ASK THE VET: Puppy’s hernia requires surgical repair; cat with kidney disease needs fluid

Q: Rosie, our pit bull puppy, has a soft lump where her belly button should be. When we push on it, it disappears temporarily. What is it, and should we be concerned?

A: It sounds like Rosie may have an umbilical hernia. Your veterinarian can do a physical exam and tell you whether it needs immediate surgical attention or can be repaired later, when she is spayed.

The lump probably contains fat that is protruding from her belly button. The hernia, likely inherited, formed when Rosie was born.

Normally, at birth, the umbilical cord falls off, the abdominal wall closes where the cord had been, and the skin comes together to form a belly button, or umbilicus.

However, Rosie's abdominal wall did not completely close, and pressure in the abdomen is forcing some of the abdominal contents out the hole.

If her intestines were forced out of the abdomen, they could strangulate — an emergency that would require immediate surgery. If the hernia is small and contains only fat, and your veterinarian feels it can be repaired when Rosie is spayed, monitor it closely until then.

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Q: Koosh, my 13-year-old cat, has chronic kidney disease. His veterinarian prescribed a canned renal diet, fish oil and weekly subcutaneous fluids, all of which have been keeping him energetic.

However, because Koosh's kidney disease is progressing, the vet is recommending we do the fluid treatments more often. The problem is that Koosh doesn't tolerate the car ride to the vet very well. Can subcutaneous fluids be given at home?

A: Cats with chronic kidney disease gradually lose their ability to filter toxins from the blood and conserve water. As the toxins build up and dehydration worsens, the cat loses his appetite and energy.

Adding fluid to the body in the form of canned food, which is 80% water, and subcutaneous ("under the skin") fluid helps maintain the cat's kidney health and quality of life. Fortunately, subcutaneous fluids can easily be given at home.

On your next visit to the animal hospital, ask if someone can teach you how to administer the subcutaneous fluids, nicknamed "sub-Q" fluids, and dispense the necessary supplies. These fluids are identical to the sterile electrolyte fluids given intravenously. However, it's much easier to administer fluids into a cat's large subcutaneous space than it is to give them intravenously.

You'll start by situating Koosh where you and he are comfortable, preferably with a few treats in front of him while you're learning. You may also wish for a cat-knowledgeable friend to help you during your first home session.

Suspend a bag of sterile fluids above Koosh, and attach a new, sterile needle to the tube exiting the bag. If you're right-handed, have Koosh sit or lie with his head to your left, and use your left hand to raise the skin over his shoulder blades to form a tent.

With your right index finger, gently feel the sub-Q space, the area between the raised skin and the underlying muscles. Use your right hand to insert the needle into the sub-Q space, open the fluid line and let gravity do the rest. Praise Koosh while the prescribed volume of fluid runs from the bag.

Then, close the fluid line and remove the needle from his skin. His body will absorb the pillow of liquid over the next 12 to 24 hours.

Most cats with chronic kidney disease feel best when sub-Q fluid administration is repeated every one to three days.

Lee Pickett, VMD, practices companion animal medicine in North Carolina. Contact her at [email protected]

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