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!

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”!