The Two Sides of Bread

I'm going to digress from my trending posts on things clients say and move onto things dogs eat.  It has been an interesting (translates to busy) pre holiday season which explains the missed posts.  We had two cases come in, both dogs that had eaten something that they shouldn't have.  The cases are different, but there is a common thread that I thought everyone might appreciate.

Here is doggy number one.  Just for a radiography review.  The head is on the left, the spine is at the top.  Air is black (see outside of the dog and the lungs on the left side surrounding the grey heart).  Muscle and soft tissue are grey.  And metal would be white.  That's right, look at all that metal in the stomach and intestines.  Not supposed to be there.  The truth is that this pup had been dining on antenna wire as it came out of the wall to where the TV used to be pre cable.  The bad news is that this pup was vomiting off and on and I was worried about the wire penetrating the intestines and causing an infection. Or, the mass on the left getting stuck in the stomach and causing a blockage.  Unfortunately, surgery would be a challenge because we would need to remove all of the wires to eliminate the danger of perforation and peritonitis.  Also unfortunately, the dog had done something similar last year and the owners were tapped out financially from that surgery. Fortunately, this was a soft braided wire and not a stiff, sharp coaxial cable sort of wire.  Although we advised referral due to the possible complications of surgery, the owner declined and we were force to treat this case medically.  A meal of bread, a strong anti emetic to induce vomiting, and an enema and laxatives to move the whole mess through, and everyone was happy within 24 hours.

Ah bread, the staff of life.  Savior of dogs.  Except when it isn't baked.  Raw dough is a real problem.  Why might you ask?  I know I love to nibble on dough when I am baking.  Well, next time you're nibbling, think of what is going on in the dough.  Yeast, water, carbohydrates...  The mixture yields what?

Now remember the radiology lesson.  This dog is positioned the same way.  Less of the lungs are in the picture towards the left.  Less metal wire too.  But look at all that gas in the intestines.  Right, the dough (an entire bowl of doughnut dough) is rising in this dog's intestines.  The carbon dioxide from the yeast is making the intestines distended with gas.  Oh, and that's not all.  Beer lovers will know that carbon dioxide is not the only product of yeast and grain.  That's right, this dog was as drunk as a skunk.  We tried to get her to vomit up the dough, but most of it was out of the stomach.  So, IV fluids and supportive care was all we had to offer.  This case was this weekend, so it isn't over yet, but so far things seem to be coming out OK.

Keep these stories in mind for the rest of the holiday season.  Dog food for dogs, cat food for cats, raw dough for, well really no one and wire for electricians.

Happy New Year.

Things Clients Say, Part 2

Friday is here again and the Turkey coma is almost passed.  Actually, I will be having daily turkey comas for a couple more days.  Anyway, I wanted to share another client misconception.  It's the "Hey Doc, he's a little stiff on the stairs but I don't think he's in pain because he doesn't cry", misconception.

Here's the deal, if your dog is stiff, slow to rise, or limping (even if it is a subtle limp), he is in pain.  (I've picked the male gender for this patient because we tend to be worse about this particular oversight than female owners.  Don't know why, just an observation)

Think about it.  When was the last time you had a limp?  Why were you limping?  I bet it was because your leg hurt.  The same goes for when you have a tough time on the stairs, or can't get up off of the ground after playing with a grandchild, the challenge is due to pain in a joint or your back.  The pain is real and can be debilitating.

Dogs and cats give us subtle (and sometimes not so subtle) signs of pain and discomfort.  Abnormal movement, decreased activity, missed jumps, you get the picture.  While these changes are often seen more frequently in older pets, they are not normal and the pain will decrease the quality of life.  If you notice these changes or anything similar, it is important to have a complete orthopedic examination at the veterinarian.  At that time, the doctor may recommend radiographs to determine the exact nature of the problem and the source of the pain.  Then, and only then, can a safe and effective treatment plan be formulated.

We use a multi modal approach to the management of chronic orthopedic pain in our patients.  Diet, supplements, medications, laser therapy, joint injections, and stem cell therapy are just some of the weapons in our battle against chronic pain in pets.

If your dog is limping, or if your cat can't jump on the counter or make it into the litter box anymore, give your vet a call and get to the bottom of the problem and relieve your pet's pain.

Things That Clients Say Because they Don't Understand, Part 1

Reflecting back on the week, I thought that I would share a few of the things that clients have told me about their pets that show just how far we have to go with education.  I want to start off, continuing on the theme of last weeks dental post.  An oral examination, including the mouth, pharynx, teeth and gums, is part of our regular wellness exams.  This past week, I had the opportunity to flip up a dog's lip and show the owner the accumulation of tarter that was caked on the outer surface of all of her dog's teeth.  It was at this point where she asked, "Why does he have tarter, he just had his teeth cleaned last year?"

A couple of points here.  Checking the records I noticed that it was closer to 18 months ago that the teeth were last cleaned.  But we all suffer from distortions of time passage, why I am pretty sure that I am still in my early forties.  Be that as it may, when it comes to dental health maintenance, our pets are similar to us in many ways. Some have excellent dental health with minimal intervention.  Others need to have work done on a regular basis.  As owners, we know that we brush our teeth twice a day. (or we should).  Still, we need to have our teeth cleaned at least once a year.  Very few pet owners ever brush their pet's teeth.  So why is it surprising that they need their teeth cleaned annually?

The truth is, proper dental care, along with good nutrition, and appropriate rational vaccination is one of the three most important things that we can do to improve the quality and longevity of our pet's lives.  I cleaned my Cookie's teeth every year for 15 years, until underlying health problems such as cancer and heart disease made the procedure more risky.  I attribute her long, basically healthy life to her good oral health.  It is important for your pets as well.

While we recognize that dental care can be expensive, routine cleanings are less expensive than the major dental work we have to do when teeth are diseased.  However, when even routine care is budget busting, we have several payment options for qualified clients.  Most are easier and less expensive to qualify for than you would expect.

So when your veterinarian tells you that your pet needs his or her teeth taken care of it does not matter when they were last treated, they need to be treated again.  Let's work to keep those pearly whites pearly white and that breath fresh.

Dentistry

Well, after a couple of hiccups and false starts, we are back up and running in our dentistry department.  That's a good thing because there have been several published epidemiology studies indicating that 80% of pets over three years of age have some form of dental disease.  In fact, the American College of Veterinary Dentists state that periodontal disease is the most common disease in older pets; and, it is preventable.

We are not talking about intervening in sewer mouth disasters. You know the dog that you can smell coming into the room because his breath belies the rotting infection that used to be his gums.  This guy will only benefit from having all or at least most of his teeth extracted under general anesthesia and the infection treated with a long course of antibiotics.

No, I am talking about the three pets that we treated today.  The first two were kitty cats, both come in regularly for dental examinations and treatments when indicated.  One had mild tarter, the other heavier tarter, but both had healthy looking gums.  Even more importantly, radiographs showed no disease under the gum line, no radiographic evidence of cavity like lesions or periodontal disease.

The third case was a dog, he had two fractured pre molars.  Once again, radiographs were valuable.  One tooth could be saved, the other had to be extracted.  All three pets were sent home with home care instructions and we hope that the owners will follow up with us as directed.  All in all, a good day in the mouths of our patients here at Crawford Dog and Cat Hospital.

Are Annual vaccines Necessary for My Cat?

The question doesn't get asked often, actually usually clients tell me, "My cat never goes out, she doesn't need any shots."  Of course, in their minds, the logical extension is that the cat never goes outside so it never needs to see the veterinarian.  Well, get ready for a shocker, I sort of agree.  Never thought that you would hear a veterinarian say that did you?



Here's may take on this topic.  All kittens need a series of injections to stimulate their immunity.  This initial series includes 2 or 3 FVRPC vaccines to stimulate the immune system against these potentially serious viral diseases.  According to the AAFP (American Association of Feline Practitioners), they should all be tested for FELV and FIV and then vaccinated against Feline Leukemia, and they should receive a rabies vaccine after they are 3 months old.  We recommend and use the Purevax recombinant DNA vaccine by Merial. All kittens should be boosted at 1 year of age with the FVRPC and Rabies (Felv not necessary if they are going to be indoor cats).  Then we recommend FVRPC vaccines every 3 years and rabies annually according to the label (and the law).  Notice that the only annual vaccine is the rabies. So, let's talk about that one first.  The truth is that the chances of your indoor cat contracting rabies is low.  It's not zero and I have a story that I would be glad to share with anyone that really wants to hear it that will illustrate a case that I had when I first started practice.  While the risk is low, the consequences are really serious.  Rabies is fatal.  Not sometimes, always.  It is contageous to all mammals, that means people as well as cats.  If your cat is not vaccinated and it bites someone, you could be forced to have your cat's brain removed and sent to the state lab for testing.  I don't write the laws, I just let you know what they are.  Vaccinate your cat for Rabies, it's the law and it's good rational medical advice.

Why the FeLV recommendations.  The AAFP recommends vaccinating kittens because their immune system is not mature, the test could be a false negative, they could have a latent (hidden) infection, and I can't tell you how many kittens come into my office with owner intentions of them never going outside ever again, only to find out one year later that they are spending time outdoors.  Once their lifestyle as an indoor cat is established and their immune system is cranked, they do not need boosters of this vaccine as long as they stay indoor cats.

The FVRPC is an excellent vaccine.  It stimulates an excellent immune response.  After a few triennial boosters, your indoor cat probably has enough immunity to protect it through the rest of it's life.  I still tend to be cautious and have always vaccinated my cats every three years.  Cat households tend to be fluid and new kittens come and go on a regular basis.  Many cats have chronic viral infections from when they were kittens and regular vaccination seems to keep these infections at bay. Plus, you can bring these viruses into the home and expose your indoor cat.  It just makes sense to me so I recommend it for my patients.

Now, just because your cat is at minimal risk for infectious disease doesn't mean that it doesn't need to be seen at least once a year by your veterinarian.  Cats are very good at hiding disease.  80% of cats over three years of age have dental disease, some times very painful dental disease.  1 in 3 cats will develop diseases such as hyperthyroidism, kidney disease, and heart disease before they are senior pets.  They won't tell you they don't feel well until it is too late for  you to do anything about it.  So, regular examinations, fecal tests for parasites (yes even indoor cats), urine tests for diabetes, infection, crystals, and inflammation of the bladder, and blood tests for evaluation of the endocrine (hormone) system and organs as well as complete blood counts to detect anemia and infections should be performed on a regular basis.  Don't ignore your cat.  Ask your vet about wellness screening and what you can do to help your indoor cat live to a ripe old age.

Chocolate Is Not the Only Toxin to Worry About This Season

Most of my clients are aware of the danger that chocolate can pose for their dogs and wit Halloween literally right around the corner, this is a concern.  However, I don't want you all to concentrate on the goodie bag on the counter and ignore some of the other hazards that lurk in our homes for our pets.

Now, the good thing for our pets is that the bulk of the candy that we bring home next week is not mostly chocolate.  While a few mini 3 Musketeer bars is likely to cause diarrhea, the delicious filling is not chocolate.  Pure chocolate bars like a Hershey's bar or even kisses are more likely to get to toxic levels.  In fact, a 15 pound dog that eats just two 1.55 oz bars in is the zone of potential side effects.  Dogs that get this amount of chocolate can become hyperexcitable, have muscle tremors, and with increasing doses of chocolate can have seizures and even die.  We had one dog get into a lethal amount of chocolate this past summer.  By the time he came into the hospital, he was in such an advanced stage of toxicity, there was nothing that we could do to save him.

Chocolate cakes and brownies (we just had a dog come in for boarding that had a breakfast at home of 2 dozen brownies) is likely to cause stomach upset, but unless you are using a dark fudge icing that is more dark fudge than icing, explosive diarrhea is probably the worst of the damage.  Fortunately for this owner, the mess will be ours to deal with while the cake bandit is staying with us and not hers.

While chocolate is on our minds this week, year round we see more pets that get into trouble taking their owner's medications.  Last week we had a dog eat a kids ADHA medication.  These medications fall into two distinct groups.  The more serious problems are usually seen with the stimulant drugs such as Adderall.  The dog we saw had gotten into an alpha antagonist medication and this drug is reversible with an injection that we have on hand.  He got to stay with us for the day on IV fluids but was able to go home that evening to sleep it off.

Another big problem is with ibuprofen.  Especially the name brand Advil is sugar coated and it seems that dogs can't resist.  Time and time again I have had owners tell me that the pill bounced on the floor once and the dog had it swallowed before the owner could do anything at all.Generics are not any safer and although not sugar coated, are extremely toxic to the kidneys and stomach lining.

And then there are cats.  While less likely to ingest pills off of the floor (way to discriminating for that), they are often poisoned by well meaning owners that give them human medicine.  Remember, a single extra strength tylenol will kill your cat.  Ibuprofen is right up there as well.  Children's cold medicines are dangerous for cats.  Do not medicate your cat without consulting with your veterinarian.

If you think your pet has gotten too much chocolate or any amount of your family's medications.  Call your veterinarian.  Or, call poison control at 1 888 426-4435.  This hot line is run by the ASPCA and they will get you the information that you need. You will have to tell them what your pet ate, how much and how long ago to get any useful help.  Time is off the essence in the case of a suspected poisoning.  Do not delay.

So, even though it is Halloween, I didn't intend to scare you, just give you some information.  Go out with your goblins and enjoy the American tradition of begging for candy while dressed up as your favorite ghoul.

Fleas

FLEAS!

I started my morning appointments today with an itchy Bulldog.  Not remarkable, most Bulldogs are itchy.  The thing that was interesting about this gal was that she was the fifth dog this week that was infested with fleas.  Crawling with them and this owner had bites on his ankles and legs.  Yet, he was still surprised when we showed him the little critters jumping all over his pet.  He was shocked because the dog never left the yard except to go on an occasional walk, and being a bulldog, and the weather being what it has been the past few weeks, those walks have been short and few.  So, how could this dog have fleas?  Here’s the deal, they are out there.  They are everywhere.  The mild winter and hot humid summer has been a bonanza for the fleas.  We are seeing fleas every day, and there is no reason for our pets to suffer.

Now, I’ve been in this business for a long time.  I spent many vacations in the seventies bathing and dipping dogs with the nastiest bunch of toxic chemicals in an effort to keep pets flea free.  We bathed, dipped, sprayed and powdered our pets with pyrethrins, organophosphates, and all sorts of nasty chemicals.  When that failed, we bombed our house with chemical foggers, spread powders in the rugs, or called in professionals every couple of weeks to try to eradicate those little blood suckers from our homes.  Flea prevention was unlikely to be very successful.  Flea treatment was the norm.

Fortunately, that is not the case anymore.  Starting with the topical products containing Fipronil (Frontline and Frontline Plus) in the 90’s, we now had a group of relatively safe and effective options to prevent flea and tick infestations in dogs and cats.  From that point on,simple, regular applications of a  product made it possible to keep our pets flea free and prevent the nasty home infestations that required chemical warfare in our living environment.  As consumers demanded better, less obtrusive products, and as fleas and ticks started to develop resistance to the older chemicals, newer collars and oral products have come to market.

Now, there is no need to worry about our pets becoming flea infested.  I put a Seresto collar  on my Bella in March when ticks first became active in our area and she has not had a single flea or tick all season long.  I replaced it in September and neither of us will need to worry about nasty bugs all year long.

That’s what makes my second appointment of the morning so frustrating.  The patient was a less than friendly Sheba Inu.  Now, if you know the breed, then you know that being unfriendly is actually normal.  You probably also know that their coats are really dense.  You couldn't find a flea on a Sheba if your life depended on it.  Due to this dog’s temperament, the owner told me that it spends a large part of its day out in the yard.  I could not believe how hard it was for me to convince him to pick up a single dose of Bravecto, an oral flea and tick medication,which would protect his dog from these parasites and keep his home safe for three months as well.  He went back and forth hemming and hawing about how the dog never leaves the yard. (Sounds like the Bulldog, no?).  Finally, when he thought about needing to get an exterminator in if the dog became flea infested, he took the product.  Wise move, don’t you think?

So, here’s the low down. There are several very good options for flea prevention in dogs and cats.  If any of your pets go outside,all of the pets in the home should be on some sort of flea control this time of year.

1.   Seresto collar: I already stated that this is my preference.  Life is hectic, fleas are fast.  One collar will give up to 8 months (I trust it for 6) of protection against fleas and ticks on dogs or cats.
2. Comfortis: The best-selling flea product in the United States.  This once a month pill will start killing fleas in 30 minutes.  It can be used in dogs and cats.  In fact, my clients that feed outdoor cats put the pill in some food to help keep the flea population down in their colonies.  Remember, if the outdoor cats that you are feeding are flea infested, your yard will be flea infested.
3.  Simperica: Zoetis animal health’s newest addition to the oral flea and tick control market.  This drug is the same class as Bravecto and Nexgard but more effective.  One chew a month will prevent fleas and ticks on dogs.

Combine one of these products with an effective monthly parasite control product and your pets and home will be safe all year round.  Now isn’t that easier than getting an exterminator in to rid your house of the bugs?