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:


Medication Mix-Ups

March 13, 2014
animal poison control image

Photo: aspca.org

Next week is Poison Prevention Week. According to ASPCA Animal Poison Control, the number one cause of poisoning in pets is prescription and over the counter drugs. The poisoning occurs because pets inadvertently consume either pet or human medications. To help raise awareness of potential sources of pet poisoning, here are some recent issues with medications reported to the veterinarians at The Animal Medical Center.

Name Swap
Most drugs have a brand name like Lasix® or Amoxi-tabs® and a corresponding generic name like furosemide or amoxicillin. I will admit I may use the brand name when speaking with pet owners but write a prescription for the generic medication because the generic brand is typically less expensive, though equally as effective. This dual naming system often creates confusion for the pet owner sometimes resulting in double medicating the pet. Oreo has heart failure and is being treated with Lasix. A second prescription of the same medication from a specialist said furosemide. The owner administered the new medication along with the old medication because she didn’t know the two were the same drug. Fortunately, the error was recognized and no harm came to Oreo.

Rainbow Roulette
Please keep in mind that your veterinarian usually doesn’t see the pills dispensed to your pet. Because I don’t see the pills, your description of “the oblong blue one” doesn’t help me determine the medication prescribed. Also keep in mind that generic medicines can be the same drug, but manufactured in different colors. If a medicine is dispensed and does not look like the last prescription for the same medicine, don’t hesitate to ask the pharmacist or someone at your veterinarian’s office to be sure the correct medication was dispensed.

A Pill for You and a Pill for Me
Last week one of our cat patients was inadvertently given one of her owner’s medications. Both pill bottles were sitting side by side on the counter. Even worse, the medication contained Tylenol® (acetaminophen), a human drug which is very toxic to cats. The owner quickly recognized the problem and successfully induced vomiting, but it could have been a disaster for the cat.

Yes, We Mean Three Times a Day
Three times a day does not mean, put all three pills in the food and hope your pet eats a bite of food containing a pill every eight hours. Don’t count on your pet to count the hours between doses. Give each pill separately at the prescribed intervals to avoid over- or under-dosing your pet.

Words to the Wise

  • Ask the prescribing veterinarian what each medication prescribed for your pet is meant to treat. If there are multiple medications to treat the same problem, ask if they are duplicate medications with different names on the labels.
  • If you see more than one veterinarian for your pets multiple problems, take all the medication bottles with you to each visit. Be sure each veterinarian knows what the other has prescribed.
  • Do not talk about the color of the pills with your veterinarian. We prefer the names of the medication to be read off the bottle. Even badly pronounced drug names are better than a description like “the white one, a little smaller than a dime.”
  • To avoid a medication mix-ups, store your medications in a different location than you store Fluffy’s.
  • Keep the toll free number of an animal poison hotline handy for an emergency:

- Pet Poison Helpline (800) 213-6680
- ASPCA Animal Poison Control (888) 426-4435


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!


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.

Dog Breeds in the News

February 5, 2014

For pet lovers, there has been exciting news about dog breeds recently. In less than a month, the American Kennel Club (AKC) will introduce three new breeds at the upcoming Westminster Kennel Club (WKC) Dog Show in New York City. The WKC Show, February 8-11, 2014, will allow dogs of any breed or no breed at all to enter their new agility competition, which will be held on Saturday before the big show. Finally, both The Animal Medical Center and Pets Best Insurance announced their top ten dog breeds, based on the number of pets we care for and they insure.

rat terrier

Rat Terrier

Old Dogs, New Club
The Portuguese Podengo PequenoChinook and Rat Terrier are new only to the AKC dog show ring. One of the most ancient of dog breeds, the Portugese Podengo Pequeno, came to Portugal from Asia Minor around 1000 B.C. This lively hound is related to other ancient breeds such as the Pharaoh Hound and the Basenji. The Rat Terrier is a home grown breed developed early in the 19th century from European terriers imported by immigrants to the United States. The Chinook is another American breed, most famous as the State Dog of New Hampshire, where the breed was developed. For more on these new AKC breeds, listen to David Frei, the voice of Westminster, on NPR. 

And the Top Dog is…
A comparison of the top ten breeds seen at The AMC, insured by Pets Best Insurance and holding AKC registrations shows some interesting trends:

top 10 dog breeds 2013

The Labrador Retriever, Dachshund and Yorkshire Terrier made all three top ten lists. The mixed breed dog topped both The AMC and Pets Best lists. No surprise here, since AKC does not include mixed breed dogs in their registration. Also on two of the three lists were several small breed dogs, such as the Chihuahua, Shih Tzu and the Maltese Terrier, possibly influenced by the dogs of Paris Hilton or Halle Berry. The ever steady German Shepherd Dog and the much maligned Pit Bull Terrier also made two of the three lists. Unique to the AMC list were the Cavalier King Charles Spaniel and the Pomeranian, probably reflecting apartment dwellers selection of a small dog.

Seeing Fewer Spots
Breed popularity comes and goes with popular culture. The movie 101 Dalmations sparked a national craze for the spotted dogs. In 2005, the Dalmatian ranked number 47 in the list of dog breeds seen at The AMC. This past year, Dalmatians dropped in the ranking to 100 as dog owners fell in love with different breeds, for example the French Bulldog.

A Rising Star Among the Breeds
According to Pets Best Insurance, a number of breeds have gained popularity in recent years. In their database, the French Bulldog has seen the most dramatic rise. In 2006, the French Bulldog was the 55th most popular dog breed enrolled with Pets Best. By 2013, this small, muscular pooch soared up the list to become the 19th most popular breed. While Pets Best insures pets nationwide, The AMC’s New York City-based practice reflects the same meteoric rise in the popularity of the French Bulldog. In 2005, Frenchies ranked 30th and our veterinarians cared for 120 individual Frenchies. In 2013, the number of these dogs seen at The AMC has increased 2.5 times to 275 individual dogs.

See More Dog Breeds and Visit the AMC Booth
Like we do every year, The AMC will have a booth in the benching area of the WKC Show on February 10th and 11th. We would love to have you stop by and visit us. You can find us in Booth 16 at Piers 92/94, right alongside the Hudson River at 55th Street and 12th Avenue.

This year, AMC veterinarians have a new role at the 138th WKC show, that of Official Show Veterinarian. Several of our veterinarians will be on site at the Piers and Madison Square Garden, which showcases the main ring events, on both nights to triage any emergencies that could arise.

If you are not a fan of purebred dogs, this year there will be mixes, mutts and Heinz 57 type dogs at the Masters Agility Championship at the WKC Show.

We hope to see you all there!


Dental DOs and DON’Ts

January 31, 2014

dog having teeth brushedBecause February is National Pet Dental Health Month, I spoke to all three of The AMC’s veterinary dentists to get a list of dental DOs and DON’Ts for my readers. A big shout-out to Drs. Dan CarmichaelDjango Martel and Stephen Riback for their help in compiling this list.

Dental DON’Ts – Bones, doggie breath and furry tennis balls
Our three dentists spend much of their time repairing fractured teeth. They blame hard nylon “bones” as a major cause of fractured teeth in dogs. According to Dr. Riback, “Any bone you think might break your tooth if you bit down on it is not one you should give to your dog.”

Don’t tolerate doggie breath in your dog (or cat). Bad breath in your Bassett, Bichon or Burmese is not normal and is very likely a sign of periodontal disease. Stinky breath in your pet means it’s time to schedule a dental cleaning with your pet’s veterinarian.

Although tennis balls are on your dog’s DO list, the tennis ball fur is very abrasive to teeth, making furry tennis balls a DON’T in the mind of veterinary dentists.

Dental DOs – Toothbrushing, VOHC, dental cleaning with anesthesia
Topping the list of dental DOs is daily toothbrushing for your dog and cat. If your pet won’t tolerate brushing, you can use special dental wipes to clean the teeth. DO select oral hygiene products like toothpaste, tartar reducing diets and treats based on the products recommended by the Veterinary Oral Health Council (VOHC).

DO choose tartar control products and dental wipes containing hexametaphosphate, a product that research has shown to decrease tartar buildup on teeth.

The final DO is to make a call now for an appointment to see your pet’s veterinarian to discuss a complete dental cleaning while your pet is under general anesthesia.

Veterinary Dental Resources

Follow @amcny on Twitter to be a part of our National Pet Dental Health Month #TweetTooth campaign to promote healthy pet dental hygiene!


Pot for Pets

January 21, 2014
pot for pets image

Photo: Fox News

The New York Times recently announced that via executive action, New York Governor Andrew Cuomo will relax the laws governing medical marijuana use in the state. New York State has some of the most restrictive and punitive laws regarding illegal drug usage, hold-overs from the Rockefeller era drug laws of the 1970s, and many feel these changes are long overdue. What does this mean for pets?

Increased Toxicity Cases
Veterinarians in New York State will need to be prepared to treat more dogs with marijuana intoxication if the experience in Colorado holds true here. Colorado is a state where medical marijuana is legal. Veterinarians in Colorado studied the number of dogs experiencing inadvertent toxicity from ingestion of marijuana. These researchers found a four-fold increase in the number of dogs treated for marijuana ingestion over a five year period. The increase paralleled the increase in the number of registered users of medical marijuana in Colorado. Pet Poison Helpline reports an increase in calls about canine marijuana intoxication as well.

Dog OD
Ingestion of marijuana, marijuana containing foods or inhalation of marijuana smoke can affect dogs; they become glassy eyed, uncoordinated, and may be very sleepy. These dogs need intravenous fluids to maintain hydration and warming blankets to maintain their body temperature. Often, dogs intoxicated by marijuana dribble urine. Some dogs become hyperactive. Severely affected dogs may seizure or become comatose requiring ventilator treatment until they regain the ability to breathe. Dogs typically recover in one to three days. Sadly, the study of Colorado cases of marijuana reports the death of two dogs ingesting baked goods made with medical grade tetrahydrocannabinol (THC) butter.

Iguana Intoxication!
Although dogs are the most commonly affected by marijuana intoxication, I found a report of three intoxicated iguanas. The iguanas had clinical signs similar to intoxicated dogs – seizures, stomach upset and one even required antiseizure medication. All three recovered fully.

Veterinary Medical Marijuana
So with marijuana legalized in some states for medicinal purposes, is medical marijuana for Fluffy and Fido next? Despite the obvious risks outlined above, some pet owners have taken marijuana for pets into their own hands.

Currently marijuana belongs to the group of drugs most tightly regulated by the Food and Drug Administration. Even though I have a license to prescribe some controlled substances, marijuana is not on the list of those I can prescribe. This tight regulation also restricts research with marijuana. Research is needed to help veterinarians understand what conditions the drug helps and how to use the drug safely and efficaciously in veterinary patients. So for now, I don’t know how to appropriately dose THC in my patients and I can’t do it legally.

If your pet inadvertently ingests marijuana or a THC containing product:

1. Keep marijuana and medical marijuana products out of reach of your pets.

2. Call animal poison control if you think your pet has eaten marijuana:

  • ASPCA Animal Poison Control (888) 426-4435
  • Pet Poison Helpline (800) 213-6680

3. Tell the animal ER what your pet ate. Making the ER veterinarians play a guessing game about your pet’s condition can delay appropriate treatment.


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!


Clea’s International Healthcare Team: Partnering for Cancer Care

December 18, 2013
Clea

Clea, French fashionista poodle

Last spring, I was contacted by a New York City veterinarian who often refers patients to me for second opinions. This time, his request was a bit different. One of his patients, a French poodle named Clea, was in France and had been diagnosed with melanoma of the tongue by a French veterinary oral surgeon. Clea’s owner wanted her treated with the DNA melanoma vaccine, a treatment not available in France. She and Clea would return to New York City, but she needed a local veterinary oncologist, so I was asked to help. Of course, I said yes.

Transatlantic medical information
Within minutes of saying yes, my email box filled with photos of Clea’s tumor, a biopsy report and photographs of the actual tumor cells under the microscope. Clea’s owner contacted me and arranged two appointments for Clea, one with me and one with our radiation oncologist, Dr. Rachel St-Vincent.

Treatment of melanoma of the oral cavity in a dog involves controlling the oral tumor using surgery or radiation therapy and using a vaccine to induce an immune response against the tumor in hopes of preventing spread of the tumor, especially to the lungs. The vaccine is not available in France, necessitating a trip home for the melanoma vaccine. Clea stayed with friends for eight weeks while she received four treatments of radiation and four doses of melanoma vaccine. When treatment was completed, she returned to France and her French veterinary team.

The French team

Clea's veterinary team

Clea’s veterinary team at Clinique Vétérinaire Advetia (www.advetia.fr)

Even though Clea has both an American and a French team of veterinarians, we all speak the same language – veterinary medicine. The French oral surgeon, Dr. Phillipe Hennet, trained in the United States and holds a certification by the American Veterinary Dental College. When new tumors showed up in Clea’s lungs, he referred Clea to an American trained board certified small animal internal medicine specialist at his clinic, Dr. Suzy Valentin. She and I conferred via email to initiate the next step of treatment.

Back in the USA
Clea was back in New York City a few weeks ago and Dr. Valentin wanted another chest x-ray. Clea arrived at The AMC with a report by a French radiologist (in French) and a CD containing her lung CT scan from a month prior. The AMC has a radiologist, Dr. Alexandre Le Rouxwho happens to be French. Looking for a translator, I took the written report and the images to him. To my surprise, the trail of veterinarians caring for Clea came full circle when Dr. Le Roux announced he knew Clea’s French radiologist!

Treatment success
For older pets like Clea, quality of life is possibly more important than quantity. I think Clea’s international healthcare team has achieved success based on this note from her owner: “So Clea is doing well. She is eating twice a day and loves the beef stew from the restaurant across the street. Dog food is definitely part of her past….”


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.”


Flu Season 2013 is Upon Us

November 20, 2013

sick dogInfluenza was in the news and on my mind last week. First a new strain of avian influenza was reported to have infected humans. Then, I got my annual flu shot and finally reader comments on an article about canine influenza clearly showed the article was misconstrued by its readers, making me think it was time to write the hard facts about influenza.

Not like avian influenza
Canine influenza is significantly different than avian influenza. Compared to avian influenza virus, the canine influenza virus is relatively new. It was identified in 2004 by researchers in Florida who were studying an outbreak of respiratory disease and pneumonia in greyhounds. Based on research published, the virus appears to have emerged in racing greyhounds in approximately 1999. Subsequently, all dogs, greyhound or not, have been shown to be susceptible to infection by the canine influenza virus. But don’t worry, Fido’s virus does not appear to affect you or the family parrot.

Not like human influenza
Canine influenza is also very different than the human flu virus. I (and millions of other Americans) get a flu shot in the fall because flu infections predictably spike in the fall and peter out in the spring, only to return again in the fall. Canine influenza is non-seasonal, occurring anytime of the year. Check with your veterinarian to see if your dog is at risk for the flu and should be vaccinated against it.

Flu virus similarities
Flu viruses are usually contagious and spread rapidly in a susceptible population. Children typically bring the flu home from school and infect their parents. Dogs tend to contract the flu in places where there are many dogs in close contact. In a dog’s world, places of close contact include puppy kindergarten, dog parks, doggie day care, shelters and boarding kennels. If your dog visits any of these types of facilities, check on their vaccination policy.

We cover our face when we sneeze to protect others from our viruses and we wash our hands to prevent transmitting viruses on door knobs and other surfaces. As clever as dogs are, they do neither of these things to prevent transmitting canine influenza to their dog friends. If your dog is coughing or sneezing, keep her away from other dogs until your veterinarian gives the all clear sign.

Be flu safe
Right now, flu activity is low in the United States. To keep track of human flu, check the Centers for Disease Control’s flu map.

Get your flu shot today! If you are sick, who will take care of your dog or cat?


Is My Pet Sick or Just Getting Older?

November 15, 2013
senior dog

Photo: seniordogcareproducts.com

As our pets get older, we expect them to slow down as part of the aging process, but how much slowing down is too much? What signs should pet owners watch out for in their senior pets that may suggest there is more going on than simply normal aging?

What qualifies a pet as a senior pet?
Senior pets can loosely be defined as those in the last 25% of their anticipated lifespan for their species and breed. For example, a cat expected to live 15 years would be considered senior at 11 years of age. What that means to dog and cat owners is 9-11 years of age is the start of your pet’s senior years. One notable exception is giant breeds of dogs who are considered senior a year or two earlier.

Slow motion
Many pet owners assume their pet is slowing down because it is older. Since aging is associated with a variety of illnesses, if you have a senior pet who seems to be slowing down, take him for a complete physical examination. Your pet can’t tell you their joints hurt from arthritis, but your veterinarian can. Never give your dog or cat your arthritis medication as these drugs are extremely toxic to pets. There are medications that can help make your arthritic pet more comfortable and kick their activity level back up a notch.

Forgetfulness
Another behavior change incorrectly attributed to aging is loss of housebreaking/litterbox use. Older cats are especially prone to developing kidney problems, and the accompanying increase in urine production. Couple an increase in urine production with creaky joints that don’t move so well anymore and your cat may act as if he has forgotten where to find the litter box. Placing litterboxes conveniently near your cat’s favorite perch will help overcome this problem. Some creaky cats can no longer climb over the edge of the litter box and will “go” right outside the litterbox. Substituting a box with lower sides or a cut out for easy entry will often resolve this situation. Diabetes and urinary tract infections will also cause what appears to be a loss of housebreaking. All of these reasons may contribute to a lack of litter box use, but the reason may be as simple as not changing the litter often enough to your cat’s liking.

Cognitive dysfunction syndrome
A syndrome is a collection of clinical signs that commonly occur together. Once your veterinarian has determined an illness is not causing your pet to slow down, cognitive dysfunction syndrome (CDS) will be considered. CDS in a decline in brain function in the aging dog exemplified by behavior changes. Dogs with CDS may stand in one place more often, greet the owners less often and have accidents in the house. At the recent Zoobiquity 3 Conference in New York City, Dr. Chad West, one of The AMC’s board certified neurologists, discussed a case of CDS in a dog. The MRI findings in the dog were strikingly similar to the second most common cause of dementia in humans, vascular dementia.

Keeping your pets young
Sadly, there is no fountain of youth for either you or your pet, but there are things pet owners can do to keep their favorite fur baby around as long as possible.

  • Don’t assume changes in your pet’s behavior, activity or appetite are “just old age.” Bring these changes to the attention of your veterinarian.
  • Take your pet for regular veterinary check-ups. The current guidelines recommend annual visits for younger pets and more frequent visits as your pet ages. Early detection of disease can mean all the difference in extending the life of your pet.
  • Keep your pet mentally and physically active. Use feeding toys to challenge your pet to “hunt” for her food. Consider low impact exercises for your dog, such as swimming. Exercise your dog or cat on a regular basis.

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