My Dog Bit Someone, What Should I Do?

May 20, 2015

dog biteMay 17 -23, 2015 is National Bite Prevention Week. The United States has 70 million dogs, all of them wonderful companions, but any dog can bite. Animal bites are a serious problem, affecting 4.7 million people per year, most of them children. Senior citizens are the second most common age group affected by bite injuries.

Preventing Bite Injuries
The best defense against dog bite injuries is prevention. Responsible dog owners follow these general guidelines to prevent their dog from becoming a biter:

  • Train your dog. Obedience trained dogs are less likely to bite.
  • Keep your dog in control and on a leash when walking on the street or in the park.
  • Leave your sick dog home. Sick dogs a prone to biting because, just like you, they are cranky when they are sick.
  • Neuter your male dog. Unneutered male dogs are more often involved in bite incidents than neutered ones.
  • Supervise all children-dog interactions.
  • Teach your children how to safely interact with dogs.

Invest in Insurance
If, despite your best efforts, your dog bites a person, you may be fined for having a dangerous dog, in violation of a local ordinance for having a dog off leash or other violations. There is also the potential for the person bitten to bring a lawsuit against you. Check your homeowner’s or renter’s insurance policy to make sure it includes coverage for the family dog. According to the Insurance Information Institute, one third of all homeowner insurance claims paid in 2013 were for dog bite injuries. New York State had the highest average cost per claim, at $43,122.

Keep Rabies Vaccination Up to Date
Should your dog become involved in a bite incident, provide the injured party with a copy of your dog’s rabies vaccination certificate as soon as possible. Their physician will need to know this information when determining what treatments are necessary for the bite injury. If the injured party needs emergency medical care, the ER may be required to report the bite to the local health department. Officials from the health department will monitor your dog’s health and as long as the rabies vaccination is up to date, may put your dog under home quarantine for a specified period of time.

Teaching Children Safe Dog Interaction
Join us on May 30, 2015 from 10am-1pm for AMC’s annual PAW Day: Pet And Wellness fun at Carl Schurz Park on E. 84th Street and East End Avenue in Manhattan. This event is family friendly, including your furry friends! At PAW Day, specially trained dogs will be available for children to practice safe dog interactions. The event features a stuffed animal veterinary clinic, Clifford the Big Red Dog, face painting and a whole lot more.


Canine Flu: An Update

April 29, 2015

Dog flu/canine influenzaFor the last few months, veterinarians and dog owners in the Chicago area and other Midwestern states have been faced with an outbreak of canine influenza. Over 1,100 dogs have been diagnosed with the virus and sadly, some have died. First identified in an outbreak of what was believed to be “kennel cough” in greyhounds, the canine influenza virus was initially described in 2005. Canine influenza virus is just one of the causes of “kennel cough” which is really a general term for canine upper respiratory tract infections.

The canine influenza virus reported in 2005 is an H3N8 strain of the virus which has been documented nationwide. The current Chicago outbreak is caused by an H3N2 virus, which is the virus circulating in Asian dogs. Exactly how the Asian strain came to the Windy City is not currently known. Canine influenza seems to be moving east and cases have now been confirmed in the state of Indiana. Just yesterday, dog flu was diagnosed in Iowa.

Dog to Dog Transmission
Canine flu is transmitted from dog to dog and dogs can transmit it prior to showing symptoms of the virus. That feature of the disease is probably responsible for its rapid transmission within a population. Inanimate objects, leashes, collars, bowls and bedding used by an infected dog could be a source of infection for other dogs coming in contact with those objects. Petting a sick dog and then petting a healthy dog can also spread the infection.

Clinical Signs of Canine Influenza
The clinical signs of canine influenza run the gamut of respiratory disease. Twenty percent of dogs infected with the virus will never show any signs, but still can infect other dogs. Most dogs develop what we might think of as a cold– sneezing, runny nose and a cough. Dogs with the flu feel out of sorts with a fever and a poor appetite. About ten percent of infected dogs will develop a serious complication of influenza – bacterial pneumonia.

What precautions should dog owners take?

  1. Avoid doggie day care, the boarding kennel, the dog park, obedience classes and any other areas where dogs congregate. The canine flu spreads most rapidly in situations where many dogs come in contact with each other or with infected dogs’ coughs and sneezes.
  2. Wash your hands well. The canine influenza virus can live on human hands for 12 hours, unless they are washed with soap and water.
  3. Talk to your veterinarian about the canine influenza vaccine. The available vaccine is for the typical H3N8 virus. Because the virus in this outbreak is H3N2, we don’t know if the flu vaccine will protect dogs against this new virus, but it is being recommended in the Chicago area. The canine flu vaccine is like the human flu vaccine; it lessens signs of flu and shortens their duration, but does not prevent the disease.
  4. If your dog contracts the flu, wash bedding, dishes, leashes and clothing which can transmit the virus for up to 24-48 hours after coming in contact with a sick dog.
  5. Keep your cat away from your sick dog since the H3N2 strain can be transmitted to cats. The H3N8 strain is not believed to infect cats.

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.

Treatment of Allergies in Pets

April 15, 2015
AMC's dermatologist, Dr. Mark Macina, examines a patient

AMC’s dermatologist, Dr. Mark Macina, examines a patient

Spring officially arrived nearly three weeks ago, but the onset of allergy season may not arrive too soon this year, given our harsh winter. But once it warms up, pollen, dust mites, fleas, grass, weeds and mold will kick off allergy season in pets.

Clinical Signs of Allergies
Does your dog rub his face along the front of your sofa or scratch incessantly? Has your cat scratched all the fur off her head and made is scabby? Are you constantly putting in ear drops or giving antibiotics to treat skin infections? All these represent clinical signs of allergies in pets.

Control Parasites
One of the top causes of canine and feline allergic skin disease stems from an allergic reaction to flea saliva. A flea bites your dog or cat, setting off an allergic reaction. This disease presents a double-whammy to your pet: discomfort from fleas crawling all over its skin and the discomfort of being itchy. Fortunately, numerous options for control of fleas are available and your choice of product can be tailored to your pet’s exact needs.

Modify the Diet
Food allergies are typically an ongoing problem, not seasonal like pollen, grass or flea saliva allergies. Veterinarians think the allergen in food is the protein source contained in the diet, but it may be other ingredients as well. The standard method for determining if food is the cause of skin disease is a food elimination trial. Elimination diets contain a limited number of ingredients and protein sources not typically found in common pet food and not previously fed to your pet. Novel protein sources include bison, herring or rabbit. Some elimination diets avoid common carbohydrate sources and include potatoes or oats, rather than corn or soy. An elimination diet requires determination on the part of the pet owner, as the skin improves slowly in response to a diet change. Patience is required to tough out a month or more of strict diet control.

Administer Immunotherapy
Immunotherapy, a medical word for allergy shots, involves specialized testing to determine whether it is pollen, dust mites, fleas, grass, weeds or mold revving up your pet’s itch-scratch pathway. Once the cause of the allergy is determined, a custom allergy vaccine can be developed for your pet. You learn to give the injections at home one to two times per week. These injections contain minute amounts of the offending antigen (pollen, dust mites, fleas, grass, weeds or mold) which trains your pet’s immune system to be tolerant of these agents.

Quell the Immune System with Drugs
A variety of drugs can be used to turn off the allergic reaction underlying the itch-scratch cycle in your pet. The most well-known, but not necessarily the most effective in pets, is antihistamines. Steroids can be very effective and rapidly reduce the clinical signs of allergies, but have unpleasant side effects, such as increasing water drinking, urination and appetite, as well as increasing the risk of infection. Another effective drug for allergy management is cyclosporine, although cost is a concern. New to the market, oclacitinib, inhibits the cells initiating the itch-scratch cycle by attacking allergies at the cellular level.

With so many options to manage pet allergies, no pet should have their summer fun spoiled by constant itching and scratching. Watch The AMC’s Dr. Mark Macina talk about managing allergies in pets.


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.

Clinical Research at The Animal Medical Center

April 1, 2015

veterinary researchOne part of The Animal Medical Center’s tripartite mission involves advancing the practice of veterinary medicine through research. Many types of research exist: scientific, historical, social science and economic are just a few examples. The AMC participates in a specific type of scientific investigation called clinical research.

Studying Healthcare
Clinical research asks and attempts to answer questions related to healthcare delivery, and in the case of The AMC, animal healthcare. At various times, the veterinarians at The AMC have studied the impact of new medications, treatment protocols, diagnostic tests and therapeutic devices on canine and feline patients. Clinical research is distinct from, but seeks to improve, clinical care.

Institutional Review Board
Research involving living patients, human or veterinary, happens only after an institutional review board studies and approves the research protocol. This process assures the safety of the patients involved in the project. The review board also evaluates the patient consent document. To ensure the pet’s family understands their family member is part of a research protocol, they must read and sign documents about the planned treatment’s risks and benefits. In any clinical study, a pet owner may withdraw their pet from the study at their discretion.

Abstract Presentation
Another component of conducting research is presentation of the findings to a group of your scientific peers. At The AMC, resident research projects are presented to the entire hospital community. The audience can ask questions and make suggestions to clarify or improve the interpretation of the results. At this year’s Resident Research Seminar, five residents presented their work to the AMC community. They addressed topics such as using MRI and CT scanning for dogs with prolapsed spinal discs, vitamin D levels in ICU patients, blood clotting abnormalities as a result of severe trauma, comparison of continuous infusion versus intermittent diuretic infusion for the treatment of heart failure, and iron supplementation in cats with cancer. The results from the studies help AMC veterinarians to improve patient care and when published, influence the care of pets everywhere.

Publish or Perish
The final step in any research project is to publish the results in a peer reviewed journal. Peer reviewed means just what it says. Expert veterinarians review the manuscript for bias in research methodology, statistical analysis and conclusions. They recommend changes to improve the final publication and once those changes are made, approve the final manuscript, which is ultimately published for all interested in the topic to read.

Recent Publications
Here are summaries of some recent AMC resident research project publications:


Blindness in Pets

March 25, 2015
Smiley

Smiley

Smiley, a blind Golden Retriever therapy dog and former puppy mill rescue, recently became an internet sensation. Born without eyes, Smiley bonded with a deaf Great Dane after he was rescued from the puppy mill. According to reports, the relationship drew Smiley out of his shell and turned him into a confident therapy dog, sharing his smile at schools, nursing homes and libraries.

Forms of Blindness
Smiley was born without eyes – medically known as ocular agenesis, but blindness in pets takes many forms. High blood pressure, especially in cats with kidney disease, causes blindness. The increased blood pressure causes vision loss from retinal detachment and intraocular hemorrhage. Chronic herpes infection in a cat’s eye can cause corneal ulcers that are painful, difficult to heal and which can lead to blindness. A lack of tear production or dry eye predisposes dogs to corneal ulcers and scarring, and if left untreated, blindness. Both dogs and cats develop glaucoma, a painful swelling of the eye. If the swelling cannot be controlled, glaucoma can rob pets of their vision.

AMC TO THE RESCUE Helps
Doc, a mixed breed puppy, had developed glaucoma, a painful increase of fluid inside the eyeball that damages or destroys vision. Doc came to see The AMC’s board certified ophthalmologist, Dr. Alexandra van der Woerdt, through a joint effort between AMC TO THE RESCUE and Doc’s rescue group, Louie’s Legacy. AMC TO THE RESCUE funds specialty care to rescued pets whose medical conditions form a barrier to their adoption, preventing them from finding a forever home.

Dr. van der Woerdt determined Doc’s vision could not be saved, and because his eyes were painful, she outlined three options to make him pain free. First, surgical enucleation, or total removal of the eye; second, chemical ablation, where a substance is placed into the eye to destroy the fluid-producing tissue, lowering the pressure inside the eye; and finally, placement of an intraocular prosthesis. This device maintains blinking eyeball shape, but removes the “insides” of the eye so fluid is no longer produced and the eye is no longer painful. Doc underwent surgical enucleation of both eyes.

New Family and a New Name
Doc is now Zach, the name bestowed by his new family who adopted him shortly after the enucleation surgery. A new name is fitting since Zach is a new dog because he no longer suffers from painful eyes. Zach’s new family says, “He is doing super well. He loves to wrestle at the dog park and can navigate around our house and neighborhood with ease. Most people don’t even notice that he is blind!”

AMC TO THE RESCUE is proud to have helped turn one more unadoptable rescue dog into a beloved family pet. For more information about this vital Community Fund, or to donate, please visit our website.


Erin Go Daugh!!! St. Patrick’s Day for Pets

March 12, 2015

St. Patrick's Day for PetsNew York City, and other cities are about to get green. Not green with envy or ecologically green, but St. Patrick’s Day green. Many of us will don green hats or a sweater with an embroidered shamrock emblazoned on the front. Pets wearing St. Patrick’s Day finery are adorable, but some of the other St. Paddy’s Day traditions can be downright dangerous for pets.

Green Beer and Irish Whiskey
For those hosting a St. Patrick’s Day party, monitor the coffee table and other low surfaces for unfinished alcoholic beverages. Your dog might decide to take a nip or two of these available beverages in honor of the Irish saint, but because dogs are smaller than we are and are not used to drinking alcohol, they can quickly develop alcohol poisoning.

Another tip to avoid a pet crisis during your St. Patrick’s Day party: give Fluffy and Fido their own party space away from your guests. Their own space will protect them against unwanted escape as your guests arrive or depart. But just to be safe, be sure your pets are wearing their collars and name tags under their St. Paddy’s Day garb.

Shamrock Plants
The shamrock, or white clover, is a plant traditionally associated with the Emerald Isle and St. Patrick. History suggests the Irish wore shamrocks on their clothing to honor St. Patrick on his feast day. Today, shamrock plants can be found in your neighborhood grocery store and brighten up window sills at this gloomy time of year. Shamrocks contain oxalate which, if the plant is eaten, is irritating to the intestinal tract. Pet familes should find decorations other than live shamrock plants for the St. Paddy’s holiday season.

Irish Soda Bread
Out of financial necessity, the Irish popularized soda bread. Irish soda bread uses inexpensive ingredients like flour, sour milk and a bit of sugar. Today this tasty, raisin loaded loaf appeals to everyone, including your dog. But keep your loaf away from your dog, since ingestion of even a few raisins or currants can permanently damage your dog’s kidneys.

Green Foil Wrapped Chocolate Shamrocks
Leprechauns often leave foil wrapped chocolate shamrocks as gifts in honor of the patron saint of Ireland. They intend for the chocolate to be eaten by humans. Dogs will happily consume the chocolate and the foil wrapping, leading to an upset stomach. If a large number of these chocolate treats are consumed, dogs can become excitable and develop a very elevated heart rate. Find some shamrock shaped dog biscuits if you are looking for a special dog treat.

If you are wearin’ the green be safe and have a happy St. Patrick’s Day!


Bladder Stones: Now You See Them, Now You Don’t

March 4, 2015

The two x-rays seen below are from the same canine patient, taken one month apart. The one on the left shows two bladder stones. On the right you can see the stones are no longer present in the bladder. How did this magic happen? Surgery? Laser therapy? Antibiotics? Food? Magic wand?

canine bladder stones

Canine x-rays. Left image indicates 2 bladder stones. (Click to enlarge.)

Surgery?
Nope. Surgery may be the fastest and most common treatment for bladder stones, but for this lucky duck dog surgery was not necessary. Bladder surgery is performed under general anesthesia. The surgeon makes an incision in the abdomen near the back legs and finds the bladder just inside the body wall. Because the bladder is a hollow organ, it will collapse when the surgeon makes an incision in the bladder wall. Special sutures are placed in the bladder to hold it up and keep it open while the stones are scooped out of the bladder with a bladder stone spoon.

Bladder spoons

Bladder spoons (click to enlarge)

PCCL?
Huh? This acronym stands for per cutaneous cystolithotomy. Using laparoscopy equipment, a pinhole incision is made in the bladder. A small camera is threaded into the bladder and its magnifying properties are used to visualize the tiniest stones. Using this non-invasive method, stones are busted up using the laser and then easily removed.

Laser therapy?
Guess again. For dogs of the right size with not too many stones, non-invasive bladder stone removal is possible. Stones can be fragmented using a special laser which is passed up the urethra and into the bladder. Once the stones are broken into small enough pieces, they are either flushed out of the bladder or removed with a special stone-removing basket which is passed up the urethra and into the bladder to gather up the stone fragments.

Antibiotics?
Yes, but only in part. I can hear you saying, “Wait a minute, this makes no sense. Stones are hard chunks of mineral. Antibiotics treat bacterial infections, they do not dissolve stone.” But, this dog’s urinalysis showed an infection in addition to the stones. The infection played a role in the development of the stones and without treating the infection, the stones will not disappear.

Diet?
Stones form in the bladder as a sequel to infection and also because there are too many minerals in the urine. Drinking more water dilutes the minerals and helps dissolve the stones. Taking advantage of that information, a diet was formulated to promote water drinking in dogs fed the special stone dissolving diet. The diet is also low in magnesium and phosphorus, the building blocks of a type of bladder stone called struvite. This diet does not work in every type of bladder stone, only the struvite ones. Antibiotics are necessary since as the stone dissolves, it releases bacteria, and thus the dog needs antibiotics until the stones are completely gone. Antibiotics alone will not dissolve the stone and diet won’t work unless the infection is controlled, so the correct answer for the magical disappearance of the bladder stones in this dog is diet AND antibiotics.

Signs of bladder stones
Dogs with bladder stones urinate more frequently than is normal, have accidents in the house and blood in their urine. If you see any signs like this, be sure to have your dog evaluated immediately by your veterinarian. View a prior blog post on bladder stones to see diagnostic images of stones.


Brand Name, Generic, Compounded or Refilled: A Prescription Primer

February 18, 2015

Confusion about prescriptions reigned in my clinic this past week. I spent a lot of time explaining the intricacies of brand name versus generic drugs. There was a lot of confusion about refills as well. So, I am reprising a condensed version of my discussions about drugs for the benefit of all.

motrinBrand name drugs are the easiest to recognize because the label on the box has ® or possibly™ after a bold-faced drug name like Benadryl® or Motrin®. Drugs recently approved by the Food and Drug Administration (FDA) cannot be made as generic drugs until the patent or exclusivity expires. The FDA approves everything surrounding the manufacture, quality control and packaging of brand name drugs. This process assures the consumer the product is both safe and efficacious. Drugs for animals are approved by the FDA’s Center for Veterinary Medicine.

ibuprofenThe box, carton or tube of generic drug appears more utilitarian than the brand name drug, but the medication inside is a copy of the brand name drug, which is the same as the brand name drug in dosage form, safety, strength, route of administration, quality, performance characteristics and intended use. Generic drugs meet the same rigid standards as the brand name drug. All generic drugs approved by FDA have the same high quality, strength, purity and shelf life as brand name drugs. The generic drug manufacturing, packaging and testing must pass the same quality standards as those of brand name drugs.

Specialist veterinarians like those of us at The Animal Medical Center use compounded medications every day to provide drugs in formulations our patients will agree to take. Most commonly, we have medications flavored with beef and turkey or have bad tasting powdered medications put in gelatin capsules to hide their nasty taste. But compounded medications should not be confused with generic medications. Compounded medicines do not have the FDA assurance of safety and efficacy because they do not undergo FDA-mandated quality control testing. In most cases, the absorption properties and the shelf life of compounded medications are unstudied and may differ from brand name or generic medications. Because different compounding pharmacies use different “recipes” to create your pet’s specialized medication, the same prescription may not have the same effect when compounded by a different pharmacist. While the lack of FDA oversight may be a negative, if compounding helps you to get your pet to take its medications, compounding becomes positive.

animal medical center prescriptionWhen I call or fax a prescription to a pharmacy for a medication that a dog or cat will take for a long time, I will pre-authorize refills. The number of refills remaining on a prescription is indicated on the label of the medication bottle. In the sample label shown here, the red circle highlights the number of refills available without the need to call your veterinarian. You simply call the pharmacy and ask for one of the refills. The next prescription label will indicate only 4 available refills. I often choose the number of refills to coincide with an anticipated recheck examination since you need to call my office to get more refills, you can also set up the recheck appointment at the same time.

Understanding medications is critical to their successful use. The FDA Center for Veterinary Medicine has a wealth of information on their website for the pet owing public.


The 139th Westminster Kennel Club Dog Show: Old and New

February 11, 2015
Coton de Tulear

Coton de Tulear | Photo: AKC

This coming weekend begins the multi-day canine spectacular known as the Westminster Kennel Club (WKC) Dog Show. The annual event is the second oldest continuous sporting event in the United States, ranking number two to the Kentucky Derby, one year its senior. Dog lovers can spend Valentine’s Day watching the second annual Master’s Agility Competition at Westminster or meeting over 100 different purebred dogs at the AKC Meet the Breeds show. The WKC Show takes place Monday and Tuesday, February 16 and 17. Daytime events are at Piers 92 and 94 (711 12th Avenue at 55th Street). The evening events, Best of Group and Best in Show, can be seen at Madison Square Garden where the Show has been held for 139 years.

Every Year Beau-tee-ful Dogs!
Nothing new here. The WKC Show will feature nearly 3,000 gorgeous dogs, at least one dog representing each of the American Kennel Club’s (AKC) 184 registered breeds. Leading the pack in terms of numbers are America’s family dogs, the Golden Retriever with 58 entries and Labrador Retrievers with 56. The breed represented by the fewest number of entrants is the Norwegian Lundehund with one ‘lone wolf’ entrant. These truly are rare dogs; I checked The Animal Medical Center’s (AMC) 57,638 dog registrations and found only three Norwegian Lundehunds. This Norse breed features six toes on each foot and a neck so flexible, the top of their head can touch their back, both advantageous adaptations for hunting puffins on the icy slopes of Norway. Like most Artic breeds, they have a thick coat to help them withstand frigid temperatures.

New Breeds at the Show
The list of 184 AKC breeds includes two breeds newly recognized by the American Kennel Club that will be seen at Westminster for the first time: the Coton de Tulear in the Non-Sporting Group and the Wirehaired Vizsla in the Sporting Group. The veterinarians at The AMC know the Coton well as they are popular pets in NYC and we have 145 of them as patients. Since the Wirehaired Vizsla was not imported to the United States until the 1970s, they are not well known. Seeing the Wirehaired Vizslas at the WKC Show will be a special treat since none of these Hungarian hunting dogs have been seen as patients at The AMC.

New Arrivals for 2016
We already know that next year there will be four new breeds ready for participation in the 2016 WKC Show: the Spanish Water Dog, the Cirneco dell’Etna, the Bergamasco and the Boerboel. Except for the Spanish Water Dog, the list appears to be more like a spelling bee challenge than names of dogs!

As Always, The AMC Will Be There
The AMC’s veterinarians will be in attendance for emergency care at both the Piers and the Garden from Saturday until the 2015 Best in Show is named. The AMC will also have an information booth at Meet the Breeds on Saturday (Booth #131 Pier 92) and at the WKC Show on Monday and Tuesday (#44 Pier 94). Please stop by and say hello.


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

February 4, 2015

Veterinary Year in Review: 2014

December 31, 2014

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.


Bigger is Better and a Lid Doesn’t Matter When it Comes to Cat Bathrooms

December 10, 2014

kitten in litter boxWho among us doesn’t covet a nice bathroom? Our homes today have more bathrooms and larger, more elaborate bathrooms than ever before. According to houzz.com, the average bathroom remodel in New York City costs $32,000, and features granite counter tops, porcelain tile and high end fixtures. Our feline companions are no different. They express definite likes and dislikes when it comes to their litter box. Provide them with a substandard bathroom and they will refuse to use it and instead will use the corner of your dining room rug as their new and more spacious bathroom! In the feline world, this problem is so serious that a 2001 research study reported inappropriate elimination as a top reason cats are relinquished to animal shelters.

What cats care about in their litter box
Bigger boxes are better
In a study published earlier this year in the Journal of Veterinary Behavior, cats were offered the choice of using a standard size litter box or a large plastic box greater than 33 inches in length. The number of urine and fecal “deposits” in each box were recorded and compared. Results determined cats like litter boxes larger than the standard ones available in pet stores.

More boxes are preferable 
Litter box issues are more common in multi-cat households. To avoid competition and territorial behavior towards litter boxes, which leads to inappropriate urination, provide your cats with multiple litter boxes.

Stinky boxes are bad
Even if you scoop daily and completely change the litter weekly, that box can get stinky. Veterinarians tested cats use of litter sprayed with a commercially available litter box odor eliminator. Cats clearly found the sprayed boxes more attractive an preferred their use over unsprayed boxes.

What cats don’t care about in their litter box
Our mothers admonished us to close the lid of the toilet during their attempts to teach us manners. Cats don’t care about a lid on their litter box. A 2013 study of cats to determine their preference for a covered or uncovered litter box found no preference in the style of box in most cats, although as any cat owner will attest to, some persnickety cats did choose an uncovered box over a lidded one or vice versa.

Seems to me that cats should care about the type of litter in their box, but I couldn’t find any research to support that theory. One study did show, the longer cats scratched in the litter box, the less likely they were to inappropriately eliminate. Scientists interpreted that finding to mean lots of scratching at the litter means a cat likes the litter in their box and they will be less likely to eliminate on the dining room rug.

Cat bathroom remodeling tips
Thankfully, remodeling a feline bathroom is much less costly than remodeling your bathroom. First, feline behavior experts believe in simple math when it comes to the number of litter boxes: number of cats + 1 = the number of litter boxes you should have. You don’t like to wait in line to use the restroom, and clearly cats feel the same way. Second, when purchasing additional litter boxes, consider upgrading to a larger box, such as an under-the-bed box or gift wrap storage box without its lid.

Finally, cats fully believe that they are gods and that “cleanliness is next to godliness.” Research has shown that daily scooping of cat waste from the litter box and weekly litter changes can resolve urine spray behavior in cats.

Remember: inappropriate elimination may be a sign of illness, so check with your veterinarian if your cat suddenly stops using her litter box.


Sharing Turkey Day Dinner with Your Pets

November 26, 2014

Happy ThanksgivingThanksgiving is all about food and family. Many of us consider our pets family members and want to include them in the holiday celebration, but menu selection for pets can be tricky. For example, dogs love chocolate, but it will cause vomiting, diarrhea and hyperactivity if Fido indulges his passion with a few foil wrapped chocolate turkeys. Your cat may find the raw turkey trimmings sitting on the counter a tasty treat. Raw poultry can be teeming with organisms such Salmonella or E. coli and give Fluffy a nasty case of food poisoning. So here are simple suggestions for taking food from your holiday table and creating a healthy and safe buffet for the family pets. More difficult will be figuring out if seating Fido next to Grandpa and Fluffy next to Uncle Ray will provoke a family fracas!

Doggie dishes
When choosing Thanksgiving food for your dog’s dish, stay away from high fat dishes, such as gravy or sausage stuffing, which can provoke an episode of painful pancreatitis. Steer clear of raisins and grapes, whether in a fruit salad or stuffing, as these delicious fruits can cause serious kidney problems. A spoonful each of nice white meat turkey, sweet potatoes or mashed potatoes minus the butter, sour cream, nuts, and marshmallows would be safe turkey day fare for your dog. Fruit often appeals to dogs, and while recreating grandma’s apple crumb pie, save a couple of apple slices for your dog.

Reptile recipes
If you have a vegetarian reptile, such as an iguana, bearded dragon or a tortoise, the Thanksgiving side dishes provide an opportunity to share the bounty of the season.  Winter greens such as collards and mustard greens make a tasty holiday treat. While you’re setting aside the greens for your special scaled friend, save some raw squash, yams and even a few fresh or boiled cranberries to create a colorful and healthy reptile dinner. In addition to the vegetables and fruit, your turtles might like a bit of white or dark meat turkey added to their plate.

Kitty cuisine
Because cats think of you as their servant, dishing up what you believe to be a special holiday meal without asking their permission may result in rejection of your best culinary efforts. Perhaps just serve up the turkey flavor of your cat’s favorite canned cat food and call it a day in the kitchen! If you must cook for your kitty, consider simmering the giblets from the turkey until they are cooked through. Once they are cooled, mince them finely for a feline Thanksgiving Day indulgence.

Pocket pet provisions
If you have a small mammal, such as a rabbit or guinea pig, save some salad fixings, like lettuce leaves and carrot pieces, to make Thanksgiving extra special. While you are making the pie, save a small piece of apple before it is mixed with sugar and cinnamon as a rabbit dessert. The family ferret can feast on small bits of plain turkey meat without gravy or seasonings.

Bird buffet
Before you add the butter, sugar or marshmallows to the steamed or boiled sweet potatoes, save a small portion for your bird’s Thanksgiving dinner. If you garnish your vegetable dishes with pecans, walnuts or slivered almonds, they too can be added to your bird’s holiday fare. Selections from the vegetable side dishes, such as carrot pieces, green beans and Brussels sprouts, make a tasty and healthy addition to your bird’s plate, but be sure to set them aside before butter or salt is added!

The Animal Medical Center wishes a happy Thanksgiving to all! “Bone” Appétit.


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.


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

November 5, 2014

National Pet Cancer Awareness MonthNovember 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. According to the Morris Animal Foundation, there are six million new pet cancer diagnoses every year. That number of diagnoses translates to millions of pet cancer treatments each year. Traditionally, surgery, chemotherapy and radiation therapy were considered the mainstays of cancer treatment in both people and pets, but recent innovations add immunotherapy and targeted drug therapy to the growing list of cancer treatments for pets.

To raise awareness of the possible treatments for pet cancer, Fur the Love of Pets will feature this two-part blog on cancer treatment options in pets.

Surgery
Surgical removal as a treatment for cancer has been practiced since Roman times. Perhaps because of a lack of surgical skill, coupled with a lack of techniques for general anesthesia, surgery was not particularly effective, if we believe the Roman physician Celsus. He wrote, “After excision, even when a scar has formed, none the less the disease has returned.” Today we know much more about how to treat canine and feline cancer patients with surgery. Tumors such as canine breast cancer, soft tissue sarcomas and mast cell tumors are potentially cured by surgical excision alone. The key to treating many types of tumors with surgery is to remove a wide swath of normal skin and tissue around the tumor to ensure complete removal of the cancer-causing cells. Anyone with a pet treated with surgery for mast cell tumor or soft tissue sarcoma can attest to the fact that the actual incision was much bigger than they anticipated. Current guidelines recommend as much as 3cm (1.25 inches) of normal tissue be removed on all sides of the tumor as part of a cancer surgery.

Surgical treatment of pet cancer recently became highly specialized when the American College of Veterinary Surgeons (ACVS) recognized the Veterinary Society of Surgical Oncologists (VSSO). Members of VSSO have achieved a high level of competence in cancer surgery though their participation in a surgical oncology fellowship following certification by ACVS.

Radiation Therapy
The second cancer treatment to be widely used in humans was radiation therapy. Veterinarians began using radiation therapy in pets in the early 1980s. Board certified veterinary radiation oncologists treat a wide variety of tumors including brain tumors, thyroid tumors and melanoma.

The radiation therapy equipment The AMC currently uses is our third machine since 1989. The first two used cobalt as the radiation source. Now we have a linear accelerator with electron beam capabilities, image modulated radiation therapy and stereotactic radiosurgery – a huge advancement in technology from our first rudimentary cobalt machine. To ensure exact positioning for each treatment, a customized “bed” is created for each patient. View a video of one of our vacuum assisted positioning devices being used in a feline patient.

Want to learn how to recognize signs of cancer in your pet? View our slide show on the “Ten Warning Signs of Cancer in Pets.”

In Part II of this blog, I’ll discuss chemotherapy, immunotherapy and targeted therapy.


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.

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