Adrenal Gland Yin and Yang

March 5, 2014

puppy-yinyangLast week was a big week for adrenal gland disorders at The Animal Medical Center. Not one, but three dogs were admitted by The Animal Medical Center’s 24-hour Emergency Service with a diagnosis of Addison’s disease, or hypoactivity of the adrenal gland. Additionally, I evaluated two of my patients for adrenal gland hyperactivity, or Cushing’s disease.

Small but Mighty
Adrenal glands are tiny organs, one sits atop of each kidney. The normal width of a dog’s adrenal gland is less than half an inch. In cats, adrenal glands are half that size. Small compared to the liver or kidneys, these glands are powerhouses pumping out an array of hormones critical to maintaining normal homeostasis. Because the adrenal glands produce so many different hormones, either condition hypo- or hyperactivity can cause a wide variety of serious clinical signs. The hormone most important in Cushing’s and Addison’s disease is cortisol.

Poodle Problem
Two of last week’s ER patients with Addison’s disease were poodles. This was no coincidence. Addison’s disease is inherited in the Standard Poodle and also the Portuguese Water Dog, Nova Scotia Duck Tolling Retriever and the Bearded Collie. Cats very rarely develop Addison’s disease. What is strange about the dogs at AMC is the diagnosis of Addison’s disease in three dogs in one week, since the prevalence of the disease in dogs is thought to be 0.6-0.28% of all dogs. Dogs with Addison’s disease have vague, nonspecific clinical signs such as vomiting and diarrhea. One reason your veterinarian performs blood tests when your dog has vomiting and diarrhea is to identify the characteristically low blood concentrations of sodium and chloride and the high concentration of potassium, classic for a diagnosis of Addison’s disease. The consequences of missing a diagnosis of Addison’s disease are dire. Dogs become progressively dehydrated and the potassium climbs to levels which can stop the heart from beating. The AMC ER has a machine which can test blood concentrations of sodium and potassium in minutes, speeding the diagnosis of Addison’s disease.

Too Much Water; Too Much Pressure
The adrenal glands of dogs with Cushing’s disease produce too much of the hormone cortisol, either because of an adrenal tumor or because the pituitary gland in the brain forgets to tell the adrenal glands to stop producing cortisol. The two patients I evaluated for Cushing’s disease had different medical problems. One dog had an increased amount of protein in her urine, high blood pressure, and an elevated liver test. All three disorders are known to occur as a result of Cushing’s disease. The other dog was drinking too much water and having accidents in the house — two more signs of Cushing’s disease. Neither dog had hair loss, but it is another common problem we see in dogs with an overactive adrenal gland. Cushing’s disease, like Addison’s disease, is rare in cats.

Giving and Taking Away
Treatment for these two opposite diseases is opposite! For Addison’s disease we give hormones, and for Cushing’s disease we take the hormones away by suppressing the adrenal glands. Dogs with Addison’s disease respond rapidly to either oral or injectable forms of the missing adrenal hormones. Treatment of dogs with Cushing’s disease takes a month or two, while oral medications are adjusted to individualize the dose for each dog.

Recognizing the Yin and Yang of Adrenal Gland Disease in Your Dog
Even though Cushing’s disease is more commonly seen than Addison’s disease, both diseases can be readily diagnosed with blood tests. Your veterinarian will suggest testing if your dog is showing the following signs:

Cushing’s Disease

  • Excessive drinking and urinating
  • Hair loss on the trunk
  • Elevated liver tests
  • High blood pressure
  • Protein in the urine
  • Pot-bellied appearance

Addison’s Disease

  • Waxing/waning vomiting and diarrhea
  • Poor appetite
  • Weight loss
  • Anemia
  • High blood potassium
  • Low blood sodium and chloride

The [Veterinary] World is Flat

February 26, 2014

digital x-raysThe title of this blog takes its name from author and New York Times columnist, Thomas Friedman’s bestselling book, The World is Flat: A Brief History of the Twenty-First Century. The book’s thesis explains globalization in the 21st century as a result of wide accessibility to personal computers and fiber optic cables which make communication via email and information gathering via the internet nearly instantaneous. This form of globalization renders geographic divisions between countries irrelevant.

Friedman describes “ten flatteners” including: the collapse of the Berlin Wall, Netscape and workflow software. My own observations of the world of veterinary medicine indicate that it is not much different than the global economy Friedman describes in his book. Paying tribute to the Pulitzer Prize winner Friedman, here are my veterinary flatteners.

A New Workflow
Digital radiography has changed the workflow of daily veterinary practice. In the pre-computer days, each x-ray was a piece of film, not easily copied and very easily misplaced. Now The AMC and many other veterinary hospitals have switched to using digital radiography, using a machine that looks like a regular x-ray machine but which takes digital images similar to those taken with your smart phone. These x-rays can’t be lost because the images are stored in a picture archiving and communication system (PACS). The image files are very large, but can be transported by burning them onto a CD or transferring them through any number of file sharing systems.

Electronic Medical Records
As it has revolutionized the global economy, the personal computer is revolutionizing veterinary practice. Electronic medical records systems (EMRS) allow rapid dissemination of medical information between specialists and primary care veterinarians. I can write a letter to a patient’s primary care veterinarian after I have completed my consultation with their patient. Through the magic of the EMRS, I can have the letter in that veterinarian’s inbox for his/her review before the pet has returned home.

Board Certification
Twenty-five years ago when I started the process of becoming a board certified veterinary oncologist, there were only about 25 veterinary oncologists in the world. The American College of Veterinary Internal Medicine now has certified over 300 oncology diplomates and there is a European College of Veterinary Internal Medicine which certifies oncologists as well. Board certified specialists all over the world form a healthcare network that trades patients back and forth when pet owners relocate or go on vacation, just as I described in a previous blog: “Clea’s International Healthcare Team.” Since veterinary oncologists and other specialists have expanded their reach worldwide, specialist veterinary care no longer has geographic boundaries.

Multinational Veterinary Companies
Specialists are not the only international flatteners. Because international companies provide veterinary products and services, veterinary specialists can access information about pets seen by a veterinarian practicing on a different continent! Take for example my patient Gigi. She came to The AMC from Kuwait, but because the biopsy of her tumor was sent to the European branch of the same laboratory used by The AMC, I was able to ask additional questions about the biopsy result. The biopsy sample was retrieved from storage and then reviewed by a pathologist in Europe. The answers to my questions were sent via email.

Real Time Communication
The internet has changed the face of veterinary education. Today, veterinarians no longer have to travel to earn continuing education credits necessary to maintain their licenses. Continuing education comes to them though their computers. This year, the keynote speaker addresses at the annual Veterinary Cancer Society Meeting were streamed live to members unable to attend. Additionally, several internet based companies offer on-demand veterinary continuing education opportunities.

The veterinary world is indeed flat and that means your pet can get excellent veterinary care from a veterinarian in your neighborhood or from a specialist somewhere a long way from home!


When Life Gives You Lemons, You Need a Buddy

February 20, 2014

gray tabbyTracy and her 14 year old grey tabby, Baller, have experienced a few bumps in the road this past year. In April, Tracy noticed Baller, named after a rap song, was defecating outside his litter box. He also had diarrhea, but he didn’t seem very sick since he was eating well and was his usual playful self. Her neighborhood veterinarian examined Baller and found two pounds of weight loss. Tracy thought she could breathe easier when she heard the blood tests were normal, but an abdominal ultrasound revealed Baller had colon cancer.

Minimally Invasive Testing
Tracy brought Baller to The Animal Medical Center for a consultation with one of our board certified oncologists. Baller’s oncologist, Dr. Maria Camps, explained the most common type of cancer in cats is lymphoma, and recommended a minimally invasive approach to diagnosis since lymphoma is treated with chemotherapy, not surgery. Ultrasonography was used to direct a small needle into the colon tumor and retrieve cells from the tumor. Within hours, Tracy found out she and Baller were facing an uphill battle against lymphoma. The anticipated survival time for a cat with lymphoma treated with chemotherapy is less than one year.

Chemotherapy Helps
Dr. Camps actually gave Tracy so much hope, and Dr. Mollica, Baller’s regular veterinarian and a former AMC intern, was also very supportive. These two veterinarians really gave Tracy that extra oomph she needed to continue Baller’s treatment. Ms. Koch says, “I knew the chemo was working almost immediately. Right after his first treatment he was feeling better again. He is one to make it known when he has issues by hiding under the bed, not eating and not able to use the bathroom. But, it was amazing that right after his first treatment he was back to his normal routine. I thought it [the chemotherapy] would help a bit, but I didn’t realize how much better it would make him feel. He was like a whole new cat, which makes me sad because who knows how long he was feeling bad before he really started to show it.”

About one third of the way through his prescribed course of chemotherapy, and just when Baller’s cancer seemed to be in control, a roadblock obstructed the path to further cancer treatments; Tracy was laid off.

Buddy Fund Helps Out
This is where the Buddy Fund comes in to assist Tracy and Baller. The Buddy Fund, one of AMC’s Community Funds, was established to provide financial support for AMC patients with cancer whose owners could otherwise not afford to treat their four-footed family members. The name of the Buddy Fund has a double meaning. The original donors to the fund had a very special cat named Buddy and the fund acts as a “buddy” to owners of pets with cancer. Baller’s oncologist recommended him for the fund because he was responding exceptionally well to the prescribed course of chemotherapy. Discontinuation of treatment would put him at high risk for relapse of his cancer.

Thanks to the Buddy Fund and its generous supporters, Baller completed his chemotherapy protocol just before Thanksgiving and without missing a single treatment. At his most recent follow up appointment he was given a thumbs up because no tumors were detected during the examination. Going forward, Baller will continue to be monitored for tumor recurrence. As the one year anniversary of his diagnosis approaches, everyone has their fingers crossed for Baller. Tracy looks forward to a time when she is employed again and can be a “buddy” to another deserving cat through a contribution to AMC’s Buddy Fund.


Heart Healthy Tests for Pets

February 13, 2014

In addition to being National Pet Dental Health Month, February is American Heart Month. Veterinary patients suffer from heart disease, although coronary artery disease, which is common in people, doesn’t occur in dogs and cats. Even so, cardiologists at The Animal Medical Center use a variety of diagnostic tests to determine if their patients have heart problems requiring treatment.

Auscultation
The stethoscope has been around since the early 1800s when it was invented by French physician René Laennec. Every veterinarian has a stethoscope and they use their stethoscopes to determine the heart rate, heart rhythm and heart sounds. Abnormal heart sounds, also known as murmurs, may be “innocent” or of no concern. Innocent murmurs are most commonly heard in pediatric patients. In adult dogs and cats, the development of a heart murmur typically indicates leaky heart valves. If your veterinarian hears a heart murmur, consultation with a board certified veterinary cardiologist for additional testing may be recommended by your primary care veterinarian.

Electrocardiogram
An electrocardiogram measures the electrical impulses produced by the heart. The recording is a graphic representation of the heart’s rate and rhythm. The normal heart rate varies depending on whether your pet is a dog or cat. Cats have a higher heart rate than dogs, and small dogs tend to have a higher heart rate than large dogs. A normal heart beats regularly. Heartbeats that occur at irregular intervals, called an arrhythmia, indicate heart disease and often land a pet in the animal ICU for emergency treatment by a veterinary cardiologist to correct the abnormal rhythm. Pets with serious abnormal rhythms may be very weak, faint and in rare cases, die suddenly.

This chest x-ray of a cat shows an enlarged heart and fluffy white patches in the lungs typical of pulmonary edema.

This chest x-ray of a cat shows an enlarged heart and fluffy white patches in the lungs typical of pulmonary edema.

Chest X-rays
Radiographs or x-rays show the size of your pet’s heart and the surrounding lungs. Enlarged hearts can occur with diseases of the heart muscle or as a result of leaky heart valves. When the valves are extremely leaky or the heart muscle becomes very weak, heart failure occurs. Heart failure allows fluid to build up in the lungs. This buildup of fluid, called pulmonary edema, can be seen on an x-ray as fluffy white patches in the normally black lungs.

Echocardiogram
An echocardiogram uses sound waves to create a real-time moving image of the heart as it beats inside the chest. The sound waves are created and recorded via a probe placed on the chest over the heart. As the probe is moved, different parts of the heart come into view. The computer inside the echocardiography machine is able to precisely measure the thickness of the heart walls, the valves and measure the rate of blood flow throughout the heart given your pet’s cardiologist an exact measure of how well all components of the heart are functioning. An echocardiogram is used to diagnose nearly all forms of dog and cat heart disease, including the most common form of heart disease in dogs, leaky valves, and in cats, heart muscle disorders.

Brain Natiuretic Peptide (BNP)
If your veterinarian recommends a BNP test as part of a cardiac evaluation, she has not lost her mind. Although the name seems just plain wrong for a heart test, BNP is actually a small hormone produced by the heart. Production increases when the heart muscle is excessively stretched, as in cases of heart failure. Sometimes the clinical signs of heart failure overlap with the signs other diseases causing breathing difficulties, including heart failure and pneumonia. This blood test provides a non-invasive method to help differentiate between cardiac and non-cardiac causes of respiratory problems. This test is most useful when combined with the other tests mentioned previously.

What can you do to have a heart healthy pet?

  • Keep in mind no test is perfect. It may take a battery of tests to determine your pet’s cardiac condition.
  • Excessive coughing or breathing difficulty in your pet should be evaluated immediately by a veterinarian.
  • Packing on the pounds puts extra stress on the heart. Keep your pet in ideal condition.

Dog Breeds in the News

February 5, 2014

For pet lovers, there has been exciting news about dog breeds recently. In less than a month, the American Kennel Club (AKC) will introduce three new breeds at the upcoming Westminster Kennel Club (WKC) Dog Show in New York City. The WKC Show, February 8-11, 2014, will allow dogs of any breed or no breed at all to enter their new agility competition, which will be held on Saturday before the big show. Finally, both The Animal Medical Center and Pets Best Insurance announced their top ten dog breeds, based on the number of pets we care for and they insure.

rat terrier

Rat Terrier

Old Dogs, New Club
The Portuguese Podengo PequenoChinook and Rat Terrier are new only to the AKC dog show ring. One of the most ancient of dog breeds, the Portugese Podengo Pequeno, came to Portugal from Asia Minor around 1000 B.C. This lively hound is related to other ancient breeds such as the Pharaoh Hound and the Basenji. The Rat Terrier is a home grown breed developed early in the 19th century from European terriers imported by immigrants to the United States. The Chinook is another American breed, most famous as the State Dog of New Hampshire, where the breed was developed. For more on these new AKC breeds, listen to David Frei, the voice of Westminster, on NPR. 

And the Top Dog is…
A comparison of the top ten breeds seen at The AMC, insured by Pets Best Insurance and holding AKC registrations shows some interesting trends:

top 10 dog breeds 2013

The Labrador Retriever, Dachshund and Yorkshire Terrier made all three top ten lists. The mixed breed dog topped both The AMC and Pets Best lists. No surprise here, since AKC does not include mixed breed dogs in their registration. Also on two of the three lists were several small breed dogs, such as the Chihuahua, Shih Tzu and the Maltese Terrier, possibly influenced by the dogs of Paris Hilton or Halle Berry. The ever steady German Shepherd Dog and the much maligned Pit Bull Terrier also made two of the three lists. Unique to the AMC list were the Cavalier King Charles Spaniel and the Pomeranian, probably reflecting apartment dwellers selection of a small dog.

Seeing Fewer Spots
Breed popularity comes and goes with popular culture. The movie 101 Dalmations sparked a national craze for the spotted dogs. In 2005, the Dalmatian ranked number 47 in the list of dog breeds seen at The AMC. This past year, Dalmatians dropped in the ranking to 100 as dog owners fell in love with different breeds, for example the French Bulldog.

A Rising Star Among the Breeds
According to Pets Best Insurance, a number of breeds have gained popularity in recent years. In their database, the French Bulldog has seen the most dramatic rise. In 2006, the French Bulldog was the 55th most popular dog breed enrolled with Pets Best. By 2013, this small, muscular pooch soared up the list to become the 19th most popular breed. While Pets Best insures pets nationwide, The AMC’s New York City-based practice reflects the same meteoric rise in the popularity of the French Bulldog. In 2005, Frenchies ranked 30th and our veterinarians cared for 120 individual Frenchies. In 2013, the number of these dogs seen at The AMC has increased 2.5 times to 275 individual dogs.

See More Dog Breeds and Visit the AMC Booth
Like we do every year, The AMC will have a booth in the benching area of the WKC Show on February 10th and 11th. We would love to have you stop by and visit us. You can find us in Booth 16 at Piers 92/94, right alongside the Hudson River at 55th Street and 12th Avenue.

This year, AMC veterinarians have a new role at the 138th WKC show, that of Official Show Veterinarian. Several of our veterinarians will be on site at the Piers and Madison Square Garden, which showcases the main ring events, on both nights to triage any emergencies that could arise.

If you are not a fan of purebred dogs, this year there will be mixes, mutts and Heinz 57 type dogs at the Masters Agility Championship at the WKC Show.

We hope to see you all there!


Dental DOs and DON’Ts

January 31, 2014

dog having teeth brushedBecause February is National Pet Dental Health Month, I spoke to all three of The AMC’s veterinary dentists to get a list of dental DOs and DON’Ts for my readers. A big shout-out to Drs. Dan CarmichaelDjango Martel and Stephen Riback for their help in compiling this list.

Dental DON’Ts – Bones, doggie breath and furry tennis balls
Our three dentists spend much of their time repairing fractured teeth. They blame hard nylon “bones” as a major cause of fractured teeth in dogs. According to Dr. Riback, “Any bone you think might break your tooth if you bit down on it is not one you should give to your dog.”

Don’t tolerate doggie breath in your dog (or cat). Bad breath in your Bassett, Bichon or Burmese is not normal and is very likely a sign of periodontal disease. Stinky breath in your pet means it’s time to schedule a dental cleaning with your pet’s veterinarian.

Although tennis balls are on your dog’s DO list, the tennis ball fur is very abrasive to teeth, making furry tennis balls a DON’T in the mind of veterinary dentists.

Dental DOs – Toothbrushing, VOHC, dental cleaning with anesthesia
Topping the list of dental DOs is daily toothbrushing for your dog and cat. If your pet won’t tolerate brushing, you can use special dental wipes to clean the teeth. DO select oral hygiene products like toothpaste, tartar reducing diets and treats based on the products recommended by the Veterinary Oral Health Council (VOHC).

DO choose tartar control products and dental wipes containing hexametaphosphate, a product that research has shown to decrease tartar buildup on teeth.

The final DO is to make a call now for an appointment to see your pet’s veterinarian to discuss a complete dental cleaning while your pet is under general anesthesia.

Veterinary Dental Resources

Follow @amcny on Twitter to be a part of our National Pet Dental Health Month #TweetTooth campaign to promote healthy pet dental hygiene!


Pot for Pets

January 21, 2014
pot for pets image

Photo: Fox News

The New York Times recently announced that via executive action, New York Governor Andrew Cuomo will relax the laws governing medical marijuana use in the state. New York State has some of the most restrictive and punitive laws regarding illegal drug usage, hold-overs from the Rockefeller era drug laws of the 1970s, and many feel these changes are long overdue. What does this mean for pets?

Increased Toxicity Cases
Veterinarians in New York State will need to be prepared to treat more dogs with marijuana intoxication if the experience in Colorado holds true here. Colorado is a state where medical marijuana is legal. Veterinarians in Colorado studied the number of dogs experiencing inadvertent toxicity from ingestion of marijuana. These researchers found a four-fold increase in the number of dogs treated for marijuana ingestion over a five year period. The increase paralleled the increase in the number of registered users of medical marijuana in Colorado. Pet Poison Helpline reports an increase in calls about canine marijuana intoxication as well.

Dog OD
Ingestion of marijuana, marijuana containing foods or inhalation of marijuana smoke can affect dogs; they become glassy eyed, uncoordinated, and may be very sleepy. These dogs need intravenous fluids to maintain hydration and warming blankets to maintain their body temperature. Often, dogs intoxicated by marijuana dribble urine. Some dogs become hyperactive. Severely affected dogs may seizure or become comatose requiring ventilator treatment until they regain the ability to breathe. Dogs typically recover in one to three days. Sadly, the study of Colorado cases of marijuana reports the death of two dogs ingesting baked goods made with medical grade tetrahydrocannabinol (THC) butter.

Iguana Intoxication!
Although dogs are the most commonly affected by marijuana intoxication, I found a report of three intoxicated iguanas. The iguanas had clinical signs similar to intoxicated dogs – seizures, stomach upset and one even required antiseizure medication. All three recovered fully.

Veterinary Medical Marijuana
So with marijuana legalized in some states for medicinal purposes, is medical marijuana for Fluffy and Fido next? Despite the obvious risks outlined above, some pet owners have taken marijuana for pets into their own hands.

Currently marijuana belongs to the group of drugs most tightly regulated by the Food and Drug Administration. Even though I have a license to prescribe some controlled substances, marijuana is not on the list of those I can prescribe. This tight regulation also restricts research with marijuana. Research is needed to help veterinarians understand what conditions the drug helps and how to use the drug safely and efficaciously in veterinary patients. So for now, I don’t know how to appropriately dose THC in my patients and I can’t do it legally.

If your pet inadvertently ingests marijuana or a THC containing product:

1. Keep marijuana and medical marijuana products out of reach of your pets.

2. Call animal poison control if you think your pet has eaten marijuana:

  • ASPCA Animal Poison Control (888) 426-4435
  • Pet Poison Helpline (800) 213-6680

3. Tell the animal ER what your pet ate. Making the ER veterinarians play a guessing game about your pet’s condition can delay appropriate treatment.


AMC Resident Research Abstract Presentations

January 15, 2014

veterinary researchJust before Christmas, The Animal Medical Center held its annual residents research abstract presentations. As part of their specialty training, residents are expected to design, execute and report on research in their area of clinical specialty, and this mini-conference provided a forum for exchange of the knowledge gained from research between members of The AMC medical staff. The AMC performs a very specific type of research – clinical research. This means we study diagnostic testing, new treatments and procedures in the patients we care for as part of our effort to improve the health and well-being of our patients. We do not test or treat any animal for the sake of “research.”

Caspary Research Institute
Research at The AMC is not new; when The AMC moved uptown in the 1960’s from Lafayette Street to its present location, a decision was made to locate the new veterinary research institute right in the middle of the Upper East Side’s strong human-focused biomedical community. The AMC became the fifth biomedical institution in the neighborhood, joining The Rockefeller University, Cornell University Medical College, Sloan-Kettering Institute and Memorial Hospital for Cancer and Allied Diseases. Early architectural drawings of the AMC building show a sign on the north side of the building saying, “Caspary Research Institute.” When The AMC opened on 62nd Street, research and patient care were its main focus areas.

Short and Sweet
From a research point of view, an abstract is a very short presentation – 12 minutes, followed by a 3 minute question and answer period. Resident research abstract presentations are commonly preliminary reports which allow discussion of data and help formulate the interpretation of results prior to the writing of a manuscript for publication. Because the information presented was preliminary, I have a few interesting tidbits to report.

Lookalike Medicines
One study evaluated treatment of cognitive dysfunction in dogs with an anti-seizure medication compared to dogs treated with a placebo. In order to help veterinarians and owners make an unbiased assessment of patient response to the actual medication, our colleagues at Best Pet Rx Pharmacy made every dog’s medication look exactly the same. No one could tell which dogs were getting the medication being studied and which dogs were getting placebo pills. This is called double blind study design. Double blind because two people, the patient and the researcher, don’t know the treatment group assignment because it is hidden by the look-a-like pills.

Challenge of Science
Most research projects do not proceed exactly as planned. A study of ICU patients was designed to follow the effects of treatment on dogs with low blood protein (hypoalbuminemia). Dogs were to have a blood sample prior to treatment and 48 hours later. The study did not meet the enrollment target. Why? Despite an impression that dogs stayed in ICU longer than 48 hours, most dogs did not stay that long and fewer dogs than projected entered the study. Of course, we were happy your dogs went home earlier than expected, which was a scientific finding on its own.

Changing Protocol
The AMC’s ICU patients often need to be fed intravenously. We use a commercially available product called Procalamine. This product provides amino acids, the building blocks of protein and glycerin, as a source of glucose for energy. One emergency critical care resident studied patients receiving Procalamine as part of their treatment protocol. Patients receiving Procalamine through a catheter in their leg had more inflammation of the blood vessel than patients who get Procalamine through other, larger blood vessels. Although the directions for Procalamine indicate it can be given in the legs, we now will try and avoid this whenever the patient’s condition allows it.

Helping Pets Everywhere
These types of studies enable AMC veterinarians to improve the level of care for your pet. Through the publications that will result from these and other studies performed here, the knowledge will improve the care of pets everywhere.


CT Versus MRI: Battle of the Big Machines

January 8, 2014

Veterinarians at The Animal Medical Center depend on high tech equipment to make diagnoses and monitor treatment success. Two commonly used pieces of high tech equipment are the CAT scan or CT (Computed Tomography) and MRI (Magnetic Resonance Imaging). Often, if I recommend a CT, pet owners will ask if an MRI would be better. I checked with one of AMC’s board certified radiologists, Dr. Anthony Fischetti, to help dispel any myths about which test is the best. He says “both are equally as good, but which test is used depends on the body part being imaged and the type of resolution required to optimally image that body part.”

Big Machines at AMC
Computed tomography was introduced to human medicine in the 1970s. The AMC acquired its first CT scanner about 10 years later and is currently using its third scanner, a high-powered 64-slice CT scanner. Magnetic resonance imaging became commercially available in the 1980s and The AMC installed its first MRI machine in 2002 and upgraded that machine in 2006 for a more powerful model. To give you a comparison of the frequency of use of these tests, in 2007, a total of 73 million CT scans were performed on humans. In 2013, 700 CT scans and 600 MRI exams were performed – just at The AMC!

CT reconstruction of the skull of a dog with a jaw tumor

CT reconstruction of the skull of a dog with a jaw tumor

Starting at the Top
Imaging the head is a particularly good example of why we need both a CT scanner and an MRI machine at The AMC. The brain is composed of soft tissue and the boney skull is clearly hard tissue. When our neurologists want an image of the brain to determine the cause of seizures, they choose an MRI because it produces images with exquisite detail of soft tissues comprising the brain. An MRI can show minute changes in both types of brain tissue, the grey and white matter. But if an internal medicine specialist suspects the cause of a bloody nose to be a tumor in the nasal passages, they choose a CT scan, not only for its speed, but for its ability to show changes in the bones composing the nose and nasal passages. Because computed tomography is part computer, the images it creates are easily manipulated into a variety of views and even three dimensional reconstructions. The image you see to the right shows a reconstruction of the skull of a dog with a jaw tumor.

CT Goes with the Flow
CT scan is a form of x-ray and can detect a special contrast agent when the agent is administered intravenously. Using an intravenous contrast agent during a CT scan (CT angiography) helps veterinarians identify abnormal blood vessels in the liver – a common congenital disorder in small breed dogs – or determine, prior to surgery, if a tumor has breached a major blood vessel. Armed with this information, surgeons can better plan their approach before they get to the operating room.

MRI image of a  heart tumor in a dog using a contrast agent

MRI image of a heart tumor in a dog using a contrast agent

MRI has a Heart
MRI also uses intravenous contrast agents to differentiate various soft tissues in the body. The MRI image you see on the right shows a tumor of the heart in a dog following administration of a contrast agent.

Your Pet and the Big Machines
Here are some tips for pet owners whose pets require a CT scan or MRI:

  1. Expect blood tests and possibly a chest x-ray to be done before the scan. Testing helps veterinarians determine safe anesthetic protocols for your pet.
  2. Unlike when you or I receive an MRI or CT scan, you should anticipate that anesthesia will be administered to your pet. You know how hard it is to get a clear photograph of your wiggly pet. We need them to be perfectly still for imaging so that we can obtain an accurate scan.
  3. Know that it may take up to 24 hours for the radiologist to issue a final report on the scan. Waiting is hard, but reviewing images takes time and should not be rushed.

The Year in Veterinary Medicine

December 31, 2013

year-in-review-revisedAs 2013 comes to a close, we have put together a review of some of the interesting veterinary and animal-related highlights of the past year. We hope some of these tidbits will bring a smile to your face, a tear to your eye or spark some conversation at a holiday party.

January
Several articles reported the veterinary profession turned 150 years old in 2013. A misnomer in reporting, it was the American Veterinary Medical Association which turned 150 years old, celebrating with a traveling Smithsonian exhibition and a commemorative book. (Cavalry horses during Roman times were cared for by practitioners known as veterinarii, suggesting the profession has existed for much longer than 150 years!)

February
The Animal Medical Center created AMC TO THE RESCUE, a new fund to support specialist level treatment of pets that are currently under the care of rescue groups. The goal of the fund is to use AMC specialists to treat correctable medical conditions, making pets, like Frankie, more adoptable into a forever home.

March
In a year without much bipartisan cooperation, two veterinarians, Kurt Schrader, a Democrat, and Ted Yoho, a Republican, joined forces to increase awareness of the role veterinary medicine plays in research, public health, animal health and welfare, food safety, and the economy.

April
Starting in April, therapy dogs were almost continuously in the news. They arrived in Boston to comfort survivors of the Boston Marathon bombing. Later in the month, therapy dogs were called to Texas in the aftermath of a fertilizer plant explosion. Finally, therapy dogs took up residence at LAX to de-stress airline passengers.

May
If April was for dogs, then May was for cats. The Cannes Film Festival is always newsworthy, but this year not because of a Hollywood starlet, but because of a small ginger tom cat who starred in the Coen brothers’ film, Inside Llewyn Davis. Tama, a Japanese calico cat, was credited with saving a cat-themed train station from closure.

June
Therapy dogs made the news again in Michigan for supporting anxious victims of violent crimes during courtroom testimony.

July
Veterinarian Dr. Ernie Ward sits in a hot car with the window cracked for 30 minutes while the temperature climbs to 116 degrees Fahrenheit to demonstrate how dangerous leaving your dog in a parked car can be.

August
Cat DNA, sent to the Veterinary Genetics Laboratory at the University of California, Davis, became key evidence used in a 2012 British murder case. Scientists in the lab identified the hairs on fabric wrapping the body as coming from the murderer’s cat.

September
News of a new and potentially lethal dog virus spread like a contagion on the Internet. But by late fall, veterinary researchers determined circovirus was not a significant threat to canine health.

October
One of the most visible victims of the government shutdown was the National Zoo’s Panda Cam. Sixteen days later when the camera again rolled, one tweet rejoiced that “our long national nightmare is over.”

The Urban Resource Institute (URI) and Purina teamed up to support victims of domestic violence through URIPALS, New York City’s first initiative to allow victims of domestic violence to enter shelters with their pets. Purina donated much-needed welcome kits and educational materials for families entering URI’s largest domestic violence shelter.

November
The Animal Medical Center hosted the Third Annual Zoobiquity Conference, along with UCLA and the Wildlife Conservation Society. The Conference explored the diagnosis and treatment of disease from the perspective of both physicians and veterinarians.

December
Rosie and Clarence, the first two official police comfort dogs, were honored at The AMC’s annual Top Dog Gala. These canine officers received the Top Dog Award for their support of first responders at critical incidents and traumatic events, including the aftermath of the Sandy Hook Elementary School tragedy and the Boston Marathon bombing.

…and, we “Pawse to Remember”
No end of the year retrospective would be complete without acknowledging the passing of those who led notable lives:

  • Tuxedo Stan, former Halifax, Nova Scotia mayoral candidate.
  • Kaiser, a World Trade Center search and rescue dog and 2011 AMC Top Dog Gala honoree.
  • George, who held the Guinness Book of World Record’s title of tallest dog.
  • Barney Bush, the AP reporter-biting former FDOTUS.
  • Brian Griffin, canine family member on Family Guy.

Wishing you and your families the very best this holiday season and a healthy and prosperous New Year!


Seeing Christmas for the First Time

December 23, 2013
Frankie

Frankie after surgery. His eyes are only closed due to the camera flash :)

Kittens are born with their eyes closed and about 10-14 days after birth the lids open. The eyelids of Frankie, the handsome orange tiger cat pictured here, opened on schedule, but something was wrong. His upper eyelids had not formed correctly.

Are eyelids important?
You probably don’t think much about your eyelids, but they are critical components of good vision. Without functional eyelids, our eyes would become very dry since with each blink, the lids move the tears across the eyeball keeping it moist. The tear film over the eye improves visual acuity. The eyelid also forms a protective cover over the delicate eyeball, which keeps dirt and foreign material out.

AMC TO THE RESCUE
Because of his misshapen eyelids, Frankie could not see well and was uncomfortable because the fur on the lids scraped against his delicate eyeball. Because of his disability, Frankie was taken in by Last Hope Animal Rescue and Rehabilitation in Wantagh, NY. The kind folks at Last Hope knew about AMC TO THE RESCUE, a community fund through which specialized healthcare is provided by AMC’s board certified specialists to increase a rescue animal’s chances of finding a ‘forever home.’

New eyelids
A volunteer from Last Hope brought 10 week old Frankie to see Dr. Alexandra van der Woerdt, AMC’s board certified ophthalmologist. She concurred with the diagnosis and recommended eyelid reconstruction once Frankie had grown a bit more. Eight weeks later, Dr. van der Woerdt employed a microsurgery technique to transplant part of Frankie’s lip margin to create new upper eyelids. Surgery was a great success and Frankie was discharged with several tubes of eye ointment and yes, the cone of shame!

Almost as good as new eyelids, a forever home
As soon as he came to Last Hope, Frankie’s photo was posted on their website. To Allison, he looked exactly like the special needs cat she had dreamt about the night before. After work, she and her daughter went to Last Hope to adopt Frankie, but found he was not yet available for adoption. The Last Hope staff allowed Allison to hold Frankie and in a minute, she felt an immediate bond to this tiny creature. Allison’s home became Frankie’s foster home throughout his surgery and recovery. Allison applied ointments to his eyes and warm compresses to his healing lids. When the ok for adoption came, he stayed on at Allison’s, joining another orange boy and a tuxedo in his forever home.

So this Christmas, Frankie will be able to see the twinkling lights and sparkling ornaments on the tree, thanks to the hard work of his rescue group, the skill of his ophthalmologist and the generosity of those who financially support AMC TO THE RESCUE. Because he knows he was given the gift of sight, Frankie has promised not to touch a single glass ball or a china snowflake on the tree. Frankie is just going to look and enjoy seeing Christmas for the first time.

For those with less perfectly behaved cats than Frankie, we suggest you cat proof your Christmas tree.


Clea’s International Healthcare Team: Partnering for Cancer Care

December 18, 2013
Clea

Clea, French fashionista poodle

Last spring, I was contacted by a New York City veterinarian who often refers patients to me for second opinions. This time, his request was a bit different. One of his patients, a French poodle named Clea, was in France and had been diagnosed with melanoma of the tongue by a French veterinary oral surgeon. Clea’s owner wanted her treated with the DNA melanoma vaccine, a treatment not available in France. She and Clea would return to New York City, but she needed a local veterinary oncologist, so I was asked to help. Of course, I said yes.

Transatlantic medical information
Within minutes of saying yes, my email box filled with photos of Clea’s tumor, a biopsy report and photographs of the actual tumor cells under the microscope. Clea’s owner contacted me and arranged two appointments for Clea, one with me and one with our radiation oncologist, Dr. Rachel St-Vincent.

Treatment of melanoma of the oral cavity in a dog involves controlling the oral tumor using surgery or radiation therapy and using a vaccine to induce an immune response against the tumor in hopes of preventing spread of the tumor, especially to the lungs. The vaccine is not available in France, necessitating a trip home for the melanoma vaccine. Clea stayed with friends for eight weeks while she received four treatments of radiation and four doses of melanoma vaccine. When treatment was completed, she returned to France and her French veterinary team.

The French team

Clea's veterinary team

Clea’s veterinary team at Clinique Vétérinaire Advetia (www.advetia.fr)

Even though Clea has both an American and a French team of veterinarians, we all speak the same language – veterinary medicine. The French oral surgeon, Dr. Phillipe Hennet, trained in the United States and holds a certification by the American Veterinary Dental College. When new tumors showed up in Clea’s lungs, he referred Clea to an American trained board certified small animal internal medicine specialist at his clinic, Dr. Suzy Valentin. She and I conferred via email to initiate the next step of treatment.

Back in the USA
Clea was back in New York City a few weeks ago and Dr. Valentin wanted another chest x-ray. Clea arrived at The AMC with a report by a French radiologist (in French) and a CD containing her lung CT scan from a month prior. The AMC has a radiologist, Dr. Alexandre Le Rouxwho happens to be French. Looking for a translator, I took the written report and the images to him. To my surprise, the trail of veterinarians caring for Clea came full circle when Dr. Le Roux announced he knew Clea’s French radiologist!

Treatment success
For older pets like Clea, quality of life is possibly more important than quantity. I think Clea’s international healthcare team has achieved success based on this note from her owner: “So Clea is doing well. She is eating twice a day and loves the beef stew from the restaurant across the street. Dog food is definitely part of her past….”


Holiday Gifts for the Naughty and Nice Pets on Your List

December 11, 2013

cat bunk bedA room with a view
What kitten wouldn’t want to find a bunk bed and playroom under the tree with her name on it? The top bunk is perfect for a perching cat or a cat nap, and the bottom bunk for a game of hide-and-seek with a catnip mouse or jingle ball.

Put some socks in his stocking
Do you have a nice, but mobility-impaired older dog? Put Woodrow Wear Power Paws on all four feet and watch these gripper slippers give traction on slippery tile or wood floors. These stylish dog socks come in a rainbow of colors and holiday designs.

Cat walking vest
Going to Grandma’s for the holiday? In addition to checking to be sure Fluffy’s microchip information is current in the registry, consider a SturdiPet™ walking vest from Sturdi Products. It is attractive and snug fitting and unlike many harnesses for cats, this one really stays on and keeps your cat comfortably restrained while you travel in the car or on the airplane to your holiday destination.

Waist watching
The peek-a-boo pet latch is a gift for your naughty dog. Using this latch on the door of the room where you keep the cat litter box will keep your dog from “snacking” in the cat box. The other use for this clever product is to keep an overweight pet out of the food bowl of a more slender pet.

Holiday hairdo
Everyone, your pet included, wants to look their best and smell nice to ring in 2014. What better way to have a coat that shines like the Times Square ball than to have a gift of dog toiletries under the tree for Sparky. Burt’s Bees, the folks with the beeswax based lip balm, now have a new line of natural pet products. Additionally, Wahl, the sponsors of America’s Dirtiest Dog contest, has cleaned up shelter dogs and can clean up your dog as well!

Rest and relaxation
After all the holiday activities, you and your pet will need some rest. Body Glove Pet will introduce a neoprene mat for use in crates or on hard floors, just after the first of the year. Neoprene is the material in wetsuits, so this product will be sturdy, washable and comfortable for a long winter’s rest.

And something for you too!
Need a calendar for 2014 and want to support a good animal cause? Here are just a few listings of calendars from a variety of animal organizations, including The Animal Medical Center!


Neutering: Not Just Doggie Birth Control

December 4, 2013

dog at vetDexter, a new dachshund patient of mine, was in last week for another round of puppy shots. He will soon be six months old and it was time for me to discuss the next step in his preventive health care plan: neutering.

Neutering meets the guidelines
The American Veterinary Medical Association has developed guidelines for responsible pet ownership. One of the guidelines obligates pet owners to control their pet’s reproduction through spaying and neutering; subsequently helping to control pet overpopulation in their community. Neutering is the common term for castration of a male dog or cat and spaying refers to removal of the ovaries and uterus, or in some cases just the uterus or ovaries, of a female pet.

Lifesaving responsibility
Pet overpopulation is a serious issue in the United States today. According to the Humane Society of the United States, over four million unwanted pets are destroyed annually. For every puppy or kitten prevented by neutering an adult pet, there is one less homeless and unwanted puppy or kitten euthanized in an animal shelter.

The traditional surgery
Surgical removal of the testicles is the current standard of care for neutering in both dogs and cats. This surgery renders a male dog or cat unable to reproduce and also removes the major source of the male hormone, testosterone. Removing the source of testosterone eliminates mating behavior in males and also plays a role in eliminating other unwanted behaviors. In both the dog and cat, neutering involves a small skin incision through which the testicles are removed. Cats typically go home the same day, but dogs may stay overnight to recover from anesthesia and for incisional monitoring.

A new method
The New York Times Well Blog recently reported on a new method of non-surgical, chemical castration, called Zeuterin. Zeuterin neutering uses zinc gluconate and arginine injected into a dog’s testicles as a less invasive method of castration. Dogs still produce a small amount of testosterone, but are unable to sire a litter of puppies. Veterinarians must be trained to use the Zeuterin method of neutering, but especially for shelters and rescue groups, the method has great appeal.

My recommendation
Dexter’s owners were concerned about the surgery. They asked if he could just have a vasectomy instead of the traditional neutering surgery. Because my job is to make the best medical recommendations for the specific health concerns of each of one my patients, I recommended the traditional surgery for Dexter. It provides him with the greatest number of health benefits. The surgery prevents unwanted litters of puppies and also prevents prostatic disease, testosterone-induced tumors and behaviors linked to testosterone production. Because a vasectomy or Zeuterin neutering are methods of birth control only, they do not offer the added advantage of decreased levels of testosterone on behavior and disease.


World AIDS Day 2013: Pet Ownership and AIDS Patients

November 27, 2013

World AIDS Day LogoThis Sunday, December 1 is World AIDS Day. This special day is an opportunity for people worldwide to unite in the fight against HIV, show their support for people living with HIV and to commemorate people who have died from the disease. World AIDS Day became the first ever global health day, with the first one held in 1988. Since we at The AMC are all about pets, today’s blog focuses on pet ownership for immunocompromised individuals such as AIDS patients.

Pets are “pawsitive”
AIDS patients and indeed all immunocompromised patients are at greater risk for acquiring infections from their pets. Yet, many believe the positive benefits of pet ownership outweigh the risks of infection. The health benefits of pet ownership are well known. People with pets exercise more, especially those with dogs. Pets lower your blood pressure and speed recovery from cardiovascular disease. Pets also increase human social interactions and decrease feelings of isolation in pet owners.

In a 2008 article, Dr. Russell Steele, a specialist in infectious diseases at the Ochsner Clinic in New Orleans, asks and answers the question “Should immunocompromised patients have pets?” Since his answer to the question is yes, Dr. Steele recommends a two pronged approach to pet ownership for immunocompromised individuals:

  1. Careful selection of the pet
  2. Frequent health monitoring of pets

Pet selection

  • Choose an adult pet with a known health history. Puppies, kittens and pets without any health information are more likely to pose a risk for infectious diseases such as Campylobacter diarrhea or bite injuries.
  • Select an indoor pet. Indoor pets have less exposure to wild animals and other sources of infectious diseases.
  • Choose a cat that tests negative for feline leukemia virus and feline immunodeficiency virus. Since these are the feline versions of AIDS, infected cats may harbor infections which can be transmitted to humans. 
  • Avoid pet birds, reptiles and rodents. These make wonderful pets for some, but the diseases they can transmit to immunocompromised patients cannot be prevented by vaccination like many of the diseases transmitted by dogs and cats. 

Healthcare and monitoring

  • Tell your veterinarian about your immunocompromised status. Details are not important. Just knowing a patient is immunocompromised is enough for me to better manage your pet’s healthcare.
  • If your pet is not neutered, talk to your veterinarian about neutering. Neutered pets are less likely to roam and bring home infectious diseases.
  • Have your pet examined by a veterinarian at least once a year.
  • Follow your veterinarian’s recommendation regarding vaccinations and fecal analysis.
  • Ask about preventive medications to keep yourself and your pet free from diseases transmitted by fleas and ticks.
  • Feed a cooked diet. Raw pet food may contain microorganisms which can make you and your pet sick.

For more information about keeping yourself healthy if you have a pet, read the Centers for Disease Control’s FAQ on pets and HIV/AIDS. Note the first line of this document says “You do not have to give up your pet.”


Flu Season 2013 is Upon Us

November 20, 2013

sick dogInfluenza was in the news and on my mind last week. First a new strain of avian influenza was reported to have infected humans. Then, I got my annual flu shot and finally reader comments on an article about canine influenza clearly showed the article was misconstrued by its readers, making me think it was time to write the hard facts about influenza.

Not like avian influenza
Canine influenza is significantly different than avian influenza. Compared to avian influenza virus, the canine influenza virus is relatively new. It was identified in 2004 by researchers in Florida who were studying an outbreak of respiratory disease and pneumonia in greyhounds. Based on research published, the virus appears to have emerged in racing greyhounds in approximately 1999. Subsequently, all dogs, greyhound or not, have been shown to be susceptible to infection by the canine influenza virus. But don’t worry, Fido’s virus does not appear to affect you or the family parrot.

Not like human influenza
Canine influenza is also very different than the human flu virus. I (and millions of other Americans) get a flu shot in the fall because flu infections predictably spike in the fall and peter out in the spring, only to return again in the fall. Canine influenza is non-seasonal, occurring anytime of the year. Check with your veterinarian to see if your dog is at risk for the flu and should be vaccinated against it.

Flu virus similarities
Flu viruses are usually contagious and spread rapidly in a susceptible population. Children typically bring the flu home from school and infect their parents. Dogs tend to contract the flu in places where there are many dogs in close contact. In a dog’s world, places of close contact include puppy kindergarten, dog parks, doggie day care, shelters and boarding kennels. If your dog visits any of these types of facilities, check on their vaccination policy.

We cover our face when we sneeze to protect others from our viruses and we wash our hands to prevent transmitting viruses on door knobs and other surfaces. As clever as dogs are, they do neither of these things to prevent transmitting canine influenza to their dog friends. If your dog is coughing or sneezing, keep her away from other dogs until your veterinarian gives the all clear sign.

Be flu safe
Right now, flu activity is low in the United States. To keep track of human flu, check the Centers for Disease Control’s flu map.

Get your flu shot today! If you are sick, who will take care of your dog or cat?


Is My Pet Sick or Just Getting Older?

November 15, 2013
senior dog

Photo: seniordogcareproducts.com

As our pets get older, we expect them to slow down as part of the aging process, but how much slowing down is too much? What signs should pet owners watch out for in their senior pets that may suggest there is more going on than simply normal aging?

What qualifies a pet as a senior pet?
Senior pets can loosely be defined as those in the last 25% of their anticipated lifespan for their species and breed. For example, a cat expected to live 15 years would be considered senior at 11 years of age. What that means to dog and cat owners is 9-11 years of age is the start of your pet’s senior years. One notable exception is giant breeds of dogs who are considered senior a year or two earlier.

Slow motion
Many pet owners assume their pet is slowing down because it is older. Since aging is associated with a variety of illnesses, if you have a senior pet who seems to be slowing down, take him for a complete physical examination. Your pet can’t tell you their joints hurt from arthritis, but your veterinarian can. Never give your dog or cat your arthritis medication as these drugs are extremely toxic to pets. There are medications that can help make your arthritic pet more comfortable and kick their activity level back up a notch.

Forgetfulness
Another behavior change incorrectly attributed to aging is loss of housebreaking/litterbox use. Older cats are especially prone to developing kidney problems, and the accompanying increase in urine production. Couple an increase in urine production with creaky joints that don’t move so well anymore and your cat may act as if he has forgotten where to find the litter box. Placing litterboxes conveniently near your cat’s favorite perch will help overcome this problem. Some creaky cats can no longer climb over the edge of the litter box and will “go” right outside the litterbox. Substituting a box with lower sides or a cut out for easy entry will often resolve this situation. Diabetes and urinary tract infections will also cause what appears to be a loss of housebreaking. All of these reasons may contribute to a lack of litter box use, but the reason may be as simple as not changing the litter often enough to your cat’s liking.

Cognitive dysfunction syndrome
A syndrome is a collection of clinical signs that commonly occur together. Once your veterinarian has determined an illness is not causing your pet to slow down, cognitive dysfunction syndrome (CDS) will be considered. CDS in a decline in brain function in the aging dog exemplified by behavior changes. Dogs with CDS may stand in one place more often, greet the owners less often and have accidents in the house. At the recent Zoobiquity 3 Conference in New York City, Dr. Chad West, one of The AMC’s board certified neurologists, discussed a case of CDS in a dog. The MRI findings in the dog were strikingly similar to the second most common cause of dementia in humans, vascular dementia.

Keeping your pets young
Sadly, there is no fountain of youth for either you or your pet, but there are things pet owners can do to keep their favorite fur baby around as long as possible.

  • Don’t assume changes in your pet’s behavior, activity or appetite are “just old age.” Bring these changes to the attention of your veterinarian.
  • Take your pet for regular veterinary check-ups. The current guidelines recommend annual visits for younger pets and more frequent visits as your pet ages. Early detection of disease can mean all the difference in extending the life of your pet.
  • Keep your pet mentally and physically active. Use feeding toys to challenge your pet to “hunt” for her food. Consider low impact exercises for your dog, such as swimming. Exercise your dog or cat on a regular basis.

Cleaning Up America’s Dirtiest Dog

October 29, 2013
Darcy, 2012 Winner of Wahl's Dirty Dog Contest

Darcy, 2012 Winner of Wahl’s Dirty Dog Contest. Photo courtesy of Wahl.

Last week I got a telephone call from someone asking a novel question: “Is my own dry shampoo safe for my pet?”

My initial reaction was that it sounded ok, but I knew I had to investigate the list of ingredients in dry shampoos. I found there are a wide variety of dry shampoos – some powder based and some aerosol. I would be willing to bet all cats and most dogs would not be happy about being “shampooed” with the aerosol variety and I made a mental note to find some powdered dry shampoos to check on ingredients.

Top ranked dry shampoos for people
Next, I looked at a Vogue ranking of dry shampoos and every one was in a spray bottle! It was impossible to find the ingredients and one product actually said the ingredients were subject change at any time! As a pet owner, that didn’t give me much confidence regarding dry shampoo safety for my pet. Another dry shampoo contained a list of chemicals worthy of the answers on a multiple choice AP chemistry test. Thinking rationally, human dry shampoos are not made to be ingested, and I guarantee you if you put them on your pet they will be! In the end, I cannot recommend human dry shampoos for pets.

Emergency pet shampooing
If you need a clean pet in an emergency situation – your dog smells and you have dinner guests on the way or the cat looks greasy and you have a big date in one hour – I suggest opening the kitchen cabinet. Dry shampoos work by absorbing the oils from your hair. A sprinkle or two of corn starch on your dog, followed by vigorous brushing, may do the trick. No corn starch? Open the bathroom cabinet and try some baby powder on your cat. Keep both cornstarch and baby powder out of your pet’s eyes and nose.

For the do-it-yourselfers, here is a link to a homemade dry shampoo made with all safe ingredients. I find lavender oil included in this recipe to be very calming for dogs who are anxious in the exam room.

Stock your pet cabinet
The easiest solution to getting your pet clean and fresh without a tub bath is to keep a pet-safe dry or waterless shampoo on hand. The Wahl product line is one I use in the clinic to spot clean my messier patients – both dogs and cats.

A quick internet search located many other commercially available dry shampoos made specifically for pets.

Dirty dog search
Got a photo of your dirty dog? Wahl and Petfinder Foundation are sponsoring a contest to find American’s dirtiest dog. Enter your dirty dog photo and you could win a year’s supply of Wahl pet grooming products, a $100 gift card, plus $5,000 and grooming supplies awarded to the animal shelter or rescue group of your choice. Now you and your dirty dog can help America’s shelter pets become clean, happy and more adoptable. Photos must be entered by October 31st.

Wahl photo contest


Lung Disease with a Twist

October 23, 2013
Muneca

Muneca

“I’m sorry, but you need to take your dog to see a cancer specialist.” These are words no pet owner wants to hear, but despite their anguish about their beloved dog’s illness, Muneca’s (a name which means “pretty baby doll” in Spanish) family followed the recommendation of their primary care and emergency room veterinarians and brought the little poodle to be examined by the Oncology Service at The Animal Medical Center. This photo shows what a happy dog she was before her illness.

Muneca’s story starts with a trip to her primary care veterinarian who, using an x-ray, discovered that fluid was accumulating around her lungs. Shortly after seeing her primary care veterinarian, Muneca’s appetite decreased and she had trouble breathing, so she was brought to the to the ER by her owners.

Emergency room visit
The ER doctors found Muneca had a blue tongue. She was not getting any oxygen into her bloodstream because the fluid surrounding her lungs prevented them from expanding. Carefully, the ER doctors administered a light sedative to allow nearly one liter of bloody fluid to be removed from around the lungs of this 25 pound tan poodle. Immediately she was her old self, but the ER doctors again recommended Muneca be examined by an oncologist.

A new diagnosis
Although cancer is a very common cause of fluid accumulation around the lungs, there are other causes. When I saw Muneca, another x-ray was taken to determine if the fluid had returned since it had been removed by the ER doctors. The fluid had returned, but when Dr. Anthony Fischetti, one of The AMC’s board certified radiologists, reviewed the new films with me, he saw something that intrigued him – bubbles of air trapped within the right middle lung lobe. Immediately he became optimistic that Muneca could be saved! The diagnosis was revised to lung lobe torsion.

A lung lobe torsion is a rare disorder seen in dogs, cats and humans. The lung lobe twists around the bronchus, or air tube, and the blood vessels supplying the lung. This traps air and blood in the lung lobe, explaining the bubbles seen on the x-ray and the accumulation of fluid around the lungs. Fluid leaks out of the lung because the blood cannot exit though the twisted vessels.

Muneca recovering after surgery

Muneca recovering after surgery

Major surgery
The treatment for a lung lobe torsion is surgery to remove the twisted lung lobe, but this is a major procedure. In Muneca’s case, The AMC provided more than just the diagnostic and surgical expertise. One of our Community Funds, the Patient Assistance Fund, covered the majority of the cost for Muneca’s surgery. Muneca’s surgeon, Dr. Janet Kovak, entered Muneca’s chest on the right side between the third and fourth ribs and removed the right middle lung lobe, which was swollen and adhered to the diaphragm. Muneca recovered rapidly and was discharged from the hospital to her happy and grateful family two days later. In the second photograph, you see her completely recovered and resting at home in her favorite spot.

A winning team
Muneca is just one patient example of why I love working at The AMC – it’s all about the team. Without The AMC team of specialists, that includes board certified radiologists and surgeons, Muneca would not be healthy once again and home with her family and what’s not to like about that!


National Veterinary Technician Week 2013

October 15, 2013
Christina and a patient in ICU.

Christina and a patient in ICU.

This week, October 13-19, is National Veterinary Technician Week when we honor veterinary technicians or nurses for their role as critical members of the veterinary healthcare team. The technicians at The Animal Medical Center are a unique group in many ways.

A whole lotta’ techs
The AMC employs 75 technicians, each and every one licensed by the State of New York. These critical veterinary team members provide exceptional care to your pets no matter if it is high noon or 3 o’clock in the morning. The lowest number of technicians on duty in the hospital at any time during a 24 hour cycle is at 3 am when there are eight licensed veterinary technicians on the premises. These multi-tasking technicians run lab tests, take x-rays and provide compassionate patient care 24/7.

Trish and a canine patient.

Trish and a canine patient.

Big skill set
Because The AMC is a specialty hospital, our technicians learn specialized skills to support the veterinarians and patients on their team. We have technicians trained to perform hemodialysis, administer chemotherapy, prep patients for surgical procedures and assist in the operating room. Technicians maintain our delicate equipment like endoscopes and cage-side laboratory equipment to keep us ready for any emergency situation. Some of our long term technicians have worked in multiple areas throughout the hospital and have multidisciplinary skills, including care of exotic pets, plus administering radiation treatments or evaluating intraocular pressure and blood pressure!

Frankie assists Dr. Quesenberry with an examination of a swan

Frankie assists Dr. Quesenberry with an examination of a swan

Lifelong learning
Continuing education is required to maintain a veterinary technician license in New York State. To facilitate continuing education credits for our technicians, The AMC sponsors lectures on topics important to technicians, such as diabetes and heatstroke, through our Partners in Practice lecture series, and welcomes the participation of technicians from other veterinary practices as well. On a national level, the numbers of specialty certified technicians is small, but growing. The AMC is leading the pack with some of the first North American Veterinary Technician Academy (NAVTA) certified specialty technicians in the country. We currently have a total of five NAVTA certified technician in emergency critical care and anesthesia. The Tina Santi Flaherty Rehabilitation & Fitness Service has two technicians certified as Canine Rehabilitation Assistants and more in training.

A heartfelt thank you to vet techs everywhere
On behalf of veterinarians and the patients who benefit from the skills and knowledge of our technician team members, thank you for your hard work and dedication. Pets and vets need techs because we can’t do it without you.


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