Radiotherapy for dogs and cats

What is radiotherapy ?​

Radiotherapy is a radiation treatment which allows cancerous cells to be eradicated when surgery alone is not sufficient. It allows a large number of tumours to be managed with few side effects. Radiotherapy is recommended as a sole treatment or in conjunction with other therapies, for the treatment of numerous cancers and some benign conditions.

When is radiotherapy useful​ ?

We suggest radiotherapy for the treatment of the following :

• Aggressive cutaneous tumours (mastocytomas, melanomas, epidermal carcinomas.) ;
• Sarcomas in soft tissues (fibrosarcomas, neurofibrosarcomas,) ;
• Tumours in nasal or oral cavities, salivary glands, tonsillar and thyroid tumours ;
• Cerebral and spinal tumours ;
• Urogenital carcinomas (bladder, urethra, prostate) ;
• Bone tumours ;
• Some lymphomas ;
• Chronic inflammatory diseases (meningoencephalitis, eosinophilic granuloma, osteoarthritis).

How does radiotherapy work ?

During a radiation therapy session, the rays will cause DNA damage to all the cells. The healthy cells will tolerate the radiation better, whereas the tumour cells are more sensitive and will die as a result. In order to preserve the healthy tissues to the greatest extent possible, the radiation doses are split. The protocol will depend on the treatment objectives, the type of tumour and the locality of the lesion to be treated. 

Are there any side effects?

Depending on the type of treatment, the locality of the area to be treated and the doses, side effects are varied. Some effects (“burns”) may appear if the treatment is intensive. These effects are normal and associated with radiation. Long-term complications are very rare. It is important to let the oncologist know about any anomaly as soon as it has been noted so that the treatment can be adapted and localised comfort can be potentially be offered. 

How do radiotherapy sessions proceed?​

According to the case at hand, a greater or smaller number of sessions may be offered (from 3 to 20 sessions) with a variable frequency (from 1 to 10 sessions per week) during treatment periods from 2 to 6 weeks. Sessions take place from Monday to Friday. A general anaesthetic is essential in order to ensure that the patient remains completely immobile (your animal must therefore have an empty stomach, with food withheld the evening before). You will therefore be reunited with your animal on the same day (a visit of 90-120 minutes). If you live too far away, Oncovet can accommodate hospitalisation covering the period of treatment. 

What is curietherapy?​

Also called brachytherapy, curietherapy is a radiotherapy technique allowing the treatment of certain cancers in dogs, cats and horses. Treatments consist of the use of a radioactive source directly in contact with the tumour via applicators or temporary implants. This approach can also be used following the removal of a tumour, to limit repeat occurrences. Curietherapy may be used to complement external radiotherapy (as a “boost”) in order to further optimise the control of the tumour. Curietherapy has many indications including certain skin tumours in sensitive areas (eyelids, lips, ears, fingers), certain tumours of the urinary system, certain aggressive tumours of soft tissues (sarcomas) and some cases of tumours of the nasal cavities.

Surgery

Surgical intervention​

During anaesthesia, monitoring (checking vital parameters) is carried out systematically. It allows the cardiac and respiratory function to be monitored, as well as the body temperature. After being anaesthetised, all our patients are intubated and they are kept under anaesthetic using gases. Depending on the circumstances, they may breathe by themselves or may be assisted by a respirator.

Post-operative infection prevention is safeguarded through the separation of premises and their respective ventilation systems being kept separate from other areas. Single-use linens and systematic autoclave sterilisation are used. The use of antibiotics is strictly monitored and adapted to each case. It is not surprising that in most cases, there will be no prescription for antibiotics when you pick up your animal.
 
Is it essential to operate? Are there other options ?

Before any surgery takes place, you will meet a vet for a consultation. It is vital to discuss the surgical indication with you.

The preoperative report and the imaging examinations are therefore indispensable. This consultation is also the time for us to explain the different options available to you and their potential risks, as well as their cost. This is when we will be able to answer any questions you may have. 

For a surgical intervention to take place under the best possible conditions, it must be part of an overall approach in collaboration with other medical disciplines. An evaluation of the specific clinical situation for your animal is essential, prior to the surgical decision being taken. The assessments are carried out in collaboration with the veterinarian treating your animal. They allow the different therapeutic options to be identified in order for them to be explained to you, and for the most appropriate solution to be chosen.

Once the surgical decision has been taken, your animal will be looked after by the surgical team and prepared for the intervention, the operation and post-operative hospitalisation. Surgical activity at Oncovet is organised in such a way as to offer your animal optimised hygiene, security and monitoring.

What about pain ?​

Pain relief is always included. For this purpose, following preoperative sedation, patients routinely receive treatment using a molecule from the morphine family. If required, anaesthesia is completed through the administration of anti-inflammatories and a local anaesthetic (nerve blocks). The immediate post-operative period is crucial for the success of the follow-up treatment. Monitoring signs of pain, reanimation if necessary and rapid intake of nutrition are all key factors for good recuperation.

During this period, we will keep you and your vet up to date with information concerning your animal’s illness. Each day, we will contact you to give you information concerning your pet. Visits are, of course, permitted (12:00 to 17:00 daily). They are arranged with our administrative office so that we are able to welcome you as comfortably as possible. These visits are approved by the surgical team and do not involve direct discussion with the surgeon, who will be in the operating room during the visiting hours. 

Practical information​

• Unless it is an emergency, your animal must not eat or drink from the evening before the procedure onwards;
• If the animal is receiving medical treatment, it is always best to ask us about the best time to administer the last treatment, and always ensure that you let us know about it;
• Once your animal has been discharged, involved instructions are sometimes given (e.g. taking your animal to your veterinarian...). It is very important to follow these instructions, as they are specifically adapted to your animal, on a case-by-case basis;
• Generally, your usual veterinarian will monitor your animal’s wound. However, sometimes, for complex surgical wounds (skin reconstruction, radiotherapy treatment), you will be asked to have the wounds monitored by an Oncovet surgeon.

Oncological surgery for dogs and cats

What is oncological surgery?

Oncological surgery is a surgical discipline in its own right which solely applies to tumours. It involves the handling of the cancerous tissue, dissection techniques, hemostasis (bleeding management) which are different from other surgeries, with the aim of minimising the spread of cancerous cells and facilitating the complete excision of the tumour (tumour removal). This is one of the steps in treating cancer. In theory, all dogs and cats affected by cancer may require surgical intervention, whether this involves a biopsy to confirm a diagnosis or a definitive surgical treatment. Both before and after the surgical intervention, the surgeon must work in collaboration with other medical disciplines (general and oncological medicine, medical imaging, histopathology...) in order to respond to vital questions: What are we fighting against (type of cancer, recurring cancer) ? How has it progressed (localised or generalised cancer) ? How aggressive is it (determine whether the cancer will recur/metastasise) ? 

Different surgical options can present themselves as far as tumour excision is concerned: intra-lesional surgery (within the cancerous tissue), marginal surgery (near to the cancerous tissue), more extensive surgery (far away from the cancerous tissue) and radical surgery (very far from the cancerous tissue, with amputation as an example). We therefore understand that surgery is just one step in the diagnosis and/or the treatment of cancer.

All these important steps are aimed at determining the best treatment and therefore the best prognosis for the dog or the cat. Thus, the treatment must not only take into account the tumour but the patient overall, including the owners ! 

The options that can be considered must be discussed with the persons who are close to the animal on a day-to-day basis: is the treatment palliative or curative ? What will the consequences for the animal be (side effects and complications) ? Could complications delay the auxiliary treatments (chemotherapy or radiotherapy) ? What is the expected budget ? These questions are covered during the pre-surgical consultation.

Poorly planned surgery could have dramatic consequences for the patient. A poor indication may increase surgical complications, promote incomplete excision and tumour recurrence.

Finally, oncological surgery involves specific postoperative management. At the end of the intervention, care related to the condition of the animal with cancer is applied. This may include pain management, nutritional requirements, rehabilitation, and the discussion of histological results: is the excision complete? Is a repeat intervention required? When will the complementary treatments begin?

In conclusion, oncological surgery remains an important step in the treatment of cancer and must be carried out according to the rules for the well-being of the patient in order to achieve the best possible prognosis. It implies positive indications as well as global patient management using a multidisciplinary approach. 

Neurosurgery

What is neurosurgery?

Neurosurgery is a discipline which treats surgical pathologies of central and peripheral neurological tissues, including surgery of the brain, the cerebellum, the spinal cord, the meninges and the nerves. The neurological damage being treated may have occurred previously or may be of low intensity (pain, abnormal gait or behaviour) but may also be acute or intense (convulsions, abrupt paralysis). Neurological problems may originate from various sources: congenital (e.g. deformations), trauma (e.g.: fractures, hernias..), metabolic (e.g. intoxications, vascular...), degenerative, caused by a tumour...Neurological tissues struggle to tolerate intense or extended onslaughts and some pathologies therefore require urgent surgical treatment. 

The diagnostic process for a neurological complaint must therefore follow different steps :

1. Confirm that the problem is neurological
2. Locate the problem within the neurological system
3. Estimate the severity and scope of the neurological lesions
4. Determine the cause and/or the pathological process
5. Estimate the prognosis based on the medical or surgical management.

 
Complementary examinations are essential to respond to questions concerning localisation, severity and cause. The most frequently occurring examinations are imaging examinations (radiography / myelography, scanner or IRM), the study of the cerebrospinal fluid, the study of electrical signals (electromyography or electroneurography), biopsies...

The results of these complementary examinations will allow the most appropriate treatment to be evaluated, whether medical or surgical.

The most frequently-occuring surgical indications in our pets are :

• for the skull: traumatic fractures, tumours (meningiomas, chondromas, malformations...)
• for the spine: vertebral instability, cervical myelopathy of the tail (Wobbler syndrome), herniated disks, vertebral or perimedullary tumours, arachnoidian cysts, perimedullary hematomas, malformations...

Neurosurgery involves multi-disciplinary management. Different medical services must collaborate beforehand (doctors, oncologists, radiotherapists, imagers..), during (anaesthetists, imagers) and after surgery (neurologists, doctors, radiotherapists..) to offer the patient the best possible care and the best prognosis. 

Orthopaedics

What is orthopaedics ?​

Orthopaedics is a surgical specialism which is intended to prevent or correct pathologies affecting the musculoskeletal system (bones, joints, muscles, tendons and nerves). The area of application includes the thoracic and pelvic limbs as well as the spine.

Orthopaedic surgeries require an accurate diagnosis involving a complete clinical examination (rule out or find a general or concomitant pathology), a specific neurological and orthopedic examination. In fact, certain orthopaedic consultations take place in a traumatic context (falling from a height, the patient having been hit by a vehicle).

The priority for admission is therefore to :

1. stabilise the patient, who may be in a state of shock
2. establish a full report of the injuries (e.g. do not focus on a leg fracture while missing pulmonary contusions or a ruptured bladder)
3. establish a diagnostic and therapeutic plan with the owner
4. plan the surgical intervention.

With the exception of an obvious or certain diagnosis, additional examinations will be necessary and will sometimes be discussed and carried out in agreement with the owner/referring vet.

It is important to remember that pain management and temporary stabilisation of a fracture are the priority. The surgical procedure in the operating room will be carried out once the patient is stable and able to tolerate an anaesthetic lasting several hours.

Orthopaedic surgery consists of reducing the fracture and stabilising it using implants such as screws, pins, plates or external fixings and sometimes plaster/resin.

Soft tissue surgery

What is soft tissue surgery?​

Soft tissue surgery, as opposed to orthopaedic (solid tissus), includes ENT, thoracic, abdominal (gastrointestinal, urogenital, liver ...) surgeries, skin and reconstructive surgeries.

Soft tissue surgery is a treatment option which is discussed on a multi-disciplinary basis (benefits and complications/secondary effects): your vet alongside an oncological vet or doctor or an Oncovet imager will determine the complementary examinations which are required for a precise diagnosis. It is at this point that the surgical option will be discussed by the vet and the owner.

Pain management and hospitalisation are major parameters in ensuring that soft tissue surgery goes well. Multi-modal analgesia (made up of several molecules, which means that toxic doses of a single molecule are avoided) is used. Frequent evaluation of pain during the post-operative period means that it is possible to wean the patient off painkillers progressively over a period of 24-72 hours. During this time, the period of hospitalisation allows us to monitor the response of the organ and the living creature which has been operated on.

“Minimally-invasive” surgeries

“Minimally-invasive” surgeries include modern operating techniques which are highly technical, meaning it is possible to minimise the “surgical invasiveness” experienced by the patient. These procedures involve small incisions or no incisions at all (e.g. tracheal stent). If the aesthetic advantage is clear, the benefit for the patient is to minimise pain, the risk of infection and the difficulty and duration of post-operative care.

Minimally-invasive surgery is carried out for 2 major indications. The first is a diagnostic indication. This involves exploring the organ using a camera in order to take biopsies for bacteriological and/or histological analysis (for example, a thoracoscopy for the thorax, laparoscopy for the abdomen or an arthroscopy to explore the joints). The second indication is therapeutic. It involves an intervention in order to treat the illness (e.g. to remove a fragment of cartilage which is causing problems for a joint).

Oncovet currently offers this type of procedure in the following areas:

• the joints via arthroscopy of the shoulders, elbows, carpal joint, hip, knee and tarsus
• the chest via a thoracoscopy (biopsy of the pleura, lymphatic nodes, lobectomy...)
• the abdomen via a laparoscopy (oophorectomy, liver biopsies...)
• endovascular or endocavitary for cardiac, tracheal or urogenitary illnesses

Ask the advice of your veterinarian or our surgical team to find out the area of application and to consider it for your pet !

Medical imaging

What is medical imaging ?​

Medical imaging is a discipline which allows the body and the organs to be explored using non-invasive techniques (no surgical intervention). These different techniques make use of physical phenomena which interact with the organs and the tissues. They are then analysed using powerful IT systems which will retranscribe them in images.

Medical imaging is essential for treating most patients, in particular in oncology. It often allows a diagnosis to be made, disease staging to be carried out (local invasion of the tumour and searching for metastases which have occurred further away) and appropriate treatment to be planned. However, it is also indispensable for internal medicine, for surgery, cardiology and neurology.

Zoom in on the most common medical imaging techniques​

The most frequently used medical imaging techniques are: radiography (the oldest technique first used at the end of the 19th century), scanning (which derives from radiography), ultrasounds, MRI (magnetic resonance imaging) and scintigraphy scanning or nuclear medicine.

Oncovet offers a technical platform which combines 4 of these 5 techniques (radiography, scanner, ultrasound and scintigraphy).

Each of these techniques have their own advantages and disadvantages and have precise indications.

When several examination techniques are possible, we ensure that we offer the technique with the greatest chances of obtaining the information required to implement the treatment. This choice depends on the area being explored, the general condition of the animal (can it be anaesthetised?) and of course the price of the examination.

The examinations are carried out by appointment, or following an oncological, internal medicine or surgical consultation or on prescription by the treating and referring veterinarian who is able to manage the care of the animal and propose treatments.

For ultrasound, scanning or scintigraphy purposes, it is often necessary for the animal to have fasted for 12 hours, either because having a full stomach impedes the quality of the ultrasound examination and may therefore mask anomalies, or because the animal needs to be anaesthetised (scanner or scintigraphy).

Radiography in dogs and cats

What is radiography?​

Radiography was the first medical imaging technique to be used. From the beginning of the 20th century, the first examinations were being carried out on the skeleton; radiography developed during the First World War and was particularly driven by Marie Curie.

This technique uses differential X-ray attenuation, i.e. images are obtained using the difference in the absorption of rays by the organs.

For around fifteen years, the images have been digitalised, which means better image quality and avoids chemical development of the film.

This is a painless technique for dogs and cats, although X-rays may pose a danger to health if exposure is excessive. Strict regulations govern the use of X-rays to limit the exposure of members of the public or staff, which is why owners are not permitted to enter the radiography room.

Radiography, the first medical imaging examination used​

Despite the development of other medical imaging techniques such as ultrasound or scans, radiography remains an essential indication and is often the first medical imaging examination to be used.

The examination is quick, and usually does not require any sedation or anaesthetic, which allows examinations to be carried out even if the dog or cat cannot be anaesthetised.

The main indications are:

• Examination of the skeleton, particularly of the limbs (fractures, bone tumours, growth disorders in young dogs and cats, joint diseases....)
• Chest examinations, in particular of the lungs (bronchopneumonia, lung tumours, disease staging (a check for pulmonary metastases of other tumours),
• Examination of acute abdomen (very strong sudden abdominal pain): checking for a foreign body in the digestive system, kidney stones or bladder stones, liquid in the abdomen (peritonitis, a bleeding tumour) or a dilatation or twist in the stomach...

Limitations of radiography​

The abdominal or thoracic organs are not always easy to distinguish from one another (lack of contrast) and the images obtained are in two dimensions only, which does not permit the visualisation of the inside of the organs and thus can prevent detection of a tumour, for example. Scans or ultrasounds are therefore often seen as a preferable option to radiography

Veterinary scanner

Why use the scanner for dogs and cats?​

The scanner allows lesions to be viewed which are invisible in a radiography examination, such a herniated disk or a brain tumour. This examination is totally painless for the dog or cat, although the animal must remain totally immobile. This is why the examination is carried out under general anaesthetic.

Principle​

The scanner, or CT scan examination uses X-rays, as does radiography. Unlike radiography, which crosses the radiography area and forms an image where the various structures are superimposed, it forms images in cross-sections, i.e. perpendicular to the spine of the animal. They can be reconstructed in a longitudinal direction, i.e. lengthwise.

The apparatus is in the form of a ring inside which your animal is placed, lying down on a table, to obtain images.

For most of the examinations, an iodine contrast solution is injected into the veins in order to offer better differentiation of the lesions. For these two reasons, your animal must therefore have fasted since the previous evening. The animal may, however, take its medications. The duration of the examination is approximately 1 hour. You will be reunited with your animal once it has regained consciousness, approx. 2 hours later.

When should a dog or cat undergo a scan?​

• Central neurological problems affecting the brain or the spinal cord (myeloscan)
• Investigations into lesions in the skull, nasal cavities, sinuses, bulla, temporomandibular joint sockets
• Upper (nasal cavities, throat) or lower (bronchus and lungs) respiratory problems
• Abdominal masses which are difficult to locate using an ultrasound scan
• Masses in the neck, thorax, pelvis
• Disease staging in the local area, locoregional area and at a distance from tumours
• Lameness (exploration of the joints of the limbs)
• Vascular anomalies (angioscan)

Scintigraphy for dogs and cats

What is scintigraphy?​

Scintigraphy, also referred to as nuclear medicine, is a medical imaging technique which uses a radioactive product to obtain images. This examination is totally painless for your animal, although your animal must remain immobile while the images are being taken. The animal must therefore be anaesthetised. The animal must be kept at the clinic for 24 hours after the examination, while the radioactive product is eliminated through the urine.

Principles of scintigraphy

The radioactive product injected is very weak, but it is detected by the device called gamma camera. The product injected is mostly eliminated by the kidneys and can be found in the urine. When you are reunited with your animal, no abnormal radioactivity will be present.

When should scintigraphy be carried out on dogs and cats?​

Skeleton​

• Primary or secondary joint tumour disorders (polyarthritis, osteochondrosis...)
• Metabolic conditions (hyperparathyroidism...)

Thyroid​

• Investigation of the thyroid nodule for hyperthyroidism, particularly in cats
• Disease staging of a thyroid tumour (investigation for ectopic tissue)

Lymph nodes

• Sentinal lymph node investigation as part of disease staging of cancer in the locoregional area

Kidney​

• Evaluation of kidney function

Liver​

• Portosystemic shunt investigation and evaluation of the shunt fraction

Lung​

• Investigation for pulmonary embolism in the case of sudden onset dyspnoea with radiographical examination or normal scan

Heart​

• Evaluation of the myocardial consequences of cardiotoxic chemotherapy
• Investigation of the left ventricular function
• Evaluation of the prognosis of cardiac disease
• Evaluation of valvular cardiac disease
• Evaluation of congenital heart disease

Brain

• Investigation into cerebral perfusion in older dogs and cats
• Detection of intracerebral mass not detected by the scanner
• Convulsions when the scan is normal
• Anomalies in the cranial nerves when the scan is normal

Ultrasound in dogs and cats

What is ultrasound?​

An ultrasound is a non-invasive examination which does not pose any danger or cause any pain to your dog or cat.

It is based on the echo, a principle of physics. An ultrasound beam is emitted and reflected in the organism, and the echo formed is analysed by the device to form an image of the region being explored. During an ultrasound, air and bones are obstacles in the propagation of ultrasounds. It is therefore necessary to shave the animal and to apply a contact gel to the skin in order to obtain a good quality image. All water-rich tissues can be explored using ultrasound. An ultrasound is a non-invasive examination which does not pose any danger or cause any pain to your animal.

Main indications:

• Digestive issues
• Urinary issues
• Reproductive and gestational issues
• Abdominal mass
• General syndromes (chronic weight loss, general weakness, polyuria-polydipsia, jaundice...)
• Abdominal effusion
• Anomalies of the blood (blood count, biochemical examination, coagulation profile...)
• Oncological disease staging
• Ultrasonic-guided sampling...

Preparation for the examination​

Good preparation is essential for a high-quality examination. The animal must not have eaten for 12 hours and must not urinate for 2 hours before the abdominal examination. Ideally, two people should accompany the animal to reassure it during the examination. The animal must be shaven in order to carry out the abdominal ultrasound.

Ultrasound is a technique that continues to improve with the experience of the imagers who carry it out and also as a result of the evolution of materials and techniques. All of the latest techniques are in use at Oncovet.

Cardiology

Heart disease in dogs and cats​

Heart disease is frequently observed in dogs and cats. Initially, most animals will not present with any symptoms. Your veterinarian may, however, note the presence of an anomaly during an examination. Symptoms may appear subsequently:

•    Respiratory difficulties, swelling in the abdomen;
•    Increasing fatigue;
•    Episodes of loss of consciousness.

In order to explore these symptoms, we can carry out different examinations.

These illnesses may have been present since the animal was born or appear over the course of its life. Heart disease may be present from a young age (congenital malformation) or may come with age.

How are cardiology treatments administered?​

Cardiological treatments are usually “for life” and require a great deal of cooperation from the owner.

Treatment of heart disease is usually medical. Sometimes, monitoring is all that is required. Some malformations can be surgically treated, such as pulmonary valve stenosis and persistent ductus arteriosus. Sometimes it is necessary to fit a pacemaker.

Cardiological treatments may sometimes be administered once or twice a day for the duration of the animal’s lifespan and must be adapted according to the development of the illness. Good cooperation between the owners, the veterinarian treating the animal and the specialist veterinarian is therefore necessary

Echocardiography in dogs and cats

What is echocardiography ?​ 

Echocardiographical examinations in dogs and cats allow most heart diseases to be diagnosed. This examination measures the size of the walls and the chambers of the heart and the speed and direction of the flow of blood within the heart

Under which circumstances do we use this examination?​

Cardiac malformations are numerous and varied and only a Doppler ultrasound will allow the defect to be identified once the veterinarian has detected a heart murmur in a puppy, and to establish a prognosis and suggest a treatment. Acquired cardiac diseases affect the cardiac muscles, the valves, the pericardium or the cardiac electrical system. Some breeds have a predisposition to each of these illnesses. Smaller breed dogs therefore present most frequently with valvular diseases (at an early age in King Charles spaniels); large dogs present with dilated cardiomyopathies; boxers, Newfoundlands and Golden Retrievers present with aortic stenosis, short-nosed breeds present with pulmonary stenosis...

What happens during the examination?​

This pain-free and risk-free examination is carried out with your cooperation in order to reassure your animal, who will remain standing or who will be laid on a table with windows during the examination.

Holter

Named after its inventor, Norman Holter, this is a piece of equipment which allows a continuous recording to be made of the electrical activity of the heart, for 24 hours as a minimum. It is used if the veterinarian observes an anomaly in the cardiac rhythm or in order to evaluate the effectiveness of a treatment that is already in place.

The apparatus consists of several electrodes affixed to the animal’s chest and linked to a box. Once the animal has returned to the clinic, the veterinarian will remove the equipment and will analyse the problems with the cardiac rhythm. Tachycardia if the beats are too rapid, bradycardia if they are too slow...

This examination, which is totally painless for the animal, has the advantage of the animal not needing to remain hospitalised during recording.

Screening

Why carry out screening?​

Some breeds of dogs are more predisposed to cardiac problems than others. Many breed clubs advocate echocardiography to detect early signs of anomalies in order to eradicate certain pathologies. This is because many of them seem to be hereditary, i.e. can be transmitted from one generation to another.

Screening is carried out by means of a Doppler ultrasound as part of an examination. This examination allows a heart murmur or any arrhythmia to be detected. The Doppler ultrasound is used to assess blood flow. It remains the most-frequently used examination for the purposes of investigating aortic stenosis.

For some breeds, screening is mandatory in order to attribute a quality level to a breeder.

Internal medicine

What is internal medicine?

Internal medicine includes the whole diagnostic process and therapeutic follow-up of major organic diseases, endocrinology, uro-nephrology, gastroenterology, pneumology, infectious and autoimmune diseases, hematology...

Internal medicine works in collaboration with all of the services offered by the clinic (oncology, cardiology, surgery, medical imaging) in order to create a plan adapted to your animal’s condition.

Oncovet is also one of the very rare canine dialysis centres in France. We offer blood purification techniques to supplement or if necessary to replace the kidneys in the case of significant dysfunction, using a machine that can carry out purification outside the body.

The clinic also offers a geriatric assessment service in order to allow your animal to grow old in good health.

Iodine therapy, one of our specialisms, is for animals with hyperthyroidism. It is an illness that is very frequently diagnosed in ageing cats. Around 10% of cats will be affected by this illness.

Dialysis - Hemodialysis

What is hemodialysis?​

This refers to all of the blood purification techniques intended to “supplement” oreven to replace the kidneys in the case of significant dysfunction, using a machine that can carry out such purification “outside”the body.

The blood is taken (via a catheter) to circulate in an “artificial kidney” or dialysis machine, within which toxins that have built up in the body and that should have been eliminated by the kidneys are absorbed. The “purified” blood returns into the animal’s blood via the same catheter; the total volume of blood is therefore filtered several times during each dialysis session.

When is a hemodialysis carried out ?​

The main indication for hemodialysis treatment is acute renal insufficiency in dogs: it is a group of illnesses due to which the kidneys have been damaged, often temporarily, and this initial trauma which lasts for a period of varying length may cause the sudden appearance of major symptoms (fatigue, vomiting, sometimes anuria). Despite this very noticeable clinical presentation, the kidneys often have strong potential for recuperation as soon as the “cause” of the renal inadequacy has been identified and treated and the patient is given the time to recuperate.

Illnesses responsible for acute renal insufficiency in dogs may be:

• Some infectious illnesses, in particular leptospirosis, renal forms of which are very frequently observed (vaccination does not always provide protection against this)
• Some intoxications, particularly from plants (grapes, lilies...) or non-steroidal anti-inflammatories
• Numerous systemic illnesses (pancreatic illnesses, complex diabetes) as a result of which circulatory insufficiency (loss of blood pressure) causes the kidneys to “cease” functioning

Indications for dialysis are:

• Very high creatinine values (the norm specified varies from 60 to 100 mg/L depending on the authors)
• Values that are lower but which are associated with noticeable symptoms
• An animal only producing a little urine or even none at all. In this case, administering dialysis is urgent to preserve life

What happens during the treatment?​

Kidney recuperation will take between several days and several weeks. If only one “conventional” treatment is implemented (notably via infusion), numerous complications may appear (digestive, neurological, cardiac lesions etc...) which will slow down recuperation and reduce the quality of life of your animal. For an optimal treatment, the sessions must be repeated on average every two to three days (sometimes more) in order to maintain an acceptable quality of life.

Only a limited number of organisations are able to carry out hemodialysis in Europe, as the equipment required is costly and use is relatively complex.

Our centre is able to carry out such a treatment if your dog’s condition requires it.

Are there risks involved with this treatment?​

This is a painless technique which does, however, require attentive monitoring of the animal’s behaviour and its vital signs. Hemodialysis, by “replacing” the kidneys on a temporary basis, can improve the clinical condition of the animal by limiting the damage associated with these toxins.

Iodine therapy for cats

When does your cat need iodine therapy?​

Hypothyroidism is an illness that is very frequently diagnosed in ageing cats. Around 10% of cats will be affected by this illness. This illness is usually due to a benign tumour (adenoma) in one or both of the thyroid glands which provokes excessive secretion of thyroid hormones to an excessive level (in 70% of cases, both glands are affected).

This illness has multiple symptoms (weight loss, polyphagia \[increase in appetite], hyperactivity, vomiting, chronic diarrhoea, tachycardia, cardiac murmurs...).

The initial diagnosis is carried out using a blood test, measuring the level of thyroid hormones in the blood (T4).

What happens during the treatment?​

Several types of treatment exist:

• Medical treatment: prescription of medicines that inhibit the synthesis of thyroid hormones.
• Surgical treatment: excision of the thyroid gland affected by the adenoma if only one gland is affected
• Treatment through the diet: low-iodine diet
• Treatment using radioactive iodine:​ This is the current treatment of choice and consists of injecting a small dose of radioactive iodine underneath the skin which is then fixed by the thyroid glands. Due to its radioactive nature, it will then destroy the cells of the thyroid adenoma. The animal will then be hospitalised in a specially adapted room for around ten days, while the radioactivity reduces.

Are there any risks involved for your cat?​

This treatment is painless, it is performed following a scan of the thyroid glands, a test that allows evaluation of the dose of radioactive iodine to be injected. After ten days, the cat will no longer present with any significant signs of radioactivity and may be returned to its owner. Complications are rare (<10%), in some cases it is essentially either that the response is incomplete, the thyroid hormone level remains high, or in the case of hypothyroidism, the level of thyroid hormones is lower than usual.

Which are the treatment steps offered by our veterinarians for your cat?​

The treatment schedule that we offer is as follows:

• Diagnosis of hyperthyroidism through T4 dosage

• Prescription of a medical treatment (methimazole) for 3 or 4 weeks

• Check of the T4 level and the kidney function

• If the kidney function is normal, a radioactive iodine treatment may be offered, and in this case, the medical treatment will cease for 2 weeks

• Thyroid scintigraphy at the end of these 2 weeks to evaluate the thyroid uptake and therefore the dose of radioactive iodine to be injected into the cat

• Injection of the radioactive iodine following scintigraphy

• Hospitalisation of the cat for 8 to 10 days

• Measurement of the T4 level before returning the cat to the owner

• Check of the T4 level and the kidney function two months after the treatment

Canine and feline geriatrics

Improvements in the care of dogs and cats, in their nutrition and in the prevention of illnesses by means of vaccination has meant an increase in life expectancy for our pets. A dog or a cat which is protected, vaccinated and loved by its owners will live much longer now than it would have 30 years ago.

This increase in life expectancy is associated with a increased risk of the appearance of “new” illnesses, which are often chronic and are more insidious in their appearance, but which will eventually influence its life expectancy or its quality of life:

Arthrosis will affect the majority of animals and reduce their quality of life

Ageing of the kidneys will not be immediately perceptible but will sometimes suddenly get worse

Heart conditions will affect more than half of small dogs and a growing proportion of cats and large dogs.

Today, cancer has become one of the main causes of death in dogs and cats, in the same way as in human beings, and age is one of the most significant risk factors when determining whether or not cancer will develop. These lesions may be visible (cutaneous mass) or invisible (abdominal or pulmonary mass).

The risk of observing two (or even more) conditions in the same animal will therefore grow exponentially as it ages.

In order to help your animal grow old in good health, the clinic also offers a “geriatric assessment service” for your pet.

What are the advantages of carrying out a geriatric assessment on dogs and cats?​

• Early detection of illnesses linked to age
• Starting appropriate treatment from the onset of the illness
• Evaluating the risks linked to the treatment of the animal (is it strong enough for an anaesthetic? Can the different treatments for the animal be combined without any risk?)
• Evaluate the severity of the different illnesses based on the prognosis.

Which examinations will be carried out as part of the test?

• Clinical examination
• Chest X-ray
• Cardiac ultrasound
• Abdominal ultrasound
• Blood test
• Punctures and cytology exams for any mass that has been highlighted

What will happen if an anomaly is detected?​

If an anomaly is detected during these examinations, Oncovet will inform the vet treating your animal who will take over the administration of the care.

Exploration of the unexplained clinical signs in dogs and cats

The exploration of the more significant syndromes in internal medicine often constitutes a long and complex process, requiring significant investment (time, knowledge and complementary examinations).

Internal medicine involves linking clinical signs which are sometimes varied or discrete to diagnostic hypotheses, which must be confirmed or refuted before proposing a treatment. The main syndromes for dogs and cats are:

• Chronic or recurrent hyperthermia
• Un amaigrissement d’origine indéterminée
• A cough, polyuria-polydipsia, jaundice, peritoneal or pleural effusions
• Evidence of an increase in liver enzymes, or of cholesterol levels with no obvious cause
• Cutaneous or ocular conditions associated with systemic signs
• Changes in blood count: anaemia, thrombocytopenia, leukopenia...