Among the problems affecting the eyes of our four-legged friends, one of the most frequent is glaucoma, an eye disorder that presents itself with very particular characteristics. Let's find out what it is, what the causes are and how glaucoma can be treated in dogs and cats.

What is glaucoma?

When we talk about glaucoma, we refer to a pathology that occurs when the pressure inside the eye increases so much to provoke serious consequences. To explain this definition, let's try to briefly understand the eyes anatomy.

The eyeball, of which we can only see the outermost portion, is deeply embedded inside a cavity of the skull. Its surface is covered with different coating structures, which are arranged in overlapping layers, each with a specific function. The outermost part is the sclera, which in the front (the one we can see) is called cornea. Below the sclera, we find the choroid, rich in blood vessels. The innermost part is the retina, which contains all the nerves essential for vision. In the most anterior part, we can distinguish, in addition to the transparent cornea, also the iris - the portion responsible for the colour of the eye - in the centre of which we find the pupil, a black hole through which light passes. Behind the iris is the crystalline lens, a thin lens that serves to focus on the images captured by the retina, and the ciliary body.

The ciliary body, in particular, is the structure involved in the glaucoma. Its function is to produce a transparent liquid, called "aqueous humor", which helps to determine the typical curvature of the eyeball. This liquid is produced by the ciliary body, and then properly drained from a structure located in the corner between the iris and cornea. The balance between the production and reabsorption of aqueous humor ensures that the volume of liquid inside the eye is always constant, as is the intraocular pressure.

Glaucoma appears when this balance is altered, so the pressure inside the eye becomes too high.

Causes

Glaucoma is more frequent in dogs than cats, who can tolerate elevated intraocular pressure with fewer consequences. Furthermore, it tends to appear mainly in adult animals, over 5 years of age.

In general, based on the triggering causes, we can distinguish glaucoma in two forms:

• Primary glaucoma: it does not depend on other conditions and pathologies and is the most common one. It is caused by a particular dysfunction of the animal, called "goniodysgenesis", which affects precisely the angle between the iris and the cornea, where the drainage of the aqueous humor takes place. If this angle is too narrow compared to normal, we speak of "primary glaucoma with closed / narrow angle", or in other words of "primary glaucoma with open angle";
• Secondary glaucoma: occurs following other disorders, such as cataracts, uveitis, lens dislocation, drugs.

In any case, among the main causes of primary glaucoma we find above all a racial predisposition. Dog breeds most prone to glaucoma include Husky, Chow Chow, Shar Pei, Shih tzu, Beagle, Cocker Spaniel, German Shepherd and several others.

In cats, secondary glaucoma is the most common, although some breeds (such as Persians, Siamese and Burmese) are more predisposed to primary glaucoma.

Symptoms

The symptoms of glaucoma are indeed very characteristic. They can affect one eye (unilateral glaucoma) or both (bilateral glaucoma), which will present:

• Redness
• Bulb volume increase
• Dilated pupil (mydriasis)
• Opacification of the cornea
• Increased tearing
• Pain (the animal rubs the eye repeatedly)
• Decreased vision to blindness

 In addition to these symptoms that only affect the eye, surely the animal will also show itself sad and often unappetizing due to the very strong pain.

Glaucoma can only be diagnosed by the veterinarian, as well as with an eye examination, also with a particular instrument that can detect intraocular pressure quickly and painlessly. The normal value in dogs and cats should not exceed 25 mmHg (calculated in millimetres of Mercury), whilst above 30 mmHg there is pretty high pressure.

In cats, it is difficult for an acute form to occur, unlike the chronic one, so the symptoms begin to appear after a long time after the onset of the problem

How do we treat it?

The treatment for glaucoma is quite complex, because it often requires very prolonged drug therapy, in some cases even for life. The most widely used drugs include diuretics, anti-inflammatories, corticosteroids which are substances used to reduce blood pressure or pilocarpine, a drug that can narrow the pupil to improve drainage of aqueous humor. Surgical therapy, on the other hand, comes in when pharmacological therapy has failed to obtain good results or is impractical.

Cats often experience annoying problems affecting the urinary tract, especially the bladder and urethra. It may happen, in fact, that he begins to "do it" around the house - refusing the idea of ​​using the litter box - he complains, licks his genitals persistently and produces few urine, often with drops of blood. But what are the causes and how do we intervene?

FLUTD: what is it?

Probably some of us have already heard this strange acronym. "FLUTD" stands for "Feline Lower Urinary Tract Disease", or "Pathology of the lower urinary tract of the cat".

First of all, a brief anatomical recap is necessary: ​​the bladder - as we all know - is a bag positioned on the lower abdomen, which receives the urine produced by the kidneys through the two long ureters, while the urethra is the thin conduit that carries the "Pee" from the bladder to the outside.

The term FLUTD, therefore, is used in a general way to encompass all the ailments that can affect the bladder and urethra. In particular, the causes of FLUTD can be divided into two main categories: obstructive and non-obstructive.

Causes of non-obstructive FLUTD might be:

• Non-obstructive idiopathic cystitis (FIC): the term "idiopathic" is used in medicine to refer to all those disorders that are really ascertained, but whose causes cannot be identified. Cystitis is generally defined as an inflammation of the bladder, which can occur in the presence of numerous factors. In the specific case of FIC, however, the bladder probably becomes inflamed for other problems such as stress. In this case, the brain sends signals to the bladder, increasing the production of substances that trigger inflammation. Another hypothesis underlying the FIC includes the reduction of the number of glycosaminoglycans or GAGs, of the substances normally present on the walls of the bladder, which have the function of protecting it from bacteria. When the GAGs decrease, the bacteria can take over and multiply, thus creating an infection;
• Bacterial cystitis: occur when bacteria - especially those present in the intestinal tract - reach the bladder or urethra and manage to multiply, generating a rather painful infection;
• Stones in the bladder: just like in humans, our four-legged friends can also meet this problem, which appears when two possible substances, struvite and oxalates, accumulate and join together inside the bladder. These are crystals of various sizes, which can remain inside the bladder, scratching the walls and thus creating inflammation;
• Malformations of the urinary tract: if the urethra is too narrow or has particular defects, debris and crystals can accumulate more easily;

• Behavioural problems: cats get stressed easily, because they are animals very tied to their daily routine. Coexistence with other animals, the arrival of a child or guests, loud noises, are just some of the reasons that can stress the cat. In addition, we must also not forget the importance of the litter box: some felines do not accept that their toilet drawer is moved, excessively perfumed or even that the brand of the usual sand is changed. The result is an inflammation of the urinary tract or in some cases even a complete refusal to urinate in the litter box, peeing around the house.

Causes of obstructive FLUTD might be:

• Urethral plug: it is undoubtedly the most frequently observed condition in cats with urinary obstruction, particularly in young males. The cells that line the walls of the bladder undergo a periodic flaking, which serves to eliminate the old tissue, which is replaced by the new one. However, it may happen that this flaking increases significantly and other debris, such as protein substances, blood cells and other types of cells produced by the kidneys and bladder, may also be added, which may or may not mix with any struvite or oxalate crystals present in the urinary tract . All this material is compacted and can gets stuck in the urethra, preventing urine from escaping. This situation can occur as a result of several factors, such as stress, an unbalanced diet, the presence of infections or tumours; 

  • Idiopathic obstructive cystitis: it is a situation very similar to non-obstructive FIC, but in this case it worsens to the point of preventing the normal emptying of the bladder;

  • Stones in the bladder: in this case, we are talking about an event practically identical to the one seen previously, but if the stones reach the urethra, they prevent the passage of urine. This situation may or may not be associated with bacterial infections.

 Symptoms

Each of the disorders associated with FLUTD manifests itself with almost identical symptoms, which can then vary according to the severity of the problem. Among these, we find above all:

• meows and persistent moans
• Difficulty urinating (the cat remains in position even for several minutes)
• Elimination of a few drops of urine (oliguria)
• Complete inability to clear urine (anuria)
• Frequent genital licking
• Presence of traces of blood in the urine
• Refusal of litter and urination in inappropriate places

In the event of complete obstruction of the urinary tract, the situation becomes considerably more complicated, as the urine is not eliminated in any way and ends up accumulating in the bladder. This leads to a strong expansion, so in a few hours it loses the ability to contract  to empty itself and can even burst, as well as causing serious repercussions on the kidneys.

How do we intervene?

FLUTD is a problem that requires a visit by the vet, who can determine what to do through a correct diagnosis. X-rays, ultrasounds, urine and blood tests may be needed. In severe cases, especially if it comes to a urinary obstruction, the veterinarian may propose surgery to remove any caps or stones.

In any case, it is very important to eliminate all predisposing factors, such as stress and incorrect nutrition. In particular, the possible stressful situations to be kept under control include

• "forced" coexistence with other animals
• Position or type of litter not appreciated by the cat
• Insufficient quantity of bedding compared to the number of animals
• Few bowls of water and food than the number of animals
• Disorder by children or puppies

 The veterinarian will also advise making sure that the cat can drink more water (for example, by purchasing electric fountains or increasing the number of bowls), as well as a very important specific diet for urinary tract problems, which we analysed in detail in this article. The purchase of synthetic pheromone diffusers is also very effective, which help to significantly reduce stress, especially if there are multiple animals in the same environment.

In this regard, in some cases the help of a behavioural veterinarian may be advisable, especially if we are talking about cases of idiopathic cystitis, which cannot be resolved in any way. Stress, in fact, is one of the main weaknesses of the cat and as such must be identified and treated with the right advice.

Any drug treatment should only be prescribed by the veterinarian on the basis of the problem. The most common drugs include anti-inflammatories to relieve pain, antibiotics and spasmolytics to relax the urethra.

One of the most difficult experiences for dog and cat owners to deal with is epileptic seizures. The animal throws itself on the ground, trembles, drools, no longer responds to any stimulus and can even defecate or urinate uncontrollably. These episodes, lasting a few seconds or a few minutes, can be caused by a condition quite difficult to understand and diagnose, known as "epilepsy". Let's find out what the causes may be, how it occurs and what the therapy is.

What is epilepsy

Defining epilepsy is not easy, considering that there are still ongoing studies to try to identify the nature of this problem. However, it is essential to clarify one aspect before starting to analyse epilepsy: epileptic seizures are not a disease, but the symptom of a condition that can trigger them, as we will see later.

As for the definition, the one most adopted by professionals was proposed by the ILAE (International League against Epilepsy), which defines the epileptic crisis as "a transient appearance of signs and / or symptoms due to an abnormal, excessive or synchronous  neuronal activity in the brain”. Let's try to make sense of this complex sentence.

The brain is an extremely important organ, capable of collecting all the stimuli that come from outside and inside the body, processing them and at the same time sending commands and signals. Everything we think, do or say depends on the brain, including behaviour and other autonomous functions, such as breathing or heartbeat. All this is made possible by the presence of neurons, specialized cells in the transport of information, which act as a large communication network in every part of the body. Their ability is to activate or inhibit certain functions.

The epileptic seizure appears when the balance between excitation and inhibition of neurons breaks down, leading to excessive or abnormal activation. If this "defect" stops in a limited area, it is generally referred to as a "partial crisis". On the contrary, a "total crisis" occurs when the neurons of the area affected by the problem "infect" those of the neighbouring areas, activating excessively different parts of the brain. Therefore, the excessive excitability of a small group of cells adds up to that of the others, leading to synchronous hyperactivity.

Each of these cells has a specific function in the body, whereby the body is stimulated to carry out certain movements, without having real control by the brain. Above all, the voluntary muscles respond, which, once activated "from above", begin to contract abnormally, giving rise to convulsions. The same speech can be applied to any other part of the body affected by the crisis, such as the muscles of the face, the eyes or jaw.

Symptoms

An epileptic attack normally follows a specific scheme; these are the four phases:

• Prodromal phase: it can last for several hours or even days, and is characterized by the presence of hyperactivity, anxiety and alterations in behaviour;
• Aura: it is the phase that immediately precedes the epileptic crisis; the animal perceives that something unusual is happening, seems restless, complains, looks for the owner, walks tirelessly;
• Attack or stroke: represents the pinnacle of the epileptic crisis, during which the animal begins to stagger, repeatedly bulges its eyes and drools, sometimes contracting its mouth rhythmically, as if it were chewing something. At this point, it can lie on one side and stiffen completely, or convulsions may appear, accompanied by contractions of the limbs that sometimes resemble pedalling. During this phase, he can roll his eyes backwards, losing consciousness completely, and he may urinate or defecate involuntarily. The duration of this phase is extremely short, on average 30 to 60 seconds, although there may be situations in which the animal continues to have seizures even for several minutes;
•  Post-ictal phase: all symptoms stop, the animal relaxes and resumes contact with reality. Often he appears confused, disoriented and seems blind. After several hours or days she returns to normal and sometimes she may ask for more food than usual - polyphagia - or drink lots of water - polydipsia.

This is the pattern of a real epileptic crisis, but the symptoms can still vary from one animal to another. We refer to an "epileptic state" when the crisis lasts for an extremely long period of time, even several hours. This is a very dangerous situation, which requires timely intervention by the veterinarian.

The causes

The reasons behind epileptic seizures can be many. First, we need to distinguish between three types of epilepsy: primary or idiopathic, secondary and reactive.

"Primary or idiopathic epilepsy" is a very particular condition, in which every possible diagnosis - after performing the appropriate tests - highlights the absence of other conditions that could cause epileptic seizures. The causes of idiopathic epilepsy are actually still unknown, although the hypotheses include above all genetic factors that lead to abnormal brain activity.

We speak of "secondary epilepsy" when epileptic seizures are the symptom of a condition that affects the brain directly or indirectly, such as:

• Head trauma
• Brain malformations
• Brain tumours and cysts (meningioma, glioma, lymphoma)
• Cardiovascular problems (ischemia, thromboembolism, hypertensive encephalopathy)
• Inflammations (meningoencephalitis, infections such as IVF, FeLV, Rabies, Toxoplasmosis, Cryptococcosis)

"Reactive epilepsy", on the other hand, concerns situations that do not directly affect the brain, but which can in any case trigger epileptic seizures, such as intoxications - for example, from pesticides or ethylene glycol, ie antifreeze for cars - and some metabolic causes , like:

• Thyroid dysfunction
• Kidney dysfunction
• Liver dysfunction
• Diabetes
• Electrolyte imbalances

The diagnosis

In case of suspicion of epilepsy, we must clearly rely on our veterinarian, who will be able to intervene in the most appropriate way, especially from the point of view of the diagnosis, which is not at all simple. To facilitate this task, it is advisable to film the animal during an attack, showing the video to the veterinarian.

Generally, the diagnosis is based on a series of investigations and examinations, indispensable to exclude any possible condition that could trigger epileptic seizures, such as:

• Auscultation of the heart
• Neurological examination (evaluation of reflexes)
• Blood tests (liver and kidney function, blood sugar, electrolytes, thyroid, etc.)
• Urinalysis
• Abdominal ultrasound
• Echocardiogram
• Magnetic resonance imaging or CT scan

In the case that none of these tests show any possible alterations, we can proceed with a diagnosis of primary or idiopathic epilepsy.

Therapy

Epilepsy is not curable, but it is possible to keep epileptic seizures under control through a good therapeutic protocol, which must be administered throughout the life of the animal.

The most used drug in these cases is phenobarbital (trade names: Gardenale, Luminale), an anticonvulsant belonging to the barbiturate family. The effect has a duration of about 12 hours, so it is administered twice a day, with a dosage that is precisely established by the veterinarian. Once therapy is started, a blood sample is taken after 2-3 weeks, to check if the concentration of the drug in the blood (phenobarbitalmia) has reached a balance. A low dosage, in fact, may not be effective in reducing seizures, whilst a high dosage can affect the quality of life of the animal, as well as its liver. Once the correct dosage has been identified - which is absolutely subjective and must be established only on the basis of phenobarbitalemia - a check examination can be carried out every 6 months, also monitoring the liver.

Alternatively, there are other solutions, such as potassium bromide - to be administered only to the dog - suitable especially for dogs suffering from liver problems or for which phenobarbital is not effective enough. In cats, potassium bromide is not recommended, as it can cause serious respiratory problems.

Other molecules may be benzodiazepines (e.g. diazepam, trade name: Valium), to be administered in association with phenobarbital or in case of very strong epileptic seizures.

The purpose of a good anti-epileptic therapy is to reduce the appearance of epileptic seizures - it is often impossible to eliminate them completely - without adversely affecting the quality of life of the animal, which must continue to carry out all normal daily activities, without feeling excessively stunned.

What to do during attacks

Often the epileptic crisis upsets the owner more than the animal. Unfortunately, there is not much we can do to help him during an attack, so the fear is combined with a sense of helplessness that prevents us from staying calm.

In any case, what we have to do, however difficult it is, is not to panic. We must avoid shouting or getting nervous. On the contrary, we talk gently to our four-legged friend and turn off the television or radio, to try to make him feel comfortable, especially once he has recovered after the attack.

We must resist the temptation to put our hands in his mouth or to squeeze it, because it could also react aggressively. In addition, we avoid lifting it, because it could fall and get really hurt.

Only in the event that the attack should occur whilst the dog or cat has food in the mouth, we must extract it to prevent it from going sideways, increasing the risk of suffocation

Too often cats become the unfortunate and unaware victims of misinformation about toxoplasmosis, a nasty disease that can cause serious harm in pregnant women. In fact, many families abandon or leave their beloved cat before pregnancy or when the baby arrives because of this. But this unhappy decision is not absolutely necessary: let's find out why.

What is toxoplasmosis?

As we have widely discussed in the article entirely dedicated to the topic (you can consult it by clicking on this link), toxoplasmosis is a parasitic infectious disease caused by a protozoa, called Toxoplasma gondii. We will try to simplify the behavior of this small parasite as much as possible.

The cat eliminates the "eggs" of Toxoplasma contained inside the feces in the litter, in the garden or in the fields. These "eggs" are not yet dangerous, but after about 24-48 hours they are, at a temperature of about 24 ° C and with high humidity. After this period of time, if they are ingested by man, other cats, dogs, mice, birds and animals in general they arrive in the intestine, they hatch and end up in the blood. From here they manage to travel to different locations, among which the most important are the muscles, but sometimes they manage to reach the eyes, brain, heart, liver or lungs. Once they have settled in a location, they incorporate into a protective cyst. When the cat hunts a small prey containing these cysts, even if we offer him contaminated raw meat, he will also clearly take on the parasite, which will be able to reproduce itself until it produces and eliminates new "eggs". This is how the cycle starts again.

What causes this parasite in the body?

In most cases absolutely nothing, both in humans and in animals. At most, we might feel tired, exhausted and perhaps with a little diarrhea and fever, but nothing more. On the other hand, if we talk about people or animals whose immune system is not strong enough, the consequences can be more serious, with the presence of encephalitis, epilepsy, vestibular syndrome or eye inflammations - uveitis in cats, chorioretinitis in humans – lungs, heart and liver problems.

What are the risks in pregnancy?  

Pregnant women is also an important topic. In fact, Toxoplasma gondii is able to cross the placenta until it reaches the fetus. In these cases it can cause different consequences depending on the period of gestation. In short words, the first six months are the most critical period for the fetus, which does not yet have adequate defenses to prevent the parasite from colonizing and damaging it.

The consequences range from abortion or children with serious neurological malformations. Among these, the main consequences are blindness, mental retardation, epilepsy. As you approach the end of pregnancy, however, the chances of the baby being born healthy increases.

However, it must be considered that, if the consequences for the fetus are greater in the early and mid-pregnancy, the risk that Toxoplasma gondii will actually manage to infect is minor. In short words, in the first few months it is more difficult for the parasite to reach the fetus, but if it manages to do so, the consequences would be very serious. On the contrary, in the last three months it can more easily infect it, but it is no longer so dangerous.

How to avoid toxoplasmosis

We now come to the most important point. Too many myths and urban legends are circulating about toxoplasmosis, particularly about proximity to cats. We think of the hundreds of women who, as soon as they discover they are having a baby, send away the much loved pet forever. Of course, the fear of pregnancy is absolutely understandable, but the only thing you really need is a correct and scientific information about this disease.

We think that the chances of the cat being able to transmit the infection to humans are very low. Let's explain why:

•  Cats that contract the parasite, host it only for short periods of time and eliminate the "eggs" with the feces for 1-2 weeks at most, often not even every time they poop. After that, they naturally become resistant to infection and will no longer eliminate them;

• Especially if we are talking about stray cats, it is likely that they have already contracted toxoplasmosis in the past, so they will no longer produce "eggs" in the future;

• The "eggs" of Toxoplasma gondii, once expelled with feces, become dangerous only after 24-48 hours and those who live with a cat hardly leave the litter dirty for more than a whole day;

• In order to take the "eggs", you should clean the litter box (after leaving it unkempt for more than 24 hours) and then, without washing your hands, you should touch your lips, eat your nails or start cooking which is highly unlikely.

So how is toxoplasmosis transmitted?

Well, dear future mothers, you should know that toxoplasmosis is most of all transmitted through food and bad habits. In particular:

• Consumption of unwashed fruit or vegetables that have come into contact with the ground (in short words, if you pick an apple from the tree there is no risk, but there is if it has fallen on the ground);
• Consumption of raw cured meats (raw ham, salami, bresaola, sausages) and raw or undercooked meat;
• Contamination of dishes and worktops during the preparation of dishes based on these risky foods;
• Cleaning the cat litter infrequently, without gloves or touching the face and food without washing your hands;
• Gardening operations without gloves or protections.

The test for toxoplasmosis in pregnancy

A simple blood test is always recommended to all women who are planning a pregnancy or who are already pregnant. This test looks for two different types of antibodies to the parasite: IgM and IgG. IgM are the first to be produced when it comes into contact with a microorganism, but they also disappear quickly, in a maximum of 2-3 weeks. On the contrary, IgG are produced immediately after, but they last for a long time, guaranteeing good protection for the woman and also for her baby, regardless of the period of pregnancy. Test results can be different:

• IgM positive, IgG negative: attention, infection in progress! The parasite flow undisturbed in the body and can reach the fetus;
• IgM negative, IgG positive: you probably didn't even notice it, but in the past you have already had toxoplasmosis, but don't worry, because you have suitable antibodies to protect your baby;
• IgM negative, IgG negative: you have never had toxoplasmosis, neither in the past, nor at present, so you must be careful if you are pregnant;
• IgM positive, IgG positive: you have probably been in contact with the parasite for 2-3 weeks or at least not for long, so the immune system has yet to complete the production of effectively protective IgG antibodies. In these cases it is necessary to repeat the test after about 20 days or you can request the so-called "avidity test", which allows you to accurately date the infection.

Even amniocentesis is able to provide a good diagnosis on the possible presence of the parasite in the amniotic fluid.

A pathology that mainly affects older dogs is the so-called vestibular syndrome. It often happens that this serious problem is confused with a stroke or a cerebral ischemia, considering the great similarity of the symptoms. Let's see together what it is, what are the causes and how to treat a dog with vestibular syndrome.

Peripheral or central?

The vestibular system is a part of the nervous system responsible for the balance and orientation of the body - especially the head, eyes, nose, ears - in space. To make this definition easier, let's think about what happens when we are on the train and look out of the window: our eyes seem to scroll horizontally continuously, as if we were watching a movie in the cinema. This curious movement of the eyes is due precisely to the action of the vestibular system, which processes the position of our body based on where we are.

We can distinguish between a central and a peripheral portion of the vestibular system. The inner ear and the vestibulocochlear nerve (VIII pair of cranial nerves) make up the peripheral portion, while some areas of the brain and cerebellum are included in the central vestibular system. This brief anatomical description is important to further understand the reason behind the problem. In fact, depending on which part of the vestibular system has been damaged, the symptoms and therapy will be different. Let's see in detail what these differences are.

Peripheral vestibular syndrome is the most frequent form and is caused by problems affecting the inner and middle ear, such as otitis, or inflammation of the ear caused by foreign bodies (generally brome grasses), bacteria or fungi. In reality, otitis affects in most cases the outermost part of the ear, without going so deep, even if this can still occur. In these cases, a few days before the acute form of vestibular syndrome appears, the dog can scratch his ears or shake his head repeatedly.

Central vestibular syndrome is certainly more rare, but also the most serious. It can be caused by numerous factors, such as:

• Head trauma
• Stroke
• Cerebral haemorrhages
• Heart attack
• Neoplasms (rare)
• Inflammations (encephalitis, meningoencephalitis)
• Infections (distemper, toxoplasmosis, neosporosis, cryptococcosis)
• Hypothyroidism
• Adverse drug reactions (aminoglycosides, metronidazole, chlorhexidine)

A very rare form is the congenital vestibular syndrome, which the animal presents from birth. To be most affected are the puppies of Boxer, German shepherd, Dobermann, Akita, Beagle, Cocker Spaniel and Labrador.

We also often hear about "Vestibular syndrome of the elderly dog" or "Geriatric vestibular syndrome", in reference to a disturbance of the vestibular system that occurs at a very advanced age. This pathology is easily confused with a stroke or cerebral ischemia, due to the extreme similarity of the symptoms. Unlike the juvenile form, the "Old dog syndrome" generally appears suddenly and very intensely, but tends to resolve itself partially or completely within a few days.

Symptoms

Regardless of the location of the problem, a vestibular syndrome manifests itself with very specific symptoms, which include:

• Rotation of the head to the side or "head tilt"
• Staggering, repeated falls, circulating movements, sometimes rolling
• Oscillation of the eyes horizontally, vertically or circularly (nystagmus)
• Strabismus
• Horner syndrome: one eye is sunken (enophthalmos), the pupil is narrow (miosis), the eyelid is lowered and the third eyelid protrudes from the inner corner of the eye
• One-sided eyelid and lip appear "drooping"
• Loss of saliva
• Nausea, vomiting

In other words, a dog suffering from this type of ailment looks really drunk. In severe cases, the staggering can be so strong as to prevent the animal from standing. It is usually possible to notice a tendency to always walk to one side only, generally by turning the head and eyes in the same direction.

The diagnosis

The diagnosis for vestibular syndrome aims to identify the site of the problem as soon as possible, that is, if it is a peripheral or central syndrome. Once this aspect has been ascertained, in fact,  it will be possible to proceed with an appropriate therapy.

Firstly, the dog's ears should be checked carefully. The veterinarian will examine them with an otoscope, to verify that there are no brome grasses or signs of inflammation. It may be necessary to sedate the animal, in order to be able to visit the ears in further depth, since generally the average and internal otitis can cause this disorder.

An X-ray can be useful to highlight any problems in the tympanic bubbles, (always to be performed in sedation). A CT scan, an MRI or a sampling of the cephalorachid fluid will also be able to reveal the presence of central causes, for example of the tumour masses.

An electrocardiogram or an echocardiogram will serve instead to ascertain the conditions of the cardiovascular system.

Blood tests (complete blood count and biochemical profile) provide important information on the presence of any type of alteration, attributable to infections, kidney, liver or thyroid damage.

If all the symptoms are undoubtedly related to the vestibular syndrome, but no diagnostic technique has shown any alterations, we could refer to "idiopathic vestibular syndrome", a typical diagnosis of the syndrome in the elderly dog.

The term "idiopathic" is used in medicine for all those conditions that are certain, but for which a precise cause cannot be identified.

How do we intervene

Clearly, the first thing to do is to run to the nearest clinic as soon as we notice suspicious symptoms. The veterinarian based on the triggering cause will establish the therapeutic process.

In any case, it is important to maintain good hydration through drips of rehydrating solutions, continuing to monitor blood pressure. Especially if the dog continues to vomit, specific antiemetics will be administered, usually those recommended in case of carsickness.

Healing is highly dependent on the cause of the problem and the severity of the symptoms.

In the case of ear or systemic infections, antibiotics (in the presence of bacteria) or antifungals (for fungal infections) should be administered. For this reason, the veterinarian could take some material from the ears, in order to accurately identify what type of infection it is, planning the exact therapy. If foreign bodies are present, they will certainly be removed as soon as possible. All other causes, such as tumors or strokes,  will carefully be evaluated for the need of a surgery.

As for the "geriatric vestibular syndrome" or "elderly dog", in the absence of serious underlying causes and therefore in the case of an idiopathic form, usually the dog heals spontaneously, often even without any therapy, although may continue to present some typical symptoms in a more or less mild form. In these cases, therefore, the treatment is based only on the livelihood of the animal, through the administration of fluids, food and drugs for nausea.

The term "stallion's tail" isn’t well known, but it is pretty common condition in dogs and cats, which manifests itself with accumulation of sebum, dark-coloured debris, hard fur combined with small tufts on the upper part of the tail. Let's find out how it manifests itself and what are the causes behind this problem.

What it is and how it looks

The "stallion's tail" is caused by hyperplasia of the supracaudal glands, particular structures located on the upper part of the base of the tail. Their function is to produce and secrete pheromones, apparently odourless substances, which however are used by animals to send messages to their fellows. In other words, it is a coded message that each dog or cat spreads in the environment to convey mastery of the territory, willingness to mate, a lurking danger or even relaxation and contentment. These glands are widespread in many parts of the body, especially on the muzzle, between the fingertips and also in the area around the anus.

In the specific case of the supracaudal glands, we can identify their presence by gently moving the hair a few centimetres away from the base of the tail. With a little attention, we will be able to appreciate an area where the hair is thicker, quite hard compared to the surrounding one. The hair follicles around the supracaudal glands, in fact, give life to a single hair, unlike the others from which instead more hair originates.

The presence of these glands generally goes unnoticed by the owner, as well as the pheromones it constantly produces. However, it can happen that the glands encounter inflammations or infections that lead to an increase in volume (hyperplasia) and an excessive production of sebum, which is accompanied by:

• Greasy hair at the base of the tail, often stuck in small tufts
• Dark and greasy deposits along the fur
• Presence of blackheads (blackheads)
• Redness of the skin
• Hair loss
• Bad smell
• Dandruff

In most cases these symptoms are limited to the base of the tail, but it can happen, especially in the presence of infections, that the affected area is larger, even reaching the lumbar area.

 Causes

The term "stallion tail" is linked to the fact that this disorder occurs mainly in whole, uncastrated male dogs and cats. The reason is due to a mechanism induced by testosterone, the most important sex hormone produced in abundance by males. In fact, in females and castrated males, its production is much lower. It would seem that the excessive increase in the levels of this hormone may be among the causes of the "stallion tail". However, it can also be found in castrated males and females, although in lower percentages.

Hyperplasia of the supracaudal glands can be caused by an accumulation of sebum and impurities, for example if the cat does not spend enough time on grooming or if the dog is not washed frequently.

During the diagnosis, the veterinarian must rule out that there are problems with an overlapping symptomatology, such as:

• Flea infestations
• Bacterial infections (pyoderma)
• Fungal infections (dermatophytosis)
• Parasitic infections (demodicosis)
• TumoUrs of the supracaudal glands                                                                                                                                                                                             Treatment

  The "stallion tail" can be effectively countered by using specific products for the reduction of sebum, available as shampoo, spot-on or lotions. In the presence of infections, it will be advisable to resort to antibiotics, antifungals or other special drugs. In most serious and persistent situation that occur in whole males, the veterinarian could recommend castration as the only alternative.

  In any case, although it is not a serious and annoying problem for the animal, it is recommended to always visit the veterinarian even in the presence of mild symptoms, to exclude other similar ailments and to prevent the situation worsening.