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This section on Rabbit Medicine will give you a good review of the major husbandry challenges, diseases, and clinical approaches to rabbit health issues. Be familiar with the clinically relevant anatomy and physiology of the domestic rabbit, especially teeth and GI tract.
Please review relevant material from 1st year Comparative Anatomy course before attending these lectures. A Colour Atlas of the Anatomy of Small Laboratory Animals: Rabbit Guinea Pig by Peter Popesko, et al.
The ICE First Step Program on Exotic Small Mammal Medicine, developed by Theresa Lightfoot, is a great supplement to this. Information on laboratory animal medicine will be discussed in an upcoming lecture and can also be obtained from the references below. Rabbit respiratory rate, heart rate and body temperature are prone to increase when stressed (i.e.
Rabbits are true herbivores and are considered monogastric hind gut fermenters (similar to a horse).
There is a slight seasonal suppression of breeding activity in the fall in domestic rabbits. Ovulation can be artificially induced with luteinizing hormone or human chorionic gonadotropin. At 12 weeks small carrot chunks can be offered but leafy greens, fruits and bread should be given only after 16 weeks of age. Their nutrient requirements are different and thus the handfeeding recommendations are different from the above recommendations for domestic bunnies. Some rehabilitators use a mixture of Esbilac and whipping cream, or various other combinations of commercially available products (multi-milk, etc.). The hutch bunny is often a child's pet, school or 4-H project, with little to no involvement of the parent.
The house rabbit on the other hand is often a family pet or even an adult pet, usually involving a much stronger rabbit-owner bond than the hutch bunny.
It might be assumed that rabbit nutrition is pretty well understood, since they have been used in the laboratory for so long. Cecotrophy or coprophagy - this is a necessary part of a rabbits daily routine and is required for efficient use of their herbivore diet. Blood collection in pet rabbits may differ from those techniques used in laboratory settings.
Rabbit blood clots very fast, so it is prudent to fill the EDTA container first when collecting larger volumes. Rabbits differ from most of our familiar domestic small animals in that a leukocytosis with a neutrophilia is rarely observed with bacterial infections.
Leukogram interpretation is complicated by the commonality of an inverse H:L ratio which occurs secondary to any source of stress (cortisol), including stress from transport or any chronic disease. Heterophils have the same function as other mammalian neutrophils, but they have acidophilic or eosinophilic granules in their cytoplasm. Total serum calcium levels in rabbits often appear high, compared to what is seen with dogs and cats.
Fat rabbits will often demonstrate elevated triglyceride levels as with other animals with hepatic lipidosis.
In general, familiar therapeutic options derived from dogs or cats are likely to be appropriate for related disease syndromes seen in rabbits (heart disease, renal disease, diabetes, etc.).
Penicillin G given subcutaneously is one of the best treatments to date for resistant respiratory tract and other recurring infections. Please note that enrofloxacin (Baytril) has been linked with arthropathy in young rabbits and should be used with caution. Oral gavage can be achieved with the use of an oral speculum or through a nasogastric tube.
Anesthetic options in the rabbit are many, depending on the required degree of restraint and analgesia: from minor restraint or anxiolysis to full and deep surgical anesthesia. Induction can be performed with the various combinations of drugs discussed above, or with inhalant anesthetics and an induction box or mask. Intubation is somewhat difficult, but is eventually easy to perform with practice on standard sized rabbits.
Instrumentation for cardiac monitoring and intravenous fluid support are recommended as for dogs and cats and should accompany any major surgical procedure. Rabbit castration is commonly performed for the purposes of contraception and for reducing aggressive or territorial behaviors. Female rabbits are neutered for the same reasons as the male and to prevent the future development of uterine adenocarcinoma. Fracture repair options in the rabbit differ somewhat from the traditional considerations for dogs and cats. Amputation is sometimes considered for fractures that are too fragmented, or where the internal fixation attempt results in a shattered bone.
An animal presenting with signs of a back injury (hind limb paresis), may not have an associated event or known trauma. Treatment may also follow traditional recommendations, however a myelogram and surgical stabilization is rarely considered by the owner. The domestic rabbit's response to disease is often very unlike that seen in other companion animals. Because of this, a well seated infection, especially one involving boney structures, carries with it a guarded to grave prognosis.
Over the last 10 years there has been an increased incidence of a severe hemorrhagic enteric disease in domestic rabbits. The disease was first recognized in China (1984), but it appears to have originated in Europe (serologic evidence from 1978). The disease is spread through direct contact (fecal-oral) or through contaminated feed or water, contaminated equipment, clothing, vehicles, etc.
Post-mortem findings include: hepatic necrosis, pulmonary hemorrhage, tracheal hemorrhage, petechiation on the surface of the kidneys, epicardium and endocardium (hemorrhage mostly due to DIC). Diagnosis can be made at post mortem and through serology utilizing hemagglutination inhibition assays, IFA or ELISA tests. Currently both New Zealand and Australia are using this virus as a form of biological control for feral oryctolagus rabbits which are classified as introduced pests in their countries.
Pasteurella multocida is a ubiquitous organism so commonplace in domestic rabbits that it may be considered normal nasopharyngeal flora. Diagnosis is made based on clinical signs, culture (if possible), and response to treatment.
As stated above dental malocclusion, particularly of the incisor teeth is a common problem in rabbits. Molar malocclusion is less common, but does occur and is likely the result of feeding a diet with inadequate roughage. Treatment for this problem involves dietary correction: increasing fiber and decrease carbohydrates, decreasing stress, increasing exercise, etc. Clinical signs are very vague, usually consisting of decreased appetite or anorexia and decreased fecal production. Diagnosis is based on history, clinical signs, physical findings, and sometimes radiographs. Oral hydration and syringe feeding usually results in return of the rabbit's appetite in a day or two.
Nutritional management appears to be helpful in preventing further development or recurrence of these conditions, but it's role is unclear. Domestic rabbits are not particularly prone to neoplastic diseases except for female reproductive tumors. The New England Cottontail is our local rarest rabbit species, being overtaken by the more successful Eastern Cottontail. Unless the stomach is completely obstructed and nothing can pass through it, medical treatment of hairballs will be successful. Medical treatments are intended to facilitate the breakdown and passage of the hair in the stomach. If the rabbit is anorexic, but not completely obstructed, it is important to force feed it during this time to avoid the development of dehydration, caloric and vitamin deficiencies, and hepatic lipidosis which can be fatal.
The development of hairballs can be avoided if the rabbit is on a good diet and the owner takes precautions, especially during heavy molts.
Sore hock, pododermatitis, or foot sores are characterized by hairless, scab-covered abscessed or raw bleeding areas over weight bearing surfaces and undersides of the feet. Signs for early recognition of this condition are a depressed rabbit that is reluctant to move around, usually staying confined to a cage corner. Clean and soak the foot two to three times daily with warm Betadine or Nolvasan solution and epsom salts. Keep a washable rug or a cushioned platform in a corner of the cage where the bunny can rest and prevent the bony area on the feet from coming into contact with hard or abrasive surfaces such as wooden or concrete floors or cage wire. Tufts OCW material is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported License.
However if the symptoms are severe, don’t hesitate to get your dog checked out by your vet. If you want to try to help out at home you can try a gentle washing with dilute Dawn detergent, aspirin, antihistamine, and cortisone ointment. If these symptoms keep occurring then your dog may be one of the unlucky breeds that are affected with chronic ear and skin problems. Benefits of a more natural diet for treating, reversing and preventing common canine health issues. Dogs that are afflicted with ear mites will typically scratch at the ears excessively and shake their heads, even pulling out their own hair as they scratch. Also, an infection by ear mites often produces a dark discharge, and a strong odor from the afflicted pet's ears. Dogs that are most susceptible to ear mite infections include young dogs and those that live in shelters or that have been abandoned. There are several products to treat ear mites, available in pet stores, feed stores, or your veterinarian. Complications may arise when an animal is not treated , and has an immune hypersensitivity reaction that results in intense irritation of the external ear. Some dogs will shake their heads so much that an hematoma of the ear will form (with blood pooling in the ear due to breakage of a blood vessel). The Papillon is a small, friendly, elegant toy dog of fine-boned structure, distinguished from other breeds by its butterfly-like ears.

Teething: Papillon Puppies start getting their adult teeth by approximately 3-4 months of age. Color coded topics indicate learning objectives that the student should become familiar with. This event is often missed by unsuspecting owners and babies are sometimes incorrectly removed from the nest for handrearing.
On the rise is the litter box trained house rabbit, now occupying similar place in the family structure as the house cat.
The rabbit may be housed with others or alone in a pen raised up off the ground and enclosed with wire. These individuals are often loose in the house for part or all of the day, are litter trained, get along with other pets (dogs and cats) and are very well observed. Venipuncture is generally performed in the pet rabbit from the marginal ear vein (small samples), the jugular vein, the cephalic vein, or the saphenous vein. Due to the fact that the lifespan of the RBC is fairly short (57-67 days) a 2-4% polychromasia is a common observation.
Most often there is only a mild absolute increase in the number of white blood cells, but instead a shift in the distribution of white blood cells is seen.
This is a serious consideration in a rabbit with anorexia caused by conditions such as a hairball, malocclusion, or snuffles. However, due to the rabbit's fragile gastrointestinal flora special care must be taken when selecting antibiotics for the treatment of bacterial diseases. Please refer to the end of this section for a list of drugs and dosages recommended in rabbits and rodents. NSAIDS and Opioids) which will work synergistically and help to reduce the individual doses of drugs and also lower the concentration of the maintenance gas (equals money saved!).
A cocktail (ketamine, midazolam, butorphanol) can be given first, or even butorphanol alone, to facilitate the placement of an IV catheter in the marginal ear vein. It can be performed in a variety of ways as long as care is taken to close the inguinal ring. This is very common in the unspayed female domestic rabbit over the age of 4 years (some reports state >90%). External fixation with casts or bandages are usually acceptable if the rabbit will leave the bandage alone.
Diagnosis should proceed as for a dog or cat, including radiographs and neurologic assessment. They often do not become febrile, their WBC count may not increase (however there may be a shift in neutrophil to lymphocyte ratio), and the way they handle bacterial abscesses is not like any other animal! It is nearly impossible to completely remove (physically) or kill all the bacteria present. This is caused by the rabbit calicivirus also called Rabbit hemorrhagic disease virus (RHDV).
It is now endemic in Asia, most parts of Europe, including Britain, and also occurs in Mexico and North Africa. It is antigenically similar to the calicivirus causing European brown hare syndrome (reported 1st in Sweden in the early 80's). To decrease potential risks for pets and lab animals in the US, discourage or ban importation of live rabbits or rabbit parts from endemic areas, possibly including frozen meat products. Lost agricultural production and damage to the environment is significant including destruction of flora and habitat which support important native species (wombat, bilby endangered due to the rabbit).
Animals are exposed to the organism from birth onwards and will demonstrate a wide variety of diseases involving the organism at any stage of its life.
Malocclusion of the incisors is largely thought to be genetic, although trauma to the teeth (teeth trimming, chewing on cage wire, etc.) can also result in malocclusion. Anorexia, depression and accompanying diarrhea with mucous may progress to cecal impaction and death. Lethal toxin is produced by overgrowth of Clostridia spiriforme, (difficile or perfringens). This change can present a problem, as in other animals, if the rabbit is suddenly starved for any reason for longer than 24 hours (e.g. Radiographic findings of material in the stomach is not abnormal and should not be over interpreted. It often begins with small abrasions or abnormal wear on the plantar surface of the hind feet, but can also occur on the front feet. Selection of low calcium foods (See Table of Nutrient Content of Some Fruits and Vegetables), avoidance of high calcium feedstuffs such as alfalfa should be adopted, and serum calcium levels monitored closely.
There is some evidence that habitat fragmentation may have compromised the New England Cottontail's ability to survive.
Baby food (fruit and vegetables), mixed baby cereal or blenderized pellets should be given voluntarily or by syringe. The rabbit should always have access to straw or fresh timothy hay to provide dietary fiber and promote passage of any accumulated hair through the intestine.
Various factors predispose the rabbit to sore hocks including excessive body weight, reduced fur pad covering the foot soles, excessive thumping and bruising, lack of movement in a small cage, abrasions from irregular cage flooring or excessive time in the litter box. Surveillance and spatiotemporal associations of rabies in rodents and lagomorphs in the United States, 1985-1994. Dogs will itch and scratch at the affected ear and shake their head in a vain attempt to relieve the pain.
A piece of a plant, a bit of grass, ear mites, or trapped dirty water from a swim can inflame the delicate tissues of the canal and cause an ear ache.
These treatments in my free download may save your dog hours of misery till you wait for your vet to open in the morning. They live on the body and in the ears of canines, but most frequently infect the ears.
Puppies tend to be more susceptible because they have not yet built up any resistance to these insects.
Also a concern is when dogs will scratch at their ears to the point that damage is done to the ear canals or ear drums. Rabbits were domesticated beginning in Roman times and extending into the 16th century for use as a source of food and for sport hunting. Temperatures of 104 are not unusual in such situations and should not be mistaken for pyrexia. Maloccluded teeth (incisors or molars) will produce abnormal overgrowth and resulting problems. The exercise area of the hutch should be large enough for the rabbit to complete 2 hops (6 ft. However, diseases related to excessive calcium are seen in the rabbit and will be discussed below.
Use of certain antibiotics has been linked to the onset of fatal enterotoxemia (see more below). Prey animals are easily stressed during handling, in an unfamiliar environment, with unfamiliar scents or noises. Propofol is then infused at a steady slow rate to achieve the desired degree of relaxation for the procedure, or for induction, intubation and the addition of gas anesthesia.
It is important to realize that iatrogenic trauma from blind intubation can lead to fatal complications. Rabbits have a very prominent open inguinal ring and are capable of prolapsing into this space following an incorrectly performed castration. They are prone to chewing at the bandage or self-mutilation of any toes or distal parts of an exposed limb. It can also be used to kick a restrainer or to "thump" in the cage as an expression of anger.
Rule-outs should include other causes of neurologic impairment including a spinal cord abscess (often Pasteurella multocida, E.cuniculi). Some cases involving moderate injury (+deep pain) do respond to steroid administration and cage rest. A great attempt is made by the rabbit to wall off bacterial infections, as if they are foreign bodies (as they truly are).
The disease was seen initially in domestic (including commercial) rabbits and also wild rabbits, all Oryctolagus cuniculus. In most locations, European brown hare syndrome appeared in hares several years before the emergence of viral hemorrhagic disease in rabbits. It is felt that vaccinated animals may shed virus if exposed to natural infection, although they do not become ill. The primary pathogen responsible is usually assumed to be Pasteurella multocida, however other organisms are also important and should not be overlooked. Chronic cases can lead to blocked nasolacrimal duct and eventually osteomyelitis or maxillary abscesses. Consequently, close attention to dietary management will help to prevent GI disturbances, some of which are life threatening. Chronic soft stools is usually related to high carbohydrate, lower fiber diet, obesity, lack of exercise, stress, or a sudden change in diet. This process is very slow, and may require quite a bit of patience and frequent bathings, cleaning up around the house! Overgrowth can occur in young rabbits, be induced by certain antibiotics, brought on by severe stress (including surgery). Build up of material in the stomach, often palpated or seen on radiographs is not necessarily the root of the problem, but will contribute or complicate the clinical picture.
Radiographs are most useful for determining partial from complete obstruction, based on characteristic gas patterns.
Rabbits appear to be extremely sensitive to GI pain (while orthopedic pain does not appear to cause the same reaction). Complete obstruction (hairball lodged in duodenum, foreign body ingestion) is a surgical emergency and carries a poor prognosis. Abrasions and wear develop into serious inflammation, eventually become infected and can progress to include osteomyelitis. 45 - 60% of the absorbed calcium is excreted by the kidneys in contrast to most other mammals that excrete most calcium via bile and <2% by the kidneys.
The incidence of uterine adenocarcinoma is extremely high after the age of 2 years, some say as high as 90%. Some reasons for excessive consumption of hair include itchy skin (parasites?), lack of dietary fiber, boredom, seasonal molting, and a naturally long hair coat (Angoras). Adequate room should be provided for daily exercise and to prevent boredom that may lead to excessive grooming.

If this painful disorder is not treated, it can progress to a severe tendonitis or osteomyelitis (bone infection). Ferrets, Rabbits and Rodents: Clinical Medicine and Surgery Includes Sugar Gliders and Hedgehogs. Prevention and treatment of Encephalitozoon cuniculi infection in rabbits with fenbendazole. When you lift up the ear flap to look and see what is bothering them, you may see black waxy gunk coming out of the ear canal. Allergies to pollens, molds, and grasses and allergies to common commercial dog food and treat ingredients may also cause a red painful ear.
There could also be the rare infection with ear mites or a plant awn or foxtail in the ear. A dilute rinse with 1:10 vinegar and water will kill unwanted bacteria and yeast invading and swimming around in the warm waxy ear discharge. Every single day 2-3 labs come with their owners seeking help for chronically infected and red painful ears. Adult dogs, only other hand, generally have developed a resistance which helps to protect them from these troublesome and irritating infections.
There have since been the development of many breeds within this species that constitute the great variety we see as pet and laboratory animals.
Frightened or stressed rabbits may also inhibit their palpebral reflex, making visual assessment difficult. Rabbit urine also may contain porphyrins (orange to reddish in color) which must be differentiated from blood.
Although malocclusion of any of the teeth is possible, congenital malocclusion of the incisors is most common in rabbits (often due to mandibular brachygnathism).
Additional sites used in laboratory settings may include the auricular artery, the orbital sinus, and cardiac puncture.
When challenged with a bacterial infection they will display a shift in the white cells to a neutrophilia and a lymphopenia, often without an overall increase in leukocytes. At Tufts we discourage the blind intubation technique due to the fact that we readily have access to good endoscopic equipment. They should also be encouraged to eat (and thus stimulate their gut motility) as soon as it is safe following anesthetic recovery. The "preferred" technique for rabbit castration is described well, and involves a prescrotal approach as in a dog (Duncan, 1993). Internal fixation of difficult fractures of the humerus or femur must be considered, but are not without problems.
This problem must be considered and discussed with the owner before proceeding with a rear limb amputation. Under the right conditions a rabbit can kick so strongly that it will result in moderate to severe back injury, from a sprain to an actual displacement or fracture. One must always remember that many of the diseases described in dogs and cats ( and humans, horses, or any other mammals for that matter) may occur in any animal, including rabbits. A great fibrous capsule is produced around the infection site, which usually contains thick caseated pus.
There is an overall high morbidity and mortality with possible devastating effects: in one year in Italy (1989), 64 million rabbits died of this disease. Specific considerations must be given to the rabbits unique response to infection and the accessibility of any antibiotics.
A simple case of conjunctivitis or even very mild rhinitis may respond well to topical ophthalmic treatments. This induces a change in gut flora resulting in the abnormal stool consistency - sticky, smallish pellets, often pasted to the perineal area. Rabbits are unable to vomit and swallowed material (such as hair and carpet can easily build up if not properly digested.
Observing fecal quantity and quality (small and dry pellets) is a good indication of motility.
Surgery is indicated only for complete obstruction, partial obstructions are managed medically and constitute the majority of cases.
Remember that anorexic overweight rabbits are susceptible to hepatic lipidosis and should be supported aggressively. Vitamin D does not affect intestinal absorption of calcium in the rabbit, but may contribute to soft tissue mineralization. Because of this, it is recommended that all females not being used for breeding be spayed by the age of 2 years. Wild rabbits (cottontails) appear to be better at healing and concurring infections than their domestic European counterparts. The rabbit's inability to vomit and the small pyloric lumen exiting the stomach predisposes it to hair accumulation within the stomach. Regular administration (every one or two weeks) of a cat laxative and one of the papain preparations will help prevent the hair from building up in the stomach. Ear mites are commonly blamed for ear infections in dogs, but I have only seen this problem in a few young puppies.
In a clean and normal canal wax produced by the lining of the ear is swept outward with the microscopic bits of dust and debris that enters from the environment.
You can soften up those pieces or plants with warm water, mineral, or olive oil, and your dog may shake them out, but those little foreign plant objects often need to be flushed out or pulled out with an instrument by your vet. In fact rinsing the ears once to twice weekly with a ear treatment rinse or dilute vinegar and water may prevent a chronic ear problem from causing pain and needing veterinary treatment. Diets including rabbit pellets alone or rabbit pellets and alfalfa hay have been linked to disorders of excessive calcium, obesity and hepatic lipidosis and chronic soft stools. Diagnostic exercises and options for treatment should always leave open these possibilities.
Another outbreak was reported again in August 2001 without finding the source of infection (see references). It has been suggested that the disease has been spread around the world through frozen rabbit meat from China.
Most indoor rabbit owners notice right away since little presents are left on furniture, etc. As mentioned above, serum elevations in triglycerides and cholesterol may indicate hepatic lipidosis.
If motility is disrupted, the rabbit becomes dehydrated, the material condenses, becomes mucinous, the stomach wall collapses against it, and obstruction ensues.
The use of the enzymes is indicated as a prevention of the buildup of material but not as a treatment (comparable with a clogged sink, once the outflow is completely obstructed it is time to call the plumber (i.e.
Prevention of hairballs and gastric stasis is best achieved through proper dietary management: feeding high fiber, low carbohydrate diet, and avoiding obesity. Aggressive early intervention and treatment can result in a cure, but requires a strong commitment on the part of the owner.
What appears to be a persistent hypercalcemia in a rabbit must be investigated with great care.
Stress is a major problem with wild rabbits in a captive setting and may contribute to their death under these circumstances.
The bedding must be changed often and regularly to avoid urine soaking the affected area and causing further inflammation. In some breeds and some individuals the ear canal may be too small, the ear canal too hairy, the wax too thick or too much of it, or the ear swollen and inflamed and the wax is blocked from escaping. They should have an area in the cage that provides shelter (wooden house) and an area that allows them to get off the wire floor of the cage (wooden platform). A diet of pellets alone, without any added roughage will contribute to the development of hairballs.
The rabbit's skeleton constitutes only 7-8% of their body weight, compared to a cat skeleton which represents 12-13% bodyweight.
This type of abscess will not drain and the capsule may severely limit the penetration of antibiotics to the target site. Diagnosis can often be made through palpation and confirmed with an ultrasound examination. This is then followed by the production of smaller and smaller stools, often containing hair and eventually no stool at all.
Unfortunately veterinarians are taught to endlessly medicate, clean, and flush ears when avoiding allergens and adding healthful food and oils may help much more. The cage should be placed in a protected part of the yard, free from direct sunlight and cold winds.
High fiber diets are also thought to be protective against the development of enteritis by helping to maintain normal motility. If left unattended, the perineal soiling can develop into serious dermatitis, attract flies, etc. It is important to screen for early onset of the condition and to avoid the progressing by addressing correct husbandry.
Surgical removal of tumors is recommended, but the prognosis is guarded since metastasis is common.
Due to the decreased caloric intake, the rabbit becomes lethargic, depressed and loses weight. I was one of those vets until my own dogs, patients, and years of practice helped me understand the underlying problems associated with chronic medical conditions so I could cure instead of patch the problems.
The lower carbohydrate timothy hay is preferred over alfalfa, since higher carbohydrates favor growth of clostridial species and thus can lead to the development of enterotoxemia.
Obesity complicates the surgery and owners are often asked to get their overweight rabbits to lose weight before the procedure is performed. Great care must be taken by the surgeon to handle the bones gently and to use the minimal implant devices required to repair the fracture. If untreated, the rabbit may die from starvation or complete obstruction and rupture of the stomach.
Which came first…the infection or the accumulation of wax due to  a narrow or hairy ear? Treatment with cholestyramine and metronidazole may be attempted, along with aggressive fluid therapy and treatment for shock. Or the most common ear inflammation due to allergies to some food ingredients or pollens and molds.

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