Heartworm Disease - The Basics: What Do You Need to Know?

Heartworm disease is caused by the parasite Dirofilaria immitis.  This is a worm that lives in the heart, lungs, and surrounding vasculature.  It is a serious disease that primarily affects the heart and lungs but can also affect the liver, kidneys, central nervous system, and if left untreated, can cause death.  Heartworms are transmitted by mosquitoes: they take a blood meal from an infected animal and transmit the microfilariae (larval stage/baby worms) into another animal with subsequent blood meals. These microfilariae will then make their way to the heart where they grow into adult worms, causing heartworm disease. Mosquitoes are required for the parasite’s life cycle which means that a dog cannot re-infect itself.

Both dogs and cats can get heartworm disease from mosquitoes!  A cat is an atypical host, and unfortunately many times goes undiagnosed. In some cats, 1-3 adult worms can be devastating and create respiratory issues, and one of the main risk factors for cats developing feline asthma is heartworm! The treatment that we use for dogs cannot be used in cats, so prevention is key for kitties.

What are the symptoms?

Some dogs are asymptomatic, meaning that they act normally. There are no changes in their breathing, exercise levels, or appetites.  With chronic infections or heavy worm-burdens, owners can notice coughing, exercise intolerance (unable to go on a walk without stopping and/or coughing), decreased appetite, sleeping more, and even weight loss.

Clinical signs in cats can be very subtle to very dramatic.  These symptoms can include coughing, asthma-type symptoms, vomiting, weight loss, lack of appetite, and fluid build up in the abdomen.

Grading Scale

There are 4 grades to heartworm disease:

  1. Grade I: Asymptomatic dog, tests positive on the annual test that is recommended by veterinarians.  Chest x-rays, blood work and urine testing is normal.

  2. Grade II: Asymptomatic or mild symptoms in dogs.  Chest x-rays will show some abnormalities or the pet may have mild changes on blood work and urine testing.

  3. Grade III: Symptomatic dogs, chest x-rays show obvious changes and blood work and urine testing is very consistent with chronic inflammation and parasitic infection.

  4. Grade IV: Severely symptomatic dogs, chest x-rays show enlarged and abnormal vessels; they may have fluid build-up in the abdomen and are in right-sided congestive heart failure.  These pets have a guarded prognosis (and in some cases treatment may need to involve surgical extraction of the worms from the heart, through the jugular vein)

Why is annual testing recommended if my pet is on regular prevention?  

Heartworm disease can be devastating.  The earlier the detection, the better chances for survival.  Since many dogs are asymptomatic at time of diagnosis, the only way it is found is through an annual test, which requires only a small amount of blood  

All pets over the age of 7 months old should be tested for heartworm disease on an annual basis, but we start giving the heartworm preventative medication as young as 8 weeks of age.

How is heartworm disease treated?

If your dog has been found to have heartworm disease and all the testing indicates that it is safe to then go ahead with treatment, it is done with a medication called Immiticide (an arsenic derivative!).  The American Heartworm Society recommends giving three injections: one injection on day one and the other two injections one month later, 24 hours apart.  Post-injection care includes strict exercise restriction for 30 days (so, for a traditional treatment - that means TWO MONTHS of STRICT restrictions), keep them on all prescribed medications (often steroids to reduce inflammation in the lungs, sedatives as needed and pain medications for injection-site discomfort) for the heartworm disease, and monthly heartworm prevention.

There is no approved treatment for cats.

What is the best way to prevent this disease?

Keeping dogs and cats on monthly prescription preventatives, year round (even in the cold months), is the best way to prevent this disease.  The two main ways to administer this are topical or oral medications.  Both are only available as prescriptions through a veterinarian.

This is definitely a disease where prevention is a lot better (and cheaper) than treatment!

The life cycle and intricacies of treatment are a lot more complicated that the basic information we’ve provided here. If you’re interested in learning more - ask your veterinarian! At Clarendon Animal Care we work with a number of local rescue groups and manage heartworm positive dogs frequently - we’re always happy to answer any questions you may have about this disease - detection, prevention, management, and general biology/life cycle.

The American Heartworm Society is also a great point of reference for pet owners.  Please visit www.heartwormsociety.org for additional information.

The “Chew” on Pet Dental Treats

Chewing is such an important part of our pet’s dental health (and with dogs, helps with mental stimulation as well!) - yet we commonly see dogs presenting with broken teeth from chewing seemingly “appropriate” treats; and cats and dogs with severe periodontal disease despite regular dental treats...what gives?

So...about brushing, that’s not happening...what other options do we have?

As we discussed in our last article, brushing your pet’s teeth regularly is the best way to prevent periodontal disease - but as we all know, that is not always feasible.

So, I guess we should start with WHY is chewing so important? The mechanical act of chewing does two important things: 1) it causes mechanical massage/stimulation of the tooth/gingival surface which increases blood flow and can help physically remove plaque and 2) it causes salivary stimulation which has anti-microbial properties and can reduce plaque (bacterial colonies) buildup.

When we start thinking about what dental chews, treats and water additives we give our pets - our first question is: has it been proven to actually help? There is a group called the Veterinary Oral Health council whose mission is just that - to determine if and set standards for products that claim to reduce plaque and tartar in our pets. We particularly like the Tartar Shield chews and treats for dogs and cats and the OraVet chews for dogs

Another consideration with chews, especially for dogs, is if they will cause physical trauma to their teeth. We regularly see dogs present with fractured teeth, dental pain and dental abscesses secondary to trauma to their teeth. This generally happens when chews that are too hard are given to our pets (such as antlers, cow hooves, dried natural bones or hard nylon products) - they may be tempting to give as dogs would chew on bones in the wild, however these products are too hard and do not mimic the effect of a dog tearing meat off a carcass.

Some non-dental considerations with chews/treats and water additives:

  • Dietary sensitivities and food allergies: some dogs have sensitive stomachs and can’t tolerate the ingredients of a chew/treat or water additive and some dogs have food allergies that needs to be taken into consideration when giving these treats. Bottom line - if you give your dog a chew/treat or water additive and they develop diarrhea or vomiting, don’t give it!

 

  • The daily caloric impact of the treats: It’s easy to lose track of how many calories your pet is getting each day when you factor in all the treats and “extras” they get. Remember that even if a treat is 50 calories - that may be 10-15% of the daily caloric requirements for a 20# dog. Those calories really add up, and while we want to take care of our pet’s teeth we don’t want to give them another problem (obesity) instead.

 

  • The size of the treat needs to be appropriate for the size of the pet. This is especially important for small dogs trying to ingest a chew that is too large and large dogs given a treat that is too small (and then “inhaling” it). If your pet does not chew the product thoroughly, discontinue use of the treat, as this can pose a risk for the treat becoming lodged in the esophagus (as well as no longer being effective for it’s intended purpose of reducing plaque/tartar.)

  • Pet dogs should be monitored while chewing a chew treat or toy, as they may swallow large pieces, leading to a variety of digestive system disorders.

Is my pet’s dental health really that important?

Well, like people, every pet’s mouth is different. Some animals and breeds are more susceptible for dental disease than others. In some animals a neglected mouth will result with some degree of plaque build up over time, and gingivitis (or inflammation and infection of the gums). But in some animals that neglected mouth will lead to severe infectious of the mouth, abscesses, pain, bad breath, and can make it more difficult to regulate other disease processes (such as diabetes). In the more severe cases, treatment may involve tooth extractions or complicated dental procedures and can lead to infections of the liver, heart and other internal organs.

In the majority of cases, dental disease is a condition where “an ounce of prevention is worth a pound of cure” -- small preventative measures such as regular brushing, appropriate chews, treats and water additives can significantly slow the progression of gingivitis, plaque and tartar accumulation.

Pet Dental Care - The Basics

February is “pet dental health month” so we’re going to dedicate our post this week and the end of the month to pet dental health. Now - this doesn’t mean your pet’s dental health should be neglected for the rest of the year!

In the majority of cases, dental disease is a condition where “an ounce of prevention is worth a pound of cure” -- small preventative measures such as regular brushing, appropriate chews, treats and water additives can significantly slow the progression of gingivitis, plaque and tartar accumulation. So regular dental upkeep and monitoring (yes, that means year-round, and that means actually looking in your pet’s mouth!) are such an important aspect of whole-pet wellness and care.

What is periodontal disease?

Periodontal disease is the inflammation and infection of the structures around the teeth, which include the gums, the ligament that attaches the tooth to the bone, and alveolar bone itself. In the earliest stage of periodontal disease — gingivitis — the inflammation and infection of the gums. In more severe forms of the disease, all of the tissues are involved.

Plaque is the build up of a “slime” layer of bacterial colonies along the gum line. As this plaque sits there longer it starts to mineralize and becomes Tartar.

What is the best way to prevent periodontal disease?

Well, it’s brushing! Unfortunately, though, in order for brushing to be most effective you need to brush your pet’s teeth at least 3 times a week...and like with us...daily is best!  Obviously, your safety is first and foremost in all circumstances, but for most dogs, and even cats, teeth brushing can be a pleasant, non-stressful experience. Check out our video for instructions on how to brush your pet’s teeth. There are fancy pet toothbrushes and enzymatic toothpastes out there - which are all great - but sometimes they create barriers or excuses that keep the brushing from actually happening. One way we recommend to brush teeth is to take a gauze square on your finger - no toothpaste or anything else on it - and wrapping your finger in it; then using that to brush/massage the gum line. You’d be amazed the amount of plaque you can get off (and you can actually SEE it on the gauze) with that technique.

The take-away: The best brushing is the one that actually happens, and we tend to find that the fewer gimmicks involved set us up better for success. That may be with a classic toothbrush, with a fingertip toothbrush or with a gauze square.

Is my pet’s dental health really that important?

Well, like people, every pet’s mouth is different. Some animals and breeds are more susceptible for dental disease than others. In some animals a neglected mouth will result with some degree of plaque build up over time, and gingivitis (or inflammation and infection of the gums). But in some animals that neglected mouth will lead to severe infectious of the mouth, abscesses, pain, bad breath, and can make it more difficult to regulate other disease processes (such as diabetes). In the more severe cases, treatment may involve tooth extractions or complicated dental procedures. Additionally, periodontal disease in general can lead to infections of the liver, heart and other internal organs, so should never be considered “just a dental” problem.

What happens when we have disease that can’t be managed with at-home care? Well, then we would discuss an anesthetized dental procedure for your pet. This allows us to fully assess the tooth and gingival health, take dental x-rays to assess tooth root and bone health and fully clean (including beneath the gum line) the teeth. Sometimes we find that teeth are far more diseased that what initially meets the eye and extractions or referral to a veterinary dentist may be indicated to bring the mouth back to health.

In our next post we’ll discuss treats and chews for our pets and give some guidance on how to pick the right one for your pet to maximize on their dental health.

More Specialists Your Vet Might Recommend

In a followup to our last post, we will discuss below some of the different veterinary specialties and why we might refer to them.

To recap, many of our daily appointments consist of pets that are not feeling well for a variety of reasons. In many instances we can determine the problem and treat effectively by obtaining a thorough history, performing a comprehensive physical exam, perform in-office diagnostics or send lab work out to a reference laboratory, and dispensing appropriate medications or treatments.

However, in some instances, problems may be more complicated or require diagnostics beyond the scope of a general practice, and a veterinary specialist may be recommended.

Behaviorist: A veterinary behaviorist is sort of a mental health professional for dogs. For some dogs, anxiety is such a large issue that certain medications we prescribe are not enough to help and, unfortunately, some dogs will hurt themselves in their crates by chewing or scratching (think of it like a panic attack). In these extreme instances, utilizing a behaviorist can help narrow down certain triggers and they can also help prescribe different medications in conjunction with a training program to help resolve these issues. Behaviorists can also be invaluable in handling a pet with difficult aggression issues that may provide a safety concern if not handled appropriately.

Dentist: It’s safe to say that most of our veterinary patients have a varying degree of periodontal disease. A dental cleaning, complete with dental radiographs, and polishing/fluoride treatment, can be done with your primary veterinarian. Many extractions can also be done with your primary veterinarian. However, sometimes the pathology in the mouth is so severe that referral to a veterinary dentist is required. They are trained to perform root canals and other endodontic treatments, or even remove parts of a jaw if there are tumors or abnormalities within the jaw bones.

Dermatologist: Veterinary dermatologists are incredibly helpful in diagnosing a multitude of skin disorders that we see on a daily basis, including allergies. After trying many different types of therapies here at our clinic, sometimes the use of a dermatologist, who may have access to newer drug therapies or diagnostics, is the best way to help your pet find relief. They can also perform skin biopsies, intradermal skin allergy testing, and different skin cultures/cytologies, etc…

Ophthalmologist: Veterinary ophthalmologists examine and correct a variety of different ocular diseases – both within the eye and on the surface. Their expertise includes, but is not limited to, performing surgeries (such as cataract surgery or third eyelid/”cherry eye” correction), managing glaucoma and complicated corneal defects, treating inflammatory conditions of the eye, etc…They also have special equipment to look at ocular structures better than most general practices.

Radiologist: Sometimes our veterinary patients eat abnormal things, or have recurrent bouts of vomiting/diarrhea. Other times we may find something abnormal while we are palpating the abdomen during a routine physical exam. Radiographs (X-rays) are a useful tool for looking at the size and shape of organs and noting if anything appears abnormal.

However, if your pet ingested something soft and we are unable to see it on an X-ray, an abdominal ultrasound will look at the internal structure of organs and determine if this object is stuck. Ultrasounds can also find tumors on some organs that are not easily identifiable via X-ray, such as the adrenal glands. Radiologists also have additional training in reading X-rays, MRIs and CT scans which can help us pick up and find subtle changes that can help us with a diagnosis.

For cats with hyperthyroidism, a veterinarian in a specialty hospital with the capacity to handle radioactive material can also administer a highly regulated radioactive isotope that can treat hyperthyroidism in one injection (with several days in the hospital for monitoring afterwards) if it is indicated by your primary veterinarian. Sounds crazy, but it’s also the treatment of choice in people, as well.

Veterinary specialists are great resources for your pets when your primary care veterinarian thinks their expertise will be needed to help make your pet feel better, faster! We are fortunate to live in an area with numerous specialty-trained veterinarians to help us provide the best care for our pets.

Why did my vet recommend a specialist?

Many of our daily appointments consist of pets that are not feeling well for a variety of reasons. In many instances, we can determine the problem and treat effectively by obtaining a thorough history, performing a comprehensive physical exam, perform in-office diagnostics or send lab work out to a reference laboratory, and dispensing appropriate medications or treatments. However, in some instances, problems may be more complicated or require diagnostics beyond the scope of a general practice, and a veterinary specialist may be recommended.  

Many people are surprised to hear that there are specialists for animals! So, what exactly is a veterinary specialist you may ask? A veterinary specialist is a veterinarian who has gone through at least four additional years of training above and beyond the four-year veterinary school education. This typically consists of a one-year internship program, followed by a three-year residency program focusing on their preferred area of specialty. They then have to sit for their national specialty examination before receiving their board-specialty certification.  

Below are some examples of specialists and why we may refer a pet to them. We’ll discuss other specialities in two weeks with our next post.

Emergency & Critical Care SpecialistLet’s face it, sometimes our pets get so sick that they needs some pretty intensive care! Emergency clinics that have a criticalist on staff have the capacity to do some extremely intensive care, including ventilatory support (i.e. breathing for the patient in an acute lung injury), in-hospital feeding tubes, extensive nursing management and tend to be on the cutting edge with treatment options for some really complicated, really sick cases.

InternistWhen we just can’t seem to find the answer to a pet’s metabolic woes or advanced diagnostics (such as endoscopy or bronchoscopy) are needed — and an internal medicine specialist is often recommended. They excel at complicated case work-ups and are very good at long-term patient and chronic disease management. The types of cases that we often request their assistance with are complicated diabetics, certain respiratory disease, multiple metabolic disease processes occurring at once, and certain infectious, inflammatory and autoimmune diseases. Their wealth of knowledge can be invaluable with making treatment decisions and when changing medications, doses, etc. to find just the right balance for a given patient. Subspecialties within internal medicine include:

Cardiologist: Sometimes we will hear a heart murmur or abnormal heart sound when performing a physical examination. A murmur is turbulent blood flow through the heart, but just listening to the heart doesn’t tell us exactly why the murmur is present. In these cases, we will refer your pet to a veterinary cardiologist to perform an examination and an echocardiogram (an ultrasound of the heart). This will help determine the source of the abnormality. Puppies and kittens may have congenital abnormalities that can be fixed via surgery. Cardiologists also can place pacemakers in certain conditions where the abnormality has to do with the electrical conduction through the heart.

Neurologist: Unfortunately, sometimes our pets go through a variety of neurological disorders. This can include herniated disks in their back, tumors within the brain, congenital abnormalities, seizures, etc. Seeing a veterinary neurologist can help narrow down the cause for some of the signs you are noticing at home and they can also perform MRIs/CT scans on your pets to determine the next best step for treatment. Veterinary neurologists are also trained to perform spinal and brain surgeries.

Oncologist: Many types of cancers in veterinary patients can be surgically removed by your primary care veterinarian, but there are certain types of cancers that do best with surgical removal followed by chemotherapy and/or radiation therapy. These are two types of treatments have to be administered by a veterinary oncologist and may help prolong the quality of life-span of your pet.

SurgeonMost primary care veterinarians can perform routine surgeries, including limb amputations. However, sometimes your pet has injured themselves to the point of needing a veterinary surgeon to repair the damage, or requires a complicated surgery that is beyond the scope of general practice. Examples of this include torn ACL repairs, performing a total hip replacement, complicated tumor removals, surgery entering the chest cavity or around the heart, repairing complicated congenital defects, to name a few.

Veterinary specialists are great resources for your pets when your primary care veterinarian thinks their expertise will be needed to help make your pet feel better, faster! We are fortunate to live in an area with numerous specialty-trained veterinarians to help us provide the best care for our pets.

New Years Resolutions 2017

We all know the drill — new year, new commitment to healthier living, lifestyle and relationships!

From your pet’s point-of-view, here are a few:  

  • I will resolve to limit myself to a strict calorie intake appropriate for my lean body weight — just like the rest of us, maintaining a lean body weight is the number one thing we can do for our pets to help them stay healthy! Unlike us, pets can’t count calories, so it’s up to us to be sure they are being fed an appropriate and balanced diet. It’s also important to be sure your pet is eating an age-appropriate diet — the AAFCO (American Association of Feed Control Officials) designates every food as appropriate for all life stages, maintenance, or growth and lactation.  

While an all life stages food may seem appealing, this often may not be the best choice for a pet with underlying health conditions or that is overweight. Additionally, for some medical conditions (i.e. kidney disease, pancreatitis) a prescription diet may really help to prolong the health and well-being of the pet.  

  • I will bug and pester my owners until they take me for at least two (preferably three to four) long walks a day, or engage in an appropriate play session with me — getting plenty of exercise is good not only for the waistline, but also for your pets. Exercise is critical for maintaining balanced behavior and reducing boredom in dogs and cats.
  • I will be sure that my parents pay attention to those pesky reminders from the veterinarian letting them know when I need to get my vaccines updated, so that I stay protected from some of those icky diseases out there.  
  • I promise to take my heart-worm and flea/tick prevention regularly and won’t spit it out — even though I sometimes resist, I know that these are good for me and are protecting me from lots of gross bugs and diseases! — in addition to preventing heart-worm disease, the monthly preventative pill also protects against hookworms and whipworms, which are intestinal parasites quite common in our area.
  • I will get my owners involved in a new activity — I’ve even heard of activity-specific meet-up groups for other dog owners! 
  • I will be cooperative for getting my teeth brushed, much as it pains me! — Daily (or a minimum frequency three days a week) teeth brushing is the single best (and least costly) way to maintain good oral health. Most dogs will get very comfortable with this once it becomes a routine — some even come to love brushing thanks to flavored toothpastes (cats too!)  
  • I will work on my obedience during leash walking so I pay full attention to my owner and no other dogs on walks — Many dogs are leash reactive and this is a very common occurrence that is hard for some owners to pick up. Working with a certified trained dog trainer and daily “homework” on walks can help solve some leash aggression and can also help the dogs (and owners) anxiety!
  • I will try to love when my owners play with my feet! — Many dogs and cats are scared of getting their nails cut. Petting their paws at home and getting them used to you feeling their nails and isolating each digit can actually help the anxiety that comes with nail trims, as this can de-sensitize them to the feeling of their nails being touched for the trims.
  • I resolve to experiment with new serving equipment for my food. It’s out with the bowl and in with the puzzle toys for me! Traditional food bowls are unstimulating and allow for too fast meals. Puzzle toys and food toys for both dogs and cats increase mental activity and decrease regurgitation from rapid eating.

Low-Stress Cat Transportation

Does your cat hide as soon as you break out the carrier from the garage or the closet? Have you ever had to cancel or reschedule an appointment because you can’t corral your kitty?

Read on for some tips on making transportation (be it to the vet office or just for a trip) a little bit easier for everyone.

Preparation:

Easy transportation starts with a good carrier. A hard sided carrier with an easy to remove top is best. Hard sides provide structure and prevent the carrier from collapsing in on your cat while you’re carrying it. A removable top circumvents the need to remove the cat from the carrier once they arrive for their appointment. Many cats prefer to stay in the bottom half of their carrier while being examined and receiving vaccines because it is familiar.

Pheromones on the bedding will also help many cats enjoy the experience of being in their carrier. The kitty pheromone we particularly like is called Feliway and can be purchased as a spray or a plug-in diffuser. Feliway is a synthetic version of the facial pheromone cats leave naturally while rubbing their faces against an object or a person when they are comfortable in their environment. The spray is most appropriate for use with the carrier; 10 sprays should be applied to the bedding at least 15 minutes before your cat will be going in the carrier, to allow time for the alcohol solvent in the spray to evaporate. This application will last for up to 5 hours, but can be reapplied as needed.

After you’ve picked out an appropriate carrier, put it somewhere your cat already likes to sit. Most cats will prefer it on an elevated surface. Take the top half of the carrier off so it’s more open.  Play with your cat in and around the carrier. Place bedding (towel, old sweater) that you cat likes, food, treats, toys, or catnip in the carrier to entice your kitty to enter the carrier on their own. Once they enter the carrier, reward with treats. If your cat is suspicious of this new piece of furniture, leave it out (with the top off) with food or toys inside and allow them to explore it over a period of days or weeks.  It’s crucial to leave the carrier out all the time, rather than pulling it out just before a car ride – as then they know something is up and only associate it with potentially traumatic experiences.

Game time:

Again, when it’s time to transport your cat in the carrier, spray pheromones in the carrier at least 15 minutes before it’s time to go. Allow your cat to get in on their own whenever possible. Transport one cat per carrier. Even cats that share a bed or sleep in a carrier together at home may become overly stressed when transported together and fights could occur. Cover the carrier with a pheromone-sprayed blanket to reduce sights and sounds both during transport and upon arrival to the clinic. If your cat enjoys them, place treats, toys, or catnip in the carrier.

When moving the carrier, hold it with both hands at chest level to avoid swinging and the cat being at eye level with dogs. Ignore the handle on the top of the carrier – it’s not a suitcase! When the handle is used, the carrier will tend to swing slightly and that can be very scary for the carrier’s occupant. Avoid startling noises during the transport. Quiet, familiar, calm music or silence in the car is fine. Secure the carrier on the floor behind the passenger seat. Once in the hosptial, face cat away from unknown people and pets in the waiting room.

Returning home:

It can be hard for cats to reintegrate with housemates after a vet visit. Your cat will smell very different, be stressed, might not be feeling well, and could even be sedate from medications used in the hospital. If any sedation was used, keep your cat in a separate space until the sedation has worn off. A good rule of thumb is 12 hours of separation. When it’s safe to re-introduce your cats, start by re-establishing a common scent profile. Take a rag or shirt and rub down the cat who was out of the house, then take that fabric and rub down the other cat, continue with the same fabric for each cat in the house, end by re-rubbing the cat who was out of the house. This will get everyone smelling the same and minimize signals that the cat who was gone is now an outsider. Supervise interactions until you’re sure they are getting along well. This may sound excessive, but we hear horror stories from owners whose cats have been at odds for weeks after one has visited the vet or other outside situation.

These steps can help reduce the stress of a vet visit for your cat and for your family. If you experience any issues during this process, let your veterinarian know and they can help you troubleshoot. A less stressed cat is a calmer and happier cat, and a happy cat can be examined fully and allow necessary tests to be done more easily so the highest quality medical care can be provided for your furry friend.

Dogs and Cats are Not Small Humans

Sometimes it’s hard to say that our fur-kids really are not human. Many of us love them and treat them like they are. While we could argue behavioral and psychological reason for and against that perspective, one thing that is pretty straight forward is drug metabolism…

Dogs and cats are not small humans and cats are not small dogs. Each species has very different abilities to metabolize certain drugs and as such, there are some human medications that should NEVER be given to our pets, some that can under direct supervision of a veterinarian, and some that are fine to use but may require a different doses for our pets than humans.

NEVER:

Tylenol (acetaminophen), in cats: Causes a life-threatening inability to deliver oxygen to tissues.

Pepto Bismol in cats and dogs: Contains aspirin in a form that is not useful for treating any condition and often causes GI bleeding.

Breath Fresheners in dogs and cats: Some human breath fresheners can contain xylitol, which has the potential to cause the blood sugar to drop dangerously low (hypoglycemia), causing loss of motor control or even seizures; and even liver failure.

Ibuprofen in dogs and cats: Very easy to overdose and can cause symptoms ranging from upset stomach, gastrointestinal bleeding, kidney failure and acute neurologic symptoms.

Pseudophedrine and phenylephrine in dogs and cats: Can cause gastrointestinal symptoms, agitation and heart rhythm disturbances.

ONLY UNDER VETERINARY DIRECTION & SUPERVISION:

Aspirin in dogs and cats: If given at high enough doses to help with inflammation, aspirin almost always causes gastrointestinal bleeding. There are far better and far safer medications to help with inflammation (arthritis and pain). We can use it safely in very low doses to reduce platelet activity and clotting in certain disease situations that predispose clotting.

Immodium AD in dogs: While not toxic to most dogs, some dogs may carry a genetic mutation that makes the more sensitive to the effects of this drug and can lead to seizures and even coma.

GenTeal Eye Lubricant: This is a useful artificial tear supplement when your dog has been accurately diagnosed with Keratoconjunctivitis Sicca (AKA “Dry Eye”). Eye issues can quickly go awry, so always have a veterinarian exam before trying to treat at home.

Tylenol in dogs: The dose range is pretty narrow and it’s definitely not a first-line pain medication in dogs. We tend to use it more with severe pain, and in combination with codeine. Overdosing can cause severe liver disease and so should only be used exactly as directed and prescribed by your veterinarian.

Antihistamines in dogs and cats: Claritin (loratidine), and Zyrtec (cetirizine) can be used to reduce itching. Claritin and Zyrtec tend to be better for general allergies in our dogs, but they do not cause drowsiness in dogs and cats they way they do in humans, so don’t try these as a sedative. Talk to your veterinarian about dosing. **Be sure NOT to use an antihistamine that contains Pseudophedrine – such as Zyrtec-D or Claritin-D**

SAFE TO USE (though we still recommend consulting with your veterinarian before starting these medications):

Pepcid AC (famotidine) in dogs and cats: Pepcid and other antacids such as Zantac (ranitidine) or Prilosec (omperazole) are safe for pets and used for many different diseases (such as gastroenteritis, kidney failure and liver failure). Check with your veterinarian for dosing.

Antihistamines: Benadryl (diphenhydramine) tends to be better for acute allergic reactions (such as bug bites and contact allergies that cause hives) and may cause mild drowsiness. It doesn’t do nearly as good a job for general allergies as some of the newer antihistamines. The dose is 1mg per pound of body weight every 8-12 hours for allergic reactions (so a 25lb dog would get 25mg every 8-12 hours). If the symptoms are not improving within 24 hours of starting Benadryl or if the allergic reaction is getting worse in spite of using Benadryl — your pet needs to be seen by a veterinarian!

Meclizine in dogs: This is a motion sickness medication, similar to Dramamine, that can be helpful for reducing car sickness and doesn’t cause much drowsiness. The dose is 12.5mg-25mg per dog given 1-2 hours before a car ride.

Topical ointments with a numbing cream: In most cases, a topical Bacitracin ointment is likely okay to use, but when they are supplemented with a pain numbing cream, such as hydrocortisone or tetracaine, these can be toxic if ingested.  Most dogs and cats tend to lick ointments immediately after application and we often recommend the use of an e-collar (i.e. the cone of shame) when using topical medications.

Additional resources on toxic and non-toxic household items, plants and medications can be found at ASPCA’s Animal Poison Control’s website: http://www.aspca.org/pet-care/animal-poison-control

Hypoallergenic Diets

Does your pet have chronic or intermittent diarrhea, but otherwise feels great? Does he or she itch and scratch constantly, have hair loss, repeated skin infections, ear infections or rashes? If you answered yes, read on, as your pet could possibly have a food allergy.

What are the most common food allergies?

Contrary to all the pet-food company marketing, it is rarely grains! The vast, vast majority of the time, the allergy is to the animal protein source, with chicken being the most common, and then beef.

What’s the difference between a food allergy and a food sensitivity?

An allergy implies that the body’s immune system is involved in the symptoms; whereas food sensitivities can cause similar but often milder symptoms that are due to a local reaction in the GI tract (think lactose intolerance in people). A food sensitivity may improve simply with a diet change to a new brand or variety, whereas a food allergy is related to the body being sensitized via the immune system to a specific ingredient.

How is a food allergy diagnosed?

Unfortunately, a true food allergy can be difficult to definitively diagnose. There is noaccurate blood test for food allergies (though Dr. Google may suggest otherwise), and the only way to really diagnose a food allergy is to do a STRICT trial with a hypoallergenic or hydrolyzed diet for 8-12 weeks. Because it can take days to weeks for an offending protein to fully be eliminated from the body, and also significant time for the GI tract to heal following insult, the full 8-12 weeks is vital to ensure we allow enough time to see clinical improvement if it is going to happen!

Not only that, in order to make a truly definitive diagnosis, at the conclusion of the food trial one must reintroduce the original food to see if the symptoms return! Understandably, many owners are reluctant to go this final step if their pet’s symptoms are significantly improved, but without it we do not know if improvement was just a coincidence (or perhaps due to some other treatments that may have been initiated at the same time or a changing of seasons).

Essentially, a food trial is a diagnostic test — but one that takes 8-12 weeks to get results.

What make a diet hypoallergenic?

A hypoallergenic diet is designed to be absent of the ingredients most likely to trigger a true allergic response. Again, protein sources are much more likely to be the culprit than grain or other ingredients. There are two ways to address this protein issue — one is with a “novel” protein — i.e. a protein that the patient has never been exposed to previously — and the other is with a “hydrolyzed” protein — i.e. a protein that is broken down into such small pieces during the manufacturing process that it is not recognized as foreign by the body.

A thorough dietary history is very important when figuring out which hypoallergenic diet route to go. If the pet has been exposed to a variety of protein sources throughout their life, a hydrolyzed diet may be a better option.

It is important to note that many of the over-the-counter (OTC) diets that may tout themselves as being lamb, bison, turkey, etc. actually do have chicken further down the ingredient list. OTC diets are frequently contaminated with minuscule amounts of non-ingredient proteins as well. Thus, for the purposes of a strict food trial, we are more apt to recommend a prescription diet that is strictly controlled in the manufacturing process and is guaranteed to be a single protein source. In a very sensitive pet, even having a trace of the offending protein (such as, may remain if there was not strict cleansing of the equipment between processing of different diet varieties) could be enough to trigger symptoms. There are a limited number of OTC options that may be viable alternatives to a prescription diet, but these should be discussed with and approved by your pet’s veterinarian prior to going to the effort of a full food trial with them, as in some cases they may not be sufficiently “hypoallergenic.”

This sounds hard!  

There’s no arguing that a strict food trial requires some restraint and diligence on the part of the owner! Treats play an important role in our relationship with our pets, and having to be really strict can be tough…but it important to remember that it’s for a relatively short period of time and that eventually you will be able to slowly reintroduce things into your pet’s diet.

It is also important that all members of the family be on board with a food trial before it’s initiated — again, all it takes is a single exposure to the offending protein to set things back to the beginning!

Good news — you finished the food trial and your pet’s symptoms are improved. Now what?

At this point, we’d typically recommend SLOWLY reintroducing things back into your pet’s diet, but still being sure to avoid the suspected offending protein — i.e. each week, add one new item back into the diet, monitoring for recurrence of the original symptoms.

Bad news — you finished the food trial and your pet’s symptoms are not improved. Now what?  

Fret not — all is not lost! You’ve still gleaned some very valuable information by ruling out a food allergy. In the case of skin symptoms, environmental allergies may be a factor and in the case of GI symptoms, a whole plethora of other possibilities remain. It will be important to work with your pet’s veterinarian to continue looking for the cause of chronic skin or GI symptoms.

Strange Veterinary Terms

Have you ever heard your doctor or pet’s veterinarian rattle off a list of strange words that seem to make no sense? Most of these are derived from Latin roots and serve to concisely describe what otherwise may be a wordy description.

Borborygmi  of Greek origin, indicating a rumbling of the gastrointestinal tract as the small intestine contracts to move ingesta through

Brachycephalic  Greek for “short head,” or a “smooshed”-faced skull conformation — i.e. Pugs, Boxers, Boston terriers, Shih Tzus

Coprophagia  The eating of feces, derived from Greek copros – “feces” and phagia – “to eat.” This rather icky tendency, especially in dogs, is also typically behavioral in nature, rather than due to a nutritional deficiency. Though animals such as rabbits will do this to maintain gut bacterial populations.

Crepitus  Grinding, creaking, cracking, grating, crunching or popping that occurs when moving a joint; Latin for “rattle” or “crack,” most often appreciated in arthritic joints

Cryptorchid — A condition that occurs when one (or both) testicle does not descend into the scrotal sac

Dolicephalic — Greek for “long”-faced skull conformation — i.e. Collies, Greyhounds, many other sight-hound breeds

Emesis — Vomiting, from the Greek word emein, which means “to vomit.” We often prescribe antiemetics to control or stop vomiting in our patients.

Hematemesis — Blood in the vomit

Hematochezia — Blood in the stool

Hematuria — Blood in the urine

Idiopathic — A condition with unknown cause or spontaneous origin and derived from Greek idios – “one’s own” and pathos – “suffering.” Basically, a fancy way to say “we don’t know.”

Melena — of Greek origin. The passage of black, tar-like stools indicating the presence of digested blood (happens with gastric or small intestinal ulceration & bleeding).

Ovariohysterectomy — Removal of the ovaries and uterus (commonly referred to as a spay)

Orchiectomy — Removal of the testicles (commonly referred to as a neuter or castration)

Peristalsis — Muscle contractions that propel food throughout the gastrointestinal tract

Pica — The appetite for non-nutritive substances such as dirt, hair or paper. In dogs and cats, is more often due to behavioral or primary gastrointestinal tract disease — that results in inadequate absorption of nutrients — reasons rather than an inadequate diet. Derived from the Latin name of the magpie bird, who reportedly was willing to eat nearly anything.

Polydactyl — Quite literally, “extra fingers,” typically seen in cats that will have more than the typical five digits

Stomatitis — Inflammation of the mouth; from Greek work stoma for “mouth”

Tenesmus — Straining to defecate; via Greek teinesmos, “straining,” fromteinein, “stretch, strain.”

And, even though this isn’t particularly relevant to us in veterinary medicine, this one is just too fun to not mention:

Sphenopalatine ganglioneuralgia — An “ice cream headache,” which is actually referred nerve pain at the sphenopalatine ganglion area of the brain caused by quick consumption of COLD beverages or foods