This section is on internal medicine topics. These are all questions that have been submitted or that I have been inspired to talk about because of a question submitted. If you have any topics that you would like to have discussed please feel free to email me with the topic or question.

What can be done to prevent bladder stones from forming?

Bladder stones form for many reasons. One of the most common reasons is secondary to a urinary tract infection (UTI). A urinalysis should be done to make sure there is not a UTI. Once the possibility of a UTI has been ruled out then one must consider diet. The two most common forms of stones are calcium oxalate and struvite (chemically made up of magnesium, ammonia, and phosphate). Calcium oxalate stones are caused by high levels of calcium in the urine and an acidic urine pH. Stopping calcium supplementation and feeding a diet that will make the urine less acidic are the primary means of preventing calcium oxalate stones from forming. Vitamin C supplementation will also help because the Vit C provides ascorbate which will bind the calcium instead of the oxalate. Struvite occurs with high levels of magnesium and an alkaline urine pH. To prevent these stones a diet that is low in magnesium as well as acidifying the urine can be fed. You can see that the diet to prevent one type of stone can actually predispose the animal to developing the other type of bladder stone. In fact, this has become an important factor in the rise of calcium oxalate stones in cats. The urinary tract health diets commonly available acidify the urine protecting from struvite but increasing the risk for calcium oxalate. Thus, it is advisable not to feed these special diets unless your animal has been diagnosed as having a predisposition to forming bladder stones and the type of stone they form had been identified.

I know that you are busy and you do not want to diagnose my Akita , I would appreciate however if you could give me some information to take to my vet. My Akita woke up yesterday and at a very healthy 2 years old could not walk, he was shaking. and looked tender and sore, he has had scabbing on his nose, and his snout is puffed up, but i thought that was form his last encounter with a skunk , 6 killed this year, yes he has had his shots. This is why I am writing to you, he had blood tests , x rays, ultr sound, they can't find anything, I just want to know where to look, We are also out of money and do not have the funds to keep looking for what is wrong. I can't see him suffer, as an Akita owner , you know what complete loves they are , He is my heart and I can't let himm suffer, but I can't see him put down if there is an explanation that can be medicated I'm online trying to find info but I can't seem to find anything. I would appreciate it

I apologize for the delay in response but I was out of town. Given the swollen muzzle and sudden onset of the condition, the first thing that I thought of was a bite from a posionous spider or snake. Or an allergic reaction to any of a number of insect bites / spider bites. Does he try to walk and cannot or does he not try to walk at all? Does his mentation seem to be normal (ie does he recognize you and respond normally)? Any ticks anywhere on his body? Any chance there are abscesses under the scabbing on his muzzle? If the bloodwork, X-ray, and ultrasound were all normal than aside from an allergic reaction or a posionous bite I don't have any possibilities springing to mind. I wouldn't hurt to give him an antihistamine (like Benadryl or Dimatap sp??) and see if that helps. As much as it pains you to see him suffer (and believe me I can understand that!), before you make any decisions I would give him a few days of TLC and nursing care to see if the problem will start to get better.

My niece told me her dog (Cairn Terrier) is bleeding at the rectum... enough to spot the rug when she sits. They first noticed it tonight (but they've been gone most of the day). The dog did throw up today.. but she has been doing that sporatically the last couple weeks. I had my niece try to go out and find the dog's last BM to see if there was blood in the stool, but she couldn't find it as it is almost dark. I had her feel the dog's abdomen, she says it doesn't feel hard, and the dog is acting fairly normal, not distressed, but hasn't eaten today... is drinking water normally though. Any ideas?

Bleeding from the rectum can be from a variety of causes ranging from infected anal glands to ulcerated intestines to coagulation problems to intestinal worms. The fact that the dog has been vomiting is of concern that there is an intestinal problem. But the fact that the dog is acting normal, drinking, and not depressed is a good sign. I would be worried about a foreign body given the sporadic vomiting. Given the information, I agree if it were my dog I would take it in but I can't honestly say that in my "professional" opinion it is a definite emergency. Rectal bleeding is one of those things that can be caused by life-threatening problems or by minor health problem (like whipworms). I guess I would argue that the best case scenario is that it is a minor health problem and they wasted the time and money of an emergency visit. In the worst case scenario it is a life-threatening problem that needs to be seen immediately to avoid serious illness or death. Whenever they take her in they need to collect some poop for a fecal, do a very thorough analysis of her environment for any potential exposure to rat poison or any propensity and opportunity to chew on and swallow things she shouldn't, and try to determine if the bleeding is bright red or dark red and if it is in the feces.

Is it possible that the bleeding is in the urine? Bladder stones (which terriers are predisposed to) or a serious bladder infection can cause blood in the urine.

I have just found out from a friend that her young dog has died, about 14 months old. My friend has a kennel property in eastern Australia and they have been suffering a heatwave over the past couple of weeks. She arrived home to find the dog on his bed in his kennel and he was very dead, however, he had been bleeding from the ears & nose. Would this be as a result of heatstroke??

Sue Scott in Perth, Western Australia

It very well could be secondary to heatstroke. As the body temperature rises the integrity of tissues start to become compromised and one of the first tissues that completely loses integrity are the blood vessels leading to secondary hemorrhage. Of course, there are several other possibilities such as trauma, rodenticides, and weird stuff like aneurysms. Given the history, however, I think heatstroke has to be the first consideration. If she has other dogs I would strongly recommend taking measures to reduce the risk of this occuring. I don't know how much or what is feasible but changes include increasing shade, providing more water and maybe tubs of water for the dogs to get into, fans and misters are excellent coolants, etc. Please express my deepest sympathies to your friend over the death of her dog and please contact me if I can of further assistance.

I recall reading somewhere that turkey is toxic to dogs. I'm not sure where I read it, and I have checked with a few veterinarians, who have either not heard this, or HAVE heard it, but have never seen a dog with a problem. Do you know anything about this?

Turkey is not toxic in the true since of the word -- ie it is not posionous to dogs. Turkey like other foods rich in fat can cause pancreatitis in dogs not used to getting people food. We see this alot at thanksgiving and Christmas when dogs get fed a lot of scraps. The high fat content "overworks" the pancreas (the organ responsible for producing the enzymes that break fat down and the hormones that control fat metabolism) causing it to become inflamed. Dogs do not tolerate an inflamed pancreas well and become very depressed, febrile, and unable to process fat in their diet. This is the reason that turkey in considered a no-no in feeding dogs. Actually, in moderation turkey is no worse than other foods it is just the sudden huge intake that often occurs at holidays that causes the condition.

I have researched and answered these questions to the best of my ability. But I am human and make mistakes. If there is any part of my answer that you feel is incorrect, please let me know. The last thing I want is to disseminate false or incorrect information.