Winter Is Finally Here

Baby, It's Cold Outside.  All kidding aside, really cold.  It seems that it had been unseasonably warm up until this past weekend and then all of a sudden, we stopped seeing fleas and ticks and started worrying about hypothermia in our pets and their owners.  Here are just a couple of things to keep in mind while we finish laying on that insulating layer of blubber from all of the goodies that were sent to the office this season.  (Sincerest thanks to all of you but I am starting to feel the consequences)

First, do not leave pets outside for long periods of time.  Sudden temperature drops make it difficult for animals to acclimate to the cold.  This is important to take into consideration if you are planning to travel with your pet.  Airlines may restrict pet travel in extreme temperatures.

Make sure out door cats have access to shelter.  Water will freeze so it is important to make sure that there is fresh, liquid water available.  Dogs that spend a large amount of time outdoors also need a snug warm shelter to keep them out of the weather.

We always worry about leaving dogs in the hot cars in the summer.  Well, now we have the opposite problem.  Bella is good down to about 30 degrees for about half an hour in the car if she is wearing her coat.  This week, I haven't left her in the car for more than a few minutes and I make sure that it is warmed up.  Her regular walks are not a problem during the day, but she wears her coat for the longer evening walks.  Also, make sure to check your dog's paws for ice and snow, especially between the pads.  Clean them when you come in to remove salt that might irritate their feet.  In the city this past weekend, I noticed that a lot of dogs in Central Park were wearing booties.  I think most owners do this to keep their apartments  free from the dirt and grime, but the dogs are protected as well.

Don't forget about our feline friends.  Cats that are coming into the veterinarian or traveling for the holidays can be subject to the cold.  Some are more sensitive than others.

On really frigid days, warm the car up before going out, put a blanket in the carrier, and of course, a sweater is appropriate for some.  With appropriate preparation, we can all enjoy the cold weather.  In fact, if you have pictures of your pet playing outdoors this winter, please, message them to me at our Facebook page.  We'll try to put a collection together so we can look back at this month fondly when the weather is warmer.  Until then, here's looking forward to warm weather and romps in the yard.

Stay warm, and everyone have a Happy and Healthy New Year.

Chronic Kidney Disease in Cats

Dr. Sandra Wu

Have you noticed that your cat is drinking a lot more? Do you scoop more urine clumps out of the litterbox than you once did? Is your cat looking a little skinnier? These aren't old age changes, but rather they can be signs of chronic kidney (renal) disease. Some people think, “My cat is drinking and urinating a lot, so the kidneys must be working well.” On the contrary, these are signs that the kidneys are not working well.

The kidneys' job is to filter out the waste into the urine, but keep in fluid and other important nutrients to maintain hydration. If there is a lot of urine produced, the kidneys are letting too much fluid out into the urine and not keeping it in the body. Then, your cat drinks more in an effort to keep her hydrated, and this water just goes straight through the failing kidneys. This cycle repeats itself and what you see is a cat that drinks and urinates a lot. Over time, the kidneys are not only letting fluid out, but also protein. This loss becomes more obvious as your cat starts losing muscle and looks old and skinny. Again, this “old age” change can actually be kidney disease.

By the time you bring a cat in with these clinical signs, it is already in chronic renal failure. We diagnose them with bloodwork and a urinalysis. At this point, the cat has already lost 75% of kidney function! That means she is working with only 1/2 a kidney!

Fortunately, a newer blood test has come out that detects kidney disease much earlier. So how do we take advantage of it? We recommend annual examinations for all our kitties, no matter if they need vaccinations or not. During our physical exam, we can detect changes in weight and assess body condition. We also perform bloodwork (including this newer test) and a urinalysis each year to track these kidney values and catch them as they go on the rise. If the changes are caught early, there is a lot that we can do to intervene and slow down the progression of the disease, thereby buying us years onto their lives.

Treatment for kidney failure has many facets. We can offer a specialized diet to protect and reduce the strain on the kidneys. There are many nutraceuticals you can also give to keep the elevated values in check. And when it gets worse (as it always will unfortunately), we can train you to give fluids to your cat on a routine basis in the comfort of your home to keep her hydrated. All of these measures can increase the lifespan and comfort of your kidney failure kitty.It is definitely easier and more effective to treat chronic renal disease early in its course; that is why we are proactive with our recommendations at Crawford Dog and Cat hospital, but we can only help your kitties early if we see them every year. 

There are many excuses for why owners are reluctant to have their feline friends seen .We know kitties get stressed coming to see us, but we love to see them and keep them healthy. We offer cat only appointments on Thursday evenings, house calls, and medications to give before an appointment to help take the edge off. Please don't let your older cat fall into the kidney failure trap too late; we can do so much to help them early! Schedule  an appointment or message us for more information more information.

Hyperthyroid Disease in Cats

Dr. Stephanie Waters

Have you noticed that your cat has a large appetite, but does not seem to be gaining any weight? Or maybe he/she has been drinking a lot and seems hyperactive or nervous. Changes in food or water intake, or increases in the amount of urine in the litter box, may be signs that your cat has elevated thyroid levels. Hyperthyroid disease is commonly found in cats greater than 8 years old but it can occur at any age.  The risk factors are not well defined but environmental chemicals found in the home may be the culprit.  Early disease may be hard to detect, but advanced cases of hyperthyroidism can cause heart and kidney disease.

Cats are masters of deception and often will hide the early signs of illness. Owners often struggle differentiating what is normal for their cat and what might be the early signs of disease.  Vomiting, (other than an occasional hair ball), decreased grooming activity, seeking cool places to sleep, as well as changes in appetite or litter box habits can be early signs of a serious problem. Changes in your cats’ routine can be the key to the early diagnosis of many treatable conditions such as Hyperthyroidism.  A simple lab test including a blood profile, CBC, and a urinalysis can differentiate between normal and abnormal conditions. By monitoring your cats blood work and giving a medication to decrease thyroid levels, your cat can be back to normal for the holidays! If you are concerned about taking your cat to the vet because they are fearful of the carrier or of the car ride, please call us ahead of time and we can talk about a low stress appointment or a house call!

 “How do I medicate my cat?”  Good question!

Luckily the medication needed for hyperthyroidism in cats comes in several compounded forms; small pills, capsules (that can be opened up on wet food), transdermal (liquid placed right in front of your cats ear) etc. Alternatively, we could discuss iodine-restricted diets as a first step, thyroidectomy (removing the thyroid) or radioactive iodine therapy (I-131 therapy) in order to eliminate clinical signs and keep your cat healthy and happy.

The thyroid gland controls all aspects of our pets’ metabolism. So, there is more to hyperthyroidism and the effects of this disease on other organ systems.  We will address some of these problems in future blog posts.  If you have questions about hyperthyroidism, you can message us at facebook.  If you are concerned about your cat’s thyroid levels, schedule an appointment for an examination and screening blood work.  Remember, we have cat only office hours on Thursday evenings.  No annoying barking dogs in the waiting room.

Fear Free Veterinary Care Helps Cats Get the Care They Deserve

CATS NEED TO GO TO THE VETERINARIAN

It is a sad state of affairs that most of the pet cats in this country do not receive adequate veterinary care.  Oh, I’m not necessarily saying that people don’t bring their cats to the veterinarian when they are sick; I’m saying that for many reasons, they do not bring them to the veterinarian before they are sick, when disease can be prevented. Wellness care and preventive medicine can improve the overall quality of life and increase the lifespan for our feline companions.  I’ve heard all sorts of excuses and I think this is a good place to start to address them.

My cat doesn’t go outside so it doesn’t need shots every year.  

This one is sort of true.  Indoor cats are at a lower risk of contracting infectious disease than cats that go outdoors.  Kittens that receive complete inoculation series and are boosted at a year of age probably have a good immunity to many viral diseases for several years.  We actually do not vaccinate adult cats against most diseases every year; rather we recommend that with the exception of rabies vaccination, adult cats should be given an FVRPC vaccine every three years.  Why?  Today’s scenario was an unvaccinated senior cat, living alone in a home with its owner until 4 days ago when she adopted a rescue cat from Florida. Now her older cat has potential disease exposure.  Or, last week’s case where I made a house call to a second floor apartment where the cats never went outside but the owner did some work with a cat rescue group.  Guess what?  She brought home a respiratory tract infection to her two pets.

We always had cats and they lived to be old and never got sick.  

That was true until they died of some illness.  30% of pet cats that die in the United States die of chronic kidney disease.  Now, coming to the veterinarian will not prevent renal disease, but early detection can slow the progression of this disease and increase your cat’s lifespan by years.  The same is true for diabetes, hyperthyroidism, dental disease, heart disease, cancer, inflammatory bowel disease; the list goes on and on.  Many chronic diseases that eventually lead to decrease vitality and early death in our pet cats can be treated, if not cured if detected early enough.

My cat hates going to the vet. 

This may be true but it is just an excuse, a barrier that owners create that prevents their pet from receiving the care it deserves.  If your cat is stressed by veterinary visits, just let us know.  Dr. Stephanie Waters is certified as a “Fear Free” veterinarian and she has brought many ideas to our practice that lessen the stress for both our feline and canine patients.  Medications can be given prior to the visit to reduce anxiety. Pheromone sprays can decrease stress, and treats in the office are always appreciated.  We now have soft, warm pads on the exam tables because we know that cats hate the cold stainless steel surface.  We have sheets in the waiting room if you think that covering your cat’s carrier will decrease stress.  We have office hours on Thursday evenings that are exclusively for cats, no barking dogs in the waiting room (except for emergencies).  If that isn’t enough to convince you that Crawford Dog and Cat Hospital is feline friendly, we make house calls.  Our doctors and staff will come to your home and examine your cat.  Just think all the benefits of proactive veterinary care on your very own couch.

Don’t let your anxiety, or your cat’s stress prevent you from doing what is best for your pet.  Wellness visits, routine blood work, and rational vaccination and parasite prevention can lengthen your pet’s life and keep your bond strong for years to come.

Local Politics

I tend to stay away from politics in my work and writing but there is an issue that is very important to the care of our pets.  Governor Cuomo has proposed tuition relief (actually free tuition for qualified students) at public universities and colleges.  Why do I care?  I know, my kids are out of school, no personal benefit to me.  Wrongo!

The staff that takes care of your pets at Crawford Dog and Cat Hospital is composed of a dedicated group of trained individuals.  Some, like receptionists and assistants have been trained on the job, over many years with us. Others, like the doctors and technicians have formal educations and are licensed by the state.  We currently have two licensed technicians on staff, Kim Green and Ellie Abrams.  these two are responsible for all nursing care, in house diagnostics, (lab work and radiographs), surgical prep, anesthesia, you name it they do it.  The state requires a t last an associates degree and then they need to pass an examination.  Associate degrees are offered locally at SUNY Farmingdale, LaGuardia College, and Delhi.  We are fortunate to have these two on our staff, but there is a shortage of qualified technicians here in New York.  Tuition assistance would help individuals that want to pursue a career in veterinary medicine to get a leg up without becoming swamped in student loan debt.

So, when this issue comes to the forefront, think of your pets and the care they deserve and support tuition assistance at our public colleges and universities.

Preventing Infectious Kidney Failure

In the past few months I've seen two heartbreaking cases of dogs that were diagnosed with acute renal failure that probably could have been prevented.  But before we talk about failing kidneys, let's talk about what healthy kidneys do for our pets. (and us for that matter).

The major functions of the kidneys is to filter waste products of the blood into the urine, maintain a state of homeostasis (constant state in the body), and stimulate red blood cell production.  There are other hormonal functions but let's stick to the biggies here.  When we do a blood test and tell you that your pet's kidney function is good, we are actually measuring the levels of Urea Nitrogen and Creatinine (two toxic by products of protein metabolism).  these levels will be maintained within a narrow normal range until about 75% of the filtering units  (glomeruli) in the kidneys are damage.  Kidney function can also be evaluated by measuring the concentration of the urine as well as looking for things in the urine that shouldn't be there, such as protein and cells. When the filtering units are damaged, the waste products build up and the condition is called azotemia, or uremia.  hen the tubules ( different part of the kidneys) are damaged, we will see dilute urine or cast like structures in the urine.  Leaking membranes in the glomeruli may allow the filtering of wast products but facilitate the leakage of protein into the urine.  When caught early, the progressive nature of renal disease can often be mitigated.  However, once the glomeruli are damaged, they are gone, and no new ones will replace them.

We had a dog present to the clinic a few months ago.  It lived in Nassau county, never went out east, mostly lived in the yard in a suburban environment that was not particularly wooded.  This labrador was not feeling well and when blood work was performed, it was in azotemic (elevated BUN/Creatinine) renal failure with severe levels of protein in the urine.  It was also positive for exposure to Lyme disease.  The owners had not vaccinated it against Lyme disease because they did not think it was at risk for exposure.  Indeed it was at low risk based on life style assessment, but no dog on Long Island is at no risk.  They also were not using any flea or tick control.  Lyme nephritis is a kidney disease caused by the body's reaction to Borrelia burgdorferi, the bacteria that causes Lyme disease.  (Note Lyme not Lyme's).  Unfortunately for this dog, once the kidneys are involved, the prognosis is guarded.  In fact, this dog did not make it and was put to sleep after a week in the hospital receiving intensive care.  While we do not see a lot of dogs in our practice that are ill with Lyme disease, we do see many that are exposed to the bacteria and therefore at risk.  This is why we recommend testing every dog every year for heartworm and tick borne diseases.  we also recommend tick control for all dogs.

The second dog presented two weeks ago with a rapidly worsening, acute renal injury.  This young German Shepherd Dog was losing weight, not eating, and had decreased energy, His blood work showed a worsening azotemia, increased levels of protein in a dilute urine, and he tested positive for leptospirosis, a bacterial disease.  Leptospirosis is spread by the urine of infected animals, in our area, dogs, raccoons, mice and rats.  While usually more common in the summer, it is obviously around all year here on Long Island.  It's prevention is complicated by the fact that there are many serovars (types of Lepto bacteria), and the vaccination only covers the 4 most common and virulent.  Many clients are reluctant to vaccinate because they have read that the vaccine causes reactions, or is dangerous.  The truth is that while vaccine reactions do occur, most often, they are similar to the type of reaction we get when we get a flu vaccine or a tetanus shot. And while we hate our dogs to have any reaction, it is better than renal failure.  Lepto is also contagious to people so having a dog that is unknowingly shedding this bacteria in the urine puts all of us at risk.  This puppy (he is only 2 1/2 years old) is still undergoing treatment with antibiotics and Intravenous fluids.  It looks like he may make it but will most likely have permanent damage to it's kidneys.

We have to remember that there are many diseases that can affect our pets (and sometimes us).  prevention is always better than treatment.  While vaccination is not always a completely benign procedure, modern vaccine science has come a long way in our fight to protect our pets from infectious diseases.