Anesthesiology Etiquette

April 13th, 2014

I’m recovering from surgery to repair a torn ligament in my thumb, sustained while building horse pasture fencing. One-handed word processing is not my forte, so this will be a much shorter blog post than the usual.

I am a veteran of surgical procedures (a wee bit accident-prone I am), and as a veterinarian, I know all too well the kinds of things that can go wrong with general anesthesia. Therefore, I’m always somewhat on edge during the three minute or so encounter I’m allowed with the anesthesiologist moments before he or she takes my life into their hands.

Imagine my reaction when the anesthesiologist assigned to my thumb surgery came waltzing into the room and cheerfully announced, “Hello. I’m Dr. Smith and I am the one who will be putting you to sleep today.” My husband, also a veterinarian, and I exchanged amused glances, and then began giggling. We tactfully explained to Dr. Smith why his choice of words affected us as they did. Truthfully, I think his statement would be off-putting to any animal lover, not just veterinarians. Wouldn’t you agree? Dr. Smith blushed profusely and apologized, stating that he wished he’d known my profession before coming into the room. He did do a bang up job with my anesthesia- I woke up comfy and nausea-free. I couldn’t ask for anything more.

This story reminds me of another one of my pre-op chats with an anesthesiologist a few years back. He asked what I did for a living. After hearing my response, he said, “That’s so cool! That’s what I always wanted to do, but I couldn’t get into vet school.” Not the reassurance I was looking for!

Have you ever had this kind of “interesting” conversation with an anesthesiologist?

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

Eating Grass: Normal or Abnormal?

April 6th, 2014

Does your cat or dog like to eat grass? If so, you may be wondering if this is normal or abnormal behavior. Either conclusion may be accurate, depending on the individual animal.

Some dogs and cats are natural born grazers. They seemingly love the taste and texture of grass. Given the opportunity, they will eat some daily without any apparent ill effects, and it is fine to let them do so. Perhaps they were cows in a previous lifetime!

For others, foraging on vegetation (grass, leaves, twigs) is a response to an underlying gastrointestinal upset. These dogs and cats typically have other symptoms such as loss of appetite, lethargy, vomiting, and/or diarrhea. Eating grass may actually induce vomiting, which, from the animal’s perspective, may be the desired effect. If your pet who normally ignores grass is suddenly ravenous for the stuff, a visit with your veterinarian is recommended.

Some overtly healthy appearing dogs and cats vomit only when they eat grass. This suggests an underlying allergy or sensitivity to such greenery, and, for these animals, grazing should be prevented.

Grazing Do’s and Don’ts

- Grazing is fine as long as your pet is overtly healthy, and eating grass does not cause vomiting or abdominal discomfort.

- Don’t let your pet graze where pesticides may have been applied. There is a known correlation between ingestion of pesticides and the development of certain types of cancers. If in doubt, keep your pet out.

- Avoid allowing your pet to graze where fertilizer has been recently applied.

- Don’t allow grazing if foxtails are present. This grassy plant grows in abundance west of the Mississippi. The foxtail heads are barbed, and can readily become lodged within an animal’s throat.

- Consider growing “cat grass” for your strictly indoor kitties. This feline treat can be purchased at most pet stores.

Do you happen to have a grazer in your household?

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

 

My So-Called Hairy Life

March 30th, 2014

Nellie. Photo by Susannah Kay

Red, brown and white are the predominant colors of my wardrobe these days. Trust me, this is not an intentional fashion statement. My horses’ shedding season has begun in earnest, and the colors of their hair coats (chestnut, bay and gray) dictate the hues that will adorn my clothing for the next several weeks. Try as I might to keep my horsin’ around clothes separate from my other garments, that horse hair is very sneaky. It manages to find its way into everything! By the way, here’s a tip for the uninitiated. While in the midst of a horse grooming session, the most effective way to remove horsehair from one’s mouth is via spitting. Trying to remove it with one’s fingers (bound to be laden with hair) simply replaces a couple of hairs with a dozen others. Those of you with horses know exactly what I’m talking about.

All that horsehair does have some redeeming qualities. It keeps my 1,000 pound babies nice and warm all winter, and provides awesome nest building material this time of year. What I appreciate most about my horses’ hair coats is their ability to accurately predict the weather. This past fall, their coats grew to the plushness level of a wooly mammoth, and their recent shedding spree has gotten off to a very late start. This all makes perfect sense given the severity and duration of the winter we’ve just experienced. For my money, a horse’s hair coat is just as good, if not better, than any Farmer’s Almanac.

Then there’s the matter of the dog hair. How is it that my eleven-pound Nellie sheds just as much as a 60-pound Labrador? Her hair is white and bristly and impossible to miss, particularly on my new couches. Technically speaking, Nellie is not “allowed” on this new furniture but, because we don’t patrol at night, she manages to “couch surf” most every evening (this in spite of the fact that we have more than a dozen cushy, comfy dog beds scattered around throughout our home). Quinn sheds a whole lot less than his lil’ sis, but his hair coat is of that super fine variety, and the hairs cling steadfastly to everything they contact.

Why is it that manufacturers of vacuum cleaners and lint rollers haven’t figured out how to identify and hit on fur balls like me? I should be easy to “profile” based on my online activities: shopping for pet supplies, reading horse and dog training blogs, and marathon You Tube sessions watching only cute animal videos. Someone really should tell these companies they are missing out on a lucrative opportunity!

I sometimes wonder what it would be like to wear a sweatshirt devoid of animal hair. How many times have my kids heard me say, “It’s an excellent source of protein,” after finding a pet hair on their dinner plate? Do my yoga instructors know that I’m the reason they must spend extra time sweeping after class? These are the kinds of questions that cross this animal lover’s mind.

Would I consider a life without animals in exchange for a lifestyle devoid of pet hair? Not in a million years!

Can you relate to any of this? I sure hope so because, as that old saying goes, “Misery loves company!”

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

The Top Ten Toxins of 2013

March 23rd, 2014

My tail is between my legs. I am a week late with this blog post. It was meant to time out in conjunction with National Poison Prevention Week which happens to have just ended! Here is some belated, but hopefully interesting and useful information gleaned from the call logs of the ASPCA Animal Poison Control Center. Here is their list of the top ten pet toxins in 2013. They are ranked below based on call volume.

1. Prescription human medications: The Animal Poison Control Center received a whopping 27,673 calls regarding exposure to human medications in 2013. The three categories of drugs most commonly implicated included heart medications (including blood pressure pills), antidepressants, and pain medications (opioids and non-steroidal anti-inflammatory medications). Honestly, I’m surprised that medicinal marijuana wasn’t a front-runner on this list!

2. Insecticides: More than half of the calls pertaining to insecticides involved cats. I certainly know from experience, that many people unwittingly apply “canine only” insecticides to their kitties, thinking that one size fits all. The important lesson here is to always carefully and thoroughly read the product label before applying an insecticide to any living creature.

3. Over-the-counter human medications: This group of drugs included acetaminophen, ibuprofen, naproxen, and some herbal and nutraceutical products such as fish oil and joint supplements. I can’t even begin to count the number of dogs I’ve treated over the years for gastrointestinal upset and/or kidney failure caused by ibuprofen. Remember, just because it’s good for us doesn’t mean it’s good for our pets.

4. Household products: The toxins reported ranged from fire logs to cleaning products. Some of the chemicals are corrosive to the gastrointestinal tract. Other products are capable of causing an obstruction if swallowed.

5. People food: The biggees here are onions, garlic, grapes, raisins, and the sugar substitute, xylitol. These food products have the potential to cause kidney failure (grapes and raisins), gastrointestinal upset and damage to red blood cells (onions and garlic), and dangerously low blood sugar levels (xylitol).

6. Veterinary products and medications: These products are often flavored in order to make for a more palatable pilling process. The more delectable the medication, the more likely the animal is to eat as many tablets as possible when inadvertently allowed access to the entire bottle. The containers may be childproof, but they’re certainly not resistant to the gnashing and mashing of canine jowls.

7. Chocolate: I’m not sure why this was not included as a “people food”. It’s certainly one of my favorites! Methylxanthine is the substance in chocolate that can cause vomiting, diarrhea, tremoring, elevation in heart rate, and even seizures. The darker/purer the chocolate is, the greater the potential for toxicity. The lesson here- always be selfish with your chocolate!

8. Rodenticides: These are poisons intended to kill mice and rats. In many cases of accidental pet exposure, the people involved either had no idea how their pet could have been exposed, or they felt certain that there was no way their pet could have accessed the product where it was placed. Pets are pretty darned clever at getting to such tasty stuff. Depending on the type of poison, rodenticide toxicity can present as internal bleeding, seizures, or kidney failure. Here’s the bottom line. If you share your home with a pet, do not use a rodenticide anywhere on your premise. Let your kitties and your terriers do the mousing.

9. Plants: Lilies are the major culprits here. When ingested, they are capable of causing an abrupt onset of kidney failure. The outcome can be favorable, but only with really aggressive therapy that sometimes includes dialysis. Spare yourself this heartache- get rid of any lilies in your yard, and don’t bring any lily containing bouquets or plants into the house. Kitties just love to nibble on them.

10. Lawn and Garden Products: What dog doesn’t love what fertilizers contain- bone meal, manure from all kinds of critters, and, sometimes, even some dried blood. Dogs that eat enough of the stuff will develop some rip roaring gastrointestinal symptoms, and potentially even an obstruction.

Have you ever had to deal with a pet-related toxicity? What happened and how did everything turn out?

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

What Would You Do? Part II

March 16th, 2014

A week ago I challenged you by asking, “What would you do?” pertaining to a series of pet-related symptoms. Thanks to the more than 100 of you who submitted your responses. All of your names were entered into the book drawing. And the lucky winner is…… drum roll…… Brenda Bass with Middle Tennessee Boxer Rescue. Congratulations Brenda!

Below, you will find my preferred responses to the scenarios I presented. Know that there is always room for differing opinions, particularly given your personal experience and what you know to be true for your own pets.

If ever you have doubt about how best to proceed in response to your pet’s symptoms, I strongly encourage you to solicit advice from a staff member at your family vet clinic or local emergency pet hospital. It is perfectly okay to have your pet examined on an emergency basis for something that ends up not being a true emergency. This happens all the time. Better to be safe than sorry, and your peace of mind will be well served.

Recommended courses of action

For all of the symptoms described below, the options were:

  1. Do some “watchful waiting”.
  2. Call a staff member at your family veterinary clinic or local emergency hospital for advice.
  3. Schedule an appointment to have your pet examined by your family veterinarian.
  4. Take your pet immediately to your family vet clinic if they are open. Otherwise head to your local pet emergency hospital.

Now, here are the my preferred responses.

1. It’s 8:00 at night and your pet just vomited some fluid mixed with food. He seems perfectly normal otherwise, and you know of nothing unusual that he might have eaten.

For this scenario, I feel comfortable advising you to do some “watchful waiting”. This is based primarily on the other information provided (nothing toxic or unusual ingested, perfectly normal otherwise, vomited one time only). Should there be more vomiting or progression to other symptoms, veterinary attention is recommended. During the “waiting and watching” period following an episode of vomiting, it is typically a good idea to withhold food for six to eight hours while offering frequent access to small amounts of water. Left to their own devices, dogs who are feeling nauseated often “gorge” on water, prompting ongoing vomiting. When food is reintroduced, it is wise to offer small, frequent meals of bland diet (a mixture of nonfat cottage cheese and plain boiled white rice for dogs, and jarred turkey or chicken baby food for cats) for 12-24 hours. After this time period, if all is well, the normal diet can be reintroduced. Calling a staff member at your family veterinary clinic or local emergency hospital for advice is an option I would fully support here as well.

2. For the past few weeks you’ve been needing to fill your pet’s water bowl more frequently than normal. Your pet seems completely normal otherwise.

While this observation does not represent an emergency situation, it definitely warrants scheduling an appointment to have your pet examined by your family veterinarian. Increased thirst can be an early symptom of many disorders, some of which include: kidney disease, liver disease, urinary tract infection, and hormonal imbalances (diabetes mellitus, Cushing’s disease, Addison’s disease, diabetes insipidus). Your vet will be pleased if, before your appointment, you’ve measured your pet’s 24 hour water intake (ideally 2-3 day’s worth). Normal water intake is less than one ounce per pound of body weight per day.

3. Your pet just had what looked like a seizure. The episode lasted approximately 30 seconds. He appeared completely normal both before and immediately following the seizure. He’s never done anything like this before, and you know of nothing unusual (toxic) he could have been exposed to.

My preferred course of action is that you take your pet immediately to your family vet clinic if they are open. Otherwise head to your local pet emergency hospital. It can sometimes be difficult to know if what was observed was truly a seizure or a fainting episode (usually caused by heart disease). In either case, early intervention has the greatest potential to arrive at a diagnosis and favorably influence the outcome.

4. Your normally very well house-trained dog or litterbox-trained cat has urinated two times on your bathroom rug. He seems completely normal otherwise.

Whenever an undesirable behavior such as inappropriate urination develops, I always encourage giving your pet the “medical benefit of the doubt”. By this I mean ruling out an underlying medical problem rather than just assuming this is “bad behavior”. In this case, it is very possible that the urination on the bathroom rug is a symptom of a urinary tract infection, bladder stones, a sterile inflammatory process within the bladder (cats), a structural problem within the lower urinary tract, or a disease causing increased thirst, therefore increased urine production. Based on the symptoms described, my recommendation is to schedule an appointment to have your pet examined by your family veterinarian.

5. Your pet suddenly appears more tired than usual, and his tongue seems pale. He seems completely normal otherwise.

The pale tongue is the key here. It creates concern about heart failure, respiratory tract disease, a shocky condition, and severe anemia caused by internal bleeding or an autoimmune disorder. All of these possibilities represent true emergencies and I recommend taking your pet immediately to your family vet clinic if they are open. Otherwise head to your local pet emergency hospital.

6. For the past week your pet has been eating his normal amount of food, but is nibbling throughout the day rather than consuming the entire meal in one sitting as he normally would. He seems completely normal otherwise.

While it may be tempting to dismiss this change given that the total amount of food your pet is eating has not changed, my advice is that this symptom warrants scheduling an appointment to have your pet examined by your family veterinarian. Dogs and cats tend to be creatures of habit, and a break from their normal routine is a heads up that something is amiss. The change in food interest described here could be caused by something as simple as a painful tooth to something as serious as kidney failure.

7. For the past two days your pet has has had a mild limp. Your thorough inspection of the leg did not identify anything abnormal. He seems completely normal otherwise.

In this situation (note that I described the limp as mild) I feel very comfortable with “watchful waiting”. Just like us, our pets can experience bruises and sprains that will improve over the course of two to three days, particularly if exercise restriction is enforced. If, after a few days, the lameness is not improving or is worsening, it is time for a veterinary visit. Even if the cause of the lameness is something more sinister (a torn ligament, a bony tumor, etc.) the overall outcome will not have been negatively impacted by having delayed veterinary care by a few days. A word of warning- please do not give your pet any over-the-counter human antiinflammatory medications (aspirin, ibuprofen, acetaminophen, etc.) during this waiting and watching period. Such products can cause far more harm than good.

8.  Your pet growled at you when you attempted to move him from the couch to the floor. This is something he’s never done before. He seems completely normal otherwise.

In this situation I strongly encourage scheduling an appointment to have your pet examined by your family veterinarian. This will help rule out an underlying medical issue, such as a painful body part, as the cause of the growling. As described in number 4 above, your four-legged family member is deserving of your “medical benefit of the doubt”.

9.  Your normally ravenous pet showed no interest in his breakfast this morning. He seems completely normal otherwise.

Our pets tend to be such creatures of habit, particularly around mealtime. When there is a sudden change in food bowl behavior, I am always concerned. While this situation does not raise any “emergency alarm bells” for me (based on the fact that everything else appears normal), I do think scheduling an appointment to have your pet examined by your family veterinarian makes good sense, with the caveat that the appointment be scheduled for sooner rather than later. Calling a staff member at your family veterinary clinic or local emergency hospital might be a reasonable option, but I am concerned that you may be advised to wait and watch. A sudden change in appetite has the potential to be associated with a serious underlying medical issue. Simply waiting and watching could sabotage a window of opportunity to create a good outcome.

10.  It’s bedtime and your pet is breathing heavily and doesn’t want to lie down. He seemed completely normal throughout the day.

This is a worrisome scenario particularly if such behavior is truly out of character for your pet. While fear or anxiety can produce an abrupt onset of these symptoms, they can also be caused by a number of serious medical maladies some of which include: internal bleeding, heart failure, severe respiratory tract disease, or any underlying problem causing severe pain. This is definitely a “better to be safe than sorry” situation and I recommend taking your pet immediately to your family vet clinic if they are open. Otherwise head to your local pet emergency hospital..

How did you do? Do you agree with my recommendations? Are there other symptoms you would have liked me to include?

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

 

What Would You Do?

March 9th, 2014

I recently came across a paper titled “Internet users’ perception of importance of clinical signs commonly seen in old animals with age-related diseases”. The study concluded that many people have difficulty accurately assessing the importance of their pets’ symptoms. For example, 14% of those surveyed indicated that they would not seek veterinary attention if they noticed that their pet had red/pink colored urine, a sure symptom of a significant problem within the urinary tract.

I am curious to know how you, my well informed readers, would evaluate various observations pertaining to your pets. I offer you this little challenge quiz. Share your responses with me publicly or privately, and your name will be entered into a drawing to receive a signed copy of Speaking for Spot or Your Dog’s Best Health. I will provide my preferred responses to these questions along with explanations in a followup blog post. Thanks in advance for your participation!

Observations

For each of the following observations, indicate the course of action you would choose. When I use the word “pet” I am referring to a dog or a cat.

1. It’s 8:00 at night and your pet just vomited some fluid mixed with food. He seems perfectly normal otherwise, and you know of nothing unusual that he might have eaten.

  1. Do some “watchful waiting”.
  2. Call a staff member at your family veterinary clinic or local emergency hospital for advice.
  3. Schedule an appointment to have your pet examined by your family veterinarian.
  4. Take your pet immediately to your family vet clinic if they are open. Otherwise head to your local pet emergency hospital.

2. For the past few weeks you’ve been needing to fill your pet’s water bowl more frequently than normal. Your pet seems completely normal otherwise.

  1. Do some “watchful waiting”.
  2. Call a staff member at your family veterinary clinic or local emergency hospital for advice.
  3. Schedule an appointment to have your pet examined by your family veterinarian.
  4. Take your pet immediately to your family vet clinic if they are open. Otherwise head to your local pet emergency hospital.

3. Your pet just had what looked like a seizure. The episode lasted approximately 30 seconds. He appeared completely normal both before and immediately following the seizure. He’s never done anything like this before, and you know of nothing unusual (toxic) he could have been exposed to.

  1. Do some “watchful waiting”.
  2. Call a staff member at your family veterinary clinic or local emergency hospital for advice.
  3. Schedule an appointment to have your pet examined by your family veterinarian.
  4. Take your pet immediately to your family vet clinic if they are open. Otherwise head to your local pet emergency hospital.

4. Your normally very well house-trained dog or litterbox-trained cat has urinated two times on your bathroom rug. He seems completely normal otherwise.

  1. Do some “watchful waiting”.
  2. Call a staff member at your family veterinary clinic or local emergency hospital for advice.
  3. Schedule an appointment to have your pet examined by your family veterinarian.
  4. Take your pet immediately to your family vet clinic if they are open. Otherwise head to your local pet emergency hospital.

5. Your pet suddenly appears more tired than usual, and his tongue seems pale. He seems completely normal otherwise.

  1. Do some “watchful waiting”.
  2. Call a staff member at your family veterinary clinic or local emergency hospital for advice.
  3. Schedule an appointment to have your pet examined by your family veterinarian.
  4. Take your pet immediately to your family vet clinic if they are open. Otherwise head to your local pet emergency hospital.

6. For the past week your pet has been eating his normal amount of food, but is nibbling throughout the day rather than consuming the entire meal in one sitting as he normally would. He seems completely normal otherwise.

  1. Do some “watchful waiting”.
  2. Call a staff member at your family veterinary clinic or local emergency hospital for advice.
  3. Schedule an appointment to have your pet examined by your family veterinarian.
  4. Take your pet immediately to your family vet clinic if they are open. Otherwise head to your local pet emergency hospital.

7. For the past two days your pet has has had a mild limp. Your thorough inspection of the leg did not identify anything abnormal. He seems completely normal otherwise.

  1. Do some “watchful waiting”.
  2. Call a staff member at your family veterinary clinic or local emergency hospital for advice.
  3. Schedule an appointment to have your pet examined by your family veterinarian.
  4. Take your pet immediately to your family vet clinic if they are open. Otherwise head to your local pet emergency hospital.

8.  Your pet growled at you when you attempted to move him from the couch to the floor. This is something he’s never done before. He seems completely normal otherwise.

  1. Do some “watchful waiting”.
  2. Call a staff member at your family veterinary clinic or local emergency hospital for advice.
  3. Schedule an appointment to have your pet examined by your family veterinarian.
  4. Take your pet immediately to your family vet clinic if they are open. Otherwise head to your local pet emergency hospital.

9.  Your normally ravenous pet showed no interest in his breakfast this morning. He seems completely normal otherwise.

  1. Do some “watchful waiting”.
  2. Call a staff member at your family veterinary clinic or local emergency hospital for advice.
  3. Schedule an appointment to have your pet examined by your family veterinarian.
  4. Take your pet immediately to your family vet clinic if they are open. Otherwise head to your local pet emergency hospital.

10.  It’s bedtime and your pet is breathing heavily and doesn’t want to lie down. He seemed completely normal throughout the day.

  1. Do some “watchful waiting”.
  2. Call a staff member at your family veterinary clinic or local emergency hospital for advice.
  3. Schedule an appointment to have your pet examined by your family veterinarian.
  4. Take your pet immediately to your family vet clinic if they are open. Otherwise head to your local pet emergency hospital.

Be sure to look for my suggested responses to these scenarios in one week. Don’t forget to share your responses to be included in the book drawing.

Are there other pet observations you wish I had included? If so, tell me what they are and we can discuss what the appropriate response to that observation would be.

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

 

Clients I Wish I Could Clone

March 2nd, 2014

Photo Credit: Susannah Kay

Just as teachers have their “pet students,” so too do veterinarians have their “pet clients” (no pun intended).  These are the clients who generate a buzz of excitement amongst the veterinary staff whenever their names appear on the appointment schedule. They have a knack for creating positive energy and seem to always make the job of caring for their pets such a pleasure.

So, what exactly is it about these “red carpet clients” that elicits such an enthusiastic response? Here are some of their endearing characteristics:

Well informed

These clients come to an office visit prepared with lots of information. They can readily provide the exact brand and name of their pet’s diet as well as all of the medications and supplements (including dosages and frequency) their pets are receiving. There’s no claiming, “It’s that food in the bag with the bold red print,” or, “I’m giving those small, blue, oval pills.”

When visiting a veterinary clinic for the very first time, they come with prior medical records in hand including vaccination history, written medical records, laboratory test results, and X-rays.

These well informed folks are responsible Internet surfers.  They glean information from reputable sites and avoid on line “junk food”. They prepare questions in advance of their office visits, but hold off asking them until their veterinarian has had the chance to gather history, perform the physical examination, and initiate discussion.

Willing to follow the game plan

These are the clients who arrive on time for an appointment out of respect for the veterinary staff as well as those people with appointments following theirs. They do their absolute best to follow doc’s orders for things such as administering medications, restricting calories and calling in with progress reports. If a question or concern arises about the agreed upon “game plan” they initiate discussion with the vet rather than revising the plan on their own. They bring their pets in for an annual physical examination, even when there are no vaccinations due.

Respectful and appreciative

The entire veterinary staff receives sincere respect and appreciation from these clients. Such sentiments are not reserved solely for the veterinarian because it is recognized that each and every staff member plays a significant role in the health and well being of their patients. The receptionist makes the call about whether or not to squeeze in an urgent request at 5:00 on a Friday afternoon. The technician cares for hospitalized patients, sterilizes surgical equipment and monitors anesthesia. It is the kennel assistant who disinfects surfaces that could be breeding grounds for contagious diseases.

Along with expressing their gratitude verbally during an office visit, these clients tend to send thank you notes and holiday greetings. From time to time they may even deliver some yummy goodies for the staff to enjoy.

Willingness to express their concerns

These clients talk to the veterinary staff about their genuine concerns and worries. Without doubt, this is difficult for some people. Discussing financial worries or crying publicly can be embarrassing. Expressing concern about a recommended test or medication may feel intimidating. Keep in mind that veterinarians who care deeply about the emotional well being of their clients (and I encourage everyone to find such a care provider) want to hear their clients’ concerns. Who better to provide genuine understanding and support?

All of these qualities help make a client one that I would love to clone, and I suspect that my colleagues would say the same.

Do any of these traits apply to you as a veterinary client?

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

Prudent Parasite Prevention

February 23rd, 2014

Did you read about recent worries pertaining to a popular flea/heartworm/intestinal parasite prevention product called Trifexis? Some folks in the Atlanta area felt certain that this product caused the deaths of their dogs. Although autopsy examinations did not implicate Trifexis as the cause, such stories can create significant stress and anxiety for people, particularly for those already experiencing stress and anxiety about giving so many medications to their dogs for parasite control. Is all this recommended prevention truly necessary?

Below, I have provided you with my feelings about parasite prevention. Please keep in mind that the following thoughts represent simply one veterinarian’s opinion. This information should not replace discussion and decision-making with your own vet. Your choices should be based on your pet’s potential exposure to various parasites as well as your own personal preferences.

Heartworm prevention

It used to be that I could tell you that if your dog lived in a particular state, city, or community you could skip heartworm prevention for your pets. Not so anymore. Heartworm disease now exists in every state within the United States. While it is intuitive to believe that a thick, long coat or exclusively indoor lifestyle will protect an animal from heartworm disease, this is not the case. Wherever an animal lives and whatever the plushness of their hair coat, year-round heartworm prevention is a good idea.

Here’s the good news about heartworm preventive medications. With rare exception, they are exceptionally safe. Adverse side effects are few and far between. Now, the bad news- heartworm resistance to commonly used preventive drugs has become a real phenomenon, documented most clearly in dogs living in the Mississippi Delta.  The American Heartworm Society is currently funding research to learn more about heartworm resistance. For this reason, it is important to have dogs tested annually for heartworm disease even when heartworm preventive is being conscientiously administered.

Heartworms can cause serious damage and treatment of this disease is no walk in the park. I strongly recommend year-round heartworm preventive medication for your dogs and cats. The main exception to this recommendation applies to very elderly or infirmed pets who are not expected to live more than six months or so. This is the approximate amount of time it takes for significant symptoms to arise following heartworm infection.

FYI- my pets receive heartworm prevention once a month year round. I reside in the mountains of western North Carolina where the temperature drops below freezing during the winter.

Prevention of intestinal parasites (worms)

Dogs and cats are most likely to have intestinal parasites when they are puppies and kittens. This is because dormant stages of some intestinal worms are activated in the pregnant dog or cat and then “shared” with their offspring. Geography and lifestyle tend to dictate whether adult animals harbor intestinal parasites. For example, a dog living in North Carolina who frequents a busy dog park is far more likely to have intestinal worms than a Wyoming dog who never sets paw where other dogs tread.

Talk with your veterinarian to determine if intestinal parasite prevention is truly needed. Simply checking a stool sample for parasite eggs (this test is referred to as a fecal flotation) once or twice a year may be the way to go. Such testing is inexpensive and efficient. Worst-case scenario and your pet develops intestinal parasites- know that the treatment for this issue is safe, effective, and relatively inexpensive. If you are looking to thin out your pet’s menu of preventive medications, this would be a good one to consider dropping.

FYI- my pets do not receive intestinal parasite prevention. Rather, I run a fecal flotation once or twice a year to assess whether or not worms are present.

Flea prevention

Flea prevention falls on the “optional” list in terms of parasite prevention. Some environments simply don’t propagate much in the way of fleas. For example, a strictly indoor kitty may remain flea-free. Fleas don’t thrive at high altitude, so flea prevention medications would be unnecessary in mile-high Denver, Colorado. Additionally, for some pets and their humans, living with a few fleas simply isn’t much of a nuisance. For your situation, use of flea prevention medication only during the “flea season” may work well. Or, it may be that year-round administration is required. Here’s the bottom line. Assess your pet’s environment and tolerance for fleas. A few flea bites may be the lesser of two evils when contemplating fleas versus flea prevention.

FYI- my pets receive monthly flea prevention during our “flea season”. They do not receive flea prevention during the winter months.

Tick prevention

The incidence of tick-borne diseases is on the rise throughout much of the United States. Of all of these diseases, Lyme seems to get the most attention, perhaps because this disease is so common in people. Other significant tick-borne diseases include Rocky Mountain Spotted Fever, Ehrlichia, Anaplasma, and Bartonella. The incidence of these diseases varies widely from region to region within the United States. These infectious organisms can cause significant symptoms that may be life threatening. Additionally, in some cases they can be difficult to diagnose and/or treat effectively. The way to prevent these diseases is via effective tick prevention. This can take the form of avoidance of tick habitats during the tick season, “tick collars”, preventive medications, and/or careful tick surveillance (literally going over your pet with a fine tooth comb at least once a day).

To determine the best course of tick prevention in your household I recommend the following two things. First, determine if your pet has tick exposure. Have you ever seen one on your pet? Secondly, talk with your veterinarian about the incidence of tick-borne diseases in your community.

FYI- my pets receive monthly tick prevention medication, but only during the “tick season”.

Summary

Here are some important take home messages to help you create a prudent parasite prevention program for your pets:

  • Year-round heartworm preventive medication is important regardless of where you live.
  • Not all pets require year-round medications to prevent ticks, fleas, and intestinal parasites. For some animals, they may be important only during certain times of the year. For others, they are not needed at all.
  • Double check that the prevention product you are using contains only the medications your pet truly needs. Avoid giving unnecessary medications simply because this happens to be the product on your veterinarian’s pharmacy shelf.
  • Any parasite prevention medication is capable of producing an adverse or idiosyncratic response in any particular animal. If your pet develops symptoms on the heels of administrating such a product, contact your family veterinarian right away.

What parasite prevention products do you use?

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

 

Injuries Affecting Agility Dogs

February 16th, 2014

Did you watch or read about the first-ever agility competition at the Westminster Kennel Club Dog Show earlier this month? A Border Collie named Kelso bested 225 other dogs by completing the course with the greatest precision and speed. I’ve been told more than once that the sport of agility is addictive. This, in part, may account for the fact that agility is rapidly becoming the world’s most popular canine performance sport.

Not without risk

No question, agility is a whole lot of fun and provides great exercise for everyone involved. There is, however, significant risk for injury associated with the sport (talking about the dogs here, although I’ve seen many a handler take a tumble). The typical agility course challenges the dog with 15 to 20 physical tasks that requiring climbing, descending, jumping, balancing, weaving, running, quick turns, and abrupt stops and starts. And the goal is to get it all done at warp speed. It’s no wonder that agility-related injuries occur with significant frequency.

Results of a survey reported in a recent edition of the Journal of the American Veterinary Medical Association quantified the frequency and types of agility-associated injuries. A second report within the same journal identified risk factors for injury.

Injury survey results

The surveys were completed by 1,669 handlers of 3,801 agility dogs around the world. The data was collected in 2009. (Yes, there is typically quite a long lag time between acquisition of data and publication within the veterinary literature.) Handlers were asked to provide information, to the best of their knowledge, about the cause and nature of their dogs’ injuries. Documentation by a veterinarian was not required.

Here are some of the studies’ findings:

  • One third (31.8%) of the dogs experienced agility-related injuries.
  • 27.6% of the injured dogs sustained more than one agility-related injury.
  • Soft tissue strains, sprains, and contusions (bruising) were the most commonly reported injuries.
  • Of the 1,523 injuries analyzed, the shoulder, back, neck, and toes were the most commonly affected sites
  • Of the injuries 50.5% were mild (required less than one month for recovery) and 44.6% were severe (required two months or longer for recovery). The remaining 4.9% were unclassified.
  • Injuries were commonly attributed to faulty navigation/interaction with bar jumps, A-frames, and dog walk obstacles.
  • There was no significant difference between the numbers of injuries that occurred during practice versus competitions.
  • Dogs had greater risk of injury if they had a history of prior injury.
  • Dogs receiving alternative therapies (acupuncture, chiropractic care, massage, or dietary supplements) had greater risk of injury.
  • Border Collies had greater risk of injury, even after statistical consideration of the popularity of this breed within the sport.
  • Dogs with less than four years of agility experience had greater risk of injury.
  • Dogs handled by individuals with less than 5 years of agility experience had greater risk of injury.

While retrospective surveys such as these are far from perfect, the data generated here provides some good food for thought. Many of the results make perfect sense. For example, it is logical that a more experienced handler is less likely to push his or her athlete too fast or too far. However, some of the results are not intuitive for me. Why would dogs receiving alternative therapies be more predisposed to injury? I have to wonder if these dogs were receiving these therapies because of prior injuries. The Border Collie risk factor is an interesting one. I suspect this susceptibility to injury has more to do with the breed’s insanely intense work ethic than it does any inherent musculoskeletal weakness.

I would love to see some prospective studies to further assess factors that may prevent or predispose to injuries. Perhaps those of you who have invested years in the sport have some ideas about this. If so, your thoughts are welcome here.

Has your dog sustained an agility-related injury? If so, I hope you will share the details with us.

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

 

Were You Smarter Than a Vet Student About Canine Parvovirus?

February 9th, 2014

Photo Credit: © Susannah Kay

Thanks to all of you who responded to the true/false “Parvovirus Quiz” I recently posted. The lucky winner of an autographed copy of Speaking for Spot is Larry Fosnick Davis from Seattle, Washington.

Now, here are the answers you’ve been waiting for!

1.  Dogs with parvovirus become contagious to other dogs (begin shedding the virus in their feces) at the time diarrhea is first observed.

This is false. Dogs typically become contagious four to seven days before the onset of any symptoms.

2.  A dog is no longer contagious (stops shedding of parvovirus in their feces) approximately two weeks following infection.

This is true. Keep in mind that this two-week period begins up to one week prior to the onset of symptoms (see question number one above).

3.  Once parvovirus is shed via feces into the environment, it can remain infectious to other dogs for several months.

This is true. This is the main reason why unvaccinated dogs are so darned susceptible to this disease. Parvovirus organisms are extremely hardy and remain active (infectious) in the environment for up to six months.

4.  Canine parvovirus can cause heart disease.

This is true. Parvovirus can damage the heart muscle in puppies infected when they are less than six weeks of age. Affected pups die rather quickly from heart failure. This parvovirus induced cardiomyopathy (disease of the heart muscle) is rare, occurring only if the mama dog has no immunity to parvovirus and her pups are exposed to this disease at an early age.

5.  Adult dogs should be vaccinated against parvovirus disease annually.

This is false. The parvovirus vaccine provides a minimum of three years of protection in previously vaccinated adult dogs. To state this more clearly, if your adult dog receives a parvovirus vaccination every year he or she is being “overvaccinated”. This subjects your dog to all the potential risks associated with the vaccine and absolutely zero benefit. Additionally, you are paying for a vaccine that is completely unnecessary. To learn more about current vaccination protocols I encourage you to read “The Vaccination Conundrum” in Speaking for Spot and Canine Vaccination Guidelines published by the American Animal Hospital Association. If your veterinarian insists on an annual parvovirus vaccination, share the information found in these resources. If this doesn’t solve the problem, it’s time to find a more progressive veterinarian to care for your best buddy. Enough said.

6. Some breeds have increased susceptibility to parvovirus disease.

This is true. Rottweilers, Doberman Pinchers, English Springer Spaniels, American Pit Bull Terriers, and German Shepherds have historically been predisposed to parvovirus infection, even when vaccinated according to protocol. This breed predisposition seems to be lessening, thanks to newer vaccines on the market. Nonetheless, with a pup of a more susceptible breed it makes sense to perform parvovirus serology following completion of the puppy vaccine series. This blood test helps confirm that the immune system’s parvovirus-fighting status is up to snuff.

7.  Canine parvovirus disease causes an elevation in white blood cell count.

This is false. Parvovirus disease typically causes a marked decrease in the white blood cell count. The patient’s recovery typically coincides with recovery of white blood cell numbers.

8.  Antibiotic therapy is not warranted because parvo is a viral disease.

This is false. Although antibiotics are not effective against viruses, they are an essential component of parvovirus therapy. A low white blood cell count (see question seven above) and severe disruption of the intestinal surfaces render dogs suffering from parvovirus disease very susceptible to bacterial infection. In fact, most parvovirus-associated deaths are caused by secondary bacterial infections.

9.  The only way a dog who is sick with parvovirus can survive is by receiving round-the-clock care in a veterinary hospital.

This is false. While round-the-clock care is the very best option for treating parvovirus disease, at a cost ranging from $1,500 to $3,000 such therapy is simply not affordable for many people. A recently completed study at Colorado State University’s College of Veterinary Medicine tested an at-home treatment protocol. Therapy consisted of an injection of a long acting antibiotic, a daily injection of an anti-emetic (anti-vomiting medication), and administration of subcutaneous fluids (fluids under the skin) three times daily. At a cost of $200 to $300 this regimen proved to be more affordable and resulted in an 85% survival rate compared to a 90% survival rate with inpatient care. While hospitalization for therapy remains the gold standard, it is nice to know that a viable option exists when cost is prohibitive.

10.  Unvaccinated dogs are three times more likely to develop parvovirus disease than vaccinated dogs.

This is false. Unvaccinated dogs are 13 times more likely to develop parvovirus disease than vaccinated dogs.

How did you do? Did you learn anything new?

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.