Chronic Disease Management for Small Animals

Practical guidance on managing chronic illnesses in small animals

Chronic Disease Management for Small Animals provides a complete resource for the long-term care and therapy of canine and feline patients with incurable conditions. Offering practical strategies for successful management of chronic disorders, the book presents expert guidance on handling these ailments and the animals that they afflict.

Written by leading experts in their respective fields, Chronic Disease Management for Small Animals takes a multidisciplinary approach to the subject, covering chronic diseases across many categories, including mobility, dermatology, ophthalmology, internal medicine, and more.  The book is not meant to replace existing textbooks, but is designed to be used as a practical guide that educates the reader about the many therapeutic options for chronic disease management. Coverage encompasses:

• The impact that chronic disease has on the quality of life for both the patient and its owner
• Specific chronic diseases, outlining diagnostics, therapeutics, and quality of life concerns
• Hospice care and end of life, including client and pet needs, quality of life, cultural sensitivities, dying naturally, euthanasia, and death

Chronic Disease Management for Small Animals is an essential reference for recently qualified and seasoned practitioners alike, supporting clinicians in making decisions and communicating with clients regarding long-term care. It is an ideal book for all small animal practitioners and veterinary students.

W. Dunbar Gram, DVM, DACVD, MRCVS, is Service Chief and Clinical Associate Professor of Dermatology at the University of Florida College of Veterinary Medicine in Gainesville, Florida, USA.

Rowan J. Milner, BVSc (Hons), MMedVet (Med), PhD, DECVIM-CA, DACVIM, is Professor and Chair of the Department of Small Animal Clinical Sciences at the University of Florida College of Veterinary Medicine in Gainesville, Florida, USA.

Remo Lobetti, BVSc (Hons), MMedVet (Med), PhD, DECVIM-CA, is an internist at Bryanston Veterinary Hospital in Johannesburg, South Africa.

List of Contributors xiii

Preface xv

Acknowledgments xvii

Part One Communication and Caregiving 1

1 Communication, Caregiving, and Chronic Disease 3
Dani McVety

Introduction 3

Overview 4

Impact of Chronic Disease on Quality of Life for Both the Patient and Caregiver 5

Part 1: Know Yourself—Set the Stage for Collaborative Decision Making, Active Listening, and Caregiving 10

Part 2: Verbal Communication 12

Part 3: Nonverbal Communication 14

References 20

Part Two Syndromes and Clinical Signs of Chronic Disease 23

2 Pruritus, Atopic Dermatitis, and Pyoderma 25
W. Dunbar Gram

Introduction 25

Diagnosis 26

Management 31

Quality of Life for Patient and Caregiver 37

References 37

3 Managing Mobility: An Integrative Approach (Orthopedic and Neurologic Impairments of Mobility) 39
Justin Shmalberg

Introduction 39

Diagnosis 39

Therapeutics 46

Quality of Life 60

End�]of�]Life Decisions 63

References 64

4 Chronic Diseases of the Eye and Adnexa 65
Caryn E. Plummer

Introduction 65

Adnexa 65

Ocular Surface Disorders 67

Corneal Disease 74

Intraocular Disease 78

Conditions of the Uvea 85

Lenticular Changes 88

Posterior Segment Disease 91

Blindness 92

References 93

5 Heart Disease 97
Simon Swift

Introduction 97

Treatment of Acute Heart Failure 98

Management of Chronic Congestive Heart Failure 100

Specific Heart Diseases 101

Further Reading 134

6 Canine Cognitive Dysfunction 135
Sheila Carrera�]Justiz

Introduction 135

Diagnosis 135

Therapeutics 137

End of Life 139

Further Reading 139

7 Vestibular Syndromes 141
Sheila Carrera�]Justiz

Introduction 141

Diagnosis 141

Therapy 143

End�] of�]Life Decisions 144

Further Reading 144

8 Seizure Disorders 145
Sheila Carrera�]Justiz

Introduction 145

Diagnosis 145

Therapy 147

Quality of Life 150

Further

Reading 151

9 Feline Hyperthyroidism 153
Sylvie Daminet and Kate Hill

Introduction 153

Diagnosis 153

Management 153

Renal Function and Hyperthyroidism 156

Iatrogenic Hypothyroidism 157

References 157

10 Hypoadrenocorticism in Dogs 159
Sylvie Daminet

Introduction 159

Clinical Presentation and Diagnosis 159

Treatment 160

Quality of Life 162

References 162

Further Reading 162

11 Canine Hypothyroidism 163
Sylvie Daminet

Introduction 163

Diagnosis 163

Main Influences on Thyroid Function Tests 163

Treatment 165

Quality of Life 166

References 166

12 Hyperadrenocorticism in Dogs and Cats 169
Eric Zini and Michele Berlanda

Introduction 169

Therapy 169

Quality of Life 173

References 173

13 Diabetes Mellitus 175
Eric Zini and Michele Berlanda

Introduction 175

Diagnosis 175

Therapy 175

Monitoring 177

Remission 178

Quality of Life 178

References 178

14 Chronic Pancreatitis 181

Penny Watson

Introduction 181

Diagnosis 181

Treatment 183

Quality�]of�]Life and End�]of�]Life Assessments 185

References 186

15 Mega�]Esophagus and Esophageal Dysmotility 187
Liza S. Köster

Introduction 187

Diagnosis 188

Therapeutics 188

Quality of Life 190

References 191

16 Chronic Gastritis 193
Liza S. Köster

Introduction 193

Diagnosis 194

Therapeutics 195

Quality of Life 197

References 197

17 Ulcerative Colitis 201
Liza S. Köster

Introduction 201

Diagnosis 201

Therapy 202

Quality of Life 203

References 203

18 Mega�]Colon 205
Liza S. Köster

Introduction 205

Diagnosis 206

Therapeutics 206

Quality of Life 209

References 210

19 Inflammatory Bowel Disease 211
Iwan A. Burgener

Introduction 211

Diagnosis 211

Therapeutics 212

Quality of Life for Patient and Caregiver 214

References 214

20 Protein�]Losing Enteropathy 217
Iwan A. Burgener

Introduction 217

Diagnosis (see also Chapter 19 on IBD) 217

Therapeutics (see also Chapter 19 on IBD) 219

Quality of Life 219

References 220

21 Cholecystitis 223
Joanne L. McLean

Introduction 223

Clinical and Diagnostic Findings 224

Therapeutic Management 224

References 226

Further Reading 226

22 Biliary Mucocele 227
Joanne L. McLean

Introduction 227

Pathogenesis 227

Diagnostics 228

Therapeutic Management 229

References 231

Further Reading 232

23 Chronic Hepatitis 233
Ninette Keller

Introduction 233

Diagnosis 233

Therapeutics 234

Quality of Life for Patient and Caregiver 236

References 237

Further Reading 237

24 Portosystemic Liver Shunts 239
Ninette Keller

Introduction 239

Diagnosis 239

Therapeutics 240

Quality of Life 241

References 241

Further Reading 241

25 Hepatic Lipidosis 243
Tanya Schoeman

Introduction 243

Diagnosis 243

Treatment 244

Quality of Life 246

References 247

Further Reading 247

26 Feline Cholangitis 249
Tanya Schoeman

Introduction 249

Diagnosis 250

Treatment 251

Quality of Life 252

References 253

27 Chronic Kidney Disease 255
Gilad Segev

Introduction 255

Diagnosis 255

Management 255

Quality of Life 258

References 259

28 Chronic Urinary Tract Infection 261
Gilad Segev

Introduction 261

Management 261

Monitoring 262

Treatment Failure and Chronic Management 262

Prophylactic/Preventative Treatment 264

Quality of Life 264

References 264

29 Feline Interstitial Cystitis 267
Tanya Schoeman

Introduction 267

Diagnosis 268

Treatment 268

Quality of Life 270

References 270

30 Canine Chronic Bronchitis 273
Richard K. Burchell

Introduction 273

Etiology 273

Diagnosis 273

Therapy and Monitoring 274

Quality of Life 275

References 276

31 Bronchiectasis 277
Richard K. Burchell

Introduction 277

Etiology and Classification 277

Diagnosis 277

Treatment 278

Quality of Life 279

References 279

32 Interstitial Lung Diseases 281
Richard K. Burchell

Introduction 281

Etiology and Classification 281

Diagnosis 281

Treatment 283

Quality of Life 284

References 284

33 Feline Asthma 285
Frank Kettner

Introduction 285

Diagnosis 285

Comorbid Conditions, Diagnostic Conundrums, and Differential Diagnoses 286

Therapeutics 287

Quality of Life 288

References 289

34 Collapsing Trachea 291
Frank Kettner

Introduction 291

Diagnosis 291

Comorbid Conditions, Diagnostic Conundrums, and Differential Diagnoses 292

Therapeutics 293

Quality of Life 294

References 295

35 Allergic Rhinitis 297
Remo Lobetti

Introduction 297

Diagnosis 297

Therapy 298

Quality of Life 299

References 299

Further Reading 300

Part Three End of Life 301

36 Hospice Care and End of Life 303
Mary Gardner

Hospice Care 303

Client Needs 307

Pet Needs 309

Quality of Life 311

Cultural Sensitivities 316

Dying Naturally 317

Dying with Assistance – Euthanasia 318

Dying Well 321

Death and Aftercare of the Body 322

Summary 325

References 325

Index 327

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