Archive for the ‘Medical Advocacy’ Category

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Age is Just a Number

Thursday, April 14th, 2011

When my clients make decisions on behalf of their senior dogs and cats, they routinely factor in their pet’s age.  I often hear statements such as, “I would pursue a diagnosis if only she weren’t so old.” and “I would treat him if only he were younger.”  When my clients voice such “senior objections” I gently encourage them to consider the situation a bit more objectively by considering their pet’s functional age rather than their chronological age.  For example, it might be far safer for me to anesthetize the vigorous, playful thirteen-year-old Labrador with normal liver and kidney function I evaluated on Monday compared to the debilitated eleven-year-old Labrador with impaired kidney function I examined on Tuesday. Functionally speaking, the thirteen-year-old is, by far, the younger of the two.  When making decisions, savvy medical advocates evaluate the whole package- spryness, organ function, overall comfort, joie de vivre- rather than considering age alone.  Just because a dog or cat is, by definition, a senior citizen doesn’t mean their body is functioning like that of a senior citizen.

I thoroughly enjoyed explaining this point on NPR’s popular show, Fresh Air With Terry Gross. “Terry, you and I could both be 80 year old women in need of knee replacement surgery.  You might be a terrific candidate for surgery, whereas I might be a horrible candidate!”

When making medical decisions, my clients frequently ask about their pet’s life expectancy. Life expectancies for cats and dogs of varying breeds are nothing more than averages.  This means some individuals will never reach “average” and others will far exceed it. 

Here’s the bottom line. If you have a happy, lively, interactive, and agile senior dog or cat on your hands, throw those age-related numbers and averages out the window.  Rather, I encourage you to observe your pet’s overall quality of life, share some nose-to-nose time with your best buddy, look deep into those beautiful eyes, and make important medical decisions based on what’s truly important rather than simply a number.  Have you ever needed to be a medical advocate for a senior pet?  If so, please share your story.

Best wishes for good health,         

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
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. 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 is available at Amazon.com, local bookstores, and your favorite online book seller.

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Posted in Canine family members, Cats, Medical Advocacy, Medicine Decision Making, National Public Radio, NPR, Senior Dogs, Speaking for Spot, Veterinary Care | 16 Comments »

Even More to Say About a Better Way to Spay

Thursday, March 17th, 2011
In January I wrote a piece called, “A Different Way to Spay” (http://speakingforspot.com/blog/?p=1931) describing two techniques for performing spay surgeries.  The method widely embraced in the United States is ovariohysterectomy (OVH) in which both ovaries as well as the uterus are removed.  The second way to spay- popular in many other countries- is ovariectomy (OVE) in which only the ovaries are removed and the uterus is left behind.  

Charlotte, OVE spay at 7 months © Kathie Meier

Since publishing the piece, many of you wrote to me expressing your frustration at not being able to find a veterinarian willing to perform OVE surgery.  I’ve written about those comments and provided an overall update on this topic for PetConnection.com- I sure hope you will read it (http://www.petconnection.com/blog/2011/03/15/a-better-way-to-spay-your-dog-that-you-probably-never-heard-about/).  Additionally, Dr. Tim McCarthy, a wonderful PetConnection colleague provided a response blog discussing the benefits of performing spays via laparoscopy- a form of minimally invasive surgery (http://www.petconnection.com/blog/2011/03/17/another-better-way-to-spay-that-you-probably-never-heard-of/).     

I look forward to your feedback about both articles.  If you are new to PetConnection, I hope you will follow my blog posts there as well as the ones you find here at Spot Speaks.     

Best wishes for good health,      

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
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. 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 is available at Amazon.com, local bookstores, and your favorite online book seller.   

    

 

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Posted in Medical Advocacy, puppies, Speaking for Spot | 4 Comments »

A Different Way to Spay

Sunday, January 2nd, 2011

This blog presents an idea that will be new for many of you and may be new for your veterinarians as well.  I thought presenting a novel idea would be a great way to kick of the new year! 

Taking a fresh look at the things we take for granted can be wonderfully enlightening.  Sometimes, the little light bulb overhead begins to sizzle and sparkle, illuminating a new and better way of doing things.  Consider this example- when some savvy veterinarians took a fresh look at performing spays, a surgery we’ve been doing the exact same way for decades, guess what happened!  They came up with a revised technique that accomplishes all of the objectives of the spay surgery with fewer complications!  How cool is that!

Spay is the term used for neutering a female dog.  As I was taught in veterinary school, the medical jargon for spaying is ovariohysterectomy (OVH). “Ovario” refers to ovaries, “hyster” refers to uterus, and “ectomy” means removal of.  In other words, spaying the traditional way involves surgical removal of the uterus and both ovaries.  The objectives of the spay surgery are to render the dog infertile, eliminate the mess and behavioral issues associated with a female dog in heat, and prevent diseases that may afflict the uterus and ovaries later in life.  Thanks to some innovative veterinarians, what we now know is that ovariectomy (OVE)- removal of just the ovaries sans uterus accomplishes these objectives just as effectively as does the OVH.  And, here’s the icing on the cake- removal of the ovaries alone results in fewer complications when compared to removal of the ovaries and uterus combined.

Here’s a simple short course in canine female reproductive anatomy and physiology that will help explain why leaving the uterus behind makes sense. The shape of the uterus resembles the capital letter “Y”.  The body of the uterus is the stem and the two uterine horns represent the top bars of the “Y”.  An ovary is connected to the free end of each uterine horn by a delicate structure called a fallopian tube (transports the egg from the ovary into the uterus).  While the uterus has only one purpose (housing developing fetuses), the ovaries are multitaskers.  They are the source of eggs of course and, in conjunction with hormones released by the pituitary gland, ovarian hormones dictate when the female comes into heat and becomes receptive to the male, when she goes out of heat, when she ovulates, and when her uterus is amenable to relaxing and stretching to house developing fetuses.  After the ovaries and the hormones they produce have been removed from the body the uterus remains inert. The dog no longer shows symptoms of heat, nor can she conceive. Additionally, any chance of developing ovarian cystic disease or cancer is eliminated.

What happens when we leave the uterus behind- is it not subject to becoming diseased later in life?  Here’s the good news- the incidence of uterine disease in dogs whose ovaries have been removed is exceptionally low.  Pyometra (pus within the uterus), is the most common uterine disorder in unspayed dogs, and typically necessitates emergency surgery to remove the uterus.  Without the influence of progesterone, a hormone produced by the ovaries, pyometra does not naturally occur. The incidence of uterine cancer is extremely low in dogs (0.4% of all canine tumors)- hardly a worry, and studies have shown that the frequency of adult onset urinary incontinence (urine leakage) is the same whether or not the uterus is removed during the spay procedure. 

If you are not already convinced that the “new spay is the better way”, consider the following complications that can be mitigated or avoided all together when the uterus remains unscathed:

- Compared to an OVH, an OVE requires less time in the operating room.  This translates into decreased likelihood of anesthetic complications.
- Removal of the uterus requires that the surgeon perform more difficult ligations (tying off of large blood vessels and surrounding tissues with suture material before making cuts to release the organs from the body).  A uterine body ligation that isn’t tied quite tightly enough can result in excessive bleeding into the abdominal cavity and may necessitate blood transfusions and/or a second surgery to stop the bleeding.
- The ureters (thin delicate tubes that transport urine from each kidney to the bladder) run adjacent to the body of the uterus.  If a surgeon is not being extremely careful, it is possible to ligate and obstruct a ureter in the course of removing the uterus.  This devastating complication requires a second corrective surgery, however damage to the affected ureter and adjoining kidney may be irreversible. 
- Removal of the uterus occasionally results in the development of a “stump granuloma”- a localized inflammatory process that develops within the small portion of uterus that is left behind.  When this occurs a second “clean up surgery” is typically required. 
- We know that the degree of post-operative patient discomfort correlates with the degree of surgical trauma.  No question, of the two surgical options the OVH creates more trauma.

European veterinarians have been performing OVE’s rather than OVH’s for years.  In fact, the bulk of the research supporting the benefits of leaving the uterus behind has been conducted in Europe.  Slowly, veterinarians in the United States are catching on, and some veterinary schools are now preferentially teaching OVE rather than OVH techniques to their students.  What should you do if you are planning to have your dog spayed?  Talk with your veterinarian about this article and provide a copy for him or her to read.  Perhaps OVE surgery is already their first choice.  If not, perhaps your vet will be willing to take a fresh look at performing this old fashioned surgery.

Wishing you many blessings for the new year,

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
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health Award
Become a Fan of Speaking for Spot on Facebook 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. 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 is available at Amazon.com, local bookstores, and your favorite online book seller.

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Posted in Medical Advocacy, puppies, Speaking for Spot, Veterinary Care | 19 Comments »

Looking back on 2010

Thursday, December 30th, 2010

Dr. V. at Pawcurious has initiated a “blog hop” recruiting her fellow pet bloggers to compile their lists of the best of 2010.  This Dr. V. is so darned nice, adorable, and funny, that I would be hard-pressed to ever decline her invitation.  So, I’ve chosen for you what I consider to be my favorite blogs from 2010.  If you think I left one out that should have made the top ten, by all means let me know.  Now, here’s a look back at 2010!

A Rottweiler Reunion

This was such a sweet story originating with two wonderfully sweet and very pregnant Rottweilers who were abandoned at my hospital.  This is a story with a wonderfully happy ending.

What is a Veterinary Specialist?

I’m always surprised by how many people don’t know that veterinary specialists exist.  This is my way of getting the word out.

Speaking for Spot Gives Back

The Speaking for Spot Gives Back Program has been wonderfully successful allowing animal-centered nonprofit organizations to benefit from sales of Speaking for Spot.  I couldn’t be more pleased.

Gastric Torsion: A Horribly Unhealthy Kind of Twist

I’ve always loved explaining this strange disease to my clients, so why not explain it to my blog audience as well!

What Not to Name Your Dog

This was a fun blog to write and based on my readers’ responses, a good reminder to me to not be so darned serious all the time!

Reasonable Expectations

My main soapbox is medical advocacy which translates into trying to convince people about what they are entitled to when it comes to medical care.  My series on “Reasonable Expectations” does exactly that.  So far there are 7 blog posts within this series and there will certainly be a few more.  The very last one (will likely show up in February) may surprise you!

A Dozen Simple Ways to Be Certain You Are Working With a Reputable Breeder

How can the “average Joe” feel confident they are purchasing a healthy purebred puppy and not supporting puppy mills in the process?  The purpose of this blog post was to teach exactly that! 

Puppy Mills: People and Their Puppies Pay the Ultimate Price

Here I am on my anti-puppy mill soapbox!  

My Puppy Mill Education

And more on my anti-puppy mill soapbox!  When will this insanity against animals ever end?

Vaccinations for Your Dog: A Complex Issue

It’s critical to be your best friend’s medical advocate when it comes to vaccinations.  This blog is my attempt to teach people how.

Best wishes for a happy new year.   

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
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health Award
Become a Fan of Speaking for Spot on Facebook 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. 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 is available at Amazon.com, local bookstores, and your favorite online book seller.

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Posted in Medical Advocacy, Speaking for Spot | Comments Off

Reasonable Expectations VII: Discussion and Open-Mindedness About Your Dog’s Vaccinations

Monday, December 27th, 2010

This is the seventh part of an ongoing series describing how people are developing new expectations when it comes to veterinary care for their pets. Parts one through six can be found at www.speakingforspot.com/blog. 

As invaluable as vaccinations are for protecting canine health, determining which vaccines are appropriate and how frequently they should be administered are no longer simple decisions. Gone are the days of behaving like  “Stepford wives” simply because you’ve received a vaccine reminder postcard or email. Vaccinations are no different than any other medical procedure.  They should not be administered without individualized discussion with your veterinarian and consideration of the potential risks and benefits. Please know that having such a discussion with your veterinarian is a perfectly reasonable expectation, and your input is an invaluable part of the vaccine decision-making process.

Consider the following:

• There are currently more than a dozen canine vaccinations to choose from! Back in the days when I was just a pup there were only five, and decision-making regarding vaccine selection for an individual dog was far less complicated.
• Over the past decade we’ve learned that, for some vaccines, the duration of protection is far longer than previously recognized.  In the past we vaccinated against distemper, parvovirus, and rabies annually.  We now know that these vaccinations, when given to adult dogs, provide protection for a minimum of three years and, in some cases protection is life-long.
• The duration and degree of immune protection triggered by a vaccine is variable, not only based on vaccine manufacturer, but from dog to dog as well.
• Other than for rabies (state mandated), vaccination protocols are anything but standardized. There are no set rules veterinarians must follow when determining which vaccines to give and how often they are administered. Unfortunately, some vets continue to vaccinate for distemper and parvovirus annually even though we know that these adult vaccines provide protection for a minimum of three years.  Some vets give multiple inoculations at once, others administer just one at a time.
• Increasingly clear-cut documentation shows that vaccines have the potential to cause many side effects.  While vaccine reactions/complications are still considered to be infrequent, they can be life threatening.

What you can do:

As your dog’s savvy medical advocate, what can you do to be sure that he or she is neither under or overvaccinated? Here are some guidelines for making wise vaccine choices for your best buddy:

1.  Educate yourself about available canine vaccinations and the diseases they are capable of preventing (in some cases treating the disease, should it arise, might be preferable to the risks and expense associated with vaccination). Learn about duration of vaccine protection and potential side effects.  Read the chapter called “The Vaccination Conundrum” in Speaking for Spot. It provides detailed discussion about all aspects of canine vaccinations including the diseases they prevent, adverse vaccination reactions, and the topic of vaccine serology (blood testing that helps determine if your dog is truly in need of vaccine booster). The American Animal Hospital Association’s “Canine Vaccine Guidelines” is also an excellent source of information (http://secure.aahanet.org/eweb/dynamicpage.aspx?site=resources&webcode=CanineVaccineGuidelines).
2.  Talk with your veterinarian to figure out which diseases your dog has potential exposure to.  A miniature poodle who rarely leaves his Manhattan penthouse likely has no exposure to Lyme disease (spread by ticks); however a Lab that goes camping and duck hunting may have significant exposure.
3.  Alert your veterinarian to any symptoms or medical issues your dog is experiencing.  It is almost always best to avoid vaccinating a sick dog — better to let his immune system concentrate on getting rid of a current illness rather than creating a vaccine “distraction.” If your dog has a history of autoimmune (immune-mediated) disease, it may be advisable to alter his vaccine protocol or even forego ongoing vaccinations — be sure to discuss this with your vet.
4.  Let your vet know if your dog has had vaccine side effects in the past. If the reaction was quite serious, she may recommend that you forego future vaccinations, necessitating an official letter to your local government agency excusing your pup from rabies• related requirements.
5.  Talk to your veterinarian about vaccine serology.  This involves testing a blood sample from your dog to determine if adequate vaccine protection still exists (remember, vaccine protection for the core diseases lasts a minimum of three years).  While such testing isn’t perfect, in general if the blood test indicates active and adequate protection, there is currently no need for a vaccine booster. Serology may make more sense than simply vaccinating at set intervals.
6.  Talk to your veterinarian about the potential side effects of proposed vaccinations, what you should be watching for, and whether or not there are any restrictions for your dog in the days immediately following vaccination.

What happens if your veterinarian declines vaccine discussion and simply wants to vaccinate based on what he or she thinks is appropriate?  Time to find yourself a new veterinarian who is progressive enough to have a working relationship with people who choose to be a stellar medical advocates for their dogs!  Is your vet willing to have open-minded discussion with you about your dog’s vaccinations?

Best wishes for a happy new year.   

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
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health Award
Become a Fan of Speaking for Spot on Facebook 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. 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 is available at Amazon.com, local bookstores, and your favorite online book seller.

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Posted in Client expectations, Important Questions to Ask You Vet, Medical Advocacy, Reasonable Expectations Series, Selecting a Veterinarian, Speaking for Spot, Vaccinations | 14 Comments »

Reasonable Expectations VI: The Ability to Discuss Your Internet Research With Your Vet

Tuesday, December 7th, 2010

This is the sixth part of an ongoing series describing how people are developing new expectations when it comes to veterinary care for their pets. Parts one through five can be found at www.speakingforspot.com/blog.  Please take your time with this one- I realize it is a lengthy post, but there is a great deal to say about this worthwhile topic!

When your beloved pet develops a medical issue, chances are you’ll be inclined to do some Internet research and then talk with your vet about what you’ve learned.  Know that having this discussion with your vet is a perfectly reasonable expectation as long as you are careful to avoid using valuable office visit time discussing “whackadoodle” notions gleaned from cyberspace.  Here are some pointers to help you find instructive, accurate, worthwhile Internet information while avoiding “online junk food”. By the way, although I’m a veterinarian teaching people how to better care for their furry and feathered family members, please know that this information also applies to your own health care.

So, let’s begin.  How can you determine whether or not a website is dishing out information that is worthy of your time? Here are some general guidelines:

1.  Ask your veterinarian for her website recommendations.  She might wish to refer you to a specific site that will supplement or reinforce the information she has provided.

2.  Veterinary college websites invariably provide reliable information.  Search for them by entering “veterinary college” or “veterinary school” after the name of the disease or symptom you are researching.

3.  Web addresses ending in “.org,” “.edu,” and “.gov,” represent nonprofit organizations, educational institutions, and governmental agencies, respectively.  They will likely be sources of objective and accurate information.

4.  If your dog has a breed-specific disease, pay a visit to the site hosted by that specific breed’s national organization.

5.  Avoid business-sponsored websites that stand to make money when you believe and act on what they profess (especially if it involves purchasing something).

6.  Be ever so wary of anecdotal information.  It’s perfectly okay to indulge yourself with remarkable tales (how Max’s skin disease was miraculously cured by a single session of aromatherapy), but view what you are reading as fiction rather than fact. 

7.  I really love disease-specific online forums.  Check out those sponsored by Yahoo (http://groups.yahoo.com).  Not only do many of them provide a wealth of educational information, members can be a wonderful source of emotional support- always a good thing for those of us who share our homes and hearts with an animal.  If you are considering joining an online forum, I encourage you to look for a group that focuses on a specific disease (kidney failure, diabetes, etc), has lots of members, and has been around for several years.  For example, an excellent Yahoo group AddisonsDogs has 3,391 members and has been up and running for eight years.  A large group such as this typically has multiple moderators who screen participants, screen comments to keep things on topic, present more than one point of view (always a good thing), and provide greater round-the-clock availability for advice and support.  Look for presentation of cited references (clinical research that supports what is being recommended). Such groups should have a homepage that explains the focus of the group and provides the number of members and posts per month (the more the better).  They may have public archives of previous posts that can provide a wealth of information.

I happen to enjoy hearing about what my clients are learning online.  I sometimes come away with valuable new information, and I’m invariably amused by some of the extraordinary things they tell me- who knew that hip dysplasia is caused by global warming!  Surf to your heart’s content, but be forewarned, not all veterinarians feel as I do.  Some have a hard time not “rolling their eyes” or quickly interrupting the moment the conversation turns to Internet research.  What can you do to realize the expectation of discussing your online research in a way that is neither irritating to your vet nor intimidating for you?  Listed below are some secrets for success:

-I may be preaching to the choir, but I cannot overemphasize the importance of working with a vet who is happy and willing to participate in two-way, collaborative dialogue with you (please reference my earlier blog about relationship centered care- http://speakingforspot.com/blog/?p=1174). Your opinions, feelings, and questions are held in high regard and enough time is allowed during the office visit to hear them. A veterinarian who practices this “relationship centered” style of communication is far more likely to want to hear about your online research than the veterinarian who practices “paternalistic care” (far more interested in telling you what to do than hearing about your thoughts, questions, or concerns).  Remember, when it comes to veterinarian/client communication styles, you have a choice. It’s up to you to make the right choice!

-Let your vet know that you appreciate her willingness and patience in helping you understand how best to utilize what you’ve learned online.

-Wait for the appropriate time during the office visit to discuss what you’ve learned on line.  Allow your veterinarian to ask questions of you and examine your precious poopsie rather than “tackling” her with questions and discussion about your Internet research questions the moment she sets foot in the exam room.

-Be brief and “to the point” with your questions.  Remember, most office visits are scheduled for 15 to 20 minutes, max.

-Let your veterinarian know that you’ve learned how to be a discriminating surfer!  You know how to differentiate between valuable online resources and “cyber-fluff”. You ignore anecdotal vignettes and websites trying to sell their products in favor of credible information provided by veterinary college sites and forums that are hosted by well-educated moderators who provide cited research references that support their recommendations.

-When you begin conversation about your Internet research, I encourage you to choose your wording wisely. Communicate in a respectful fashion that invites conversation as opposed to “telling” your vet what you want to do.

In the Internet, we have an extraordinary tool at our fingertips. I encourage you to be selective when choosing which websites you intend to take seriously and which ones you wish to visit for a good chuckle.  Approach conversations with your vet about your Internet research thoughtfully and tactfully.  These strategies are bound to facilitate constructive conversation and create a win-win-win situation- for you, your veterinarian and your beloved best buddy! 

Have you had conversation with your vet about your Internet research?  If so, how did it go?

Now here’s wishing you and your four-legged family members abundant good health.  

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
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health Award
Become a Fan of Speaking for Spot on Facebook 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. 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 is available at Amazon.com, local bookstores, and your favorite online book seller. 

Free holiday gift wrap with books purchased between now and December 25th (www.speakingforspot.com/purchase.html).

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Posted in Canine Diseases, Canine Symptoms, Client expectations, Internet Veterinary Information, Medical Advocacy, Reasonable Expectations Series, Speaking for Spot, Veterinary Office Visits | 6 Comments »

A Short Sabbatical

Saturday, November 13th, 2010

After four years of procrastination, I’m finally gonna do it!  I’m heading into the operating room, only I won’t be the one holding the scalpel blade.  A team of surgeons aim to fix a nagging back issue I’ve been annoyed by for far too long. Fret not, the prognosis is very good and I aim to be busy word processing again in no time!  In the meantime, some of my esteemed co-bloggers will provide guest posts that I know you will enjoy.  While in the midst of my post-operative narcotic haze, I won’t be emailing blogs as I normally do. Rather, I hope you will join me on Facebook (http://www.facebook.com/speakingforspot) so you will be notified of new blogs as they are posted.  

And now for some shameless self-promotion!  I emphatically urge you to place Speaking for Spot at the very top of your holiday gift list for all of your dog loving friends, relatives, groomers, trainers, pet sitters, and dog park compatriots. And while you’re at it, don’t forget your veterinary hospital staff!  

Here are five reasons to give the “Gift of Spot” this year:  

  • Free Christmas gift-wrap included (an adorable double-sided wrap with bright Christmas doggie décor on one side and red and white dog bones on the other).
  • Free Chanukah gift-wrap included; sorry, no adorable canine theme (go ahead, you try to find dogs and Chanukah on the same wrapping paper!).
  • Four dollars from each book purchased will be sent to the participating animal-centered nonprofit organization you designate at the time of purchase.
  • Your gift will be personally signed by yours truly!
  • Your gift will provide an invaluable lifelong resource that is sure to enhance the life of a dog! 

Please visit www.speakingforspot.com/purchase.html to do your holiday shopping!  

Thank you for your readership. I extend my heartfelt best wishes to you and your loved ones (including those who are furry or feathered) for a peaceful and healthy holiday season.   

Dr. Nancy Kay
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
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health Award
Become a Fan of Speaking for Spot on Facebook

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Posted in Holidays, Medical Advocacy, Speaking for Spot, Speaking for Spot Gives Back Program | 3 Comments »

Stop That Scratching!

Thursday, April 22nd, 2010

If the sounds of a canine or feline “scratchfest” is interrupting your slumber, or you’re snarling, “Stop scratching!” several times a day, chances are you have an allergic pet on your hands. Just as with human hay fever, most dog and cat allergies are the result of an exaggerated immune system response to allergens in the environment such as plant pollens, tree pollens, and mold spores.  The scientific name for this inherited allergic condition is atopy or atopic dermatitis. Terriers of any type are notorious atopy sufferers along with Dalmatians, Lhasa Apsos, Shar-peis, Bulldogs, and Labrador Retrievers. 

Whereas people are prone to runny nose and eyes, dogs and cats with atopy develop itchy skin, often accompanied by skin and ear infections. Symptoms are initially mild and seasonal, but tend to progress year by year in terms of severity and duration.  Fortunately, there are many options for treating atopy including medicated shampoos, antihistamines, fatty acid supplements, and drugs that alter the immune system’s overzealous behavior (cyclosporine, cortisone).  Just as for people, desensitization injections can be administered after specific testing is done to determine which allergens are provoking the immune response. Elimination of exposure to the allergens may also be an option (a good excuse to move to Hawaii!). 

Some dogs and cats develop allergies to their food.  This can result in year round itchy skin, ear infections, and/or gastrointestinal symptoms (vomiting, diarrhea, gassiness).  If a food allergy is suspected, your veterinarian will recommend an “elimination food trial.”  This requires strict adherence (including elimination of your pet’s favorite treats) to feeding a novel protein diet for six to eight weeks. There are many such diets to choose from these days that contain duck, rabbit, venison, salmon, and even kangaroo! If the chronic symptoms disappear in response to the diet change, voila, the diagnosis of food allergy has been made. One must then hope that, over time, the animal doesn’t develop an allergy to the new diet! 

Lastly, some dogs and cats develop an allergy to fleas, more specifically, to the flea’s saliva.  Whereas many fleas are required to cause most animals to scratch like crazy, for those with a flea allergy, just one bite is all it takes to set off an intensely itchy reaction that can last for days. The best treatment for this allergy is stringent flea control, or relocation to Colorado; fleas don’t survive in high altitude locations! 

‘Tis the season for fleas and seasonal atopy.  Do you have an itchy dog or cat on your hands?  If so, what will your strategy be to soothe your pet’s itch and preserve your sanity? 

Best wishes to you and your four-legged family members for abundant good health,   

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health Award
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life

Website: http://www.speakingforspot.com
Become a Fan of Speaking for Spot on Facebook   

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. 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 is available at Amazon.com, local bookstores, or your favorite online book seller.

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Posted in Canine Symptoms, Medical Advocacy, Speaking for Spot, Veterinary Medicine, Veterinary Office Visits | 4 Comments »

What is a Veterinary Specialist?

Sunday, March 21st, 2010

I participate in a list serve for veterinarians who specialize in internal medicine. The list serve “topic de jour” concerns veterinarians who are general practitioners (also known as family veterinarians), yet bill themselves as “specialists” in specific venues such as surgery, dentistry, or cardiology.  The responses have been strongly disapproving, and here is the reason why:  The American Veterinary Medical Association dictates that the term “specialist” be reserved only for veterinarians who have completed all of the requirements to become a “diplomate” within a specialty organization. What must a veterinarian do to become an official specialist/diplomate? Trust me, it is a long and arduous process! After graduating from veterinary school, wannabee specialists must complete a minimum three-year internship and residency training program, author publications in peer reviewed journals, and pass some insanely rigorous examinations specific to the specialty they are pursuing.  (Note that the requirements differ for those who become specialists in complementary/alternative medicine fields of veterinary medicine such as homeopathy, acupuncture, chiropractic, and Chinese herbs.) If one is successful in completing this rigorous and extensive training they achieve “board certification” status and are deemed to be “specialists” or “diplomates” within their chosen specialty.  This is much like the process physicians go through to become specialists.

The world of veterinary specialists has grown by leaps and bounds.  Much like Starbucks®, if there’s not already a group of specialists in your community, there likely will be soon!  Veterinary specialists are found in university teaching hospitals and in some private practices.  They often “cohabitate,” sharing specialty staffing, equipment and laboratory services with specialists in different areas of expertise.  When this is the case, you, the lucky client, end up with access to multiple specialists under one roof.  Not only is this convenient, it also focuses a lot of brainpower and experience on your pet- group discussions about patients (medical rounds) typically occur daily in such specialty hospital settings.

When might you need the services of a veterinary specialist? Just as your family physician refers patients to specialists, your family veterinarian should be considering referral in the following three situations:

  1. A second opinion is desired by you or your veterinarian.  Yes, you definitely have the right to request a second opinion.  I know it can be tough telling your vet you would like a second opinion, but as your beloved pet’s medical advocate, you are obligated to do so just as soon a your “gut” starts suggesting that a second opinion makes sense. I encourage you to read the chapter called, “A Second Opinion is Always Okay” in Speaking for Spot- it will provide you with plenty of helpful coaching about how to tactfully broach the subject with your veterinarian! Hopefully your vet has established relationships with local specialists- the kind she would trust to take good care of her own dog should the need arise. Not all family veterinarians are keen on “letting go” of their patients, so self-referral might be your only way to seek out the help of a specialist.
  2. Help is needed to figure out what is wrong with your pet. Specialists have advanced diagnostic tools (ultrasound, endoscopy, CT imaging, MRI scans, etc.) and have developed the skills to use them. Additionally, because of their extensive experience with challenging cases, specialists often have the ability to hone in on a diagnosis in the most direct and expedient manner.
  3. Your vet doesn’t specialize in the disease your pet has or the therapy he needs.  Just as with our own health issues, treatment is ideally managed by someone who works with that particular disease issue day in, and day out, and regularly pursues continuing education pertaining to that disease.

How can you tell if a particular veterinarian is truly a specialist?  Simply examine the initials following his or her name. See the list of specialties and their corresponding initials below. For example, if you look at the initials following my signature (ACVIM), you can tell that I am a specialist in The American College of Veterinary Internal Medicine. To learn more about any of these areas of specialization, pay a visit to the websites.  Those listed below are within the United States, but you will find comparable organizations in many other countries or continents.

Have you ever taken your pet to a veterinary specialist?  Have you ever wanted to do so, but had trouble getting “buy in” from your family veterinarian?  If so, please share your experience.  I’d love to hear from you.

Diplomate, ACVIM Internal medicine (acvim.org)
Diplomate, ACVIM, Cardiology Cardiology (acvim.org)
Diplomate, ACVIM, Oncology Oncology (acvim.org)
Diplomate, ACVIM, Neurology Neurology (acvim.org)
Diplomate, ACVS Surgery  (acvs.org)
Diplomate, ACVD Dermatology (acvd.org)
Diplomate, ACVR Radiology (acvr.org)
Diplomate, ACVO Ophthalmology (acvo.org)
Diplomate, AVECC Emergency and critical care (acvecc.org)
Diplomate, ACVA Anesthesiology (acva.org)
Diplomate DACVB Behavior (dacvb.org)
Diplomate, ACVN Nutrition (acvn.org)
Diplomate, AVDC Dentistry (avdc.org)
Diplomate, ACT Theriogenology (theriogenology.org)
CVA Veterinary acupuncture (Ivas.org)
TCVM Chinese veterinary medicine (tcvm.com)
AVH Homeopathy (drpitcairn.com) or (theavh.org)
ACVA Chiropractic (animalchiropractic.org)
CCRP Canine rehabilitation (caninerehabinstitute.com)

Best wishes to you and your four-legged family members for abundant good health,

Nancy Kay, DVM
Diplomate, ACVIM
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health Award
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Website: http://www.speakingforspot.com
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. 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 is available at Amazon.com, local bookstores, or your favorite online book seller.

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Posted in Important Questions to Ask You Vet, Medical Advocacy, Selecting a Veterinarian, Speaking for Spot, Veterinary Specialists | 9 Comments »

Breed Profiling

Saturday, March 13th, 2010

Racial profiling is considered taboo, and for good reason.  Breed profiling, however, is fair game for those of us in the veterinary profession! We breed profile on a daily basis particularly pertaining to health issues.  Name just about any breed of dog or cat and I can provide you with a laundry list of potentially inherited diseases.  Patty Khuly, VMD (the “VMD” means her veterinary degree is from the University of Pennsylvania) has created a wonderfully comprehensive list of canine breed related diseases (the feline list is in the works).  I encourage you to check it out at www.embracepetinsurance.com/PetHealth/default.aspx. Not only does she list the most common maladies for each dog breed, she rates the risk for disease inheritance (low, medium, or high), describes each disease, and provides the approximate (emphasis on approximate) cost to diagnose and treat each disease. Hats off to Dr. Khuly for creating such a useful tool!  And if all of this weren’t enough, Dr. Khuly also manages to find the time to pen a witty and informative daily blog (www.petmd.com/blogs/fullyvetted).    

So how might Dr. Khuly’s information about breed-specific diseases be useful for you?  Certainly, if you are thinking about adopting a purebred pup, what you learn might sway your opinion about a particular breed.  If you already have your heart set on a specific breed, the disease-specific information will empower you to ask the right questions of the breeder to learn if the litter’s dam, sire, grandparents, and aunts and uncles have been affected.  A word of warning: don’t dare rely on the proverbial, “None of my dogs have ever had that problem.”  A conscientious breeder will offer forth official paperwork rather than verbal reassurances. Finally, if you already share your heart and home with a particular breed or think you know what breeds have gone into the “making of your mutt” being informed about the diseases that may arise will allow you to better be on the lookout for early symptoms. Timely detection and intervention can favorably affect the long-term outcome.     

Official White House Photo

Now, just for kicks, let’s check Dr. Khuly’s list of inherited diseases pertaining to Bobama (the name I’ve affectionately bestowed upon the newest dog in the White House).  According to the list, Portuguese Water Dogs are at medium risk for hip dysplasia (instability of the hip joints that results in arthritis), and at high risk for Addison’s disease (a hormonal imbalance) and follicular dysplasia (a hair follicle issue resulting in abnormal hair growth).  President Obama might be interested to know that one of his predecessors in the White House had Addison’s disease- none other than the late John F. Kennedy!  I wish Bobama a lifetime of good health, not only for the sake of the first family, but for the sake of the White House veterinarian as well!   

Best wishes to you and your four-legged family members for abundant good health,   

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health Award
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Website: http://www.speakingforspot.com
Become a Fan of Speaking for Spot on Facebook    

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. 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 is available at Amazon.com, local bookstores, or your favorite online book seller.

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Posted in Canine Diseases, Canine family members, Internet Veterinary Information, Medical Advocacy, Speaking for Spot | 7 Comments »

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