Are you preventing Heartworm Disease?

With spring and warmer weather upon us, mosquitoes will be making their appearance anytime. Heartworms are transmitted by the bite of an infected mosquito. This is a major health concern for your pet!

Signs of heartworm disease include: coughing, difficulty breathing, panting, decreased exercise tolerance or even sudden death. Pets may not show signs until very late in the course of the disease and that is why annual blood testing is recommended.

However, heartworm disease is easily prevented with either a chewable tablet or a topical medication placed on the skin between the shoulder blades. Both types of preventative are used monthly. If you have a difficult time remembering to treat your dog monthly, we now have an injection that will last six months.

Let’s not forget our feline friends. Although cats are not the proper host for heartworms, some cats can contract the disease. Identifying cats with heartworm disease is very difficult, but the infection can be easily prevented with use of monthly and/or topical medication.

Easter Toxins

Easter is a happy of time of year to celebrate with family and friends and welcome spring. But it is also a busy time of year for pet toxin ingestion making March Poison Prevention Month. The most common calls this time of year involve Easter lilies, chocolate, and Easter grass.

True lilies such as Tiger, Day, Asiatic, Easter, and Japanese Show lilies are highly toxic to cats. All parts of the Easter lily plant are poisonous – the petals, the leaves, the stem and even the pollen. Cats that ingest as few as one or two leaves, or even a small amount of pollen while grooming their fur, can suffer severe kidney failure. In most situations, symptoms of poisoning will develop within six to 12 hours of exposure. Early signs include vomiting, loss of appetite, lethargy and dehydration. Symptoms worsen as kidney failure develops. Some cats will experience disorientation, staggering and seizures.

There is no effective antidote to counteract lily poisoning, the sooner you can get your cat to the veterinarian, the better his chances of survival will be. If you see your cat licking or eating any part of an Easter lily, call our office or Pet Poison Helpline (855-764-7661-fee applies) immediately. If left untreated, his chances of survival are low.

Treatment includes inducing vomiting to get any remaining plant material out of the stomach, administering drugs like activated charcoal (to bind the poison in the stomach and intestines), fluid therapy to flush out the kidneys, and monitoring of kidney function through blood testing.

Tiger, Day, Asiatic, Japanese Show, and my personal favorite Stargazer lilies are popular in many gardens and yards. These lilies are also commonly found in florist bouquets, so it is imperative to check for poisonous flowers before bringing bouquets into the household.
Non-toxic types of lilies – such as the Peace, Peruvian and Calla lilies typically only cause minor drooling.

Thankfully, lily poisoning does not occur in dogs or people. However, if a large amount is ingested, it can result in mild gastrointestinal issues such as vomiting and diarrhea.

With Easter comes Easter baskets and decorations and Easter grass… the fake grass that often fills those decorative Easter baskets. When your cat or dog ingests something “stringy” like Easter grass, it can become anchored around the base of the tongue or stomach, rendering it unable to pass through the intestines. It can result in a linear foreign body and cause severe damage to the intestinal tract, often requiring abdominal surgery.

And what’s the other favorite thing in those Easter baskets? Chocolate of course! Chocolate rabbits and hundreds of kinds of chocolate eggs! While the occasional chocolate chip in one cookie is not typically an issue, certain types of chocolate are very toxic to dogs. In general, the darker and more bitter the chocolate, the greater the danger. Baker’s chocolate and dark chocolate pose the biggest problem. The chemical toxicity is due to methylxanthines (a relative of caffeine) and results in vomiting, diarrhea, hyperactivity, an abnormal heart rhythm, seizures, and possibly death. Treatment here too requires inducing vomiting to get as much of the chocolate out as possible. The colored foil wrappers on some of those chocolate eggs do make vomiting a colorful process in a lot of cases! The treatment is much the same as lily ingestion where we give activated charcoal (not at all the same as grill charcoal, so please don’t try that) to absorb the toxins. We control the seizures and abnormal heart rhythm with supportive medications as warranted. And give fluids to help flush the toxins out of the blood stream.

Just a reminder, our family of clinics always has a doctor on call 24/7, 365 days a year. Call one of our regular clinic phone numbers and follow the prompts to reach our emergency doctor.

Muzzle Is Not a Dirty Word

Sometimes when asked how work is going, I answer, “Not too bad. I still have all ten fingers.” It’s my poor attempt at a joke, but I’ve realized that a lot of people unfamiliar with veterinary medicine ask if that’s really a risk of the job. Although we have countless wonderful pets that walk through our doors, the reality is that some patients are more difficult – and more dangerous – to handle than others. So yes, there really is some inherent risk in working with animals.

The reason I wanted to discuss this is that some people think when we muzzle a dog, it’s cruel. It’s not. It’s a matter of safety. We all love animals and love the patients we work with, but that doesn’t mean we’re willing to take a trip to the emergency room instead of muzzling your pet. There are many reasons we use muzzles when dealing with patients beyond the obvious case of an aggressive dog. Even the sweetest dog has the potential to bite if they are in severe pain, so most painful patients are given a muzzle as a precaution. Some dogs that pose no threat to bite are simply calmer when they are wearing a muzzle. It’s difficult to draw blood from a wiggly dog, but many become more stationary with a muzzle. Many exams and treatments become a lot quicker when a nervous dog is muzzled, so we can get that dog back to the comfort of home much sooner.

I can personally relate to owners whose dog requires a muzzle because I am one of those owners! My dog cannot stand his nails being trimmed. He can be a real pain – and quite honestly, a danger – to anyone trying to trim his nails. But, when he is wearing a muzzle, he’s a completely different dog. He is more relaxed and less active making the procedure less stressful for him and easier for us. The muzzle allows us to give him a much quicker, better, and safer nail trim – a win for everyone!

So, if your dog requires a muzzle, it’s not something to be embarrassed by. If the appointment is easier, quicker, and less stressful for your dog (and you), then the muzzle is definitely a good thing!

Misfortune of bad teeth

This is Chip – he is my dog. Chip has the misfortune to have been born from a mother and father who both had bad teeth. Chip is nine years old. He is about ready to have his third dental cleaning. (He doesn’t know it yet). 

He was on my lap the other night and his breath grossed me out. I immediately carried him to the kitchen counter (my in-house exam table) and did an oral exam. Diagnosis—halitosis due to bacteria in mouth with grade II dental disease.


Grade I= good teeth and oral health

Grade II=gums red and mild to moderate tartar

Grade III=tartar and gingivitis beginning periodontal disease

Grade IV=advanced periodontal disease diseased or loose teeth.

When is the last time you looked at your pet’s teeth? Or did you just not want to look?

The number one abnormal finding on routine physical exam in dogs and cats is obesity. The number two problem is dental disease. The best way to help your pet have good oral health is to brush it’s teeth. 1% of my clients brush their pet’s teeth. Unfortunately for Chip I am in the 99% and likely so are you. Brushing is the best but there are other things you can do if you can’t brush.

Some options for you at home to care for your pets teeth with a lot less work are:

• Hill’s Prescription Diet T/D (a fiber matrix tooth food) used as treats. This is what I do for Chip. He gets 4 a day.

• Greenies treats work well, he gets one of these occasionally.

• Dentahex oral solution (like mouthwash for dogs) you wipe it on and it helps clean the teeth. I wipe his teeth when his breath smells.

These products work and we have them available at the clinic.

There are other products as well. You can find other oral health care products in many stores. It is easy to make a claim to help keep teeth clean. It is another to have been tested and given the VOHC (Veterinary Oral Health Council) seal of approval. If a product has this seal it is a good product. Others I can’t speak for.

See how you do answering a few questions about your pet’s oral health.

1. True or False?  If your pet’s teeth are nice and white they are OK.
2. True or False?  Hard food always keeps your pets teeth clean.
3. True or False?  Bones are good for your pet’s teeth.
4. True or False?  Bad teeth can lead to heart, liver and kidney problems
5. True or False?  Bad teeth are painful.

Answers:

1. False. The mouth isn’t OK just because the teeth are white if the gums are swollen or red.
2. False. Hard food helps only if the pet chews the food well. Most swallow their kibble whole.
3. True. As long as bones don’t break the teeth they help but I have seen a lot of broken teeth and my dog never gets bones!!!
4. True. Bad teeth do a lot of damage that can go unseen until serious problems crop up.
5.  True. Did you ever have a tooth ache? Our pets don’t show us tooth pain except occasionally drooling or dropping their food when they try to eat. None the less they hurt.

"Diet Starts Tomorrow..."

We've all probably said this to ourselves at some point, especially after the holidays when delicious treats and over-indulgence have run rampant and wreaked havoc on our waistlines. We are not alone, though, as our pets share an increase in poundage and probably for the same reasons – they join in our celebrations of the holidays and special occasions and we want to reward them with the foods they love because they are a beloved part of our families.

The number one response I get when I mention that a pet I'm examining has gotten a bit overweight is something along the lines of "The weather just makes it impossible to go for walks." It is understandable that no one wants to be outside in a polar vortex trucking through the snow with their dog to work off that extra slice of pie. But what many pet owners do not realize is that exercise has only a small fraction to do with their pet's weight loss! Don't get me wrong, exercise is great; it helps build lean muscle and burns calories and strengthens the heart, just to name a few benefits. I consider exercise a bonus to a good weight loss program, not a necessity because let's face it, not everyone is lucky enough to spend time outdoors with their pets year-round!

I have often thought about how awesome it would be to have a personal chef. Everything in front of me would be healthy and in the right proportions, and I wouldn't have to even think about it! Our pets are so lucky because we are their personal chefs. We control what goes into their mouths (for those of you that have labs or beagles this may not always be true, despite your best efforts...)! So how do you make the best choices for your pet?

It is all about how much food you make available to them. If you grab a big drinking cup and scoop it full of your dog or cat's food and then leave it out all day for them, they are probably going to be taking in way too many calories throughout the day to stand a chance at weight loss.

My first piece of advice would be to start measuring out how much food you are already feeding your pet. To do this you need to obtain an actual measuring cup. Pour the same amount of food that you would normally feed your pet into one or more measuring cups to get an idea of how many cups you are actually feeding. Then take a look at your pet's food bag. There will usually be a chart showing how much food to feed based on a given weight range. This is the important part: if your pet is already overweight you do not want to feed based on their current weight because they will either maintain or gain weight! You need to feed based on their ideal weight. If you need help figuring out what number this is feel free to talk to your veterinarian. I have found with many food bags that the recommended feeding quantities are very generous, so keep that in mind! It also helps to feed them a designated number of meals during the day, instead of just feeding "free-choice."

Another recommendation to help with your pet's weight loss is to gradually switch to a low-calorie food which will often have more fiber to help make them feel fuller, longer. It also helps to have one person in the household in charge of all the feedings, that way you stay consistent.

I know you are probably wondering about treats which for some is a very important part of their pet's routine. Table scraps should be eliminated because the food we eat is simply too high in fats and sugars for our pets. If you must feed "people food" stick to vegetables like carrots or green beans which make great low-calorie treats. Or you can just try using your pet's dry food kibble as treats throughout the day, a little here or there. Keep in mind, too, that you don't need to give your pet a massive handful of treats to show them you love them or to reward them. They are just as happy with a small nugget here and there; it's still a treat!

If you make these changes to your routine when feeding your pet you should see gradual weight loss and maybe even notice positive changes in them like an increase in energy and activity levels, not to mention the health benefits like decreased risk of heart disease and diabetes and decreased stress on their joints, just to name a few! Then when the weather gets nice again you can supplement these great new habits with exercise outside to maintain their weight loss you've worked so hard to achieve and keep your pet (and you!) happy and healthy!

Blastomycosis (Fungal Pneumonia)

Blastomycosis (Blasto) is a systemic, fungal infection caused by the soil organism Blastomyces dermatitidis. The organism grows in the soil and can be inhaled by dogs digging or sniffing in the soil. The organism travels to the lungs where it causes pneumonia and then can be disseminated in the bloodstream throughout the body. The Blasto organism causes a severe immune response which can result in dysfunction of the body organs affected.

Eighty-five percent of affected dogs have lung disease. Eyes, skin, lymphatic system, and bones are commonly affected also.

The incidence of Blastomycosis depends on environmental and wet soil conditions that favor growth of Blastomyces. Blasto is found most common along the Mississippi, Ohio, and Tennessee river basins which includes our area in central Illinois. Wet environments foster growth of the fungus; banks of rivers, streams, and lakes or in swamps; most affected dogs live within 400 meters of water. Exposure to recently excavated areas can increase the risk.

Large breed dogs weighing more than 50 pounds, especially sporting breeds are most commonly affected due to their increased exposure of digging and sniffing the soil. Young dogs, two to four years of age, are most commonly affected. It is very uncommon in dogs seven years and older.

Most common clinical signs of Blasto are: weight loss, depressed appetite, cough and difficult breathing, eye inflammation and discharge, lameness, and draining skin lesions. Dogs can exhibit a fever up to 104 degrees F, harsh dry cough, generalized or localized swelling of the lymph nodes, inflammation of uvea and conjunctiva and may lead to glaucoma. Dogs can be very painful and lame when the organism infects the bone. Blasto can also cause swelling of the testicles and prostate as well as inflammation of the heart.

The disease is most commonly diagnosed by radiographs showing a “snow storm” appearance within the lungs. Also in the last couple of years, a very accurate urine test helps to identify the disease and its severity.

Obviously, the earlier the disease is diagnosed and treatment started the better prognosis. Itraconazole is the drug of choice for treatment. Affected dogs should be treated for a minimum of 60 days or for one month after all signs of disease have disappeared. After 60 days, the patient should be re-xrayed and repeat urine test to determine the stage of disease.

Unfortunately, about 25% of affected dogs will die during the first week of treatment; early diagnosis improves chance of survival. About 20% of dogs will have a recurrence, usually within three to six months after completion of treatment and will need to be treated again.

Blasto is not spread from animals to people, except through bite wounds. Affected pet owners need to be aware that Blasto is acquired from an environmental source and that they may have been exposed at the same time as the patient; common source exposure has been documented in duck and raccoon hunters; the incidence in dogs is ten times that in humans. Owners of infected dogs that have respiratory and skin lesions themselves, should inform their physicians that they may have been exposed to Blastomycosis.

At our Dwight Veterinary Clinic, we see an average of five to 10 dogs per year with Blasto. The wetter the year, the more common the incidence of disease. So if your dog has a respiratory or skin infection that does not improve with the first round of antibiotics, be certain to discuss with your veterinarian the possibility of Blastomycosis.

Let's Talk About Bloat

Let us talk about bloat, (as the general public refers to it). Actually, let us talk about gastric dilatation with volvulus also known as gastric torsion. These are conditions that affect dogs primarily of the larger and deep chested breeds like the Great Dane.

The two conditions are not synonymous, however torsion/volvulus is usually preceded by bloat. Simple distension of the stomach with food, water, air or some combination, while uncomfortable, is not generally a life-threatening condition. Perhaps you have felt this recently with the holiday feasts we indulge in. Volvulus/torsion on the other hand is very serious and frequently leads to fatality if not treated rapidly and aggressively. The latter condition occurs when the full stomach has rotated within the abdomen in such a way that both ends of the stomach are effectively closed off not permitting much of anything to get in or out of the stomach. In addition to the stomach twisting, the vessels that provide blood to, and take blood away from the stomach are also compromised. The cascade of events that takes place both locally at the stomach as well as hemodynamically to the whole body results in pain, depression, shock, collapse and death if not treated.

While this is a simplistic look at the condition, what I want to make people aware of is that there is a simple and effective means of preventing it from happening. We can feed the right foods, in the right amounts and frequency, control post eating activity, etc. but that does not always insure that torsion will never occur. Owners of at risk breeds can have a procedure called a gastropexy performed that very effectively reduces the chances of torsion from occurring. It does not stop bloating from occurring if the pet over eats, or drinks but as I said above bloat is not typically a huge problem unless it is followed by torsion. The key is knowing the difference and that requires examination and radiographs. Any acutely bloated dog should be seen as soon as possible to determine which problem is present.

Here at Pine Bluff Animal Hospital, we perform what is called a laparoscopic assisted gastropexy, LAG for short. This is a minimally invasive procedure that effectively anchors the wall of the stomach to the wall of the body cavity thus preventing the twisting and rotating. Complications are rare and to date, after over 800 LAGS performed there have been no occurrences of torsion. The vast majority of dogs we have done have been Great Danes thanks to working with 2 prominent Great Dane rescue organizations as well as a number of breeders/handlers of show dogs. Torsion does not affect every Great Dane or deep chested dog, but when it does, it is an acute life-threatening condition that if not caught in time usually results in death.

Winter and Fleas

Think the flea threat is over with cold weather approaching –- think again!

With winter coming and colder temperatures with it, many fleas will die off. Once temperatures drop below 37 degrees Fahrenheit fleas start to freeze, but it can take up to 10 consecutive days of temperatures below 37 degree before fleas outside die. If day time temperatures exceed 37 degrees the fleas can survive and remain active.

Fleas are crafty and often find ways to survive the cold. The body heat of outside animals provide a safe haven for fleas even in the coldest weather. Micro-environments is another way fleas survive the winter. Outside animals often seek warmth up near foundations, under porches and in mulch beds. In these areas the temperature may not drop below 37 degrees and the fleas remain active. If your curious pet explored these areas, they may be the next hot meal for the fleas and can transport them into your home, only to thrive in the warm environment. Form theses areas fleas may find their way into your home through cracks in the foundation or other small openings.

So with cold weather the flea risk may diminish but it is not gone. To prevent flea infestation in your home we recommend using flea control products like Frontline Plus, Revolution or NexGard all year long.

Holiday Floral Threats

During the holidays, many homes may be decorated with traditional greenery – poinsettia, holly, mistletoe and lilies – which present potential toxic encounters for household pets. If these plants are part of your holiday tradition, limiting your pets' exposure is key.

Poinsettias, a common Christmas plant, only represent a mild concern with self-limiting signs. The white sap in the plant contains chemicals that if exposed to or ingested, may lead to skin irritation, drooling, vomiting or rarely diarrhea. These signs, when noted in dogs and cats, usually resolve without a need for medical intervention.

Mistletoe may be found in American (Phoradendron sertinum) and European (Viscum album) varieties, the American variety being less toxic – the berries contain various toxins and, if ingested in small quantities or accidentally, present similar signs to Poinsettia – drooling, vomiting and diarrhea. However, IF ingested in large amounts, more serious signs such as abnormal heart rate, hypotension, seizures and death have been reported.

Holly, with its spiny leaves and berries, may also cause mild digestive distress in dogs and cats. The leave, with the spines, can cause mechanical injuries on sensitive oral membranes, and berries contain several toxic substances that may lead to head shaking, vomiting, drooling and diarrhea.

Depending on the plant species, lilies represent a mild threat to a severe one to cats. Less toxic species such as Peace, Peruvian and Calla Lilies may cause only short-term signs of foaming at the mouth, drooling and vomiting. Of greater concern are true lilies of Lilium or Hemerocallis species, such as Day, Tiger, Easter, Red and Western Lilies. Even small amounts ingested of a few petals or even vase water may result in acute kidney failure. If your cat is seen eating any part of a lily, immediate veterinary attention is indicated. Decontamination via induced vomiting, intravenous fluid therapy and kidney function tests may all be indicated.

If there are any suspected toxic exposures to any of the plants discussed, call our offices for recommendations. Remember, preventing contact with and keeping these decorative plants out of reach helps ensure a peaceful holiday for all.

Poisons and Your Pet

Did you know the ASPCA has a poison control hotline for pet owners? In my 3rd year of veterinary school, as part of a toxicology course, I was required to shadow at the Animal Poison Control Center in Urbana, Illinois. I found it to be very interesting and up until my experience there had no knowledge of the poison control center and the services they offer to pet owners. They have a hotline available 24 hours a day, 7 days a week, 365 days a year! Calls do require a $65 fee, but if your pet is microchipped there are certain microchip companies that will pay for calls to the hotline.

The poison control center is equipped with trained professionals that are standing by to answer your calls. What I found most interesting was the technology they utilize – computer programs that will allow them to enter a pet, its weight, along with the possible poison ingested and the amount, allowing calculation of how high a risk the pet is for toxicity for that particular ingestion. From there they can instruct you how to proceed which involves anything from just monitoring your pet for clinical signs of illness to inducing emesis (vomiting) to remove a recently ingested poison, to advising contact with your veterinarian as soon as possible.

In 2013, the ASPCA Animal Poison Control Center in Urbana, Illinois, handled nearly 180,000 cases exposed to possibly poisonous substances. Topping the list for the sixth year in a row were prescription human medications. Nearly 20% of all calls were from owners whose pets got into medicines intended for human use. You can visit the ASPCA Animal Poison Control website (www.aspca.org) for the top ten list of toxins of 2013.

Some common household toxins to be aware of if you have pets include chocolate, coffee, alcohol, avocado, macadamia nuts, grapes/raisins, yeast dough, raw/undercooked meat, eggs, bones, xylitol (which is discussed in more detail in a previous blog by Dr. Johnson), onions, garlic, chives, milk, and salt. Visit the website for additional information on these toxins as well as plants that can be dangerous to your pet.

It's a relief to know that if you are unsure if a substance your pet ingested is toxic you can always get a hold of someone for advice, and it is a lot more reliable than Dr. Google! The number for the poison control hotline is (888) 426-4435.

Holiday Season means delicious foods...and Pancreatitis

As the holiday season draws near, gathering with friends and family dominate many of our plans for the upcoming months. Many times, our furry family members are right there with us enjoying the festivities. But before you let your pet indulge on treats from the parties, be aware that it can put them at risk for serious consequences.

Pancreatitis commonly occurs due to increases of lipoprotein (complexes of lipid aka fats and protein) in the blood. These lipoproteins in the blood are increased when pets eat things like fatty steak, pork, bacon, greasy French fries, etc. Pancreatitis can also occur secondary to inflammation of the liver or bile duct causing lack of blood flow and trauma to the pancreas. High levels of calcium, toxins, or infectious disease can be other causes of pancreatitis. Certain breeds are affected more than others. These include the Miniature Schnauzer, Miniature Poodle, and Cocker Spaniel. The Siamese cat also seems to be at higher risk. The average age of dogs presenting with pancreatitis is 6½ years but it can happen at any age.

The gland secretes enzymes and digestive juices that help the body digest food. The pancreas also produces hormones that help regulate the glucose taken from food. Dogs typically present with gastrointestinal signs like vomiting and/or diarrhea. They can be sluggish, depressed, not want to eat, run a fever, be dehydrated, and have abdominal pain.

Diagnosis of pancreatitis often includes blood testing to rule out other organ involvement like the kidney or liver. Blood enzymes like lipase and amylase are often increased on a standard full chemistry. There is also more specific testing looking at enzymes that only come from the pancreas. Sometimes inflammation of the pancreas shows up on an x-ray but it’s just as important to rule out a foreign body in many cases.

Treatment of pancreatitis is based on controlling the signs being shown by the disease. If severe enough, it may be recommended that the pet stay hospitalized. Often times, they need fluids given either IV or under the skin. We give anti-vomiting medications by injection to calm the stomach. Pain medication is often important to keep the pet comfortable. If the pet is still vomiting or having diarrhea, we will fast the pet for 1-2 days to allow the pancreas to rest. After that time, the key is addition of small amounts of low fat food. Lean meats like drained, rinsed hamburger, chicken, or rice are good places to start. If the pet still won’t eat, sometimes we need to resort to a feeding tube to put liquid food directly into the patients stomach. Often antibiotics are included if bloodwork shows an infection or if we haven’t been able to confirm pancreatitis. Chronic or recurring pancreatitis requires long term administration of low fat food. If severe, diagnosis and complete treatment can get quite costly.

So, lets keep those pets happy and healthy over the holidays and I hope I don’t see any of you on emergency for pancreatitis.

Saying Goodbye

Recently, I did one of the hardest things I have ever done. I had to put “Daisy Duke” to sleep. I have been practicing for 38 years. I have performed euthanasia for many patients over the years. It is ALWAYS a sad event to end the life of a beloved family member, friend and companion. Our clients are our family and their pets are our pets too.

Euthanasia is one thing that I won’t miss when I retire. It is an emotional drain on all involved. It is so hard to come to the decision when the time is “right” and it is just never “right”. It just has to be done because we have run out of the ability to provide quality of life through treatment and loving care at home.

The reason it was so hard with “Daisy Duke” is that she belonged to my daughter and son-in-law and their two kids. Not only was I the caregiver but also part of the grieving family trying to be supportive as a doctor, father, and grandpa plus having all those feelings myself. It was a tough job.

Daisy is in a better place now and free of pain. The grandkids wrote letters to God to look after her and give her treats and we are all recovering.

As I look back, it gives me renewed insight on just how bad it is to have to put a pet to sleep. It hurts in so many ways, yet it may be the last, kindest thing you can do for your pet.

Why do I need bloodwork before anesthesia and surgery?

So you’ve been told your pet needs surgery. For many, hearing those words brings on all kinds of emotions, fears and anxieties. Seems everyone knows someone who knows someone who has an unpleasant story to tell either human or veterinary, with regards to either anesthesia or the surgery itself. There are many kinds of surgery performed in veterinary medicine from the cosmetic bump removal to the most extensive of orthopedic reconstructions. Some veterinarians specialize in only certain surgeries, I.E. veterinary ophthalmologists and eye surgery. Others are limited to only soft tissue surgeries and yet others, only orthopedic surgery. But common to all is the need for anesthesia, a procedure by which our patients are rendered immobilized, unconscious, and free of pain and anxiety before, during, and after the procedure is performed.

Humans come in all sizes and shapes but the variability in size, body conformation, weight, and even species is far greater in the veterinary setting. To compound this even further there are species specific issues and even individual breed variabilities within a species that play a role in deciding what is the best and safest protocol for a given patient. In many instances, particularly the elderly or very sick, or severely injured patient, the anesthesia is the highest risk part of the overall surgical event. Unfortunately, we cannot always wait for the patient to get better to do their surgery as the surgery itself may be the only way to get better.

Every patient undergoing anesthesia at our hospital is given a physical exam prior to administering any anesthetic agents. This is on top of the exams that have been done in establishing the reason for surgery, either by our own doctors or the referring doctors. In addition to physical exams, preoperative bloodwork is routinely done. While the physical exam is very important, many things cannot be determined by the exam alone. Bloodwork is our means of assessing the internal functions of the animal and combined with exam, help us to choose the best, safest means of anesthesia that allows for the procedure to be completed. Like the scan tool used to diagnoses automotive problems, bloodwork can uncover issues before they are even noticed by the owner as an issue, Considering a liver could lose up to 80% of its functional ability before liver disease is seen or it may take up to up to 66-75% loss of kidney function before obvious urinary/kidney disease signs are reported, bloodwork becomes very important to the overall assessment of a patients overall health. Our goal is have the entire surgical experience be successful and this includes being able to wake up from the anesthesia and not suffer from some other disease process that the anesthesia was detrimental to. With all this said there are still some issues that exam and bloodwork are simply incapable of predicting. Allergic /hypersensitivity reactions, blood clots to name just a couple. While adverse reactions under anesthesia are uncommon, we do whatever we can to know the potential for one beforehand AND be prepared for the unknowns during. The placement of IV catheters and fluid administration during surgery is the norm to aid in maintenance of blood pressure, perfusion of vital organs with oxygen carrying blood, aid in elimination of anesthetic drugs afterwards and to provide a port for the immediate administration of emergency drugs should the need arise. In addition to all these measures, monitoring of the anesthetized patient by trained veterinary technicians and is carried out throughout the whole preoperative time.

Thankfully “problems” during anesthesia and surgery are rare thanks to the exams, tests, agents used and monitoring. But, when they do occur, being trained to recognize it early and prepared to respond to it can be the difference between a pet owner still having a successful outcome or having an unpleasant story of their own.

Tick-borne Diseases: Lyme Disease

Following the lead of our colleague, Dr. Miller, we will take a closer look at Lyme disease, our area's most common tick-borne disease. Lyme disease (named for the Connecticut town) has been around for over a century but did not gain public notoriety until the 1980s. The Northeastern US and upper Midwest represent disease “hotspots,” but with warming temperatures, the disease is spreading. While we see scattered cases throughout our clinic's areas, the Goose Lake region especially represents a regional/local hotbed. Lyme disease is caused by a bacterium, Borrelia burgdorferi, which is transmitted by Ixodes ticks, in our area better known as the deer tick.

Map of the State of Illinois Canine Lyme Disease Prevalence for 2014. (CAPC)

Lyme disease, or Borreliosis, while also a well-known human disease, manifests itself differently in our canine patients. Greater than 90% of dogs who are infected with the organism are not “sick” because of it and are asymptomatic. In dogs, the disease may not manifest itself for weeks to months after infection and they may present with signs of arthritis or perhaps a fever. Fortunately, symptoms of the disease respond quickly to a course of appropriate antibiotics. Although rare, the most serious potential long-term effect is kidney disease. Due to this potential risk, in some cases we may recommend a urinalysis be checked to look for any possible indications of kidney involvement. Lastly, while cats may become infected with the organism, they appear more resistant to its effects, do not develop clinical signs and currently, the disease is not regarded to be of clinical concern in our feline patients.

As noted earlier, the deer tick transmits the bacterium, causing infection. There are three life stages involved: larvae, nymph and adult, that utilized various-sized 'hosts' for their feeding (blood sucking!). These hosts range from small (white-footed mouse) to large (dogs, deer, humans) depending on the life stage of the tick. Not surprisingly, the mouse and deer are quite prevalent in our area. Whit the tick feeds on its host, it requires a minimum of 48 hours to pass the bacterium, thus, if the tick is removed within 48 hours of attachment, the bacterium cannot be transmitted and the host will not get the disease.

Diagnosis of Lyme disease is confirmed through blood testing. When performing our recommended yearly heartworm testing, the test also checks for three tick-borne diseases: Lyme, Ehrlichiosis and Anaplasmosis, the latter two being less common in our are. Remember, simply having a positive result does not constitute illness. However, if the patient is exhibiting joint pain and maybe a fever, we may prescribe a course of antibiotic therapy. Treatment does not eliminate the organism, it will remain in a low latent state, similar to the 90% of infected dogs who do not experience illness.

Tick control is the hallmark of Lyme disease prevention. Ticks can be active year-round and continuous protection is recommended. We carry and utilize monthly topical applications or a new chewable monthly medication, all of which kill ticks before they can transmit disease. In addition to these products, vaccination offers additional protection against Lyme disease. The vaccine inactivates the bacterium within the tick. While we do not vaccinate ever canine patient, it is recommended for patients who reside in regional hotspots, those individuals whose lifestyle is higher risk such as hunting dogs, or individuals who travel to other geographical hotspots such as Wisconsin.

Remember, prevention is the key to protecting both our canine companions AND their human friends, as we take to the woods and fields in our area!

Click here to find more information about CAPC prevalence maps for pet parasites.

ALS Ice Bucket Challenge Can Help Your Pets, Too!

The ice bucket challenge to raise money for ALS research is everywhere, but did you know it can help your pets too?

ALS (amyotrophic lateral sclerosis) is a degenerative neuropathy that causes human patients to lose their ability to use their muscles to move.  Dogs can suffer from a similar nervous system disease called canine degenerative myelopathy.  This disease causes dogs to slowly loose function of their hind legs until they can no longer walk and begin having incontinence issues.  Like ALS, there is currently no cure for canine degenerative neuropathy. 

Due to a recent "One Health Initiative", scientists and doctors from veterinary and human medicine are sharing their research with each other better than ever before. So, research in human medicine is being used to address diseases seen in veterinary medicine, and vice versa.  This means that ALS research funded by money raised from the ice bucket challenge has the potential to provide treatment options for not only human ALS patients, but also dog neuropathy patients. 

Whether you donate to the ALS Association (http://www.alsa.org/) or an organization that funds veterinary research such as Morris Animal Foundation (http://www.morrisanimalfoundation.org/), support for medical research is important to help veterinarians and human medical doctors continue to improve the care provided for their patients. Another way to help is to ask your legislators to maintain current federal funding of medical research. 

In summary: Dumping a bucket of ice water over your head to raise awareness of the need for funding of ALS research may help develop treatments for dogs (and other animals) suffering from similar neurologic diseases.  

Members of Pine Bluff Animal Hospital participated in the ALS #icebucketchallenge!

Video.

Intestinal Parasites: What’s Lurking In Your Yard?

There are three common intestinal parasites that not only infect your dog or cat, but can also infect you and your family. Those parasites are roundworms, hookworms and giardia and they are found in sandboxes, soil, grass, and water. The parasites are released through an animal’s feces and the eggs can live in the environment for months. Transmission occurs by ingesting the worm egg, drinking contaminated water, or penetration of the skin by larvae. 

In our pets, infection with these parasites can cause allergic reactions, blood loss and anemia, digestive problems, and damage to internal organs. People infected with these same parasites may experience digestive problems, liver and lung damage, partial or total blindness, and itching skin lesions. Early detection of intestinal parasites is the first step in control and protection.

The Companion Animal Parasite Council (CAPC) recommends the following fecal test schedule:

      • Puppies and Kittens: 2-4 times a year
      • Adult pets not taking a broad-spectrum heartworm preventative: 
        2-4 times a year
      • Adult pets taking a broad-spectrum heartworm preventative: 

        1-2 times a year

Some action to protect your pet and family include:

      • All year us of a broad-spectrum heartworm preventative

      • Remove pet feces from your yard as often as possible

      • Keep sandboxes covered when not in use

      • Wash hands after working in the soil or playing with pets

      • Teach children not to eat dirt   

By following these simple tasks,
we and our pets can safely enjoy our time spent outside!

Turtles and Lizards and Snakes, Oh My!

Exotic pet medicine is an exciting field of veterinary medicine that can greatly differ from the traditional care given to dogs and cats. Many different species are considered “exotic pets” including small mammals, birds, reptiles, and even fish. As you can imagine, the practice of medicine on a rabbit is greatly different from a goldfish.

If you have an exotic pet, the first step is to simply call and ask your veterinarian to see if he/she is comfortable seeing that species. Even veterinarians who see exotics do have some limitations. For example, I will not see monkeys, miniature pigs, or spiders. Some veterinarians who do not have a lot of experience with certain animals may be comfortable with seeing your pet initially, but may have to refer you to another veterinarian if there is an issue that they do not have the right equipment or supplies to treat (just like we have to do with some of our dog and cat patients). You can also ask if your veterinarian is a member of any special organizations. My biggest interest is reptiles, so I am a member of the Association of Reptilian and Amphibian Veterinarians and attend an annual conference to learn about cutting edge topics and share stories about interesting cases with other reptile veterinarians.

When you bring your exotic pet to the vet, make sure you bring all of your pet’s “husbandry” information with you. “Husbandry” refers to the way exotic pets are kept and includes details about their diet and habitat. This is the biggest difference between exotic pets and dogs / cats. Most exotic pets require specific temperature, moisture, and lighting requirements. Even the best owners cannot perfectly replicate the natural environment or diet exactly the same as the animal would experience in the wild. So, we continually re-evaluate husbandry, especially on animals that are sick. If your veterinarian asks you specific questions about how you keep your pet or offers you advice on possible improvements, this is only because the vet is trying to help you keep your pet as healthy as possible.

The internet is not a bad place to look for husbandry requirements, but do not trust everything you read online. Care sheets from websites of exotic animal hospitals are more reliable than a random message board. Also, please remember that recommendations are always evolving based on new research to help us adjust the husbandry standards to provide the best care for our exotic pets. There are many older resources out there that were considered reliable until research proved that alternatives were better.

One example of an outdated resource is a reptile textbook from the 1970’s that I recently came across. In its time, this book was considered a reliable resource. Within the book is a strategy recommending putting turtles in the freezer to induce anesthesia. This technique is now considered very cruel. The same type of outdated information is out there for husbandry techniques for many exotic pets, so please be careful what you follow. If you have any questions, please ask an exotic veterinarian for recommendations for trustworthy resources.

Xylitol: Sweet...but Deadly!

Xylitol is a low-calorie sugar substitute that has helped diabetics and weight loss seekers to get their sugar fix without the calories. Xylitol is appearing in products you'd never suspect. New products on the market such as sleep aids, multivitamins, sedatives, antacids, stool softeners amy contain unexpectedly large amounts of xylitol. Dogs that ingest these products may face a double risk – poisoning by the xylitol (a sugar alcohol) and also liver failure.

Just a small sample of some of the more popular household products containing xylitol.

Xylitol is also sold in bulk to substitute of table sugar for baking and home use. Pet Poison Helpline has had several cases of dogs becoming severely intoxicated after ingesting homemade bread, muffins and cupcakes made with xylitol.

Toxicity is dose dependent. The dose necessary to cause dangerously low blood sugar could be as little as one piece of xylitol chewing gum for a 10-pound dog. To obtain a list or which products contain xylitol, google “products containing xylitol.”

If you suspect that your dog has ingested a xylitol containing product, call the Poison Control Hotline at 1-800-548-2423.

Fear-Free Pet Visits!

One of the more recent emphases being advocated by “America’s Veterinarian”, Dr. Marty Becker, and the veterinary profession, is the “fear free” experience of taking your pet to the veterinarian.

Hippocrates said it this way: “Cure sometimes, treat often, comfort always.”

Our veterinary oath obligates us to, “the prevention and relief of animal suffering.”

Many people are hesitant to bring their pets to the veterinary clinic because of the perceived stressful experience for them and their pet.

Animal Behaviorist, Dr. Karen Overall, states that fear is the most damaging thing a social species can experience. So what is the solution – to create fear free visits that happen inside a fear-free practice.

A Fear-Free Practice actually starts at home with fear-free pets. Well-behaved animals at home are, of course, much more likely to behave well when their owners bring them to the veterinary clinic. Training pets are like raising children, the more time we spend early on teaching and rewarding them for acceptable behavior, the more this will promote the peace and harmony of the human-animal bond.

Here are six ways Karen Overall says people can help their pets
live in peace and harmony:

1. Teach people how to pet their dogs and cats. Make it a rule to only give their pets attention when they are calm, and use gentle, soft strokes to pet. For dogs, focus on petting the chest, side of the neck, or the side of the body – areas the pet relaxes into.
2. Encourage pet owners to commit to consistent training and rewards (treats, praise, play, petting). Never allow one family member to “rough play” with the dog & allow mouthing, but not allow this with other household members. This is very confusing to the dog as to what behavior is acceptable.
3. Desensitize your pet to the transportation crate by having it out all the time at home and putting tasty treats or toys in the crate so your pet feels very comfortable in it.
4. Number four is about timing and consistency. The reward structure should be clearly defined and appropriately reinforced at all times. Pet owners need to understand that when teaching a new behavior we teach best best by rewarding at every instance of appropriate behavior and that our pets will retain what they have learned best by rewarding them intermittently.
5. Human and pet expectations. Make sure you are rewarding the pet with what is intrinsically rewarding to them, not what you think they should like. Think of food as currency. You have to understand exactly what currency will make a pet’s eyes light up. (Freeze dried liver, turkey hotdog, deli turkey, salmon, Gerber’s Graduate Meat Stick, Honey Nut Cheerios, Peanut Butter Captain Crunch. Cats thrive on tuna, easy cheese or canned cheese, Feline Greenies, and baby food. 
6. Establish “leadership” vs dominance with your dog. Leadership helps the human family gain influence over their dog simply by controlling all resources to use as motivators to reward dogs for appropriate behavior

Procedures that we are using in our veterinary clinic
to help pets to have a more pleasant experience:

• We are using pheromones (chemical substances that are produced and secreted by animals that influences their behavior and gives them a sense of well-being) in the exam & treatment rooms.

• Putting the treat into treatment.

• We recommend that owners do not feed their pets before coming to the clinic so their pets will be hungry and be much more likely to respond to treats which will distract them. We want them to think of their visit like a trip to the Dairy Queen with lots of good things to eat and can’t wait to come back.

• If necessary, pet sedation protocols are started before the pet owner leaves home to help the pet to be relaxed and happy.

The bottom line: the more calm and relaxed the pet when coming to the veterinary clinic, the more enjoyable and productive experience for all concerned.

Stay tuned for more developments and procedures
to enhance the “Fear Free Experience”!