Research at The AMC Demonstrates There are Fewer Tears in ICU

October 1, 2014

Tear testMedicine is a discipline full of questions. Clients want to know how their pet got a disease and medical professionals want to know how best to fix the disease. Many of these questions can best be answered using real patients with spontaneously occurring medical conditions. This type of research, called clinical research, is the type performed at The Animal Medical Center. In our day to day practice we have hundreds of questions on how better to care for our patients, and some of these questions ultimately form the basis for the research performed and published by AMC veterinarians. Here is a summary of one such study.

Measuring Tears
Veterinarians have a very simple method for measuring tears, the Schirmer tear test which is shown in the photo. This test uses a special type of ruler paper that turns Blue as it absorbs the tears. Normal eyes produce about 15-25mm of tears per minute, as indicated by the blue color on the strip pictured. A decrease in normal tear production is called ‘dry eye’ and predisposes dogs and cats to developing corneal problems, such as painful corneal ulcers.

Causes of Dry Eye
Medications, general anesthesia, infections and immune disorders can decrease tear production. Dogs and cats in any intensive care unit, The AMC’s included, are the most seriously ill patients in the hospital and are the patients with a myriad of problems. Intensive care patients also receive many drugs and often need general anesthesia to correct their problems.  Because The AMC’s ICU and ophthalmology veterinarians recognized the potential for tear production to be decreased in ICU patients. They also recognized decreased tear production would add to these patients long list of problems. Acting on those concerns for their patients, these veterinarians teamed up to study the tear production in canine ICU patients.

Fewer Tears in ICU
The study’s hypothesis was tear production in canine ICU patients would be decreased, compared to a group of normal dogs. Thirty normal and 30 dogs in ICU were studied, and true to the hypotheses, dogs in ICU had significantly decreased tear production as measured by the Schirmer tear test. This finding is important for dogs in ICU’s everywhere because the study’s conclusion was to recommend ocular lubricants be considered in all dogs hospitalized in ICU to prevent the consequences of dry eye. Although not every dog was re-examined, two dogs were and both regained normal tear production after hospital discharge, suggesting the decrease in tear production in ICU patients is not always permanent.

You and Your Pet Can Help
Clinical research like this happens every day at veterinary hospitals. If your veterinarian suggests you and your pet participate in a clinical trial, seriously consider it. Your pet will receive top-notch care as a participant and will help advance medical care benefitting other pets as well.


Rabies: An Ancient Disease, Still Important Today

September 24, 2014

World Rabies Day logoRabies is an ancient and universally feared disease. The first known description of rabies occurred before 2300 BC in Egypt. Aristotle, the Greek philosopher, wrote about rabies around 350 BC. Louis Pasteur developed the first successful rabies vaccine in the late 1800s and widespread vaccination programs have greatly decreased rabies in domestic animals; although wild animals continue to be a reservoir for rabies in the United States.

Still Important Today
Despite the development of excellent and safe vaccines against rabies, every 10 minutes, somewhere in the world, a person dies of rabies, most of them children. The majority of cases of human rabies occur in Asia and Africa, regions of the world which lack the resources to implement rabies vaccination programs. For these people, every interaction with a dog is a potential exposure to rabies. Every year on World Rabies Day (September 28), stakeholders work to raise awareness about the disease and encourage appropriate vaccination.

Because we live in a global society, rabies can pop up anywhere. All it would take is the inadvertent transport of a rabid animal into a previously rabies free area to set off an epidemic.

Rabies in NYC
In the United States, the primary reservoir for rabies is bats, but, always the trendsetter, NYC’s reservoir is the local raccoon population. In 2013, 56 rabid animals were identified in NYC, a number four times the 2012 number. Of the rabid animals, 46 rabid raccoons were identified, mostly in Staten Island. A rabid dog has not been identified in NYC since 1954, but for three of the last four years, a rabid cat has been identified in our city. This trend is especially alarming since cats see the veterinarian less than once a year, and lapses in rabies protection are becoming more frequent.

Although NYC has a plethora of rats, mice and squirrels, these rodents are typically resistant to rabies. Groundhogs, another member of the rodent family, can contract rabies and a rabid groundhog was identified in NYC in 2007.

Protect All Family Members Against Rabies
Vaccinate your pet against rabies, as recommended by your veterinarian. Educate your children about safe interactions with dogs and other animals. Don’t feed wildlife because it may attract a rabid animal into your neighborhood. If you or your pet are bitten by an animal, seek medical attention immediately.

For the most up to date information about rabies in NYC, check the NYC Department of Health and Mental Hygiene’s website.


Feeding Your Pet for Optimal Health

September 17, 2014

Can We Talk…About Endoscopy? What Joan Rivers’ Death Teaches Us About Pet Healthcare

September 10, 2014
Joan Rivers with her dog, Max

Joan Rivers with her dog, Max

Joan Rivers’ tragic death last week dominated social media and made many ask questions about the safety of endoscopy, pet owners included. Joan Rivers was an unabashed dog lover. And so using one of her signature lines, “Can we talk?” this blog talks about veterinary endoscopy and how veterinarians at The Animal Medical Center safely and successfully use endoscopy every day to diagnose and treat a variety of conditions.

What is Endoscopy?
Endoscopy is a compound word created from endo, which is Greek for within, and the common suffix ­-scopy or -scope found on many English words: telescope, periscope and microscopy. Once again, scope comes from the Greek word ‘skopein,’ meaning to look. The word endoscopy is generic and describes multiple medical procedures, including esophagoscopy, gastroscopy, laparoscopy (WARNING: This video was taken during an actual laparoscopy where a liver biopsy was performed. Weak-kneed readers should not view this video) colonoscopy, cystoscopy, nasopharyngoscopy, and bronchoscopy. What these procedures all have in common is the use of a piece of medical equipment containing a tiny lens or video camera and specially designed minimally invasive equipment to look inside the body and correct problems with few to no surgical incisions.

What is an Endoscope?
An endoscope appears to be a simple, long tube, but it is actually a very high tech device. The endoscope requires a light source to illuminate the inside of the body. The light source is very powerful since the tip inside the patient can be two to three feet away from the scope’s other end. Endoscopes can be flexible for snaking down the twists and turns of the airways or intestines, or it can be a rigid stainless steel tube. Flexible endoscopes use fiberoptics for transmitting the internal images along the length of the scope to a video monitor for the entire medical team to view. Rigid scopes use a series of lenses and the image is viewed through an eyepiece or on a monitor. Biopsy forceps, scissors and grabbers thread down the endoscope via a separate channel to facilitate biopsy and retrieval of accidentally ingested objects or bladder stones.

Why is Anesthesia Required?
Because of the nature of our patients, anesthesia is a necessity for any endoscopic procedure in a veterinary patient. Your dog or cat must hold perfectly still to allow precise placement of the endoscopic device. Because endoscopy equipment facilitates collection of biopsy samples, general anesthesia manages any pain associated with the procedure. Bronchoscopy, esophagoscopy and gastroscopy require the endoscope to be threaded though the mouth into the lungs, esophagus or stomach. Think what your pet’s chompers do to their favorite toy. Imagine what those same chompers could do to our delicate fiberoptic endoscope. Anesthesia is a must; however many precautions are taken before and during anesthesia by your pet’s medical team to ensure a safe endoscopic procedure.

Why Would My Pet Need Endoscopy?
AMC veterinarians use endoscopy every day to diagnose and treat patients. Our internal medicine team biopsies the nose, stomach, small intestine and colon endoscopically. Ditto for the retrieval of accidently swallowed bones, balls and socks. Orthopedic surgeons use arthroscopsy to identify and repair torn cartilage inside joints. Surgeons avoid putting your pet through major surgery by using laparoscopic and thorascopic procedures in treating diseases of the abdomen and chest. Our interventional radiology team can correct misplaced ureters and remove bladder stones via minimally invasive cystoscopy.

Anytime you hear someone say your favorite fur baby has a medical problem and needs a procedure, I know your heart flutters for a moment. Now that you know more about these diverse and life saving types of endoscopy, I’m sure you realize your veterinarian has ordered a sophisticated and medically advanced procedure for your pet.


Five Money Saving Tips to Cut Expenses on Pet Medical Care

September 4, 2014

dog imageWe all want to save money, but when it comes to our pets, we strive to give them the best of everything.  Here are five tips to help you save money on your pet’s medical expenses and still provide your favorite fur baby with top-notch treatment. 

  1. Be an educated pet owner.
    Start by visiting your local library for a basic book on pet care. Check with your neighborhood veterinarian or animal rescue group to see if they offer classes in pet care. Familiarize yourself with the common signs of illness in your pet. For example, review this slide show about the 10 warning signs of cancer in pets and consider subscribing to our Fur the Love of Pets blog to have pet health information delivered to your inbox weekly.
  2. Don’t skimp on preventive care.
    An annual visit to your pet’s veterinarian is worth its weight in gold. During a routine physical examination, your veterinarian can assess your pet’s risk of contracting a contagious disease, such as parvovirus or Lyme disease, and administer vaccinations or parasite preventatives to protect your pet. Subtle changes in body weight or the ability to ambulate identified during an examination may indicate the need for additional testing, medications to alleviate pain, or a diet adjustment. Without an annual examination, your pet’s undetected illness can spiral out of control and might cost much more than an annual veterinary visit.
  3. Don’t ignore signs of disease such as vomiting, weight loss or inactivity.
    If I had dollar for every time I heard a pet owner attribute signs of disease to something other than disease, I would be rich. Here are just a few examples: “He’s not moving around much anymore, but he is older.” Diagnosis: arthritis. “I think she’s losing weight, but I am feeding her the light food.” Diagnosis: intestinal lymphoma. “He vomits every day, but that’s normal for cats, right?” Diagnosis: chronic kidney disease. Don’t miss an opportunity to be proactive and keep your pet healthy and pain-free by quickly recognizing signs of disease.
  4. Create a safe, but enriched environment for your pet.
    One of the most common reasons for pet admissions to The AMC Emergency Service results from hazards in the home. In the month of August alone, AMC emergency and critical care veterinarians treated pets for ingestion of human foods toxic to pets, such as xylitol and chocolate; rat poison intoxication; and consumption of human prescription and recreational drugs, especially marijuanaFalls from open windows without screens commonly result in feline ER visits and hospitalization for shock and broken bones. In addition to pet-proofing your home, protect your pet by creating activities to keep Fluffy and Fido busy during the day using feeding toys, a cat tree or mechanized toys. There are many ways to create an enriched backyard for your dog. Some of these ideas can be adapted for indoor cats as well. 
  5. Invest in pet insurance.
    Purchasing the right pet insurance requires you to invest some of your time into researching the best policy for your family and your pet. The strength of some policies lies in the area of preventive care. These policies cover annual wellness visits and medications to prevent fleas, ticks and heartworms. Other policies lean towards covering catastrophic medical care, such as emergency surgery or hospitalization for diseases like heart failure or kidney disease. Purebred dog and cat aficionados should scrutinize potential policies carefully for any breed related exclusions. As you review policies, keep in mind some charge additional fees to cover expensive treatments such as chemotherapy.

So now you are an educated, proactive pet owner with a pet safe home and a well insured pet, I’ll bet that makes both you and your pet sleep better at night.


Pet Picnic Perils

August 27, 2014

Weird Worms

August 21, 2014

Practicing in an urban setting, we don’t see too many pets with worms, partly because the city lifestyle reduces exposure to fleas and vermin which transmit worms and partly because I follow the Companion Animal Parasite Council and recommend year round heartworm prevention. Those medications control many common intestinal parasites. Here is information about some of the less common worms veterinarians see in pets.

Tapeworms

Tapeworm segments on a dog's bedding

Tapeworm segments on a dog’s bedding

The photograph on the right came in with one of my patients the other day. The owner was concerned about the rice grains she was seeing on the dog’s bedding and was worried her dog was not digesting the rice in the lamb and rice dog food. What she thought were rice grains were actually tapeworm segments. Dogs become infected with tapeworms when they ingest a flea or eat a small mammal containing tapeworm eggs. Inside the dog’s intestine, a tapeworm consists of hundreds of little segments which are connected to form a worm. Segments break off and can be found moving around near the anus or on your dog’s bedding. Safe dewormers are available to eradicate tapeworms from your dog, but protecting your dog against fleas and limiting their access to vermin will also prevent them from acquiring tapeworms.

Raccoon Roundworms
Even though NYC is urban, we have lots of raccoons. I saw three youngsters washing their hands in a Central Park pond about two weeks ago. Raccoons carry a roundworm in their intestine (Baylisascaris procyonis) and shed roundworm eggs in their feces. Raccoon roundworm eggs are very hardy and remain infective in the soil for years after being shed in the stool. 

The New York City Department of Health and Mental Hygiene advises New Yorkers to avoid raccoon latrines (the area where raccoons repeatedly defecate) and to wash their hands if they come in contact with raccoon feces. Children are especially susceptible to infections with the raccoon roundworm. 

Tracheal Worms
Most pet owners think of worms as living in the intestine, but there are worms that live in other organs as well. Dogs can be infected with two different species of tracheal worms, Crenosoma vulpis and Filaroides osleri. F. osleri induces the formation of wart-like lesions in the trachea and bronchi of infected dogs, causing a hard, dry cough. Dr. Kelly Gisselman, an AMC trained ACVIM certified small animal internal medicine specialist, recently posted a YouTube video of a worm she spied while performing a bronchoscopy on a young dog with a cough. Deworming completely resolved the cough which had been going on for a year and a half! Since the worm did not induce the formation of wart-like lesions, we suspect it is C. vulpis

Protecting Your Pets and Your Family Against Weird Worms

  • Check out the Companion Animal Parasite Council’s website for more information on pet parasites.
  • Wash hands thoroughly with soap and water after being outdoors and before eating.
  • Administer year round monthly heartworm prevention. Those effective against dog roundworms will also treat raccoon roundworms.
  • Use medications to prevent fleas which carry the infective form of the tapeworm.
  • Clean up raccoon feces on your property, but wear gloves and wash your hands after doing so.
  • Put trash in tightly covered containers and don’t put food out for wildlife that may carry weird worms.

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