Shedding Light on Feline Hairballs

April 22, 2015

Feline HairballsHairball Awareness Day is April 25th. Most of us become aware of hairballs in the middle of the night, either when we hear that characteristic yacking sound made by a cat about to deposit a hairball on the sheets or as we inadvertently step on a cold, slimy furball deposited on the darkened bedroom floor.

Even though cat families believe hairballs are a common problem, a survey of British cats found most had never vomited a hairball – at least that their family discovered. Intuitively, the same study found long haired cats were more likely to vomit hairballs than short haired cats.

Why do cats get hairballs?
Cats may spend as much as 25% of their waking hours grooming. When a cat grooms, the barbs on her tongue act as a comb and brush. The shed hairs get caught in the barbs and are swallowed. In normal cats, ingested hair is excreted in the stool. Because most ingested hair is excreted in the feces, an uptick in the frequency of hairball production suggests a problem in your cat.

Can hairballs indicate a medical problem?
The simple answer is yes. Formation of hairballs suggests a cat is suffering from excessive hair ingestion or is not excreting ingested hair normally. Excessive hair ingestion can result from overzealous grooming behavior leading to hairball formation. Excessive grooming is a clinical sign of several feline health concerns such as fleas, itching due to allergies, an overactive thyroid gland, food sensitivity or stress.

Decreased grooming behavior is frequently a sign of illness in cats. If the illness progresses, hair mats develop. Once the cat resumes grooming, hairballs may form and you may also notice increased hair in your cat’s stool.

An increase in the frequency of hairball vomiting may also signal some sort of gastrointestinal problem preventing normal passage of hair out in the stool. My patient Sunshine developed an intestinal obstruction from a hairball when intestinal lymphoma disrupted her ability to pass hair in her stool.

Cat families often talk about “coughing” up a hairball, but if your cat is coughing, that is a completely different problem that should be brought to your veterinarian’s attention.

What can cat families do to minimize hairballs?

  • Control loose hair with regular brushing. Don’t just smooth over the top coat, but use a deshedding tool to remove dead undercoat. Many cat resist brushing, so start with short grooming sessions and use rewards liberally.
  • Feed commercially available food, treats and supplements formulated to improve intestinal motility and facilitate hair excretion.
  • Consider a lion cut to decrease the amount of hair ingested. Check out a photo of my patient Toby who tangled with a nasty hairball and now routinely gets clipped.
  • An increase in hairball vomiting can be a sign of illness. Report any increase to your cat’s veterinarian.
  • Ask to your veterinarian about medications that might help facilitate hair movement through the intestinal track.

Flea and Tick Prevention: 2015 Update

April 8, 2015
Photo: Vetstreet.com

Photo: Vetstreet.com

When I started my career as a veterinarian, the options for flea and tick control were limited, smelly and messy. I dispensed cans of spray, bottles of dip, and cartons of powder, but hardly ever prescribed a flea collar. Back then, the collars were not that effective and some thought the only way a flea collar killed a flea was by squashing it when you put the collar on your pet. Thirty years later, the options for pet owners to prevent ectoparasite infestations are infinitely better and way more numerous.

Better flea and tick control has resulted in healthier pets. I used to routinely see dogs and cats crawling with fleas from head to toe. Many developed flea allergic dermatitis, often complicated by a superficial skin infection. While we still see allergies in pets, flea allergic dermatitis is much less common and pets are much more comfortable, thanks to these new products.

Top Spot Products
The big revolution in flea and tick prevention started when top spot products were introduced. These are the little tubes of liquid that come in multipacks for monthly application to the nape of your pet’s neck. The product then distributes throughout the haircoat and kills fleas and ticks when they come in contact with the medicine on your pet’s hair. They also come with stickers for your calendar or an app for your mobile device to remind you when to apply the medication. Many of the manufacturers of these products have videos on their website demonstrating proper application of the product.

Oral Flea and Tick Prevention
Oral products can be active against only fleas or prevent multiple species of ticks as well. Most oral products come as tasty chew treats and are administered monthly; although long lasting products are also available. Not all oral products start working instantly. If your pet has a flea infestation because you missed a dose, check with your veterinarian about a rapidly acting oral product for quick flea takedown.

Long Lasting Collars
Unlike the early flea collars, today’s models last for months at a time. Depending on which collar your veterinarian prescribes, modern flea collars may be active against a single species of tick or fleas and multiple species of ticks. If you choose a collar, check the label carefully as some collars may take a week to reach full strength on your pet.

Choosing What’s Right for Your Pet
When selecting from this array of products, consider the following criteria:

  1. Talk with your veterinarian about the types of parasites in your area. Selecting a product with a profile that fits your area’s parasite population is critical.
  2. Top spot products often repel as well as kill fleas and ticks. If you live in a geographic locale with high numbers of fleas and ticks, you might want this added protection.
  3. Certain collars and oral preventatives last for months at a time. If you are busy and forgetful, one of these products might be a good choice.
  4. Not all top spot preparations and collars are waterproof. If your dog is a swimmer, choose a waterproof product or consider an oral flea and tick preventative.
  5. If you have a puppy or kitten, make sure the product you select is safe for the newest family member. Some products are not labeled for pets < 6-12 weeks of age.
  6. Use dog products for dogs and cat products for cats. Never switch, or you may need a trip to the animal ER.

Hound’s Tooth and Cat’s Teeth: A Photo Blog in Honor of National Pet Dental Health Month

February 4, 2015

The AMC Gives Not Just at Christmas, but All Year

December 24, 2014

For over 100 years, The Animal Medical Center has held fast to the mission of community service embraced by our founder, Ellin Prince Speyer. In 1910, Mrs. Speyer and her organization, the New York Women’s League for Animals, established a dispensary and out-patient clinic for all animals whose owners could not afford to pay for medical treatment. The clinic treated 6,028 animals in the first full year. To this day, in addition to caring for New York City pets 24/7, The Animal Medical Center continues to give back to the community.

AMC TO THE RESCUEAMC TO THE RESCUE
Because The AMC’s main mission lies in promoting the health and well-being of companion animals through advanced treatment, research and education, we recently created a new Community Fund, AMC TO THE RESCUE, to provide subsidized specialty care to animals currently cared for by rescue groups. Through AMC TO THE RESCUE, we have provided a means for needy animals to receive care from one of our 30 board certified veterinary specialists. Since its inception in 2013, 20 dogs, 15 cats and one rabbit have received medical care supported by AMC TO THE RESCUE, which has led to the adoption of many of these pets into a forever home. Without the specialty care provided by The AMC’s board certified ophthalmologist, neurologist, internist, dentist, cardiologist, soft tissue and orthopedic surgeons, these pets might be spending yet another holiday as homeless and unadoptable rescue animals.

AMC at the WKC showThe Westminster Kennel Club Dog Show
Veterinarians from The AMC volunteered their time to manage minor health issues and triage emergencies for the dogs competing at the 2014 Westminster Kennel Club Dog Show from the start of the First Annual Masters Agility Championship until the moment GCH After All Painting the Sky captured the 138th Westminster Kennel Club Best in Show. Our doctors happily donated their time and skills to ensure the health and welfare of these beautiful animals.

Animal Medical Center Doggy Dash at the NYC Triathlon
For the past seven years The Animal Medical Center has been the title sponsor of the Animal Medical Center Doggy Dash. Doggy Dash gives a runner and their best canine friend the chance to compete in tandem over a 5 mile course through Central Park, finishing at the NYC Triathlon finish line. Twenty-nine dogs and their human runners participated in 2014. To ensure the health and safety of the canine participants, seven AMC veterinarians and four licensed veterinary technicians volunteered to perform the pre-race health certification and monitor canine participants on the hot and steamy day of the race.

AMC trains first respondersEmergency Medical Training for NYC First Responders
A new program for 2014, involving AMC veterinary volunteers, was a canine first aid and critical care workshop for first responders. AMC veterinarians and technicians provided training using canine dummies and cadavers to teach such practices as venipuncture, catheter placement, intubation, CPR, oxygen administration, and treatment of dogs in shock. Thirty-two medical operations personnel, including men and women from the FBI, undercover agents, fire department EMTs, paramedics, physicians, and even an Air Force para-rescue jumper benefited from the expertise and time of AMC volunteer instructors.

Partnering with Angel On A Leash
The AMC and Angel On A Leash are both champions of the human-animal bond and its role in enhancing human health and quality of life, believing in the positive role of therapy dogs in health care facilities, schools, rehabilitation, hospice, extended care, correctional facilities, and crisis intervention. Because of our shared missions, The AMC and Angel On A Leash again worked together this past September on the Ronald McDonald House Family Fun Walk held in Carl Schurz Park.

Giving Tuesday
On #GivingTuesday, the global day dedicated to giving back, the staff of The AMC gave not of time, but of money when they participated in a raffle. The proceeds, nearly $1,000, were donated to SAVE – Seniors’ Animal Veterinary Effort – a community fund supporting pet care for New York City seniors’ pets.

The AMC wishes you and yours the best of the holiday season and a 2015 filled with healthy and happy pets.


Keeping Your Senior Pet Healthy

November 19, 2014

senior petsSince November is National Adopt a Senior Pet Month, this image posted on Twitter by @PetLiving caught my eye. Adopting a grey muzzle pet bypasses the need to housebreak, train and socialize your pet, all necessary tasks when you adopt a puppy or kitten. The text accompanying this photo highlights just two of the health issues, loss of vision and hearing, that you might expect when you adopt a senior pet.

Do you have a senior pet?
A dog or cat is considered a “senior” when he or she is in the last 25 percent of the breed’s expected lifespan. So a Great Dane with a life expectancy of 8 years might be a senior at 6 years. Conversely, a miniature poodle with an expected lifespan of 15 years might not be a senior until 11 or 12 years. The lifespan of cats remains more consistent across breeds than in dogs, and cats over 10 years of age are considered seniors.

Keeping your senior cat healthy
Essential to keeping your senior cat healthy are regular preventive care visits to the veterinarian. Over the past 10 or so years, the frequency feline patients see their veterinarian has dropped to less than one time per year. Without routine care, small problems become big ones. Take for example feline teeth. In a British study of over 140,000 cats, nearly 15 percent suffered from periodontal disease.

Periodontal disease is a painful condition which can be nipped in the bud by routine dental prophylaxis. Wait too long to have your cat’s teeth treated and the need for multiple extractions increases. Preventive health care visits allow your cat’s veterinarian to perform blood tests which can reveal kidney disease at a time when dietary therapy can be effective. Routine visits to your cat’s veterinarian also help to keep tabs on your cat’s weight. Overweight cats have a greater risk of developing diabetes and bladder problems.

Keeping your senior dog healthy
Three critical factors in keeping your senior dog healthy are preventing obesity, promoting mobility and monitoring for cancer.  A multi-year study of Labrador retrievers demonstrated the negative impact of obesity on longevity. Dogs fed a restricted amount of food lived nearly two years longer than dogs fed a higher number of calories.

Keeping your senior dog in lean body condition is directly tied to maintaining mobility. Overweight senior dogs with creaky joints have a much more difficult time getting around than their slimmer counterparts. More time sitting on the sofa translates to a decline in muscle strength and turns into a dog that can barely walk. During your twice yearly senior pet checkup, your veterinarian has in her pharmacy a variety of medications to keep your senior dog moving comfortably. Experts estimate that almost 50 percent of all dogs over the age of 10 will develop cancer, making this a significant problem in the senior dog. You can easily monitor for skin cancers by simply doing a through belly rub and petting your dog from nose to tail. If you find any lumps or bumps, bring them to the attention of your veterinarian immediately.

Better medical treatment means pets can live longer and healthier than ever before. Don’t assume your senior pet is just slowing down as a normal part of aging. Slowing down could indicate your pet is developing a disease. That’s why veterinarians recommend your senior pet see them twice yearly. Make an appointment for your senior pet today!


National Pet Cancer Awareness Month: Pet Cancer Treatment Options, Part II

November 12, 2014

dog receiving chemotherapyNovember has been designated National Pet Cancer Awareness Month to raise awareness about the causes, prevention and treatment of dogs and cats with this terrible disease. To raise awareness of the possible treatments for pet cancer, this second part of my two-part blog on cancer treatments for pets discusses three additional treatment therapies: chemotherapy, immunotherapy and targeted therapy. Part I focused on surgery and radiation therapy.

Chemotherapy
Although the use of radiation therapy in humans preceded the use of chemotherapy, chemotherapy was more widely used in pet cancers before radiation therapy. Chemotherapy is administered when a biopsy indicates a tumor has spread or might spread, such as in feline breast cancer.

Chemotherapy can also be administered when a tumor is too widespread for either surgical removal or radiation therapy. At the top of the veterinary list of pet cancers treated with chemotherapy is lymphoma.

Veterinary oncologists treat both dogs and cats for lymphoma using a variety of chemotherapy drugs. Most commonly used is the CHOP protocol. CHOP is an acronym representing the first letter of each chemotherapy drug in the protocol and is repurposed from human oncology. Despite the bad reputation chemotherapy has, both cat and dog owners report a good quality of life in their pets receiving chemotherapy.

Immunotherapy
The concept of harnessing the cancer patient’s own immune system to fight cancer is an idea that has been around a long while. The idea came to fruition when a vaccine to treat melanoma in dogs was approved in 2010.

Dogs suffering from melanoma are given four vaccinations over two months and then boostered every six months. This treatment protocol prolonged survival by 300 days or more in dogs receiving the vaccine. In people with lymphoma, treatment using monoclonal antibodies like Rituxan® has dramatically improved patients’ survival time. In a similar vein, AMC oncologists are currently studying a monoclonal antibody against T cell lymphoma and a monoclonal antibody against B cell lymphoma is also available.

On the horizon for the treatment of lymphoma is a new cancer vaccine for a particular type of lymphoma in dogs called large B cell lymphoma.

Targeted Therapy
In 2009, toceranib phosphate, known as Palladia®, became the first targeted therapy approved for use in dogs diagnosed with mast cell tumors.

A second targeted therapy, mastitinib, known as Kinavet®, has conditional approval for the treatment of the same tumor. Targeted therapies exploit a physiologic abnormality in tumor cells, not present in normal cells. Targeted therapies commonly work by turning on or off a cellular process critical to cancer growth and metastasis, halting tumor growth. In the future, expect to see more targeted drugs used in dogs and cats.

Because cancer is diagnosed in over six million pets each year, you may be faced with this diagnosis in your favorite furry friend. But treatment of cancer in pets is possible. You and your pet have more treatment options and more specially trained veterinarians than ever before to help you achieve a good outcome if your pet is diagnosed with cancer. To find a board certified veterinary cancer specialist in your area, visit the American College of Veterinary Internal Medicine website and use their search function.


Feline Stomatitis: A Pain in the Mouth

October 29, 2014
Stomatitis

Redness and swelling indicative of stomatitis

You can bet with a high degree of certainty that any medical condition ending in -itis is painful. Think appendicitis, neuritis and bronchitis. The suffix –itis means inflammation. Stomatitis means inflammation of the mouth, and in cats, the redness and swelling seen in the photo on the right characterizes feline stomatitis.

Don’t confuse stomatitis with gingivitis
This cat has gingivitis. The thin red line at the tooth-gum junction seen in the second photograph is gingivitis, which is much less painful and much easier to treat than stomatitis. Gingivitis is a mild, localized form of oral inflammation and stomatitis is more widespread.

Gingivitis

Gingivitis in a cat

Causes of stomatitis
A recent research publication reported on over 5,000 cats. Cats with oral disease were more likely to test positive for either feline leukemia virus or feline immunodeficiency virus (FIV). Stomatitis was most strongly associated with FIV infection. An exuberant immune reaction to plaque buildup on the teeth has been suggested as a cause of stomatitis. Feline calici virus infection may be the trigger for the exuberant immune reaction against the plaque.

Recognizing stomatitis in your cat
You might not even know your cat has gingivitis unless you lift their lip and look in their mouth. Recognizing stomatitis in your cat is easier. Cats with stomatitis paw at their face, refuse their favorite cat food, drool and yawn. Sometimes you will notice blood in the drool or your cat screaming when she yawns. Any of these clinical signs should provoke a visit to your cat’s veterinarian.

Treatment of stomatitis
A professional dental cleaning will remove plaque, but in severe cases of stomatitis, teeth cleaning may not be enough to correct the problem on a long-term basis. Antibiotic treatment may also provide a short-term benefit through temporary reduction of bacteria levels in the mouth. If these measures do not resolve stomatitis and your cat is still painful, tooth extraction will likely be the next recommended treatment. How many teeth are extracted depends on the severity and location of the oral inflammation. A routine tooth cleaning and extractions of diseased teeth may cure or control the mild cases, but extraction of all molars and premolars is a common prescription. In some cases, removal of all the teeth, including the fangs and the tiny front teeth called incisors is necessary to control stomatitis. After a post-operative recovery period, cats can eat canned food and have an improved quality of life once the stomatitis has resolved. While this sounds drastic, research has shown 80% of cats have resolution of oral pain with tooth extraction.

Cat owner’s role in preventing stomatitis

  • Train your kitten to accept tooth brushing during kittenhood, and brush daily.  This will help to keep levels of plaque low.
  • Treat your cat with products designed to removed plaque and tartar as recommended by your veterinarian.
  • Take your cat to the veterinarian for annual examination and recommendations about dental cleaning.
  • Keep your cat indoors to protect them against infection with the feline leukemia virus or feline immunodeficiency virus.

What Does a Vet Tech Do?

October 8, 2014

Feeding Your Pet for Optimal Health

September 17, 2014

AAHA Certification: The AMC Takes the Test to Meet Veterinary Practice Standards of Excellence

July 30, 2014

AAHAlogoDedicatedThe Animal Medical Center undergoes a triennial accreditation evaluation by the American Animal Hospital Association (AAHA). The AAHA is an industry leader that sets the standards for small animal hospitals in North America, standards which are often emulated internationally. For example, in Japan, the Japanese Animal Hospital Association (JAHA) serves a similar role to AAHA in the United States. Recently, AAHA has added new accreditation categories for referral hospitals and university hospitals.

The Benchmarks
Over 900 different standards are assessed during the accreditation evaluation. The standards focus on the quality of care in the areas of: anesthesia, contagious diseases, dentistry, pain management, patient care, surgery and emergency care. The standards are grouped into 20 large categories covering quality of care in diverse areas such as contagious disease, dentistry, diagnostic imaging, emergency and critical care, and pain management. Mandatory standards detail 46 critical/crucial hospital functions required of every AAHA accredited hospital. These “deal breaker” standards include the requirement that dentistry is performed under general anesthesia with tracheal intubation, and all patient care is provided under the supervision of a licensed veterinarian. The standards require hospitals to provide diagnostic services (x-ray and laboratory) facilitating quick and accurate diagnosis of your pet’s illness. Accredited hospitals must dispense medications so treatment can begin immediately.

The focus of the benchmarks is not just on patient care, but on how the veterinary team interacts to achieve high quality patient care. Standards pet owners might not expect as part of the evaluation process include an assessment of confidentiality, security and integrity of medical records, fire safety, diagnostic image archiving, continuing education, and referral standards. While not exactly medical standards, these functions are clearly critical to an accredited hospital’s ability to provide top-notch patient care.

Exam Prep
The AMC is continuously prepping to meet the AAHA accreditation standards. Our accreditation team reviews the benchmarks and educates the staff regarding their responsibilities in implementing each standard. When a new standard is issued, the appropriate hospital team writes our policy to ensure the new standards are met. That policy is then distributed to the implementation teams. Each new standard improves the quality and safety of The AMC’s patient care.

A Pop Quiz
On-site examiners perform a full-day thorough and comprehensive review of the hospital. Preparing for an AAHA evaluation is like preparing for a pop quiz; they can ask questions about any of the 900+ standards and they don’t have to give you a heads-up as to which ones are on the quiz. The examiners speak with a variety of staff and review hospital policies to ensure standards are met. If any deficiencies are identified, they suggest methods of improvement.

Perfect Scores
The accreditation process is rigorous and encompasses all aspects of pet healthcare. Only 15% of all veterinary hospitals meet these stringent quality standards. The AMC is proud to say it has been an AAHA accredited hospital since 1976 and passed its most recent evaluation with flying colors. We achieved a perfect score in six of the 20 categories of standards. All of the standards ultimately affect the care pets receive at The AMC, but most important to pet owners are the A pluses The AMC received for management of contagious diseases and emergency and critical care medicine. Overall, we received a solid A, or 94%, which does not mean we got six questions wrong. We scored 30,250 out of a possible 32,310 points! No wonder it took weeks to prepare for this evaluation.

Standards Met
For over 100 years, The AMC has been a leader in veterinary teaching, research and exceptional clinical care. The AAHA is another leader in veterinary medicine whose opinions and stance are relied upon for setting high hospital standards. Achieving AAHA certification is just one way we continue to provide the highest quality of medicine and surgery to nearly 40,000 patients every year.


Choosing a Veterinary Hospital

July 31, 2013

Exotics1Is there a new puppy in your family? Has the backyard cat installed himself on your family room sofa? Have you inherited grandma’s piano and her parrot? If so, you won’t want to leave the important decision regarding the choice of your new pet’s healthcare provider to chance. Here are some tips for choosing the right veterinarian and veterinary hospital for your pet.

Location, location, location
In Sunday’s New York Times, healthcare reporter Elizabeth Rosenthal, talks about choosing a hospital for your own care. She writes, “Indeed, with thousands of good hospitals across the nation, the best selling point for routine medical care may simply be convenience…” Whether or not you agree with her point of view regarding your personal healthcare, proximity may be a consideration in choosing a primary care veterinarian. A new puppy will need several rounds of vaccines and a spay or neuter surgery requiring transporting the pet to and from the hospital on multiple occasions. But if you have a parrot, the closest veterinary hospital may not have a veterinarian with expertise in avian medicine and you will need to choose a clinic providing bird care, not necessarily the closest clinic.

Proximity plays an even more important role in the selection of an emergency hospital. When your pet is hit by a car and in shock, has serious bleeding or can’t breathe, time is of the essence and the closest animal ER is the best ER for your pet.

Assessing hospital quality
If you personally needed a heart valve replacement, for example, you might look for data on outcome for valve replacement surgery at the various hospitals in your area. In New York State we have the New York State Hospital Report Card. You could also search the doctor ratings on the website of your healthcare provider. Since this type of information is lacking for veterinary hospitals, you might turn to online sources to read the opinion of pet owners who have posted their experiences. I must admit, to me, these online reviews can often seem more like rants and may not provide the objective information you need to guide your pet healthcare decision making process.

A better method of assessing hospital quality would be to look for a hospital accredited by the American Animal Hospital Association (AAHA). Their website also allows you to search for the AAHA accredited hospital nearest you. Choosing an AAHA accredited hospital assures pet owners that the hospital they select has the staff, equipment, medical procedures and facilities that AAHA believes are vital for delivering high-quality pet care. The Animal Medical Center has been AAHA accredited since 1976, and to maintain our accreditation we voluntarily receive triennial evaluations on over 900 standards of small animal hospital care.

Finding the right specialist
The easiest way to find a specialist for your pet is for your primary care veterinarian to recommend one she works with on a regular basis. This will ensure a good line of communication and seamless medical care. If your veterinarian doesn’t have a recommendation:

  • Search the website of the type of specialist you are looking for, e.g. veterinary cardiology, veterinary surgery or veterinary dentistry.
  • For a cutting edge therapy, you might have to travel a good distance to find the specialist your pet needs. Use a scientific search engine like PubMed or Google Scholar. Search for the procedure your pet needs. When the search identifies a particular hospital where the procedure is commonly performed or a veterinarian who is a frequent author of scientific articles on the procedure, focus your search on this clinic or veterinarian. Examples of this type of procedure include repair to a ruptured ligament in the knee or image modulated radiation therapy.

Quick tips on finding the right veterinary hospital

  • Know where the closest animal ER is and keep its address and phone number in your GPS device, cell phone and on the refrigerator list so you are prepared for an emergency.
  • Don’t be afraid to visit potential veterinary hospitals before booking an appointment. Find out if their clinic schedule matches your availability. Ask the receptionist about their preventive healthcare protocols.
  • In case your pet develops an unusual medical condition or requires specialized surgery, ask your trusted primary care veterinarian about the network of specialists they recommend.

I Took My Kittens to the Vet: My View From the Other Side of the Table

September 13, 2012

I did something new last week: I took my kittens to the veterinarian!

Since my father was a veterinarian, he cared for my childhood pets and, of course, I and my colleagues at The Animal Medical Center have taken care of my recent pets. Consequently, I have never made an appointment or sat in the waiting room of a veterinary clinic other than to chat with a pet owner.

Foster care kittens

Last week things changed. You may remember my last foray into fostering.

My family and I temporarily adopted a pregnant cat, helped her deliver her kittens, and subsequently cared for her babies until it was time to let them go. This time, I am fostering two kittens already weaned from their mother. They are both underweight and under socialized. They came to me for a bit of TLC to spiff them up before getting a forever home. The female turned the corner the previous weekend when she started asking for attention and food. Her renaissance made the little orange male look even more malnourished and he retreated into a scruffy ball of fur with no appetite, even for delicately poached chicken breast or the most expensive kitten food from my local pet store.

Had the orange boy been my personal kitten, he would have come to work with me and undergone a full battery of tests. But, my foster care agreement specifies sick kittens come back to the rescue organization for medical care. So, I contacted them first thing in the morning and arranged for an appointment late in the day.

A day of worry

I spent the entire time, from making the appointment until leaving for the clinic, worrying about what was going to happen. Was the kitten so sick it couldn’t be helped? Could the whole problem be the healthy kitten spent all day pouncing on the little one, hoping for a playmate, preventing the little one from eating? The worst worry: what if the healthy kitten was ready for a forever home, the sick kitten required hospitalization, and I had to go home with an empty kitten carrier to an empty kitten palace because both kittens had to stay at the clinic?

The clinic visit

Luckily one of my friends at work drives past the rescue organization on her way home so the kittens and I got a ride, supplemented by a comforting conversation during the trip; the familiar face of the foster care coordinator was reassuring as well. The veterinarian, who might have been young enough to be my son, kindly thanked me for my participation in the foster care program, but when he said the kitten had lost 6 ounces, my pleasure melted away. Because the young veterinarian sees foster kittens daily and kittens are definitely not my core patient base, he gently explained foundling kittens frequently just stop eating for no apparent medical reason. The fix for the problem is simple: force feeding the kitten in the clinic for a few days to jump start their appetite and get them back on track. He also listened to my concern about the disparity in the size and energy level of the kittens. Together we decided the kittens should be separated and I would keep the healthy one while the poor-doer would stay in the hospital.

The moral of the story

I know from experience, it is impossible not to worry about your sick pet. And I also know your veterinarian wants your sick pet to get better almost as much as you do! But a kind word, an open ear, and a treatment plan that took my input about the kittens into consideration put my mind at ease and got the sickly kitten back on the road to good health.


Fracture Repair in Dogs and Cats

July 21, 2011

A couple of weeks ago I was interviewed by a reporter about pet owner administered first aid for dogs and cats when an injury may have resulted in a fractured bone. The article has good information for pet owners to read now in preparation for a potential emergency in the future. This blog post will pick up where that article left off and explain the fracture repair techniques used by veterinary surgeons The Animal Medical Center.

For the veterinarian, the critical piece of successful fracture management is to immobilize the fracture. This can be accomplished using one of several different methods. For some fractures, more than one method might be appropriate and for others there may be only one solution to fix the broken bone. All x-rays were taken by the AMC’s Diagnostic Imaging Service.

For centuries, fractures have been treated by immobilization using casts or splints. These days the old style plaster of Paris cast has been replaced in human medicine by plastic or fiberglass. In animals we tend to use splints of fiberglass or plastic for repair of simple fractures where the bones do not need realignment. The arrows in the photo to the right point to two toe fractures in a young dog which healed when the paw was placed in a splint.

Optimal healing of a fracture requires the joints above and below the fracture be immobilized. When the fracture occurs in a location where these joints cannot be adequately immobilized by an external bandage or cast, the fracture must be repaired internally via a surgical procedure. The x-ray to the left shows the use of two small pins in the front of the hind leg bone known as the tibia.

If a bone is fractured in multiple places or spirals along the length of a bone, a simple pin will not provide enough support to immobilize the fracture and allow healing. Shown below are before and after x-rays of a fractured arm (radius and ulna) in a dog. Notice the splint on the before films. The AMC’s Emergency Service placed the splint to immobilize the fracture until surgery could be performed. The AMC surgeons chose to repair the leg with a plate and screws since both bones of the leg were broken.

As research discovers more about fracture healing, methods of repair are changing. When possible, minimally invasive procedures are chosen as large invasive surgeries disturb the covering of the bone (periosteum), the blood clot at the fracture site and the muscles which provide the blood supply to the fracture. The AMC surgeons are using a new technique called MIPO (minimally invasive plate osteosynthesis) or percutaneous plating. This method of fracture stabilization, involves application of a bone plate through small skin incisions on either end of the fracture site. The fracture is aligned and the plate and screws are placed using guidance from a special intraoperative x-ray machine. Not all fractures are amenable to MIPO.

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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.

Images: AMC Diagnostic Imaging Department


National Pet Fire Safety Day

July 18, 2011

Last Friday, July 15, 2011, was National Pet Fire Safety Day. When we hear about pets and fires in the home, we often think of the dog who awakens his owner, saving lives with a warning bark about a fire in the house.

But pets are also the victims of fire. According to Pet Safety Alert, 40,000 pets are killed in fires annually, most of them in residential fires.

Every year, The Animal Medical Center provides care to pets who have been trapped in burning buildings and rescued by New York’s bravest, our friends at the NYC Fire Department.

As a pet lover, you can take action to prevent pet-related fires and to protect your pet if there is a fire.

To help firefighters find all of your pets, the folks at ADT Home Security Systems offer a free window cling to alert firefighters to the presence of pets in the home. You can request one through their website.

Firefighters want to help pets suffering from smoke inhalation, but the oxygen masks designed for humans are not shaped to fit a pet’s nose. If you are feeling philanthropic, donate a pet oxygen mask to your local firefighting team.

Pet proofing your home can help to prevent a catastrophic fire. Candles are a huge danger for pets. A wagging tail can knock a candle off the coffee table and into a pile of flammable papers. My own cat, who had a big puffy tail, swished it over a lit candle and nearly went up in flames! Space heaters and backyard grills present a hazard, as they can easily be knocked over by a pet and start a fire.

To protect the entire family, make sure your smoke detectors and carbon monoxide detectors have their batteries changed twice a year. A good time to change the batteries is when you change the clocks for daylight savings time in the spring and fall.

Like people, pets can suffer from carbon monoxide poisoning. If everyone in the family is ill and your pet is exhibiting the following signs, see your veterinarian and mention you are concerned about carbon monoxide poisoning.

  • Nausea
  • Vomiting
  • Cough
  • Loss of exercise stamina
  • Disturbances in gait

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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.

Photo: iStockphoto


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.


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