How Do You Know if Your Dog is in Pain?

I get asked this question daily by at least one worried dog owner. Since dogs can’t talk, how do we identify a dog in pain?

Jack's legs

Dogs and Pain
Sometimes identifying pain is easy. Dogs hit by a car or suffering from another traumatic injury are obviously painful. Here is a photograph of an Irish Setter, with two reasons to be in pain. The leg on the right side of the photo looks red, sore and swollen. This skin change is induced by radiation therapy used to treat a bone tumor and it will resolve now that radiation is completed. The swelling is caused by a bone tumor. Bone tumors are particularly painful and tend to cause limping, which is what clued the dog owner in to Jack’s problem. Treatment is already making him walk better.

Sylvie after back surgery

Back Pain in Dogs
A dog with a slipped disc in the back (intervertebral disc disease) typically cries and whines, without external signs of injury, but the dog owner can readily determine there is a pain problem. Sylvie, shown here after her back surgery, came toThe AMC because her owners noted her crying when they picked her up. Later, they noticed she was having difficulty walking. Examination at The AMC identified her back as the source of the pain and she had surgery to remove the disc and relieve the pain.

Signs of Subtle Pain
Extreme pain is reasonably easy to identify; subtle pain may not be so easy to spot. With hospitalized patients, we look for changes in the sleep-wake cycle, a decrease in appetite or poor grooming habits. We also watch how the dog sits or lays in its cage. Painful dogs may hide in the back of the cage or sit in a strange fashion to protect a painful area of their body. Licking, rubbing or scratching a particular area of the body may also indicate a painful area. Whining and crying are not reliable pain indicators, but we monitor these behaviors in our hospitalized patients in case they indicate pain in a particular individual.

If you think your animal is in pain, a trip to the veterinarian is in order. In the past few years, new drugs to treat pain have been developed for dogs. Keep in mind, painful animals are typically frightened and even the most docile pet can bite when handled if it is experiencing severe pain. If your dog is injured and needs transportation to the ER, consider using a muzzle, or if you don’t have one, a necktie to gently tie his muzzle closed while he is handled because you don’t want to have to go to the ER too.

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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.

10 Reasons to Go to the Pet ER Now!

Although I regularly share pet healthcare information on the AMC blog, I also like to remind readers that this information is not a substitute for a vet visit. You should always contact your veterinarian in an emergency. In case you are unsure as to what constitutes a pet emergency, here are my top ten reasons to take your pet to the ER (in no particular order):

1. Vomiting or diarrhea — not the run of the mill variety, but more than 2 or 3 times in an hour or if it is bloody. If the retching is unproductive in a dog with a distended abdomen, worry about bloat.

2. Red eye, runny eye or an eye injury. The littlest eye injury can quickly turn into a big problem.

3. Ingestion of a possible toxin, such as antifreeze (ethelene glycol), rat poison, human medications or a toxic plant.

4. Difficulty breathing or excessive coughing. Your dog might hold her head and neck extended to get more air or your cat might start breathing through his mouth.

5. Traumatic event such as being hit by a car or falling from a window. On the outside your pet might look fine, but internally may have suffered a serious injury.

6. Straining to urinate, especially if no urine is being produced.

7. Collapse, loss of consciousness or a possible seizure. Early intervention could prevent another one of these frightening episodes.

8. Bleeding from anywhere: a cut, a torn toenail or serious bruising under the skin.

9. An acute allergic reaction, especially if it involves swelling of the face and could compromise breathing.

10. Just to show the ER doctors how much better your pet is feeling and to thank them!

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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.

Big Dog or Little Dog: Whose Bite is Worse Than Their Bark?

Two news articles caught our attention at The Animal Medical Center last week regarding the type of dogs involved in bite injuries to humans. The articles seem to tell different stories, or do they?

Would you believe that “tiny” dogs were responsible for a record number of reported bites in New York City, according to a recent NY Post article? Surprisingly, the leader of the pack was the chihuahua.

The infamous pit bull came in second on reported bites in NYC, and are the vast majority of dogs in NYC shelters, according to MSNBC.com.

It’s important to remember that “any dog — any size — can bite.” Some dogs, unaware of their actual size, may bite out of instinct, fear or surprise.

Small dogs may not have developed the social skills required for interactions with strangers, perhaps because their owners may not realize all dogs — even small ones — require some form of obedience training. Living and working in New York City, I see small dogs tagging along with their owners — whether it’s shopping, running errands (eg: dry cleaners, bank) or even to lunch. Often these little creatures are poking their heads out of a tote bag or being carried in the owner’s arms. Consequently, it’s not unusual for passersby to reach out and want to pet these adorable dogs. Perhaps fearful of their touch or surprised by it, many of these small dogs resort to biting as a way to protect themselves.

Based on New York City data, pit bulls were ranked second with reported human bites. Moreover, many municipalities are becoming increasingly concerned about the risks associated with pit bulls.

Research has shown that dogs who have been neutered and had some form of obedience training are less likely to bite. Unfortunately, it is a widely recognized that pit bull owners may be less likely to neuter and obedience-train their dog.

While pit bulls are all too common in New York City shelters, San Francisco has been successful in reducing the number of pit bulls in their shelters.Thanks to a “sterilization law” passed in 2005, San Francisco has reported 26% fewer pit bulls have been impounded and 40% fewer have been euthanized. No doubt, the reported number of bite injuries related to the pit bull has dramatically been reduced, too.

I’m happy to report that the ASPCA in New York City is taking action to help reduce the pit bull population. The program, coined “Operation Pit,” offers free spays and neuter surgeries for pit bulls. These surgeries have both health and reproductive benefits in dogs.

The Animal Medical Center applauds The ASPCA on this effort and recognizes this as a call-to-action for pit bull owners. Please take advantage of Operation Pit, along with any obedience training opportunities you can find. Let’s work together to get the pit bulls out of the shelters, trained, neutered and into loving homes…and off the top of the New York City biter list.

This blog may also be found in the “Tales from the Pet Clinic” blog from WebMD.

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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.

Pet Related Injuries

Martha Stewart with Francesca & Sharkey (photo: marthastewart.com)

The popular press reported last week how an accidental head butt from Martha Stewart’s French Bulldog Francesca resulted in an injury requiring nine stitches to repair the damage to Ms. Stewart’s lip. The accident occurred when the sleeping Francesca was startled by Ms. Stewart saying goodbye. Francesca jumped up — crashed into Ms. Stewart and illustrated the consequences of not letting sleeping dogs lie.

Ms. Stewart was not likely the only one seen in the ER last week with a pet related injury. A national sample of ER visits from 60 hospitals over a six year period reported 7,456 visits were related to falls caused by pets. On a national level, this would translate to nearly 90,000 fall injuries associated with cats and dogs per year. Researchers also found dogs were over seven times more likely to cause falls than cats were.

Women were twice as likely as men to be injured by pet related falls. The elderly had a highest rate of fractured bones, but children 0-14 years of age were frequently injured as well.

In addition to being injured in animal related falls, children are also the most frequent victims of dog bite injuries. A boy, aged 5-9 years is the typical dog bite victim and children are commonly bitten in the face and neck. Bites often occur when children try to take food away from the family dog or unknowingly approach an unfriendly dog.

Awareness of these types of injuries is just the first step in prevention. The Animal Medical Center’s veterinarians recommend teaching your pet manners through obedience training — one method of minimizing behaviors which might precipitate a fall, such as pulling on a leash or jumping up on people. Unneutered male dogs are more commonly involved in bite injuries than female dogs. Preventing bite injuries is just one reason The AMC’s veterinarians recommend neutering male dogs at 6 months of age. Children should be educated regarding appropriate behavior around dogs and should always ask permission of the dog owner if they want to pet a dog they meet on the street.

This blog may also be found in the “Tales from the Pet Clinic” blog from WebMD.

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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.

Measuring Your Pet’s Medication

Medical professionals, veterinarians included, speak to each other in our own language, more difficult to understand than either ancient Latin or Greek. This language is confusing to pet owners and often results in question about medication administration.

This weekend was a case in point. An owner called while she was out of town on vacation. I had completely confused her with my instructions on how much medication to administer. She was hours away and unable to drop by The Animal Medical Center for a refresher course. In giving instructions, I forgot pet owners are not always well versed in scientific weights and measures and the sight of an oral dosing syringe can induce paralysis in even the most educated client. Here are the definitions for some of the most confusing terms.

Milliliter (ml) is a measure of volume and a liquid medication dose is commonly given in milliliters. A milliliter is the same as a cc (cubic centimeter). But a milliliter does not tell how much medication is being given. Medication is typically measured in milligrams (mg). For example, a tablet of the antibiotic amoxicillin contains a set number of milligrams, but the milligrams contained in a milliliter of amoxicillin depend on the particular antibiotic brand’s strength. In other words, all liquid medications are not created equal. Veterinarians will always talk about how many milligrams your pet needs when you want to know is how many milliliters to squirt down the throat of your dog who has its teeth clamped shut and has just slipped under your king sized bed.

A diabetic pet presents a special set of challenges, one of which is how much insulin to give. Based on the comments above, the careful reader would surmise insulin is given in milliliters – it is a liquid medication after all. But no, it is given in units and double no, 1 unit does not equal a milliliter. If you have U 100 insulin, 100 units = 1 milliliter. If you have U 40 insulin, 40 units = 1 milliliter. To complicate matters more, each insulin needs its own special syringe matched to the type of insulin, ie, U 100 syringes for U 100 insulin. Understanding these seemingly trivial differences means success or failure in treating your diabetic pet.

Decimal points are another prescription predicament. The numbers 5.0, 0.5 and .05 are 100 fold different and yet when they appear on a prescription label they can be confusing. Proper prescriptions use zeros to highlight a decimal point. Numbers should have a leading zero before any decimal point, ie 0.5 is correct. Numbers should not have a trailing zero, ie 5.0 is incorrect. These differences highlight how carefully pet owners should read a medication label before administering a new medication.

Finally, because of the obesity epidemic in pets, veterinarians are making pet owners more conscious of how much pets eat. One cup is easy to understand, but calories per cup vary dramatically. One cup of Eukanuba puppy food contains 503 kcal and one cup of their weight control product for large breed dogs contains 272 kcal. Some foods list kcal per kg (kilogram) of food. Converting kilograms (a measure of weight) to cups (a measure of volume) requires advanced math, or a scale from your local cookware shop.

So when it comes to medicating your pet, ask lots of questions and don’t be afraid to call your veterinarian’s office for clarification, because a microgram of prevention is worth a milligram of cure.

Have you ever encountered problems with your pet’s medication dosing? Tell us your story by commenting below!

This blog may also be found in the “Tales from the Pet Clinic” blog from WebMD.

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For nearly 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.

Bedbugs and Pets

A few weekends ago, I was volunteering at The AMC’s “Ask the Vet” booth during AKC’s Meet the Breeds show at the Jacob Javits Center in New York City. A pet owner came to the booth with questions about bedbugs and pets. I know there is a nationwide epidemic of bedbugs, but in veterinary school parasitology, I remember learning bedbugs are a nuisance to humans not animals. I decided to do some reading and here is what I found.

First, a bit about bedbug biology. They belong to the family Cimicidae and are flightless, so they crawl to their host. Like most parasites, bedbugs are very specific in their choice of host. And fortunately for your pet, bedbugs prefer people over pets. The blood of humans, dogs and cats is different and bedbugs have evolved to feast on human blood. Bedbugs climb on their host only to feed and spend the rest of the time in mattresses, furniture and crevices. As nocturnal creatures, they feed at night, attacking their sleeping host, hence their colloquial name bedbug. For more information on bedbug biology from entomologists (bug experts), go to http://www.oasas.state.ny.us/AdMed/FYI/bedbugs.cfm.

Bedbugs live in environments, not on pets or people, and can easily be confused with other household bugs. If your pet has critters crawling in its fur, black specks deposited on its blanket and is scratching up a storm, most likely your pet has fleas, not bedbugs. This time of year when the weather gets cold, fleas are looking to move indoors and you might be more likely to see them in your house. 

If you do discover bedbugs, there are a few things you can do to decrease the number of bedbugs in your home. Wash bedding in hot, soapy water and dry them in a hot dryer (>120 degrees F). Vacuuming thoroughly and discarding the bag after each vacuuming session will help decrease bedbugs in the environment. Ultimately, most people need a professional exterminator to clear the bedbugs from their home. For more information on eradicating bedbugs from your home, go to http://www.nyc.gov/html/doh/downloads/pdf/vector/bed-bug-guide.pdf.

If you use the services of a professional exterminator, follow his directions explicitly. Keep in mind, insecticides are common causes of toxicity in pets. Insecticides used in the treatment of environmental bedbugs are generally safe for pets if used properly. 

If your pet has previously experienced reactions to flea and tick preventatives, check with your veterinarian to determine if the product your exterminator recommended is safe for your pet.

This blog and many others may be found in the “Tales from the Pet Clinic” blog from WebMD.
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For nearly 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.

World Rabies Day 2010

Tuesday September 28 is World Rabies Day. This is the 4th year of the event to raise awareness of and resources for rabies prevention and control.

For most Americans, rabies is not an imminent threat, but worldwide, rabies is estimated to kill 55,000 humans annually. Over 99% of human cases are caused by the bite of a rabid dog. Most cases of human rabies occur in Asia and Africa where rabies vaccination of dogs to prevent human exposure to the rabies virus is beyond the financial scope of these country’s public health system.

Despite the lost cost and ready availability of a rabies vaccine for both dogs and cats in the United States, not all states require rabies vaccines in pets. There are 12 states that do not require rabies vaccinations for dogs and 20 that do not require rabies vaccinations for cats. Rabies has been on the decline in dogs since the early 1990’s. The lower number of states requiring feline rabies vaccinations may explain why the nationwide data for 2008 reports 294 rabies positive cats and only 75 rabies positive dogs.

Rabies vaccination is successful in controlling the spread of this deadly disease. Case in point is New York City, where the canine vaccination requirement has resulted in a city free of canine rabies for over 50 years. Although rabies vaccination is required for New York City cats, 12 cats have tested positive for rabies since feline rabies surveillance started in 1992, mirroring the increase in feline rabies nationwide. Despite the success in vaccinating pet against rabies, New York City is currently experiencing an increase in rabies in raccoons and coyotes in our large parks. Rabid wildlife and rabid feral cats pose a risk to the public since it is hard to resist feeding and petting animals in the park if they appear friendly.

Rabies prevention starts with the pet owner. When your cat or dog makes its annual wellness visit to the veterinarian, ask if a rabies vaccine is appropriate for your pet. Veterinarians consider rabies vaccination a ‘core’ vaccine. This means the vaccination is critical to protecting the health of the pet and the pet’s family. Very few pets will not be given the ‘core’ vaccines. Your family veterinarian is the person to advise you on the laws regarding rabies in your state and the need for your pet to be vaccinated against rabies.

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For nearly 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.

National Dog Bite Prevention Week: May 16-22, 2010

The most recent data from the New York City Department of Heath and Mental Hygiene indicates that 3,452 New Yorkers reported being bitten by a dog in 2007 and 3,598 in 2008. Since many bites go unreported, the actual number of bites is probably higher in our city. Dog bites are more commonly reported in New York City than lead poisoning in children and reported dog bites are equal to the number of citywide HIV diagnoses for the same years. The Centers for Disease Control reports children ages 5-9 years have the highest rate of dog bite injuries. Most of these injuries occur to the head and neck region and boys are more likely to be bitten by dogs than girls.

Vigilant parents have their kids tested for lead poisoning and talk to their kids about the spread of HIV. Dog bite prevention should be added to the parenting to do list. Here are some suggestions to make this part of parenting easier:

• Supervise all interactions between babies/small children and dogs.
• Teach your children to avoid approaching a strange dog.
• Have children always request permission from the dog owner before petting any dog.
• Add a dog safety book to your home library. Two cute ones are: May I pet your dog? by Stephanie Calmenson and The Blue Dog Parent Guide and CD sponsored by the Blue Dog Trust (UK).
• Watch a free, child-friendly dog safety video together, such as “Play Nice With Dogs” from HealthyPet.com.

Following these guidelines can help keep your children and your dog safe. Join us on Saturday, June 5th at The AMC’s PAW Day 2010, a FREE pet health and wellness fair, and find out more about how to play it safe with your beloved pets. Several child appropriate activities will be available to reinforce dog safety. For additional information about this event, please contact Courtney Rabb at 212.329.8666 or courtney.rabb@amcny.org or visit www.amcny.org.

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For nearly a century, The Animal Medical Center has been a national leader in animal healthcare, 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. Visit www.amcny.org for more information.

How to Prevent Dog Bites

May 17-23 is National Dog Bite Prevention Week and The Animal Medical Center (AMC) is kicking it off on Saturday May 16th with “Don’t Be Ruff,” a dog safety fair at Asphalt Green on Manhattan’s Upper East Side. This event, sponsored by the Veterinary Medical Association of New York City, New York City Department of Health and Mental Hygiene, Asphalt Green, Ada Nieves and Prima Dog, DoDo, and , Dick Flanagan-State Farm Insurance , is being held from 3:00-5:00 p.m. and is free! The event will be educational and fun for all age groups.

Dog bite injuries are a serious issue and comprise one percent of all emergency room visits. The good news is that dog bites are a preventable health concern. Prevention of dog bite injuries requires education about risk factors and avoidance strategies. These two issues will be the target of Saturday’s “Don’t Be Ruff” event, with educational information developed by AMC staff veterinarians. Friendly well trained dogs will be at the event to allow children to practice safe dog interactions.

Fortunately, due to research by veterinarians and physicians, we have identified easily modifiable risk factors associated with dog bite injuries. Those at greatest risk for being bitten are children between five and nine years of age. Most bite injuries in children are inflicted by a dog known to them, either the family dog or a neighbor’s dog. Postmen, home health care workers and meter readers are also at increased risk. Entering a dog’s “space,” interacting with a dog while it is eating or surprising a sleeping dog can provoke even a gentle dog to bite.

Certain dogs are more likely to be involved in bite injuries. Intact (not neutered) male dogs are three times more likely to be involved in dog bite injuries. Dogs that are kept tied up outdoors can be territorial, making them more prone to biting. Dogs with medical conditions are more likely to bite than dogs that are healthy.

Additionally, more bite injuries occur in the summer months, perhaps because children and dogs are frequently together outdoors or perhaps dogs are cranky, just like the rest of us are when it is hot and sticky outside.

The veterinarians at The Animal Medical Center recommend proper care and training of the family dog to help prevent bite injuries because behavior is a reflection of both emotional and physical health. The AMC suggests every dog see its veterinarian annually to spot any correctable health problems early. Due to their increased risk for biting, all male dogs should be neutered at about six months of age. Spaying is done in female dogs at the same age, but for different health benefits. Obedience training teaches dogs to politely interact with humans and other dogs and will make a dog less likely to bite.

Several simple steps can help protect family members from dog bite injuries. All children should be taught the steps of safely interacting with dogs and coached to ask a dog owner if he/she can pet a dog they meet. Parents should be extra vigilant about dog safety in the summer, since most dog bite injuries occur in the warmer months. All interactions between children and the family dog should be supervised. Playing with your dog is important, but the games you play should not be tug of war or chasing games which could get out of control and lead to an inadvertent bite. When walking your dog, it should be under your control on a leash to allow you to prevent an unwanted interaction with a stranger or strange dog.

Following these guidelines can help keep you and your dog safe. Join us next Saturday, May 16th at “Don’t Be Ruff” and find out how to play it safe with your beloved pets. For additional information about this event, please contact Courtney Rabb at 212.329.8666 or courtney.rabb@amcny.org or visit www.amcny.org.

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For nearly a century, The Animal Medical Center has been a national leader in animal healthcare, 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. Visit www.amcny.org for more information.