The document is the May 2009 issue of Compendium, a peer-reviewed veterinary continuing education journal. It includes the following:
- Editorial information such as the executive editor, managing editor, advisory board members, and publication details.
- The table of contents listing continuing education articles on topics such as flea allergy dermatitis, laryngeal paralysis, and pneumothorax.
- Advertisements for Hill's pet food products and Boehringer Ingelheim's heart failure drug Vetmedin.
- Contact information for subscriptions, sales, marketing, and customer service.
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1. Compendium
CompendiumVet.com | Peer Reviewed | Listed in MEDLINE Vol 31(5) May 2009
6 CE Contact Hours CONTI N U I NG EDUCATION FOR VETERI NARIANS ®
NEW
SERIES
A
Applied Dermatology
Flea Allergy
Dermatitis
FREE
CE Laryngeal Paralysis
FREE
CE Pneumothorax
Clinical Snapshot
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4. May
2009 Vol 31(5)
CompendiumVet.com | Peer Reviewed | Listed in MEDLINE
EDITORIAL BOARD
Anesthesia Internal Medicine
Nora S. Matthews, DVM, DACVA Dana G. Allen, DVM, MSc, DACVIM AMERICAN
Texas A&M University Ontario Veterinary College BOARD OF
Cardiology Internal Medicine and Emergency/ VETERINARY
Bruce Keene, DVM, MSc, DACVIM Critical Care PRACTITIONERS
North Carolina State University Alison R. Gaynor, DVM, DACVIM
(Internal Medicine), DACVECC
(ABVP) REVIEW
Clinical Chemistry, Hematology,
North Grafton, Massachusetts BOARD
and Urinalysis
Betsy Welles, DVM, PhD, DACVP Nephrology Kurt Blaicher, DVM, DABVP
Auburn University Catherine E. Langston, DVM, ACVIM (Canine/Feline)
Dentistry Animal Medical Center
Plainfield Animal Hospital
Gary B. Beard, DVM, DAVDC New York, New York
Plainfield, New Jersey
Auburn University Neurology Canine and Feline Medicine
EDITOR IN CHIEF R. Michael Peak, DVM, DAVDC Curtis W. Dewey, DVM, MS, DACVIM
The Pet Dentist—Tampa Bay Veterinary (Neurology), DACVS Eric Chafetz, DVM, DABVP
Douglass K. Macintire, Cornell University Hospital for Animals
Dentistry (Canine/Feline)
DVM, MS, DACVIM, DACVECC
Largo, Florida Vienna Animal Hospital
Oncology
Department of Clinical Sciences Emergency/Critical Care and Ann E. Hohenhaus, DVM, DACVIM Vienna, Virginia
College of Veterinary Medicine Respiratory Medicine (Oncology and Internal Medicine) Canine and Feline Medicine
Auburn University, AL 36849 Lesley King, MVB, MRCVS, DACVECC, Animal Medical Center
DACVIM New York, New York Henry E. Childers, DVM,
University of Pennsylvania DABVP (Canine/Feline)
Gregory K. Ogilvie, DVM, DACVIM
Endocrinology and Metabolic Disorders (Internal Medicine, Oncology), Cranston Animal Hospital
Marie E. Kerl, DVM, ACVIM, ACVECC DECVIM-CA (Oncology) Cranston, Rhode Island
University of Missouri-Columbia CVS Angel Care Cancer Center Canine and Feline Medicine
EXECUTIVE Epidemiology
and Special Care Foundation
for Companion Animals
ADVISORY Philip H. Kass, DVM, MPVM, MS, PhD, Carlsbad, California
David E. Harling, DVM,
BOARD DACVPM DABVP (Canine/Feline),
University of California, Davis Ophthalmology DACVO
MEMBERS David A. Wilkie, DVM, MS, DACVO Reidsville Veterinary Hospital
Exotics
Avian
The Ohio State University Reidsville, North Carolina
Behavior Canine and Feline Medicine,
Thomas N. Tully, Jr, DVM, MS, DABVP Parasitology
Sharon L. Crowell-Davis, (Avian), ECAMS Ophthalmology
Byron L. Blagburn, MS, PhD
DVM, PhD, DACVB Louisiana State University Auburn University
The University of Georgia Jeffrey Katuna, DVM, DABVP
Reptiles David S. Lindsay, PhD
Douglas R. Mader, MS, DVM, DABVP (DC)
Wellesley-Natick Veterinary
Virginia Polytechnic Institute Hospital
Dermatology Marathon Veterinary Hospital and State University
Craig E. Griffin, DVM, Marathon, Florida Natick, Massachusetts
DACVD Pharmacology Canine and Feline Medicine
Small Mammals
Animal Dermatology Clinic Katrina L. Mealey, DVM, PhD, DACVIM,
Karen Rosenthal, DVM, MS, DABVP
DACVCP Robert J. Neunzig, DVM,
San Diego, California (Avian)
Washington State University
University of Pennsylvania DABVP (Canine/Feline)
Rehabilitation and Physical Therapy The Pet Hospital
Wayne S. Rosenkrantz, Feline Medicine Bessemer City, North Carolina
Darryl Millis, MS, DVM, DACVS
DVM, DACVD Michael R. Lappin, DVM, PhD,
University of Tennessee Canine and Feline Medicine
Animal Dermatology Clinic DACVIM (Internal Medicine)
Colorado State University
Tustin, California Surgery
Compendium is a
Margie Scherk, DVM, DABVP Philipp Mayhew, BVM&S, MRCVS,
(Feline Medicine) DACVS refereed journal. Articles
Nutrition
Cats Only Veterinary Clinic Columbia River Veterinary Specialists published herein have
Kathryn E. Michel, DVM, Vancouver, British Columbia Vancouver, Washington
MS, DACVN been reviewed by at least
University of Pennsylvania Gastroenterology C. Thomas Nelson, DVM two academic experts on
Debra L. Zoran, DVM, MS, PhD, Animal Medical Center
the respective topic and
DACVIM (Internal Medicine) Anniston, Alabama
Surgery Texas A&M University by an ABVP practitioner.
Elizabeth M. Hardie, Toxicology
Infectious Disease Tina Wismer, DVM, DABVT, DABT Any statements, claims, or product
DVM, PhD, DACVS Derek P. Burney, PhD, DVM ASPCA National Animal Poison Control endorsements made in Compendium
North Carolina State Gulf Coast Veterinary Specialists Center are solely the opinions of our authors
and advertisers and do not necessarily
University Houston, Texas Urbana, Illinois
reflect the views of the Publisher or
Editorial Board.
202 CompendiumVet.com
m
8. Canadian News
Veterinary Cancer Centre Opens Therapy Dogs Trained
T
he St. John Ambulance Company
T he Western Veterinary Specialist and
Emergency Centre in downtown
Calgary, Alberta, opened its new Can-
ulated radiation therapy capabilities that
allow radiation to be targeted specifically
at tumor cells, sparing normal tissues.
of Comox Valley, Vancouver Island,
British Columbia, has 10 new therapy
dog teams, bringing the total to 34 active
cer Centre Tuesday, April 14. The centre, The Western Veterinary Specialist teams. The addition of these new teams
which has been in development since and Emer gency Centre treats more makes the St. John Ambulance Therapy
2006, will use cutting-edge technology, than 8000 companion animal patients Dog Branch the largest on Vancouver
previously unavailable in Canada, to annually at its Island.
treat pets with cancer. 30,000-square- The therapy dogs serve as surro-
The Cancer Centre is equipped with foot facility. gate pets for people who are no lon-
a linear accelerator with intensity mod- ger able to have animals of their own.
Before entering the program, the dogs
are tested against national standards for
OVC Pet Trust Funds $232,500 temperament and obedience for work
in seniors’ facilities. Volunteers commit
in Companion Animal Research to a minimum of 1 hour per week.
T
he donor-supported OVC Pet Trust the needs and expectations of pet own- SPREAD YOUR GOOD NEWS
has funded 19 research projects at the ers whose animals are receiving cancer Canadian News
Ontario Veterinary College (OVC). The care at the OVC. Another will study the c/o Veterinary Learning Systems
projects were chosen in a fall 2008 com- use of laser lithotripsy (the treatment 780 Township Line Road
petition. Species to be studied include of choice in humans) to pulverize kid- Yardley, PA 19067 USA
,
companion animals such as cats, dogs, ney and ureteral stones in vitro in dogs. E-MAIL editor@CompendiumVet.com
parrots, and veiled chameleons. Other areas of research funded by the FAX 800-556-3288
The chosen projects cover a wide Pet Trust include hematology, cardiol- WEB CompendiumVet.com
range of topics. One project will explore ogy, and infectious disease topics.
Coming Events
July 16 September 9 October 13
Ontario Veterinary Medical Association: Calgary Academy of Veterinary Medicine: Toronto Academy of Veterinary Medicine:
Career Planning for Associate Ophthalmology Early Resuscitation and Stabilization of the
Veterinarians & Potential Clara Christie Theatre, Health Sciences Emergency Patient
Practice Owners University of Calgary, Alberta Dave and Buster’s
Ontario Veterinary Medical Association This seminar will offer 1.5 hours of scientific Toronto, Ontario
Milton, Ontario CE and will be presented by Dr. Cheryl Cullen. This seminar will focus on practical
This course presents the benefits and Phone 403-863-7160 emergency management using case
downsides of owning a practice as well as E-mail info@cavm.ab.ca examples. It will offer 5.5 CE credits.
the practical aspects of practice ownership. Web www.cavm.ab.ca/ce_calendar.html Phone 800-670-1702
Web https://www.ovma.info/Meetings/ Web www.tavm.org
September 15
August 8–13 Toronto Academy of Veterinary Medicine: October 18
World Association for the Advancement Update on Clinical Gastroenterology Calgary Academy of Veterinary Medicine:
of Veterinary Parasitology: Dave and Buster’s Hematology
22nd International Conference Toronto, Ontario Clara Christie Theatre, Health Sciences
Calgary, Alberta This seminar will provide an update on University of Calgary, Alberta
This conference will discuss current issues GI disorders of cats and dogs, with an This seminar will offer 6 hours of scientific CE
in parasitology, with a theme of “One emphasis on diagnosis and treatment. and will be presented by Dr. Marjorie Brooks.
World One Health: Parasites in a Changing It will offer 5.5 CE credits. Phone 403-863-7160
Environment.” Phone 800-670-1702 E-mail info@cavm.ab.ca
Web www.waavp2009.com Web www.tavm.org Web www.cavm.ab.ca/ce_calendar.html
206 Compendium: Continuing Education for Veterinarians® | May 2009 | CompendiumVet.com
10. Clinical Snapshot
Particularly intriguing or difficult cases
Case Presentation #1
❯❯ Jeff Ruth, DVM, DABVP (Canine/Feline)
Bissonnet/Southampton Veterinary Clinic
Houston, Texas
A 3-year-old intact male Persian cat presented with chronic, greasy skin of the
tail and an unkempt haircoat (A). Prior unsuccessful attempts to treat the cat
included systemic antibiotics (cefpodoxime 6.25 mg/kg PO q24h for 14 days)
and antibacterial shampoo (4% chlorhexidine every 14 days for 3 months).
A 2 × 6–cm focal zone of seborrhea oleosa, yellow crusting, and alopecia
affected the proximal third of the tail (B). Additional abnormalities included
mild medial canthal entropion of the left eye and resultant obstruction of
nasolacrimal tear drainage.
A
1. Given the history and clinical
signs, what is the most likely
cause of the lesion?
2. What ancillary tests should be
performed?
3. What are the recommended treat-
ment and the prognosis for this cat?
SEE PAGE 210 FOR ANSWERS AND EXPLANATIONS.
B
208 Compendium: Continuing Education for Veterinarians® | May 2009 | CompendiumVet.com
12. Clinical Snapshot
Answers and Explanations Case Presentation #1
A B
SEE PAGE 208 FOR CASE PRESENTATION.
1. Feline tail gland hyperplasia (FTGH). 3. Treatment goals are to minimize
The tail gland, or supracaudal gland, the accumulation of seborrheic
is a dense accumulation of seba- oil produced by the glands and
ceous glands located on the dorsal to address secondary skin infec-
surface of the tail in cats and dogs. tions. The influence of androgens
Hyperplasia of the sebaceous glands is poorly understood, and cas-
and resultant sebum overproduction tration is unlikely to completely
induces focal clinical signs that may resolve the condition. The use of
include a greasy haircoat, hyperpig- keratolytic and keratoplastic sham-
mentation, furunculosis, alopecia, poos (e.g., sulfur 2% and salicylic
and comedones in the region of the acid 2% q36h for 4 weeks, then
tail gland. FTGH, or stud tail, is a weekly) or degreasing agents (e.g.,
disease of young cats of either sex, benzoyl peroxide 2.5% q36h for
altered or intact. 4 weeks, then weekly) is recom-
mended. Systemic antiseborrheic
2. Skin cytology should be conducted agents used in veterinary medicine
to detect secondary bacterial pyo- include synthetic retinoids such as
derma or Malassezia infection, isotretinoin and etretinate. While
which may complicate the disease. these agents may have benefit in
Dermatophyte culture and skin refractory cases, their use carries
scrapings for Demodex spp are also a greater risk of adverse effects.
warranted. Seborrheic dermatitis Clients should be prepared to
also necessitates the identification invest time in regular grooming
and strict control of fleas and other to minimize the largely cosmetic
ectoparasites. clinical signs of this disease. With
A variety of primary and sec- attention to routine care, the prog-
ondary keratinization defects have nosis for FTGH is favorable.
characteristics that can mimic
FTGH. Among these are gener-
alized primary seborrhea, allergic
dermatitis, neoplasia (carcinoma in
Recommended Reading
g
situ or cutaneous lymphoma), and Guaguère E, Prélaud P. A Practical
zoonotic infectious disease (pythiosis, Guide to Feline Dermatology. Paris:
phaeohyphomycosis). If the signs are Merial; 1999.
not localized to the region of the tail Scott DW, Miller WH, Griffin CE.
gland, or if the initial workup fails Keratinization defects. In: Scott DW,
to elucidate a cause, biopsy for his- Miller WH, Griffin CE, eds. Muller
topathology and culture is indicated. and Kirk’s Small Animal Dermatol-
Histopathology in cases of FTGH ogy. 6th ed. Philadelphia: WB Saun-
demonstrates the characteristic hyper- ders; 2001:1046-1048.
plasia of regional sebaceous glands.
210 Compendium: Continuing Education for Veterinarians® | May 2009 | CompendiumVet.com
13. Editorial
COLUMN EDITOR
COLUMN EDITOR Craig E. Griffin, DVM, DACVD
Animal Dermatology Clinic, San Diego, California
COLUMN EDITOR
COLUMN EDITOR Wayne S. Rosenkrantz, DVM, DACVD
Animal Dermatology Clinic, Tustin, California
Dr. Yu (shown here with his dogs
[from left to right] Timmy, Joey,
and Bitsy) is associate professor
Overview of Flea Allergy Dermatitis of dermatology at The University
of Guelph Ontario Veterinary
College in Canada.
❯❯ Andrea Lam, DVM ❯❯ Anthony Yu, DVM, MS, DACVDa
University of California Davis Veterinary Medical Teaching Hospital University of Guelph Ontario Veterinary College
F lea allergy dermatitis, or flea-bite hypersensitivity, is the
most common small animal dermatologic condition.1–3
In some regions of the world, it is the most commonly seen
sources. The larvae feed on adult flea feces
(partially digested blood) in the environment.
Within 5 to 11 days, a larva undergoes two sep-
arate molting stages before forming a pupa.
canine disease. This disease does not exist in locations that The pupal stage is the most resilient of all
are inhospitable to fleas, such as those at elevations above stages because the cocoon is highly resistant
to desiccation. It also has a sticky surface that
1500 ft or with low humidity (e.g., the desert).
helps to prevent premature removal from the
Although there are more than 2000 docu- environment and that accumulates dust and
mented species and subspecies of fleas, the other household particulates to provide pro-
cat flea (Ctenocephalides felis felis) is the spe- tection. On average, the pupal stage lasts 8 to
cies most frequently found infesting dogs, cats, 9 days; however, fleas can pupate for up to 6
and all caged pets in North America. months if the environmental conditions are not
ideal for emergence. Only with proper environ-
Flea Facts mental stimuli, such as an increase in carbon
The life cycle of the flea ranges from as few dioxide, warmth, physical pressure, and vibra-
as 12 to as many as 190 days, with an average tion, will an adult flea emerge from its cocoon.
of 21 days. The time needed for development After emerging from the cocoon, adult fleas
At a Glance depends heavily on environmental conditions, search for an appropriate host. Adult fleas are
particularly temperature and humidity. The opti- attracted to light and tend to migrate upward
Flea Facts
Page 220 mal environment is a low-altitude geographic toward surfaces where contact with an appropri-
location, a temperature of 75°F (23.8°C), and a ate host is more likely. Once a host is found, feed-
Pathogenesis
Page 220
relative humidity of 78%. ing and mating take place within 8 to 24 hours.
An adult flea takes its first blood meal from Female fleas can consume 15 times their body
Diagnosis a host within minutes of contact. Female fleas weight in blood per day. Adult fleas act as obligate,
Page 222
lay their first egg 24 to 36 hours after this permanent ectoparasites, preferring to remain on
Treatment blood meal. Flea eggs are smooth and slick. a host rather than in the environment.
Page 223
Only 30% of eggs remain on the haircoat; the
Flea Control remainder fall off the host into the environ- Pathogenesis
Products ment. Hatching takes place within 1 to 10 days, Flea saliva contains histamine-like compounds,
Page 224 again depending on humidity and tempera- proteolytic enzymes, and anticoagulants. These
ture. A single female flea can lay 1000 eggs proteins are released into the host during
within 30 days, and most average 2000 eggs feeding and can act as inflammatory or anti-
❯❯ Wayne S. Rosenkrantz, ❯❯ Craig E. Griffin, DVM,
during their life. genic stimuli in sensitive animals. Various
Although eggs can hatch anywhere in the immunologic responses are provoked, includ- WEB
environment, development of the larvae that ing immediate and delayed hypersensitivity EXCLUSIVE
a
Dr. Yu discloses that he emerge from the eggs must take place off the reactions,4 late-phase IgE-mediated responses,
has received financial sup- host because mammalian body temperatures and cutaneous basophil hypersensitivity reac- An extended version of
port from Greer Laborato-
DVM, DACVD DACVD
are too high for survival. Larvae are highly sen- tions.5 Dogs with atopic dermatitis appear to this article is available on
ries, Iams, Novartis Animal
Health, and Pfizer Animal sitive to heat and desiccation and therefore tend be predisposed to the development of flea CompendiumVet.com.
Health. to move downward and away from direct light allergy dermatitis.6,7
220 Compendium: Continuing Education for Veterinarians® | May 2009 | CompendiumVet.com CompendiumVet.com | May 2009 | Compendium: Continuing Education for Veterinarians® 221
Animal Dermatology Clinic Animal Dermatology Clinic
Tustin, California San Diego, California New dermatology series begins on page 220.
Applied Dermatology
S
kin and ear diseases are the most common be written or coauthored by diplomates or residents
problems that veterinarians deal with in of the American College of Veterinary Dermatology,
practice on a daily basis. Because many of who will present evidence-based approaches to
these cases are secondary to genetic causes, cure common dermatologic conditions. This new col-
is often not possible, and management becomes umn will appear quarterly. Occasionally, recog-
the mainstay of therapy. Fortunately, many nized dermatology experts will contribute their
advances in diagnostics and therapeutics have individual approaches to specific problems as
been made in the field of veterinary dermatology, online supplements to this series; the first of these
and pet owners are demanding a higher level articles, “A Practical Approach to Diagnosing and
Managing Ear Disease in Dogs,” by Paul Bloom,
The new dermatology series will provide DVM, DACVD, DABVP (Canine and Feline), will be
published on CompendiumVet.com this month.
practical, easy-to-use techniques for the We hope that this new column will provide
valuable information on how specialists approach
diagnosis and treatment of many common
and manage common skin and ear diseases and
canine and feline ear and skin diseases. will help keep you updated on new diagnostic
and therapeutic options so you can better han-
of care and are often willing to allow advanced dle these often frustrating cases in your clinical
diagnostic testing and therapy. To be able to offer practice.
your clients this higher quality of medicine, it is
imperative to stay current on the latest options
available to manage these chronic and sometimes SHARE YOUR COMMENTS
frustrating cases. Have something to say about this
To help you in this effort, the new Compendium editorial or topic? Let us know:
dermatology series, Applied Dermatology, will pro-
E-MAIL editor@CompendiumVet.com
vide practical, easy-to-use techniques for the diag-
nosis and treatment of many common canine and FAX 800-556-3288
feline ear and skin diseases. The articles in this new
series, which debuts on page 220 of this issue, will
CompendiumVet.com | May 2009 | Compendium: Continuing Education for Veterinarians® 211
14. 3 CE
CREDITS CE Article 1
Laryngeal Paralysis in Dogs
❯❯ Ralph P. Millard, DVM Abstract: Laryngeal paralysis is a common cause of upper airway obstruction in large-breed dogs.
❯❯ Karen M. Tobias, DVM, Although congenital forms have been reported, the disease is usually an acquired condition in older
MS, DACVS dogs. Clinical signs include voice change, inspiratory stridor, and dyspnea. Laryngeal paralysis is
❯❯ University of Tennessee diagnosed by observing the absence of arytenoid abduction during laryngeal examination under a
light plane of anesthesia. The most common method of surgical treatment is unilateral arytenoid
lateralization. Most dogs experience significant improvement in respiration following surgery;
however, they have an increased risk of aspiration pneumonia for the remainder of their lives.
L
aryngeal paralysis is a well-recog- laryngeal paralysis displayed neurogenic
nized disease of large-breed dogs atrophy of the cranial tibial muscle and
that results in upper airway obstruc- axonal degeneration of the peroneal nerve
tion and dyspnea. The condition results in all cases, regardless of whether the
from dysfunction of the caudal laryngeal dogs had signs of peripheral neuropathy.8
nerves, which are the terminations of Within 2 years after diagnosis of laryn-
the recurrent laryngeal nerves. The cau- geal paralysis, clinical signs of general-
dal laryngeal nerves provide innervation ized lower motor neuron disease were
to all the muscles of the larynx except
the cricothyroideus muscle. Dysfunction FIGURE 1
of these nerves results in the loss of
arytenoid abduction by the cricoarytenoi-
deus dorsalis muscle and the inability to
actively constrict the glottis or relax the
At a Glance vocal folds1 (FIGURES 1 AND 2).
Etiology Etiology
Page 212
Laryngeal paralysis can be congenital or
Signalment and Clinical acquired. A hereditary form has been
Signs described in Bouvier des Flandres, dal-
Page 213 matians, rottweilers, and Siberian huskies
Diagnosis and is usually reported in dogs younger
Page 213 than 1 year.2–5 Acquired laryngeal paraly-
Medical Management sis may result from trauma or iatrogenic
Page 216 injury to the recurrent laryngeal nerve
(e.g., during thyroidectomy) or compres-
Surgical Treatment
Page 217 sion of the recurrent laryngeal nerve by
a cranial mediastinal or cervical mass.6
More commonly, however, laryngeal paral-
ysis is classified as idiopathic in older
dogs. Although the underlying etiology is
Cranial view of a dissected canine
unknown, idiopathic laryngeal paralysis
larynx. (a) Corniculate process of arytenoid
is most likely part of a generalized periph- cartilage, (b) cuneiform process of arytenoid
eral neuropathy.7 In one recent study, cartilage, (c) epiglottis, (d) vocal fold, (e) laryn-
muscle and peripheral nerve biopsy sam- geal ventricles, (f) cricoid cartilage, (g) muscu-
ples obtained from 11 dogs with acquired lar process of arytenoid cartilage.
212 Compendium: Continuing Education for Veterinarians® | May 2009 | CompendiumVet.com
15. FREE
Laryngeal Paralysis in Dogs CE
present in all dogs in the study. 8 Although FIGURE 2
laryngeal paralysis has been reported in dogs
with hypothyroidism, the association between
the two conditions is unknown.9,10 Myasthenia
gravis has also been suggested as a cause of
laryngeal paralysis in dogs.11
Signalment and Clinical Signs
Laryngeal paralysis is most commonly reported
in older, large-breed dogs, especially Labrador
retrievers.9,12–14 The average age at the time of
presentation is approximately 10 years.9,12,14
Males are affected more frequently than
females.12–14 Clinical signs progress as laryn-
geal dysfunction becomes more severe. Early
in the disease process, owners may notice a
voice change, inspiratory stridor, and exercise
intolerance. Owners may initially believe that Lateral view of a dissected canine larynx. (a) Thyroid cartilage, (b) cricoid
the dog’s reluctance to move is simply a sign cartilage, (c) hyoid apparatus, (d) epiglottis, (e) corniculate process of arytenoid
of aging. Dysphagia can also occur, possibly cartilage.
in association with peripheral neuropathy.9,14
Owners may also report vomiting; however, could contribute to exercise intolerance. A
they may actually be seeing regurgitation from complete neurologic examination should be
concurrent esophageal disease or gagging and performed to evaluate for signs of polyneu-
retching from a soft palate that has elongated ropathy, such as decreased postural reactions,
as a result of inspiratory dyspnea. Once the deficits in spinal reflexes, and cranial nerve
laryngeal muscles are paralyzed bilaterally, abnormalities.7
dogs may develop severe dyspnea, cyanosis, A rectal temperature should be obtained,
and syncope. Exercise, obesity, excitement, and all dogs should be evaluated for sys-
and increased ambient temperature can exac- temic signs of heatstroke, such as petechial QuickNotes
erbate clinical signs, leading to an emergency hemorrhages associated with disseminated
presentation.9 Affected dogs may develop intravascular coagulation, excessive panting, Acquired laryngeal
pneumonia or pulmonary edema, which can collapse, hyperemic mucous membranes, and paralysis may be
contribute to respiratory distress. Inability abnormalities in mentation, regardless of body associated with a
to constrict the glottis properly during swal- temperature at time of presentation.17,18 The generalized periph-
lowing, regurgitation, or vomiting increases primary means of heat loss in dogs is evapo- eral neuropathy.
the risk of aspiration. Pulmonary edema can ration while panting. Dogs affected by acute
develop in cases of upper airway obstruction signs of laryngeal paralysis are more suscepti-
as a result of changes in intrathoracic pressure ble to hyperthermia due to a lack of heat dissi-
and hypoxia, which cause increased perme- pation through an obstructed respiratory tract.
ability of alveolar capillary membranes.15,16 Heatstroke from sustained hyperthermia can
progress to multiorgan failure and death.17,18
Diagnosis If the body temperature is ≥106°F (41°C) or
If an affected dog is stable, it should undergo systemic signs of heatstroke are evident, addi-
a thorough physical examination. The thorax tional diagnostics (e.g., coagulation panels,
should be auscultated for evidence of pneumo- immediate evaluation of glucose and elec-
nia or pulmonary edema, such as harsh crack- trolytes) and supportive treatment should be
les, wheezes, or rales, and for cardiac murmurs instituted.
or arrhythmias. Arterial pulses should be pal- Complete blood count and serum biochem-
pated for rate, rhythm, symmetry, and strength istry profile results are typically normal unless
to assess for cardiovascular abnormalities that concurrent diseases are present. In dogs with
CompendiumVet.com | May 2009 | Compendium: Continuing Education for Veterinarians® 213