frequency of the injections depending on how she responds.   The advantage of this treatment is pretty obvious – its less invasive and its cheaper.  But this treatment does not get rid of the tumor, it only manages the clinical signs.  It also can become less effective over time.

The second option is melatonin – yup, the same stuff people take to go to sleep.  Any ferret vet can carry out implanting a melatonin implant under the skin. It is just like microchiping a pet and is significantly less invasive than surgery.  The cost of this treatment is similar to the Lupron® therapy.  This therapy has been reported in the literature to be extremely effective in cases where Lupron® stops working or wasn’t working well enough.

Now if you find that you can’t afford the medications,  (Lupron® injections cost about $40 per month), and you need to finance the surgery or her medications, I wrote a post on our blog about how to do so (CareCredit).
As you can see, you have a lot of options besides just surgery.  If you need help finding an exotics vet, check out my blog post on how to do so .  You can also search the Ferret Vet locator.   I wish you the best of luck with Debbie and I look forward to you evaluating the medical alternatives I provided.
Dr. Laci Schaible

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