Rat-Bite Fever and Pet Rats: How Concerned Should We Be?

April 16, 2014
Photo: freeinfosociety.com

Photo: freeinfosociety.com

The recent report of a 10-year-old boy that died from rat-bite fever in San Diego has raised concerns about the risk of contracting this disease from pet rats. The family of the child is suing Petco, where they bought a pet rat two weeks before the boy died after a 48-hour illness characterized by flu-like symptoms. This incident has brought into discussion the rare but real risk of this zoonotic disease, which is caused by two different bacteria that are carried by rats. The type of rat-bite fever that is most common in North America is caused by Streptobacillus moniliformis. Another form of rat-bite fever is caused by Spirillum minus and occurs primarily in Asia. Rats can carry both bacteria as part of the normal flora of their respiratory tract. Because of this, rats do not usually exhibit any outward signs of illness from these bacteria. People are infected with the bacteria through rat bites or exposure to urine, feces or saliva of rats that carry the organism.

Illness after the bite of a rat has been described for thousands of years in Asia in poor populations that are exposed to wild rats. With the increased use of large numbers of laboratory rats in the last century, this disease has been seen most often in laboratory animal workers in the US, as well as in poor populations. However, the growth of the pet industry and the increased popularity of fancy pet rats in the last 30 years have shifted the disease incidence so that now more than 50% of the cases in the United States are seen in children. Rat-bite fever is not a reportable disease in the US, so the actual number of cases that occur annually is unknown. However, the incidence of the disease in the US is very low, and death from rat-bite fever is also rare. The cases that are known are those that are documented in the medical literature. To complicate matters, the clinical signs of rat-bite fever in people are nonspecific, and the tests to isolate or identify the organisms involved are not routine. Often, a history of exposure to a rat, in combination with the clinical signs, is the clue that doctors use to suspect rat-bite fever in patients, and then diagnosis is based on specific testing methods. If the disease is suspected or diagnosed, treatment with antibiotics is curative in most cases. A good review of this disease is available – see Rat Bite Fever and Streptobacillus moniliformis.

So what is the risk of this disease if you or your children have a pet rat? Fancy rats are very popular as easy to maintain, social and gentle pets. They are common children’s pets but also have an avid following among adults who can’t afford or don’t have the lifestyle suitable for a dog or cat. Fancy rats are widely available from both pet stores and private breeders in different colors, sizes and conformations. However, few, if any of the pet rats sold are tested for the bacteria that cause rat-bite fever. The prevalence of the bacteria in rats can vary, from as few as 10% to as many as 100% of rats in a breeding colony or laboratory that are infected. Any pet rat can carry these organisms, but the risk of actually contracting the disease from the rat is very low.

What should you do? As with any animal that carries a risk of zoonotic disease, hand-washing after handling is of utmost importance. Using either soap-and-water or an alcohol-based hand cleanser after handling the pet rat and cleaning the cage is mandatory. Children should be instructed to always wash their hands after playing with the pet and to always tell parents about any bites that occur when handling the pet. Owners of pet rats should immediately report unexplained fevers, illness or rashes to their healthcare provider. Specialized screening tests to see if your pet rat is a carrier of S. moniliformis are available from veterinarians, but make sure you call ahead to see which veterinarians provide this test, as it is not routinely offered.

This blog was written by:
Katherine Quesenberry, DVM, MPH, DABVP (Avian)
Head, Avian and Exotic Pet Service

The Animal Medical Center


Dogs Get Cirrhosis? Cats Get Lung Cancer?

April 9, 2014

cat and dogFrom a medical perspective, we are not that different from our pets. Humans, dogs and cats have many diseases in common and the treatments for these diseases are often strikingly similar. Diabetes in pets is treated with a special diet and insulin injections; radioactive iodine therapy is used to treat feline hyperthyroidism; and dogs with heart disease receive diuretics (water pills) and ACE inhibitors. Despite these similarities, disease in our pets is not always the same as it is in humans.

Dogs Get Cirrhosis?
In people, cirrhosis of the liver is most often associated with alcoholism, or hepatitis virus infection. Since dogs don’t drink (or they shouldn’t) and the hepatitis virus is a human virus which does not infect dogs, how do dogs get cirrhosis? The diagnosis of cirrhosis does not imply a cause and the cause in dogs differs from humans. Cirrhosis is a liver disorder in which the liver loses its normal structure and function as a result of chronic inflammation. Inflammation, in turn, causes replacement of normal liver cells with scar tissue and destroying their function. If enough of the liver is damaged, dogs show signs of liver failure: jaundice, accumulation of abdominal fluid (ascites) and a bleeding tendency. Labrador Retrievers, Cocker Spaniels and West Highland White Terriers are breeds with an increased risk for developing liver inflammation and cirrhosis. The inciting cause of the inflammation in dogs remains a mystery.

Lung Cancer in Nonsmokers?
The number one cause of lung cancer in humans is cigarette smoking. Since pets don’t smoke, why do they get lung cancer? Veterinarians don’t know exactly. Studies evaluating the impact of the home environment on dogs with lung cancer did not find an association with either living in an urban or a rural environment. We know secondhand smoke affects pets, increasing their risk of lymphoma and oral squamous cell carcinoma, but secondhand smoke has not yet been linked to lung cancer in dogs and cats. If you smoke, don’t do so near your pet; better yet, quit.

But What About Heart Attacks?
Heart attacks, a leading cause of sudden death in the United States, occur when the blood flow to the heart is abruptly blocked. Most heart attacks are the result of high cholesterol and blockage of the coronary arteries which supply blood to the heart muscle. Dogs and cats do not develop coronary artery disease as a result of high cholesterol, and thus do not have heart attacks like their human companions. However, since heart attacks often cause sudden death, grieving families frequently blame a heart attack when their pet dies unexpectedly. Heart disease in pets can be a cause of sudden death due to abnormal heart rhythms, ruptured heart valves and bleeding tumors of the heart.

To read more on disease affecting pets and people, read some of our previous blog posts.


Making a Specialist Visit Special

April 2, 2014
A French bulldog is examined by AMC's Ophthalmologist

A French bulldog is examined by AMC’s Ophthalmologist

Your pet needs a second opinion from a board certified veterinary specialist and your veterinarian has helped you set up the appointment with the right specialist. You know this is going to be different than seeing the familiar veterinarian you have trusted with your pet’s care since you brought him home from the shelter in a cardboard carrier. How can you make this nerve-wracking experience efficient and affect the best possible outcome for you and your pet?

Look at a consultation with a veterinary specialist at The Animal Medical Center or another specialty hospital like you do any other meeting. If you are running a meeting at your office, you will be sure the right people are invited to attend the meeting; the meeting will have an agenda agreed upon in advance; it will have a start and stop time and meeting attendees will be assigned tasks to complete after the meeting is over. All of these points also describe your appointment with a veterinary specialist.

The Right Attendees
I am a veterinarian and my job is to take care of sick pets. To me, your pet is a critical participant in the specialist consultation. While your role of transporting your pet to the appointment and being its spokesperson is also crucial, I really need to examine your pet and see first-hand the problems that need correcting. You would be surprised at how many people come to see me without their pet. If you choose to leave your pet at home and fly solo at a consultation with me, I can guarantee one of your tasks after the meeting will be to bring your pet to The AMC for an examination.

Specialist Agenda
A veterinary specialist has been trained to approach patients with a basic agenda:

  • Ask about the past history and review any documentation from the primary care veterinarian
  • Perform a physical examination
  • Make a list of possible diagnoses
  • Create a list of tests to determine which diagnosis is the correct one
  • Interpret the test results once they become available

Pet owners can streamline that agenda by having medical records, x-rays and blood tests sent in advance of the scheduled consultation.

Pet Owner Agenda
Simply put, the pet owner agenda for a specialist consult revolves around one of three issues: making a diagnosis, treating a disease or improving the quality of life. For some pet owners there may be other issues that are equally important, such as having the pet attend a family function. If there is an important issue for you and your pet, be sure to let the specialist know what it is and how you feel this issue might impact the recommended diagnostic and therapeutic plan.

The To-Do List
At the end of the consultation, the specialist or a member of their team will explain the plan for your pet. It might be to give medications or schedule a follow up test at your veterinarian’s office. Following the plan exactly and scheduling tests or treatments on time will help get your pet back on its feet as soon as possible. And having a healthy pet is what makes any visit to the veterinarian’s office special.


Medicine By the Numbers

March 26, 2014
Dr. Ann Hohenhaus

Dr. Ann Hohenhaus

We all rely on numbers to help us make decisions. The stock market is above 16,000; time to sell. Your chance of winning the Powerball Jackpot with a two dollar ticket is one in 175 million, but it’s only two dollars so you buy yet another losing ticket. One in four Americans dies of heart disease every year; more exercise and less butter for you. In my line of work, veterinary medicine, quoting numbers is not nearly as easy.

I have been struggling with a particularly complicated cancer case the past few weeks. After hours of discussion and many more of pondering the options, a clear plan has emerged for this patient. And then the client asked the number one question: “What are the chances my pet will benefit from this procedure?” Having never been much of a math whiz or very successful at gambling, explaining the concept of odds is difficult. The odds of A versus B are calculated from a large group of patients with the same disease. But when I am talking about Fluffy or Fido, it becomes harder to predict the outcome for an individual patient. In some ways it’s a 50-50 coin toss. Your pet gets better or it doesn’t. Because medicine rarely has 100% certainty, no doctor, human or animal, will ever guarantee a 100% chance of success. Even with a 99.9% chance of success, there will be some patients who do not have the desired outcome after the test, treatment or surgery is completed.

An article in last week’s New York Times ‘Science Section’ written by a physician, numbers and their connection to disease appear again. Dr. Abigail Zuger writes about using a reasoned numerical approach (“30 percent of people with your problem of X will develop Y”). Yet, she writes, “many studies (and all casinos and lotteries) illustrate how abysmal is the average person’s understanding of risk when couched in mathematical terms.” Her patients have a hard time grasping the importance of risk factors on their future health or as she calls them “pre-diseases.”

If two medical professionals have difficulty using numbers in their daily practice, then how can people or pet owners make well-informed decisions on healthcare matters?

  1. Preventing disease is much easier (and cheaper) than correcting a problem. If your veterinarian gives you numbers on preventing disease, pay close attention. For example, obesity quadruples your dog’s risk of cruciate ligament rupture. Getting your dog’s weight down saves money two ways – you buy less food and your dog doesn’t need an expensive reconstructive knee surgery.
  2. There are actually some medical conditions that doctors can predict the outcome with reasonable certainty; for example, diabetes. Without administration of insulin, which is deficient in dogs and cats with diabetes, your pet will die of high blood sugar within days.
  3. Since not all diseases come with certainty of outcome like diabetes, think about quality of life. If your pet’s current problem is decreasing their quality of life, consider a treatment to improve it. Keep in mind this is where numbers can become overwhelming and sometimes a decision is made based on your heart rather than your head.

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:


Adrenal Gland Yin and Yang

March 5, 2014

puppy-yinyangLast week was a big week for adrenal gland disorders at The Animal Medical Center. Not one, but three dogs were admitted by The Animal Medical Center’s 24-hour Emergency Service with a diagnosis of Addison’s disease, or hypoactivity of the adrenal gland. Additionally, I evaluated two of my patients for adrenal gland hyperactivity, or Cushing’s disease.

Small but Mighty
Adrenal glands are tiny organs, one sits atop of each kidney. The normal width of a dog’s adrenal gland is less than half an inch. In cats, adrenal glands are half that size. Small compared to the liver or kidneys, these glands are powerhouses pumping out an array of hormones critical to maintaining normal homeostasis. Because the adrenal glands produce so many different hormones, either condition hypo- or hyperactivity can cause a wide variety of serious clinical signs. The hormone most important in Cushing’s and Addison’s disease is cortisol.

Poodle Problem
Two of last week’s ER patients with Addison’s disease were poodles. This was no coincidence. Addison’s disease is inherited in the Standard Poodle and also the Portuguese Water Dog, Nova Scotia Duck Tolling Retriever and the Bearded Collie. Cats very rarely develop Addison’s disease. What is strange about the dogs at AMC is the diagnosis of Addison’s disease in three dogs in one week, since the prevalence of the disease in dogs is thought to be 0.6-0.28% of all dogs. Dogs with Addison’s disease have vague, nonspecific clinical signs such as vomiting and diarrhea. One reason your veterinarian performs blood tests when your dog has vomiting and diarrhea is to identify the characteristically low blood concentrations of sodium and chloride and the high concentration of potassium, classic for a diagnosis of Addison’s disease. The consequences of missing a diagnosis of Addison’s disease are dire. Dogs become progressively dehydrated and the potassium climbs to levels which can stop the heart from beating. The AMC ER has a machine which can test blood concentrations of sodium and potassium in minutes, speeding the diagnosis of Addison’s disease.

Too Much Water; Too Much Pressure
The adrenal glands of dogs with Cushing’s disease produce too much of the hormone cortisol, either because of an adrenal tumor or because the pituitary gland in the brain forgets to tell the adrenal glands to stop producing cortisol. The two patients I evaluated for Cushing’s disease had different medical problems. One dog had an increased amount of protein in her urine, high blood pressure, and an elevated liver test. All three disorders are known to occur as a result of Cushing’s disease. The other dog was drinking too much water and having accidents in the house — two more signs of Cushing’s disease. Neither dog had hair loss, but it is another common problem we see in dogs with an overactive adrenal gland. Cushing’s disease, like Addison’s disease, is rare in cats.

Giving and Taking Away
Treatment for these two opposite diseases is opposite! For Addison’s disease we give hormones, and for Cushing’s disease we take the hormones away by suppressing the adrenal glands. Dogs with Addison’s disease respond rapidly to either oral or injectable forms of the missing adrenal hormones. Treatment of dogs with Cushing’s disease takes a month or two, while oral medications are adjusted to individualize the dose for each dog.

Recognizing the Yin and Yang of Adrenal Gland Disease in Your Dog
Even though Cushing’s disease is more commonly seen than Addison’s disease, both diseases can be readily diagnosed with blood tests. Your veterinarian will suggest testing if your dog is showing the following signs:

Cushing’s Disease

  • Excessive drinking and urinating
  • Hair loss on the trunk
  • Elevated liver tests
  • High blood pressure
  • Protein in the urine
  • Pot-bellied appearance

Addison’s Disease

  • Waxing/waning vomiting and diarrhea
  • Poor appetite
  • Weight loss
  • Anemia
  • High blood potassium
  • Low blood sodium and chloride

The [Veterinary] World is Flat

February 26, 2014

digital x-raysThe title of this blog takes its name from author and New York Times columnist, Thomas Friedman’s bestselling book, The World is Flat: A Brief History of the Twenty-First Century. The book’s thesis explains globalization in the 21st century as a result of wide accessibility to personal computers and fiber optic cables which make communication via email and information gathering via the internet nearly instantaneous. This form of globalization renders geographic divisions between countries irrelevant.

Friedman describes “ten flatteners” including: the collapse of the Berlin Wall, Netscape and workflow software. My own observations of the world of veterinary medicine indicate that it is not much different than the global economy Friedman describes in his book. Paying tribute to the Pulitzer Prize winner Friedman, here are my veterinary flatteners.

A New Workflow
Digital radiography has changed the workflow of daily veterinary practice. In the pre-computer days, each x-ray was a piece of film, not easily copied and very easily misplaced. Now The AMC and many other veterinary hospitals have switched to using digital radiography, using a machine that looks like a regular x-ray machine but which takes digital images similar to those taken with your smart phone. These x-rays can’t be lost because the images are stored in a picture archiving and communication system (PACS). The image files are very large, but can be transported by burning them onto a CD or transferring them through any number of file sharing systems.

Electronic Medical Records
As it has revolutionized the global economy, the personal computer is revolutionizing veterinary practice. Electronic medical records systems (EMRS) allow rapid dissemination of medical information between specialists and primary care veterinarians. I can write a letter to a patient’s primary care veterinarian after I have completed my consultation with their patient. Through the magic of the EMRS, I can have the letter in that veterinarian’s inbox for his/her review before the pet has returned home.

Board Certification
Twenty-five years ago when I started the process of becoming a board certified veterinary oncologist, there were only about 25 veterinary oncologists in the world. The American College of Veterinary Internal Medicine now has certified over 300 oncology diplomates and there is a European College of Veterinary Internal Medicine which certifies oncologists as well. Board certified specialists all over the world form a healthcare network that trades patients back and forth when pet owners relocate or go on vacation, just as I described in a previous blog: “Clea’s International Healthcare Team.” Since veterinary oncologists and other specialists have expanded their reach worldwide, specialist veterinary care no longer has geographic boundaries.

Multinational Veterinary Companies
Specialists are not the only international flatteners. Because international companies provide veterinary products and services, veterinary specialists can access information about pets seen by a veterinarian practicing on a different continent! Take for example my patient Gigi. She came to The AMC from Kuwait, but because the biopsy of her tumor was sent to the European branch of the same laboratory used by The AMC, I was able to ask additional questions about the biopsy result. The biopsy sample was retrieved from storage and then reviewed by a pathologist in Europe. The answers to my questions were sent via email.

Real Time Communication
The internet has changed the face of veterinary education. Today, veterinarians no longer have to travel to earn continuing education credits necessary to maintain their licenses. Continuing education comes to them though their computers. This year, the keynote speaker addresses at the annual Veterinary Cancer Society Meeting were streamed live to members unable to attend. Additionally, several internet based companies offer on-demand veterinary continuing education opportunities.

The veterinary world is indeed flat and that means your pet can get excellent veterinary care from a veterinarian in your neighborhood or from a specialist somewhere a long way from home!


When Life Gives You Lemons, You Need a Buddy

February 20, 2014

gray tabbyTracy and her 14 year old grey tabby, Baller, have experienced a few bumps in the road this past year. In April, Tracy noticed Baller, named after a rap song, was defecating outside his litter box. He also had diarrhea, but he didn’t seem very sick since he was eating well and was his usual playful self. Her neighborhood veterinarian examined Baller and found two pounds of weight loss. Tracy thought she could breathe easier when she heard the blood tests were normal, but an abdominal ultrasound revealed Baller had colon cancer.

Minimally Invasive Testing
Tracy brought Baller to The Animal Medical Center for a consultation with one of our board certified oncologists. Baller’s oncologist, Dr. Maria Camps, explained the most common type of cancer in cats is lymphoma, and recommended a minimally invasive approach to diagnosis since lymphoma is treated with chemotherapy, not surgery. Ultrasonography was used to direct a small needle into the colon tumor and retrieve cells from the tumor. Within hours, Tracy found out she and Baller were facing an uphill battle against lymphoma. The anticipated survival time for a cat with lymphoma treated with chemotherapy is less than one year.

Chemotherapy Helps
Dr. Camps actually gave Tracy so much hope, and Dr. Mollica, Baller’s regular veterinarian and a former AMC intern, was also very supportive. These two veterinarians really gave Tracy that extra oomph she needed to continue Baller’s treatment. Ms. Koch says, “I knew the chemo was working almost immediately. Right after his first treatment he was feeling better again. He is one to make it known when he has issues by hiding under the bed, not eating and not able to use the bathroom. But, it was amazing that right after his first treatment he was back to his normal routine. I thought it [the chemotherapy] would help a bit, but I didn’t realize how much better it would make him feel. He was like a whole new cat, which makes me sad because who knows how long he was feeling bad before he really started to show it.”

About one third of the way through his prescribed course of chemotherapy, and just when Baller’s cancer seemed to be in control, a roadblock obstructed the path to further cancer treatments; Tracy was laid off.

Buddy Fund Helps Out
This is where the Buddy Fund comes in to assist Tracy and Baller. The Buddy Fund, one of AMC’s Community Funds, was established to provide financial support for AMC patients with cancer whose owners could otherwise not afford to treat their four-footed family members. The name of the Buddy Fund has a double meaning. The original donors to the fund had a very special cat named Buddy and the fund acts as a “buddy” to owners of pets with cancer. Baller’s oncologist recommended him for the fund because he was responding exceptionally well to the prescribed course of chemotherapy. Discontinuation of treatment would put him at high risk for relapse of his cancer.

Thanks to the Buddy Fund and its generous supporters, Baller completed his chemotherapy protocol just before Thanksgiving and without missing a single treatment. At his most recent follow up appointment he was given a thumbs up because no tumors were detected during the examination. Going forward, Baller will continue to be monitored for tumor recurrence. As the one year anniversary of his diagnosis approaches, everyone has their fingers crossed for Baller. Tracy looks forward to a time when she is employed again and can be a “buddy” to another deserving cat through a contribution to AMC’s Buddy Fund.


Heart Healthy Tests for Pets

February 13, 2014

In addition to being National Pet Dental Health Month, February is American Heart Month. Veterinary patients suffer from heart disease, although coronary artery disease, which is common in people, doesn’t occur in dogs and cats. Even so, cardiologists at The Animal Medical Center use a variety of diagnostic tests to determine if their patients have heart problems requiring treatment.

Auscultation
The stethoscope has been around since the early 1800s when it was invented by French physician René Laennec. Every veterinarian has a stethoscope and they use their stethoscopes to determine the heart rate, heart rhythm and heart sounds. Abnormal heart sounds, also known as murmurs, may be “innocent” or of no concern. Innocent murmurs are most commonly heard in pediatric patients. In adult dogs and cats, the development of a heart murmur typically indicates leaky heart valves. If your veterinarian hears a heart murmur, consultation with a board certified veterinary cardiologist for additional testing may be recommended by your primary care veterinarian.

Electrocardiogram
An electrocardiogram measures the electrical impulses produced by the heart. The recording is a graphic representation of the heart’s rate and rhythm. The normal heart rate varies depending on whether your pet is a dog or cat. Cats have a higher heart rate than dogs, and small dogs tend to have a higher heart rate than large dogs. A normal heart beats regularly. Heartbeats that occur at irregular intervals, called an arrhythmia, indicate heart disease and often land a pet in the animal ICU for emergency treatment by a veterinary cardiologist to correct the abnormal rhythm. Pets with serious abnormal rhythms may be very weak, faint and in rare cases, die suddenly.

This chest x-ray of a cat shows an enlarged heart and fluffy white patches in the lungs typical of pulmonary edema.

This chest x-ray of a cat shows an enlarged heart and fluffy white patches in the lungs typical of pulmonary edema.

Chest X-rays
Radiographs or x-rays show the size of your pet’s heart and the surrounding lungs. Enlarged hearts can occur with diseases of the heart muscle or as a result of leaky heart valves. When the valves are extremely leaky or the heart muscle becomes very weak, heart failure occurs. Heart failure allows fluid to build up in the lungs. This buildup of fluid, called pulmonary edema, can be seen on an x-ray as fluffy white patches in the normally black lungs.

Echocardiogram
An echocardiogram uses sound waves to create a real-time moving image of the heart as it beats inside the chest. The sound waves are created and recorded via a probe placed on the chest over the heart. As the probe is moved, different parts of the heart come into view. The computer inside the echocardiography machine is able to precisely measure the thickness of the heart walls, the valves and measure the rate of blood flow throughout the heart given your pet’s cardiologist an exact measure of how well all components of the heart are functioning. An echocardiogram is used to diagnose nearly all forms of dog and cat heart disease, including the most common form of heart disease in dogs, leaky valves, and in cats, heart muscle disorders.

Brain Natiuretic Peptide (BNP)
If your veterinarian recommends a BNP test as part of a cardiac evaluation, she has not lost her mind. Although the name seems just plain wrong for a heart test, BNP is actually a small hormone produced by the heart. Production increases when the heart muscle is excessively stretched, as in cases of heart failure. Sometimes the clinical signs of heart failure overlap with the signs other diseases causing breathing difficulties, including heart failure and pneumonia. This blood test provides a non-invasive method to help differentiate between cardiac and non-cardiac causes of respiratory problems. This test is most useful when combined with the other tests mentioned previously.

What can you do to have a heart healthy pet?

  • Keep in mind no test is perfect. It may take a battery of tests to determine your pet’s cardiac condition.
  • Excessive coughing or breathing difficulty in your pet should be evaluated immediately by a veterinarian.
  • Packing on the pounds puts extra stress on the heart. Keep your pet in ideal condition.

AMC Resident Research Abstract Presentations

January 15, 2014

veterinary researchJust before Christmas, The Animal Medical Center held its annual residents research abstract presentations. As part of their specialty training, residents are expected to design, execute and report on research in their area of clinical specialty, and this mini-conference provided a forum for exchange of the knowledge gained from research between members of The AMC medical staff. The AMC performs a very specific type of research – clinical research. This means we study diagnostic testing, new treatments and procedures in the patients we care for as part of our effort to improve the health and well-being of our patients. We do not test or treat any animal for the sake of “research.”

Caspary Research Institute
Research at The AMC is not new; when The AMC moved uptown in the 1960’s from Lafayette Street to its present location, a decision was made to locate the new veterinary research institute right in the middle of the Upper East Side’s strong human-focused biomedical community. The AMC became the fifth biomedical institution in the neighborhood, joining The Rockefeller University, Cornell University Medical College, Sloan-Kettering Institute and Memorial Hospital for Cancer and Allied Diseases. Early architectural drawings of the AMC building show a sign on the north side of the building saying, “Caspary Research Institute.” When The AMC opened on 62nd Street, research and patient care were its main focus areas.

Short and Sweet
From a research point of view, an abstract is a very short presentation – 12 minutes, followed by a 3 minute question and answer period. Resident research abstract presentations are commonly preliminary reports which allow discussion of data and help formulate the interpretation of results prior to the writing of a manuscript for publication. Because the information presented was preliminary, I have a few interesting tidbits to report.

Lookalike Medicines
One study evaluated treatment of cognitive dysfunction in dogs with an anti-seizure medication compared to dogs treated with a placebo. In order to help veterinarians and owners make an unbiased assessment of patient response to the actual medication, our colleagues at Best Pet Rx Pharmacy made every dog’s medication look exactly the same. No one could tell which dogs were getting the medication being studied and which dogs were getting placebo pills. This is called double blind study design. Double blind because two people, the patient and the researcher, don’t know the treatment group assignment because it is hidden by the look-a-like pills.

Challenge of Science
Most research projects do not proceed exactly as planned. A study of ICU patients was designed to follow the effects of treatment on dogs with low blood protein (hypoalbuminemia). Dogs were to have a blood sample prior to treatment and 48 hours later. The study did not meet the enrollment target. Why? Despite an impression that dogs stayed in ICU longer than 48 hours, most dogs did not stay that long and fewer dogs than projected entered the study. Of course, we were happy your dogs went home earlier than expected, which was a scientific finding on its own.

Changing Protocol
The AMC’s ICU patients often need to be fed intravenously. We use a commercially available product called Procalamine. This product provides amino acids, the building blocks of protein and glycerin, as a source of glucose for energy. One emergency critical care resident studied patients receiving Procalamine as part of their treatment protocol. Patients receiving Procalamine through a catheter in their leg had more inflammation of the blood vessel than patients who get Procalamine through other, larger blood vessels. Although the directions for Procalamine indicate it can be given in the legs, we now will try and avoid this whenever the patient’s condition allows it.

Helping Pets Everywhere
These types of studies enable AMC veterinarians to improve the level of care for your pet. Through the publications that will result from these and other studies performed here, the knowledge will improve the care of pets everywhere.


CT Versus MRI: Battle of the Big Machines

January 8, 2014

Veterinarians at The Animal Medical Center depend on high tech equipment to make diagnoses and monitor treatment success. Two commonly used pieces of high tech equipment are the CAT scan or CT (Computed Tomography) and MRI (Magnetic Resonance Imaging). Often, if I recommend a CT, pet owners will ask if an MRI would be better. I checked with one of AMC’s board certified radiologists, Dr. Anthony Fischetti, to help dispel any myths about which test is the best. He says “both are equally as good, but which test is used depends on the body part being imaged and the type of resolution required to optimally image that body part.”

Big Machines at AMC
Computed tomography was introduced to human medicine in the 1970s. The AMC acquired its first CT scanner about 10 years later and is currently using its third scanner, a high-powered 64-slice CT scanner. Magnetic resonance imaging became commercially available in the 1980s and The AMC installed its first MRI machine in 2002 and upgraded that machine in 2006 for a more powerful model. To give you a comparison of the frequency of use of these tests, in 2007, a total of 73 million CT scans were performed on humans. In 2013, 700 CT scans and 600 MRI exams were performed – just at The AMC!

CT reconstruction of the skull of a dog with a jaw tumor

CT reconstruction of the skull of a dog with a jaw tumor

Starting at the Top
Imaging the head is a particularly good example of why we need both a CT scanner and an MRI machine at The AMC. The brain is composed of soft tissue and the boney skull is clearly hard tissue. When our neurologists want an image of the brain to determine the cause of seizures, they choose an MRI because it produces images with exquisite detail of soft tissues comprising the brain. An MRI can show minute changes in both types of brain tissue, the grey and white matter. But if an internal medicine specialist suspects the cause of a bloody nose to be a tumor in the nasal passages, they choose a CT scan, not only for its speed, but for its ability to show changes in the bones composing the nose and nasal passages. Because computed tomography is part computer, the images it creates are easily manipulated into a variety of views and even three dimensional reconstructions. The image you see to the right shows a reconstruction of the skull of a dog with a jaw tumor.

CT Goes with the Flow
CT scan is a form of x-ray and can detect a special contrast agent when the agent is administered intravenously. Using an intravenous contrast agent during a CT scan (CT angiography) helps veterinarians identify abnormal blood vessels in the liver – a common congenital disorder in small breed dogs – or determine, prior to surgery, if a tumor has breached a major blood vessel. Armed with this information, surgeons can better plan their approach before they get to the operating room.

MRI image of a  heart tumor in a dog using a contrast agent

MRI image of a heart tumor in a dog using a contrast agent

MRI has a Heart
MRI also uses intravenous contrast agents to differentiate various soft tissues in the body. The MRI image you see on the right shows a tumor of the heart in a dog following administration of a contrast agent.

Your Pet and the Big Machines
Here are some tips for pet owners whose pets require a CT scan or MRI:

  1. Expect blood tests and possibly a chest x-ray to be done before the scan. Testing helps veterinarians determine safe anesthetic protocols for your pet.
  2. Unlike when you or I receive an MRI or CT scan, you should anticipate that anesthesia will be administered to your pet. You know how hard it is to get a clear photograph of your wiggly pet. We need them to be perfectly still for imaging so that we can obtain an accurate scan.
  3. Know that it may take up to 24 hours for the radiologist to issue a final report on the scan. Waiting is hard, but reviewing images takes time and should not be rushed.

The Year in Veterinary Medicine

December 31, 2013

year-in-review-revisedAs 2013 comes to a close, we have put together a review of some of the interesting veterinary and animal-related highlights of the past year. We hope some of these tidbits will bring a smile to your face, a tear to your eye or spark some conversation at a holiday party.

January
Several articles reported the veterinary profession turned 150 years old in 2013. A misnomer in reporting, it was the American Veterinary Medical Association which turned 150 years old, celebrating with a traveling Smithsonian exhibition and a commemorative book. (Cavalry horses during Roman times were cared for by practitioners known as veterinarii, suggesting the profession has existed for much longer than 150 years!)

February
The Animal Medical Center created AMC TO THE RESCUE, a new fund to support specialist level treatment of pets that are currently under the care of rescue groups. The goal of the fund is to use AMC specialists to treat correctable medical conditions, making pets, like Frankie, more adoptable into a forever home.

March
In a year without much bipartisan cooperation, two veterinarians, Kurt Schrader, a Democrat, and Ted Yoho, a Republican, joined forces to increase awareness of the role veterinary medicine plays in research, public health, animal health and welfare, food safety, and the economy.

April
Starting in April, therapy dogs were almost continuously in the news. They arrived in Boston to comfort survivors of the Boston Marathon bombing. Later in the month, therapy dogs were called to Texas in the aftermath of a fertilizer plant explosion. Finally, therapy dogs took up residence at LAX to de-stress airline passengers.

May
If April was for dogs, then May was for cats. The Cannes Film Festival is always newsworthy, but this year not because of a Hollywood starlet, but because of a small ginger tom cat who starred in the Coen brothers’ film, Inside Llewyn Davis. Tama, a Japanese calico cat, was credited with saving a cat-themed train station from closure.

June
Therapy dogs made the news again in Michigan for supporting anxious victims of violent crimes during courtroom testimony.

July
Veterinarian Dr. Ernie Ward sits in a hot car with the window cracked for 30 minutes while the temperature climbs to 116 degrees Fahrenheit to demonstrate how dangerous leaving your dog in a parked car can be.

August
Cat DNA, sent to the Veterinary Genetics Laboratory at the University of California, Davis, became key evidence used in a 2012 British murder case. Scientists in the lab identified the hairs on fabric wrapping the body as coming from the murderer’s cat.

September
News of a new and potentially lethal dog virus spread like a contagion on the Internet. But by late fall, veterinary researchers determined circovirus was not a significant threat to canine health.

October
One of the most visible victims of the government shutdown was the National Zoo’s Panda Cam. Sixteen days later when the camera again rolled, one tweet rejoiced that “our long national nightmare is over.”

The Urban Resource Institute (URI) and Purina teamed up to support victims of domestic violence through URIPALS, New York City’s first initiative to allow victims of domestic violence to enter shelters with their pets. Purina donated much-needed welcome kits and educational materials for families entering URI’s largest domestic violence shelter.

November
The Animal Medical Center hosted the Third Annual Zoobiquity Conference, along with UCLA and the Wildlife Conservation Society. The Conference explored the diagnosis and treatment of disease from the perspective of both physicians and veterinarians.

December
Rosie and Clarence, the first two official police comfort dogs, were honored at The AMC’s annual Top Dog Gala. These canine officers received the Top Dog Award for their support of first responders at critical incidents and traumatic events, including the aftermath of the Sandy Hook Elementary School tragedy and the Boston Marathon bombing.

…and, we “Pawse to Remember”
No end of the year retrospective would be complete without acknowledging the passing of those who led notable lives:

  • Tuxedo Stan, former Halifax, Nova Scotia mayoral candidate.
  • Kaiser, a World Trade Center search and rescue dog and 2011 AMC Top Dog Gala honoree.
  • George, who held the Guinness Book of World Record’s title of tallest dog.
  • Barney Bush, the AP reporter-biting former FDOTUS.
  • Brian Griffin, canine family member on Family Guy.

Wishing you and your families the very best this holiday season and a healthy and prosperous New Year!


Holiday Gifts for the Naughty and Nice Pets on Your List

December 11, 2013

cat bunk bedA room with a view
What kitten wouldn’t want to find a bunk bed and playroom under the tree with her name on it? The top bunk is perfect for a perching cat or a cat nap, and the bottom bunk for a game of hide-and-seek with a catnip mouse or jingle ball.

Put some socks in his stocking
Do you have a nice, but mobility-impaired older dog? Put Woodrow Wear Power Paws on all four feet and watch these gripper slippers give traction on slippery tile or wood floors. These stylish dog socks come in a rainbow of colors and holiday designs.

Cat walking vest
Going to Grandma’s for the holiday? In addition to checking to be sure Fluffy’s microchip information is current in the registry, consider a SturdiPet™ walking vest from Sturdi Products. It is attractive and snug fitting and unlike many harnesses for cats, this one really stays on and keeps your cat comfortably restrained while you travel in the car or on the airplane to your holiday destination.

Waist watching
The peek-a-boo pet latch is a gift for your naughty dog. Using this latch on the door of the room where you keep the cat litter box will keep your dog from “snacking” in the cat box. The other use for this clever product is to keep an overweight pet out of the food bowl of a more slender pet.

Holiday hairdo
Everyone, your pet included, wants to look their best and smell nice to ring in 2014. What better way to have a coat that shines like the Times Square ball than to have a gift of dog toiletries under the tree for Sparky. Burt’s Bees, the folks with the beeswax based lip balm, now have a new line of natural pet products. Additionally, Wahl, the sponsors of America’s Dirtiest Dog contest, has cleaned up shelter dogs and can clean up your dog as well!

Rest and relaxation
After all the holiday activities, you and your pet will need some rest. Body Glove Pet will introduce a neoprene mat for use in crates or on hard floors, just after the first of the year. Neoprene is the material in wetsuits, so this product will be sturdy, washable and comfortable for a long winter’s rest.

And something for you too!
Need a calendar for 2014 and want to support a good animal cause? Here are just a few listings of calendars from a variety of animal organizations, including The Animal Medical Center!


Neutering: Not Just Doggie Birth Control

December 4, 2013

dog at vetDexter, a new dachshund patient of mine, was in last week for another round of puppy shots. He will soon be six months old and it was time for me to discuss the next step in his preventive health care plan: neutering.

Neutering meets the guidelines
The American Veterinary Medical Association has developed guidelines for responsible pet ownership. One of the guidelines obligates pet owners to control their pet’s reproduction through spaying and neutering; subsequently helping to control pet overpopulation in their community. Neutering is the common term for castration of a male dog or cat and spaying refers to removal of the ovaries and uterus, or in some cases just the uterus or ovaries, of a female pet.

Lifesaving responsibility
Pet overpopulation is a serious issue in the United States today. According to the Humane Society of the United States, over four million unwanted pets are destroyed annually. For every puppy or kitten prevented by neutering an adult pet, there is one less homeless and unwanted puppy or kitten euthanized in an animal shelter.

The traditional surgery
Surgical removal of the testicles is the current standard of care for neutering in both dogs and cats. This surgery renders a male dog or cat unable to reproduce and also removes the major source of the male hormone, testosterone. Removing the source of testosterone eliminates mating behavior in males and also plays a role in eliminating other unwanted behaviors. In both the dog and cat, neutering involves a small skin incision through which the testicles are removed. Cats typically go home the same day, but dogs may stay overnight to recover from anesthesia and for incisional monitoring.

A new method
The New York Times Well Blog recently reported on a new method of non-surgical, chemical castration, called Zeuterin. Zeuterin neutering uses zinc gluconate and arginine injected into a dog’s testicles as a less invasive method of castration. Dogs still produce a small amount of testosterone, but are unable to sire a litter of puppies. Veterinarians must be trained to use the Zeuterin method of neutering, but especially for shelters and rescue groups, the method has great appeal.

My recommendation
Dexter’s owners were concerned about the surgery. They asked if he could just have a vasectomy instead of the traditional neutering surgery. Because my job is to make the best medical recommendations for the specific health concerns of each of one my patients, I recommended the traditional surgery for Dexter. It provides him with the greatest number of health benefits. The surgery prevents unwanted litters of puppies and also prevents prostatic disease, testosterone-induced tumors and behaviors linked to testosterone production. Because a vasectomy or Zeuterin neutering are methods of birth control only, they do not offer the added advantage of decreased levels of testosterone on behavior and disease.


World AIDS Day 2013: Pet Ownership and AIDS Patients

November 27, 2013

World AIDS Day LogoThis Sunday, December 1 is World AIDS Day. This special day is an opportunity for people worldwide to unite in the fight against HIV, show their support for people living with HIV and to commemorate people who have died from the disease. World AIDS Day became the first ever global health day, with the first one held in 1988. Since we at The AMC are all about pets, today’s blog focuses on pet ownership for immunocompromised individuals such as AIDS patients.

Pets are “pawsitive”
AIDS patients and indeed all immunocompromised patients are at greater risk for acquiring infections from their pets. Yet, many believe the positive benefits of pet ownership outweigh the risks of infection. The health benefits of pet ownership are well known. People with pets exercise more, especially those with dogs. Pets lower your blood pressure and speed recovery from cardiovascular disease. Pets also increase human social interactions and decrease feelings of isolation in pet owners.

In a 2008 article, Dr. Russell Steele, a specialist in infectious diseases at the Ochsner Clinic in New Orleans, asks and answers the question “Should immunocompromised patients have pets?” Since his answer to the question is yes, Dr. Steele recommends a two pronged approach to pet ownership for immunocompromised individuals:

  1. Careful selection of the pet
  2. Frequent health monitoring of pets

Pet selection

  • Choose an adult pet with a known health history. Puppies, kittens and pets without any health information are more likely to pose a risk for infectious diseases such as Campylobacter diarrhea or bite injuries.
  • Select an indoor pet. Indoor pets have less exposure to wild animals and other sources of infectious diseases.
  • Choose a cat that tests negative for feline leukemia virus and feline immunodeficiency virus. Since these are the feline versions of AIDS, infected cats may harbor infections which can be transmitted to humans. 
  • Avoid pet birds, reptiles and rodents. These make wonderful pets for some, but the diseases they can transmit to immunocompromised patients cannot be prevented by vaccination like many of the diseases transmitted by dogs and cats. 

Healthcare and monitoring

  • Tell your veterinarian about your immunocompromised status. Details are not important. Just knowing a patient is immunocompromised is enough for me to better manage your pet’s healthcare.
  • If your pet is not neutered, talk to your veterinarian about neutering. Neutered pets are less likely to roam and bring home infectious diseases.
  • Have your pet examined by a veterinarian at least once a year.
  • Follow your veterinarian’s recommendation regarding vaccinations and fecal analysis.
  • Ask about preventive medications to keep yourself and your pet free from diseases transmitted by fleas and ticks.
  • Feed a cooked diet. Raw pet food may contain microorganisms which can make you and your pet sick.

For more information about keeping yourself healthy if you have a pet, read the Centers for Disease Control’s FAQ on pets and HIV/AIDS. Note the first line of this document says “You do not have to give up your pet.”


Cleaning Up America’s Dirtiest Dog

October 29, 2013
Darcy, 2012 Winner of Wahl's Dirty Dog Contest

Darcy, 2012 Winner of Wahl’s Dirty Dog Contest. Photo courtesy of Wahl.

Last week I got a telephone call from someone asking a novel question: “Is my own dry shampoo safe for my pet?”

My initial reaction was that it sounded ok, but I knew I had to investigate the list of ingredients in dry shampoos. I found there are a wide variety of dry shampoos – some powder based and some aerosol. I would be willing to bet all cats and most dogs would not be happy about being “shampooed” with the aerosol variety and I made a mental note to find some powdered dry shampoos to check on ingredients.

Top ranked dry shampoos for people
Next, I looked at a Vogue ranking of dry shampoos and every one was in a spray bottle! It was impossible to find the ingredients and one product actually said the ingredients were subject change at any time! As a pet owner, that didn’t give me much confidence regarding dry shampoo safety for my pet. Another dry shampoo contained a list of chemicals worthy of the answers on a multiple choice AP chemistry test. Thinking rationally, human dry shampoos are not made to be ingested, and I guarantee you if you put them on your pet they will be! In the end, I cannot recommend human dry shampoos for pets.

Emergency pet shampooing
If you need a clean pet in an emergency situation – your dog smells and you have dinner guests on the way or the cat looks greasy and you have a big date in one hour – I suggest opening the kitchen cabinet. Dry shampoos work by absorbing the oils from your hair. A sprinkle or two of corn starch on your dog, followed by vigorous brushing, may do the trick. No corn starch? Open the bathroom cabinet and try some baby powder on your cat. Keep both cornstarch and baby powder out of your pet’s eyes and nose.

For the do-it-yourselfers, here is a link to a homemade dry shampoo made with all safe ingredients. I find lavender oil included in this recipe to be very calming for dogs who are anxious in the exam room.

Stock your pet cabinet
The easiest solution to getting your pet clean and fresh without a tub bath is to keep a pet-safe dry or waterless shampoo on hand. The Wahl product line is one I use in the clinic to spot clean my messier patients – both dogs and cats.

A quick internet search located many other commercially available dry shampoos made specifically for pets.

Dirty dog search
Got a photo of your dirty dog? Wahl and Petfinder Foundation are sponsoring a contest to find American’s dirtiest dog. Enter your dirty dog photo and you could win a year’s supply of Wahl pet grooming products, a $100 gift card, plus $5,000 and grooming supplies awarded to the animal shelter or rescue group of your choice. Now you and your dirty dog can help America’s shelter pets become clean, happy and more adoptable. Photos must be entered by October 31st.

Wahl photo contest


How to Recognize a Sick Cat

October 2, 2013
Abyssinian cat

Abyssinian cat

Cats are the masters of disguise. Here we see a beautiful Abyssinian cat decoratively perched on a pedestal and disguised as a piece of sculpture- that is until she changes her mind and becomes something else!

Although cats in disguise bring enormous enjoyment to our lives, many cat owners are frustrated with their favorite fur person’s Academy Award-winning ability to masquerade as a healthy cat until hospitalization and intensive care are required. Sick cats commonly hide under the bed or in the closet; however, many cat owners mistakenly believe this behavior is simply their cat expressing its feline independence rather than a potential sign of serious illness. Another sick cat behavior frequently mistaken for bad cat behavior is a loss of litter box training.

Common illnesses, common signs
According to Best Pets Insurance, the top five medical claims for insured cats include: chronic kidney diseasehyperthyroidism, allergies, cancer and diabetesThese five diseases make up one-third of all feline claims to Best Pets Insurance. I don’t want to minimize the important impact allergies have on your cat’s quality of life but, in general, allergies are not life threatening and because they manifest on the outside of your cat, allergies are easy to detect. This blog will focus on how to recognize the big four: chronic kidney disease, hyperthyroidism, cancer and diabetes.

Weight loss in all
Many cat diseases look the same, which is one reason it is difficult for cat owners to identify that their cat may be ill. In fact, weight loss is a common clinical sign in cats with chronic kidney disease, hyperthyroidism, cancer and diabetes.

Increased water drinking in most
When I talk to cat owners at an annual physical examination, I ask about water consumption. Increased drinking can result from chronic kidney disease, hyperthyroidism or diabetes. Only occasionally, does cancer cause cats to drink more water.

Hungry all the time in a few
Hyperthyroidism causes metabolic rate to soar. Hyperthyroid cats are hungry all the time to compensate for their increased metabolic rate. Diabetic cats lack insulin, which allows nutrients to enter the cells. Diabetic cats are hungry because their bodies cannot utilize the food they eat. Cats with cancer and kidney disease usually have poor appetites.

Early recognition

  • An annual physical examination by your veterinarian will go a long way to detecting weight loss, which is a common feature of the big four.
  • Collect a urine sample and take it to your cat’s annual physical exam, since abnormalities like sugar in the urine will help diagnose diabetes early.
  • If your pet is showing any of these signs, discuss blood testing with your veterinarian to help identify your cat’s medical condition.

World Rabies Day: September 28, 2013

September 25, 2013

world rabies dayWorld Rabies Day takes place each year on September 28, the anniversary of the death of Louis Pasteur who, with the collaboration of his colleagues, developed the first efficacious rabies vaccine. The promotion of World Rabies Day aims to raise awareness about the impact of rabies on humans and animals, provide information and advice on how to prevent the disease, and inform us of ways individuals and organizations can help eliminate global sources (World Rabies Day website, 2010).

A recent article in the Palm Beach Post sets the tone for this year’s World Rabies Day blog. Four people, trying to help a sick kitten, have been exposed to rabies and have undergone rabies post exposure prophylaxis.

Feline rabies rising
This story helps underscore the importance of rabies vaccination in cats. Depending on the laws in your town and the type of vaccination used, cats may need to be vaccinated for rabies every one, two or three years by your primary care veterinarian. The Centers for Disease Control and Prevention reports feline rabies is on the rise.

For the last three decades, the animal causing the most human exposure to rabies is the cat. According to New York State’s Wadsworth Laboratory, which performs statewide rabies testing, between 2003 and 2009 in New York State, there were about 25-30 feline cases of rabies per year. That number jumped to about 40 cases in 2010-2011, decreased to the usual level in 2012, and hopefully will continue to decrease. The Wadsworth Laboratory also reports cats are the number two animal tested (behind bats) and the number one domestic species tested for rabies. In 2012, 22 New York State cats tested positive for rabies, but no dogs tested positive for the rabies virus. Dog rabies occurs infrequently due to the successful vaccination programs in place.

Veterinarians are concerned the number of feline rabies cases will not decrease, since cats see their doctors less often than dogs see theirs. Fewer veterinary visits mean fewer opportunities to vaccinate cats against rabies, resulting in more unvaccinated cats at risk of developing rabies.

Feral cat reservoir? 
Since feral cats live at the intersection between humans and wild animals, some suggest feral cats serve as a reservoir for rabies. The rabid kitten of the Palm Beach Post article was believed to have come from a feral cat colony. Some colonies of feral cats are managed to facilitate population control and rabies prevention, but the Palm Beach colony was not managed in any way, causing some to call for removal of the entire colony.

Protecting your cat against rabies

  • Vaccination is the best method for preventing rabies. Follow your veterinarian’s recommendations.
  • Keep your cat indoors and away from wild animals that may harbor rabies.
  • Don’t feed wild animals in your yard; you may be attracting trouble and putting your pets and family at risk.

Check out the Worms & Germs Blog for more information about rabies.

 


The New Dog Virus: Circovirus

September 11, 2013
dog with circovirus

Photo: WRGT-TV FOX 45 News

The internet has been buzzing with talk of an emerging and possibly deadly virus occurring in dogs. Concern about this virus is significant enough that even during a webinar I attended yesterday on using social media in veterinary medicine, dog circovirus received a mention. The Animal Medical Center’s Facebook friends have been discussing the virus and their concerns about their dogs, as well.

Circovirus?
I had actually not heard of the circovirus group until recently, probably because the majority of circoviruses infect birds. Until this new virus was isolated from sick dogs in April, pigs were the only mammal known to be infected with a circovirus, which causes pneumonia, gastrointestinal signs, and systemic inflammation. The genome of a dog circovirus was reported back in 2012, but the authors of that paper do not report where the virus was found or if the virus made dogs sick.

Sick dogs in California
In April of this year, Emerging Infectious Diseases published an article, “Circovirus in Tissues of Dogs with Vasculitis and Hemorrhage.” In California, a young dog, sick with signs of vomiting and bloody diarrhea, died and was autopsied. Tests for typical diseases causing bloody diarrhea, parvovirusSalmonella and Giardia, were negative. Researchers performed additional testing on the tissues, leading to the identification of a strain of dog circovirus. Fecal analysis of samples from both healthy dogs and sick dogs with signs similar to the dog in California found about 10% of fecal samples were positive for circovirus, but many dogs had other pathogens in their stool including coronavirus, Giardia and Salmonella. One common historical feature of these cases was group housing, such as a shelter or boarding kennel.

Sick dogs in Ohio
Last month, an astute veterinarian in Ohio treated several dogs, all with a history of staying at the same boarding kennel, and reported this cluster of cases to the Ohio Department of Agriculture. The dogs had strikingly similar signs to one another and to the dogs reported in Emerging Infectious Diseases: bloody diarrhea, vomiting, weight loss, lethargy and inflammation of the blood vessels. One dog had circovirus isolated from a fecal sample, and further testing is underway in one of the dogs that died to determine the cause of death.

Treat with common sense
Medical caution is indicated in this situation. Finding a virus in a sick patient does not automatically determine causality and much more research is necessary before circovirus infection can be added to the list of potential diagnoses for sick dogs. Our friends at the Veterinary Network News urge caution in attributing too many illnesses to this newly found virus.

The unknown can be scary. Since so little is known about dog circovirus, making rational recommendations is a hard task.

  1. Use common sense. Keep your dog away from sick dogs.
  2. Wash your hands after petting someone else’s dog and before you pet your dog.
  3. Report all illnesses to your veterinarian.
  4. Still nervous? Check for updates on the virus on The AMC website. We will recommend if it might be best to forgo the dog park, boarding kennel and doggie day care if the risks become more evident.

Pet Insurance: FAQ from The AMC

August 21, 2013

Pet-Insurance2The webmaster at The Animal Medical Center fields questions related to pet health from all over the world. Many of the recurrent questions are related to pet health insurance. Here are the answers to a few of the most common pet health insurance questions.

What insurance policies does The AMC accept?
Pet insurance is different than human insurance. My doctor’s office has negotiated contracts with several insurance companies; therefore, she cares for patients who purchase policies from those companies. The contract in pet insurance is between the pet owner who purchases the policy and the pet insurance company. The AMC provides information and invoices to the pet owner, who in turn submits a claim to their pet’s insurance company and is reimbursed for their expenditures by the insurance company.

What will pet insurance cover?
Coverage depends on the company and the details of the policy. Trupanion policies focus on coverage for illness and recovery rather than preventive healthcare. The ASCPA policy, underwritten by the Hartfield Group, has several different levels of care, two of which include coverage for preventive healthcare.

How much do policies cover?
Commonly, policies state they reimburse 80-90% of customary and usual charges for covered services. Each veterinary hospital sets its fees to reflect their costs of operation. If you live in a city where the cost of living is high, ask if the insurance company has higher “customary and usual charges” for calculating your level of reimbursement. Alternatively, ask a prospective insurer what percentage of submitted claims is paid out to pet owners in your area. Healthy Paws reimburses based on the actual veterinary bill as do a couple of other companies. Some companies have annual or lifetime caps on total payments. Others cap payments for specific conditions.

Can I get pet insurance for all my pets?
All companies insure dogs and cats. Insurance for the other members of Noah’s crew, including birds, reptiles, small mammals, marsupials, amphibians, rodents and lagomorphs is available only through VPI, the oldest pet insurance company in the United States.

What about coverage for pre-existing conditions?
Again, this type of coverage varies from policy to policy. For example, some policies exclude genetic conditions, such as elbow dysplasia and hip dysplasia, from coverage. If your dog has already had a cruciate ligament repaired on the left and the right cruciate ligament ruptures, he will not be covered by all policies as some consider cruciate disease to be a bilateral disease. Pets Best seems to be one exception to this exclusion.

Another point to keep in mind: your veterinarian may recommend therapies not covered by your policy. If she does, your claim would be denied. Before you renew your policy, ask if any illnesses reimbursed in the previous policy cycle will be excluded as pre-existing conditions once your renew.

Surprising coverage
I found several interesting features of the policies I reviewed. Pet’s Best lists coverage for some groundbreaking treatments, like stem cell therapy for feline kidney disease. I found a 13 page list of medications covered by one plan, and another with coverage for boarding if you are hospitalized and need to board your pet.

Employee Benefit?
A recent news article highlighted increasing numbers of companies offering pet insurance as an employee benefit. Check with your human resource department before you select a policy for your favorite fur person.

Final word: Read the policy carefully
I found at least one policy that does not cover two common (and costly) problems of older dogs and cats: heart disease and diabetes. Cancer is another group of diseases which are not covered by all policies; although many policies can be upgraded to cover cancer diagnosis and treatment.


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