Dogs, cats and blood pressure

September 17, 2012

When you visit the doctor, before our physician comes into an examination room, a nurse measures our weight, temperature and blood pressure. When your pet goes to the veterinarian, the nurse comes in to take his weight and temperature, but not blood pressure. Does this mean blood pressure is not important in dogs and cats?

Blood pressure measurement is important in our pets, but in a different way than in humans. As many as one-in-four Americans suffers from high blood pressure and most may not even know it. Hypertension, aptly named the silent killer causes heart attacks, strokes and kidney disease.

Smoking, drinking and obesity increase our risk of developing hypertension. Some of us are prone to developing hypertension even without smoking, drinking or eating too much due to a predisposition in our genetic profile. Pets become hypertensive from completely different medical conditions.

Pets have different risks

Genetics is the first point where we and our pets differ with regard to hypertension. Inherited hypertension is extremely rare in dogs and cats and because dogs and cats do not drink alcohol or use tobacco; these are not risk factors either. Obesity causes serious medical problems in pets, but not hypertension.

What causes pet hypertension?

The number one cause of hypertension in pets is one form or other of kidney disease. The normal kidney plays a critical role in controlling blood pressure. A diseased kidney can no longer perform well as a blood pressure regulator. Since we see more kidney disease in cats, we see more hypertension in cats, but I have a nice Wirehair Fox Terrier patient who has hypertension as a consequence of kidney disease. Hyperthyroidism, exclusively a feline disease, is another cause of hypertension. Finally, some rare tumors of the adrenal gland can cause hypertension, and I have seen only a small handful of pets with this type of hypertension.

Consequences of pet hypertension

Untreated hypertension causes serious problems in pets: strokes, heart enlargement and damage to the eye causing blindness. Controlling hypertension decreases the risk of these disorders.

Treatment is the same for everyone

If you have hypertension, your doctor has recommended lifestyle changes such as quitting smoking and losing weight. You will be prescribed drugs to decrease blood pressure and you may even be asked to monitor your blood pressure at home since some patients get nervous at the doctor’s office and suffer from “white coat” hypertension.

If your pet has hypertension, your veterinarian will recommend lifestyle changes such as a special kidney-friendly food. A common drug used to treat pets with hypertension is amlodipine, a drug also used in people with hypertension. Other treatments will be needed to manage kidney disease or an overactive thyroid gland. Finally, your veterinarian may ask you to monitor your pet’s blood pressure at home since pets also get white coat hypertension. The procedure is not very difficult and The Animal Medical Center has blood pressure monitors to lend pet owners for home monitoring. If you pet has hypertension, ask if home monitoring is necessary.


Top 5 Health Issues Facing American Pets Today

March 19, 2012

1. Pets are becoming medically underserved

Data shows the pet population in the U.S. is climbing, but visits to veterinarians are declining. On an annual basis in 2007, dogs saw a veterinarian 2.6 times per year and cats only 1.7 times, indicating cats are affected more than dogs. This number has continued to decline in the aftermath of the Great Recession of 2008. Taking your cat or dog to the veterinarian allows early detection and intervention before medical problems like obesity cause serious disease.

2. Obesity in pets, like in humans, is skyrocketing

Veterinarians know pets are getting fatter, but research has shown pet owners are not likely to recognize obesity in their pets, perhaps because they themselves are overweight. In dogs, obesity is linked to an increased body mass index (BMI) in their owners. If you love your pet and want it to live a long, healthy life, keep its weight down. Obese pets have a shorter lifespan and increased risk of cancer, heart disease, respiratory problems, bladder disease, and, like humans, diabetes.

3. Diabetes is increasing in both cats and dogs

Banfield State of Pet Health reports a 32% increase in diabetes in dogs and 16% increase in cats, comparing 2006 to 2010. This is likely tied to the obesity epidemic in pets. Diabetes can be treated in dogs and cats, but it involves someone in the family injecting insulin once or twice daily under the skin and monitoring response to treatment. Preventing diabetes by maintaining an ideal body weight is simply easier for everyone.

4. Cancer: a major illness in both cats and dogs

According to the Morris Animal Foundation, 1 in 4 dogs dies from cancer and cancer is the leading cause of death in dogs over 2 years of age.

In dogs, breed is strongly associated with specific types of cancer. Golden retrievers commonly develop lymphoma, German shepherds a splenic tumor called hemangiosarcoma, and Pugs a skin tumor known as a mast cell tumor. Cats get cancer too, most commonly lymphoma. Annual examinations and blood tests by your family veterinarian will help to detect tumors while they are still easily treatable.

5. Dental disease is on the rise

Reluctant is the descriptor for many pet owners when it comes to dental procedures in their pets. I understand their concern for the required general anesthesia, but I am concerned their reluctance is compromising their pet’s health. Periodontal disease is very prevalent in cats and in one study, all cats had evidence of periodontal disease. Over 10% were severely affected and nearly all had bone loss in the jaw as determined by dental x-rays.

Having periodontal disease may cause collateral damage in other parts of your pet’s body. In dogs, periodontal disease was associated with increases in markers of systemic inflammation and indicators of failing kidney function, and was also associated with endocarditis and heart muscle problems.

For more information on healthcare issues facing American pets today, watch my video interview with Yahoo! Animal Nation.

Photo: iStockphoto
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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.

 


How Important is Food?

February 16, 2012

We all know food provides the energy and nutrients each of us, including our pets, need every day. But as a veterinarian, food is more important than just providing nutrients; it is an integral component of disease and recovery.

Food and disease

Food is also related to common illnesses veterinarians diagnose on a regular basis. Take for example Jack, the cat lost at JFK, who succumbed to hepatic lipidosis, a disease provoked by inadequate food intake and treated by feeding!

Excess food intake often results in obesity. Obese animals live shorter lives and have more medical problems, including arthritis, bladder problems, and respiratory disease.

Food as medicine

Veterinarians have been using specially formulated diets as a component of medical therapy since the 1940’s.

“Prescription” diets are now manufactured by several pet food companies. These diets are available by prescription only since the nutrients have been modified to address certain nutritional differences in pets with a variety of diseases, so they are not appropriate for every pet. Take for example the reduced protein diets used in dogs and cats with liver problems. Too much protein can cause seizures in these patients. Protein-restricted diets are commonly prescribed to minimize the protein-induced seizures. For pets with suspected food allergies, diets have been formulated with novel ingredients to facilitate diet elimination trials. The exotic ingredient list for these diets – kangaroo, rabbit, duck, peas, and sweet potato – help veterinarians to eliminate common causes of food allergies, like beef, chicken, corn, and wheat, while maintaining a convenient source of nutrition for your pet. Specially formulated kidney friendly diets are one of the most important types of therapeutic diets and have been shown to minimize clinical signs of severe kidney failure (uremia) while maximizing survival in both dogs and cats with kidney disease.

For The Animal Medical Center’s brochure on feeding pets with kidney disease, click here.

Food and insurance

Can you believe food just got more important? The Trupanion Pet Insurance Company recently expanded coverage to include veterinarian prescribed diets.

Here is the coverage as listed in the sample policy:

Therapeutic Pet Food

(1) Therapeutic Pet Food – We will cover the incremental cost of therapeutic pet food when recommended and dispensed by your veterinarian in the treatment of injuries or symptomatic illnesses covered by this policy for up to two months of feeding. If you continue to feed your pet the veterinarian recommended therapeutic pet food as a long-term replacement diet, you will be eligible for a discount to your monthly premium. This coverage is not for routine/preventive care.

This is great news for pets and pet owners. Clearly, Trupanion understands the importance of food and I hope other pet insurance companies will recognize it too!

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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.


Measuring Your Pet’s Medication

November 8, 2010

Medical professionals, veterinarians included, speak to each other in our own language, more difficult to understand than either ancient Latin or Greek. This language is confusing to pet owners and often results in question about medication administration.

This weekend was a case in point. An owner called while she was out of town on vacation. I had completely confused her with my instructions on how much medication to administer. She was hours away and unable to drop by The Animal Medical Center for a refresher course. In giving instructions, I forgot pet owners are not always well versed in scientific weights and measures and the sight of an oral dosing syringe can induce paralysis in even the most educated client. Here are the definitions for some of the most confusing terms.

Milliliter (ml) is a measure of volume and a liquid medication dose is commonly given in milliliters. A milliliter is the same as a cc (cubic centimeter). But a milliliter does not tell how much medication is being given. Medication is typically measured in milligrams (mg). For example, a tablet of the antibiotic amoxicillin contains a set number of milligrams, but the milligrams contained in a milliliter of amoxicillin depend on the particular antibiotic brand’s strength. In other words, all liquid medications are not created equal. Veterinarians will always talk about how many milligrams your pet needs when you want to know is how many milliliters to squirt down the throat of your dog who has its teeth clamped shut and has just slipped under your king sized bed.

A diabetic pet presents a special set of challenges, one of which is how much insulin to give. Based on the comments above, the careful reader would surmise insulin is given in milliliters – it is a liquid medication after all. But no, it is given in units and double no, 1 unit does not equal a milliliter. If you have U 100 insulin, 100 units = 1 milliliter. If you have U 40 insulin, 40 units = 1 milliliter. To complicate matters more, each insulin needs its own special syringe matched to the type of insulin, ie, U 100 syringes for U 100 insulin. Understanding these seemingly trivial differences means success or failure in treating your diabetic pet.

Decimal points are another prescription predicament. The numbers 5.0, 0.5 and .05 are 100 fold different and yet when they appear on a prescription label they can be confusing. Proper prescriptions use zeros to highlight a decimal point. Numbers should have a leading zero before any decimal point, ie 0.5 is correct. Numbers should not have a trailing zero, ie 5.0 is incorrect. These differences highlight how carefully pet owners should read a medication label before administering a new medication.

Finally, because of the obesity epidemic in pets, veterinarians are making pet owners more conscious of how much pets eat. One cup is easy to understand, but calories per cup vary dramatically. One cup of Eukanuba puppy food contains 503 kcal and one cup of their weight control product for large breed dogs contains 272 kcal. Some foods list kcal per kg (kilogram) of food. Converting kilograms (a measure of weight) to cups (a measure of volume) requires advanced math, or a scale from your local cookware shop.

So when it comes to medicating your pet, ask lots of questions and don’t be afraid to call your veterinarian’s office for clarification, because a microgram of prevention is worth a milligram of cure.

Have you ever encountered problems with your pet’s medication dosing? Tell us your story by commenting below!

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

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For nearly 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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