Managing Tracheal Collapse in your Dog

A Facebook friend of The Animal Medical Center posted a question asking how they might prevent tracheal collapse in their dog. Unfortunately, tracheal collapse may not be preventable, but dog owners can help lessen the impact of a collapsing trachea on their dog’s quality of life. Since tracheal collapse is an important problem in dogs and is likely to flare up more now that spring is here, I have expanded on my Facebook response for the readers of Fur the Love of Pets.

The problem

If you are a large dog owner, you may not know what tracheal collapse is since the disorder is most common in toy and miniature breed dogs – Chihuahuas, Pomeranians, Poodles, Shih tzus, Lhasa apsos, and Yorkies. In a normal dog, the tubular shape of the trachea comes from cartilage in the C-shaped tracheal rings. The two ends of the C are joined by a soft membrane completing the circle. In dogs with tracheal collapse, the cartilage loses it rigidity and becomes flabby. The flabby rings pull on the soft membrane, stretching it and flattening the tubular trachea into an oval with a narrow inner dimension. With each inspiration, the flabby trachea collapses, producing noisy respirations and a cough. Sometimes the cough progresses to full-blown respiratory distress requiring a trip to the animal ER for a stay in an oxygen cage pictured above.

Weight control

Overweight dogs have more difficulty breathing and being overweight contributes to the chronic cough typical of tracheal collapse. If your dog is already overweight, see your veterinarian to develop a plan of diet and exercise to take off the extra pounds. In a small dog like a Yorkie, 1/4-1/2 pound of weight loss may make a big difference.

Change your restraint method

Use a harness and not a collar when walking your dog. You may want a collar for the ID tags (and don’t forget the microchip too) but hook the leash to a harness, which pulls less on the throat and neck. Less pulling usually means less coughing.

Avoid heat and humidity

As the weather warms up and the humidity climbs, owners of dogs with tracheal collapse will begin to worry about the impact of heat and humidity on their dogs’ respirations. When it is hot outside your dog should be inside if she is one with tracheal collapse. Every veterinarian will tell you when the humidity is up, coughing increases and the oxygen cages in animal ERs are full. To prevent your dog from being in the ER oxygen cage, take them out only in the cool of the early morning or late evening to avoid provoking coughing spells instigated by breathing heavy, wet summer air. Keep your dog in the air conditioning on days the air can be cut with a knife.

For other tips to prevent heat-related health issues in your pet, click here.

Lost in Translation

Veterinarians request a lot of information from pet owners. We interrogate them: What does his cough sound like? We dictate to them: Give these pills three times a day. And we expect them to understand a foreign language — doctor talk. Mistranslated doctor talk results in communication gaps between veterinarians and pet owners. Here are some examples from last week’s patient visits at The Animal Medical Center.

Barfy is regurgitating twice a day.

This “lost in translation” example comes from the innocent misuse of the word regurgitate. Medically speaking, regurgitate is similar to vomiting, but there is an important difference. When a dog regurgitates, a forceful heave-ho and wretch are missing. The food or liquid comes back up without an increase in abdominal pressure. Picky, I know, but, as a veterinarian, this information is diagnostically critical. Dogs and cats that regurgitate have an esophageal problem, and those that vomit typically have a problem further down the digestive tract. This picky distinction directs my diagnostic evaluation, so I have to get it right or I bark up the wrong diagnostic tree, so to speak.

Is Fluffy urinating more than usual?

This translation gap was my fault. The poor cat owner didn’t know how to answer. Was I asking more in frequency or more in volume? I tried to avoid using doctor talk to ask what was really on my mind; was Fluffy pollakiuric or polyuric, the special words for increased frequency of urination or increased volume of urination. Increased volume of urination suggests diseases like diabetes, kidney failure or a kidney infection. Increased frequency of urination suggests a bladder infection, bladder stones or possibly a bladder tumor. Once again picky, but critical.

My cat, Peter, gets dialysis at home every other day.

This comment was made by a patient new to The AMC and it caught me off guard. The AMC is the only center for dialysis between Boston and Philadelphia and this cat was a local from 89th Street in Manhattan. Dialysis happens in the hospital and not at home. What really happened was the owner had been trained by her regular veterinarian to give fluids subcutaneously to her cat to help combat the effects of failing kidneys. Cats with kidney disease often become dehydrated as their failing kidneys waste water by producing excessive amounts of urine. Supplementing feline fluid intake with subcutaneous fluids keeps cats feeling and eating better because they are not dehydrated. Dialysis, also used to treat failing kidneys, filters the blood through a machine to remove waste product since the kidneys no longer perform this function. Same disease, different treatment.

If you are not sure what your pet’s veterinarian just told you or can’t understand the question you were just asked, don’t hesitate to ask for clarification. Don’t let your pet’s diagnosis get lost in translation.

Salmonella in Pets and Humans

On April 6, 2012, the United States Food and Drug Administration announced a voluntary recall of Diamond Naturals Lamb Meal and Rice dry dog food. Since the initial recall, several other brands of food manufactured in a South Carolina plant have been voluntarily recalled for possible Salmonella contamination. Voluntary recalls of pet food are not uncommon, but this recall is unusual. Illness in humans, not dogs, prompted the recall.

Outbreak investigation

Scientists at the Centers for Disease Control checked the genetic fingerprint of the Salmonella found in the dog food against a national database of foodborne infections and found people infected with an identical bacterium. Because the Salmonella isolated from the dog food and the people is a rare type, the humans were interviewed to determine if there was a common source of infection. These interviews revealed many of the infected people had been exposed to dogs and the brand of dog food included in the initial recall. Subsequent recalls have all involved food manufactured in the same facility.

Why did people get sick?

This medical mystery seemed backwards to me. I could understand if my dog and I both got sick from some food I slipped her at the table, but I would suspect hardly any of us grab a handful of tan nuggets from our dog’s bowl as a quick snack.

So to help me understand, I called my sister, Mary Hohenhaus, MD, FACP, who is also a board certified internist (but for people) with Brigham and Women’s Physicians Organization in Boston.

The other Dr. Hohenhaus says:

Salmonella bacteria are a leading cause of infectious gastroenteritis in humans – more than a million cases in the U.S. each year. Symptoms include diarrhea, cramping, and fever starting anywhere from 12 to 72 hours after exposure.

Catching Salmonella is easy only if the bacteria can find their way into your mouth. I use a scoop to measure out dry food for my cat, but I could just as easily grab a handful of kibble for Sam’s bowl – and if the next thing I did was grab a handful of grapes for my breakfast, I could be in trouble.

Food and water contaminated with animal feces are a common source of Salmonella infection. Outbreaks have been associated with meat, eggs, dairy products, and fresh produce, as well as processed foods. Pet birds and reptiles can carry Salmonella without appearing ill. Feces from infected humans are another source.

Many infections are mild and don’t come to medical attention. Most people get better within a week just with extra fluids and rest. Children, the elderly, and people whose immune systems don’t work well are more likely to have severe cases of Salmonella, where the bacteria enter the bloodstream. These people need intravenous fluids, antibiotics and close monitoring in a hospital.

This current outbreak is a good reminder that Salmonella can show up in some surprising and unexpected places. It also reminds us that contaminated foods look, smell, and taste perfectly normal. The best protection against Salmonella and many other infections is common sense: keep your hands clean (and out of your mouth) and practice food safety.

When should you wash? After using the toilet, before preparing food, and any time your hands are visibly soiled are a must. Don’t forget to wash after playing with pets, not just after poop-scooping. A pocket-sized bottle of hand sanitizer is a great addition to your daily walk with Fido.

In the kitchen, wash utensils and work surfaces thoroughly after handling raw meat and eggs and before preparing produce – especially important if fruits and vegetables will be served raw. Thoroughly cook meat and eggs, and be sure to serve hot foods hot and cold foods cold. For more information click here.

This Dr. Hohenhaus is worried about dogs

Although the Salmonella cases making the news are human, dogs can also contract Salmonella after eating tainted food. Veterinarians in New York City are required to report certain diseases to the Department of Health and Mental Hygiene just like physicians are. We report zoonotic diseases, diseases transmitted between animal and humans, which include: Salmonellosis, tuberculosis, Rocky Mountain spotted fever, and leptospirosis.

I contacted one of my colleagues at the New York City Department of Health and Mental Hygiene, Dr. Sally Slavinski, Assistant Director Zoonotic, Influenza and Vector-borne Disease Unit, and she says no canine cases associated with this recall have been reported to the DHMH. I do have veterinary colleagues out of state who have seen a smattering of dogs they believe contracted Salmonellosis from the recalled foods.

Prevention in pets

For tips on preventing foodborne infections in your pets, click here.

Dog Bites Happen to Everyone, Even Me!

May 20-26, 2012 is Dog Bite Prevention Week. Dog bites are a serious public health issue. In the United States, 4.7 million bites are estimated to occur each year. Children ages 5-9 are the most common victims of dog bites, but everyone is at risk.

I want to share my personal dog bite story and one that happened to my friend Susan the very same day.

You may immediately think that I was bitten by one of my dog patients. Not this time. I was walking down the hall of my apartment building just as the door to the service elevator opened. Thinking someone would come out of the door with their arms full; I stood still, away from the service elevator door, so the person could easily pass when the door opened. When it opened, out came a dog on a leash. My neighbor did not have a good hold on the leash, her dog jumped up on me, and, unprovoked, bit my arm. Fortunately, my arm was only bruised and the dog had been vaccinated for rabies. The dog owner’s veterinarian provided an official rabies vaccination certificate and there was no need for alarm.

Susan’s story is not as simple. While at an outdoor café, Susan saw a cute dog and asked the owner’s permission to pet it. Permission was granted and as soon as Susan began to pet the dog, it bit her on the hand causing serious bleeding. In the fray, the dog and the owner disappeared, Susan was taken to the emergency room, and because the dog’s rabies vaccination status was unknown, she had to get the series of rabies shots for her own safety.

Fur the Love of Pets readers can learn some valuable lessons from these two stories:

• Always follow the rules for safe interaction with dogs. To view a video, click here.
• Following the rules does not guarantee safety, and children interacting with any dog should always be supervised. Both Susan and I followed the rules for safe interaction with dogs. Susan asked permission from the owner before petting the dog and I stood still as a tree even when the dog rushed toward me.
• Train your dog to safely interact with strangers so they don’t jump up and bite when they meet new people.
• Keep your dog current on rabies vaccinations.
• If your dog bites someone, no matter how embarrassing it is, give your name and address to the person who was bitten. It may save them from needing the series of shots required to prevent rabies, like Susan received.
• Provide a copy of your dog’s rabies vaccination certificate to the person your dog has bitten. They will sleep a bit easier knowing your dog is protected against rabies and this knowledge may prevent them from needing the human rabies shots.

Susan and I are unusual in that we were adult victims of a dog bite. Children are more likely to be involved. If you have children, the American Academy of Pediatrics has a lesson in dog safety for parents.

Fighting Breed-Related Diseases

The refinement of purebred dogs over the past four or five centuries has created interesting versions of Canis familiaris, such as dogs with dreadlocks, wrinkles, extra toes, a double coat, or an innate ability to herd sheep.

Selective breeding of dogs to propagate characteristics related to coat, foot size, or herding prowess may also have created the predisposition of some purebred dogs to specific diseases. As humans bred dogs to meet their own specifications, the genes controlling disease tagged along into the next generation with the genes controlling desirable characteristics such as dreadlocks and double toes. But the cloning of the canine genome in 2005, coupled with the multi-generational pedigrees available in purebred dogs and the close genetic relatedness of dogs within a given breed gave scientists powerful tools to study genetic disease in purebred dogs.

Eye diseases no more

Genetic tools combined with the advanced clinical skills may also be used to eradicate some diseases. For example, veterinary ophthalmologists have nearly eradicated breed-related disease of the eye in several breeds, including progressive retinal atrophy in Irish Setters and Irish Red and White Setters. This inherited disease results in blindness due to a failure of the retina to transmit images to the brain. The diagnosis can be made by a veterinary ophthalmologist using CERF (Canine Eye Registration Foundation) testing of puppies as young as five or six weeks of age. Now a genetic test is available to identify dogs carrying the mutation causing progressive retinal atrophy in the two types of Irish Setters. The test requires only a small amount of blood and identifies dogs that are clear of the mutation, the ones optimal for breeding to avoid producing puppies with abnormal eyes. The Irish Setter Club actively supports research into the diseases of their breed and a list of open studies is on their website.

Inherited drug sensitivity

We mostly think of genetics as determining physical stature and predisposition to disease, but a genetic mutation, found predominantly in herding dogs, called MDR1 (multiple drug resistance) determines heightened sensitivity to a variety of medications.

Possibly most important on this list are two drugs commonly used to prevent heartworms in dogs, ivermectin and milbemycin. Collies, Australian Shepherds (both the standard and mini), and other breeds lack the ability to process not only the previously mentioned heartworm preventatives but also acepromazine, butorphanol, and chemotherapy drugs used on a daily basis by veterinarians. Standard doses of these drugs can prove fatal in a dog with the MDR1 mutation. Genetic testing is available to identify dogs with the mutation, allowing veterinarians to prescribe safer medications.

The current version of the AAHA-AVMA Canine Preventive Healthcare Guidelines recommends the use of genetic testing in dogs and if I see one of the breeds on the list for a MDR1 mutation, I would test that dog prior to administering chemotherapy, if the test had not be performed as part of a preventive healthcare program.

If you have a purebred dog, ask your veterinarian about genetic testing for any diseases that run in your breed. If you are thinking of adding a purebred dog to your family, do your homework and investigate possible health concerns. Also, ask the breeder if they are involved in helping to eradicate their breed’s diseases.

Healthy Pets Make Happy Homes: National Pet Week 2012

May 6-12, 2012 is National Pet Week and the theme chosen by the Auxiliary to the American Veterinary Medical Association is “Healthy Pets Make Happy Homes.”

Each year the Auxiliary sponsors a poster contest around the year’s theme. This year’s winner, Stephanie Jensen, depicts a whimsical home filled with children and happy family pets. While the painting is charming and deserving of accolades, the scene made me think hard about pets and families.

Just the right number of pets makes a happy home

Ms. Jensen’s painting shows a home containing every imaginable pet, but when adding pets to your family, each addition requires careful consideration. For those of us who love pets, it is difficult to resist adding another foundling to our brood. But if we continually increase our home’s pet population, at some point, the number of pets we have will exceed the resources we have to care for them. By resources I am not talking just about financial resources, but space, time, and energy as well. My current feline foster family of seven makes me very happy every morning when I peek in and see all those little cats snoozing in their fur bed. Since the family will be adopted once the kittens are self-sufficient, I can handle caring for seven cats for several weeks, but I could not do this on a forever basis and still work full time!

Children and pets, happy together

In addition to showing many different pets, Ms. Jensen’s painting shows children and their pets. The benefits of pets for children were recently the topic of a New York Times blog by pediatrician Perri Klass.

As a pediatrician, she reports commonly asked questions about children and pets, because of the widely held belief that pets are good for children’s social and emotional health. She also says that, until now, there has been little good scientific research on the benefits of pets for children. Some recent studies suggest a variety of positive outcomes associated with children and pets:

• Young children living in a household with a dog may be less likely to become overweight.
• Animal assisted therapy has a positive influence on children’s development.
• Animal assisted therapy alleviates acute pain in children.

Pets can also pose health risks to young children, and parents should take steps to protect their children from pet-related illness, especially bites.

Keep your pet healthy and keep your home happy

The pets depicted in Ms. Jensen’s painting look very healthy. To keep your pet healthy and your home happy, provide your cat and dog with a good preventive healthcare program and visit their veterinarian annually.

How do you keep your family and pets happy and healthy? Share your stories in the comments section below.

Photo: Stockbyte

Your Child and the Loss of a Pet: Answers to Tough Questions

In my last blog I wrote about children and pet loss based on a presentation given at The Animal Medical Center by Dr. David Schonfeld, a developmental-behavioral pediatrician. I recently posed some frequently asked questions about pet loss to him; here’s what he had to say.

Q: I just found out our 15-year-old family cat has a serious medical problem. What should I tell my children?

Begin by telling your children that your cat has a serious illness. In simple terms, appropriate to the children’s developmental level(s), help them understand what is wrong with the cat’s health (e.g., the heart is weak and may not be able to beat for much longer; the cat’s kidney isn’t working, which means he can’t make urine like he needs to in order to keep from getting very sick, etc.). Explain that you are doing what you can to take care of the cat and keep it comfortable, but unfortunately, the veterinarian does not feel she will be able to cure the illness; you are concerned that the cat may die from the sickness.

Remember, very young children have a short time perspective – dying “soon” may mean some time that day. If the illness is such that it will likely limit the lifespan of the cat, but death is not likely to occur within days, weeks, or even months, it’s probably better to say that the cat is seriously ill and may not be able to get over the illness (without suggesting it will likely die from the illness, unless the child asks a question about whether death is possible from the illness).

Some additional points to keep in mind: Children may worry that the illness can spread to them or others in the family – you may wish to reassure them that it isn’t contagious. Children often worry that they did, didn’t do, or should have done something to prevent the illness – explain that there is nothing they did to cause the illness and nothing that they or anyone else can do now to make it get better. They can, though, help to keep the cat comfortable. Share with your children how this news makes you feel (e.g., sad, worried about the cat, etc.) and what you are doing to help cope with those feelings. Once you have provided this information, stop and let your children ask additional questions and react to the information. Take your lead from your children about how to continue the conversation.

Q: Some parents want to replace a dead pet without telling their child the old one has died by substituting a similar pet without the child’s knowledge. Why is this problematic?

Children begin to understand death at a very young age – well before most parents think they do. Replacing a pet without acknowledging the pet’s death may suggest to children that you don’t think they can handle the reality or you are not able or willing to address difficult or sensitive topics with them. Certainly, that’s not a good message for children to hear from their parents. Some children may also become insulted because it suggests that you think their personal connection with their pet was so meaningless that it doesn’t even warrant acknowledgement. If you try to replace a pet too early, children may reject the new pet. They miss their pet – the one they knew and loved. They don’t just miss having any pet. Allow them to experience and express their grief and help them learn how to cope with the distress – it’s unfortunately not going to be the last time in their lives they experience loss or disappointment. But it may be one of the first times you can help them learn the skills to cope with such loss (thereby making them more resilient when faced with loss in the future) and it helps them see you as someone who is there for them when they really need you most. After all, that’s what makes parents really special in children’s lives.

Q: Our family dog died last week and my child seems very sad and is not talking very much about anything. What can I do to help?

Parents should explain what’s happened and what it means and invite children to ask questions and share their feelings. Model sharing some of your feelings and techniques that you have used to cope (e.g., talking with a family member or friend, remembering happy times you spent with the pet when it was alive, looking at pictures, etc.). But as with all invitations, you need to wait for children to accept – you shouldn’t try to force children to speak before they feel ready. Be physically and emotionally present and periodically inquire how the children are doing and make references to the pet in casual conversation. Children will take the opportunity to talk when they are ready, or they may express their thoughts indirectly through play, writing, or in other ways.

For parents coping with a death in the family, either of a pet or a human family member, a free guide (available in English, Spanish, Japanese and Chinese) is available for parents on how to support a grieving child and includes more discussion on how to explain death to a young children – it can be downloaded or you may order free, printed copies.

Photo: iStockphoto

Children and the Loss of a Pet

Last week I received a telephone call from one of my clients. She realized the time had come for her 17-year-old dog to be euthanized. She had not previously euthanized a pet and we had a long discussion about the logistics related to timing, the procedure itself, and the options of cremation and burial. All veterinarians are experienced in addressing these specific issues and I gave concise and informative answers. But then she asked me a hard question, “Should I bring my daughter, and how should I prepare her for this?”

This question gave me a parenting flashback. When he was about 4 years old, my son saw a butterfly displayed in a shadow box on the wall of a quaint restaurant. The entire lunch conversation alternated between his two questions and my two honest, but inadequate answers.

“Why is the butterfly not moving?”

“Because it is dead”

“How do you know it is dead?”

“Because it is not moving.”

Shortly after this circular conversation, I learned a better way to answer children’s questions about death from Dr. David Schonfeld, a developmental-behavioral pediatrician and the Thelma and Jack Rubinstein Professor of Pediatrics and director of the Division of Developmental and Behavioral Pediatrics and the National Center for School Crisis and Bereavement at Cincinnati Children’s Hospital Medical Center. Several years ago, Dr. Schonfeld gave a presentation at The Animal Medical Center. When talking about death with children, Dr. Schonfeld says you must keep in mind they may not understand death and you must give complete answers to their questions. My answer was not detailed enough. I should have gone on to say a dead butterfly or (anyone else that is dead) does nothing a live butterfly does. They do not eat, fly, sleep, or breathe and these changes are permanent. If your child asks about their own death or that of a beloved family member, gently tell them we all die, but hopefully it won’t be for a long time. Explaining the lifespan of people is much longer than that of most pets may help your child to understand why you think human family members will be around for many more years.

I agree with Dr. Schonfeld when he said honesty is important when discussing death with children. Sometimes the death of a pet may be a child’s first experience with the permanence of death. If parents hide the death of a pet, act like nothing has happened, or ignore their child’s questions about death, the child may incorrectly deduce there is something shameful about death, putting them at risk of complicated grieving when a human family member, such as an elderly grandparent, dies.

When the time comes to euthanize the family pet, veterinarians want it to be as positive an experience as something not very happy can be. I always offer for family members to come with their dog and say goodbye or be with their dog during the procedure, or to say goodbye after the euthanasia. I allow the family to choose some, all, or none of these options. For children and also for some adults, being present for the death may be too much. I also have found children find the book Dog Heaven, by Cynthia Rylant, a comfort after the loss of a beloved dog.

Because I have found Dr. Schonfeld’s presentation so helpful both in my job and at home, I asked Dr. Schonfeld to reprise some of the information he presented at The AMC and his answers will be the subject of my next blog.

Photo: Lifesize

Seizures

Seizures are a frightening medical condition. Like lightning, a seizure strikes out of the blue, due to a short circuit in the brain. After a minute or two, the brain resets itself. Even though seizures commonly last a minute or two, watching your pet lose consciousness, twitch, jerk, and maybe even lose bowel and bladder control is scary. Seizures brought Ruby, a sleek black cat, to see Dr. Chad West of The Animal Medical Center’s Neurology Service.

Two years before she came to The AMC, Ruby’s primary care veterinarian diagnosed her with a seizure disorder. Treatment with an anticonvulsant medication controlled the seizures, but just prior to her visit at The AMC, the seizures became more frequent.

The cause of seizures discovered

While Ruby was not having a seizure when she arrived at The Animal Medical Center, her physical and neurological examination demonstrated that she had weakness of the left side of her body, and there was evidence that the pressure on her brain was not allowing adequate blood flow to this vital organ. The combination of Ruby’s signs represented a potentially life-threatening situation and the neurology team immediately performed an MRI to evaluate Ruby’s brain for the cause of her issues and to develop the best therapeutic plan.

This panel from Ruby’s MRI shows the large areas of water on the brain marked with red stars.

Water on the brain

Ruby’s diagnosis was obstructive hydrocephalus (high pressure water on the brain) associated with head trauma when Ruby was a youngster. In addition to the anticonvulsant medication that Ruby had been taking, steroid treatment was instituted to decrease the pressure on Ruby’s brain and to help her have a normal quality of life, despite decreased cerebral blood flow. The decision was made to also add a second anticonvulsant drug, Keppra, to ensure better seizure control.

Trying a new drug

Keppra is a relatively new anticonvulsant medication, and at the time of Ruby’s presentation and diagnosis, very few cats in the world had been treated with Keppra to help with seizure control. In addition to being an extremely safe medication with limited side effects, Keppra has the ability to protect the brain during times when there is abnormal blood flow.

Treating cats with anticonvulsant medications can be tricky. Veterinary neurologists focus on seizure control without losing sight of the cat’s quality of life. Their goal is to have them behave normally without having seizures. Generally, attaining the appropriate balance takes a few minor adjustments in dose. Some anticonvulsant medications also require regular blood test monitoring to ensure that other organs are not being harmed by the anticonvulsant drugs.

The high dosage of phenobarbital, Ruby’s original anticonvulsant medication, put her at risk for developing liver failure. The addition of Keppra, coupled with lowering the pressure on Ruby’s brain, allowed reductions in her phenobarbital dosage to a safer level and improved her overall quality of life.

The outlook

Even though Ruby will require life-long medications, she has done fabulously well in the four years since she first came to The AMC and her neurologists expect her to continue to do well.

The successful treatment of Ruby is an excellent example of why finding the right specialist is critical when your pet has a serious disease. The experience, knowledge and technology of The AMC neurology team allowed an accurate diagnosis and novel treatment resulting in an excellent outcome.

Bronchoscopy: In the Words of a Dog Owner

I was happy to receive an email from an old friend of mine, but was concerned when the subject line said, “Summer’s cough.” My friend no longer lives in New York City and was updating me on a medical procedure her dog, Summer, had earlier that day. The procedure, a bronchoscopy, was performed by board certified small animal internal medicine specialist, Dr. Leyenda Harley, an alumna of The Animal Medical Center’s internal medicine training program and a former staff doctor here.

Jenny wrote: “Summer has been coughing for some time and initially an antibiotic improved the cough, but then it got worse. Dr. Harley recommended bronchoscopy.”

The procedure

Bronchoscopy involves threading a special endoscopy unit (bronchoscope) through the mouth, down the trachea, and weaving it in and out of various bronchi to determine the cause of disease in the respiratory track. A camera is an integral component of the bronchoscope, allowing the veterinarian to view the inside of the airways. A bronchoscope can also be used to remove stuck objects from the trachea of dogs as I wrote in a previous blog.

Summer had bronchoscopy and bronchoalveolar lavage. Bronchoalveolar lavage involves flushing a small amount of sterile saline through a channel in the bronochoscope and retrieving the saline which, after swishing around in the lungs, will contain infective agents, blood and lung cells, and, hopefully not, tumor cells.

The results

Jenny went on to say: “The main findings in Summer included red and inflamed lower airways with a moderate amount of mucus throughout. To see a video of the inflamed airways and the mucus plug, click here. When the bronchoalveolar lavage fluid was examined under the microscope, many neutrophils (a type of white blood cell usually indicative of bacterial infection) were seen. Samples of the material in her airways were sent to a laboratory for cytology, PCR, and culture with antibiotic sensitivity [standard operating procedure following bronchoscopy].”

When specially trained veterinarians, called clinical pathologists, look at samples of cells obtained from various fluids, lumps, or tissue using a microscope, it is called cytology. Polymerase chain reaction, or PCR for short, hunts for scraps of DNA belonging to infectious organisms which might be the cause of illness in your pet. The sterile saline collected after it was used for bronchoalveolar lavage is placed in special media to promote bacterial growth and facilitate identification of the best antibiotic to eradicate the bacterial infection.

“Bronchoscopy also identified a mucous plug in one small lower airway, and using the special bronchoscopy brush, the plug was removed and sampled for the laboratory. No inhaled foreign objects like a bit of plant material [or thankfully no tumors] were identified.”

The treatment

All these tests helped direct Summer’s therapy. In an emailed update, Jenny wrote, “She received Baytril as treatment for a Pseudomonas infection and prednisone [steroids] to decrease inflammation. Today we started the inhalation therapy, and it went well. I hope that she will continue to improve to the extent that she will not have to be on Flovent indefinitely.” Flovent is an inhaled [steroid] administered through a device called Aerodawg, similar to a spacer used to treat children with asthma.

Between the medications and a change in halter style, Summer’s cough has markedly improved and Summer is ready for summer like all of us.

Many thanks to Jenny for letting me transcribe her clear and informative email into my blog, to Dr. Harley for providing the images, and to Summer for sharing her successful treatment with readers of Fur the Love of Pets.

Kitten Questions

After last week’s blog on my litter of foster kittens, I received a surprising number of questions about raising a litter of kittens. I guess I shouldn’t have been surprised since most families are not lucky enough to have the fun of raising a litter of kittens from day one. I thought readers of Fur the Love of Pets might find the answers interesting.

Q: How long did the delivery take for seven kittens?

A: I had planned to carefully record the color and sex of each kitten as it was born, but they came so fast and Lucy seemed to tire after the third kitten, so I took over rubbing down each new kitten with a clean towel to get it to begin breathing. Once it was breathing well on its own and moving vigorously, I gave each one back to Lucy and collected the next newborn. The details of the delivery are a blur. I can remember the first kitten was dark-colored and stillborn, the second orange and the third dark, but with the litter consisting of two female dark ones and four male orange ones, I have no idea which one came first. I noticed the first kitten arrived at 7 am and the last kitten was born at about 8:45 am, making each delivery a brief 15 minutes.

Q: How big are newborn kittens?

A: I must confess that as the labor and delivery staff of one, I did not weigh the kittens until they were about 48 hours old. At that time, they ranged from 136-160 grams. But a picture is worth a thousand words and they were about the size of a sick of butter.

Q: Can the kittens meow?

A: These kittens are incredibly noisy. First, they have no manners and slurp when they eat. The slurping is audible across the room. If they wander too far from the rest of the litter, the wanderer mews and whines until Lucy thrill, the kittn gets is bearing and heads back to the group. They also have a distress call –piercing, sharp and the volume of a lion’s roar. They don’t make this noise often, but if they do, their mother comes immediately and moves the distressed kitten back to the nest box, picking it up by the nape of the neck. Separating a kitten from the litter to photograph it near a stick of butter will provoke this cry!

Q: How strong are the kittens?

A: Much stronger than you think and yet not so strong. One of them hooked a toenail in a towel I was using as a bumper to keep them from wandering too far outside their nest box. Poor little thing was not strong enough to unhook the toenail from the loops of thread in the towel, and mewed until I unhooked it. But, when I tried to restrain the kitten for a pedicure, it seemed like I was holding a 150 gram tiger and I was rewarded with the lion-sized distress cry once again.

Blueberry: An AMC Living Legend

Blueberry in a stabilizing neck wrap. Photo: Dr. Joshua Gehrke

Blueberry, a 2 year old fawn and white Chihuahua, was rushed to The Animal Medical Center one night after having what his family thought might be a seizure. When he arrived at The AMC and was under observation by the ER staff, Blueberry had another terrible episode of pain which appeared to be originating from his neck. The astute observation of excruciating neck pain coupled with weakness in all four legs helped the ER staff to formulate a short list of possible diagnoses for further investigation.

Drs. John McCue and Joshua Gehrke and The AMC’s Neurology Service consulted on Blueberry’s case and confirmed the list of possible diagnoses: a disk extrusion in the neck pressing on the spinal cord, cranial occipital malformation syndrome or an atlantoaxial luxation. Later that same day, under general anesthesia, an MRI was performed to determine the diagnosis.

Using The AMC’s 1.5 Tesla MRI, the strongest magnet in use for veterinary patients in the New York Metropolitan area, The AMC’s radiologist confirmed one of the potential diagnoses, atlantoaxial luxation, a common condition of toy breed dogs. In addition, The AMC radiologist also noted that Blueberry’s spinal cord had kinked, resulting in a hemorrhage in the spinal cord.

Immediately, Blueberry was wrapped in a stabilizing neck splint and prescribed cage rest until surgery could be performed. The AMC neurology service was unsatisfied with the standard techniques often used to repair the alignment of the first and second neck bones. Current techniques were fraught with potential complications and Blueberry’s small size made many of these risky. A dorsal (top) stabilization was considered the best approach. Stabilizing the bones from the top requires a wire be passed over the spinal cord and anchored into the spinous process of the second cervical bone; sounds tricky and it is.

Radiograph taken after placement of Kishigami device (fishhook-like image). Blueberry's head is on left, neck to right.

For Blueberry, the Neurology Service recommended a state of the art repair technique using the Kishigami atlantoaxial tension band. The technique was developed 25 years ago by a Japanese veterinarian, but the procedure was not widely utilized. In 2010, a group of French veterinarians published the results of using the Kishigami technique in eight toy breed dogs and The AMC Neurology team was anxious to use this improved procedure in a dog with an atlantoaxial luxation. To repair Blueberry’s neck, the special device had to be purchased and shipped from Spain since a Spanish company currently is the only manufacturer of this device. Due to difficulties in purchase and transport of the Kishigami device, Blueberry waited one month after his diagnosis for surgery wrapped in a neck stabilizing bandage resembling a cocoon to prevent further damage to his brain stem.

At his three month post-operative check, Blueberry was given a clean bill of health by Dr. McCue. “Blueberry is completely back to normal.” Dr. McCue told me. “Even better, the Kishigami device holds Blueberry’s first and second cervical vertebra in perfect stable alignment and he should continue to do well on a long term basis.” Based on the success Blueberry enjoys with his Kishigami device, a box of the devices are sterilized and ready to go so no dog will have to wait for this repair again.

Blueberry will be honored as an AMC Living Legend at the Fourth Annual Living Legends Luncheon on May 9th. Blueberry’s is being recognized for his patience during a month long hospitalization and for his pioneering spirit in being the first AMC patient treated with the Kishigami technique.

What to Expect When You’re Expecting Kittens

Lucy and her litter

My family is trying something new this spring: we are hosting a pregnant cat as part of a local foster cat program. Destiny, now known affectionately as Lucy, will be in residence until her kittens finish nursing, are eating well on their own, and weigh two pounds each. Before she came to our home, we attended a training class on how to care for cats and kittens.

Expectant Waiting

Since Lucy was a foundling, no one knew when to expect the kittens. The situation was very different than in “What to Expect When You are Expecting Puppies,” where Tallulah’s litter was a planned pregnancy and we could calculate a delivery date quite accurately. Tallulah performed admirably, whelping (the dog word for the birth of puppies) on the middle day of the three days we anticipated delivery. Not so for Lucy. When I picked her up she seemed big as a house but wasn’t showing any nesting behavior. By the second weekend of her stay, I could tell the time was coming. She would go into one of the two cardboard boxes we strategically placed around her room, scratch and hang out in the box a few minutes. At the beginning of her third week with us, she started to produce milk.

Expectant Eating

Food motivated Lucy’s life, and no wonder, since she was eating for eight. She delivered six live kittens and one stillborn kitten, so she is now nursing a large litter. Before the kittens came, I noticed she would come into the kitchen while I was making dinner and yowl for food. I purchased a clicker at my neighborhood pet store and took advantage of her food motivation by clicker training her to come. I gave two clicks when she came into the kitchen and rewarded her with Greenies – her favorite treat. Pretty soon, she learned two clicks meant a Greenie and now she comes quite quickly when she hears the clicks. Now we are working on sitting on a mat for a Greenie.

Expecting No More

The kittens came three weeks to the day after Lucy arrived at our house. The morning started normally, with Lucy following me into the kitchen, but she refused even a Greenie, so I thought something was up. We had collected several cardboard boxes for use as potential queening (the cat word for birth of kittens) boxes. Being a New Yorker, Lucy chose to deliver the kittens in a Fresh Direct delivery box. [Fresh Direct is one of the most popular New York City online grocers]. The front of the box was covered with a fleece for privacy, but she removed every blanket, towel and pad I gave her for bedding and chose to deliver on the cardboard. I was glad I had collected other boxes before the kittens came. The Fresh Direct box was soiled and needed to be thrown out, so I was able to move the new family to another familiar, but clean box after all the kittens had come.

To see a video of the new family, click here.

The foster care program provides spaying and neutering for Lucy and her family when they are ready for adoption. I predict there will be seven very delighted cat-owning families sometime in the very near future.

A Matter of Taste: Why Dogs Love Sweets

Bitsy

Because at The Animal Medical Center every day is take your dog to work day, I know a quite a bit about the dogs who work here.

Bitsy, a nearly 4-year-old Maltese, likes sweets, especially apples. She doesn’t like more neutral foods such as carrots, and don’t come near her if you have just juiced a lemon. Bitsy’s love of sweets is not unusual. In fact, many dogs like sweets, as evidenced by the number of dogs seen for chocolate ingestion by our Emergency Service.

Treatment for ingestion of toxic substances is not unique to The AMC’s canine patients. The ASPCA Animal Poison Control Center reports 85% of the calls they receive are about dogs, many of them for ingesting toxic foods.

On the other hand, we almost never examine a cat for eating too many sweets. Cats seem to prefer moving food, perhaps due to their predatory nature. They will pounce on that pill you accidently drop on the floor or gnaw your spider plant down to a stump when the leaves are waving in the breeze from an open window. What accounts for this big difference between our two favorite companion animals?

Anatomically speaking, dogs and cats both have taste buds that can be seen on a tongue biopsy. But these taste buds may not be as sensitive to taste as ours are and many believe dogs and cats choose their food more by smell than by taste.

Both dogs and cats belong to the order Carnivora, but cats and dogs belong to different families within the order Carnivora. Cats belong to Felidae, which is a group of 36 different species of obligate carnivores, and dogs belong to Canidae, a group of 35 different species of omnivores—animals that eat both plants and meat. The fact that dogs are more flexible eaters may account for their ability to recognize different flavors in their food. Domestic and wild cats carry the gene for the sweetness receptor, but due to a mutation in the gene which makes the sweet detecting apparatus nonfunctional, cats cannot detect sweetness even if they eat a sweet food.

Similar mutations were discovered in other exclusively meat-eating animals, such as dolphins.

So the next time you find your dog eyeing the chocolate rabbit in your Easter basket, remember they have a sweet tooth like you and I do and may not be able to resist eating the entire rabbit in one sitting. Put chocolate and any other sweet treats out of range of your dog to protect them from a trip to the animal ER. The chocolate eggs and jellybeans may not be attractive to your cat, but the pot of Easter lilies on the window is. Keep all lilies away from cats as they can cause serious kidney problems.

For more information about taste in various other animals click here.

Photo: Courtesy of Bitsy’s Family

What Ever Happened To…?

Over the past several months, I have written about several patients treated by the veterinarians of The Animal Medical Center. Each blog is a snapshot in time and the case resolution is not always known when I post the story. Today, I will follow up on four patients whom I have previously written about as a way of sharing what happens during a typical day.

A lump on the rump

Addie's lump

Dogs have more skin lumps than any humans I know and I spend a good deal of my time measuring lumps and recording their precise locations as a cancer monitoring tool. In “Will that be One Lump or Two?” I wrote about Addie, a Standard Poodle with a benign lump on her rump. At the time of writing the first blog, my decision was to do nothing as the aspiration of the cyst proved it to be benign. However, the sebaceous cyst grew and started to look like it might rupture. And even though the lump was benign, we removed it since once these cysts rupture, they can become infected and an annoyance to both the dog and the owner. Below you see how we had to remodel her upscale hairdo when we prepped her for surgery. You can also see how large the mass had become, compared to the original photograph, necessitating its removal before it burst.

Washing away ringworm

Elizabeth

Ringworm is a common disease in kittens, and I wrote about treating a gorgeous pair of Abyssinian kittens for ringworm in “Spa Day for Kittens.” The crusty, scaly lesions on Elizabeth and Moby’s ears resolved with topical treatment and a lyme sulfur dip. To make sure ringworm has been eradicated from the fur, I performed a toothbrush test. This involved brushing the kittens with a toothbrush and submitting the hair collected in the bristles for ringworm testing. Much to my (and their owner’s) chagrin, the test was positive even though the photograph shows the hair has completely grown back compared to the original photograph. The kittens, now nearly cats, are back on my appointment schedule on a weekly basis for dips and oral anti-ringworm medications.

 The kitten with the feeding tube

Joey

Joey, “The War Horse Kitten,” spent many of her first days at The AMC being treated for an esophageal problem that required placement of a feeding tube to provide her with adequate nutrition and several procedures to stretch out her esophagus using a balloon dilator. Joey, now nearly a year old, has been spayed and rules the roost at home. After a pretty rough start, she’s turned out spectacularly beautiful, as you can see from her photo.

Pregnancy primer

Jasmine

Here’s a recent photograph of Jasmine, one of the puppies born in “What to Expect When You’re Expecting Puppies.” I had great fun doctoring the five female Jack Russell Terrier puppies born to Tallulah. They were a hit at Show and Tell for a class of first grade girls, who hugged the puppies while I talked about playing safely with dogs. Jasmine is staying with her mother’s family and will continue to be my patient, so stay tuned for more stories about her and other wonderful pets.

Photos: Ann Hohenhaus, Joey’s family, Jasmine’s family

Estate Planning: Providing for Your Pet’s Future

I saw a new patient last week; an older cat with many serious problems, including cancer. After we finished agreeing on a plan for her cat, the owner told me this would be her last cat. When I asked why, she cited her age as the major factor. She thought if she got a kitten at her age, it might outlive her and she worried how she would provide for the cat after her death.

This conversation prompted me to think about the options available for pet owners to plan for their pet’s future. So I recently sat down with one of The Animal Medical Center’s long-term clients and pet legal expert Debra Hamilton.

Below is the information I gathered from our conversation to help my readers understand the options open to them and their pets.

Q: What types of legal instruments can be used by pet owners to provide care for them in the event the pet owner dies before their pets do?

A: There are two types of legal instruments that can be used to make provision for pets: your will and a pet trust.

Q: Can I include my pet in my will?

A; Yes, plans for your pet can be specified in your will, but if you are too ill to care for your pet or to make decisions about your pet, provisions in your will do not help you provide for your pet until after your death. Moneys allocated to your pet in your will may not be available until after the will is probated. The lack of funds prior to probate may pose a problem for your pet’s new caretaker.

Q: What is a pet trust? Isn’t that what Trouble Helmsley had?

A: Trouble Helmsley did have a pet trust; although most pets do not require the $12 million dollars bequeathed to Trouble for his ongoing care. A pet trust is separate from and more flexible than your will. It can be set up to be used if you are disabled, unemployed, or die. Money allocated for pet care in a will can only be used if you die and many pets may need a care plan implemented before your death. If there is residual in the pet trust after your pet’s death, you can specify the recipient of those funds be the caretaker or your favorite charity.

Q: My will is already written and I don’t want the legal hassle of setting up a pet trust, is there anything else I can do?

A: A pet protection agreement does not require a lawyer and one can be found on the internet. This document allows you to specify a guardian and a successor with individual agreements for those who will be providing care to your pet. The money set aside by a pet protection agreement can be taken by your creditors or more easily challenged by family members since no attorney is involved in setting up a pet protection agreement. Even so, this type of document is better than having no agreement at all.

Q: Why do I need a document specifying my wishes? My children say they will keep my cat if anything happens to me.

A: Most people assume their family members will take over the care of their pets. Although your kids may want to keep your cat or dog or snake, sometimes the situation is beyond their control. For example, they may have children of their own who are allergic to cats, their own pets may not be accepting of yours, they may live in a “no pets” building, or their spouse maybe really squeamish about snakes. Advanced planning helps to provide options for your pet.

Q: Are there any pets advanced planning is more important for than others?

A: All pet owners should have a written plan for all their pets, but because large parrots and horses have such long lifespans compared to other pets and also because caring for horses is so expensive, advanced planning is critical for these particular pets.

Many thanks to Debra Hamilton for generously sharing her knowledge and for suggesting Petriarch, by Rachel Hirschfeld as a resource for readers of Fur the Love of Pets.

Photo: Stockbyte

Ruptured Air Sac: A Unique Bird Disease

Raquel the macaw

In 1984, The Animal Medical Center established one of the first Avian and Exotic Pet Services in a veterinary specialty hospital. At that time, the patients seen by the Avian and Exotic animal veterinarians reflected the most popular exotic pets such as ferrets, iguanas, and exotic cats. Over the years the popularity of various pets has waxed and waned, including the rise and fall of the hedgehog, sugar glider, prairie dog, and an occasional frog.

But the presence of birds in our waiting room has been a constant.

Raquel is a talkative blue and gold macaw that is at least 27 years old. She came to see Dr. Katherine Quesenberry for a dime-sized swelling in her axillary area (equivalent to our armpit) between the base of her wing and flank. Dr. Quesenberry suspected a ruptured air sac and scheduled a CT scan to investigate further.

Evolution made birds lightweight for flying. To lighten their bones, some bones contain air (pneumatic bones) as part of their respiratory system. Like reptiles and mammals, birds also have lungs, but bird lungs function differently than ours. With each breath, our lungs fill and empty with air due to movement of the diaphragm. Birds lack a diaphragm, and air moves through the lungs and into and out of the air sacs in two cycles as their sternum expands and contracts with each breath. While air is in the lungs, exchange of oxygen and carbon dioxide occurs. The air sacs help keep birds “light as a feather” and buoyant for flight.

Even though The AMC’s 64-slice CT scan is lightning fast, general anesthesia is required for the procedure. The bird’s unusual respiratory system makes anesthesia a greater challenge than in dog and cat patients. While birds are under anesthesia, we assist their breathing to prevent a build up of anesthetic gases in their air sacs. The advantage that birds have over mammals is that because their respiratory cycle is so fast, they wake up from anesthesia rapidly once the anesthetic gas is discontinued.

On the right you see a reconstructed image of Raquel from her CT scan. Although you can’t see it, her head is at the top, legs at the bottom. The image clearly shows the abnormal air sac exactly as the examination described it, under the right wing. The image is reversed and the right side is shown on the left.

The cause of ruptured air sacs is unknown; even so, they can be successfully treated. A small stent was sutured into Raquel’s ruptured air sac to remove the accumulated air. A follow-up visit showed resolution of the swelling. Raquel is now doing well and hopefully will stay in good health for at least another 27 years!

Photo: Photo of Raquel courtesy of Lynne Freeman-Gassem

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This may also be found in the Tales from the Pet Clinic blog on WebMD.com.

For over a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.

Pills and Poison Prevention

Sadie

Last week was National Poison Prevention Week and the 50th anniversary of this poison prevention campaign. The theme for the 2012 National Poison Prevention week, “Children act fast, so do poisons,” could also be: “Pets act fast, so do poisons.”

Here is the story of Sadie, a beautiful 9-month-old Weimaraner who acted fast and almost didn’t make it to her first birthday.

Weimaraners are energetic dogs, originally developed for hunting. Maybe that’s what got Sadie into trouble; she was hunting and the target of her attentions was an entire bottle of 200mg ibuprofen tablets. She consumed all the contents, as well as the bottle. Ibuprofen is a drug which should never be used in dogs. Sadie ate so many tablets she ingested 455mg of ibuprofen per kilogram of body weight. The over-the-counter dosage for an adult human is 400mg, given three times daily.

Triage

Sadie’s regular veterinarian initiated treatment by giving intravenous fluids, inducing vomiting, and administering activated charcoal to prevent absorption of the ibuprofen. Despite these treatments, Sadie’s condition deteriorated and when she arrived at The Animal Medical Center, she was nearly comatose and was having seizures.

Dogs are highly sensitive to the toxic effects of ibuprofen. The gastrointestinal tract and the kidneys are the primary targets. The ER staff administered three different drugs in an attempt to stave off rupture of an ibuprofen-induced gastric ulcer and the hemodialysis team was called in for consultation on how best to manage the potential kidney damage.

Charcoal perfusion

Oral administration of activated charcoal is a common treatment for intoxication. The charcoal is not systemically absorbed, but stays in the intestine and absorbs the toxin, preventing signs of illness. A novel method for using activated charcoal in cases of intoxication is to use charcoal hemoperfusion. Our hemodialysis team recommended a four-hour charcoal hemoperfusion treatment for Sadie and used the hemodialysis machine and a special charcoal cartridge instead of the standard cartridge used for patients with kidney failure. The treatment was completed very early in the morning and by the time of morning rounds, she was alert and feeling so well she was eating hospital food with gusto.

Only a few days in the hospital

Sadie stayed at The AMC for less than a week after her hemoperfusion treatment while her ibuprofen-induced diarrhea resolved. There was a brief scare when one of the kidney blood tests increased, and everyone held their breath while we waited to see if Sadie would take a turn for the worse. Happily, she was discharged to her relieved family five days after her charcoal hemoperfusion. Today, Sadie is a normal, happy 2-year-old Weimaraner.

Ibuprofen poisoning is common

According to the ASPCA Animal Poison Control Center, the number one cause of poisoning in pets is prescription and over-the-counter drugs, both of the human and pet variety, including painkillers, cold and flu preparations, and antidepressants. The Pet Poison Hotline reports nonsteroidal anti-inflammatory drugs (NSAIDS) like ibuprofen and naproxen are the fourth most common dog poisoning in their database for 2011.

Be sure you have the pet poison hotline numbers posted where you can easily find them, so you can act fast if your pet ingests something toxic like ibuprofen.

ASPCA Animal Poison Control
888-426-4435

Pet Poison Hotline
800-213-6680

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This may also be found in the Tales from the Pet Clinic blog on WebMD.com.

For over a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.

Top 5 Health Issues Facing American Pets Today

1. Pets are becoming medically underserved

Data shows the pet population in the U.S. is climbing, but visits to veterinarians are declining. On an annual basis in 2007, dogs saw a veterinarian 2.6 times per year and cats only 1.7 times, indicating cats are affected more than dogs. This number has continued to decline in the aftermath of the Great Recession of 2008. Taking your cat or dog to the veterinarian allows early detection and intervention before medical problems like obesity cause serious disease.

2. Obesity in pets, like in humans, is skyrocketing

Veterinarians know pets are getting fatter, but research has shown pet owners are not likely to recognize obesity in their pets, perhaps because they themselves are overweight. In dogs, obesity is linked to an increased body mass index (BMI) in their owners. If you love your pet and want it to live a long, healthy life, keep its weight down. Obese pets have a shorter lifespan and increased risk of cancer, heart disease, respiratory problems, bladder disease, and, like humans, diabetes.

3. Diabetes is increasing in both cats and dogs

Banfield State of Pet Health reports a 32% increase in diabetes in dogs and 16% increase in cats, comparing 2006 to 2010. This is likely tied to the obesity epidemic in pets. Diabetes can be treated in dogs and cats, but it involves someone in the family injecting insulin once or twice daily under the skin and monitoring response to treatment. Preventing diabetes by maintaining an ideal body weight is simply easier for everyone.

4. Cancer: a major illness in both cats and dogs

According to the Morris Animal Foundation, 1 in 4 dogs dies from cancer and cancer is the leading cause of death in dogs over 2 years of age.

In dogs, breed is strongly associated with specific types of cancer. Golden retrievers commonly develop lymphoma, German shepherds a splenic tumor called hemangiosarcoma, and Pugs a skin tumor known as a mast cell tumor. Cats get cancer too, most commonly lymphoma. Annual examinations and blood tests by your family veterinarian will help to detect tumors while they are still easily treatable.

5. Dental disease is on the rise

Reluctant is the descriptor for many pet owners when it comes to dental procedures in their pets. I understand their concern for the required general anesthesia, but I am concerned their reluctance is compromising their pet’s health. Periodontal disease is very prevalent in cats and in one study, all cats had evidence of periodontal disease. Over 10% were severely affected and nearly all had bone loss in the jaw as determined by dental x-rays.

Having periodontal disease may cause collateral damage in other parts of your pet’s body. In dogs, periodontal disease was associated with increases in markers of systemic inflammation and indicators of failing kidney function, and was also associated with endocarditis and heart muscle problems.

For more information on healthcare issues facing American pets today, watch my video interview with Yahoo! Animal Nation.

Photo: iStockphoto
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This may also be found in the Tales from the Pet Clinic blog on WebMD.com.

For over a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.

 

Soldier Dogs

Rufus and Sgt. Duke

The Wall Street Journal recently published an essay that caught my eye. It is an excerpt from the new book Soldier Dogs by Maria Goodavage. Touted as a tour of military working dogs’ extraordinary training, heroic accomplishments, and the lasting impact they have on those who work with them, the book will be released March 15, 2012.

For those of us who love and admire dogs, the extraordinary feats of military dogs are not surprising. What I found charming, touching, and extraordinary were the comments by the readers of the essay. The comments are aimed directly at the heart of what makes dogs great and clearly come from dog lovers. I have included three of my favorites.

War is different, dogs are not

One reader comments, “War has changed, but the human-canine bond has not. I have no doubt that today’s dogs do as much to support our soldiers’ morale and help them withstand the stress and horrors of war as those faithful dogs of long ago did for the Civil War soldiers they accompanied.”

The American Civil War is the only war fought entirely on American soil. There were over one million casualties, many of them from disease. Compare the Civil War to our current wars being fought far from home. The casualties are fewer, but no less wrenching for the bereaved families. Military dogs continue to play an important role for our soldiers. In addition to the military dogs, there are the family dogs that wait patiently at home. These dogs, shown in this video with nearly a quarter million hits, are jubilant when their solider comes home.

America’s number one dog

According to the American Kennel Club, the gentle, intelligent and family friendly Labrador Retriever continues to be the most popular dog in America. This reader understands how irresistible these lovable dogs are:

“That [having Labrador Retrievers trained to identify improvised explosive devices would appear to be a smart move, since a major facet of the counterinsurgency mission is to win the hearts and minds of the indigenous population. One can surmise that a Labrador Retriever accompanying combat troops conveys a…peaceful image.” What better ambassador for America and what better companion for our soldiers than American’s number one dog?

We love them even if they shed

Labrador Retrievers are notorious shedders; so much so that I have written about Labrador hair previously. The third comment comes from someone who is clearly a Lab aficionado. “Expect lots of hair in the MREs [Meals Ready to Eat]. My lab passed away this August, but I am still finding his hairs everywhere in the house.” I can tell from this comment, the author’s Labrador will always hold a special place in his heart. Soldier dogs are special, but what dog isn’t?

Soldier dogs can find explosives, function as a sentry, or take down an enemy soldier. For this we praise their courage and cunning. But the commenters on Maria Goodavedge’s essay see more in dogs than their clever minds. They see the heart and soul of the beast, the part we love and cherish most.

Photo: Sergeant Christopher Duke and his Afghan dog, Rufus, reunited back in the USA. Rufus was honored by The Animal Medical Center in 2010 for saving 50 American soldiers from a suicide bomber in Afghanistan. Photo by Josh D. Weiss

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This may also be found in the Tales from the Pet Clinic blog on WebMD.com.

For over a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.