Popular Posts

Friday, July 30, 2010

Brutus and Benson -My Friends

The past week has been rough for me. I found out that two good buddies of mine have malignant cancer. To make matters worse, the cancers have metastasized in both cases, meaning surgery is not an option. Yes, my friends Brutus the Rottweiler and Benson the Golden Retriever probably have only a few weeks to live if they receive no treatment. Happily, their pet "parents" have elected to have them undergo chemotherapy for their cancers.

"What?! Chemotherapy? For a dog? You have got to be kidding! I would never put my dog through that. Who wants their beloved pet to have all his hair fall out, vomit all the time, or waste away from chemo? Besides, the expense must be ridiculous. I mean I love my dog as much as the next person, but...chemo?" This is a typical response a person gets when their friends find out they've chosen chemotherapy to prolong the life of their pet.

What's important to understand is that chemotherapy in pets is pretty different from chemotherapy in people. The primary difference is that in people, the goal is usually to affect a cure. In pets, the goal is to improve and prolong the life of an animal with cancer. We use the same drugs as in people, but at lower doses. Side-effects are still possible, and potentially very serious, but whereas side-effects are expected and accepted in human patients, our goal is quality of life throughout the treatment process for our canine and feline patients.

Cost certainly can be a factor. Benson's chemo (which will be administered by a veterinary oncologist) is something like $500-$600 per treatment for four or five treatments. Brutus' chemo will be given by me (he has a more common form of cancer), and will average $100-$150 per week for twelve weeks. There are no guarantees of success for either dog, but we are hopeful to give them each another happy year with their families.

I'm certainly not saying that everyone who has a pet with cancer has a moral obligation to put them through chemo, but many people dismiss the notion immediately, before they even understand what they're rejecting. It is true that some pets are just too sick to get chemo, and in those cases I don't even recommend it. Almost all the patients I've given chemo to have benefited, for some length of time, from the improved quality and quantity of life chemo has given them.

So keep your fingers crossed for Brutus, Benson, their families, and me. I'd sure like to see their smiling faces and wagging tails for at least another year.

Friday, July 23, 2010

"Senility" in Dogs and Cats-There is Hope!

A friend emailed me a story from the Huffington Post (Google it!) in which a human neurologist writes about dementia in her two dogs and how it resembles Alzheimer's disease in people. The dogs suffered from a condition called Cognitive Dysfunction Syndrome (CDS), and it is much more common than you think. Because there is no readily-available test for CDS, and many people attribute the symptoms simply to "old age", I feel CDS is dramatically under-diagnosed, and therefore under-treated.

CDS almost always occurs in older pets and is a result of pathological changes in the brains of those affected. The symptoms have a slow, insidious onset, and may be somewhat benign at first. In dogs, the symtoms of CDS which you may overlook include: decreased attentiveness, less enthusiasm when greeting you, increased sleep time, changes in appetite, and staring into space. Just sounds like a dog who is getting older, doesn't it? Unfortunately, the symptoms usually become more serious over time: getting "lost" in the back yard or "stuck" in corners, having accidents in the house, becoming restless at night, not recognizing familiar people, and/or not responding to verbal commands or their own name. Symptoms in cats are similar, but even more difficult to recognize because, well, they're cats, and they tend to be less interested in verbal commands and the affairs of people in general! (By the way, I am a "cat person", with three of my own at home.)

If pet-parents aren't aware of this disease, they may assume their pet is just getting old and won't report the symptoms to their vet. This is a shame, because we can help them! The therapy consists of a very effective (in most cases) medication called Anipryl (Pfizer), and increased attention and interaction with the pet. Also, there is a prescription dog food called b/d Diet (Hills) which has been shown to improve "learning" in senior dogs. We have recently been trying a holistic medication called Senilife (Ceva).

Most of the "parents" of my CDS patients have been incredibly grateful once the therapy starts working. They feel like they're getting their pet back. The disease is not curable, but it is also not fatal. So pay attention to the signs of "old age" in your senior pets. It may be something more.

Wednesday, July 14, 2010

Parasites in Cat Hearts

When I was in vet school, I was taught that cats don't get heartworms. Well, that was good, because there was one less thing to worry about in my feline patients. Unfortunately, they taught us wrong. Cats DO get heartworms, and probably more often than we realize.

The problem is, heartworms behave very differently in cats than in dogs. In the cat, heartworms rarely become adults. It is a tiny larval form of the worm that usually causes all the trouble. And it does cause trouble! These larvae reside in the cats' airways where they may cause significant damage, even though the cats may show no symptoms at all. After a few months, these immature worms die and cause a much greater inflammatory response in the lungs resulting in coughing, difficult breathing, and sometimes death. Cats with these symptoms may be misdiagnosed as having asthma.

You see, there really is no good diagnostic test for heartworms in cats. They can even be missed at autopsy. I wonder how many cats over the years I thought had asthma that really had heartworms. To make matters worse, there's no good way to safely cure a cat that has heartworms. We just treat the symptoms and hope for the best.

The solution is to prevent cats from getting heartworms to begin with. Since heartworms are spread by the bite of a mosquito, all cats (EVEN INDOOR CATS!) are susceptible. I recommend that all my feline patients take monthly heartworm preventative. My favorite is Revolution. It's a topical spot-on product applied once a month which also does a great job at killing fleas and intestinal worms. It is a prescription product, so you can't get it at Rural King, the pet store, etc... My opinion is that all cats should be on Revolution year-round.

Friday, July 2, 2010

Routine Labwork in Healthy Pets - Waste of Money?

I had a couple of interesting cases last week which inspired this blog. The first was an eight year old cat who came in for her annual vaccine visit and wellness exam. She was a new patient at our hospital. Her owner said she was doing fine, but maybe had lost a little weight, which she attributed to the cat getting older. We advised the owner that we recommend routine labwork on annual wellness visits just like MDs do for people. She consented, and low and behold, the cat had a serious thyroid imbalance (hyperthyroidism). This condition is usually fatal if untreated, but the prognosis is good with treatment. The cat was lucky we caught it early!

The second case was a little less dramatic. It involved a healthy little dog who also came in for his annual wellness visit and vaccines. On his labwork we found that he was infected with a protozoan parasite called Giardia, which is potentially contagious to his owner. Like the cat's hyperthyroidism, this condition can cause serious health problems if allowed to continue untreated, not to mention the risk to the owner's health.

It is a very rare week when I don't have at least three or four patients who come in for their "shots", but have some undectected condition which will threaten their health. These conditions are usually VERY easy to treat when detected early, and VERY difficult (and in a few cases impossible) to treat when the pet is showing advanced symptoms.

I'm the "old fogey" at our practice, and I was resistant to the idea of routine labwork for healthy patients at vaccine visits. One of my associates convinced me about seven years ago to give it a try, and I am now leading the parade for wellness labwork. I do it for myself (through my MD), I do it for my pets, and I recommend it for yours.