tag:blogger.com,1999:blog-37772414465382078602024-03-13T00:04:03.296-05:00Horseshoe Lake Animal HospitalDr. David Hallhttp://www.blogger.com/profile/06298254530599841492noreply@blogger.comBlogger67125tag:blogger.com,1999:blog-3777241446538207860.post-13635229302404232172016-09-27T11:53:00.001-05:002016-09-27T11:53:28.754-05:00The Social Media MonsterHi guys! I am a hypocrite.<br />
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I am writing this to (mostly) complain about social media. Then, I will post it ... on social media.<br />
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It's pretty self-evident that as a service provider, social media is quite the mixed blessing for my practice. I am certain that the same can be said by any person or business in the public eye. When people share their great experiences at our practice (or <i>we </i>share something positive about our practice), it's really gratifying to know that we did well. It's even better to think that someone who might be looking for a veterinarian could see that post and seek us out.<br />
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I also enjoy the opportunity that social media gives us to share our celebrations (Dr. Gammon had her baby!), accomplishments (congrats to Dr. Randla on completing his "Cat-Friendly" certification), and helpful information (here's what you need to know about Canine Flu). It is also a great place to recognize special organizations and promote their needs (Partners 4 Pets needs help paying for "Arrow's" surgery), and highlight our patients ("Peanut" turned 20 today!)<br />
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But of course social media is a fickle friend. If someone is <i>not </i>happy with their experience here, they have a public platform on which to share how rude/incompetent/greedy etc... they perceive us to be. Fortunately, that doesn't happen often, but when it does, it is obviously very hurtful to all of us.<br />
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I will be the first to admit that we don't always get it right. Like everyone else, we sometimes make a mistake. I have always felt that the best way to judge any business is their willingness to "make right" their mistakes. We take a great deal of pride in our willingness to do that. But I admit that I miss the "old days" when people who were unhappy would call or come in to the office with their complaint. These grievances were (and still are) taken very seriously, and usually rectified, to the best of our ability, by myself or our Practice Manager.<br />
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You see, most complaints we get originate from some misunderstanding. We preach and teach communication skills to all our staff because of this. If we get a chance to hear why the client is unhappy, we can often correct the misunderstanding, apologize for our part in it, and make it right. This process cannot happen on social media. Not even close. And of course, now all of that person's "followers" have heard only one side of the story. Ugh.<br />
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As a greybeard, I have had many veterinarian friends complain to me about the social media "monster." I usually tell them that we all have to take the bad with the good. But I do wonder why, if someone truly wants a solution to some problem that we have caused, they don't pick up the phone and give me a call?Dr. David Hallhttp://www.blogger.com/profile/06298254530599841492noreply@blogger.com5tag:blogger.com,1999:blog-3777241446538207860.post-81734700198141067712016-03-29T13:43:00.001-05:002016-03-29T13:43:27.313-05:00Antibiotic-Resistant Bugs Threaten Pets and Owners Some of you may be familiar with the acronym "MRSA" (pronounced <i>mer-sah</i>). It stands for Methicillin-Resistant Staph Aureus. MRSA is a bacteria which is resistant to most antibiotics, and people who get it can die from it. However, people can carry the bacteria and have no symptoms at all; it's usually folks who are compromised in some other way (very old, pre-existing illnesses, immune-suppressive medications, etc...) who could be in trouble if they contract a MRSA infection.<br />
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Dogs and cats are not typically infected with MRSA, although they can, rarely, be carriers. In those rare cases, they usually are carrying a MRSA which they picked up from a person. So it is unlikely that you would "catch" this from your pet. And it is even less likely that a pet could get sick from a MRSA infection. <i>Staph aureus</i> just doesn't seem to like pets.<br />
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However, we are starting to see resistant bacterial infections more and more in our dog and cat patients. In these cases, the culprit is usually a different species of Staph, called <i>Staph pseudintermedius. </i>When this bug becomes resistant, it goes by the acronym "MRSP" (Methicillin-Resistant Staph Pseudintermedius). We see these infections most frequently on skin or in wounds, and they are extremely difficult to cure. Usually they require intense topical therapy (medicated baths, sprays, creams, etc...) and expensive, high-powered antibiotics, not to mention the cost of expensive culture tests. It is a nightmare for the owner, the veterinarian, and most of all, the pet. It is important to note, however, that MRSP is usually not infectious to people, just like MRSA is not infectious to pets.<br />
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Like in human medicine, veterinarians have a responsibility to do everything possible to reduce the threat of these resistant "bugs". To do that, we must recognize how they become resistant in the first place. Usually it is due to <u>inappropriate use of antibiotics.</u> This includes:<br />
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1. Inadequate duration of antibiotic therapy. If you don't give antibiotics long enough, you may kill most of the bacteria (enough so your pet appears cured), but the ones which are left behind are the most resistant ones. The next infection will be the offspring of these resistant bacteria, and will be much tougher to cure. <i>So always give ALL antibiotics until they're gone, even if your pet is better after just a few doses.</i><br />
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2. Using "big gun" antibiotics when they're not needed. We have some really great antibiotics at our disposal, and it's tempting to use these a lot because they are likely to work. However, the more often bacteria "see" these antibiotics, the more likely they are to become resistant. When infections become resistant to our "big guns," we are in serious trouble. Veterinarians should always choose the most "narrow spectrum" antibiotic likely to work in each given situation, and leave the big guns for resistant or life-threatening infections.<br />
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3. Indiscriminate use of antibiotics. Again, it's so tempting to give antibiotics to make clients feel better. It's also wrong. Our clients <i>love </i>antibiotics. However, antibiotics are sometimes not indicated, even if our clients don't understand that. In these cases, antibiotics will not do anything other than to give the bacteria which might normally be carried by the pet a chance to become resistant. Here are three very common examples: a. Viral upper respiratory infections in cats. Because they are viral, not bacterial, antibiotics will not help. b. Ear infections. These are often caused by yeast. The only way to know is by looking under a microscope at the organisms taken from the ear. If there is a yeast infection, antibiotic ear medicine is the wrong thing to use. But we get phone calls every day wanting us to prescribe an <i>antibiotic</i> ointment for someone's pet who doesn't want to bring the pet in. c. "Cystitis" in cats. Young cats often get a condition that looks a lot like a bladder infection. There is blood in the urine and discomfort when urinating. Without doing a culture, the condition is indistinguishable from an actual bladder infection. Cultures are expensive, and we know that statistically over 95% of cats under the age of ten with these symptoms do NOT have an infection, so I rarely prescribe antibiotics for young cats with these symptoms.<br />
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In all the cases mentioned above, the use of antibiotics can contribute to an increasingly-resistant population of bacteria, and that's bad news for all of us.<br />
<br />Dr. David Hallhttp://www.blogger.com/profile/06298254530599841492noreply@blogger.com0tag:blogger.com,1999:blog-3777241446538207860.post-64057927833621283122015-10-05T10:50:00.000-05:002015-10-05T10:50:46.979-05:00When Is It Okay To Give Your Pet Aspirin?I am writing on the topic of aspirin in pets today at the request of one of my senior vet techs. She was telling me that it sure would be nice if our clients understood how they are complicating (and often compromising) their pets' care when they give them aspirin. So here you go!<br />
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Aspirin can be a terrific drug for people (and sometimes, rarely, pets) when used properly. It reduces fever, inflammation, and pain. It also helps decrease blood clotting, which can be good or bad. Back in "the day" before safer anti-inflammatory drugs ("NSAIDs") were developed, it was not unusual for veterinarians to recommend aspirin for certain conditions.<br />
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Unfortunately, the safety profile for aspirin in pets (and especially cats) is not good. The difference between a therapeutic dose and a toxic dose is small. But it gets worse. Even at therapeutic doses, aspirin has the potential to cause serious harm to the lining of a pet's stomach, resulting in gastritis, ulceration, and even perforation leading to death.<br />
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These serious complications rarely occur after a single therapeutic dose of aspirin in an appropriate patient. However, the administration of one or more doses of aspirin by the pet-owner at home can seriously restrict the safety with which your veterinarian can prescribe safer and/or more appropriate medications. <u>Giving your pet aspirin changes his body chemistry</u> (temporarily), making certain subsequent medications more dangerous. This may tie our hands and delay treatment of your pet's condition.<br />
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Here's an example. A dog develops severe swelling of his face or jaw. The owner decides to give the poor guy aspirin. He looks up the dose on one of the hundreds of "be your own pet's veterinarian" websites (I'm going to blog about those in the future), and gives it to the dog. Even though he gave the proper dose, the swelling doesn't improve, so he gives a second dose 12 hours later, like the website says to do. This doesn't help either, and the dog seems to be getting worse, so he takes him to the vet. The vet diagnoses the dog as having an allergic reaction to an insect sting and wants to give a cortisone injection which should rapidly reduce the swelling and keep the reaction from escalating. Unfortunately, giving cortisone to a dog that has recently had aspirin can greatly increase the risk of gastric ulceration. The vet has to give an antihistamine instead of cortisone, knowing that it may not work nearly as well. The vet keeps the dog for observation, deciding that if the antihistamine doesn't work, she will just have to "risk it" and give the cortisone, along with multiple medications to try to protect the stomach.<br />
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There are still situations (extremely rare in veterinary medicine) where it is okay to give aspirin to a pet. But in my opinion, this should only be done after consulting a veterinarian. At our practice, and most others, there is a veterinarian available 24/7 for client emergency phone consults. Ask us before you give that aspirin!<br />
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By the way, Tylenol is never safe for cats, and usually not appropriate for dogs. Again, call us before you give it!Dr. David Hallhttp://www.blogger.com/profile/06298254530599841492noreply@blogger.com0tag:blogger.com,1999:blog-3777241446538207860.post-24058051351277099992015-08-31T10:59:00.000-05:002015-08-31T10:59:03.838-05:00Things Your Veterinarian Would Like You To NOT Do!1. <b>Cleaning your pet's ears before bringing him in for an ear problem. </b>We would really like to see what those ears look like (what kind of "goo" is in there) to help us determine the severity of, and help characterize the nature of, the problem. Cleaning them before the visit makes it harder for us to do this!<br />
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2. <b>Not coming back for the recheck visit because your pet is all better now, and you don't need to pay us to tell you that. </b>I understand the thinking here, but there's a couple reasons that recheck visits are important in pets who are doing well with their treatment. First of all, the pet may be doing much better, but there can be subtle things going on which indicate that there still is a problem. Detecting and addressing these things before they spiral is pretty cost-effective, and better for the pet. Secondly, I often use the recheck visit to determine, based on your pet's response to the initial treatment, a long-term plan to prevent recurrence of the problem. This is especially important in skin and ear diseases.<br />
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3. <b>Not coming back for the recheck visit because your pet isn't better, and we obviously don't know what we're doing. </b> Again, I understand the rationale, but there is much to be learned from treatment failure. If you switch vets at this point, you will be starting all over from scratch. We are human, and we don't hit the target 100% of the time when treating your pets' illnesses. Lack of response to therapy is an important diagnostic clue which helps us redirect our thinking, hopefully in a direction which will lead to an improved outcome. I've been the "second opinion" doctor on many of these cases over the years, and usually the original doctor had done exactly what I would have done. But when it didn't work, the client decided to seek a second opinion. Please give your vet a couple opportunities to come up with an effective treatment plan!<br />
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4. <b>Making an appointment, then not showing up. </b>Believe it or not, when you make an appointment, your vet has reserved about 30 minutes of time, which could be used to help other patients! If you can't come in, please have the courtesy to call and tell us.<br />
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5. <b>Sending someone in with your pet who has no authority to make decisions. </b>An important part of coming up with a treatment plan for a pet is the owner's willingness and ability to pay for it, and "how far you're willing to go" in treating the pet. We want to work with you to find a plan that best addresses the pet's needs and also takes in to consideration the owner's desires. If the decision-maker isn't at the appointment, we end up guessing. You can imagine how well that works out.<br />
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6. <b>Sending someone in with your pet who can't handle him. </b>It's really fun when a really worked-up pet is brought in by someone who is afraid of them.<br />
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7. <b>Bad-mouthing another vet to us. </b>This is just awkward. Also, it makes us wonder if you will be bad-mouthing us after this visit.<br />
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8. <b>Citing your medical or animal knowledge to challenge our diagnosis or treatment plan. </b>Do you seriously think animals and their diseases are exactly the same as human diseases? Do you really think that just because you have bred and raised dogs that you know more about their illnesses than a trained doctor? Look, you are welcome to question my thinking, and I will be glad to explain it. I also know that you might think of something I didn't, which could actually benefit your pet. We are happy to consider your ideas. However, you really should defer to us when we disagree. Animal diseases are what we have spent years of our lives becoming expert at. We have more and better resources than you. Give us your questions and your input, but trust us to decide what will best help your pet get better.<br />
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9. <b>Taking advantage of a personal relationship for free pet advice, if you take your pet somewhere else that is "cheaper." </b>I am very willing to chat with friends and even distant acquaintances about a problem their pet may be having, as long as I am that pet's doctor. But if you have chosen to take your pet elsewhere for veterinary care, don't come up to me at a social event and start asking my advice.<br />
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10. <b>Not controlling your pet in the waiting room. </b>Your dog may be super-friendly, and doesn't know a stranger. That's great, but other dogs, cats, and their owners often get very anxious at best, aggressive at worst, when another dog runs up to them. PLEASE keep your dog on your lap or a short leash. You can invite people to come pet him, and of course our staff is always more than happy to lavish attention on him! We love our friendly dogs!Dr. David Hallhttp://www.blogger.com/profile/06298254530599841492noreply@blogger.com0tag:blogger.com,1999:blog-3777241446538207860.post-37695814689054288612015-05-22T16:05:00.002-05:002015-05-22T16:05:38.012-05:00Veterinarians and SuicideSeveral veterinary newsmagazines and journals have recently published articles on the high rate of suicide among members of my profession. According to statistics for 2014, male and female veterinarians have considered suicide at a rate of 14% and 19% respectively, compared to rates of 5% and 7% among the general US population. These numbers are also higher than those for people in other medical professions. Scary stuff from where I sit.<br />
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There are varying opinions on why veterinarians experience high rates of depression, suicide, and suicide "ideation." As I read through these opinions, I began to relate and better understand this tragic phenomenon. First of all, our job is quite stressful. I suppose everyone thinks their job is stressful! But, keep in mind that more and more people really consider their pets as family members (me too!) When their four-legged family members become seriously ill or injured, it's a really big deal. The rub is, there is no insurance company or government-subsidized system to help pay for expensive care. This places two burdens squarely on the shoulders of the veterinarian: 1.A specialist referral is often not an option, so the general practitioner is <i>on her own</i> for the diagnosis and treatment 2. There is pressure (and guilt) to keep costs low, <i>but without jeopardizing the outcome</i>. I'm not having a pity party here, but it really is unfair what is sometimes expected of us.<br />
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Then there is the euthanasia thing. I really feel that ending the life of a suffering animal is one of the kindest and most compassionate things we do. But often we are asked to euthanize a young healthy pet because of a behavior problem, or for an inconvenience the pet is causing the family. Don't get me wrong, sometimes euthanasia is the only safe and compassionate solution for a behavior problem. But it sure takes a toll on us to end the life of a young, bright-eyed dog or cat. Even in cases of old pets with incurable diseases it can be awful. Often, we have known these animals and their owners for 10 years or more. The grief in the room can be overwhelming. Sometimes, the grief goes home with us, and we see those pets in our dreams.<br />
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One article discussed personality traits which veterinarians often possess that might increase the risk of depression and suicide. Veterinarians tend to be extremely hard on themselves. We are not "buck-passers." In addition, we tend to be "...highly-driven perfectionists and high achievers." And to further add to the risk of suicide, one expert describes veterinarians as "...lone wolves. They like to go into a corner and lick their wounds. Companionship and community lead to positivity and happiness, but veterinarians are introverts and soloists."<br />
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On a personal note, I feel very fortunate to have earned the privilege of being a veterinarian. I honestly can't imagine having enjoyed myself as much in any other profession (which I could realistically have achieved, which rules out rock star and quarterback!) I can certainly relate and have experienced the risk factors mentioned above, but I have never considered taking my own life. For this I credit a sincere and meaningful relationship with God (and a church family which nourishes that); an amazing family support group which includes my late mother, my amazing wife Kathy, my three terrific kids, my older sisters, and my dad. And I also credit the fact that I have been able to work beside some really gifted and giving veterinarians, as well as having a relationship with our support staff over the years that has felt more like "my family" than "my employees."<br />
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It really is a rewarding career in many ways. I never would have thought that becoming a veterinarian would increase one's risk for suicide, but after learning why it is, I get it. I have never had a colleague end their life, and I hope I never do. But I do worry about my friends in the profession - stay strong guys!Dr. David Hallhttp://www.blogger.com/profile/06298254530599841492noreply@blogger.com2tag:blogger.com,1999:blog-3777241446538207860.post-34800837799395371852015-03-02T10:39:00.000-06:002015-03-02T10:39:01.368-06:00Is Beneful Harming Our Dogs?I'm going to briefly touch base on a topic that we've been getting a lot of calls about. It seems that there is a class-action lawsuit being brought against Nestle-Purina because a gentleman feels that their "Beneful" dog food caused the illness or death of his three dogs. He claims that Propylene Glycol and mycotoxins in the food are the culprits. In spite of the claims, Propylene Glycol is safe for dogs to consume at recommended levels according to veterinary nutritionist, Dr. Jennifer Larson. Mycotoxins certainly could be harmful, but I have seen no data to support the claim of mycotoxins in Beneful.<br />
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Before I go any further, I want to be clear that I have no financial investment in Purina or Beneful. I do carry Purina diets at my hospital, but they have not contacted me to defend them, and I get no special favors or perks from them other than getting my personal dog food at reduced cost (every pet food company offers that same deal to vets).<br />
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What concerns me is the general alarm among people because of this lawsuit. I certainly get that the prospect of feeding our friends a dangerous food is horrifying. However, please keep in mind that Beneful is an extremely popular food, which means that hundreds of thousands of dogs are eating it. Many of these dogs are going to get sick and/or die from <i>something. </i>That doesn't necessarily mean the food is at fault.<br />
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At my hospital, we track pet food recalls and post them on our Facebook page to help warn our clients when a food might be dangerous. We subscribe to reliable, unbiased data to get this information. It is dangerous, in my opinion, to make decisions based on unfounded accusations, your neighbor's opinion, or social media.<br />
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With regard to the whole "big pet food companies are evil" notion, here is my opinion after spending over thirty years researching and practicing ways to keep pets (including my own) as healthy as possible (as posted on our Facebook page):<br />
<span data-reactid=".6y.1:3:1:$comment10153064825062978_10153070810472978:0.0.$right.0.$left.0.0.1.$comment-body.0.0" style="background-color: #f6f7f8; color: #141823; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 12px; line-height: 13.9636354446411px;"><span data-reactid=".6y.1:3:1:$comment10153064825062978_10153070810472978:0.0.$right.0.$left.0.0.1.$comment-body.0.0.$end:0:$0:0">There are a lot of opinions out there, and people are understandably concerned for the welfare of their pets. Please keep a few of things in mind: 1.Dogs (unlike cats) are omnivores, not carnivores. 2.Just because someone brings a lawsuit, that doesn't</span></span><span data-reactid=".6y.1:3:1:$comment10153064825062978_10153070810472978:0.0.$right.0.$left.0.0.1.$comment-body.0.3" style="background-color: #f6f7f8; color: #141823; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 12px; line-height: 13.9636354446411px;"><span data-reactid=".6y.1:3:1:$comment10153064825062978_10153070810472978:0.0.$right.0.$left.0.0.1.$comment-body.0.3.0"><span data-reactid=".6y.1:3:1:$comment10153064825062978_10153070810472978:0.0.$right.0.$left.0.0.1.$comment-body.0.3.0.$end:0:$0:0"> mean their claim is legitimate. 3.There has been a tremendously successful MARKETING campaign by certain "boutique" and "natural" pet food companies promoting grain-free dog foods. I hate to break the bad news, but these companies are looking to make a profit just like Purina, Iams, or any other company. That doesn't make them, or their products bad, it's just something to keep in mind. I have spoken with several nutrition specialists on this topic, and they all say that there is NO specific benefit to grain-free diets for most dogs. Again, grain-free is fine, but corn, wheat, etc as dog food ingredients are fine as well! Here is a direct quote from a respected veterinary nutritionist, who does not work for any pet food company as far as I know: <i><b>"There are a lot of myths and misconceptions out there. Some people hate by-products (which can be a great ingredient, very nutrient rich) and some people hate grains (I still don't get why potato starch is so much better than corn starch), and some people dislike meals (a rendered product) and only want meat... The thing is, you cannot tell the quality of an ingredient by its name. There are very good meals out there but some of them are not so good (meaning that their digestibility is bad), and the same goes for meats, by products, vegetable products... </b></i></span></span></span><br />
<span data-reactid=".6y.1:3:1:$comment10153064825062978_10153070810472978:0.0.$right.0.$left.0.0.1.$comment-body.0.3" style="background-color: #f6f7f8; color: #141823; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 12px; line-height: 13.9636354446411px;"><span data-reactid=".6y.1:3:1:$comment10153064825062978_10153070810472978:0.0.$right.0.$left.0.0.1.$comment-body.0.3.0"><i><b><br data-reactid=".6y.1:3:1:$comment10153064825062978_10153070810472978:0.0.$right.0.$left.0.0.1.$comment-body.0.3.0.$end:0:$3:0" /><span data-reactid=".6y.1:3:1:$comment10153064825062978_10153070810472978:0.0.$right.0.$left.0.0.1.$comment-body.0.3.0.$end:0:$4:0">My usual recommendation is to choose a diet from a reputable company, ideally that has undergone AAFCO feeding trials (all diets should have an AAFCO statement, and this will tell you if the diet has been through trials or it has been formulated to meet the requirements for that specific life stage), and feed it to achieve a good body condition. </span><br data-reactid=".6y.1:3:1:$comment10153064825062978_10153070810472978:0.0.$right.0.$left.0.0.1.$comment-body.0.3.0.$end:0:$5:0" /></b></i><span data-reactid=".6y.1:3:1:$comment10153064825062978_10153070810472978:0.0.$right.0.$left.0.0.1.$comment-body.0.3.0.$end:0:$8:0"><i><b>Many diets fit this bill, and it is usually possible to find a diet that is also acceptable to owners with different feeding philosophies."</b></i> - Cecilia Villaverde, BVSc, PhD, DACVN, DECVCN</span></span></span><div>
<span data-reactid=".6y.1:3:1:$comment10153064825062978_10153070810472978:0.0.$right.0.$left.0.0.1.$comment-body.0.3" style="background-color: #f6f7f8; color: #141823; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 12px; line-height: 13.9636354446411px;"><span data-reactid=".6y.1:3:1:$comment10153064825062978_10153070810472978:0.0.$right.0.$left.0.0.1.$comment-body.0.3.0"><span data-reactid=".6y.1:3:1:$comment10153064825062978_10153070810472978:0.0.$right.0.$left.0.0.1.$comment-body.0.3.0.$end:0:$8:0"><br /></span></span></span></div>
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<span data-reactid=".6y.1:3:1:$comment10153064825062978_10153070810472978:0.0.$right.0.$left.0.0.1.$comment-body.0.3" style="background-color: #f6f7f8; color: #141823; font-family: Helvetica, Arial, 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 12px; line-height: 13.9636354446411px;"><span data-reactid=".6y.1:3:1:$comment10153064825062978_10153070810472978:0.0.$right.0.$left.0.0.1.$comment-body.0.3.0"><span data-reactid=".6y.1:3:1:$comment10153064825062978_10153070810472978:0.0.$right.0.$left.0.0.1.$comment-body.0.3.0.$end:0:$8:0">I don't know about you, but I'm going to believe the opinion of a respected professional who spends her life studying animal nutrition over a grieving dog-owner who wants someone to pay because he has lost a pet, or the social media rumor-spreaders. These decisions are too important to make based on anything less than the best available information.</span></span></span></div>
Dr. David Hallhttp://www.blogger.com/profile/06298254530599841492noreply@blogger.com0tag:blogger.com,1999:blog-3777241446538207860.post-19062425373947689452014-10-17T11:57:00.001-05:002014-10-17T11:57:21.247-05:00Ebola and PetsThe Ebola virus was first discovered in 1976 near the Ebola River in the Congo of Africa. It has caused outbreaks of death and disease in Africans ever since. The most recent outbreak has been particularly horrible, and the illness has crossed the border to threaten other nations, including ours. We know that African Fruit Bats can act as reservoirs and can spread the disease to people, so the question arises: can dogs do the same? One dog has already been euthanized, and another quarantined after being exposed to their infected owners.<br />
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A study published in 2005 demonstrated that some dogs exposed to Ebola virus (many through eating carcasses of Ebola-infected animals) developed titers to the disease. None of the dogs showed any clinical signs of illness. So what does that mean? It could mean that some dogs, when heavily-exposed to the virus (as in eating it) may actually become "infected." Can these asymptomatically-"infected" dogs spread the virus to people? We don't know, <i>but at this time there is zero evidence that it has ever happened.</i><br />
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Another question is, could dogs (or other animals, for that matter) spread the virus on their feet or fur from an infected person? The answer to that is also unknown, but it seems likely to me that they could, since the virus is known to survive on inanimate objects for a period of time.<br />
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The CDC assures us that Ebola is extremely unlikely to become a widespread threat in the US, and I certainly believe that to be accurate, because we are much more "organized" in the disease-control area than third-world countries. Hopefully, probably, this will prove to be true.Dr. David Hallhttp://www.blogger.com/profile/06298254530599841492noreply@blogger.com4tag:blogger.com,1999:blog-3777241446538207860.post-55040180265074623722014-09-19T14:48:00.003-05:002014-09-19T14:48:54.504-05:00The Grain-Free Myth or "The Emperor's New Diet"<span style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.3999996185303px;">As described by Wikipedia, "</span><b style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.3999996185303px;">The Emperor's New Clothes</b><span style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.3999996185303px;">" </span><span style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.3999996185303px;"> is a short tale by </span><a href="http://en.wikipedia.org/wiki/Hans_Christian_Andersen" style="background: none rgb(255, 255, 255); color: #0b0080; font-family: sans-serif; font-size: 14px; line-height: 22.3999996185303px; text-decoration: none;" title="Hans Christian Andersen">Hans Christian Andersen</a><span style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.3999996185303px;"> about two weavers who promise an </span><a href="http://en.wikipedia.org/wiki/Emperor" style="background: none rgb(255, 255, 255); color: #0b0080; font-family: sans-serif; font-size: 14px; line-height: 22.3999996185303px; text-decoration: none;" title="Emperor">Emperor</a><span style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.3999996185303px;"> a new suit of clothes that is invisible to those unfit for their positions, stupid, or incompetent. When the Emperor parades before his subjects in his new clothes, a child cries out, "But he isn't wearing anything at all!" The tale has been translated into over a hundred languages.</span><br />
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<span style="color: #252525; font-family: sans-serif;"><span style="background-color: white;"><span style="font-size: 14px; line-height: 22.3999996185303px;">The wave of grain-free diets that are flooding the pet food market very much reminds me of this parable. Several times a week I have a client proudly proclaim that they have switched their pet to the new, healthier grain-free food!!!! I admit, that like the townspeople in the story, at first I was unable to respond to these proclamations with anything other than a hearty congratulations (while doing my best to hide my bewilderment).</span></span></span><br />
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<span style="color: #252525; font-family: sans-serif;"><span style="background-color: white;"><span style="font-size: 14px; line-height: 22.3999996185303px;">Grains (which include wheat and corn as they are processed for pet food) have been implicated lately in every animal malady possible. I have heard it blamed for every possible digestive disorder (of course), urinary tract problems, immune system problems, skin problems (this is a biggie), seizures, and cancer. Yes, I have had clients brag that, "Fluffy's ________ problem has completely resolved since we switched to grain-free!" This is sometimes accompanied with an insinuation that they are disappointed in me for not thinking of switching their pet to a grain-free food. </span></span></span><br />
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<span style="color: #252525; font-family: sans-serif;"><span style="background-color: white;"><span style="font-size: 14px; line-height: 22.3999996185303px;">Most of the time, the improvement also coincides with some other form of therapy or medication, which gets no credit at all for the miraculous recovery. Sometimes not. However, it is important to remember that many chronic conditions wax and wane in their severity. Improvement which is credited to the new food, may simply be the condition taking its normal course. Lots of folks seem to think that "grain" is a major food allergen in pets. Scientific research says otherwise. In dogs, beef/dairy comprise 70% of all food allergies, followed by poultry, lamb, and pork. In cats, beef, dairy, and fish are the most common allergens. </span></span></span><br />
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<span style="color: #252525; font-family: sans-serif;"><span style="background-color: white;"><span style="font-size: 14px; line-height: 22.3999996185303px;">So, not ever having read or heard of the miracle of grain-free food in the extensive continuing education and veterinary references utilized by the doctors at my clinic (yes, we discussed this), I set out to research what </span><b style="font-size: 14px; line-height: 22.3999996185303px;">factual, non-anecdotal </b><span style="font-size: 14px; line-height: 22.3999996185303px;">evidence is out there regarding the benefits of grain-free diets. I didn't find any. None. So I sought out a veterinary nutritionist and asked him. He laughed and said, "You have no idea how many veterinarians have asked me that question in the past two years." He further said that as far as the experts are concerned, it is simply a fad being propagated by the growing boutique pet food industry. I bet that if you go to a fancy pet food store and try to buy a bag of Purina, some salesperson will try to get you to switch to some "wild," "natural," or grain-free food.</span></span></span><br />
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<span style="color: #252525; font-family: sans-serif;"><span style="background-color: white;"><span style="font-size: 14px; line-height: 22.3999996185303px;">In fact, several large, reputable pet food manufacturers now carry "grain free" pet diets. Why? If they can't beat them, they are joining them. The grain-free fad is causing them to lose market share. </span></span></span><br />
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<span style="color: #252525; font-family: sans-serif;"><span style="background-color: white;"><span style="font-size: 14px; line-height: 22.3999996185303px;">Now I know this seems like a rant against grain-free foods. It's really not. In my search for information, I found nothing "bad" about these diets. They are usually nutritionally complete. So if you want to feed them, go ahead. No problem! But don't be fooled by the Emperor's new diet.</span></span></span><br />
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<br />Dr. David Hallhttp://www.blogger.com/profile/06298254530599841492noreply@blogger.com0tag:blogger.com,1999:blog-3777241446538207860.post-32784627396174013112014-08-22T11:39:00.001-05:002014-08-22T11:39:43.957-05:00Lyme Disease Is Coming Our Way<div class="vcl" style="border: 0px; box-sizing: border-box; color: #432f0f; font-family: helvetica, arial, sans-serif; font-size: 15px; line-height: 25.999950408935547px; margin: 0px; padding: 0px; vertical-align: baseline;">
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Here is an interesting (and somewhat worrisome) article I found on the Companion Animal Parasite Council website. If you check the map, you can see that the St. Louis area is showing an increased incidence of Lyme Disease. If your dogs get ticks, make sure they're vaccinated! -DH</div>
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Lyme disease infection occurs when an infected tick feeds on a dog and transmits the organism that causes disease. The 2014 Parasite Forecast Maps from the Companion Animal Parasite Council show that Lyme disease is expanding westward from the historic focus of the northeastern United States. Southern New England and the Pacific Coast continue to be key hotspots of activity, and are likely to experience elevated rates of disease prevalence, with an increasing numbers of infections seen for this year. Consistently stable activity levels are predicted for the Mid-Atlantic States and the upper Midwest. The CAPC forecast also shows that Lyme continues to expand southward and involve more areas of Appalachia.</div>
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<img alt="" src="http://www.petsandparasites.org/images/uploads/images/2014LymeForecast2.jpg" style="border: 7px solid rgb(62, 43, 14); box-sizing: border-box; font-family: inherit; font-size: 15px; font-style: inherit; font-variant: inherit; font-weight: inherit; height: auto; line-height: inherit; margin: 0px 0px 6px; max-width: 100%; padding: 0px; vertical-align: middle; width: 610px;" />Dogs infected with Lyme disease do not usually have the bull’s-eye-rash as seen in people, but may have clinical signs of fever, lameness, swollen joints, lethargy, and depression. Dogs cannot transmit Lyme disease to people, but they are considered a “sentinel” of the disease. This means a high prevalence of Lyme disease in dogs provides an advance human warning system of can provide a warning of humans contracting the disease.</div>
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The 2014 CAPC Parasite Forecast Maps have predicted higher-than-normal levels for Lyme disease in several areas of the country, which means dogs in these areas, may be at greater potential risk for infection. Even if you don’t live in an area where Lyme disease is a problem, there are many different tick-borne diseases, so year-round tick protection is still important. Dogs can also be exposed to tick-borne diseases if they travel with you to parts of the country where those diseases are more common.</div>
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CAPC bases its parasite forecasts on many different factors, including temperature, precipitation, humidity, ground elevation, forest cover, population density, reported human Lyme disease cases and deer strikes with cars. These factors are incorporated into an equation created by a team of statisticians that allows CAPC to predict the likelihood of any parasitic disease. The forecast is also the collective expert opinion of respected parasitologists who engage in ongoing research and data interpretation to better understand and monitor disease transmission and changing life cycles of parasites. <a href="http://www.petsandparasites.org/expert-insights/building-the-capc-parasite-forecasts/" style="border: 0px; box-sizing: border-box; color: #e8931a; cursor: pointer; font-family: inherit; font-size: 15px; font-style: italic; font-variant: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;">Click here</a> to learn more.</div>
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You can use the <a href="http://www.petsandparasites.org/parasite-prevalence-maps/" style="border: 0px; box-sizing: border-box; color: #e8931a; cursor: pointer; font-family: inherit; font-size: 15px; font-style: italic; font-variant: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;">CAPC Parasite Prevalence Maps</a> to check the risk for different parasitic diseases in your geographic area, down to the county level. You can also check the maps when you are traveling with your pet to other areas of the country so you can be aware of any possible new risks to protect you dogs against ticks. The maps provide statistics about the number of dogs infected by Lyme disease and other parasitic diseases by state and county. This information can serve as a helpful starting point for a discussion with your veterinarian about the best year-round parasite protection program for your pet.</div>
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Automatic email updates from CAPC will help you stay informed about ongoing parasite activity in your area. You can sign up by going to the CAPC Parasite Prevalence Maps and clicking on “Get Updates.” Enter your email address in the provided field and click “Subscribe.” You will begin receiving updates as soon as they are posted. Visit the <a href="http://www.petsandparasites.org/expert-insights/how-to-sign-up-for-monthly-email-updates-from-the-capc-maps/" style="border: 0px; box-sizing: border-box; color: #e8931a; cursor: pointer; font-family: inherit; font-size: 15px; font-style: italic; font-variant: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;">How-To</a> page to sign up now. Year-round parasite protection is essential for all pets, and knowing which diseases are more significant in your area will help keep your pets safe and free of parasites. Your veterinarian can help you decide how to best protect your pet against the threat of parasitic diseases.</div>
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<img alt="Lyme Disease Is Expanding Its Range Westward In 2014" height="70" src="http://www.petsandparasites.org/images/sized/images/uploads/images/Little,_Susan_08-70x70.jpg" style="background-color: #efebe0; border: 0px; box-sizing: border-box; float: left; font-family: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; height: 70px; line-height: inherit; margin: 0px 15px 0px 0px; max-width: 100%; padding: 5px; vertical-align: baseline; width: 70px;" width="70" /><div style="border: 0px; box-sizing: border-box; float: left; font-size: 13px; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 1.73333em; margin-bottom: 13px; padding: 15px 0px 0px; vertical-align: baseline; width: 305px;">
<span style="border: 0px; box-sizing: border-box; color: #ee9e24; font-family: futura-pt; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; text-transform: uppercase; vertical-align: baseline;">WRITTEN BY</span> Dr. Susan Little</div>
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Dr. David Hallhttp://www.blogger.com/profile/06298254530599841492noreply@blogger.com0tag:blogger.com,1999:blog-3777241446538207860.post-33686641639859395512014-07-23T16:22:00.001-05:002014-07-23T16:22:53.872-05:00A Lesson Learned From "Marley and Me"I have never read the book or seen the movie. There are two topics I just can't tolerate in print or film when it comes to my reading or viewing for fun, and those are cancer and the death of a pet. My wife knows this - I get really (embarrassingly) emotional about those topics - so we don't watch movies about a beloved pet dying or a person struggling with cancer. So, I've neither read nor seen "Marley and Me." However I do know that (spoiler alert!) Marley dies. I also have been told that Marley dies of a condition called "GDV" (Gastric Dilitation and Volvulus).<br />
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Now, I don't know if "Marley and Me" is based on a true story, but if it's not, GDV is a creatively-dramatic (and horrible) way for a protagonist-pet to die. I hope I never see another case of it during my career as a veterinarian. Some of the most agonizing deaths I've seen were patients with GDV.<br />
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In GDV, the stomach becomes distended with gasses and/or liquid ("bloat"). Then the distended stomach twists on its axis. This gives the air/liquid no way to escape and also severely compromises the blood flow to the stomach. As a result, the stomach becomes more distended and at the same time the stomach wall starts to die. The dog is in unimaginable pain.<br />
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Despite a lot of misinformation on the internet and other places, we really don't know much about what causes GDV. We do know that it it occurs almost exclusively in large, deep-chested dogs (German Shepherds, Irish Setters, Golden Retrievers, Dobermans, Great Danes, etc...) Once a dog develops GDV, the only hope is through emergency surgery, and even with that the prognosis is fair to guarded at best.<br />
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The good news is, we now have an effective method to prevent GDV. It is a preventive surgical procedure called <i>gastropexy. </i>A gastropexy is where a veterinarian attaches the stomach to the body wall so that it is unable to twist. We usually do this surgery at the time that the pet is spayed or neutered. Dogs with gastropexys are <b>twenty-nine times less likely to develop GDV. </b>So, in my mind if you have a new puppy that is a high-risk breed for GDV, doing a gastropexy at the time of spaying/neutering is a no-brainer.<br />
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Who knows? If we were offering gastropexys during the time "Marley and Me" was written, the story might have had a happier ending.Dr. David Hallhttp://www.blogger.com/profile/06298254530599841492noreply@blogger.com0tag:blogger.com,1999:blog-3777241446538207860.post-80097880724665788002014-04-09T11:35:00.000-05:002014-04-09T11:35:49.321-05:00Leptospirosis Is Sneaking It's Way Into Your LifeThere is an infectious disease "out there," and it is trying to find you. It's called <i>Leptospirosis, </i>but we call it Lepto for short. It is caused by a bacterial organism of the same name. It can affect most wildlife species, domestic livestock, dogs, and people. It is a pretty horrible infection to acquire, as it usually infects the kidneys, and sometimes the liver.<br />
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This bacterial organism loves water, and is passed in the urine of infected mice, rats, deer, cows, raccoons, dogs, people, etc... Once the organism gets into a wet environment, it will thrive. As water moves, so will the bacteria. Your dog can become infected simply by sniffing or licking the moist grass after a hard rain. We used to think of this as a "rural" disease, but recent statistics show that urban dogs are at higher risk than we thought - probably due to transmission by rats and mice.<br />
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The disease is not easy to diagnose because the symptoms are vague, and mimic a number of other conditions. This is especially bad because the longer it takes the veterinarian to diagnose your dog, the longer your family will be unsuspectingly at-risk for acquiring the infection from the dog. There is a veterinarian near my practice who lost a kidney to Lepto.<br />
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The best way to protect your dog from Lepto is via vaccine. The vaccine is not 100% protective, but greatly reduces the risk for infection. The new Lepto vaccines (at least the ones we use) are much safer than the old vaccines from 10 years or more ago. We still occasionally see some soreness or lethargy in smaller vaccinated dogs, but it is usually self-limiting. It definitely beats getting Lepto! We do not feel that vaccination is necessary for dogs leading extremely sheltered lives (ie never go outside, potty indoors on papers, do not go for walks outdoors, etc...)<br />
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<br />Dr. David Hallhttp://www.blogger.com/profile/06298254530599841492noreply@blogger.com0tag:blogger.com,1999:blog-3777241446538207860.post-54627088818873747912014-02-05T11:07:00.002-06:002014-02-05T11:07:38.469-06:00Spaying, Neutering, and Cancer: The ControversyA week or so ago, a retrospective study on the effects of spaying and neutering on age of onset of cancer and behavioral disorders in Vizslas was published in the Journal of the American Veterinary Medical Association. This study suggests that, in the Vizsla (which is a relatively-uncommon purebred dog), the risk for developing certain cancers and storm-phobias is significantly increased if the dog is spayed or neutered. This follows a similar study in Golden Retrievers published last year which showed an increased risk of certain cancers and orthopedic conditions in dogs which have been spayed or neutered. Both of these studies were peer-reviewed (the gold standard), and in my opinion, properly done, and should be taken seriously.<br />
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Understandably, there has been a bit of an uproar calling for "us" to stop, um "mutilating" our pets with these horrible procedures (spays and neuters) which rob them of their reproductive organs and make them get cancer and other debilitating diseases. I am not trying to belittle these concerns, but before we rush to judgement, we might want to gather more information. I own two Golden Retrievers, and I want them to live the longest, healthiest lives possible. For that matter, I want all of my patients to live the longest, healthiest lives possible!<br />
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There certainly appears to be some serious disadvantages to spaying and neutering, at least in Vizslas and Goldens. (Note: these studies also suggest that <i>early-age</i> spay/neuter may increase the risk even more.) Another study suggests that neutering male dogs can increase the risk for prostate cancer. However, when we look at life expectancy (which is kind of important, wouldn't you agree?), the picture is a little different. The Golden Retriever study did not look at life expectancy, and the Vizsla study showed no difference in life expectancy between spayed/neutered dogs and intact dogs. So even though the S/N dogs were getting more cancer, they were getting less of something else - which made it a "wash." A more comprehensive study, looking at ALL dogs <i>and cats</i> (purebred and otherwise) was also published last year. There were 2.2 million dogs and 460,000 cats in this study. In this one, they looked at life expectancy in S/N pets versus intact pets. Guess what? S/N dogs of all breeds live 15% longer, and S/N cats live about 50% longer.<br />
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Does this mean we should mindlessly continue to recommend spaying and neutering all dogs and cats? Or should we crucify those who advocate spaying and neutering? Well, I for one don't want to judge anyone. There is still a lot to learn, and as more studies become available we will know more. Society (including companion animals) has benefited tremendously from the S/N "movement." How? Since routine spaying and neutering of pets has grown in acceptance (starting around 1970), the euthanasia of unwanted animals in shelters has declined from 24 million to 4 million. As a guy who "moonlights" at an animal control facility, I can tell you that's huge.<br />
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I will not bore you by listing all the <i>benefits to the individual pets</i> from spaying or neutering, although I've already mentioned the longevity study. But they are there, and they are documented. At my practice, we are keeping an open mind. Maybe we will be doing vasectomies and hysterectomies (a spay is an <i>ovario</i>hysterectomy, and a neuter is a castration) some day. But please be assured that we want very much to do what's best -we will recommend for your pet what we would do for our own.Dr. David Hallhttp://www.blogger.com/profile/06298254530599841492noreply@blogger.com0tag:blogger.com,1999:blog-3777241446538207860.post-89929233107816665922014-01-22T11:44:00.000-06:002014-01-22T11:44:15.217-06:00$20 Chemical NeutersA local television station recently ran a story about a "new" chemical neutering agent for dogs. I believe it's called "Zeuterine." I didn't see the story, but I've been told that it claimed that male dogs could be "neutered" with this product for about $20. Understandably, I have received quite a few inquiries about this since the story ran. Here is my response to one such inquiry, as posted on Facebook:<br />
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<span style="background-color: #edeff4; color: #333333; font-family: 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 10.909090995788574px; line-height: 12.799999237060547px;"><b><i>A very similar (maybe even the same thing?) injection was marketed to veterinarians several years ago called "Neutersol." It is a caustic agent, which, when injected into the testicles, causes them to necrose (it destroys the tissue). It had a lukewarm reception after more vets started using it. There were/are two main drawbacks: it decreases testosterone levels only about half as much as neutering (many dog-owners neuter their dogs to decrease testosterone-driven behaviors), and a portion of the dogs developed complications such as abscesses and self-mutilation - some of these had to be subsequently neutered. My humble opinion is that it is a very useful tool for decreasing dog overpopulation in third-world countries, and even poverty-stricken areas in the US. It is not something we will use for our clients' pets for the reasons stated above. Once this injection starts being more widely used, we will know a lot more. Maybe it will be a significant upgrade from it's predecessor, but that's not what I'm hearing yet. Stay tuned...</i></b></span><br />
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<br />Dr. David Hallhttp://www.blogger.com/profile/06298254530599841492noreply@blogger.com0tag:blogger.com,1999:blog-3777241446538207860.post-54319326233163749882014-01-07T11:08:00.000-06:002014-01-07T11:08:26.227-06:00New Year's Resolutions for Cat OwnersCat-owners (of which I am one), are a unique bunch. We love our cats (every bit as much as dog-owners love their dogs), but we tend to be more "hands-off" with their care. This is probably because cats don't complain much, especially if allowed to stay in their routine. They tell their humans, "You do your thing and I'll do mine. I'll let you know if I need anything." And they do, especially at 6:00 AM when they are ready for us to WAKE UP! However, cats are not necessarily keen on change, even if it's for their own good. They detest going to the vet, having their food changed, meeting new cats, etc... This is another reason we cat owners are hands-off: <i>We don't want them ticked off at us. </i><br />
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So cat-owners are a tough crowd for us veterinarians. When "what is best for the cat" doesn't jive with "what the cat wants", they are caught in the middle. "Do I really want to incur Garfield's wrath, just because this guy in the white coat says I should?" Trust me, I understand. But there are so many things that cat-owners could do better for their cats, that it really is worth it in the long run to make some changes. So here are my New Year's Resolutions for cat-owners:<br />
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<b>1.Bring your cat to us at least once a year, no matter what!</b> I know your cat hates it. I know she never goes outside. I know she seems perfectly healthy. But cats are the very best at hiding illness. It is very common for me to see an extremely sick cat, and have the owner swear that they brought her in as soon as they noticed a problem. Many of these problems have actually been chronic, and have pushed the cat to the breaking point, at which time my job becomes a lot tougher, and the outlook for the cat is much worse.<br />
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<b>2.Put your cat on heartworm/intestinal parasite/flea medicine every month. </b>Even indoor cats get parasites. Heartworm infection in cats is extremely difficult to diagnose, but can definitely shorten the cat's life by causing asthma-like symptoms, wasting disease, or even sudden death (I've seen it happen.) Cats can also carry intestinal worms, with no symptoms, which are contagious to her owners (gross!) Prevention is easy - there is a once-a-month topical product (no pills!) called <i>Revolution </i>which protects your cat against all these parasites. <br />
<br />
<b>3.Give your cat canned food, at least once in a while. </b>The more we learn about feline medicine, the more we discover the value in treating many chronic conditions with certain "prescription" canned foods. The dietary therapy is often more effective than drugs (really!), and soooo much easier....as long as the cat will eat it. Yes, some of these diets also come in a dry form, but the canned food is almost always more effective. The biggest obstacle is trying to get a cat that has always eaten dry food to switch to canned (did I mention that cats hate change?) So, get your cat used to eating canned food, at least once a week or so. It may pay off later.<br />
<br />
<b>4.Feed your spayed/neutered adult cat about 30% less than the label says. </b>AAFCO feeding guidelines are based on studies done mostly on non-spayed, non-neutered cats. We know that a spayed or neutered cat has about a 30% lower metabolic rate, and so needs fewer calories. Having said that, every cat is different, so the nutritional plan for your cat should be discussed with your veterinarian!<br />
<br />
<b>5.Play! </b>All cats need physical and mental stimulation. They are predators by nature and are physiologically healthier if allowed to "scratch" their predatory "itch." Strings, feather toys, and laser pointers all provide the stimulation needed to help keep a cat healthy. Here is a link to a terrific website regarding environmental enrichment for indoor cats: <a href="http://indoorpet.osu.edu/cats/">http://indoorpet.osu.edu/cats/</a>.Dr. David Hallhttp://www.blogger.com/profile/06298254530599841492noreply@blogger.com0tag:blogger.com,1999:blog-3777241446538207860.post-66650797522153892092013-11-22T14:02:00.000-06:002013-11-22T14:02:21.385-06:00My Dog Just Had A Seizure!One of the most awful and disconcerting things a pet owner may suffer is watching their pet experience a grand mal seizure. These seizures are often violent, and the pet seems to be dying right in front of you. They usually fall over, their eyes roll back in their heads, and there are uncontrollable body movements. In addition, some will urinate and/or defecate on themselves. It is a terrible, terrible thing to see.<br />
<br />
The good news is that a single seizure is rarely as serious as it appears. They usually last no more than a couple of minutes (although they seem to last forever), and after some recovery time, the dog returns to normal. As with most medical problems, there are some exceptions.<br />
<br />
Some dogs who have a seizure, only have a single one, and then are fine. For this reason, I usually do not do a full work-up on a young adult dog who has had a single seizure, has no other symptoms, and has a normal physical exam. However, if a dog is less than a year old, older than five years old, has other symptoms, <i>or has had more than one seizure; </i>that dog will need a full work-up.<br />
<br />
By far, the most common cause of seizures is a disease called Idiopathic Epilepsy. Epilepsy usually first appears in dogs between the ages of one and five. There is no known cause, but certain breeds seem to be predisposed. There is no test for epilepsy, so the diagnosis is made by ruling out other causes of seizures. So, what are some other causes of seizures? The list is long, but includes: head trauma, toxins, metabolic disorders (low blood sugar, kidney disease, liver disease), congenital brain disorders (such as hydrocephalus), cancer, meningitis, heart disease, and "stroke." My typical work-up for a seizure dog includes an ECG, CBC, blood chemistries, blood pressure, and a thyroid test. If these tests are all normal, but the dog is showing other neurologic symptoms or is not responding to treatment, I refer the dog to a specialist who can do more advanced testing such as CT scan or MRI.<br />
<br />
My first choice anti-seizure drug for epileptics is phenobarbital. Phenobarbital is very effective in most cases and is fairly inexpensive (the dog will be on medication for life). There are potential side-effects of phenobarbital which include transient sedation, increased appetite, and most significantly - liver toxicity. The liver problem is uncommon, but we closely monitor liver values on our patients who take phenobarbital. For those patients whose seizures are not adequately controlled with phenobarbital, I usually add potassium bromide. When combined with phenobarbital, potassium bromide is a very effective anti-seizure drug, and is also fairly inexpensive. Dogs on potassium bromide have an increased risk for pancreatitis.<br />
<br />
There are newer anti-seizure drugs on the market, which are significantly more expensive. However, these drugs tend to have fewer side-effects, and are sometimes effective in patients not responding to (or who are having side-effects from), phenobarbital or potassium bromide.<br />
<br />
A recent study showed that the sooner an epileptic dog is put on medication, the better the medication will work, and lower doses will be needed. Historically, veterinarians (including myself) tended to not start anti-seizure drugs until the patient was having seizures with unacceptable frequency ("unacceptable" was based on the owner's tolerance, but I often would suggest that more than every two months was "unacceptable.") Since the newer information has come out, I strongly urge that my epileptic patients start medication after the second seizure. Being able to use lower doses of anti-seizure drugs (lower-doses = less chance for side-effects) with better results is definitely in the best interest of the patient!<br />
<br />
<br />Dr. David Hallhttp://www.blogger.com/profile/06298254530599841492noreply@blogger.com0tag:blogger.com,1999:blog-3777241446538207860.post-88905163267116314252013-09-26T14:26:00.000-05:002013-09-26T14:26:32.091-05:00Well-Thought Complaints From a Client, And My Response<span style="color: blue;">As the owner of a fairly large (4 DVMs, 35 support staff) suburban veterinary practice in the year 2013, I occasionally get complaints from disgruntled clients. Yesterday I received a well-written letter from a client which was clearly thought-through, and significantly, logical. I appreciated the feedback, and the opportunity to respond. Here is her letter, followed by my response and a comment or two.</span><br />
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<span style="font-family: "Comic Sans MS"; font-size: 12.0pt; line-height: 115%;">Dear Horseshoe Lake Animal Hospital,<o:p></o:p></span></div>
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<span style="font-family: "Comic Sans MS"; font-size: 12.0pt; line-height: 115%;">Thank you for the care that you provide my pet. I appreciate the work that you have done in
the past and currently, but I feel that I need to communicate my feelings as
customer feedback. When I first began
bringing my pets to your clinic, I felt that the care was great and the price
was also reasonable; however, in recent years I really dread bringing my pet to
the clinic, because it’s difficult to leave without a $200+ bill and
significant guilt for treatments may be as well. I have several examples from my pets’
histories to call from. <o:p></o:p></span></div>
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<span style="font-family: "Comic Sans MS"; font-size: 12.0pt; line-height: 115%;">One day I brought my dog in for severe diarrhea. She was examined and I was asked if I wanted
a giardia test. I said if you feel that
the test is necessary, then give it to her.
The end result was that she was negative for giardia but she was given
flagyl (Metronidazole) to take at home.
My frustration with this incident is that she was given the treatment
for giardia even though she as negative.
I understand that the treatment for severe diarrhea with a protozoal or
anaerobic bacterial etiology would be Metronidazole. I do not understand why the giardia test is
necessary if she is going to be given the treatment for it despite the test
outcome. It was a waste of your time and
my money to do that test when she was going to receive the medicine
regardless. <o:p></o:p></span></div>
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<span style="font-family: "Comic Sans MS"; font-size: 12.0pt; line-height: 115%;">Secondly, each time I visit for a well animal visit, there are
many options for tests and extra vaccines that are presented to me. Of course I want my dog to have good
treatment and prevention of disease, but I feel that my pet is probably not at
high risk for many of these diseases because she is indoors most of the time
(example: Leptorspirosis vaccine). I
feel guilty for refusing each time I say no to a test or a treatment, but I
suppose if I accepted everything that is offered or recommended, I would leave
with a $300-400 bill. This is more than
I typically spend on my family of 4 per year for healthcare clinic/hospital charges. <o:p></o:p></span></div>
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<span style="font-family: "Comic Sans MS"; font-size: 12.0pt; line-height: 115%;">In addition, I feel that some of the medications are
overpriced and that, since you have your own pharmacy, the option to have the
meds filled elsewhere is taken away. For
example, some antibiotics and generic medications at Schnucks pharmacy and many
other pharmacies are free or next to nothing in price, yet I pay a premium to
have them filled by the pharmacy at the clinic.
I know some veterinary medications are not carried at standard
pharmacies, but some are. In those
cases, I would appreciate your recommendation to have the script filled
elsewhere.<o:p></o:p></span></div>
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<span style="font-family: "Comic Sans MS"; font-size: 12.0pt; line-height: 115%;">Most recently, my pet came in with a limp. I thought I established before the
appointment that the cost of treatment is an issue for me. Two to three weeks prior to the appointment,
my dog hurt herself while chasing a rabbit (or other creature). The injury happened acutely. After examining my dog and feeling an
effusion around the knee, the veterinarian order 2 films- one of the knee, and
one of the pelvis area. Understandably,
he was trying to rule out a hip; and given the acute onset of the injury the
knee was the most likely culprit. To
save cost, it seems prudent to only order 1 x-ray, and if that comes back
negative, to order an additional film if necessary. When patients don’t have insurance to help
offset the cost (and even when insurance is available), prudent management of
diagnostic tests and films is necessary.
Maybe ordering 2 x-ray views in this situation was the same cost of
ordering 1 (I could not tell definitively from my bill); but coming away from
the appointment, I felt that maybe this could have been an unnecessary cost and
I find myself frustrated at myself for agreeing to x-rays at all. At this visit, I also had to reject two of
the three therapies that may help my animal based on cost and this also made me
feel terrible. <o:p></o:p></span></div>
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<span style="font-family: "Comic Sans MS"; font-size: 12.0pt; line-height: 115%;">Please understand, I don’t question the excellence of care
given to animal at your clinic. The
veterinarians and the techs are amazing with the animals. However, to keep coming to the clinic I need
to feel that you are also considering the cost to the “parents” of the
patient. Sometimes I feel like I’m being
taken advantage of by the number of tests and preventative treatments that are
strongly encouraged. I feel like there
might be a money making aspect to some of the recommendations.</span><span style="font-family: 'Comic Sans MS'; font-size: 12pt; line-height: 115%;"> I would just like to feel the vets are
doing their best to keep the cost of care down for the “parents”.</span></div>
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<span style="font-family: "Comic Sans MS"; font-size: 12.0pt; line-height: 115%;">Thank you for your consideration.<o:p></o:p></span></div>
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<span style="font-family: "Comic Sans MS"; font-size: 12.0pt; line-height: 115%;">Sincerely, <o:p></o:p></span></div>
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<span style="font-family: "Comic Sans MS"; font-size: 12.0pt; line-height: 115%;">(Name Withheld By Dr Hall)<o:p></o:p></span></div>
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<span style="font-family: "Comic Sans MS"; font-size: 12.0pt; line-height: 115%;"><br /></span></div>
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<span style="font-family: "Comic Sans MS"; font-size: 12.0pt; line-height: 115%;"><span style="color: blue;">My response:</span></span></div>
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Dear (Name Withheld),</div>
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Thanks so much for your letter. I am always appreciative when clients have
the courage to voice their opinions to us, even if they are unhappy. I would like to address your specific
concerns as much as possible, and also speak to the “big-picture”. By the way, thank you for your nice words
about the care that your pets have received at Horseshoe Lake Animal Hospital.</div>
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I will start with the occasion that you mentioned when (name
withheld) was tested for giardia, and then given Metronidazole anyway. My guess would be that the Metronidazole was
prescribed for its anti-inflammatory effects on the large and small intestine,
and not anti-protozoal. If (name
withheld) would have tested positive for giardia, this would have changed
things in two; and possibly three ways.
First, a follow up giardia test would have been indicated to make sure
the infection was cleared. In our experience,
giardia is probably the most difficult parasite to clear from the body. Second, giardia is potentially contagious to
people. We always have a conversation
with our clients about zoonotic risk when their pets have giardia. And lastly, Metronidazole is no longer
considered the treatment of choice for giardiasis in dogs. Had (name withheld) tested positive, the
doctor probably would have prescribed fenbendazole. I hope this explains why we would not
consider the giardia test to be unnecessary.</div>
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Your second concern involved the tests and extra vaccines
that are presented to you at annual wellness visits. You specifically mentioned
leptospirosis. There is a national
advisory commission that meets every few years to determine the best vaccine
recommendations for companion animals.
This commission has currently determined that there are four “core”
vaccines (vaccines that all patients should receive) for dogs, four “non-core”
vaccines (vaccines that should be administered to at-risk patients), and
numerous non-recommended vaccines. “Lepto”
is considered non-core by the commission, and therefore by us. However, lepto
has become so pervasive that the Veterinary colleges at the University of
Missouri and Purdue University (among many others), consider it “core”. The fact is, just about any dog that goes
outside faces some risk, and dogs that travel away from their homes (like going
for runs/jogs) are at increased risk. I
hope you understand that preventable diseases such as leptospirosis can be
devastating to a dog’s health, and like giardia, lepto is contagious to
people. Our focus is always going to be
putting the best interest of the pet and family first. </div>
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Having said that, we <u>never</u> recommend vaccines from
the non-recommended list , and we do not recommend a
non-core vaccine for a pet with no risk factors, but we will have the
conversation to determine risk. </div>
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You may also be referring to the “wellness testing”
recommended at each annual visit. We do
believe in the value of wellness testing for our patients, and have hundreds of
experiences where early disease detection has benefited them. My personal physician orders labwork on me
every year, even though I perceive myself to be healthy. Since many patients age <u>so</u> much faster
than humans, and they can’t talk to us, I believe that wellness testing is even
more important for them. I do understand
that many pet owners cannot or choose not to spend their dollars on wellness
tests, which is why these things are optional.
But we at least owe it to you to make you aware of the benefits so you
can make an informed decision. </div>
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There is a mention of writing prescriptions for our clients
to take to human pharmacies in order to save money. We do write or call in prescriptions for our
patients on a daily basis. However,
there is even some concern on our part about this practice. Dogs are <u>not</u> small people, and in many
cases the biological activity and dosing of drugs is dramatically different
between people and pets. You may be
aware of the pharmacist in Tacoma who talked this client out of giving the
dosage of medication the veterinarian prescribed for her dog, telling her it
could kill the dog. The dog suffered
needlessly because the owner was afraid to give the medication. </div>
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Lastly, regarding your recent visit with (name withheld), you
are correct that I suspected a problem in her knee. But after practicing for almost 30 years and
seeing some really awful things from missed diagnoses (usually pathologic
fractures from undiagnosed bone tumors), I want to make sure not to miss
something obvious. I do not always order
x-rays for limping dogs (although I probably should), especially if I think
it’s just an arthritic issue or a soft-tissue injury based on history and
physical exam. (Name withheld)’s history
of acute onset single-leg lameness with minimal improvement in over two weeks suggested
something other than arthritis or soft-tissue.
</div>
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Any radiologist will tell you that when radiographing any
body part, <u>two views should always be taken</u>. In (name withheld)’s case, I wanted the V-D
view to also include the hips (pelvis) since that could easily be incorporated
into the V-D view of the knee. This is
standard procedure and gives us “more bang for our buck”.</div>
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In summary, I am truly sorry that you are frustrated with
the costs involved in the care of your pets at our hospital. I hope that this helps you understand that
every decision that we make is driven by what is in the best interest of our
patient. I assure you that surgical
correction of (name withheld)’s knee is reasonable therapy (and may become
imperative at some point), but I felt that conservative treatment also had a
good chance at helping her, and I always prefer that over surgery, when
feasible. If my recommendations are
based on what makes the most money, I would have chosen to recommend surgery.</div>
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I do very much appreciate your feedback, and I hope we can
do a better job of explaining your options, and why we are recommending (or
just discussing) them moving forward. It
is my true and sincere hope that (name withheld)’s knee will do well, and that
she will be running around normally in the future.</div>
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God Bless,</div>
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Dr. David Hall</div>
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<o:p><span style="color: blue;">The only thing I would add is that she mentions that she has the potential to spend more for her vet visits than on her family's healthcare in a year. This conveniently overlooks the THOUSANDS of dollars that she or her employers are spending annually on health insurance, which then pays most of their medical bills. I've seen my health insurance premiums, and I've seen the medical bills before insurance. No one can reasonably assert that veterinary care is anywhere close to the cost of human health care. I assure you, no one at my practice (including me) is getting rich. And by the way, I'm not complaining: I make a good living, and I don't mean to suggest that veterinary care should cost as much as human health care.</span></o:p></div>
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<span style="font-family: "Comic Sans MS"; font-size: 12.0pt; line-height: 115%;"><span style="color: blue;"><br /></span></span></div>
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Dr. David Hallhttp://www.blogger.com/profile/06298254530599841492noreply@blogger.com0tag:blogger.com,1999:blog-3777241446538207860.post-886405948417494052013-09-11T16:53:00.000-05:002013-09-11T16:53:19.730-05:00When The World Gets CrookedIt won't happen to too many pets, but if it happens to yours, it will have you thinking that it's finally time to "put her to sleep." Your dog (or cat) will suddenly (as within a few hours) become extremely disoriented - probably to the point where she is running into things and falling over. There's a good chance she'll vomit, and for sure she will refuse to eat. You may or may not notice that her head is tilted, and her eyes are doing crazy things! You will see these symptoms and fear the worst. And who can blame you? This almost always happens to older pets: the ones that we are waiting and fearing something terrible is going to happen to anyway. And this certainly is something terrible.<br />
<br />
Except, it often isn't as bad as it looks. I just described to you the symptoms that animals with <i>vestibular disease </i>often present with. Vestibular disease is a generic term which simply means there is a problem with the pet's equilibrium. The problem can be located in the inner ear, or more often in the brain. What the pet is experiencing is akin to someone spinning us around at a high rate of speed and then asking us to walk across the room. We will stumble, stagger, and maybe even vomit if we were spinning fast enough.<br />
<br />
The various causes of vestibular disease in pets are still pretty mysterious to us. The most common maladies are "old dog vestibular disease" and "feline vestibular disease." The bad news is that we don't know what causes either one of these syndromes. The current thinking is that they are some form of vascular accident (think "stroke"). The happy news is that the prognosis is usually pretty good. Usually time, antivertigo drugs, and maybe some steroids work wonders for these patients.<br />
<br />
Vestibular symptoms can less-often be caused by inner ear infections, trauma, or tumors. The prognosis varies in these cases.<br />
<br />
My typical workup for a dog or cat with vestibular symptoms is to check the blood pressure (hypertension makes me suspicious of a vascular accident), and thyroid levels (hypothyroid dogs seem to be at increased risk for neurologic problems). I also do a thorough physical exam with special emphasis on the ears. The typical patient will improve over the next 2-4 weeks. If there is no improvement, I will do a more complete blood workup and skull radiographs to look for changes deep in the ear canals. If these tests are normal (which they usually are) and my patient isn't improving, the prognosis is less favorable and I am sending her to a veterinary neurologist for a second opinion and possible MRI.<br />
<br />
I am happy to say that in my personal experience, about 80% of these pets do remarkably well, and the owners are REALLY glad I talked them out of euthanasia.<br />
<br />Dr. David Hallhttp://www.blogger.com/profile/06298254530599841492noreply@blogger.com0tag:blogger.com,1999:blog-3777241446538207860.post-46962074173047131782013-08-29T11:28:00.001-05:002013-08-29T11:28:22.082-05:00Aspirin in Pets - Bad IdeaLast night I had a patient who was in a really bad way. He had a serious arthritic condition which had gotten progressively worse over the past several months to the point where the dog could no longer stand on his back legs. In an effort to help, someone in the house had given the dog aspirin. <i>Ugh.</i> <div>
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<div>
First of all, I could have done a whole lot more for this poor dog had he been brought to me months ago. Arthritis is a relentlessly progressive condition in dogs, and once it occurs, arthritic destruction of cartilage and remodeling of bone cannot be reversed. However, the progression of the disease and the pain that accompanies it can be dramatically reduced in most cases IF TREATED EARLY. Okay, that's not the topic of this blog, so...about that aspirin...</div>
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<br /></div>
<div>
Aspirin in dogs is an effective pain-reliever at the proper dose. In fact, I would prescribe it for some of my patients 20-25 years ago. You can still buy "doggie aspirin" with the dose listed on the bottle. But unfortunately, aspirin has a very high potential to cause more problems than it helps. The number-one risk is gastric ulceration, which can cause death from hemorrhage or stomach perforation. I have seen it happen. Aspirin can also cause kidney failure, especially in older pets (which are the ones most likely to receive it).</div>
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<br /></div>
<div>
Now we have newer drugs which are similar to aspirin, but much safer and more effective. These drugs can also cause serious side-effects, but their risk-profile is muuuuuch safer! The problem is, if our patient has been given aspirin for any recent length of time, it changes the dog's ability to handle the safer drugs. What this means is, if you give your dog more than one dose of aspirin before bringing him to see me, you have effectively tied my hands from giving him something much better and safer. </div>
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<br /></div>
<div>
Dogs who have received previous aspirin therapy should go through a 5-7 day "washout" period of no medication, before we can give the good stuff. During this time, the dog has to suffer with the pain that we could be treating had the dog not been given aspirin. </div>
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<br /></div>
<div>
As a side-note, aspirin is quite toxic in cats, except at super-low doses and prolonged intervals. Never give aspirin (or Tylenol) to a cat without specific instructions from a veterinarian. You know what? Let's just not give any medication to our pets without first checking with the vet. DVMs know what is safe, and at what dose. Use us! That's what we're here for.</div>
Dr. David Hallhttp://www.blogger.com/profile/06298254530599841492noreply@blogger.com0tag:blogger.com,1999:blog-3777241446538207860.post-8529585266602187022013-08-12T14:54:00.000-05:002013-08-12T14:54:37.985-05:00The Difficult DecisionFive minutes ago, I ended the life of an older, but not "ancient" cat on a soft towel in a quiet room in the back of my office. She went to sleep peacefully and painlessly. This cat belonged to some nice folks that my family has been acquaintances with for a long time. The husband spoke to me yesterday about their cat. I was not at work, and we had been talking about something else (probably sports), when he abruptly mentioned that his cat had started urinating and vomiting all over the house. She had ruined several pieces of furniture as well as the carpet in the basement. He said, "I think it's time to put her down, don't you?"<br />
<br />
I never quite know how to respond to those situations, because you see, we had not seen his cat in two years. I assumed that since he hadn't brought her for an exam (and possible testing), that he really wasn't interested in trying to find out why she was vomiting and urinating all over. He was really just wanting me to "sign off" on a decision that had already been made. The cat had originally belonged to his son, who had long since moved away.<br />
<br />
I'm not judging him. There are often mitigating factors when people decide that it's best to end the life of a pet. We usually are not privy to these circumstances. I believe that sometimes the person making the decision isn't even aware of some of the psychological "baggage" that is influencing their choice. The gentleman in my story is an intelligent guy. He is smart enough to know that maybe I could have done something medically that would have helped his cat. He's also smart enough to know that it might have been expensive, unrewarding (ie ineffective), or labor-intensive (have you ever tried sticking pills down a cat every day?)<br />
<br />
So he probably had his reasons for not seeking my medical assistance, but instead my reassurance that they were making the "right" decision. Was it the "right" decision? I am humble enough to admit that I don't know. There are simply too many factors that I am unaware of.<br />
<br />
I do know this: His is a good family, and although the cat might not be high on their priority list, I think they provided a comfortable home for her. I also know that humane euthanasia results in no suffering for the pet. I was there to make sure she left this world in a painless manner (which is better than many of us will have.) For reasons of their own, they chose euthanasia over exploring medical options. It's not the decision I would have made, but that doesn't make it wrong.<br />
<br />
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<br />Dr. David Hallhttp://www.blogger.com/profile/06298254530599841492noreply@blogger.com0tag:blogger.com,1999:blog-3777241446538207860.post-85135650604233051832013-06-11T10:43:00.001-05:002013-06-11T10:43:14.139-05:00Tularemia - An Emerging Threat To Cats and PeopleThis just in from the Illinois State Veterinary Medical Association:<br />
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<b id="yui_3_7_2_1_1370964180459_9126"><span id="yui_3_7_2_1_1370964180459_9125" style="color: #ed7b0f; font-family: Arial, sans-serif; font-size: 11pt;">Cats Test Positive for Tularemia</span></b></div>
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<strong id="yui_3_7_2_1_1370964180459_9124"><i id="yui_3_7_2_1_1370964180459_9123"><span id="yui_3_7_2_1_1370964180459_9122" style="color: #213667; font-family: Verdana, sans-serif; font-size: 10pt;">Champaign-Urbana Public Health District Encourages Citizens to Keep Cats Indoors to Help Minimize Tularemia</span></i></strong><span id="yui_3_7_2_1_1370964180459_9120" style="color: #213667; font-family: Verdana, sans-serif; font-size: 10pt;"><br /><br />Champaign, IL – The Champaign-Urbana Public Health District (CUPHD) is encouraging area residents to keep cats indoors to reduce the likelihood of contracting tularemia. The Champaign-Urbana Public Health District has identified two additional cats positive for tularemia in Champaign-Urbana. Previously, five cats were diagnosed with tularemia at the University of Illinois, College of Veterinary Medicine; one cat from Champaign and one from Urbana; and three cats from two households in Savoy. Tularemia is caused by the bacterium Francisella tularensis found in animals (especially rodents, rabbits and hares).</span></div>
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<span id="yui_3_7_2_1_1370964180459_9131" style="color: #213667; font-family: Verdana, sans-serif; font-size: 10pt;">Cats may prey on rabbits and rodents and become infected or they may become infected through tick exposure. Cats may develop a variety of symptoms including high fever, mouth ulcers, depression, enlarged lymph nodes and behavioral changes including not eating. Persons whose cats have contact with the outdoors should take their pet into the veterinarian if they should develop these symptoms.</span></div>
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<span id="yui_3_7_2_1_1370964180459_9134" style="color: #213667; font-family: Verdana, sans-serif; font-size: 10pt;">People may also contract tularemia developing sudden fever, chills, headaches, diarrhea, joint pain, muscle aches, cough and weakness. People can become infected by handling pets or wild animals with tularemia, being bitten by ticks or by inhaling the organism. If you develop symptoms of tularemia see your health care provider.</span></div>
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<span style="color: #213667; font-family: Verdana, sans-serif; font-size: 10pt;">To reduce the chances that your cat will become infected:</span></div>
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<span style="color: #213667; font-family: Verdana, sans-serif; font-size: 10pt;">• Do not allow your cat to hunt outdoors<br />• Consult with your veterinarian to make sure your cat is protected from tick bites<br />• Report any unexplained large die-offs of rodents or rabbits to your local animal control. • To reduce the chance that you or your family members will become infected:</span></div>
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<span id="yui_3_7_2_1_1370964180459_9155" style="color: #213667; font-family: Verdana, sans-serif; font-size: 10pt;">• Wear tick protection when outdoors<br />• Do not mow over sick or dead animals<br />• Do not handle wild animals<br />• Cook wild game meat thoroughly before eating and use gloves when handling the animal and preparing the meat for cooking<br />• Take any pet with symptoms of tularemia to the veterinarian</span></div>
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<span id="yui_3_7_2_1_1370964180459_9150" style="color: #213667; font-family: Verdana, sans-serif; font-size: 10pt;">If you have questions about tularemia in humans, please contact Rachella Thompson, Communicable Disease Investigator, with CUPHD at (217) 531-5361 or your health care provider. If you are a cat owner or have questions about tularemia in animals, please contact your veterinarian. Visit <a href="http://www.bt.cdc.gov/agent/tularemia/facts.asp" id="yui_3_7_2_1_1370964180459_9152" rel="nofollow" style="color: purple; outline: 0px;" target="_blank"><span id="yui_3_7_2_1_1370964180459_9151" style="color: #ed7b0f;">http://www.bt.cdc.gov/agent/tularemia/facts.asp</span></a> or<a href="http://www.avma.org/public_health/biosecurity/tularemia_facts.asp" rel="nofollow" style="color: purple; outline: 0px;" target="_blank"><span style="color: #ed7b0f;">http://www.avma.org/public_health/biosecurity/tularemia_facts.asp</span></a> for additional information.</span></div>
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<span style="color: #213667; font-family: Verdana, sans-serif; font-size: 10pt;">Note from Dr Hall: There is no vaccine for Tularemia!</span></div>
Dr. David Hallhttp://www.blogger.com/profile/06298254530599841492noreply@blogger.com0tag:blogger.com,1999:blog-3777241446538207860.post-17950585738702796822013-05-21T12:03:00.001-05:002013-05-21T12:03:50.693-05:00Laser Therapy -- The Latest and GreatestAfter years of research, conferences, and opinion-gathering, we finally took the plunge and purchased a therapeutic laser for our veterinary hospital. Normally equipment purchase decisions are not so agonizing, but therapeutic lasers are so new in veterinary medicine that there aren't a lot of published, refereed studies to prove (or refute) their efficacy. We take considerable pride at our hospital in the fact that we practice "evidence-based" medicine, which basically means that the medications and other therapies we recommend have been proven effective (usually in university studies). Therapeutic laser is really not an evidence-based therapy. Yet.<br />
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The majority of veterinarians I have talked to over the past couple of years who use laser therapy could not say enough good things about it. I have attended laser therapy lectures at major veterinary conferences and been impressed by the tremendous upside and the lack of an actual downside. Once we decided to purchase a laser, we opted to go with the one we felt was clearly superior to all the others, and that was an MLS unit. This unit uses two different wavelengths simultaneously to control pain and inflammation. There is no heat generated (thus the sometimes-used term "cold laser"), and no discomfort to the pet.<br />
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The great news is the results we have seen in the few weeks since we started using the laser. The most obvious benefit can be seen in patients with traumatic wounds. We are witnessing a speed of wound healing which has absolutely amazed all of us. There are pictures posted on our Facebook page which show this. But we are also seeing it's benefits for cats with bladder problems, joint pain, post-surgical pain and inflammation, abscesses, and spinal problems. I will say that there have been some cases that have responded less dramatically than others, but I have found that to be true of any treatment modality I have ever used. There is no such thing as one therapy that works better than all others in every situation.<br />
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The bottom line is that I am thrilled that we have the laser and that it has out-performed our expectations. Many of our staff have asked us to let them use it on themselves which I guess is the best testimony of all. Dr. David Hallhttp://www.blogger.com/profile/06298254530599841492noreply@blogger.com2tag:blogger.com,1999:blog-3777241446538207860.post-60481195883005300932013-02-25T11:07:00.001-06:002013-02-25T11:07:59.440-06:00Pain Control as an Option? Really?I'm going to share an "industry" secret with you. We price-shop our competition. All veterinary hospitals/clinics do this as a way to make sure our prices are in line. We have to do this by calling other veterinary clinics and pretending to be a price-shopping client. Anti-trust laws prevent us from having honest discussions with our competition about what they/we charge, so we all have to be clandestine.<br />
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Anyway, as we were calling around last week to get price quotes for dental and surgical procedures, we discovered something that disturbs me very much. A small number of veterinarians consider pain medication and/or IV fluids optional. The absence of pain-controlling medication for an invasive surgical or dental procedure is, in my opinion, barbaric. Would anybody out there be willing to experience a hysterectomy, castration, or tooth extraction and wake up with nothing to help the pain? Really? If you were the patient, would you want your surgeon to make that an optional thing?<br />
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When I was in veterinary school in the '80s, pain control was not a point of major emphasis. We were taught that animals don't experience pain in the same way as humans, and that some degree of pain was helpful in preventing our patients from "over-doing" it after surgery. We now know that animals in pain are adept at hiding it, but they are hurting/suffering just as much as we would be under similar circumstances. We also know that effective pain control actually speeds healing. So there is a comfort benefit and a medical benefit.<br />
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Without going into a boring physiological description, I would like to briefly describe the purpose of IV fluids in an anesthesized patient. First of all, it gives the surgeon/anesthesist quick venous access in case of an anesthetic emergency, or even if the patient needs additional pain control under anesthesia. Secondly, it allows much greater regulation of blood pressure in these patients. We now know that most anesthesized patients experience a significant drop in blood pressure, which could result in organ damage that may not show up for weeks or months. Even though these patients may "wake up" from their procedure just fine, damage HAS been done. Only IV fluids and blood pressure monitoring can minimize this risk for the patient under general anesthesia.<br />
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For a veterinarian to skip, or make optional, these services, in order to offer a cheaper spay (or whatever), is unforgiveably irresponsible.Dr. David Hallhttp://www.blogger.com/profile/06298254530599841492noreply@blogger.com0tag:blogger.com,1999:blog-3777241446538207860.post-13999543962244981332013-01-28T14:47:00.000-06:002013-01-28T14:47:50.796-06:00I Bet You Don't Take Your Cat To The VetAdmit it. You have a cat that I, your veterinarian, don't even know about. I have been taking care of your dogs for many years now, so we know each other pretty well. But you never mention that cat. I know what you're thinking. "Why should we talk about the cat? He seems healthy enough, never goes outside, and besides, he HATES car rides and new situations."<br />
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You are in good company. The overwhelming majority of American cat-owners do not take their cats for routine check-ups and vaccines. They all think like you do (we have survey results). It's understandable, but dead-wrong to not give your feline friend the same medical care as dogs get. I blame myself (and my colleagues) for your misinformation. Veterinarians do not do a good job of educating the public about why cats NEED regular veterinary care. So here I am, trying to help correct this oversight.<br />
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I'm going to start with the most important reason to take your cat to the vet every year. Cats are amazing at hiding signs of illness. I mean really gifted. More often than not, when we see a sick cat, we see a cat who is in real danger of dying from their disease. And the owners of these dying felines usually tell us that their cat has only been sick for a few days (and doesn't even seem too sick). Meanwhile, the weight loss, pale mucous membranes, heart murmur, jaundiced eyes, or disastrous lab results tell a different story. The owners simply never noticed the signs because the cat was too clever to give himself away.<br />
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You see, cats are not small dogs. If one of your cats lost 2 pounds (20-25% weight loss) over a 6-month period, would you notice? Or if one of your cats was drinking more or urinating more? What if one of your cats (assuming, like many cat owners, you have three or more) stopped eating, and was hiding more? How long before you notice? Well, you can bet that most cats are sick long before they start even showing these signs that you won't notice.<br />
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I can tell you with total confidence, that cats who get regular check-ups will have their diseases noticed much sooner, with less medication needed, and most-importantly, a better prognosis. <br />
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What about the fact that, unlike your dogs, your cats never go outside? This makes them less at-risk, right? Hmmm.... maybe so, but not much. Parasites, and disease carrying vectors will find their way into every home. Did you know that most commercial potting soil is contaminated with roundworm eggs? Also, indoor-only cats are actually at an increased risk (compared with indoor-outdoor cats) for certain diseases such as interstitial cystitis. The most important thing to think about here, though is this: staying inside will not protect your cats from diabetes, hyperthyroidism, chronic liver and kidney disease, asthma, etc....<br />
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Now, I know your cat hates to ride in the car, and hates new situations. My cats do too. However, we do have a special cat-friendly exam room just for him. We like cats here. We will be gentle. He will still get stressed out, but in all honesty, didn't your kids get stressed out at the doctor when they were little? But you still took them, because the alternative was very frightening. Your cat is in the same situation. I know you love him and want the best for him. You didn't know! Now you do. I will see you both soon. :-)Dr. David Hallhttp://www.blogger.com/profile/06298254530599841492noreply@blogger.com0tag:blogger.com,1999:blog-3777241446538207860.post-47322092866339915812012-11-06T12:24:00.003-06:002012-11-06T12:27:17.678-06:00Pets Aren't FruitcakesWith the holiday season fast approaching, this is a good time to write about something that bothers every veterinarian I know, which is the concept of giving a pets as presents. If you stop to think about it, you can easily figure out how this might not be a good idea, but in case you can't, I will explain.<br />
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A pet (and I'm talking mostly dogs and cats here) is an ongoing expense, and a LOT of work. When you give someone a pet, you are giving them a tremendous amount of responsibilty that they may not have asked for. Those of us who love our pets (and consider them family members) are willing to deal with the accidents on the rug, the chewed-up furniture, the need to skip happy hour so we can let the dog out, the smelly litter box, the humongous vet bills, and all of that...because WE agreed to these things when we got our pet(s). <br />
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However, if you aquire a pet involuntarily, all of these issues become yours for the next 10-15 years. Merry Christmas. As a veterinarian, and especially in my position of County Veterinarian, I have witnessed what can happen when someone gets a pet they didn't ask for. Usually it's the pet that suffers the most. These innocent animals are neglected, resented, and occasionally abandoned or abused. That's a tragic thing for a creature who mostly wants love and companionship. Sometimes, the owner tries valliantly to do right by their unwanted pet. But this can be sad too. I've had several nice folks bring their "gifts" to me for regular check-ups and illnesses, but with every visit they say, "You know, he's a nice dog - I just didn't ever want him. I feel guilty saying this but...I'll be glad when he's gone."<br />
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We animal-lovers know how special and wonderful it can be to have the companionship of a beloved pet (or pets in most cases!) But there has to be just as much commitment and devotion from the owner as there is from the animal. The decision to become a pet-owner, and what type of pet to get, is one that should take a lot of thought, and should never ever be made for someone else. <br />
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Can't decide on what to give someone? Give them a fruitcake. At least no one is hurt if that gets neglected or discarded.<br />
<br />Dr. David Hallhttp://www.blogger.com/profile/06298254530599841492noreply@blogger.com0tag:blogger.com,1999:blog-3777241446538207860.post-17121876587567628252012-10-26T16:54:00.000-05:002012-10-26T16:54:13.082-05:00You Think Your Dog Is Safe, But...One of the large veterinary pharmaceutical companies recently conducted a survey of clients leaving veterinary clinics who had declined heartworm preventative medication for their dogs. When questioned why they had chose not to protect their dogs from heartworms, the most common responses were: 1.They didn't think it was very likely that their pet could get heartworms 2.They figured it would be cheaper to just treat the dog if it got heartworms than to pay for preventative medication. This blog is to address these misconceptions.<br />
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First off, heartworms are much more common than people believe. At our practice, the majority of our dog-owning clients give their pets at least <em>some</em> heartworm preventative. Unfotunately, many of these folks skip or "miss" a few months every year (even though they tell us otherwise, the data doesn't lie). Of the dogs who get no heartworm prevention or intermittant heartworm prevention, we see more than <strong>sixty</strong> new cases of heartworm infections per year at our practice alone! Here's what their hearts will look like:<br />
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Because heartworms are spread by mosquitos, ALL dogs in the midwest are at risk without prevention. The travesty of this is how easily (and relatively inexpensively) heartworm infection can be prevented. We sell heartworm prevention pills which cost from $5 a month for small dogs to $7.50 a month for large dogs. There is even a twice-yearly shot for those who hate pills! In contrast, it typically costs $500-$1,000 to safely treat a heartworm-infected dog. Plus, you don't have to subject the dog to what is shown in the photo above.<br />
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I had to tell a long-standing client this week that her 9-year old dog had heartworms. She had always purchased preventative from us, but admitted that she did occasionally skip a month when she wouldn't get around to picking up more pills. She is now racked with guilt (she cried when I gave her the news), and faces the expensive prospect of heartworm therapy. She's one of those who always thought "It can't happen to my dog."<br />
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The take-home message? Get your dog tested every year, and buy a year's worth of preventative when you do. The medication is much cheaper when purchased as a full year's supply, and you are less likely to subject your best friend to what is shown in the photo above.Dr. David Hallhttp://www.blogger.com/profile/06298254530599841492noreply@blogger.com0