July is Sarcoma Awareness Month

July 23, 2014
The wrist of a dog diagnosed with osteosarcoma.

The wrist of a dog diagnosed with osteosarcoma.

Both veterinary and human oncologists talk about three big families of cancer: carcinomas, sarcomas and tumors of the blood and lymphatic system. Carcinomas frequently originate from glands – like breast or prostate carcinomas. The most well-known tumors of the blood and immune system are leukemia and lymphoma. Sarcoma is a form of cancer arising from bones, tendons, muscles, nerves, joints, blood vessels and fat. Over 13,000 Americans were diagnosed with sarcoma in 2013. Sarcomas are rare in adults, but represent 15% of all childhood cancers.

Pets Get Sarcomas Too
Cancer registries for pets exist, but recording the types of cancer pets have is not mandatory as it is for human cancer diagnoses. Some information about the occurrence of sarcomas in pets has been published. In a survey of Greek dogs with skin cancer, 40% of the tumors were sarcomas, the two most common were mast cell tumors and fibrosarcoma. A study of American dogs found the mast cell tumor was the most common malignant tumor on this side of the Atlantic as well. An Italian tumor registry based out of Genoa found sarcomas occurred more commonly as a dog aged. Breed also influences the development of sarcomas. A survey of flat coated retrievers in the United Kingdom found 55% of malignant tumors and 26% of all tumors in this breed were sarcomas.

Common Dog Tumors with the Last Name Sarcoma
Osteosarcoma (bone sarcoma) is ten times more common in dogs than in humans. Large and giant breed dogs have a greater risk of developing osteosarcoma. In dogs, the tumor destroys the bone (see the above photograph) and to control pain, amputation is often recommended; although limb-sparing surgery and radiation therapy are also used to control pain. Coupling surgery or radiation with systemic chemotherapy helps to control the spread of osteosarcoma and thus prolongs survival.

Hemangiosarcoma is a tumor of blood vessels. Because the vessels are cancerous, they rupture easily and dogs with hemangiosarcoma frequently end up in the animal ER with catastrophic hemorrhage from a ruptured tumor in their spleen, liver or heart.

Soft tissue sarcomas include tumors whose name is a mouthful like hemangiopericytoma, or that sound like a more benign tumor, such as the nerve sheath tumor. Soft tissue sarcomas are a mixed group of tumors frequently of the skin and often lumped together because of a similar clinical course. These tumors send tentacles of tumor out into the surrounding tissue, making complete removal challenging. Successful surgical removal of a soft tissue sarcoma requires a much bigger incision than most dog owners expect in order to remove the tentacles. If residual tumor is left behind, these tumors commonly recur and may require radiation therapy to control.

Cat Tumors with the Same Last Name

An injection site sarcoma in a cat just prior to surgical removal.

An injection site sarcoma in a cat just prior to surgical removal.

An injection site sarcoma is a very specific type of sarcoma, most commonly found in cats where injections are administered, such as a vaccination or insulin injection. When these tumors develop on the nape of the neck (as in the photograph on the right) or on the hip, they are very difficult to completely remove and they recur much more frequently than soft tissue sarcomas of dogs. Most patients need follow up with radiation therapy, and because 25-40% of these tumors metastasize, chemotherapy as well.

Raising Sarcoma Awareness

  • Osteosarcoma causes bone pain and limping. Don’t assume your limping dog has a bum knee or weak ankles. Have your limping pet seen by your veterinarian.
  • Soft tissue sarcomas and injection site sarcomas often start as a skin lump. See your veterinarian for any lump that is enlarging over a month, is larger than 2 cm (3/4 inch) in diameter, or has been present for more than 3 months.
  • Sarcomas can often be diagnosed based on a fine needle aspirate. Help your veterinarian take the best care possible of your pet and allow this simple procedure if it is recommended.

What Causes Bloat in Dogs?

July 16, 2014
An x-ray of a dog taken from the right side, showing the gas-filled stomach typical of a dog with bloat.

An x-ray of a dog taken from the right side, showing the gas-filled stomach typical of a dog with bloat.

A few weeks ago, social media couldn’t stop talking about the risks of giving ice water to dogs, based on a blog written by a pet owner. As the story goes, a dog owner gave a bowl of ice water to her overheated dog. When the dog later arrived at an emergency clinic, the ER veterinarian admonished her for giving ice water, blaming it for causing the dog’s bloated stomach. Multiple veterinarians took to Twitter, Facebook and traditional media to debunk this urban legend.

What is bloat?
Bloat is the colloquial name for one of two canine stomach disorders: gastric dilatation (GD), where the stomach fills with gas; and gastric dilatation and volvulus (GDV), where the gas-filled stomach then twists on itself. Both can cause shock because the distended, gas-filled stomach obstructs blood flow. Gastric dilatation can be relieved by pumping the stomach, but GDV requires emergency surgery to untwist the stomach and save the dog’s life.

So if ice water doesn’t cause bloat, what does?
Urban legend still prevails here. Hot food, cold food, big kibble, little kibble, too much food, too much exercise, too many carbohydrates, and stress have all been touted as causes of bloat, but remain unsubstantiated. Scientific studies have repeatedly shown that breed is a risk factor for developing bloat. Large and giant breed dogs with deep chests and narrow waists, like the Weimaraner, St. Bernard, Gordon setter, Irish setter, Rottweiler and Standard poodle, but even Chihuahua’s can experience bloat. Dogs with a littermate that has experienced bloat also have an increased risk of developing the disorder themselves. The risk of bloat increases as a dog ages. One study showed the presence of a foreign object in the stomach predisposed dogs to bloat. Nervous dogs, food gulpers and dogs fed once daily also may have an increased likelihood of bloat, and dogs engaging in a moderate amount of exercise are less likely to bloat. More bloat cases seem to occur in November, December and January, but they occur all year round, so dog owners must always monitor their dog for abdominal distension and nonproductive retching, which are two of the common signs of bloat.

Can bloat be prevented?
Families with one of the at-risk breeds previously mentioned or other large or giant breed dogs should discuss prophylactic gastropexy with their veterinarian. I recommend my patients of these breeds have their stomachs tacked in place at the time of neutering. This surgery can be done using minimally invasive techniques. This surgery does not prevent gastric dilatation, but has been determined to be cost-effective in preventing GDV.

Since once daily feeding and gulping food have been associated with bloat, divide your dog’s food into two daily portions and feed the food in a feeding toy or a specially designed go slow bowl. Be sure your dog gets daily exercise and maintains a healthy body weight.

 


High Rise Syndrome in Cats

July 9, 2014
Cat peeks out an open high rise window

Cat peeks out an open high rise window

Warmer weather ushers in “high rise” season: the time of year when The Animal Medical Center’s ER sees an uptick in the number of cats injured as a result of an accidental fall from their apartment windows. Dogs also fall from apartment windows or terraces, but not as often as cats.

Not Just in New York
In the early 1980s, The AMC was the first to report on what was dubbed “high rise syndrome” in cats. Over a five month period, we treated 132 cats that had fallen out of a building and 90% of these cats survived. High rise syndrome is not unique to New York City. Recently, a study of Croatian cats found most cats who fell were less than a year old and those who fell more than five stories had more serious injuries. In a study of Viennese cats published last year, inflammation of the pancreas was a common sequel to the trauma of falling from a building.

Triad of Injuries
High rise cats seen at The AMC suffer from a common triad of injuries: chest trauma, head/facial injuries and limb fractures. Prince Michael, Sox and Tyra are three recent AMC high rise patients who have this classic set of high rise injuries. Prince Michael was only 12 weeks old when he fell four stories from his West Side apartment window. He must have landed on his chin and chest. He fractured one of his upper fangs, abraded his chin and suffered lung bruises. The fracture of the tooth opened the pulp cavity, or central blood vessel supplying the tooth, and to prevent an infection from moving up through the open pulp cavity, the tooth was extracted a couple of weeks after his fall.

Sox, a four year old cat, fell five stories onto his head and was badly scraped up. The force of the fall caused a tear in his lungs, allowing air to leak out and into the space between his lungs and ribs. The accumulation of air prevented his lungs from expanding and he was experiencing respiratory distress when he arrived at The AMC. Our ER doctors removed the excess air, restoring his ability to breathe. The fall also fractured the roof of his mouth and a back leg. Once the lungs were healed, AMC surgeons repaired the roof of his mouth and splinted the leg.

Current Record Holder

Fractured humerus

Fractured humerus

So far in the 2014 high rise season, the highest fall seen at The AMC has been 17 stories. Tyra, a six month old kitten, suffered a fractured hip socket and lung bruising. Fortunately, Tyra’s orthopedist recommended cage rest and not corrective surgery. Most people wouldn’t think lungs could get bruised, but the impact from a fall can bruise the lungs, the same way you can bruise your elbow if you fall off your bike. When lungs become bruised, they cannot exchange oxygen well and Tyra required oxygen cage therapy until the lung bruises resolved. Happily, Tyra was discharged three days after her fall.

High Rise Syndrome is Preventable
Although all three of these cats were fortunate enough to eventually go home, not all high rise cats survive. Take these steps to keep your cat safe:

  • Keep window screens tightly in place
  • Close windows if you don’t have screens
  • Prevent falls by keeping your pet off open terraces and balconies

Protect Your Pet Against Summertime Hazards

July 2, 2014

The Hunt for Huckleberry: Finding Your Lost Pet

June 25, 2014
Huckleberry

Huckleberry

A couple of evenings ago, I received a frantic phone call from one of my cat-owning clients. Their young cat, Huckleberry, had been missing for a couple of hours and had not come to the kitchen at his appointed dinner hour.

Search Everywhere
When my clients discovered him missing, they took immediate action: opened all the room and closet doors in their apartment in case Huckleberry had accidently been shut in or out of his favorite hiding places, checked the dryer for a cat toasting in a pile of warm, clean, fluffy towels and looked in the hallway outside their apartment door. They even went so far as to disassemble some electronic devices. But, no Huckleberry.

Alert the Veterinary Community
I emailed the front desk and the Emergency Service at The Animal Medical Center alerting them to a possible “injured stray cat” meeting Huckleberry’s description. The front desk in turn emailed Huckleberry’s photo and microchip number to all of the 24 hour emergency hospitals in our area and gave Huckleberry’s home phone number in case a good Samaritan found him and took him to a local animal emergency room.

Use Social Media
Next, I tweeted Huckleberry’s photo, giving his New York City neighborhood and The AMC’s phone number in case someone recognized the little guy on the street looking for a way home. If I had a “do over” I would use a neighborhood hashtag and would have tagged some neighborhood and cat Twitter handles. Still, over 5,000 people got the tweet.

A Happy Ending
This story has a happy ending. After ten hours of searching, Huckleberry was discovered, hungry and in serious need of a litterbox, in his apartment building’s freight elevator. His family speculates the curious cat hopped a ride with a repairman earlier in the day.

I hope none of my readers ever have to search for a missing pet, but the hunt for Huckleberry brings up some important points and ideas for finding lost pets:

  • Be sure your pet has a microchip and the information in the microchip database is up to date.
  • Keep a current photo of your pet readily accessible for making “lost/missing” posters, emailing and posting on social media.
  • Use social media such as Twitter, Facebook and Instagram to broadcast photographs of your missing pet. The wider you broadcast, the greater your chance of finding your pet.
  • If you live in an apartment building with security cameras, ask the building staff if you can review the security tapes for clues to your pet’s whereabouts.
  • Check strange places like inside a box spring or an electronic device with an open area inside the case.

Fifty Years of Postgraduate Education: A Look Back

June 18, 2014

50 years of postgraduate educationThe next two weeks at The Animal Medical Center mark an important milestone for the institution, veterinary medicine and pets everywhere. On June 24th, we are celebrating the graduation of the 50th class of veterinary interns. Earlier this week, we welcomed the 51st intern class at our annual White Coat Ceremony.

Over the past 50 years, more than 1,200 veterinarians have completed a formal internship at The AMC and many have gone on to become leaders in our profession. Today, AMC-trained veterinarians work in all facets of veterinary medicine including teaching, research and clinical practice. The first intern class graduated in 1965 and consisted of three men and one woman. The members of this class embody the mission of The AMC: teaching, research and clinical service. Dr. Daryl Biery retired as a professor of radiology from The University of Pennsylvania, Dr. Stephen Ettinger is best known for his Textbook of Veterinary Internal Medicine, now in its seventh edition, and Dr. William DeHoff founded MedVet, a specialty hospital which was just named “Hospital of the Year” by the American Animal Hospital Association. The first class was also the smallest class to graduate. The largest class graduated 31 years later and had 35 members.

Training the Leaders of Tomorrow
Currently there are over 50 AMC-trained veterinarians who are members of the faculty at colleges of veterinary medicine throughout the world, and another 30 who have retired from their faculty positions. These numbers do not include a handful of AMC-trained veterinarians who serve as veterinary academic leaders such as deans, associate deans and program administrators, such as Dr. Mark StetterDr. Rodney PageDr. Claudia KirkDr. Robert Mason, and Dr. Joseph Taboada. I would venture to say nearly every AMC alumnus has, at one time or another, helped to train a future veterinarian when they have taken a young aspiring veterinarian under their wing and into their practice.

Discovering Knowledge for the Future
Part of The AMC’s mission is the discovery of new knowledge through research into naturally occurring disease. This month’s scientific publications in veterinary medicine highlight that mission through the publications of AMC alumni. In the current issues of the Journal of the American Veterinary Medical Association, the Journal of the American Animal Hospital Association and the Journal of Veterinary Internal Medicine, there are eight publications by AMC-trained veterinarians. These topics include the equine athlete, canine urinary tract infections, polyarthropathy, and the minimum clinical database. There are two articles each on feline hypertrophic cardiomyopathy and lymphoma. In the past, AMC alumni were instrumental in identifying feline taurine deficiency cardiomyopathy, West Nile Virus infections in the United States, hepatic copper toxicosis in Bedlington terriers and techniques to repair kneecaps in dogs.

Saving Animals Every Day
The accomplishments listed above are noteworthy, groundbreaking and important to the veterinary profession, however most graduates of AMC training programs are like me, providing medical, surgical and preventive healthcare for animals of all species, day in and day out. Some of us are specialists and others are your favorite neighborhood veterinarian, but we all love to celebrate a new puppy, reflect on the life of a 19 year old cat, piece together a fractured bone, or put cancer into remission.

So, happy 50th birthday to AMC’s Postgraduate Education program, congratulations to this year’s graduating class and welcome to the incoming class of interns. Click here to see an extensive list of the accomplishments of AMC alumni.


Keep Your Kitties Safe from these 10 Potential Toxins

June 11, 2014

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