Your pet is at risk for contracting deadly diseases until the initial vaccination series is completed. That is why it is so important to complete this initial vaccination series on time.

Dr. Innes will schedule this series of vaccinations and send reminders to help ensure adequate protection for your pet.

 

Immunity in young unvaccinated pets is constantly changing. If the mother has sufficient immunity, some of this protection is passed to the unborn pet. During the first 24 hours after birth, more short-term protection is passed to the newborn when it nurses and takes in the mothers colostrum. Unfortunately, if the mother has no immunity herself, the infant receives none either.
This passive immunity weakens over a short period of time (0 to 20 weeks – window of susceptibility on graph) at different rates for different diseases. During this period, the infant’s immune system begins to produce its own protection (immunity) when vaccines are administered if protection obtained from the mother does not “block” its own immune response.
When vaccinations are given at appropriate intervals, they help decrease the window of opportunity for these infections because an effective level of vaccine is present at the time the infant’s immune system is able to respond and mother passive immunity is waning. Unvaccinated dogs are susceptible to life-threatening diseases like canine parvovirus and canine distemper. Unvaccinated cats are susceptible to fatal diseases like feline panleukopenia and feline leukemia.
It is not realistic to test for antibody levels for each potentially fatal disease and it is impossible to know when the maternal antibody levels will are low enough not to interfere with vaccines, and the infant’s immune system mature enough to begin producing  antibodies needed for protection from any one disease. This is why following an initial vaccination series schedule is so important.

DHPP: Protects against the diseases of canine distemper, canine hepatitis, parainfluenza, and parvovirus. Booster yearly.

Bordetella: Prevents kennel cough (canine infectious tracheobronchitis). Booster every 6 months.  Given intranasally. This vaccine is highly recommended for all dogs, especially those being boarded or groomed regularly.

Lyme: Prevents the tick-borne disease known as Lyme Disease. Booster yearly in high risk dogs.

Rabies: Vaccinate at 16 weeks, 1 year later, and then booster every 3 years. Required by state law.

6-8 weeks	10-12 weeks	14-15 weeks	16+ weeks
DHPP#1	DHPP#2	DHPP#3	RABIES#1
BORD #1	BORD#2	LYME #2
	LYME#1

FVRCP: Prevents feline viral rhinotracheitis, calicivirus, and panleukopenia. Booster yearly.

FeLV: For outdoor cats only. A feline leukemia virus (FeLV) blood test should be run prior to the vaccination series to identify those cats that are positive for FeLV. If a cat is positive for FeLV, then there is no reason to vaccinate for FeLV. Booster yearly.

Rabies: Not required by law, but strongly recommended because most rabies cases in domestic animals occur in cats. Vaccinate at 16 weeks, 1 year later, and then booster every 3 years.

6-8 weeks	10-12 weeks	14-15 weeks	16+ weeks
FVRCP#1	FVRCP#2	FVRCP#3	RABIES#1
	Felv TEST	Felv#2
	Felv#1

There are others vaccines available for animals such as the Rattlesnake vaccine, but they are used on an individual as needed basis. We use only the best quality vaccines available for your pet, keep the cost as low as possible, and our vaccines are available every day at the same price – our clinic price!!!

The Village Veterinary Hospital has a state-of-the-art surgical suite designed with similar features found in human hospitals. Sophisticated computerized monitoring equipment is used on all surgical patients to continually assess patient status including pulse oxymetry, ecg, temperature, and carbon dioxide levels.

• No food after 10:00 p.m. the day before the surgery.

• It is OK to leave water out for your pet prior to surgery and take it away first thing  in the am.
• Admittance time is usually @ 8:30 a.m., but can always be specially arranged with advanced notice.
• Please notify us of any medications given 24 hours prior to surgery.
• We may require an exam and pre-anesthetic blood work if your pet has not been seen by us recently.
• Depending on the type of surgery your pet is receiving, he or she may be required to spend the night with us for further monitoring of his or her recovery. Dr. Innes will discuss this with you at your pre-surgical visit.

Dr. Innes has 20 years of experience in the most common and some advanced veterinary surgical procedures. Dr. Innes is trained in the latest surgical techniques. We offer a full range of orthopedic and soft tissue surgeries, from routine spays, neuters, and mass removals;  to more advanced procedures, such as laser surgery, orthopedic surgeries including knee (TTA),fracture repair,  and hip surgeries; to abdominal exploration and intestinal surgery. When needed, our state-of-the-art Digital X-Ray and Ultrasound equipment provides the highest level of detail to aid in the diagnosing these problems to determine the type of procedures required for your family pet. We strive to make our patients and their families as comfortable as possible, from your pre-surgical consultation to your pet’s dismissal and aftercare. We’re with you every step of the way, applying our commitment and expertise to ensure a safe procedure and a speedy recovery and regular telephone follow-ups.

• State-of-the-art equipment to monitor your pet’s heart, lungs, oxygen saturation levels, temperature, and blood pressure as noted above
• Only high quality induction medications including diazepam, midazolam, and propofol administered through intravenous catheters and followed by IV fluids during the procedure when elected.
• Pain management before, during, and after your pet’s surgery with a wide array of opiates, NSAIDS, local nerve blocks, and other pain medications.
• A veterinary technician to monitor your pet throughout his or her surgical process, from placing him or her under anesthesia, through the surgical procedure, and during his or her full recovery to standing from anesthesia.
• Complimentary nail and anal gland expression

The most common knee injury in the dog is rupture of the Cranial Cruciate Ligament (CCL), also frequently referred to as the Anterior Cruciate Ligament (ACL).  This injury can occur at any age and in any breed, but most frequently occurs in middle aged, overweight, medium to large breed dogs.  This ligament frequently can suffer a partial tear, leading to slight instability of the knee. If this damage goes untreated, it most commonly leads to complete rupture and possibly damage to the medial meniscus of the knee.  The meniscus acts as a cushion in the knee.   Complete rupture results in front-to-back instability, commonly called Tibial Thrust, and internal rotation of the lower leg, commonly called Pivot Shift.  Untreated legs usually become very arthritic and painful from the instability.
An injured Cruciate Ligament can only be corrected by surgery. There are numerous surgical corrections currently being performed. The most common are 1) External Capsular Repair, 2) Tightrope Procedure (a variation of the External Capsular Repair), 3) Tibial Plateau Leveling Operation (TPLO), and 4) Tibial Tuberosity Advancement (TTA).
This article will focus on the TTA, which is the newest procedure, and probably the best repair for most dogs.  The forces within the knee are very complicated and change as the knee is rotated through its range of motion. In a normal standing position there is a tendency for the lower end of the Femur to slide backwards on the tilted Tibial Plateau, this is called Tibial Thrust. This force can be corrected by either cutting the Tibial Plateau and rotating it into a more flat position (TPLO) or by counteracting this force by changing the angle of pull of the very strong Patellar Tendon by advancing the Tibial Tuberosity (TTA). It has been shown that the TPLO procedure can still allow rotational instability (Pivot Shift) and this may lead to the progression of arthritis as the dog ages. This Pivot Shift does not seem to be a problem with the TTA procedure because it results in more control of rotation by the large quadriceps muscle which pulls on the Patellar Tendon.  The difference in the physics has been worked out quite well by the researchers.  Anyone interested in the details can easily find them by doing an internet search on “TTA vs. TPLO”.

Thanks for visiting and we look forward to serving you. Please call our office to schedule an appointment.

 

The normal Knee Joint (also know as the Stifle joint, has multiple structures which are important to its function. This drawing shows a view from the front with the muscles removed. It is important to note that the Patellar Tendon, a vital structure in the joint has been removed, so that you can see “behind” it. The Patellar Tendon is thick, tough band that runs from the Patella (green dot) to the Tibial Tuberosity (red dot). The medial meniscus is frequently also injured or damaged when the cranial (anterior) cruciate ligament is torn or ruptured.

Typical Joint Angle

In the typical joint, the angle formed between the Tibial Plateau and the Patellar Tendon is about 115 degrees when the leg is in a normal standing position.

Surgical Appearance

This diagram shows the knee once it has been stabilized with the appropriate Titanium implants. These implants are very lightweight and are designed to stay in permanently.

Normal Stifle Joint

The normal joint, viewed from the side, shows the upper bone – the femur and the lower bone – the tibia. The tibial plateau is the actual point of contact between the femur and the tibia. In the diagram, the patellar tendon is clearly visible. It is the patellar tendon that must offset the abnormal forces that are created with a rupture of the cranial cruciate ligament.

Corrected Angle

The abnormal motion that occurs in a knee with a torn cruciate ligament is called Tibial Thrust.  After the TTA Surgery, the corrected angle is now 90 degrees, which will offset the forces in the knee that tend to make it unstable.

Post-operative radiograph of a Village Veterinary Hospital patient.

 

Please call our office to schedule an appointment!!!!!!!!!!!

Post-surgical incisional appearance and patient.

Neutering or spaying is the removal of an animal’s reproductive organ, either all of it or a considerably large part. The process is often used in reference to males whereas spaying is often reserved for females. Colloquially, both terms are often referred to as fixing. Neutering is the most common sterilizing method in animals in the United States. At The Village Veterinary Hospital we perform hundreds of spays and neuters each year.

Besides being a birth control method, and being convenient to many owners, neutering/spaying has the following health benefits:

• Sexually dimorphic behaviors such as mounting, urine spraying and some forms of male aggression (relating to females in estrus) may be reduced due to the decrease in hormone levels brought about by neutering. This is especially significant in male cats due to the extreme undesirability of male cat sexual behavior for many pet owners.
• There is some weak evidence that neutering reduces the risk of mammary tumor considerably in female dogs when done before 2.5 years, and even more so if done before the first estrous cycle. It is a very common disorder of female dogs, with a reported incidence of 3.4%. Of female dogs with mammary tumors, 50.9% have malignant tumors. Spaying female dogs more than two years before the removal of mammary tumors increases the dog’s survival odds by 45%.
• Without its ability to reproduce, a female animal effectively has a zero risk of pregnancy complications, such as spotting and false pregnancies, the latter of which can occur in more than 50% of unspayed female dogs.
• Pyometra, Uterine cancer, Ovarian cancer and Testicular cancer are prevented as the susceptible organs are removed, though Stump pyometra may still occur in spayed females.

General

• As with any surgical procedure, immediate complications of neutering include the usual anesthetic and surgical complications, such as bleeding and infection. These risks are relatively low in routine spaying and neutering; however, they may be increased for some animals due to other pre-existing health factors. In one study the risk of anesthetic-related death (not limited to neutering procedures) was estimated at 0.05% for healthy dogs and 0.11% for healthy cats. The risk for sick dogs and cats were 1.33% and 1.40% respectively.
• Spaying and neutering cats may increase the risk of obesity. In cats, a decrease in sex hormone levels seems to be associated with an increase in food intake. In dogs, the effects of neutering as a risk factor for obesity vary between breeds.
• Neutered dogs of both sexes are at a twofold excess risk to develop osteosarcoma as compared to intact dogs. The risk of osteosarcoma increases with increasing breed size and especially height.
• Studies of cardiac tumors in dogs showed that there was a 5 times greater risk of hemangiosarcoma, one of the three most common cancers in dogs. Spaying and neutering is associated with an increase in urinary tract cancers in dogs.
• Neutered dogs of both sexes have a 27% to 38% increased risk of adverse reactions to vaccinations. The incidence of adverse reactions for neutered and intact dogs combined is 0.32%.
• Neutered dogs have also been known to develop hormone-responsive alopecia (hair loss).
• 2004 study found that spayed and neutered dogs had a higher incidence of cranial cruciate ligament (CCL) rupture, a form of anterior cruciate ligament (ACL) injury.

Specific to males

• About 2% of neutered male dogs eventually develop prostate cancer, compared to less than 0.6% of intact males. The evidence is most conclusive for Bouviers.
• In a study of 29 intact male dogs and 47 castrated males aged 11–14, the neutered males were significantly more likely to progress from one geriatric cognitive impairment condition (out of the four conditions – disorientation in the house or outdoors, changes in social interactions with human family members, loss of house training, and changes in the sleep-wake cycle) to two or more conditions. Testosterone in intact males is thought to slow the progression of cognitive impairment, at least in dogs that already have mild impairment.
• As compared to intact males, male neutered cats are at an increased risk for certain problems associated with feline lower urinary tract disease, including the presence of stones or a plug in the urethra and urethral blockage.
• Neutering also has been associated with an increased likelihood of urethral sphincter incontinence in males.

Specific to females

• There is some weak evidence that spaying can increase the risk of urinary incontinence in dogs, especially when done before the age of three months. Up till 12 months of age, the risk decreases as the age at spaying increases.
• Spayed female dogs are at an increased risk of hypothyroidism.

In female animals, spaying involves abdominal surgery to remove the ovaries and uterus (hystero-oophorectomy). Spaying is performed commonly on cats and dogs, as a method of birth control and behavioral modification.

The surgery is most commonly performed using a traditional open approach or by laparoscopic “keyhole” surgery. Open surgery is more widely available as laparoscopic surgical equipment costs are expensive and few veterinary hospitals other than specialty surgical facilities have the equipment.

Traditional open surgery is usually performed through a ventral midline incision below the umbilicus. The incision size varies depending upon the surgeon and the size of the animal. The uterine horns are identified and the ovaries are found by following the horns to their ends.

There is a ligament that attaches the ovaries to the body wall which may need to be broken down so the ovaries can be identified. The ovarian arteries are then ligated with resorbable suture material and then the arteries transected. The uterine body (which is very short in litter bearing species) and related arteries are also tied off just in front of the cervix (leaving the cervix as a natural barrier). The entire uterus and ovaries are then removed. The abdomen is checked for bleeding and then closed with a 3 layer closure. The linea alba and then the subcutaneous layer are closed with resorbable suture material. The skin is then stapled, sutured, or glued closed.

 

 

 

 

 

 

 

 

How the uterus and ovaries appear during a routine spay.

In male animals, castration involves the removal of the testes, and is commonly practiced on both cats and dogs for birth control and behavior modification.

Rattlesnakes in Southern California include the Western Diamondback, Sidewinder, Speckled rattlesnake, Red Diamond rattlesnake, Southern Pacific, Great Basin rattlesnake and the Mojave rattlesnake. The most common encounter in our area is with the Southern Pacific Rattlesnake.  Rattlesnakes are pit vipers (they have a heat sensory pit between the eye and nostril); they have a shovel shaped head; and retractable fangs.

Rattlesnake venom is a modified salivary secretion designed to immobilize and start pre-digestion of rodent prey. The classic presentation of rattlesnake evenomation is marked swelling due to destruction of blood vessel cells with resultant leakage of blood cells and plasma that results in severe bruising and pain. Young snakes are venomous and have been shown to have a higher level of toxic poisons in their venom.

As mentioned, the clinical signs of evenomation are severe local swelling and bruising along with low blood pressure, coagulation problems, and in some cases neurological signs. The majority of dogs are bitten on the head, face, and shoulders; cats are most commonly struck on the trunk and feet.

Animals bitten by rattlesnakes should be immediately transported to a veterinary hospital that has antivenin available and be kept calm and quiet. Therapy of rattlesnake evenomation should be rapidly initiated and aggressive with lab work to evaluate a CBC, platelet count, and coagulation parameters. Intravenous fluid should be started to counteract low blood pressure, as a route to give antivenin and antibiotics – snake mouths are full of pathogenic bacteria. The most effective treatment is by administering Rattlesnake antivenin, it is most effective when given as soon as possible after a bite has occurred, but may be given as indicated. Antivenin is quite expensive and depending on the severity of the bite several vials may be needed.  Rattlesnakes are active year round here but are most common in the early, warm spring and summer. The best way to avoid your pet being bitten is to become familiar with high incidence regions, don’t hike with your dog during the early warm emergence period, keep your dog on a leash, snake fence your yard if indicated, and take your dog to snake avoidance classes.

The Village Veterinary Hospital’s digital x-ray technology and ultrasound machines provide detailed, non-invasive information about our patients. Digital technology allows for images to be electronically sent to specialists for confirmation of interpretation if indicated. The Village Veterinary Hospital utilizes Board Certified Veterinary Specialists for more complex studies such as echocardiograms and radiographic review.

Digital X-rays are superior to X-ray film for many reasons:

• Instant images are produced on the computer screen, allowing quick assessment of position and correct exposure, resulting in fewer X-rays taken and exposing your pet to less radiation.

• Digital X-rays can be enhanced and magnified, allowing for diagnosis of problems that we would not normally see on traditional X-ray film.
• Digital X-rays can be sent quickly to board-certified radiologists for interpretation of difficult cases.

We also use digital dental X-rays that allow for diagnoses of dental problems hidden below the gum line. Also, digital is much faster than dental X-ray film and does not waste precious time while your pet is under anesthesia.

Ultrasound is an advanced, state-of-the-art diagnostic imaging technique that is painless and non-invasive. Ultrasound is used for the abdominal cavity to obtain detailed imaging of the stomach, liver, spleen, gall bladder, kidneys, lymph nodes, adrenal gland, and urinary bladder. It is also used for pregnancy evaluations and to diagnose heart disorders and some diseases of the chest.

Dr. Innes has advanced training in this field. This allows us to get an ultrasound diagnosis quicker than other veterinary practices and without the need for a referral to another hospital. This means financial savings and less critical time wasted in getting a diagnosis of a life-threatening problem

We have both flexible and rigid video endoscopy. Flexible endoscopy is used to evaluate the stomach, small intestine, and colon. We can often diagnosis chronic intestinal problems with taking a biopsy that is much less invasive than surgical biopsy. Also, we use the flexible endoscope for removal of foreign bodies.

Throughout the years, we have been able to remove numerous foreign bodies with the help of endoscopy, thereby preventing the need for major abdominal surgery. These foreign bodies have included jewelry, coins, rocks, and cloth material.

Rigid video endoscopy is used for many different things, including  the inside of ear canals, nasal passages, urethra, and bladder.

At The Village Veterinary Hospital, laser therapy is a new technology used to aid in the treatment of a variety of injuries and conditions such as wounds, dermatological conditions, and orthopedic and neurological problems. Laser therapy is an FDA-approved, sterile, and painless treatment for pets.

Professional and Olympic athletes use laser therapy for pain relief as well as to improve their bodies’ ability to heal. This technique originated in Europe and Russia, where it has been used for many years. Sports medicine physicians and chiropractors now use it successfully on humans.

The therapeutic laser produces energy in the form of light waves that change cellular metabolism. This in turn affects the production of endorphins, relieving pain; and the laser light beam photons are absorbed by cells within the damaged tissue and increase blood circulation. Structures within these cells communicate the message to increase production of cellular energy which provides the damaged cells with the fuel and tools necessary to accelerate the cell regeneration process. This enables a much faster, quicker, and more efficient return to normal function. The end result is relief from pain, increased circulation, reduced inflammation, and an acceleration of the healing process.

We use a class Ⅳ therapy laser, which is the most effective therapy laser on the market today. Some of the many uses of laser therapy include:

• Arthritis (Degenerative Joint Disease)
• Back Pain (Intervertebral Disc Disease)
• Trauma (Skin, Muscle, Bone)
• Open or necrotic non-healing wounds (Trauma)
• Surgery (Incisions, Growth Removals, Bone Surgery)
• Inflammatory Conditions:
  • Acute or chronic otitis (Ear problems)
  • Anal Gland inflammation
  • Periodontitis (Gingivitis)
  • Hot Spots
  • Lick Granulomas
  • Idiopathic Cystitis – (Bladder Inflammation)
  • Sinusitis, Rhinitis (Nasal problems)
  • Provide a new and non-invasive option for pain management

In a typical treatment session, the laser wand is applied to the area to be treated. “Depending on the area and the energy you are delivering, it can take up to 10 to 20 minutes,” says Dr. Innes.

And, the good news about laser therapy for dogs is there’s no need to shave or clip the area to be treated and the dog doesn’t need to be sedated during the process. That means that treatment can be applied multiple times a day or a number of times per week.

Price points for laser therapy range from $25.00 to $45.00 per session at the The Village Veterinary Hospital. Some sessions are packaged as a bundle on the first day the dog is evaluated. Then the dog comes in twice a week and half the time a technician will perform the treatment.

Laser therapy won’t cause your dog any unwanted side effects. The laser used for this type of treatment will not burn your dog’s skin.

Not all veterinary practices have the facilities to offer laser treatment for your dog, as the laser equipment can be exceptionally pricy. Laser therapy treatment is becoming more popular. With increased popularity, the equipment will become more affordable and then more widely available.

“I would like to see this type of technology in every practice, just like prescription and injectable drugs. This should be one more way to manage our patients in the future,” says Dr. Innes. “It’s really not alternative therapy, but more of an integrative approach.”

Laser therapy improves the quality of a dog’s life as well as the life of its owner, because if your dog is happy, you are happy.

At The Village Veterinary Hospital we use the advanced K-Laser pictured below.

 

 

 

 

 

 

 

 

 

Please visit the K-Laser website for further information @ www.k-laserusa.com/your-k-laser/animal-veterinary/

Give laser therapy a try! Call for an initial discounted trial.

Dr. Innes has been credentialed and certified by Vetstem in the collection and use of stem cells!

What is Vet-Stem Regenerative Medicine?

Regenerative Medicine is a broad definition for innovative medical therapies that will enable the body to repair, replace, restore and regenerate damaged or diseased tissues.

Vet-Stem Regenerative Medicine uses a concentrated form of autologous adipose-derived adult stem cells to treat traumatic and degenerative diseases, including bowed tendons, ligament injuries, osteoarthritis, and osteochondral defects in horses, dogs and cats.

Despite its infancy, regenerative medicine is not new. Success in numerous animal models of disease and emerging success in human clinical trials for Crohn’s fistulas1 and stroke2 , along with hundreds of ongoing clinical trials (See sidebar) support the rationale for stem cell use, and now success, in veterinary medicine. Vet-Stem collaborative and clinical research demonstrate positive results in treating horses with tendon and ligament injuries, osteochondral defects, and osteoarthritis.3-6 The first peer reviewed double-blinded multicenter study for adipose-derived stem cell therapy use in canine osteoarthritis of the hip showed significant improvement in all post treatment evaluation times for lameness, pain, and range of motion. Similar results have been obtained for canine elbows and stifles.

Stem cells are multipotent and can differentiate into tendon, ligament, bone, cartilage, cardiac, nerve, muscle, blood vessels, fat, and liver tissue22,23 (see figure below). The stromal fraction that is harvested from adipose tissue is a heterogeneous mixture of regenerative cells (see below).

 

 

 

 

 

 

 

 

 

 

Vet-Stem Technology: Summary

 

Vet-Stem Regenerative Cell Therapy is based on a clinical technology licensed from Artecel Inc. Original patents are from the University of Pittsburgh and Duke University.

• Rationale based on consistent therapeutic success in numerous animal models of disease (see sidebar)
• Adipose-derived stem cells (Vet-Stem Regenerative Cells: VSRC™)
• Autologous cell therapy
• Currently used in horses with bowed tendons, ligament injuries, and fractures, and in dogs with osteoarthritis
• More than 4,000 horses treated since 2003
• More than 3,500 dogs treated since 2006
• No systemic adverse events reported and < 0.5% local tissue reactions.3-6
• Demonstrated efficacy with VSRC therapy in horses and dogs
  • Cornell University double-blind, placebo controlled study5
  • Retrospective studies3,4,37
  • Case studies6
  • Double-blinded placebo controlled multicenter study

Why use adipose-derived regenerative cells rather than regenerative cells derived from bone marrow?

Adipose-derived regenerative cells are:

• Readily available source
• Can be collected in far greater concentrations than those from bone marrow.
• Able to differentiate into multiple lineages implicating their potential in bone, cartilage, and cardiac repair23 (See figure above)
• Fractions isolated from adipose tissue contain a heterogeneous mixture of regenerative cells, including:
  • Mesenchymal stem cells (MSCs)
  • Endothelial progenitor cells
  • Pericytes
  • Immune cells
  • Fibroblasts
  • Other growth factor-secreting bioactive cells

Differences in Regenerative Medicine compared to traditional medicine:

• Does not rely on a single target receptor or a single pathway for its action
• Regenerative cell mixture is delivered either directly to the traumatic wound (e.g.: tendonitis, desmitis, fracture) or are delivered systemically (e.g.: liver disease, renal disease)
• Regenerative cells can differentiate into many tissue types, induce repair, and stimulate regeneration
• Regenerative cells “communicate” with the cells of their local environment through paracrine and autocrine modalities, creating the optimal environment for natural healing
• Regenerative cells produce a variety of both secreted and cell surface substances that regulate tissue growth, integrity, and function

Mechanisms for success…

Vet-Stem Regenerative Cell (VSRC™) therapy delivers a functionally diverse cell population able to communicate with other cells in their local environment. Until recently, differentiation was thought to be the primary function of regenerative cells.  However, the functions of regenerative cells are now known to be much more diverse and are implicated in a highly integrated and complex network. VSRC therapy should be viewed as a complex, yet balanced, approach to a therapeutic goal. Unlike traditional medicine, in which one drug targets one receptor, Regenerative Medicine, including VSRC therapy, can be applied in a wide variety of traumatic and developmental diseases. Regenerative cell functions include:

Anti-inflammatory/Immunomodulation: In general, in vitro studies demonstrate that MSCs limit inflammatory responses and promote anti-inflammatory pathways.

• When present in an inflammatory environment, data demonstrates that MSCs may alter the cytokine secretion profile of dendritic cell (DC) subsets and T-cell subsets causing a shift from a pro-inflammatory environment to an anti-inflammatory or tolerant environment.
• MSCs do not express MHC class II antigens or costimulatory molecules and they suppress T cell proliferation.
• MSC suppress mixed lymphocyte reactions and inhibits T cell proliferation induced by a third cell type or by mitogenic factors.
• MSC are able to control lethal graft versus host disease (GVHD) in mice after haploidentical hematopoietic transplantation.

Trophic Support:
Multiple studies demonstrate that MSCs secrete bioactive levels of cytokines and growth factors that that support angiogenesis, tissue remodeling, differentiation, and antiapoptotic events. 25,28 MSCs secrete a number of angiogenesis-related cytokines such as:28

• Vascular endothelial growth factor (VEGF)
• Hepatocyte growth factor (HGF)
• Basic fibroblast growth factor (bFGF)
• Granulocyte-macrophage colony stimulating factor (GM-CSF)
• Transforming growth factor – β

Differentiation:
Adipose derived MSC studies demonstrate a diverse plasticity, including differentiation into adipo-, osteo-, chondro-, myo-, cardiomyo-, endothelial, hepato-, neuro-, epithelial and hematopoietic lineages, similar to that described for bone marrow derived MSC. 22  These data are supported by in vivo experiments and functional studies that demonstrated the regenerative capacity of adipose-derived MSCs  to repair damaged or diseased tissue via transplant engraftment and differentiation. 6,9,30

• Awad and colleagues reported significant improvements using autologous MSC delivery in a rabbit Achilles tendon repair model compared to cell-free collagen control rabbits.
• Nixon and colleagues demonstrated statistically significant  improvement in histological repair of a collagenase-induced injury in the superficial digital flexor tendonitis in horses treated with autologous regenerative cells harvested from fat.
• In a caprine model of traumatic joint injury, MSCs delivered intra-articularly engrafted and repaired meniscal tissue, leading to a statistically significant reduction in the progression of osteoarthritis.
• Multiple studies demonstrate in vivo bone regeneration and repair in animal models. Bruder and colleagues demonstrated in two studies that MSCs could be used to repair a critical defect in a non-union fracture model in dogs.
• Cowan and colleagues demonstrated that MSCs heal a critical-size mouse calvarial defect in which there was increased bone formation and mineralization compared to controls.
• A human clinical case showed a dramatic regeneration of the calvarium in a young girl with severe traumatic damage.
• In a rodent cerebral infarct model, Jeong and colleagues demonstrated that infracted rats administered magnetically labeled MSC administered two weeks after the creation of an infarct experienced restoration of locomotor function compared to controls.

Homing:
Homing (chemotaxis) is an event by which a cell migrates from one area of the body to a distant site where it may be needed for a given physiological event.  Homing is an important function of MSCs and other progenitor cells and one mechanism by which intravenous or parenteral administration of MSCs permits an auto-transplanted therapeutic cell to effectively target a specific area of pathology.

• Nilsson and colleagues demonstrated that labeled cells of bone lineage injected intravenously into mice can engraft, form bone, and give rise to osteocytes and bone lining cells detectable on the mouse femur.
• Chen and colleagues performed peripheral intravenous experiments using a cerebral arterial occlusion model of stroke and demonstrated that labeled MSCs administered  24 hours and 7 days post-injury has demonstrated migration to the area of injury as well as a dramatic reduction in stoke infarct size.

Revascularization:
Adipose derived regenerative cells contain endothelial progenitor cells and MSCs that assist in angiogenesis and neovascularization by the secretion of cytokines, such as hepatic growth factor (HGF), vascular endothelial growth factor (VEGF), placental growth factor (PGF), transforming growth factor (TGFβ), fibroblast growth factor (FGF-2), and angiopoietin.25

• Chen and colleagues examined the effect of intravenous administration of MSCs after cerebral arterial occlusion in the rat and demonstrated new capillary formation, increased vessel formation and increased VEGF (vascular endothelial growth factor) expression in the areas of the lesion.
• In an in vivo model of hind limb eschemia, intravenous injection of MSC were associated with an increase in blood flow and capillary density and incorporation of the cells in the leg vasculature.
• Rehman and colleagues demonstrated that nude mice with ischemic hind limbs demonstrated marked perfusion improvement when treated with human MSC.

Anti – Apoptosis:
Apoptosis is defined as a programmed cell death or “cell suicide”, an event that is genetically controlled.35  Under normal conditions, apoptosis determines the lifespan and coordinated removal of cells.  Unlike necrosis, apoptotic cells are typically intact during their removal (phagocytosis).

• Rehman and colleagues demonstrated this effect in acutely injured tissue denied critical blood-flow resulting in ischemia. MSC significantly reduced endothelial cell apoptosis.
• Kortesidis and colleagues also demonstrate that MSCs express factors that support cell survival and avoid apoptosis thereby preserving cells that would otherwise be destroyed.

THIS INFORMATION HAS BEEN TAKEN DIRECTLY FROM THE VETSTEM WEBESITE. FOR EVEN MORE INFORMATION PLEASE VISIT www.VETSTEM.COM
If you are interested in stem cell therapy for your pet please call our office!!!!

For more information please visit www.aspca.org/pet-care/poison–control/

Chocolate
One of the most common poisonings in small animals, especially dogs, is chocolate and other human caffeine containing medications such as No-Doz or Vivarin. Caffeine and theobromine (the toxin in chocolate) are naturally occurring compounds called methylxanthines.   Dogs must eat 250-500 mg/Kg of body weight of chocolate for it to be toxic; this equals approximately 15 oz of milk chocolate or 4oz of baking chocolate per 15# of body weight. Clinical signs of chocolate toxicity include vomiting, diarrhea, increased urination, heart arrhythmias, drunken gait, and possibly seizures. Treatment includes supportive therapy with IV fluids, speeding elimination of the toxins through induction of vomiting, urinary catheter,   and enemas, treating heart arrhythmias, and controlling seizures.  There is no specific antidote but activated charcoal given orally can have a significant effect on helping eliminate the toxin. As with most toxins, rapid identification of the problem and proper treatment often lead to a good positive outcome, but chocolate can be lethal.

Grapes and Raisins
Grapes and raisins have been reported to cause poisoning in some dogs that lead to kidney failure. It does not seem to be a problem for all dogs, but in some as few as 4-5 grapes can be toxic. The toxic compound is still unknown at this time. It appears the toxin is some form of kidney toxin that alters blood flow to areas of the kidney leading to cell degeneration and death of those areas. The toxic effect is not dose dependent and doesn’t occur in all dogs. The biggest concern is that we cannot predict which dogs it will happen to. Treatment includes aggressive kidney support with fluids and prognosis is based on how fast the problems was identified and treated.

Macadamia Nuts
Ingestion of macadamia nuts in dogs has been associated with weakness, depression, vomiting, wobbly gait, joint swelling, and joint pain. The minimum ingestion seen in dogs that causes clinical signs is about ½ nut per pound of body weight. The toxic agent and the way it affects the body are currently unknown. Dogs with intoxication often present with hind limb weakness, wobbly gait, muscle tremors, and elevated temperature. The problem usually resolve within 48 hour with IV supportive care and monitoring.

Xylitol (sugar free products)
Xylitol is a sugar substitute found in many sugar-free products (gum, cookies, candy, etc.) Dogs will readily eat these diet products and become poisoned often within 60 minutes.  The chemical causes severe hypoglycemia (low blood sugar leading to weakness, collapse, and seizures. In some patients, the low blood glucose may lead to liver failure.  Immediate induction of vomiting, fluid therapy to support low blood sugar and liver disease are required for a favorable outcome. Prognosis appears to be based on age and size of the dose ingested, and how early aggressive therapy is initiated. There is no antidote.

Anticoagulant Rodenticides
Anti-coagulant rodenticides make up a large proportion of poisonings in our practice. They are usually of the new “second generation” compounds which are a long acting compound that can depress blood clotting mechanisims for up to 4 weeks. Correct identification of the brand and chemical is very important to be sure it is an anti-coagulant and not another poison and to treat for the proper length of time, bringing the packaging is very helpful. The most common problems are difficulty breathing, lethargy, and lack of appetite. Hemorrhages under the skin, bleeding into the eyes, dark stool, and excessive bleeding at blood collection sites also may be seen. Simple blood tests are used to confirm the diagnosis. Treatment is with vitamin K1, however, some dogs are severely affected by the time of diagnosis they may need intensive care with blood or plasma transfusions. Late stage poisonings and those with ingestion over a long period of time may certainly be lethal.

Ethylene Glycol (Antifreeze)
Ethylene glycol is commonly found in antifreeze, rust removers, and photographic developing fluid; has a sweet taste; and a low minimum lethal dose making it very dangerous. The minimum lethal dose is less than a tablespoon for a cat and 4 ounces for a 25# dog. Metabolization produces toxic by-products which cause acidification of the body and kidney damage.
Pets with ethylene glycol poisoning often present with vomiting, depression, and excessive drinking and urination. If the ingested dose is large, death may be within hours. If the animal survives for some time then kidney failure ensures which leads to lack of urine production, progressive depression and lethargy, and often excessive salivation and oral ulcers. Treatment is with iv fluid support and ethylene glycol competitor molecules such a alcohol or a drug called 4-MP. Acute ingestion, diagnosis, and treatment can be effective; but most pet owners miss the toxin ingestion and do not observe the clinical signs until severe and at the point of irreversible kidney damage.

Sago Palms
Sago palms (cycads) are common local ornamental plants. They contain poisons that are toxic to the liver, GI tract, and nerves. The seeds contain the highest amount of the poisons but the entire plant is toxic and dogs often eat the fleshy roots after digging around the plants or knocking a potted plant over. Liver and GI signs begin within 24 hours as do abnormal laboratory liver values. The most common presenting signs are vomiting, depression, diarrhea, anorexia, and seizures. Treatment is by induction of vomiting to remove ingested material, repeat doses of activated charcoal, supportive IV fluid therapy, and repeat blood work to monitor liver values. Prognosis is good if caught early, but guarded to poor in cases where the animal is already clinically ill.

Mushroom Poisoning
Mushroom poisoning occurs as a result of ingesting toxic Amanita mushrooms. Pets have been known to eat mushrooms in yards and while on walks. While 99% of mushrooms have little or no toxicity, the 1% that are highly toxic can cause life-threatening problems in pets. Take extra care to keep pets away from areas where mushrooms might be growing. Dogs take a special interest in Amanita species, quite possibly because of their fishy odor. The fatality rate for Amanitin poisoning is about 50-100% without prompt, knowledgeable medical treatment. Amatoxins are doubly dangerous due to the fact that the symptoms are delayed for 6 to 24 hours after ingestion, by which time the toxins have been completely absorbed by the body.

If you have any reason to suspect that your dog has ingested an amanitin-containing mushroom, DON’T WAIT for symptoms to appear! There is no antidote for amanitin poisoning, and the best hope is to rush the pet to the The Village Veterinary Hospital or the local emergency vet hospital where the toxins can be removed before being fully absorbed into the body.

Always bring the suspected mushroom with you when you bring your dog to us, or if you have mushrooms growing in your yard bring them in a brown paper bag for identification.

Amanita mushrooms are the most toxic and cause the destruction of cells, especially liver and kidney cells. The following are some of the more common symptoms associated with mushroom poisoning:

• Vomiting                             Yellowing of the skin
• Diarrhea                              Uncoordinated movements
• Abdominal pain                   Excessive drooling
• Weakness                           Seizures
• Lethargy                             Coma

Mushroom poisoning is an emergency that will requires immediate hospitalization. If acute ingestion has occurred vomiting will be inducted and activated charcoal is given by mouth to bind the toxins present in the stomach and intestines. Hospitalization with IV fluid therapy to stabilize fluid levels and enhance urination, to help in the elimination of toxin, is needed.  Prognosis depends on response to treatment and evaluation of on going liver damage by repeat blood work, and amount of time between ingestion, diagnosis, and treatment.

Lillies
Members of the lily family have been shown to cause acute renal failure in cats. The toxic principle is unknown, but is known to be water soluble. Even minor exposures, from a few bites on a leaf or ingestion of pollen, may resuly in toxicosis. Therefore, all feline exposures to lilies should be considered potentially life-threatening and should warrant clinical intervention.

Exposed cats often vomit within a few hours of exposure, the vomiting often subsides within a few hours and the cat may seem to be back to normal or mildly depressed. Within 24-72 hours renal failure develops that is usually accompanied by vomiting, depression, and anorexia. The kidney lesions are similar to those seen in dog with grape or raisin toxicity. Lab results indicating kidney failure are detectable within 12-24 hours.

Treatment includes decontamination, induction of vomiting and IV fluid support. Like all poisons, if treatment is started early (in this case 12-18 hours) the prognosis could be good, treatment thereafter is not as successful and a poor prognosis is warranted.  In severe cases dialysis may be of benefit while the kidneys attempt some regeneration.

Beware at Easter!!!!

Human or Veterinary prescriptions

Many human prescriptions are poisonous or toxic to our pets. Any inadvertent prescription ingestion should be a concern and a prompt call to The Village Veterinary Hospital, an emergency veterinarian, or the link below should be made for more information.