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I noticed a raised lump on my Staffordshire bull terrier aged 8 on the 21st of November on my dog head that ulcerated the next day. The ulcerated lump scabed over then got knocked off the following week. I have been to 2 different vets within that time and both feel it either a histiocytoma or a mast cell tumour with both vets leaning toward it being a histiocytoma but only a biopsy will make sure. I have a biopsy for Wednesday but my question is would it be worth doing is this lump too close to the eyes for good margins? I have done days of googling and I see 1cm is all that needed for good margins and 90% of other sites saying 2-3cm is needed. I would not put my dog through radio therapy so if good margins is not possible would it be worth doing a biopsy? Another thing is I know it low chance but I don’t want to risk Anesthesia with my dog being that 1 in 2000 dog to die from it. Anyone know if good margins is possible from looking at the picture of my dog?
Hello! I just discovered this app via a YouTube video, as I now spend my days googling things like “Cat breathing loudly” and “normal cat breathing”…!
Since perhaps June I’ve noticed with increasing regularity my cat, Clover, breathing very loudly, sometimes to the point of waking me up with the sound. In September this progressed and my husband noticed her breathing freakishly fast and we rushed to a vet.
However 5 vets, including a specialist, many xrays, and treatment for gum disease later, no one seems to know what it is, and I can’t take the wait and see method they are prescribing. She is playing and eating and otherwise normal, but her breathing does seem to bother and annoy her and at times she looks very despondent.
The history is that almost two years ago I made the most terrible judgement call of my life and she got out the window of a new apartment and fell 4 floors. She was unable to use her back legs for a few days during which they kept her under observation and she needed stitches in her soft palate. She has made an almost complete recovery.
The accident happened exactly a week after our other cat contracted an unknown disease and died suddenly and shockingly at aged 5. I still haven’t recovered from our other cat’s passing and both my husband and I comfortably acknowledge that Clover is the number one love in my life, and I will do everything to keep her alive and happy. However we have reached our pet insurance limit and I am so concerned about what will be next.
I have done all of the internet researching there is to be done, and I just know looking at her and hearing her stressful breathing that something is very wrong. I don’t know if it’s connected to the fall, but it isn’t bronchitis or asthma both of which treatments did less than nothing.
If anyone has any advice or had a cat with similar symptoms please let me know what you think?!
Good morning-
I am very sorry that even after all of your vet visits and research, you are still at a loss. Other than finding another specialist, my only thought is if there is a teaching veterinary hospital/school that would want to take on your case. Hoping that some other Pawbly friends may be able to share mor advice with you. Very best of luck to you…????????
Thank you so much!
Hello,
In many of these cases I have found that these cats have chronic rhinitis. A friend scan if about the best way to identify this, but, it isn’t usually able to be cured, only somewhat managed with long term use of anti inflammatories and adjunct treatment options like minimizing allergens and managing weight. I have also tried cerenia drips and steroids to some help. Or even an inhaler to see if it helps. Ideally I keep these cats in a clean ventilated moist environment and minimize allergens to include all household cleaners, litter and even their own pet dander. Finding a diagnosis is a challenge as it isn’t infection and if it isn’t it is harder to cure. Some cats just snore no matter what we do.
Thank you so much for taking the time to reply. It it usual for it to come on relatively unprovoked? Or could it be connected to the fall? Also, as it is deteriorating so quickly now, what is the likely time she can live with it?
The whistling is relatively constant now, with every day becoming more extreme.
We have an air purifier running constantly, I have never used harsh cleaning chemicals ever and we are in a small apartment, so her exposure to irritants is as low as I can make them.
She was on cerenia but it did nothing and nor did the steroids.
Thank you so much again.
Also anti inflammatories did nothing I should add!
Hi Pawbly friends. Quick question about apples???? Rontu and Riva (GSDs about 85 and 70 lbs. respectively) found apples that Were put in the compost because they were going soft. They just finished chowing down about three of them- the rest have been removed from them. Safe? Watch to make sure they don’t have any issues going? Or is it something we should be more concerned about!
Hello,
Then only toxic part are the seeds. And you have to ingest a huge amount for them to be toxic. So no worries.
Thank you???? They sure keep me on my toes????
Apples make a GREAT doggy snack! If they’d started to ferment, you might have slightly tipsy dogs on your hands (you don’t want to know how I learned about that…). Otherwise…let’em have a slice or two when you’re snacking on them every so often. 🙂
I have a 14 month old pit mix that has terrible anxiety. He is terrified of being by himself, even if we are just behind the closed door using the bathroom. He cries terribly & will pace the house until we’re done. If I take a shower or bath I leave the door open so he feels a little better, but he then cries & tries to grab my arm to pull me out (not in an aggressive way). When people come into the house he paces, jumps, & whines for them. He also does this outside when he sees people or other dogs. He is told “down” when he jumps & warned with the beeping noise on his training collar. He will sit but it is very hard for him to stay still, as he continues to whine, shakes, & then rolls into the ground. It’s like he knows to listen & tries very hard but literally can not stay still. He also is terrified of thunder & the sound the trash truck makes. When those sounds are occurring he runs right under the table & won’t come out. We are in the process of training & we were told by them that they also think he has anxiety. They think he would be able to comprehend better if it was under control. I have been researching non stop for things to help with this major issue. I don’t want him on prescription anxiety meds that cause him to seem “sedated” & not like himself (that happened with my family dog). I have come across a tablet to help with separation anxiety & the behaviors that come with it. It is called clomicalm & every review or story I have read about it was positive. I really do think this could be a successful choice for him IF I know this is something that is not harmful. There are possible side effects that could occur but that could happen with pretty much any medication humans or pets. This tablet does not cause dogs to seem drowsy from what I’ve read from people’s experiences & has a high success rate to treat anxiety. We have tried natural treats, oils, thunder vests, etc. & nothing has helped him in the slightest bit. I just want to know if this something that would be okay for him to take daily or even okay to take at all?
Hello,
It sounds like it is time to get help from a behaviorist. Please ask your vet for a referral and also ask them about medications to help bridge the gap as you start to help him overcome his fears and anxieties. Medications can help but they should not be used without also implementing training, socialization and behavior modification therapy. I hope this helps and I hope your pup gets help soon.
I agree with Dr. Magnifico. A behaviorist will be money very well spent and will benefit ALL of you. Very best of luck. Don’t give up!!????????
I agree with the others – find a behaviorist. I’d also invest time in a sport of some sort. This can help build the confidence it sounds like he lacks.
I noticed last Friday a faint circle on my dog head between his eyes the following day it opened up and they was a circle of blood. I took my dog the vet on Monday and was given cream that I applied till Friday yesterday morning. Yesterday the scab came off and they was a small red circle not sure if they was any bleeding. The 4th picture show what it look like today. Can this be cancer? As I don’t understand if cancer develope a scab ? If it was just a bump that opened up and a scab formed for it to heal then should it not be showing a fleshy circle still ? How long does it usally take for this type of thing to heal? I have spent days looking at picture of cancer and they are all lump that bleed and I ain’t seen a picture of a scab forming over any. I asked my vet on Monday after she checked it out if it could be cancer and she said it could be but if it was just a scab would she not know ? Or can cancer form scabs?
The saying goes that cancer can do whatever it wants. The best way to identify what this is is by taking a biopsy. Please ask your vet to help you monitor the masses progression and consider surgical biopsy if it persists or doesn’t heal.
Hello and thanks for the response. How long should I watch this for? If it just a bump from say hitting his head that opened up and scabed over Then should it of not already healed within a week or does it take longer to heal? It been 8 days since the faint circle appeared for it to open up the next day then form a scab so how many more days should I wait to see if it heals? His also got other little lump showing up 2 on his neck and 2 on his side but they ain’t progressed like the one on his face, they are just small hard lumps.
I noticed last Friday an outline of a circle on my dog head that you can to look for a certain angle to see. The next day you could see it more and it open up and was bleeding. I took my dog to the vets on Monday and asked if it could be cancer and was told it could be then given betafuse that I applied twice a day till today, the cream done nothing. The growth itself I don’t think has grown outwards but I think it grown a bit upwards. His been acting less energetic lately it mite be due to him getting older as his close to 8 he only seem full of energy when it come to walks or play but he just seem a bit of off less up for going up the stairs. His also got a small lump on his side and neck tho they ain’t the size of this lump.
Hello,
The only way a lump or bump is definitively diagnosed is with a biopsy. A photo can’t provide the answer as many of them look very similar. I would follow the directions of your vet and follow up if it worsens or doesn’t resolve. You can also ask about a biopsy or a referral to a veterinary dermatologist. Because it is on the head I would also ask about it possibly being a histiocytoma. Let us know what happens.
Hello and thanks for the response. How long should I watch it for, would waiting and seeing not risk the chance of spreading or is this not a concern with tumour on top of the skin?
My question is about food for my cats and dogs.
Cats
Ive always been told to keep dry food out at all times so I do but I also feed them in the morning and at dinner with a mixture of wet and dry. They are all 6 years old and they are putting on weight. Should I take up the dry food so they don’t graze on it all day and just feed them their 2 meals a day. Is that enough?
Dogs
I have always fed my 13 year old once a day with a mixture of wet and dry and of course he gets tid bits from our plates through the day. Lol. He’s always been a healthy weight and seems very happy. I rescued a dog a year go that was a stray and she was 1. I kept dry food out for her all day, as suggested by my vet, and also feed her with her brother at diner time with the same mixture. I have recently taken up her dry food and only feed her once a day Now with the brother.
Am I doing the correct things for my animals. I don’t want to overindulge them and have them become overweight and have the many problems that come along with that. But i also don’t want them hungry. Not sure what to do.
Thanks
Hi there???? Personally, we feed twice a day, our cats and dogs both. They get fed in the morning after their first walk and then again in the evening after their last walk. We also only feed dry food. They do get small pieces of dog treat throughout the day for good behavior and training as well. If you are truly questioning your feeding habits though, I would speak with your vet for advice. Best of luck!
I agree with Sarah!
I agree with Sarah, as well. Never free feed, especially with multiple animals in the house. It’s hard to track who is eating what and who’s off their food. In addition, you may find it better for both dogs to feed twice a day, to keep their blood sugar even and their guts happy. (I have a breed prone to bile pukes if they aren’t fed twice daily.)
Hello,
For indoor overweight cats I recommend one 5 oz can of a high quality canned food per cat twice a day. I also say to add water. It will help them feel full and not add calories. Also limit how much dry food you offer and the type of dry food. There are lots of low calorie options available. I use these as snacks during the day.
For dogs I feed twice a day because they need calories twice a day and that way you know who is eating and how much. Which is super important if anyone gets sick or isn’t feeling well. I am a bit old. Fashioned. I like science diet. They have lots Of options and Are always affordable.
Hi, I have a 15 year old chihuahua named Peanut. He was diagnosed with IVDD on Sunday. He is able to stand for 30 seconds on his own and can walk a few steps before falling over. His right front leg and right back leg are the main limbs that knuckle over and give out when he stands. He can’t get himself to an upright standing position. He is currently on Gabapentin and galliprant. When the pain killers don’t have him knocked out he is crying and whimpering. He looks like he is pain and can’t get in a comfortable position . He is eating and drinking water. He is able to use pee and defecate on his own but most of the time does it while he’s laying down in his pen.
I feel so bad for him I’m honestly just crying all the time because it hurts to see him in pain and I feel helpless. I try and let him stand and walk for a few
Minutes a day with my support but should I be letting him walk? Or should I be trying to make him rest more? Also he doesn’t let me switch the side he lays on. He only lays on his right side . I know Dr. Krista said we need to switch the aside they lay on but he looks like he’s in more pain when I try to switch him to the left.
Any advice , thoughts, or feelings? I really just needed to not feel so alone in this.
Peanuts X-rays
Good morning-
I’m so sorry you are going trough this. Dr. Magnifico has a lot of videos regarding ivdd posted, and you might find them useful. Another thing to maybe try as far as getting him on his opposite side- when he has his pain killers in his system and is sleeping for close to it, perhaps gently maneuver him to the another side and see if that works any better. If he is not giving up, please don’t give up either. Best of luck to you both!!!!
Thank you so much for the advice! I’m going to continue to fight with him as long as he can. He still looks like he’s trying his hardest!
Have a 16 year old cat that has been very sick with so much mucus coming out of his nose. Been sick for for a while now. Gave him 10 days of amoxicilin from vet. He’s having a really hard time breathing from all the mucus so we have Ben doing everything possible to keep him alive cause he is a fighter. He stops breathing a lot cause h’s so clogged it’s heart breaking. We give him warm steam and humidifier along with taking him outside to get more oxegen. He stays up most of the time cause when he puts his head down it blocks his airways. I have been pulling the discharge out with a small eyedropper when the bogies show. Really hoping he can beat the illness and get better soon but vets are taking all our money with doing much. We are on limited income. I think he needs a nasal flush maybe but can’t do it myself cause of lack of knowledge and medical equipment. Please contact me at 619 453 1747 if you have any ideas. Some days he looks like he won’t make it but then other days his eyes look so clear and beautiful. We have been giving him syringes of water and blended food to help him k==p the weight on cause he stopped eating a few days ago from lack of smell. He never did drink much water but maybe cause there was some underling issue. I have a Web cam and could show you or talk to someone if they care to reach out. He is a huge part of the family for many years and I know he wants to live longer but unless he gets better soon we will be at a great losss. He has a vet appointment today but I don’t think they will offer many answers besides sending him to more specialist we can’t afford. He has been sneezing fluid for about a month. He is the sweets cat ever and would do anything to keep him around.
Hello,
It sounds like a nasal flush might be helpful. It also sounds like it is time to try to get a diagnosis to make sure this is just infection and not something more insidious like cancer. Has your cat been tested for FELV or Fiv? Have they checked or talked about a polyp? Can you call around and ask for help from any of the rescues or shelters? Or even for payment plans or billing? For cases like this I try a few antibiotics (usually clavamox, doxy and then azithromycin), and then talk about looking for a polyp. After that I think these guys are either chronic rhinitis or I worry about herpes or cancer. That is my typical work up if people can not afford advanced imaging or cultures and biopsy. Ask your vwt about all of these. Also we are now trying diluted Cerenia nasal drops too. Maybe ask about them? Please keep me posted and very best of luck.
Not any test done cause mom is on ssi limited income and I’m disabled without income either. Will try more antibiotics if u think it might help. Has bad teeth but not sure extent. Was thinking it could be infection of teeth possibly cause he can’t eat dry food very easy. Haven’t tested for much anything really. I don’t think it’s fiv case when I open his mouth his lung’s seem strong and good with no sounds. I sit by him all day and pull boogies out with eye small dropper hoping it helps. Hydrating helps the mucus come out more I think.. will ask around for assistence like you recomend. He might have herpes. Had a lot of fluid come of eyes out when he was more stuffed up. Will discuss polup. Will defiantly look into ceria drops. I feel once the mucus is gone he would breath much better . When I pet him and he purrs sometimes he breeds through his mouth and get way more oxegen to his brain. Love goes a long way with this cat. Weird how just petting him would open his lungs for such a long time. When he stops breathing from weekends I’ll open his mouth at times, don’t want him to go brain dead before he gets help. I been literally with him for 3 days 24h a day to monitor his breathing and help him any way I can. Petting him goes a long way . Thank you so much for the valuable feedback, it is greatly apprecieted. Found your site from a polyp removal video on YouTube and it seemed like you had a lot of compassion to help people with low funds. Very cool of you to help people like that. Your service to the world is immeasurable!!!
Took kitty to vet. Got the cerenia you mentioned. Helped a lot last night but waiting for 24hr to use it again. Hes all dry now with dark green booties. Very thick.. vet said he might have a tumor in his nasal area because his one nostril is larger than the other with slight unevenness. Hes doing mostly mouth breathing today with many sneezes. Gave him a baby saline solution today with minimal effect. Also tryed steam from tea pot. When he falls asleep he stops breathing from being blocked many times through night. Also got more antibiotics . Vets said it’s not fungal. She recomended if he does not get better think about euthinisation. He was a lot better yesterday and showing so much love. Was back in my room all yesterday instead of bathroom but a lot of snorkels. .limited on funds and she said it would be a big workup and more tests before s nasel flush could be considered because at this point she would not put him under anesthesia. Is there a way I could check at home for the back of throat polyp? Not expecting miricals but it is really hard for me to give up on the little guy. Didnt think he would make it this long but I dont know how long sickness takes to run its course. I wish I could try a nasel flush but is cost prohibitive considering all the workup tests required. He slept by me all night for the first time in a week. Syringes with water seem to help the dryness but right now its ultra dry. Can I give him the carina drops before 24 hours is up?
Best regards
Cerenia works well but it weres off. At night he gets stopped up bad. Can I use Cerenia more than once every 24h? I’m sure the answer in no but its hard to sleep knowing hes not getting oxygen at time..
I wish I could try the nasel flush but cant afford it with all the added tests beforehand. Do nasel flushes always make cats nose blead and how harmful is it for there nose to blead with tubes that are used?
Puffy doing a bit better. When he was barely breathing a few days I noticed him biting the carpet cause he was suffering g so bad. Thought it might be his teeth cause symptoms are almost the same from some research. Cat is much healthier now due to diligent care. nose removing mucus with warm rag when showing discharge. Hes on cerenia, baby saline nasel drops and new antibiotics. We still feed with syringe and hes finally gaining weight. We have been slowing adding more food to his diet. He now drinks more and eats more on his own but he has a hard time breathing while eating and drinking so its limited. We been trying to discontinue humidifier slowly but I feel it helps him breath and loosens mucus. Hes very tired and less social these days but better than he was a few days ago. My main goal is to help him breath better soon. Could be one of three things. Either tumor behind nose cause nostrils are uneven but better a little now. Infected tooth, or possibly nasel polyp. Hes very skinny to the bone from not eating before but food syringes seem to help a lot so far. Mucus is much thicker and stronger making it harder to come out of his nose. Might try a animal safe decongestant I seen another vet use today along with lavender oil in humidifier. How do u feel about vicks?
Kitten with completely atonic colon, possible causes? (Long text ahead)
So Nov. 3th in the evening we got 2 kittens, estimated 6 weeks old, thin. However due to being cold outside they already had very thick fur, so it wasn’t visible how thin they were. Weight was 550 & 650gr.
The finder said they have been more active before and only now they were able to get those two. They borrowed to live traps to get the mother and another kitten.
Both were seen eating. They were treated against worms (Milbemycinoxim/Praziquantel) and fleas (Lotilaner)
Nov 4th: Overnight everything was eaten, poo was solid. Kittens were responsive and alert. To the evening only half was eaten. Poo was still solid.
Nov 5th: Nothing was eaten over night, the little one seemed a bit weaker. I started to feed them with a syringe. They started with diarrhea, but that sometimes happens when feeding with a syringe.
Nov. 6th: They still don’t eat by themselves. The smaller one still seemed weaker, but otherwise it seemed fine. A bit diarrhea. In the evening I found it the litter box, not being able to stand, barely reacting. It hat vomited (at least it looked like it), and still had poo stuck on it. It was immediately brought to a vet. It received glucose solution s.c., something against vomiting, pain and an antibiotics. Lung sounded free, heart (ultrasound) was fine, too. A test of parvovirosis came back negative. I took both of them home that night, so I could feed it smaller portions more often and to give more fluids. 2 hours later to was able to stand again. I fed them every 3-4 hours, fluids every 6 (only small amounts obviously). It was lying on a warmth mat. The bigger one was fine, but avoided it’s litter mate.
Nov. 7th: No further improvement. None of them was eating on their own. The smaller one was still lying down most of the time, sleeping, but would react when I came to feed them. It would stand up and walk to the litterbox between the feedings, but the poo had a weird consistency. Not really diarrhea, but veeeery sticky, so it always carried it back to it’s sleeping place. So I had to clean it before every feeding. A test on giardia was positive, treatment started with Carnidazol. Continue to feed them with a Syringe and fluids for the smaller one. Fluids were always absorbed to the next feeding, but it still was a bit dehydrated (skin fold test). The bigger one would play in between and seemed fine otherwise.
Nov. 8th: No changes in the smaller one during the day, still weaker, able to walk, sit and stand, but sleeping most of the time. Today there was rarely poo in the toilet. I assumed that the treatment started working and it was a good sign (although I already had the feeling that something was wrong… wish I would have trusted that feeling). In the evening it seemed weaker, but would still accept being fed with a syringe. It felt different, less body tension, but would still walk away/go to the t. 10pm feeding. More calm, didn’t want to eat that much, peed on me. Meowed louder during giving the fluids than usual and tried to get away. 2am clock, the fluids weren’t absorbed completely, it’s abdomen felt like a sponge. I only fed a tiny amount. 6am weaker, would lie down immediately, breathing was shallow and faster, meowing, I didn’t feed it, fluids still not absorbed. Rushed to the vet.
-> Heart had a low frequency, breathing fast and shallow
-> X-Ray lungs were free, only a tiny amount of fluids in the abdomen, however the complete colon and stomach were filled with food. There was no visible blockage or air.
-> Ultrasound: Absolutely no movement in the colon/stomach, no blockage or air seen either. Kidneys and liver seemed fine
-> Punctation of the abdomen: ca. 3-4ml of fluids, lots of proteins, a bit of blood. Didn’t look like FIP. Possible that the fluids came out of the colon.
It was given something against vomiting, pain, antibiotics, something to help the cardiovascular system and something to get the colon moving again. To help with its breathing got a mask with additional oxygen. However in the next hour it got worse, so we decided to let it go. After it was gone food came back out of it’s mouth. And it didn’t even smell like it had started to digest.
It’s littermate is still with me and fine. It started to eat on its own yesterday.
Now I obviously ask myself what i could have done better/different. By now I think I should have started with additional syringe feeding earlier – at least with the smaller one. And I should have reacted when my feeling told me that something was wrong, even when there were no obvious changes yet. I somehow have the feeling that I sis something wrong and killed it. Did I give too much fluids (but lungs were free and only a bit fluid in the abdomen)? Did I feed too much? Other kittens eat even more without problems – and the other one is fine.
And what can be the causes for the complete stop of movement in the colon/stomach?
I know that FIP can cause this and an ileus (but there were no visible blockage, everything was filled with food), are there other causes? Can giardia do this?
Hello,
First it is important to give yourself a very firm and big pet on the back. You have gone above and beyond and saved these kittens from a slow awful death. Next this isn’t a question about the colon this is a question about what is causing all of the clinical signs you are seeing. Ileus (slow or absent moving gi tract) has many many causes but something caused it. Probably has everything to do with the same something causing everything else you are seeing. There is a huge list of possible causes. Infection, congenital disease, malnutrition before they got to you. Infectious disease like rabies, etc etc. my recommendation is to stick with the basics of keeping them warm, fed, and treated for parasites (internal and external). After that (or before your preference often dictated by amount owner can spend) is to keep asking for second opinions and keep running. Diagnostics. I really applaud your dedication and I have to say as much as sometimes we try we just aren’t able to save them all. This is especially true with kittens. Which have been some of the most rewarding and most heart breaking of all the cases I have seen.
Hello,
thanks so much for your answer and the nice words. Malnutrition would be definitly possible, it’s nearly winter here and they were thin when we got them. Maybe it was too much for the gi tract after not getting much for some time.
What additional diagnostics would you have recommended to do? I think bloodworks could have been an option, but what parameters? Just the large profile or other tests (besides FIV/FelV)?
I added the xRay. I was only present at the ultrasound, where I couldn’t see air. The xRay shows air in the stomach and colon. But otherwise everything is just… filled – theres not really something visible. Kidney and Liver could be seen in the ultrasound and looked normal. The “swelling” on it’s belly is the fluid that wasn’t absorbed – altough it felt a bit harder that a fluid bubble under the skin usually does.
The other one is still fine, active and playing, starting to eat on it’s own. Purring and cuddly. Yesterday we got the 3rd littermate, the mother is nowhere to be found until now. I haven’t seen the new one eat yet, but it was hungry when i fed it with a syringe – and it liked it. So I’ll just feed it a bit too, just not as much. That’s also nice for bonding. But it ate what was in the trap – so it knows cat food. It’s still very afraid, so I guess it will mostly come outside when I’m not in the same room.
We also got another one, a little male that the fidners named Nero – same area but not same place – but same age (a bit younger possibly) and also black furred. But this one is in bad shape, too. Very calm and tired. Lying most of the time. It’s just skin and bones, dehydrated. I haven’t seen it eating or using the litter box yet – and since the other two use it and the towel it lays on is wet sometimes I think it doesn’t really go. But it is able to stand and walk – I think it’s just to tired/weak to do so without need. This one is also fed every 3-4 hours and gets fluids. I heard him sneezing, so maybe it’s getting cat flu.
All were treated against internal and external parasites and no diarrhea until now from the new ones.
Thanks again for taking your time to read my wall of text(s) and answering so detailed.
Hi there-
Sorry you are going through so much stress with this situation. Unfortunately, it is always so hard to tell anything definite from A picture. I would have frank discussion with my vet and ask about all of my different treatment options from aggressive on down. They know you and your pet best, and can advise accordingly. Best of luck to you both.????????