Looking for a fun, outdoor activity for the whole family this weekend? Join us at The AMC’s Annual PAW (Pet and Wellness) Day celebration in Carl Schurz Park (84th Street and East End Avenue, 10am – 1pm), where every family member, including the furry ones, will find special activities designed just for them.
Doggy massages and more Members of The AMC’s Tina Santi Flaherty Rehabilitation & Fitness Service will teach two sessions on how to relax your dog with yoga and massage. Veterinary staff from The AMC will provide free screenings for canine high blood pressure (hypertension), tooth brushing lessons, obesity assessment and many other hands-on health activities.
There will also be two sessions entitled, “Pet First Aid for the Pet Owner,” presented by one of The AMC’s board certified emergency and critical care veterinarians. Other specialist veterinarians from The AMC will be on hand to answer questions about pet health and disease. They will distribute pamphlets and fliers as well as free samples of treats and pet products.
Kid’s stuff This year, PAW Day will feature a dog well known to children – Clifford, the Big Red Dog, from the PBS series of the same name. Another PAW Day highlight for children will be the stuffed animal veterinary clinic. Children may bring their favorite stuffed animal for a veterinary examination and treatment or adopt an animal at the event. Children attending PAW Day can also purchase a veterinary kit and receive instruction on examination techniques by the highly trained AMC veterinarians.
Over 400,000 children receive medical treatment each year for dog bite injuries. Since children are the most common victims of dog bites, every parent should be concerned with teaching their child how to safely interact with dogs. Children attending PAW Day can practice the four steps of being safe around dogs with friendly dog volunteers who will be on-hand. If children are shy around dogs, they can still learn about safe interactions with dogs at the coloring book station, which will be in a dog free zone.
PAW Day is free and open to the public, so stop by and say hello to your favorite AMC veterinarian! Check out The AMC’s website for additional information about the event: www.amcny.org/pawday2013.
Every morning around 5am, the veterinary staff at The Animal Medical Center receives an email listing the cases admitted to the hospital overnight. I found last Sunday’s list particularly intriguing. Four dogs were admitted to the hospital suffering from ingestion of a variety of toxic agents. All four dogs ultimately recovered, but there are some important lessons to be learned from these cases.
High time to avoid marijuana
Despite his bold name, Tiger is a tiny Chihuahua. He came to The AMC’s ER in the middle of the night for being wobbly and weak. The veterinarians used a special drug test kit on his urine and found he had been exposed to marijuana. Small dogs like Tiger can easily become intoxicated by ingesting marijuana or. They develop clinical signs similar to humans, but in serious cases, signs may progress to seizures and even coma. Veterinarians in Colorado, one of the states where medical marijuana is legal, report an increase in canine marijuana toxicity in their animal ERs.
Just say no to human drugs
Charlie, a cute Yorkshire terrier, landed in the ER for one of the most common intoxications: ingestion of a human medication. His owners thought he was painful and administered just a sliver of a naproxen tablet. Naproxen alone is enough to cause a gastric ulcer as well as damage his kidneys, but Charlie was also taking a steroid medication. Steroids plus naproxen are a ‘one, two punch’ to the stomach lining and Charlie vomited a dozen times on the way to The AMC. After two nights in the hospital, Charlie was much better and was released.
Chocolates are no treat
Bibi, a chocolate colored standard poodle, gave herself an abnormal heart rhythm by eating one half of a giant dark chocolate bar. Chocolate contains theobromine, a stimulant related to caffeine. The ER staff administered activated charcoal to help decrease the absorption of the theobromine. The darker the chocolate, the greater the concentration of theobromine in the chocolate. The theobromine is responsible for the hyperactivity, vomiting and abnormal heart rhythms. Like most dogs, Bibi has quite a sweet tooth. This is not the first time she has eaten chocolate, but the first time she consumed enough to require medical attention.
A sugar-free spree
Rocky, a German shepherd was the least sick of the overnight admissions, thanks to the quick response by his family and the ER staff. He had chowed down on some sugar-free gum containing xylitol. Dogs react much differently to xylitol than we do. Just a few pieces of gum are enough to drop a dog’s blood sugar to dangerously low levels and also cause liver failure. Because his family saw him eat the gum and the ER staff forced him to vomit, the gum did not cause any problems for Rocky other than a night away from home and some lost sleep.
Keeping your pet safe from toxins
The only medications your pet should receive should be those prescribed by your veterinarian. Although we often prescribe human medications, the doses used in pets may be vastly different than those used in humans, so never give your pet human medications without the approval of your veterinarian.
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:
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.
Always warm up your dog with a 10 minute walk prior to jogging or heavier exercise.
Train your dog gradually to increase the amount of time and intensity of exercise over several weeks, just as you would train yourself.
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.
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.
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.
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.
Keep dark coated dogs out of direct sunlight while exercising. Their dark coats absorb heat, making them prone to heatstroke as well.
Consider a cooling jacket for dogs exercising in summer heat.
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.
Everyone has heard them: the rapid fire voiceovers on television advertisements for medications. They sound something like this, “Do not use this medication if you have serious heart disease, suicidal thoughts, liver problems or hangnails. Ask your doctor if this drug is right for you.” If you fast forward through commercials on your DVR and have missed the voiceover, then perhaps you have opened a bag from your pharmacy and found the accordion pleated paper, printed in size two font, containing drug information, warnings, contraindications, precautions, adverse reactions and risks.
Here is a portion of one for a commonly used human medication:
General: Urticaria, drug rash, anaphylactic shock, photosensitivity, excessive perspiration, chills, dryness of mouth, nose, and throat
The United States Food and Drug Administration has strict regulations governing drug labels. Drug labels should be accurate and not promotional. The list of possible side effects is comprehensive to help prescribers, like me, alert their patients, like your pet, to possible problems that might arise while the medication is being taken. Without this critical information, you might keep giving a medication that is actually making your pet worse. The information on a drug label helps me to weigh the risk of not treating a disease with benefits of a medication used to treat the disease.
The warning labels for both the commonly used human drug and the canine chemotherapy agent sound moderately frightening and yet these drugs are critical to improving a patient’s quality or quantity of life. What the drug labels can’t substitute for is experience. Once your veterinarian or physician has used a drug on many patients, we know what to expect and what to tell you to expect. Reading the drug label is a good thing since it helps you to recognize any adverse reactions to medications early. Not giving a drug to your sick pet because the drug label is frightening is foolish, unless you tell your veterinarian about your concerns and together you decide the best course of action for your pet. Remember, we love to talk about sick pets and about medications; it’s what we do every day!
Oh, by the way, the human drug with the seven body system long list of adverse effects was Benadryl.
According to VetLearn, a company focused on continuing education for veterinarians and veterinary technicians, one of the top ten articles they published in 2012 was on anemia in dogs and cats. If an article on anemia tops your veterinarian’s reading list, then your pets are perplexing anemia cases. I would guess you have questions about anemia too.
Anemia: definition
Although the causes of anemia are complex, the definition is simple: if your pet is anemic, she doesn’t have the normal number of red blood cells speeding through her blood vessels carrying oxygen and nutrients to cells and removing cellular waste products. Without adequate oxygen, your usually peppy pup or cavorting cat acts dull and tired.
Liver and onions cause anemia?
You may think liver is a cure for anemia: not true. Last week we saw a cute wiener dog named Klauss. He came to The Animal Medical Center with dark brown urine. Although, Klauss didn’t seem sick to his owner, the color of the urine was frightening, provoking a trip to The AMC ER. The ER doctors found his urine contained a large amount of bilirubin, a breakdown product of red blood cells. They also found Klauss was anemic. Upon further questioning, the family reported of a raid on the trash can containing the leftovers of a of liver and onion dinner. Onions and garlic can damage the red blood cells of both dogs and cats, causing them to rupture and resulting in anemia. Klauss only needs to avoid eating onions and his body will shortly make new red blood cells.
Ironclad diagnosis
We take better care of our pets than ourselves, providing them with nutritious food while we snack out of the pantry. Because of their high level of nutrition, iron deficiency is rare in our furry friends. My patient Jackie, a Labrador with a jaw tumor, has developed a rare case of iron deficiency anemia. Three weeks ago, her tumor eroded a blood vessel and caused a major hemorrhage. When she lost blood, she also lost iron. On her most recent blood count, the red blood cells were tiny. The small size is a result of inadequate iron which keeps them from growing to normal size. An injection of iron will easily fix Jackie’s anemia.
Strange, but true
Hatshepsut, an Egyptian Mau cat, was not acting right. Because of a waning appetite, she came to the hospital for an evaluation. The radiologist saw an intestinal tract full of kitty litter when he reviewed her x-rays. Hatshepsut has a strange but true sign of anemia-pica – an appetite for eating non-food substances. Kitty litter is common, but I have seen dogs with anemia spend all day licking the grout between the bathroom tiles. The presence of kitty litter in the intestine made me suspect anemia, and a blood test confirmed it.
In conclusion
Blood loss, red blood cell destruction and faulty bone marrows are all causes of anemia.
Is your pet tired, eating strange items or just not feeling well in general? See your veterinarian for a blood count.
Does your pet’s skin or urine have a funny color? Take a urine sample to the veterinary clinic for testing.
Does your pet’s stool have funny color? Take a sample for analysis.
Sunday was Tripawds Awareness Day on the cleverly chosen date of 3/3. To celebrate tripawds, I thought I would tell you about a triplet of tripawd patients.
Every veterinarian has dog and cat patients with only three legs, or as one website calls them, tripawds. Because I am a cancer specialist, my tripawd patients all have a malignant tumor as the cause of their amputation, but other veterinarians perform amputations to treat a variety of diseases and injuries. One common cause of amputation in cats is a serious fracture that cannot be repaired. Infections of the bone cannot always be cured by antibiotic therapy and if the infection starts to cause pain, an amputation controls both pain and infection. When hit by a car, dogs and cats may suffer nerve damage to their front leg, sometimes resulting in paralysis. The paralyzed limb may drag on the ground and develop sores. Amputation resolves this problem once veterinarians have determined there is no hope of the limb regaining function.
Handsome Lester
Lester, a refined gentleman of a dog, came to The Animal Medical Center nearly two years ago. He has the black tongue of a Chow Chow, the coat of a Samoyed and sadly, osteosarcoma. Osteosarcoma is the most common bone tumor in dogs and in my practice is the most common cause of amputation. Because amputation treats the tumor in the bone but does not treat the little tumors lurking elsewhere, like the lungs, Lester received chemotherapy intravenously for a few months after surgery. Then Lester exceeded our expectations and was tumor-free for over one year. Late last summer, chest x-rays picked up new tumors in his lungs. Thanks to an oral chemotherapy drug, tripawd Lester continues to exceed our expectations with a great quality of life – walking on the beach with his naughty brother Nicholi.
Long live Ajax
Ajax, a 10 year old tripawd Labrador, appeared in an earlier blog when he had two simultaneous tumors, a thymoma near his heart and a soft tissue sarcoma on his hind leg. The sarcoma attached itself to his leg bone and could not be removed without losing the functionality of his leg. Ajax’s soft tissue sarcomas behaved very differently than Lester’s osteosarcoma. Amputation was the only treatment required to cure him of this tumor and he has survived nearly three years since the surgery.
Cheerful Jill
Jill’s family desperately tried to save her leg. They let several pathologists study her toe biopsy and we were hopeful surgical removal of the toe would be all the treatment she needed. Several months after the toe amputation, Jill’s family found a hard mass on the back of her leg, and a biopsy indicated the giant cell osteosarcoma of the toe had recurred. Since the possibility of amputation was discussed during the evaluation of the toe biopsy, Jill’s family was not surprised at the recommendation for an amputation once the tumor had returned. We also recommended chemotherapy, the same drugs we used successfully in Lester. To hear more about Jill and her adventures, read her blog on Tripawds.com.
Want more information about tripawd dogs?
In addition to the Tripawds website, there is also Canine Amputees. Their page of links is excellent.
Watch a video of a pair of bi-paws and their new rolling front legs.
Last week I saw two patients with Staph infections. Finding a Staph infection is not unusual; veterinarians see Staph infections every day because Staphylococcus bacteria are normal inhabitants of the skin of dogs. Staph infections start like this: your dog scratches, breaks the skin and the Staph slip in and cause an itchy infection in the hair follicle called pyoderma. Staphylococcuspsuedintermedius is one of the resident bacteria in the skin of dogs and a common cause of pyoderma. Staphylococcus aureus is the analogous human bacteria. When either of these bacteria acquires resistance to an antibiotic called methicillin, they have been branded “superbugs,” and in medical terms are called methicillin resistant Staphylococcus psuedintermedius (MRSP) or Staphylococcus aureus (MRSA). Just because they have the name superbug, doesn’t mean the infections caused by these bugs are not treatable; they are not successfully treated with the typical antibiotics we use for a “normal” Staph infection.
Hospital bug
Originally, MRSA/MRSP infections occurred in hospitalized human or animal patients, but recently MRSA infections have been found in patients who have never been in the hospital. This type of MRSA/MRSP infection is often called community acquired. Hospital acquired methicillin resistant infections can readily be transmitted from patient to patient in the hospital, and preventing transmission is one reason veterinarians and physicians wash and sanitize their hands between patients.
Infections with methicillin resistant bacteria may be becoming more widespread. Recently reports indicate wild rats can be carriers of MRSP and a baby alpaca was found to be colonized with MRSA. Obviously, these animals did not acquire the infection in the hospital.
Pets with the superbug
In studies testing a large number of dogs and cats for MRSP, less than one percent of animals screened carried these bacteria. This week’s first patient with MRSP developed a bladder infection confirmed via a urine culture to be MRSP. Neither she nor anyone in her family has been hospitalized, but she has recently completed a course of chemotherapy for a mast cell tumor and possibly the infection is related to those treatments. Happily, the test results indicated a common antibiotic will be effective in treating the infection.
People to pets?
The healthy pets living with humans infected with MRSA have been tested and some found to carry the MRSA which appears to be the same in both the pet and the human. In this interesting study, dogs, cats and even a hamster living with a human infected with MRSA were found to carry MRSA.
Whether the pets were the source of the infection or simply accidently infected by the human is unknown. Nevertheless, this study shows pets could be a source of infection or reinfection for their human family members.
Last week’s second patient with a Staphylococcus psuedintermedius infection did not have a methicillin resistant one, but she could have. Angel is a therapy dog who visits hospitals. Because of her occupational risk, we tested her to protect not only her health, but the health of those under her care.
What can a pet owner do?
If your veterinarian recommends a culture of your pet’s skin or urine, I strongly recommend you agree to the test to help determine the best course of treatment and to identify MRSA/MRSP early.
If you have a therapy pet, follow the guidelines set out by your therapy pet group to protect your pet, yourself and your patients.
If your pet has an infection, tell your veterinarian if someone in your family has recently been hospitalized or diagnosed with MRSA. This information is critical when we submit tests to the lab and prescribe antibiotics.
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.
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.
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.
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.
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!
Just in time for Valentine’s Day, February is American Heart Month. In 2012, The Animal Medical Center’s spokes-cat was Sidney, who developed fainting episodes which led to the diagnosis of a heart muscle abnormality, a condition common in cats.
This year, we have a spokes-dog who does not want to be outdone by last year’s spokes-cat. This dog has not one, but two types of heart problems at the same time!
An accidental tumor
Chad is a rescued, older male dachshund. After he found a forever home, he needed some dental work. Because his regular veterinarian heard a heart murmur, an echocardiogram was ordered as part of the pre-dental evaluation. Echocardiograms evaluate the heart noninvasively using sound waves. The test showed Chad’s heart murmur was due to leaky valves. Leaky valves are the most common cause of a heart murmur in a dog.
In Chad’s case, the test surprisingly found a tumor near the base of the heart and he came to The Animal Medical Center in March of 2012 for further evaluation.
Magnetic resonance imaging
Heart tumors are quite uncommon; one study showed heart tumors occur in less than 0.2% of all dogs. The two most common types are often hard to distinguish using an echocardiogram. To image the heart, we use a special type of MRI. The MRI showed the tumor was located in the heart wall and could not be removed surgically. We started chemotherapy and between treatments, when he was feeling well, his teeth were cleaned. Chemotherapy finished in November 2012 and an echocardiogram showed the tumor was smaller.
Heart problem number two
In January 2013, Chad’s leaky valves worsened causing heart failure, a buildup of fluid in his lungs. The AMC’s Emergency Service treated him with diuretics (water pills), oxygen and other medications to decrease the fluid in his lungs. The Cardiology Service prescribed medications to keep his broken heart working and the fluid from building up again in his lungs. After two days in the ICU, his heart was ticking well and he went home to his anxiously waiting family.
Is your dog coughing? It might be heart failure. Our friends at the Washington State College of Veterinary Medicine have a nice list of the causes of coughing in dogs.
Still worried your dog might have heart failure? Review the clinical signs and see your veterinarian if you think your dog has heart failure.
I suspect many of my readers think practical DNA testing is an oxymoron. For many, DNA testing conjures up visions of sleek, shiny, sterile laboratories for solving crimes, but not day to day management of sick dogs and cats. DNA testing can also be fun when it is used to determine the ancestry of your mixed breed dog. This week I used DNA testing in my clinical patients to help better manage their health.
Platelet problems
Coco is one of my patients without cancer. She came in for a routine examination. Because she is a Cavalier King Charles Spaniel and screening blood tests showed her platelet count was low, she needed DNA testing. Platelets are blood clotting cells and patients with a low platelet count may have severe hemorrhage. Coco wasn’t sick in any way, but because certain dogs within the Cavalier breed have a genetic disorder causing a low platelet count, we tested her DNA for the known mutation.
The strange thing about Cavaliers with an inherited low platelet count is that they are not prone to hemorrhage, but if you don’t know for sure your patient has the mutation, you cannot distinguish between a Cavalier with the inherited platelet disorder and one with a propensity to bleed. Luckily, Coco has the mutation and we need not worry about her low platelet count.
Drug intolerance
Gus has a different genetic problem. He is a flashy, blue merle Australian shepherd. Dogs of this and other collie-like breeds have a genetic mutation leading to poor tolerance of certain drugs which, in Gus’s case, are chemotherapy agents he desperately needs for the treatment of his lymphoma. For us to safely treat him with chemotherapy drugs, we tested his DNA to determine if he carried this mutation before choosing the drugs in his treatment protocol. Fortunately for Gus, his DNA is just fine and he can be treated with our standard multidrug regimen. Additionally, affected dogs are also sensitive to common heartworm preventatives and diarrhea medications.
Anemia and DNA
Aby-Doux is an Abyssinian cat with a decreased number of red blood cells, also known as anemia. Once again I used DNA testing to help elucidate the cause of his anemia. Some Abyssinian cats have a genetic mutation affecting their red blood cells.
The mutation weakens the robust normal red blood cells and causes them to rupture inside the blood stream. When this occurs, the affected cat becomes lethargic and sometimes is jaundiced. Genetic testing did not find the mutation in Aby-Doux. Further investigation found his anemia was due to blood loss from an intestinal tumor which was then surgically removed.
Additional information
Does your dog’s breed have a predisposition to a genetic disease? The Orthopedic Foundation for Animals has a listing by breed.
Are you an international reader? Find a listing of genetic testing laboratories worldwide on the University of Pennsylvania Medical Genetics website.
I lost one of my favorite patients last week. She was a fifteen pound willful Wire Fox Terrier aptly named Willa. Because she was a terrier, she defined the word tenacity. She nearly died several summers ago when her pancreas failed and a severe infection caused her skin and footpads to peel and crust. Despite the simultaneous occurrence of two serious diseases, she persevered, recovered and continued to patrol the woods for doggie delicacies such as goose poop. But maybe what I admired the most about this dog was her commitment to scientific research.
Contributing to kidney research
As part of Willa’s annual examination early last year, a blood test known as a senior profile was submitted to the laboratory. Although her physical examination was normal and her family reported she was doing well, we found mild changes in her kidney tests. Additional testing revealed protein loss in her urine and high blood pressure. Home blood pressure monitoring, blood pressure medications and a kidney-friendly diet kept these problems in check.
Dogs with kidney disease tend to develop blood clots, often in their lungs. Veterinarians do not have a quick, easy test to determine which dogs will develop this catastrophic complication, and veterinary clinician researchers at The AMC received a grant from the Morris Animal Foundation to identify dogs at risk for developing blood clots using a special machine called a thromboelastograph. If we can identify dogs at risk for blood clots, then we can target those dogs for treatment with blood thinners. The thromboelastograph tests blood clotting differently than traditional tests and the hypothesis was that this test would identify dogs with an increased risk to form blood clots. Though a process called “informed consent” Willa’s family agreed to the use of a half teaspoon of her blood to be tested using thromboelastography. Willa’s test was normal, and results of this study’s data are still undergoing analysis prior to publication.
Investigating infectious disease
Willa’s next research project was in the area of infectious disease. She became acutely ill after spending part of the Christmas holiday in the country. Leptospirosis is an infectious disease carried in the urine of wildlife and often found in puddles of water. Because she had been in the country and because her illness affected her liver, her family again agreed to allow additional testing of her blood for another ongoing AMC study. First described in 1886 and a frequent cause of death during both world wars, leptospirosis is not a new disease. But because this disease can infect humans as well as dogs, any improvements we can make in diagnosis and treatment benefits both dogs and humans. Testing confirmed the diagnosis of leptospirosis in Willa. We alerted her owners and checked out the other dog in the family. Sadly, the combination pancreatic failure, kidney disease and now a liver problem was too much for Willa and she crossed the Rainbow Bridge, restored to health and vigor.
What Willa taught me
Annual examinations and screening blood tests are critical to early identification and management of chronic diseases like kidney disease.
More research is needed in all areas of veterinary medicine, including kidney disease and infectious disease.
Even a small, willful terrier can make a meaningful contribution to research benefiting both dogs and humans.
Today, I received a call from a pet owner whose dog I had taken care of several years ago. I remember how heartbroken she was when I euthanized Stormy, her rescued Labrador. Stormy was not sick, his liver and kidneys were fine and he didn’t have cancer. But Stormy could no longer walk due to the lifelong effects of hip dysplasia. Nursing a large dog with limited mobility in a New York City apartment without an elevator is nearly impossible. After a Herculean effort to keep Stormy going, this loving pet owner realized his time had come.
She called today because she was thinking about getting a new dog. She hoped not to repeat the scenario she had experienced with Stormy and asked for advice on how she might help prevent hip dysplasia in her new dog.
What is hip dysplasia?
The end result of hip dysplasia is hip arthritis, but the problem starts much earlier. Hip dysplasia is an incurable developmental disorder. While the exact mechanism is unknown, one theory suggests loose hips in young dogs change the maturation of the hip joint, resulting in abnormally formed hip joints, which later lead to hip arthritis. A competing hypothesis proposes dogs with hip dysplasia have abnormal cartilage and bone formation in their hips as the cause of arthritis. Regardless of the cause, as the arthritis worsens, dogs become stiff, less active and lose strength in their hind legs. In the worst cases, they lose the ability to walk without assistance.
How do dogs get hip dysplasia?
Hip dysplasia starts with the genetic make-up of a dog. Certain genes have been identified that occur in dogs with hip dysplasia.
Someday, veterinarians hope to be able to screen dogs’ DNA through a simple blood test and determine their risk for hip dysplasia.
Dogs without hip dysplasia
No one can promise with total certainty that your new dog will not have bad hips. Purchasing a dog born to parents with certified hips may decrease the risk. Two well-known organizations are Orthopedic Foundation for Animals (OFA) and PennHip.
We know small breed dogs are less likely to have hip dysplasia than large breed dogs, but some small breed dogs still suffer from this disease.
Preventing hip dysplasia
Obesity is a hip dysplasia risk factor you can control. Scientific research has shown that thin dogs are less likely to develop hip dysplasia, and if your dog has bad hips and is overweight or obese, losing weight will improve his ability to walk.
A recently published study of Norwegian dogs including Newfoundlands, Leonbergers, Labradors and Irish Wolfhounds, found an association between daily use of stairs in puppies less than three months of age and development of hip dysplasia. For puppies less than three months of age, exercising in an area with soft ground and park-like terrain protected puppies against developing hip dysplasia.
With the holidays over and summer not yet here, now is a good time to think about advanced planning for the upcoming trip you and your pet will be taking. If you haven’t thought about taking a trip with your pet, think again. Millions of Americans travel with their pets both locally and internationally and according to an August 2012 TripAdvisor.com survey, 49% of the pet owning public have plans to travel with their pets.
Get some ID
Entrance into many countries requires your pet to have a permanent form of identification. The best form is a microchip placed by your veterinarian. Even if you don’t plan to travel anytime soon, every pet should have a microchip to help get them back home if they are lost. If your pet already has a microchip, double check and make sure the registration information is paid and up to date. Inaccurate information in the microchip database prevents animal rescue groups from contacting you when they find your pet.
Do your homework
Research the pet entry requirements for your destination. Every country is different. As a start, review the information provided by the United States Department of Agriculture.
You should also locate information on pet travel on the website of the country you plan to visit. Although you and your pet are simply going on vacation, the information about pet entry requirements may be found under import/export regulations. If you cannot find the information or you need further clarification, call the country’s consulate or embassy. The United States Department of State has a listing.
If you find conflicting information about entry requirements, the destination country holds the trump card, so rely on their website and embassy.
Pack the paper
Not newspaper, but your pet’s papers. According to TripAdvisor.com, only 45% of pet owners travel with health certificates and rabies documentation. I find this surprising. Keeping your pet’s vaccinations up to date and keeping their vaccination certificates on file will help streamline obtaining critical travel documents. Bring copies with you and ask your veterinarian for a summary of your pet’s medical conditions and medications.
Important reminders
Start early. Some countries require your pet to have a special rabies blood test performed. Only certain laboratories perform this test and timing is critical.
Even though you may have started preparing early for your trip, certain travel documents must be signed only days before departure. Allow time in your schedule to finalize any of your pet’s travel documents.
Some countries require your pet’s health papers be signed by a USDA accredited veterinarian. Not all veterinarians are accredited, so check with your veterinarian well in advance of your trip to make sure you have an appointment with one who can sign the travel papers.
Early last week, Steel, a healthy, well cared for young Labrador, was rushed to The AMC in the wee hours of the morning for intractable vomiting. The poor dog looked miserable with vomit on his face and paws. The emergency doctors determined he was dehydrated and started intravenous fluids along with medications to help control nausea. They also performed a critical test when they took an abdominal x-ray.
X-rays hold the key
The abdominal x-ray showed that several of Steel’s intestinal loops were over distended with gas and fluid. The distension exceeded that of normal intestinal gas and suggested something was blocking the progression of food through the intestinal tract. As he scanned the x-ray further, the radiologist saw a one and three-quarter inch long tubular object containing little bits of gas evenly distributed throughout. To the radiologist, this structure looked like a corn cob, but Steel’s family had not served any corn on the cob lately.
Surgery answers the question
Shortly after the x-rays were taken, Steel was anesthetized and wheeled into the operating room where the emergency surgeon readily identified the obstruction in the intestine. Because the intestine had been damaged by the obstruction, a small portion of the intestine was removed (resection) and the ends sutured back together (anastomosis). In surgical terms these procedures are often called an R&A. Once the damaged intestine was removed, it was opened revealing – you guessed it –a corn cob! Where the corn cob came from, Steel is not telling.
Steel’s abdominal x-ray shows gas filled intestinal loops and the offending corn cob, which I have outlined in red.
I am certain Steel’s family wishes they knew where the corn cob came from to prevent another serious illness for their dog. Make your best effort to protect your dog against eating something dangerous by:
Covering and locking all trash cans
Keeping human food out of your dog’s reach
Storing human AND pet mediations up high and in closed cabinets
Keeping your dog busy and out of trouble by providing an enriched environment with window seats, interactive feeding toys and plenty of exercise
Watching your dog during walks to prevent him from eating garbage or foreign objects
For other interesting stories about the strange eating habits of dogs, read about Lola and Ratchet.
We live in a world obsessed with clean. Our floors are scrubbed with antibacterial cleaners, we squirt hand sanitizer gel on our children’s hands and wipe down our kitchen counters with antibacterial wipes. Knowing this, you shouldn’t be surprised there was a big buzz when a poop transplant between a mother and her toddler son was used as treatment for a serious intestinal infection, Clostridium difficile.
Scientifically known as a fecal microbiota transplant, this unappealing therapy was a lifesaver for the sick child.
This veterinarian is not surprised
As a veterinarian, the concept of transplanting bacteria from a healthy patient to a sick patient is really nothing new. A “cud” transplant has long been used to transfer good bacteria to sick ruminant animals (sheep, goats and cows). Ruminants have a biochemically complex digestive process required to break down the dense plant material that forms their diet. The cud is a wad of partially digested food which returns to the mouth and is chewed a second time as part of this complex process. Veterinarians collect a cud from a healthy ruminant and feed it to sick one, transferring the healthy digestive tract bacteria much like the fecal microbiota transplant did in the sick toddler.
Fecal microbiota transplantation
Every living animal has its own microbiome on the skin and in the gastrointestinal tract. These endogenous bacteria help keep us healthy. Illness and antibiotic therapy disturb the normal bacterial and allow bad bacteria like C. difficile to proliferate and cause illness. Transplantation of bacteria takes several forms. The toddler received a fresh fecal transplant, but feces from a donor can be frozen for future use. There are even synthetic cultures of bacteria commonly found in the gastrointestinal tract. Transplantation of the good bacteria occurs via a nasogastric tube or by colonscopy.
A very recent study shows improvement in 79% of patients treated in this dramatic fashion.
Dogs and cats are lucky
Today, ruminants are the only veterinary patients receiving fecal microbiota transplant therapy; although pets sick enough to spend time in an ICU may contract C. difficile. Fortunately, this infection doesn’t happen as often as it does in human ICU patients.
Therapy dogs visiting human health care facilities have a greater risk of being colonized by C. difficile.
If your pet develops diarrhea following hospitalization or while taking antibiotics, be sure to tell your veterinarian as further testing may be required.
If your dog is a therapy dog, follow the healthcare guidelines and the visitation rules of your animal assisted therapy organization to protect your dog against this type of serious infection.
One of my friends was in the hospital last week. Not a human friend, but a dog friend. Happily, I have dog friends who are not dog patients and Decoy is one of those. This lovable lab is a member of a family who are friends of my family.
Under the weather
I saw Decoy’s name on the overnight admission list which is emailed to all the veterinarians at The Animal Medical Center at about 5:30 every morning. Decoy came to The AMC ER for vomiting and limping. The ER doctors found abdominal pain, a fever and an elevated heart rate. On my way into the hospital, I stopped by his cage to say hello, but could tell my normally tail-waggin’ friend was a hurtin’ pup; Decoy was living up to his name by looking more like an inert, stuffed dog than a real one.
In the blood tests
Blood tests for AMC patients are available online. To help with interpretation, abnormal results are displayed in red, normal results in black. Decoy’s reports were shockingly red. His illness was impacting his liver, his blood calcium level, and dramatically increasing his infection-fighting white blood cells.
Inside the abdomen
Because Decoy’s blood tests indicated multiple organs within the abdomen were affected by whatever was making him sick, his internal medicine specialists ordered an ultrasound of his abdomen. Ultrasounds let veterinarians look at intra-abdominal structures in a different fashion than x-rays allow. X-rays show bones and lungs very clearly, but we can only see the outline of abdominal organs like the liver and kidneys. The pancreas cannot be seen using x-rays and we rely on ultrasound to help make a diagnosis of pancreatic disease. Because pancreatic disease could account for Decoy’s clinical findings of vomiting and diarrhea and his multiple blood test abnormalities, an ultrasound was done and confirmed the suspicion of pancreatic inflammation or pancreatitis. The ultrasound showed pancreatic swelling. The swollen pancreas displaced the colon out of its normal position and was even causing a small amount of fluid to accumulate in the abdomen.
On the road to recovery
There is no antidote to stop pancreatic inflammation. Veterinarians provide what we call supportive therapies while the inflammation subsides and then we try to decrease risk factors for recurrence. Decoy received intravenous fluids, antiemetic agents, and antibiotics in case the pancreatitis was turning into an abscess. Every day he improved a little bit and he was discharged from the hospital a few days later.
Follow up
To help prevent another bout of pancreatitis, Decoy’s doctors made several recommendations to his family. First, overweight dogs are at greater risk of developing pancreatitis. I suspect a diet will be on Decoy’s list of New Year’s resolutions. High-fat diets increase the risk of pancreatitis. This means he may need to eat a special low-fat diet and certain dog delicacies like bacon will no longer be a menu option for him. In the future, his doctors will avoid certain medications to prevent provoking another serious case of pancreatitis.
Pancreatitis is a common disorder of dogs and it can become a recurrent problem. In Decoy’s case, the problem was quickly corrected, but when pancreatitis becomes a chronic problem, seeking input from an internal medicine specialist is a good idea.
For me, one of the most charming movies ever is the 2007 release “The Bucket List,” starring two of my favorite actors, Morgan Freeman and Jack Nicholson. In the film, two dying men team up to create their bucket lists – lists of adventures they hope to complete before they “kick the bucket.”
Last summer, a young boy named Cole created a bucket list, or as he called it, a “lick it list,” for his dying service dog, Bingo. The list went viral and the dog received treats from all over the world, which allowed him to tick off one item on his bucket list.
Since the Cole and Bingo story hit the news, several of my pet families have spent their pet’s last days treating them to adventures. I thought my readers would enjoy these stories and the wonderful memories they must have created for the dogs and their families.
Bicoastal Dottie
Always one of our favorites, Dottie the American Bulldog got a cross-country trip and her own backyard as part of her bucket list. Dottie loved the beach, and in the video clip below, you can see how much she enjoys the sand and surf despite the fact that her lymphoma is out of remission for the third time. She spent her last New York days at the beach while her family organized their westward move. Dottie’s cat flew economy class to California, but Dottie went in style on a cross-country road trip with her best friend, Henry. Dottie emailed me from exotic places along the way like Nebraska and Colorado! At the end of the long trip was a surprise – a new house with a backyard – something most New York City dogs can only imagine, but Dottie got to cross off her list.
The red convertible
Safety in the car is as important for dogs as it is for humans, and I recommend dogs ride with a restraint device and the windows rolled up. Although dogs love to ride with the wind in their muzzles, it is just not a safe way to travel. The bucket list of one dog, Rufus, included a ride in the family’s red convertible. Not the best vehicle for dog safety, but on one of his last days, the boys played hooky from school and took their beloved dog on the ride of his life with the top down and the wind in his face.
A can of Alpo
In her 2011 book, I Remember Nothing, Nora Ephron wrote two lists, one of which was a bucket list of sorts. Her “What I Will Miss” list includes everyday joys we take for granted: favorite foods, a walk in the park, and our own comfy bed.
I suspect simple things might be on your dog’s bucket list too. Louie, the standard poodle, got one of those simple things in life: a can of Alpo dog food. Louie’s family felt the enlargement of the lymph nodes, indicating the return of his cancer. Shocked by how quickly the lymph nodes increased in size and wanting to give his dog something he had never experienced before, his owner rushed to the store for a can of Alpo dog food. Louie enthusiastically responded by gulping down the entire can in one sitting. Simple and satisfying.
What would be on your dog’s bucket list? Write back and let us know.
The deadliest feature of Hurricane Sandy was not the wind and rain, but water from the storm surge. The storm surge was so massive it brought water into the lobby of The Animal Medical Center, but my basement, prone to flooding during a heavy rain, stayed dry.
The severe flooding has displaced families, ruined homes and washed away cars. Flooding can also make you sick when it contains bacteria, viruses, and parasites from sewage. Severe flooding can also make your dog sick by providing ideal conditions for a bacteria known as leptospira. It rarely affects humans, but at The Animal Medical Center we see several serious cases of leptospirosis in dogs each year. Recently, leptospirosis in outdoor cats has been reported.
Fall hurricane season provides an optimal situation for leptospirosis to occur. Even without a hurricane, cases are more common in the spring and fall. Several different varieties of leptospira bacteria are responsible for illness, but all are considered waterborne illnesses, explaining why flooding increases the risk of contracting it. Rats are considered the major reservoir of leptospira bacteria in urban areas such as New York City. Sandy’s flooding “displaced” rats from the subway tunnels, bringing rats and their leptospira bacteria into the city streets.
Because of the increasing interface between wildlife and suburbia, even dogs in flooded suburban areas are at risk for contracting leptospirosis carried by mammals other than rats, including deer, mice, skunks, raccoons, cattle, and rabbits.
Dogs infected with leptospira bacteria are lethargic, refuse to eat, and vomit. When veterinarians test the blood of these dogs, anemia, decreased blood clotting ability, kidney failure, and liver dysfunction were commonly found. In severe cases, the lungs also lost function. Leptospirosis is treatable with antibiotics, but severe cases of kidney failure may require intensive treatment, including dialysis.
If your dog is sick and has been exposed to floodwaters, tell your veterinarian.
Don’t let your dog walk in or drink water where flooding has occurred.
Talk to your veterinarian about your dog’s need for the leptospirosis vaccine.
If you visit a friend in the hospital, you are likely to notice their doctor is treating them with intravenous fluids. If you visit your pet in the veterinary hospital, you will notice the same may be true – clear fluid is dripping intravenously through a catheter.
Veterinarians and physicians use fluid therapy for exactly the same reasons: to treat dehydration, to increase low blood pressure, to replace fluids lost through vomiting and diarrhea or hemorrhage, and to provide fluids to animals during anesthesia or who may be unable to drink due to illness.
Fluid types
The major ingredient in intravenous fluids is water. But not water like what comes from the tap. First, intravenous fluids must be sterile. Fluid composition must also mimic the composition of blood with regard to the content of sodium, potassium, chloride and pH; if it does not, vital organs could be damaged by fluid therapy. Some fluids have extra components like calcium, magnesium, dextrose (sugar), and bicarbonate. The patient’s medical condition dictates which of the various preparations of intravenous fluids should be used.
Fluid administration
The fluid dripping from a plastic bag into your dog’s leg is being administered through the most common and direct route – intravenously. In emergency situations and when intravenous catheters cannot be easily placed, fluids can be administered into the hollow center of a leg or arm bone. Fluids may also be administered into the abdominal cavity, but fluid administered this way does not enter the blood vessels as rapidly, making it a less than ideal route of administration in emergency situations. Fluids given under the skin make home fluid therapy possible.
Fluids @ home
Many cat owners manage the dehydration associated with chronic kidney disease by giving fluids at home. The same types of fluids we normally administer intravenously are given under the skin, more scientifically called subcutaneous fluids. Here is a video of administration of subcutaneous fluids in a cat.
Fluids can be given as often as once a day or less frequently to meet the cat’s fluid needs. The cat’s blood vessels slowly absorb the fluid from the subcutaneous space, providing additional fluid to help the ailing kidneys. Some dogs and cats with other diseases may be treated this way as well.
Fluids are not food
Many pet owners assume intravenous fluids provide nutrition. We can give nutrition intravenously but the fluid administered contains the building blocks of food – amino acids, lipids, and sugar. Administering nutrition intravenously is called parenteral nutrition and is reserved for patients with a non-functioning intestinal tract. Parenteral nutrition solution is milky white due to the lipids, not clear like fluids. Veterinarians do supplement intravenous fluids with intravenous sugar (glucose) for patients with low blood sugar from an insulin overdose or a serious infection resulting in low blood sugar.
If you have a sick pet, ask your veterinarian if subcutaneous fluids might be helpful as home care.
Belle takes a stroll. Photo courtesy the Rabb Family.
One of my most favorite things to do here in New York City is to walk in Central Park.
Filled with beautiful trees, twittering birds, and, of course, dogs, Central Park provides a shady, calm respite from the hustle and bustle of city life. As of late, I have been noticing more dogs being rolled about the park and wheeled to The Animal Medical Center in special dog strollers. Then last week, one of my friends called and asked my opinion about these devices, which he had also noticed were growing in popularity with city dog owners.
Just following doctor’s orders
All I said was, “Your dog needs six weeks of cage rest,” and I could see the pet family slumping in their chairs. They had plans for attending their children’s soccer match and picking pumpkins on the weekend. The thought of excluding their dog from these important events was dreadful. To follow my no-dog-exercise rule, they zipped Rover into a dog stroller and everyone got out of the house for some fresh air while still following doctor’s orders.
Getting there is half the battle
Many of the dogs I have seen in the park have been taken out of their strollers to enjoy the grassy park lawns. Often I notice these dogs are recovering from orthopedic or neurologic disorders and are a bit unsteady on their feet. The stroller allows them to come to the park, walk on the grass, and get stronger. Falling while walking to the park on the hard asphalt and concrete of the city would be dangerous, but a tumble on the grass is much safer until they completely recover.
Tired, small dogs
Small dogs are popular with city apartment dwellers. A Sunday afternoon walk to see the leaves changing color sounds just right for a fall afternoon, but halfway through the walk, your pooch poops out and refuses to walk another step. Either you drag your dog by its leash all the way home or you carry it. Dragging is not appropriate and carrying even a tired 10 pound dog for more than a block or so is hard work; a stroller lets you continue on the walk without breaking your back carrying a tired dog.
A crate on wheels
Many people are proponents of crate training for dogs. Think of a dog stroller as a crate on wheels. You can give your dog a safe place of her own while still being part of the family. The upcoming Thanksgiving holiday represents a perfect time to use the dog stroller. Your dog doesn’t like strangers or children or Uncle Mortimer. Prevent a holiday mishap by keeping your dog zipped in the dog stroller and Uncle Mortimer safe during dinner.
A do or don’t
Doctor’s orders, dog safety, and your back – all good reasons for dog strollers to be on your “Doggie Do” list. A stroller is a don’t for healthy dogs who need regular exercise to maintain themselves in option body condition.
Looking for a fun, outdoor activity for the whole family this weekend? Join us at The AMC’s Annual PAW (Pet and Wellness) Day celebration in Carl Schurz Park (84th Street and East End Avenue, 10am – 1pm), where every family member, including the furry ones, will find special activities designed just for them.
Posted by Fur the Love of Pets 
