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.

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.

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.

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”!

Ticks!

 

The next creepy-crawly parasites for us to discuss are ticks. Unlike fleas, ticks are not insects. They are actually arachnids, more closely related to spiders than fleas. Ticks are especially abundant in wooded areas around us, but some people don’t realize that the most common place to pick up a tick is from the tall grass or underbrush. So, the sides of the trails in our prairie state parks are a prime location for your pets (and you) to encounter ticks.

One of the most common misconceptions about ticks is the proper way to remove a tick from your pet. Did your grandma ever teach you to light a match, blow it out, and then place the match on the tick to burn it off? Mine did. And she was wrong. It’s also not a good idea to try to drown the tick in petroleum jelly or nail polish.

The correct way to remove a tick is actually very simple. Use a pair of tweezers to grab the tick as close to the pet’s skin as possible, and then quickly pull upward to rip the tick away from the skin. That’s it. Quick, easy, and simple, (and gross to some people). If you don’t feel comfortable removing a tick from your pet, bring your pet in for us to do it.

Another misconception a lot of people are concerned about is leaving the tick’s head behind. People worry about this more than they need to. Usually the “head” that is left behind is actually the tick’s mouthparts that anchor to the skin. After the tick is removed, these should fall out of the pet’s skin with time. If the area of the tick bite becomes red, starts to swell, or oozes some discharge, then bring your pet in so that we can make sure that additional treatment is not required.

What we should really worry about with tick bites are the dangerous diseases that ticks can transmit to your pets. Our hospitals have seen multiple cases of dogs positive for different tick-borne diseases including Ehrlichiosis, Anaplasmosis, and Borreliosis (better known as Lyme Disease). These diseases have the potential to be very dangerous – sometimes even life threatening, and some of the medication used to treat these diseases can be very expensive, especially for larger dogs. You can protect your pet by giving monthly tick preventative medication. We do have a new oral monthly tick preventative medication if you don’t like using the topical liquid medication. Also, we can give the Lyme vaccine to dogs that are at high-risk. (Sadly, we don’t have a vaccine against Ehrlichia or Anaplasma.) We’ll share more information about specifics of tick-borne diseases including Lyme Disease in a later blog post.

If you have any questions about ticks, tick preventative medication, or tick-borne diseases, please contact us.

Year-round with heartworm, flea, and tick prevention?

It is that time of year again when we will start to see insects flourish, this includes fleas, ticks, bees, and mosquitoes. We’ve already seen our first cases of tick infestation and bee sting reactions in the middle of April this year. So, have you been giving heartworm, flea, and tick prevention through the winter?

 

Heartworm disease requires a ‘middle man’ which is the mosquito in order for the microfilaria (baby heartworms) to mature to the infective L3 larva stage. Heartworm disease is spread when a mosquito bites a dog which has microfilaria, the microfilaria then mature, and the mosquito goes and bites an unprotected dog or cat. It then takes 6-7 months for the microfilaria to mature before the adult worms start producing microfilaria of their own. This also the time frame it takes for adult female worms to produce the antigens that are picked up in our standard heartworm tests.

We’ve been talking about year-round heartworm prevention for over a decade. I hear a lot of clients who are still only giving prevention during the warm months. But anymore, we are seeing mosquitos into November. Unfortunately, heartworm prevention does not kill all the circulating microfilaria with one dose. It can take 2-3 months before preventatives will kill all the microfilaria. Several specialists are even talking about resistant microfilaria which take more doses to control. If you are traveling south with your pets, that is also going to affect the disease risks. Year-round prevention which also covers intestinal parasites is going to ensure that your pet does not pick up a parasite that can passed to people.

This year-round recommendation applies to flea and tick prevention as well. We see many cases of flea infestation over the winter despite a good freeze outside. Flea eggs can lie dormant in areas of the garage, basement, in the furnace filter, and even on wildlife in the backyard. When these areas warm up, the eggs start to hatch. When heartworm, flea, and tick prevention become a monthly habit all year-round, it helps insure we don’t miss a dose or get off the monthly schedule when our pets do need the protection the most.

So what about cats? Yes, they can get heartworm disease as well but it works a little differently than in the dog. In the cat, only a handful of adult worms mature and so there is a very low level of microfilaria, if any. But it only takes a few worms to make a cat very sick because of the difference in body size. Unfortunately, there is no current treatment for heartworm disease in cats. Since we live in an area where heartworm disease is prevalent in dogs, we recommend heartworm prevention in cats year-round as well. 

Fleas!

Even though we see patients with fleas year-round, as spring approaches the fleas become even more prevalent. So, we wanted to share some information to help you understand more about fleas and how to keep them off your pets and out of your house.

Two species of fleas are seen in pets, the cat flea (Scientific name: Ctenocephalides felis) and the dog flea (Ctenocephalides canis). Strangely enough, the cat flea is actually the most common species of flea we see on pet dogs. Lucky for us, these two species are very similar and respond to the same flea preventive medications.

Fleas are insects, and just like other insects such as butterflies, fleas go through several life stages before they complete their metamorphosis into an adult flea. One female flea can lay up to 50 eggs a day, which then fall off of the pet and end up in your carpet, furniture, bedding, or any other crevice that can provide protection. When the eggs hatch, a larva emerges, which is like the caterpillar stage of the butterfly. Because the larva likes to find a dark hiding place, we usually don’t see this stage of the flea. Like a caterpillar, the larva creates a cocoon for the next life stage, which is called a pupa. While in its cocoon, the pupa can remain protected and dormant for several weeks. The pupae are provoked to transition to adult fleas and emerge from their cocoons when a pet walks by that they can jump onto.

Now that we’ve covered some basic flea biology, we can use that background to answer some common misconceptions we hear:

1. “My pet doesn’t go outside, so he can’t have fleas.”
   1. If your pet goes outside to use the bathroom, that is enough time to pick up fleas that wildlife may have left in your yard. Also, other pets and people can track in fleas or flea eggs that have the potential to infest your house and pets.
2. “My dog brought home fleas from the boarding kennel.”
   1. Sometimes we will get reports from owners that when they brought their pet home from boarding, they started seeing fleas on their pet. Although it is always possible for pets to bring home fleas, usually this situation means that dormant pupae were hiding out in the house and were awakened when the pet came home. If your pets became overdue for their monthly flea preventive while they were boarding, make sure they receive it as soon as you get home.
3. “It’s winter. My pet doesn’t need flea preventative now.”
   1. Since pupae can lie dormant for an extended period of time, your pet can still be exposed to fleas during colder months if there are pupae hiding in your house.
4. “We already treated my pets for fleas last month. We still have fleas, so it didn’t work.”
   1. The eggs, larvae, and pupae that can hide out in your house can persist for months. It can take several consecutive months of treating ALL the animals in the house in order to eliminate fleas from your house. The current recommendation is to treat all the pets in an infested house for at least 3 consecutive months. Also some flea medications can cause fleas to become hyper-excited before they die, so it seems like there are suddenly more fleas because they are now hyper-active and not hiding.
      
      

So, what is the best way to prevent fleas from infesting your pets and your house? The best way to control fleas is to treat every pet every month with flea preventives from a veterinarian. We have multiple choices available including topical liquids you place on your pets back and oral flavored medications. Not every medication is perfect for every pet. If you have questions, please ask us and we will decide together what is best for you, your pet, and your pocketbook.

Keep a lookout for our next blog about another creepy-crawly parasite – Ticks!

Cats!

 It is no secret that I am a cat lover. Don't get me wrong, dogs are great, too, but there is a special place in my heart for the furry felines (and the not so furry, for that matter...I'm looking at you sphinxy)! I could go on to say that if they happen to be orange this only ups the ante. The staff here for the most part knows that if there is an orange cat in the facility I am to be notified right away. The technicians have gone out of their way to come out of an exam room to plop an orange cat in my lap, especially when they know I am having a particularly stressful day. I owe my love for cats to my own orange cat, Oliver. I adopted him my first year of vet school, and he has been with me ever since. He was my shadow all throughout vet school; keeping me company while I spent countless hours studying, even if only to sleep on his bed next to my desk till all hours of the night and early morning...and in true cat fashion to often sleep ON my desk or ON my books, keyboard, lap, back of my desk chair, etc. (cat people, you know what I am talking about)! 

Now that I am part of the family at Pine Bluff Animal Hospital, I have been working on educating myself about a cat-friendly practice. There are 86 million owned cats in the US and 78 million owned dogs yet there are twice as many cats than dogs that never see a vet. 39% of people say they would only bring their cat to the vet if the cat was sick. It is just as important that a cat sees us at least yearly for health checks and preventative care such as vaccines, fecal tests, etc. Senior cats, cats that go outdoors, have exposure to outdoor cats, or already have chronic diseases such as Feline Immunodeficiency Virus (FIV or feline AIDS) and/or Feline Leukemia Virus (FeLV) are among the many that should visit the vet even more frequently than just the basic yearly health checks. Just because a cat is healthy as perceived by their owner does not mean it does not need to see a vet. We see sick AND healthy pets and checking in with our fantastic felines once a year can increase the likelihood that we will catch an early disease state while it is still manageable.

Some of the hallmarks of a cat-friendly practice are found in the waiting room and traced all the way to the very back of the hospital where pets are boarded. Staff that is knowledgeable about the least stressful restraint and handling techniques and understand the little idiosyncrasies of cats can make all the difference in our feline visits. We've already made some small changes at our hospitals and will be working towards more in the coming months. My ultimate goal is to increase our feline visits by making them as minimally stressful on our owners AND their special cats. In the meantime, I encourage you to bring your cat in if it hasn't been seen by a vet in awhile (or ever). And if it is orange...be prepared :)