Canine and Feline Heartworms: The Long and Skinny for Pet Owners

March 21, 2014
Photo: American Heartworm Society

Photo: American Heartworm Society

Just in time for spring, the American Heartworm Society has released its updated 2014 Canine and Feline Guidelines for treatment and prevention of heartworm disease. We always think about heartworms in the spring because they are spread by mosquitoes that become active at this time of year. These days, with global warming and urban heat islands, mosquitoes have expanded their season and their territory; the American Heartworm Society has amended its guidelines to provide up-to-date recommendations for your dog and cat 

Treat Your Dog Year-Round with a Heartworm Preventative
This recommendation is designed to offer your dog maximum protection against heartworms, with minimal effort on your part. Heartworm disease is a serious and life-threatening illness in dogs. Although treatment of the disease can be successful, it is far more prudent for pet owners to administer a medication that is safe and simple than to treat a dog that has contracted the disease. Here at The AMC in NYC, where we have experienced a more severe winter than in recent years, there is clearly not a mosquito around to spread heartworms. However, I have recently signed many health certificates for travel to warmer, mosquito filled climates. If these patients are on year round heartworm medication, their families have one less travel worry in preparation for a trip down south.

Get Your Dog an Annual Heartworm Test
Most cases of canine heartworms can be diagnosed using less than a teaspoon of blood and an in-clinic test. Annual heartworm screening can detect infections early, before the cardiopulmonary system has been damaged due to the presence of heartworms within the heart and the blood vessels of the lungs. Early diagnosis gives your dog the best chance of recovering from a heartworm infection.

Don’t Think of Your Cat as a Small Dog When it Comes to Heartworms
Cats are susceptible to heartworm infection, but less so than dogs and they tend to have fewer worms than dogs do; however, given the small size of cats, a few worms is enough to cause serious heart and lung disease. Heartworms persist in cats for 2-3 years and then they die. When adult heartworms die, that is when they are most dangerous for your cat. Dead heartworms can cause blood clots to form in the lungs which can be fatal. Prevention of heartworm infection in cats is critical since the Heartworm Society reports there is no treatment that prolongs survival of cats diagnosed with adult heartworms. Cats can take a monthly heartworm preventative, just like dogs do.

Follow These Simple Rules

  1. Test your dog annually for heartworms. Any dog over 7 months of age is old enough to have contracted the disease.
  2. Talk to your veterinarian about which type of heartworm preventative—pills, topical or injectable—is best for your pet’s lifestyle.
  3. Give heartworm preventative on schedule. A late dose can result in heartworm infection.
  4. Avoid taking your pet out at dusk and dawn when mosquitoes are most active, and keep them away from standing water where mosquitoes breed or tall grass where they reside.

Want more information about heartworms? Read these previous posts:


Canine Heartworm Update

August 14, 2013

Last week I was a guest on Dr. Frank Adams’ monthly pet show on NYU Langone Medical Center’s “Dr. Radio.” One of the callers asked if heartworm preventative was really necessary in her dogs. She thought (incorrectly) that since she lived in an area where mosquitoes are uncommon, her dogs would be safe against heartworm infection. My answer to her was a resounding “yes” and I added, “Give those pills exactly on time.”

canine heartworm life cycle

Click image to enlarge

Treatment versus prevention
No dog owner would ever miss a dose of heartworm preventative if they knew how difficult and dangerous treating heartworms can be. When a diagnosis of heartworm disease is made, any signs of heart failure must be immediately controlled. After your dog’s heart has been stabilized, veterinarians then administer a drug by injection to kill the adult heartworms. Strict cage rest is instituted to minimize the risk of blood clots which may form in the lungs as a result of dying heartworms. Cage rest continues for at least a month after adult heartworm treatment. Protocols for the treatment of adult heartworms are 90-98% successful and if unsuccessful, your dog will need to be treated a second time. Throughout treatment for adult worms, your dog must be maintained on heartworm preventative in case of another bite by an infected mosquito.

Heartworm review
Mosquitoes transmit heartworms. A bite from an infected mosquito injects heartworm larvae into your dog’s blood stream. Heartworm preventative kills the larvae before they mature. If unchecked by heartworm preventative, the larvae mature in the large blood vessels of the heart and lungs, leading to severe heart and lung compromise.

CAPC changes heartworm recommendations
Last month, the Companion Animal Parasite Council revised its guidelines regarding canine heartworm disease. Council members cited new evidence of resistance of heartworms from the Mississippi Delta region to heartworm preventatives, specifically ivermectin, selamectin, moxidectin and milbemycin oxime, confirming years of speculation about resistance in the veterinary community. At this time, it is not known how widespread heartworm resistance is, but it makes an annual heartworm test even more important than before.

Heartworm prevention tips

  • Year round administration of heartworm medication gives the best protection against heartworms.
  • Giving heartworm medication precisely on time is critical to successful prevention.
  • Place the stickers from the heartworm preventative medication on your calendar to remind you to give the monthly heartworm preventative.
  • Sign up for email or text message reminders on your smartphone from the website of your heartworm preventative manufacturer.
  • Get the reminder app from the website of your heartworm preventative manufacturer.
  • Mosquitoes are most active at dawn and dusk. Keep your dog indoors during peak mosquito activity.
  • Ask your veterinarian about monthly flea and tick medications that also repel mosquitoes.

Ten Tips for Dog Safe Summer Exercise

April 17, 2013
Animal Medical Center Doggy Dash participants

Animal Medical Center Doggy Dash participants

With summer just around the corner, everyone, including your dog, wants to be in shape for summer activities. Outdoor activities can be a fun way to spend time with your favorite pup. The veterinarians at The AMC have the following suggestions to make exercise safe and healthy for your dog:

  1. Have your pet examined by a veterinarian to ensure exercise is safe for your dog. Stop exercise and let your dog rest anytime he is resisting you, unable to keep up or showing other signs of distress.
  2. Always warm up your dog with a 10 minute walk prior to jogging or heavier exercise.
  3. Train your dog gradually to increase the amount of time and intensity of exercise over several weeks, just as you would train yourself.
  4. Massage your dog and provide gentle passive range of motion for all major joints.  You may do this before or after exercise, but it is most beneficial AFTER exercise.  In a side-lying position, keeping the limbs parallel to the body, gently flex and extend each joint of the front and hind limbs. Check out these videos on forelimb passive range of motion and hindlimb passive range of motion.
  5. Do not feed your dog a large meal for 2 hours prior to exercise. Exercising on a full stomach can predispose your dog to bloat, which can be life-threatening.
  6. Give your dog small and frequent amounts of water.  To facilitate this, consider carrying a collapsible bowl or a specially made, dog-friendly, BPA-free water bottle.
  7. Avoid exercising during the warmest part of the day, especially if you have a short-nosed dog.  Pugs and all types of bulldogs should stay in an air conditioned environment as much as possible and only have brief outdoor walks for bathroom breaks during peak heat.  When heat and humidity are high, short-nosed dogs cannot cool themselves by panting as efficiently as their long-nosed cousins and are more prone to heat stroke than the average dog.
  8. Keep dark coated dogs out of direct sunlight while exercising.  Their dark coats absorb heat, making them prone to heatstroke as well.
  9. Consider a cooling jacket for dogs exercising in summer heat.
  10. Provide your dog a shady place to rest after exercising.  For elegant comfort, try these fashionable outdoor beds.

If you and your dog are running partners, consider registering for the Animal Medical Center Doggy Dash, a 5 mile run in conjunction with the New York City Triathalon.

Thanks to Dr. Leilani Alvarez from The Animal Medical Center’s Tina Santi Flaherty Rehabilitation & Fitness Service for her helpful hints on exercising your dog.


Avoiding the Knife: Preventing Pet Surgeries

April 11, 2013

At The Animal Medical Center, our board certified surgeons and neurologists perform approximately 1,500 surgeries each year. A recently released pet insurance study completed in 2012 listed the top ten surgery claims for both dogs and cats:

Top-10-Canine-Conditions-large

Survey attributed to VPI Pet Insurance 2012

Since none of us want our pets to be subjected to the difficulties most surgeries pose, I will devote this blog to suggestions on how to avoid some of the most common canine and feline surgeries.

Tooth extractions

Topping the surgery list for cats and coming in at number three for dogs were tooth extractions. Keeping your pets’ teeth healthy means daily brushing and annual dental cleanings. The American Veterinary Dental College website provides good information about home dental care in dogs and cats. Remember, doggy breath often means periodontal disease, so if your pet has smelly breath, see your veterinarian for treatment before extractions become necessary.

Skin abscess, inflammation and pressure ulcers

This list of skin conditions ranks number two as a reason for surgery in both dogs and cats. Pressure ulcers generally occur in older dogs with limited mobility. Padding, padding and more padding will help prevent pressure ulcers on their elbows and thighs. Investigate orthopedic beds for your dog and try to keep him from laying on hard surfaces like the bathroom tile floor which can aggravate pressure sores. Promote mobility in your dog through regular exercise and management of arthritis with diet and medications.

Feline bite wounds

When I was a veterinarian in a more suburban area, we treated cat bite wounds on a daily basis. Preventing cat bite injuries is as simple as keeping your cat indoors. Cat bites not only cause wounds which can become abscesses, but cat bites transmit the feline immunodeficiency virus and possibly blood parasites as well. Priceless is how I define the value of keeping your cat indoors and healthy.

Aural hematoma

The tenth most common surgery in dogs was to repair an aural (ear) hematoma. Cats can develop aural hematomas too, just not as commonly as dogs. This condition is essentially a blood blister inside the ear flap. Blood accumulates in the ear flap when your dog incessantly shakes his head or scratches her ears. Usually, the shaking and scratching is in response to an allergy or an ear infection. If you see this behavior, check inside the ear for redness or discharge. See your veterinarian immediately to treat the cause of the shaking and scratching to prevent the development of an aural hematoma.

While some surgeries are unavoidable, these are prime examples of how a visit to your veterinarian for routine preventive care can help your pet avoid surgery.


Brush Up on Your Bicuspids: A Dog and Cat Tooth Tour

February 11, 2013

February is National Pet Dental Health Month. According to the American Veterinary Dental College, your pet needs daily toothbrushing and annual dental cleanings to keep their pearly whites white. Just like your visit to the dentist, where x-rays are taken to find periodontal disease or tooth abscesses, x-rays are a critical component of an annual dental cleaning for your dog or cat. Since most pet owners don’t get a chance to see their pet’s dental x-rays, I thought I would show you some from The Animal Medical Center.

dental1

Above, you see Spanky the cat’s six normal front teeth (incisors) flanked by his big fangs, also called canine teeth, even though he is a cat. Based on x-rays, the rest of Spanky’s teeth were normal and he did not have to have any teeth extracted during his annual dental cleaning.

 dental2

In this x-ray you see one of Rhett Butler’s big molars. Both roots are surrounded by a dark area, instead of normal white bone. The dark area represents a periapical tooth root abscess which was the cause of his reluctance to eat and his swollen face. Once the tooth was extracted and he was treated with antibiotics, he recovered quickly.

dental3dental4

Here you see dental x-rays of the right jaw of two different cats – Spanky on the left and Willie on the right. At first glance, the two look the same. If you look closely you will notice the third tooth in Willie’s x-ray appears moth eaten, especially on the left side of the tooth. The appearance is characteristic of a feline odontoclastic resorptive lesion (FORLS) or root resorption. Teeth with root resorptions need to be extracted as they can be painful and are prone to fracturing. The American Veterinary Dental College recommends cats affected by FORLS should be evaluated twice annually to detect and treat these lesions early.

dental5

Despite daily tooth brushing by her owner, Pippa has developed periodontal disease. You can see a pocket of bone loss around the two adjoining teeth. Both teeth had to be extracted during her annual dental cleaning.

Since I shared pictures of pets’ pearly whites, you might want to share yours!

On Flickr: http://www.flickr.com/groups/pearlywhitepets

On Facebook: http://www.facebook.com/events/121936134646100/

On Twitter: Use the hashtag #pearlywhitepets


Pneumonia in the Summer?

August 23, 2012

The veterinarians at The Animal Medical Center, myself included, spent much of last week diagnosing and treating pneumonia in our canine and feline patients. I suspect many readers are surprised to find me writing about pneumonia in the summer. Cold weather, colds, and the flu bring pneumonia to mind, not the heat and humidity of August. None of these patients had a cold or the flu, but all had other medical problems leading to pneumonia.

Delbert’s debacle

Asthma in cats differs in most ways from the disease in humans – except both cats and humans with asthma are prone to developing pneumonia. The bronchi (breathing tubes in the lungs) of cats with asthma become inflamed. The inflammation blocks transfer of oxygen in the lungs, causing a cough or difficult breathing. Inflammation of the bronchi disturbs normal lung function, increasing a cat’s risk of developing pneumonia. This is exactly what happened to Delbert. He has asthma. Last summer and again this summer, he is fighting a case of pneumonia provoked by his asthma.

Gem’s tummy troubles

Twisted stomachs, also called bloat, threaten dog’s lives; not just because of the stomach problem, but because these dog’s vomit frequently. Gem successfully underwent surgery to put her twisted stomach back in place, but one of the many times she vomited, food went down the wrong pipe and into her lungs. When food goes into the lungs, the condition is called aspiration pneumonia. Aspiration pneumonia can occur after any episode of vomiting, but is most likely to occur in an already critically ill pet, not after a simple case of tummy upset.

Frederik the Great

This champion Cavalier King Charles spaniel stars in an award-winning children’s book, Frederik goes to Hollywood. Right now he is the star ICU patient with, you guessed it, pneumonia. Frederik has a malfunctioning esophagus which cannot properly transport food into the stomach. This abnormality, called megaesophagus, creates a situation similar to Gem’s, where food ends up in Frederik’s lungs and causes pneumonia. Frederik has the most severe case of the three patients. Severe cases of pneumonia require treatment in an oxygen cage, intravenous fluids, and antibiotics. Happily, the pneumonia has been improving and he will go home shortly.

Recognizing pneumonia

How can you as a pet owner recognize pneumonia before your pet is seriously ill? As these cases show, the time of year clearly does not help you recognize pneumonia in your pet. Pneumonia might start with a cough which gets worse over time. Delbert’s family noticed weight loss and a few days later a cough. I saw Frederik in the waiting room just prior to his admission to the hospital. He looked like a limp rag. His owner thinks the pneumonia could have been triggered by the difference between last week’s heat and humidity outdoors compared to the cool of the air conditioned apartment. Gem developed a fever following surgery. The fever clued her doctors in to the possibility of pneumonia. Cough, weight loss, lethargy, and fever are all good reasons to see your pet’s veterinarian to make sure pneumonia is not the problem.


Urine Dribbling: Plugging the Leaking Dog

December 14, 2011

Willa came to The AMC today. Her owner was worried she might have diabetes because the dog bed was smelly and soaked with urine the last couple of mornings. Dogs with diabetes (and cats too!) will drink and urinate excessively, often having accidents in the house. When I questioned Willa’s owner, the “accidents” only happened when the dog was sleeping and there was no increase in water consumption or urinations. A quick test of the urine the owner brought with her dog determined diabetes was not the problem.

Causes of Urine Dribbling
Simple and complex disorders can lead to urination abnormalities in dogs. Infections, bladder stones and hormone problems are common causes of urine leakage and can readily be identified with routine blood tests, analysis of urine and x-rays. The x-ray to the right shows a dog with four large stones in its bladder. In some cases, a special diet will dissolve bladder stones. In this case, surgical removal of the stones resolved the urine dribbling.

In Willa’s case, testing showed no urinary tract infection, no stones and no blood test abnormalities. Because she is an older spayed female dog, I thought she might have “urethral incompetence.” Large breed, older, spayed female dogs are at risk for developing this condition, which may be related to a lack of estrogen in spayed female dogs and occasionally neutered males.

Treatments for Urine Dribbling
Commonly it is treated with medications including drugs to tighten the urethra (known as α-blockers), such as phenylpropanolamine, ephedrine or pseudoephedrine, or with estrogen replacement therapy using diethylstilbestrol. Recently, the Food and Drug Administration approved estriol for use in dogs.

If your dog resists taking medications, specialists at The Animal Medical Center can inject collagen into the urethral wall using special noninvasive endoscopic equipment to help narrow the urethral lumen and prevent urine dribbling. For refractory cases, AMC specialists also use a hydraulic urethral occluder.

Willa quickly responded to treatment with estrogen and once again has a dry bed in the morning. With all these options available to plug the leak, no dog should have to suffer with a stinky, wet bed.

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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 http://www.amcny.org. To make an appointment, please call 212.838.7053.


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