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.

Veterinary Year in Review: 2014

December 31, 2014

Keep Your Kitties Safe from these 10 Potential Toxins

June 11, 2014

Hairball Awareness Day 2014

April 23, 2014

This Friday, April 25, 2014 is Hairball Awareness Day. Most of us think of hairballs left for us by our pet cats as an annoyance, found typically between the bedroom and the bathroom. Their peak occurrence is somewhere around 3am and appear only when you have bare feet. As annoying as hairballs are to us, to pets they can actually cause a surgical emergency. Here to prove it is my patient Toby.

Toby clipped

Toby after having his fur clipped

Toby is an eight year old long-haired cat, but in this photo you can see he has been clipped, thanks to a hairball emergency. The second photo shows him with a full coat. Toby’s story starts with a voice change and trouble breathing. In addition, his owner noticed Toby had not been eating well and was not grooming himself. A visit to The Animal Medical Center emergency room found a tumor on his larynx. Ultimately Toby’s diagnosis was lymphoma of the larynx, readily explaining his voice change and respiratory difficulties. Because the tumor was also obstructing the opening to his esophagus, a soft food diet was prescribed, instead of his normal crunchy hairball prevention formula.

Toby at home

Toby at home

A few days later, Toby started chemotherapy. Within days he could meow, was breathing and eating well and resumed his normal grooming routine. But just before his fourth chemotherapy treatment, Toby vomited up a six inch long hairball and initially seemed to be fine, however, on the day of his chemotherapy appointment, he vomited twice and we began to worry about a hairball obstruction since Toby seemed painful when we examined his abdomen. An abdominal ultrasound confirmed the presence of a hairball obstruction. Surgeons at The AMC discovered a hairball blocking his small intestine and removed it. Toby recovered uneventfully and resumed chemotherapy once he recovered from surgery.

Today, Toby is back on his hairball prevention diet, has completed chemotherapy and is enjoying a complete remission of his cancer. Whenever we sedate him to evaluate his larynx, we clip his fur to prevent another hairball emergency.

How to avoid a hairball crisis in your pet:

  • Feed your pet food or treats designed to move hairballs efficiently through the intestine.
  • Brush, brush and brush your pet daily.
  • Use a deshedding tool to efficiently remove loose hairs before your pet swallows them.
  • Use caution when removing hair mats as scissors can cut the underlying skin if the mat is tightly adhered.
  • Consider a professional grooming if your pet is severely matted.

Making a Specialist Visit Special

April 2, 2014
A French bulldog is examined by AMC's Ophthalmologist

A French bulldog is examined by AMC’s Ophthalmologist

Your pet needs a second opinion from a board certified veterinary specialist and your veterinarian has helped you set up the appointment with the right specialist. You know this is going to be different than seeing the familiar veterinarian you have trusted with your pet’s care since you brought him home from the shelter in a cardboard carrier. How can you make this nerve-wracking experience efficient and affect the best possible outcome for you and your pet?

Look at a consultation with a veterinary specialist at The Animal Medical Center or another specialty hospital like you do any other meeting. If you are running a meeting at your office, you will be sure the right people are invited to attend the meeting; the meeting will have an agenda agreed upon in advance; it will have a start and stop time and meeting attendees will be assigned tasks to complete after the meeting is over. All of these points also describe your appointment with a veterinary specialist.

The Right Attendees
I am a veterinarian and my job is to take care of sick pets. To me, your pet is a critical participant in the specialist consultation. While your role of transporting your pet to the appointment and being its spokesperson is also crucial, I really need to examine your pet and see first-hand the problems that need correcting. You would be surprised at how many people come to see me without their pet. If you choose to leave your pet at home and fly solo at a consultation with me, I can guarantee one of your tasks after the meeting will be to bring your pet to The AMC for an examination.

Specialist Agenda
A veterinary specialist has been trained to approach patients with a basic agenda:

  • Ask about the past history and review any documentation from the primary care veterinarian
  • Perform a physical examination
  • Make a list of possible diagnoses
  • Create a list of tests to determine which diagnosis is the correct one
  • Interpret the test results once they become available

Pet owners can streamline that agenda by having medical records, x-rays and blood tests sent in advance of the scheduled consultation.

Pet Owner Agenda
Simply put, the pet owner agenda for a specialist consult revolves around one of three issues: making a diagnosis, treating a disease or improving the quality of life. For some pet owners there may be other issues that are equally important, such as having the pet attend a family function. If there is an important issue for you and your pet, be sure to let the specialist know what it is and how you feel this issue might impact the recommended diagnostic and therapeutic plan.

The To-Do List
At the end of the consultation, the specialist or a member of their team will explain the plan for your pet. It might be to give medications or schedule a follow up test at your veterinarian’s office. Following the plan exactly and scheduling tests or treatments on time will help get your pet back on its feet as soon as possible. And having a healthy pet is what makes any visit to the veterinarian’s office special.


The [Veterinary] World is Flat

February 26, 2014

digital x-raysThe title of this blog takes its name from author and New York Times columnist, Thomas Friedman’s bestselling book, The World is Flat: A Brief History of the Twenty-First Century. The book’s thesis explains globalization in the 21st century as a result of wide accessibility to personal computers and fiber optic cables which make communication via email and information gathering via the internet nearly instantaneous. This form of globalization renders geographic divisions between countries irrelevant.

Friedman describes “ten flatteners” including: the collapse of the Berlin Wall, Netscape and workflow software. My own observations of the world of veterinary medicine indicate that it is not much different than the global economy Friedman describes in his book. Paying tribute to the Pulitzer Prize winner Friedman, here are my veterinary flatteners.

A New Workflow
Digital radiography has changed the workflow of daily veterinary practice. In the pre-computer days, each x-ray was a piece of film, not easily copied and very easily misplaced. Now The AMC and many other veterinary hospitals have switched to using digital radiography, using a machine that looks like a regular x-ray machine but which takes digital images similar to those taken with your smart phone. These x-rays can’t be lost because the images are stored in a picture archiving and communication system (PACS). The image files are very large, but can be transported by burning them onto a CD or transferring them through any number of file sharing systems.

Electronic Medical Records
As it has revolutionized the global economy, the personal computer is revolutionizing veterinary practice. Electronic medical records systems (EMRS) allow rapid dissemination of medical information between specialists and primary care veterinarians. I can write a letter to a patient’s primary care veterinarian after I have completed my consultation with their patient. Through the magic of the EMRS, I can have the letter in that veterinarian’s inbox for his/her review before the pet has returned home.

Board Certification
Twenty-five years ago when I started the process of becoming a board certified veterinary oncologist, there were only about 25 veterinary oncologists in the world. The American College of Veterinary Internal Medicine now has certified over 300 oncology diplomates and there is a European College of Veterinary Internal Medicine which certifies oncologists as well. Board certified specialists all over the world form a healthcare network that trades patients back and forth when pet owners relocate or go on vacation, just as I described in a previous blog: “Clea’s International Healthcare Team.” Since veterinary oncologists and other specialists have expanded their reach worldwide, specialist veterinary care no longer has geographic boundaries.

Multinational Veterinary Companies
Specialists are not the only international flatteners. Because international companies provide veterinary products and services, veterinary specialists can access information about pets seen by a veterinarian practicing on a different continent! Take for example my patient Gigi. She came to The AMC from Kuwait, but because the biopsy of her tumor was sent to the European branch of the same laboratory used by The AMC, I was able to ask additional questions about the biopsy result. The biopsy sample was retrieved from storage and then reviewed by a pathologist in Europe. The answers to my questions were sent via email.

Real Time Communication
The internet has changed the face of veterinary education. Today, veterinarians no longer have to travel to earn continuing education credits necessary to maintain their licenses. Continuing education comes to them though their computers. This year, the keynote speaker addresses at the annual Veterinary Cancer Society Meeting were streamed live to members unable to attend. Additionally, several internet based companies offer on-demand veterinary continuing education opportunities.

The veterinary world is indeed flat and that means your pet can get excellent veterinary care from a veterinarian in your neighborhood or from a specialist somewhere a long way from home!


AMC Resident Research Abstract Presentations

January 15, 2014

veterinary researchJust before Christmas, The Animal Medical Center held its annual residents research abstract presentations. As part of their specialty training, residents are expected to design, execute and report on research in their area of clinical specialty, and this mini-conference provided a forum for exchange of the knowledge gained from research between members of The AMC medical staff. The AMC performs a very specific type of research – clinical research. This means we study diagnostic testing, new treatments and procedures in the patients we care for as part of our effort to improve the health and well-being of our patients. We do not test or treat any animal for the sake of “research.”

Caspary Research Institute
Research at The AMC is not new; when The AMC moved uptown in the 1960’s from Lafayette Street to its present location, a decision was made to locate the new veterinary research institute right in the middle of the Upper East Side’s strong human-focused biomedical community. The AMC became the fifth biomedical institution in the neighborhood, joining The Rockefeller University, Cornell University Medical College, Sloan-Kettering Institute and Memorial Hospital for Cancer and Allied Diseases. Early architectural drawings of the AMC building show a sign on the north side of the building saying, “Caspary Research Institute.” When The AMC opened on 62nd Street, research and patient care were its main focus areas.

Short and Sweet
From a research point of view, an abstract is a very short presentation – 12 minutes, followed by a 3 minute question and answer period. Resident research abstract presentations are commonly preliminary reports which allow discussion of data and help formulate the interpretation of results prior to the writing of a manuscript for publication. Because the information presented was preliminary, I have a few interesting tidbits to report.

Lookalike Medicines
One study evaluated treatment of cognitive dysfunction in dogs with an anti-seizure medication compared to dogs treated with a placebo. In order to help veterinarians and owners make an unbiased assessment of patient response to the actual medication, our colleagues at Best Pet Rx Pharmacy made every dog’s medication look exactly the same. No one could tell which dogs were getting the medication being studied and which dogs were getting placebo pills. This is called double blind study design. Double blind because two people, the patient and the researcher, don’t know the treatment group assignment because it is hidden by the look-a-like pills.

Challenge of Science
Most research projects do not proceed exactly as planned. A study of ICU patients was designed to follow the effects of treatment on dogs with low blood protein (hypoalbuminemia). Dogs were to have a blood sample prior to treatment and 48 hours later. The study did not meet the enrollment target. Why? Despite an impression that dogs stayed in ICU longer than 48 hours, most dogs did not stay that long and fewer dogs than projected entered the study. Of course, we were happy your dogs went home earlier than expected, which was a scientific finding on its own.

Changing Protocol
The AMC’s ICU patients often need to be fed intravenously. We use a commercially available product called Procalamine. This product provides amino acids, the building blocks of protein and glycerin, as a source of glucose for energy. One emergency critical care resident studied patients receiving Procalamine as part of their treatment protocol. Patients receiving Procalamine through a catheter in their leg had more inflammation of the blood vessel than patients who get Procalamine through other, larger blood vessels. Although the directions for Procalamine indicate it can be given in the legs, we now will try and avoid this whenever the patient’s condition allows it.

Helping Pets Everywhere
These types of studies enable AMC veterinarians to improve the level of care for your pet. Through the publications that will result from these and other studies performed here, the knowledge will improve the care of pets everywhere.


%d bloggers like this: