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.

SAVE Saves a Bird

August 13, 2014
Scarlett's x-ray

Scarlett’s x-ray shows her stuck egg

As her name suggests, Scarlett is a pet that is red, but not a red setter, a redbone coonhound or a red Abyssinian, she’s an African grey parrot with a red tail. This 25-year-old parrot is also an artist, creating colorful abstract works of art in the bathtub. She was referred to The Animal Medical Center to see Avian and Exotic specialist Dr. Kathy Quesenberry for an egg that wasn’t being laid, an avian condition known as egg binding, putting a damper on her artistic endeavors.

Like many medical problems, egg binding occurs in overweight birds with a sedentary lifestyle or a diet lacking adequate calcium. Medical treatments can be effective in resolving a stuck egg – calcium, fluids, lubrication and keeping the bird warm may cause the egg to pass, if not, then manual or surgical removal of the egg may be necessary. These treatments had been tried in Scarlett, but they were unsuccessful.

IDing an Egg
One of the first steps in treating an egg-bound bird is to pinpoint the egg’s location within the reproductive tract. Because eggshells contain calcium, they can easily be seen using a standard x-ray. In the x-ray image on the right, you can see a thin, egg-shaped structure in Scarlett’s abdomen between her pelvic bones representing Scarlett’s stuck egg.

Avian Endoscopy
The inside of a bird’s vent, called the cloaca, contains multiple openings – one for the intestinal tract, one for the reproductive tract, and two small openings for the urinary tract. Dr. Quesenberry used endoscopy to view inside the vent and was planning to remove the egg at the same time. Endoscopy identified a tear at the end of the oviduct where it entered the cloaca, making surgery urgently necessary.

Scarlett in the tub

Scarlett as a component of her artwork

Bird Spay
During the two and a half hour endoscopy and surgery, Scarlett’s torn oviduct at the cloaca was repaired, and the remainder of her oviduct was removed to prevent another egg binding episode. Unlike mammals, most birds have only a single left oviduct and ovary. Because a bird’s ovary is close to large blood vessels, it cannot be removed safely. A “bird spay,” or salpingectomy, is the procedure of removing most of the oviduct so that an actual shelled egg cannot be formed, even though the ovary still functions normally. Scarlett recovered uneventfully. Two weeks after surgery her sutures were removed and she was given a clean bill of health and she has returned to emulating Jackson Pollack-esque abstract impressionism in her bathtub. The photo seen here shows Scarlett as a component of her own artwork.

Help From an AMC Community Fund
The happy ending to Scarlett’s story would not have been possible without the generosity of those who support The AMC’s Community Funds. Scarlett’s care was covered by the Seniors’ Animal Veterinary Effort (SAVE), which provides free or subsidized general and emergency veterinary services for the pets of the indigent elderly.

To learn about other pets treated through The AMC’s Community Funds, read the heartwarming stories about TikoFrankie, and Baller.

Become a supporter of The AMC’s Community Funds today.


Watch Scarlett at work in her bathtub studio on The AMC’s YouTube channel.


View Scarlett’s virtual art gallery.

Click to play this Smilebox slideshow

What Do Pongo and Perdita Have to Do with Deafness in Dogs and Cats?

August 6, 2014

Image from 101 DalmatiansThe image on the right, is of Pongo, Perdita and their family, the iconic Dalmatians from the classic Disney movie, 101 Dalmatians. Yes, it is one of my childhood favorites, but the image is here because today I am writing about hearing loss in dogs and cats, and Dalmatians are the breed most commonly associated with an inherited form of deafness. Inherited deafness is just one type of hearing loss. Medically, veterinarians use several different classification schemes to categorize hearing loss in pets.

Inherited or Acquired Deafness
Inherited means hearing loss is due to abnormalities in the genetic material coding for hearing. In dogs, inherited deafness is associated with white haircoats, piebald (spotted) haircoats like the Dalmatian, or merle (dappled) haircoats like the Australian Shepherd. Most inherited hearing loss becomes obvious at just a few weeks of age. Acquired deafness occurs because a disease or medication destroys hearing function or because of normal aging.

Sensorineural or Conductive
While these words may not be familiar to many of my readers, the explanation of the words is quite easy to understand. In order for sound to be conducted from the ear to the brain, sound must get into the ears. Either a bad ear infection (a really common cause of hearing loss in dogs and cats) or a tumor or the ear canal (a much less common cause of hearing loss) can obstruct the ear canal. Both conditions result in conductive deafness. Sensorineural deafness results from dysfunction of the hearing structures of the ear, nerve damage to the auditory nerve or a problem in the brain’s ability to perceive sound. Sensorineural deafness is the common form of hearing loss in older animals.

Congenital or Late Onset
Congenital deafness is a condition present at birth. The majority of white cats with two blue eyes are born deaf. Less than half of white cats with one blue eye are deaf and they are usually deaf on the side with the blue eye. If we use all the classification schemes together, white cats with blue eyes have inherited congenital sensorineural deafness.

If you have an older dog who has had multiple bad ear infections and can no longer hear well, he probably has acquired late onset conductive deafness.

Dog with BAER electrodes attached

Dog with BAER electrodes attached

Hearing Tests in Pets
The Animal Medical Center’s Neurology Service uses a test called the brainstem auditory evoked response (BAER) to diagnose hearing loss in pets. The BAER machine measures brainwaves in response sound using electrodes attached to the skin.

Alterations in brainwaves indicate conductive or sensorineural deafness. BAER can be used to identify congenital deafness in puppies and kittens and exclude them from breeding programs.

Treatments for Deafness in Pets
If hearing loss is caused by an ear infection, treatment may restore hearing. Pet owners often ask about hearing aids for dogs. For pets with congenital deafness like the Dalmatian or white, blue-eyed cats, hearing aids will be of no benefit as hearing aids amplify sound, but this type of hearing loss cannot detect any sound at all, even really loud sounds. The use of hearing aids has been tried in dogs with limited success. Dogs are not always cooperative with devices placed in their ears. Many dogs (and cats) acclimate to their hearing loss. Since smell is a dog’s most highly developed sense, deaf dogs and cats can function well as indoor pets.

Further Reading


AAHA Certification: The AMC Takes the Test to Meet Veterinary Practice Standards of Excellence

July 30, 2014

AAHAlogoDedicatedThe Animal Medical Center undergoes a triennial accreditation evaluation by the American Animal Hospital Association (AAHA). The AAHA is an industry leader that sets the standards for small animal hospitals in North America, standards which are often emulated internationally. For example, in Japan, the Japanese Animal Hospital Association (JAHA) serves a similar role to AAHA in the United States. Recently, AAHA has added new accreditation categories for referral hospitals and university hospitals.

The Benchmarks
Over 900 different standards are assessed during the accreditation evaluation. The standards focus on the quality of care in the areas of: anesthesia, contagious diseases, dentistry, pain management, patient care, surgery and emergency care. The standards are grouped into 20 large categories covering quality of care in diverse areas such as contagious disease, dentistry, diagnostic imaging, emergency and critical care, and pain management. Mandatory standards detail 46 critical/crucial hospital functions required of every AAHA accredited hospital. These “deal breaker” standards include the requirement that dentistry is performed under general anesthesia with tracheal intubation, and all patient care is provided under the supervision of a licensed veterinarian. The standards require hospitals to provide diagnostic services (x-ray and laboratory) facilitating quick and accurate diagnosis of your pet’s illness. Accredited hospitals must dispense medications so treatment can begin immediately.

The focus of the benchmarks is not just on patient care, but on how the veterinary team interacts to achieve high quality patient care. Standards pet owners might not expect as part of the evaluation process include an assessment of confidentiality, security and integrity of medical records, fire safety, diagnostic image archiving, continuing education, and referral standards. While not exactly medical standards, these functions are clearly critical to an accredited hospital’s ability to provide top-notch patient care.

Exam Prep
The AMC is continuously prepping to meet the AAHA accreditation standards. Our accreditation team reviews the benchmarks and educates the staff regarding their responsibilities in implementing each standard. When a new standard is issued, the appropriate hospital team writes our policy to ensure the new standards are met. That policy is then distributed to the implementation teams. Each new standard improves the quality and safety of The AMC’s patient care.

A Pop Quiz
On-site examiners perform a full-day thorough and comprehensive review of the hospital. Preparing for an AAHA evaluation is like preparing for a pop quiz; they can ask questions about any of the 900+ standards and they don’t have to give you a heads-up as to which ones are on the quiz. The examiners speak with a variety of staff and review hospital policies to ensure standards are met. If any deficiencies are identified, they suggest methods of improvement.

Perfect Scores
The accreditation process is rigorous and encompasses all aspects of pet healthcare. Only 15% of all veterinary hospitals meet these stringent quality standards. The AMC is proud to say it has been an AAHA accredited hospital since 1976 and passed its most recent evaluation with flying colors. We achieved a perfect score in six of the 20 categories of standards. All of the standards ultimately affect the care pets receive at The AMC, but most important to pet owners are the A pluses The AMC received for management of contagious diseases and emergency and critical care medicine. Overall, we received a solid A, or 94%, which does not mean we got six questions wrong. We scored 30,250 out of a possible 32,310 points! No wonder it took weeks to prepare for this evaluation.

Standards Met
For over 100 years, The AMC has been a leader in veterinary teaching, research and exceptional clinical care. The AAHA is another leader in veterinary medicine whose opinions and stance are relied upon for setting high hospital standards. Achieving AAHA certification is just one way we continue to provide the highest quality of medicine and surgery to nearly 40,000 patients every year.


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.

 


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