The Pen Cap May Be Mightier than the Sword…

July 15, 2011

But it can’t beat a bronchoscope!

Barcley

One thing I love about pets is their unpredictability. You just can never guess what they will do next. Here’s the story of Barcley, the French bulldog and the nearly fatal pen cap.

The beginning seemed innocent enough: a dog playing with a bright blue highlighter pen. Suddenly, he couldn’t breathe and his owners rushed him to The Animal Medical Center. Quick administration of oxygen and a sedative by the ER staff seemed to alleviate the breathing problem enough to allow a chest x-ray to be taken.

No one would have predicted the x-ray would show Barcley’s windpipe contained what looked like the cap of the bright blue highlighter!

Barcley’s chest x-ray. Arrows point to outline of pen cap in his windpipe.

The ER staff had to think quickly and cleverly. Barcley needed anesthesia and a bronchoscope to remove the highlighter pen cap, but the standard anesthetic plan of placing a breathing tube into the windpipe was out of the question; it was already full of the highlighter cap. To further complicate matters, Barcley is a brachycephalic (short nosed) dog, a type of dog known to have a greater risk of anesthetic complications.

Dr. Stacy Burdick of The AMC’s Internal Medicine Service was called in at 1:30 am to perform the procedure which took 20 minutes, but seemed like a lifetime. She placed a small rubber tube in the windpipe to deliver oxygen and administered an injectable anesthetic agent into Barcley’s vein. Dr. Burdick cautiously advanced the bronchoscope down Barcley’s windpipe. She was worried the windpipe could have been damaged as the cap went down, or worse, the windpipe could tear when she pulled it back up.

Pen cap in windpipe

On the right, you can see what Dr. Burdick saw when the cap came into view. The cap blocked the entire lumen of the windpipe. Knowing she had to work quickly to restore the delivery of oxygen to the lungs, she passed a special grabber device through the bronchoscope, grabbed the cap and gently pulled it gently out through the mouth as she pulled out the bronchoscope.

Barcley’s life was saved from the pen cap by the mighty bronchoscope and the skilled Dr. Burdick.

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

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


Dogs and Cats as Diana and Orion, the Hunters

July 13, 2011

Photo: Hemera

Pet owners believe their well-fed, or more likely overfed, dog or cat should have no reason to hunt, but lately it seems my patients are on a hunting spree.

Most cat owners who allow their cats outside, become accustomed to freshly killed gifts of mice and other small rodents carefully placed as an offering on the back stoop. But this week the take has been much more substantial.

Take Francie, for example, a special needs Cavalier King Charles Spaniel on anti-seizure medication. Twice last week she captured an unidentifiable furry creature and dragged it in through the doggie door. One unfortunate victim was hauled into Francie’s crate and the other left with pride in the middle of the kitchen floor. Franice’s family was outwardly distressed over her behavior, but the diminutive “Diana” seemed pleased with her hunting success.

Dixie and Mabel, a pair of Labradors, have not been hunting because they are, of course retrievers! To their owners’ initial horror, they were about to retrieve what appeared to be a dead possum, when the possum stopped “playing possum” and safely scampered back into the woods.

The Orion of the group is Willie, a handsome black Standard Poodle. He was out romping in his yard when a fawn strolled by. He tackled the fawn and was immediately tackled by his owners, who saved the fawn and had it safely transferred to the care of a wildlife rehabilitator.

I can share all these stories with you because the pet owners called me; not to brag, but out of concern for their pet’s health. Most were concerned about the potential for rabies transmission from wildlife. This is a real concern for pet owners and just one very good reason for having your pet vaccinated for rabies. Rabies vaccines are very effective and rabies is very uncommon in vaccinated dogs and cats.

Another concern is for parasite which can be carried by wildlife and transmitted to your dog or cat. The Dianas and Orions need annual fecal examinations and routine year round parasite prevention as recommended by the Companion Animal Parasite Council.

These pet owners also called wondering how to handle injured wildlife. First, you should not attempt to touch or move injured wildlife as you may be bitten. In New York State, the Department of Environmental Conservation licenses wildlife rehabilitators who can provide assistance and care for injured wildlife. There is also a FAQ page with great information about wildlife in your yard.

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

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


Everything Old is New Again: Plague and Leprosy

July 7, 2011

Nine banded armadillo, which can carry leprosy, seen in Brooklyn’s DUMBO neighborhood at modern:ANTHOLOGY.

Last week there were two very interesting stories in the news about the intersection between people and animals. Both reported on diseases we rarely hear about anymore: plague and leprosy.

Leprosy is the older disease and has been reported since Biblical times. The first reported epidemic of plague occurred somewhat later, in the 6th or 7th century. Bubonic plague, or the Black Death, was the scourge of the Middle Ages.

Plague is an infectious disease caused by the bacteria Yesinia pestis. The usual source of Y. pestis is the rat flea, but hunting pets can contract the plague from eating infected rodents or rabbits. Even though Y. pestis is predominantly found in California, Utah, New Mexico, Arizona and Nevada, cases can be seen throughout the country if a human or pet travels to one of these areas and contracts the disease before they return home. An infected pet can, in turn, infect humans. The possibility of plague transmission is one reason prairie dogs may not make the best pets.

The name bubonic comes from the word bubo, which is a fancy word for enlarged lymph node. Wikipedia shows an illumination from a medieval Bible of sinners afflicted with buboes.

Both humans and pets with bubonic plague have enlarged lymph nodes, which are painful. Fever, malaise and non–specific flu-like symptoms are typical for plague in both humans and pets. Although last week’s plague case occurred in a dog, in general, cats are more susceptible to plague than dogs.

Leprosy was in the news too; not because of a sick dog or cat, but because of armadillos. Those prehistoric-looking armored mammals carry the leprosy bacteria, Mycobacterium leprae. Most leprosy cases occur outside the United States, but cases occur in people who have not traveled outside the USA. This finding puzzled researchers until the DNA of the M. leprae was studied. Both armadillos and humans infected with M. leprae in the USA share the same unique strain of the bacteria. This bacterium is different from the strain of M. leprae found outside the USA. The New England Journal of Medicine article concluded humans can contract leprosy from infected armadillos.

To help protect yourself and your pet from contracting diseases of wildlife:

  • Keep your pet leashed or indoors to prevent contact with wild animals which can cause serious diseases.
  • Never approach, pet or handle wildlife even if they are acting friendly.
  • If your pet is sick, always tell your veterinarian where your pet has traveled and do the same when you visit your physician. It may be just the perfect clue to the diagnosis.

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

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


Summer Noise Phobias

July 5, 2011

Lovely weather, summer holidays and a relaxed atmosphere make summer everyone’s favorite season – everyone except for dogs with noise phobias. Fireworks and thunderstorms create unexpected loud noises, frightening to many dogs and cats as well. The veterinarians at The Animal Medical Center see dogs and cats injured and lost over the Fourth of July weekend as a result of their noise phobias.

Signs of noise phobia:

Destructive behavior

  • Scratching/digging at door or wall
  • Chewing
  • Loss of housebreaking

Anxious behavior

  • Clinging to owner
  • Drooling
  • Hiding, especially cats
  • Panting
  • Expressing anal glands
  • Dilated pupils

Abnormal behavior

  • Skipping meals
  • Jumping out of windows/running out of doors
  • Shaking
  • Loss of training, i.e., not responding to commands

Home Remedies
Consider trying home remedies for noise phobia. One of my patients with thunderstorm phobia calms down if her owner wipes her fur down with a dryer sheet. Dryer sheets may decrease the buildup of static electricity caused by the impending thunderstorm. I suggest the unscented ones, since dogs don’t like smelling like an ocean breeze. Anxious dogs may feel calmer during storms or fireworks if you apply a dab of lavender oil to their ear tips. The lavender oil fragrance has calming properties and is available at health food stores and on the internet.

Noise Phobia Products

  • Along the lines of the antistatic dryer sheet is the Storm Defender Cape which has a special lining to diffuse static electricity.
  • The Thundershirt is a snug fitting dog T-shirt which some of my dog owners have used for anxiety related to car rides, veterinarian visits, as well as thunderstorms.
  • An interesting product I found is dog ear muffs, but I don’t have personal experience with them.

For additional tips on managing fireworks phobia in dogs read a previous blog, “Fireworks and Your Dog.”

If you need professional help managing noise phobias in your pet, a behavioral consult with a Diplomate of the American College of Veterinary Behaviorists can help set your dog or cat on the road to recovery.

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

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


Cat Food Myths Debunked

June 30, 2011

A few months ago I wrote about cats and “cat salad.” Since we are at the end of Adopt–a-Cat month, I hope there are many new cat owner readers who will be interested in these food myths about cats. These myths have come from conversations with my cat-owning clients at The Animal Medical Center.

All cats like fish.
Partial myth. Cats’ food preferences are strongly influenced by those of their mother. If the mother liked and ate fish, the kittens are likely to crave fish as well. But the food preferences of the finicky feline are not so simply categorized. Despite the daredevil behaviors of young cats – flying from cabinet to refrigerator and scaling bookshelves with abandon – they are not so adventurous when it comes to food. Young cats fed the same diet consistently are often reluctant to eat a different diet if one is offered to them later in life. A cat food with a “good” smell is more likely to be chosen by a finicky feline, and if your cat doesn’t find any of the food attractive based on smell, it may taste several before choosing one. One fun fact about cats’ food preferences is cats probably don’t chose food based on salty or sweet flavors since their taste buds are insensitive to salts and sugars.

Cats should have milk to drink.
This is a companion partial myth to “cats like fish.” Some cats like milk, some don’t. Most cats lack the digestive enzyme, lactase, responsible for digestion of lactose, or milk sugar. A bowl of milk may lead to an upset stomach or diarrhea in cats. This situation can be avoided by treating your cat to a bowl of low fat lactose-free milk or one of the cat milk products available at the pet store. Since treats should comprise only 10% of the daily caloric requirement, keep the amount of milk to about 1/3 of a cup, or roughly 30 calories per day for the average 8 pound cat. Cat milk products have the added advantage of supplemental taurine, an essential amino acid for cats.

Cats can be vegetarians.
This is a myth, and a dangerous one. Nutritionally speaking, cats are obligate carnivores. Everything about their physical structure says “meat eater” from their sharp pointy fangs to their short digestive tract. Veterinarians will discourage owners from preparing vegetarian or vegan foods at home for their cats. Without the input of a specialized veterinary nutritionist, homemade vegetarian and vegan diets for cats are frequently deficient in taurine, arginine, tryptophan, lysine and vitamin A. Taurine deficiency leads to heart failure and a cat fed a diet without arginine may suffer death within hours. Both taurine and arginine are found in meat.

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

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


Recognizing Arthritis Pain in Your Cat

June 28, 2011

When working with the Animal Medical Center veterinarians participating in our post graduate training programs, I often say, “Cats are not little dogs.” What I really mean is, a particular disease in dogs does not appear the same as the disease does in cats. For example, dogs with heart disease typically have heart failure from leaky heart valves, while cats with heart disease commonly have abnormalities of their heart muscles, not their valves. When it comes to disorders of the thyroid gland, dogs suffer from an under active thyroid and cats from an over active thyroid.

Normal hips in a cat. Arrows point to nice, smooth joint surfaces.

A pet’s behavior in response to arthritis pain is also different between cats and dogs.

Arthritis is a common cause of pain in dogs and owners of arthritic dogs are quick to point out their dog is limping. Despite the fact that x-rays show evidence of arthritis in somewhere between 15-65% of cats, limping is really uncommon in feline patients. 

Cats with arthritis suffer from weight loss, anorexia, depression, urinating outside the litter box, poor grooming and, in some cases, lameness. One of my 21-year-old feline patients had to be moved onto a single floor of the house because he was too painful to use the stairs to the basement to get to his litter box. He got a new litterbox too, which had lower sides since he couldn’t step into his old one with higher sides.

Both hips in this cat are affected by arthritis. Arrows point to roughened edges of joint.

Pain in cats is difficult for both veterinarians and cat owners to assess. From my veterinarian’s viewpoint, if I put a cat on the exam room floor in an attempt to watch it walk, it will immediately run under the desk and hide. It will definitely not limp as it rockets underneath the desk.

In a recent study evaluating pain assessment in cats by veterinary researchers in North Carolina, cat owners reported they found it difficult to identify mild pain in their cats. Cat owners believed they could correctly identify changes in their cat’s function and activity. Dog owners more readily identify how pain interferes with their dog’s activities, possibly because dogs participate more fully in family activities such as ball toss, Frisbee and hiking.

If you notice your cat moving around less, not using the litter box or showing reluctance to go up and down the stairs, see your veterinarian for an arthritis evaluation.

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

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


Day at the Museum: The Animal Medical Center Sequel

June 23, 2011

The Animal Medical Center has a computer system to manage our diagnostic imaging, including x-rays, ultrasound, CT scans and MRIs. The Picture Archiving and Communications System (PACS) lists all the images for any given day. If you looked at the list for June 17, you would see my patient Dakota, who got a chest x-ray, Chippie, the dog who had a full series of dental x-rays, and BooBoo who had a brain MRI — a typical list for a Friday.

But reading down the list you get to Croc 1, Bird 2, Snake 3 and Ibis 4. These images come from the oldest patients ever seen at The AMC. No, not a 25 year old dog or a 30 year old cat. These 32 patients are 2,500 year old animal mummies.

CT scan of Croc1. Head left, tail right

Like many AMC patients, these animals came to The AMC across the Brooklyn Bridge into Manhattan. Unlike any other AMC patients, these patients belong to the Brooklyn Museum’s Egyptian collection.

Like all patients who come to The AMC, they came for our diagnostic expertise, utilizing our state of the art equipment. In this case, the animal mummies came to The AMC for CT scanning in our 64-slice CT scanner.

Reptile mummy in its box being placed in 64-slice CT scanner

The AMC’s 64-slice CT scanner rapidly produces high quality images. So fast, all 32 were scanned in one day as outpatients! Rapid is better for our usual patients, since the faster the scan, the shorter the anesthesia time. For the animal mummies, the high quality images are critical in helping AMC’s board certified radiologist, Dr. Anthony Fischetti, collaborate with the curators from the Brooklyn Museum to decipher the mummy’s contents. The 64-slice CT scanner can recreate three dimensional and multiplanar images of the patient. In our usual patients, we use these features to better diagnose and treat illnesses. Our colleagues at the Brooklyn Museum plan to use the reconstructed CT images to study the mummies’ contents without disrupting the intricate linen wrapping.

If our CT scanner is so fast and can scan thirty two mummies in one day, you might wonder why your AMC veterinarian wanted your pet here all day when it had a CT scan. A CT scan in one of our usual patients requires administration of a short-acting anesthetic. Obviously, an animal mummy does not require anesthesia, the associated monitoring of the heart, respiration and blood pressure and does not have to recover from anesthesia. All these differences shorten the procedure time.

Most of our usual patients have two CT scans back to back. The first scan is before and the second is after administration of a contrast agent. The contrast agent highlights abnormalities the veterinarians are hunting for, such as inflammation and tumors. Administration of contrast was not possible or necessary in the animal mummies.

This animal mummy project between The Animal Medical Center and the Brooklyn Museum will culminate in an exhibition in 2013, so mark your calendars now!

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

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


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