I don't know if I have admitted it on here yet, but for a little over a year, we have been a Golden Retriever family. Our Golden (named "Baron") is really Kathy's dog, and she is his "person," but he is happy to include me in his activities when Kathy is not paying attention to him.
Anyway, as I was roughhousing with Baron this morning, I realized that he is really a very lean and muscular dog...and I am happy about that. In fact, he is pretty different from many of the large-breed dogs I see in my practice. Like people in America, our dogs are fatter than ever.
Now I know we are all tired of hearing about the health risks associated with obesity in people and in pets, so I'll keep this short and to the point. The most common reason large-breed dogs are euthanized at my practice is because of crippling arthritis, which is usually complicated (or caused) by obesity. Purina did an eye-opening study a few years ago in which two groups of Labrador Retrievers were free-fed, or fed limited quantities their entire lives. The average dog in the free-fed group lived eighteen months less than the average dog in the limited-quantity group. This means that lean Labradors live about 12% longer!
It is reasonable to extrapolate this information to all large breeds. I know that Kathy would do anything to get an extra 18 months of health for Baron. So our 80-pound dog gets 3 and 1/2 measuring cups of food per day, and a cracker-sized treat at night. The rule of thumb for feeding adult dogs is 1/2 cup of dog food per 20 pounds of dog twice a day. For puppies, it's 1/2 cup of puppy food per 10 pounds given twice a day. I have learned the hard way not to estimate the volume of food you're giving -- get an actual measuring cup to scoop the food!
A couple of quick notes on cat nutrition would be approriate here. Recently-published data shows that most cat food label directions will result in over-feeding cats. This data recommends (as do I) feeding adult cats 30% less than the label says. Additionally, we now know that there are a number of feline diseases which can be effectively treated by giving canned veterinary diets. Therefore, I recommend supplementing dry kitten or cat food with a teaspoon (or less) of canned food several times a week, just so these cats will learn to eat canned food in case it ever becomes necessary later in life.
I get asked a lot about raw-meat diets lately, and there is some debate about canned vs dry food in cats, so those will be topics of a future blog. I know, I know...my future blogs tend to be waaaay in the future. I will try to do better!
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Wednesday, August 17, 2011
Friday, July 22, 2011
Gotta Love Pet Insurance
I have a friend who LOVES Shar Peis. She has five of the wrinkley little creatures. Now, owning a Shar Pei (by the way, "Shar Pei" is a breed of dog that is covered with wrinkles) is not for the faint of heart. These dogs have enough medical problems to keep a small veterinary practice in business all by themselves.
Anyway, my friend was telling me about her experience with her pet insurance provider, Trupanion. One of her recently-acquired pups had developed horrible ear canal disease; so much so that both ear canals had almost completely grown shut with swollen tissue. Medical therapy wasn't helping much, and the ears were miserable.
The only recourse to alleviate the suffering was to remove the ear canals altogether. The surgery is called a "total ear ablation" and required the expertise of a board-certified veterinary surgeon. As you can imagine, it wasn't cheap. I think the total cost was in the $1500 range. Right. Ouch. But the cool thing is that she had purchased a pet health insurance policy from Trupanion just after a free trial membership. She paid the bill for the surgery, then submitted the claim. Within two days she got an email telling her the claim was being processed. Within a week, she had been reimbursed for about 90% of the bill! So before the sutures were even out, the surgery was paid for, and her pup was feeling great.
This is is very typical of the feedback I get from clients who purchase pet health insurance. The premiums are reasonable, and most companies pay quickly and generously. We all know that veterinary medicine is capable of some pretty miraculous things in this new century. We also know that these miracles are only available to those with the means to pay for them. Pet insurance is a reasonable way to make the miraculous stuff available.
A few tips: 1.Buy insurance while your pet is young. Premiums will be cheaper, and there will be less chance of your pet having a pre-existing condition which won't be covered. 2.Buy a "Major-Medical" type policy that does NOT cover routine care such as shots and dental cleanings. You can plan and save for routine care, and the premiums will be much lower. 3.Some pet insurance companies will not cover certain conditions in breeds that are pre-disposed to those conditions. Check in to this before purchasing a policy.
In this age of veterinary miracles, pet insurance is your way to make sure our miracles are available to you.
Anyway, my friend was telling me about her experience with her pet insurance provider, Trupanion. One of her recently-acquired pups had developed horrible ear canal disease; so much so that both ear canals had almost completely grown shut with swollen tissue. Medical therapy wasn't helping much, and the ears were miserable.
The only recourse to alleviate the suffering was to remove the ear canals altogether. The surgery is called a "total ear ablation" and required the expertise of a board-certified veterinary surgeon. As you can imagine, it wasn't cheap. I think the total cost was in the $1500 range. Right. Ouch. But the cool thing is that she had purchased a pet health insurance policy from Trupanion just after a free trial membership. She paid the bill for the surgery, then submitted the claim. Within two days she got an email telling her the claim was being processed. Within a week, she had been reimbursed for about 90% of the bill! So before the sutures were even out, the surgery was paid for, and her pup was feeling great.
This is is very typical of the feedback I get from clients who purchase pet health insurance. The premiums are reasonable, and most companies pay quickly and generously. We all know that veterinary medicine is capable of some pretty miraculous things in this new century. We also know that these miracles are only available to those with the means to pay for them. Pet insurance is a reasonable way to make the miraculous stuff available.
A few tips: 1.Buy insurance while your pet is young. Premiums will be cheaper, and there will be less chance of your pet having a pre-existing condition which won't be covered. 2.Buy a "Major-Medical" type policy that does NOT cover routine care such as shots and dental cleanings. You can plan and save for routine care, and the premiums will be much lower. 3.Some pet insurance companies will not cover certain conditions in breeds that are pre-disposed to those conditions. Check in to this before purchasing a policy.
In this age of veterinary miracles, pet insurance is your way to make sure our miracles are available to you.
Monday, June 27, 2011
My "Sick" Cat
My name is David Hall, and I'm an inconsistent blogger. It's been two months since my last blog. Hi David.
All I can say is it's been a busy summer! I'm here now, and I wanted to share a personal story about one of our family cats named "Mae". Mae is about ten years old and has lived with us almost her entire life. She started off as my oldest son Tristan's cat, then adopted my youngest son, Dylan, when Tristan moved out.
Mae is a very mellow "live and let live" kind of cat. She tolerates anything and is most happy sitting on the pillow next to Dylan as he sleeps. We had noticed that Mae seemed to be losing a little weight, but we weren't too worried about it since Mae has always struggled to maintain her ideal weight. OK, she's fat.
Anyway, when we brought Mae in for her annual check-up, labwork, and vaccines, we got an unpleasant surprise: Mae has diabetes.
The good news for Mae (and us) is that diabetes in cats can often be "cured." With a specific type of insulin (Lantis), a special diet (M/D by Hills), and monitoring and adjusting at home, any diabetic cat, if diagnosed early, has a reasonable chance of going into remission, and resuming a normal life without further insulin injections.
We have started Mae's insulin, and Dylan regularly gives her her special food. I will be teaching my wife how to get a drop of blood from Mae's toe to test her sugar levels (this has to be done four hours after the insulin when I'm typically at work). We are hopeful that we can cure her, and thankful that we did the "routine" labwork at her check-up. If Mae's diabetes had gone on undetected, we would have had a much sadder prognosis.
All I can say is it's been a busy summer! I'm here now, and I wanted to share a personal story about one of our family cats named "Mae". Mae is about ten years old and has lived with us almost her entire life. She started off as my oldest son Tristan's cat, then adopted my youngest son, Dylan, when Tristan moved out.
Mae is a very mellow "live and let live" kind of cat. She tolerates anything and is most happy sitting on the pillow next to Dylan as he sleeps. We had noticed that Mae seemed to be losing a little weight, but we weren't too worried about it since Mae has always struggled to maintain her ideal weight. OK, she's fat.
Anyway, when we brought Mae in for her annual check-up, labwork, and vaccines, we got an unpleasant surprise: Mae has diabetes.
The good news for Mae (and us) is that diabetes in cats can often be "cured." With a specific type of insulin (Lantis), a special diet (M/D by Hills), and monitoring and adjusting at home, any diabetic cat, if diagnosed early, has a reasonable chance of going into remission, and resuming a normal life without further insulin injections.
We have started Mae's insulin, and Dylan regularly gives her her special food. I will be teaching my wife how to get a drop of blood from Mae's toe to test her sugar levels (this has to be done four hours after the insulin when I'm typically at work). We are hopeful that we can cure her, and thankful that we did the "routine" labwork at her check-up. If Mae's diabetes had gone on undetected, we would have had a much sadder prognosis.
Wednesday, April 13, 2011
Do Animals Feel Pain?
When I was in veterinary school, we didn't talk too much about animal pain. It was a topic mostly discussed from the perspective of using analgesics ("pain-killers") to enable us to use lower doses of anesthetics in high-risk surgery patients. That's all I remember. I'm not sure we were taught this, but I do recall having a very definite impression that animals do not experience pain in the same way humans do. I do remember being taught that post-surgical pain is a good thing, at least to a certain extent, because it is nature's way of preventing the patient from doing things they aught not to.
Looking back, these concepts seem barbaric to me, although I admit that I adhered to them in my early years. Like my colleagues in the profession, I simply didn't know any better. The truth is, animals demonstrate pain very differently than people, but things that would be painful to us are just as painful to our dogs and cats. We often don't percieve that they hurt, because they can be quite adept at disguising the pain, especially cats. I have seen fascinating video footage of dogs recovering from painful surgical procedures in which they appear alert and relaxed/happy when a human is in the room, only to demonstrate obvious signs of pain and discomfort when left alone.
I am happy to report that today's veterinarians are fully aware and proactive in dealing with painful conditions. We also have numerous resources in dealing with animal pain, from narcotics and other analgesics, to physical therapy, acupuncture, massage, and local anesthetic agents, among others. There are classes, seminars, and textbooks on veterinary pain management. Veterinarians are trained to recognize potentially-painful conditions and the subtle symptoms on animal pain. Even though we have a hightened awareness of pain in our patients, it can still be tricky to diagnose.
We also know that the concept of pain as a useful mechanism to prevent an injured (or recently-operated-on)pet from doing things he or she shouldn't is mostly flawed. Pain-response studies demonstrate that patients whose pain is well-controlled have significantly shorter healing times. Similarly, arthritic patients whose pain is treated are much more mobile, which allows the joints to benefit from the "physical therapy" benefits of simple activities such as walking and running.
Looking back, these concepts seem barbaric to me, although I admit that I adhered to them in my early years. Like my colleagues in the profession, I simply didn't know any better. The truth is, animals demonstrate pain very differently than people, but things that would be painful to us are just as painful to our dogs and cats. We often don't percieve that they hurt, because they can be quite adept at disguising the pain, especially cats. I have seen fascinating video footage of dogs recovering from painful surgical procedures in which they appear alert and relaxed/happy when a human is in the room, only to demonstrate obvious signs of pain and discomfort when left alone.
I am happy to report that today's veterinarians are fully aware and proactive in dealing with painful conditions. We also have numerous resources in dealing with animal pain, from narcotics and other analgesics, to physical therapy, acupuncture, massage, and local anesthetic agents, among others. There are classes, seminars, and textbooks on veterinary pain management. Veterinarians are trained to recognize potentially-painful conditions and the subtle symptoms on animal pain. Even though we have a hightened awareness of pain in our patients, it can still be tricky to diagnose.
We also know that the concept of pain as a useful mechanism to prevent an injured (or recently-operated-on)pet from doing things he or she shouldn't is mostly flawed. Pain-response studies demonstrate that patients whose pain is well-controlled have significantly shorter healing times. Similarly, arthritic patients whose pain is treated are much more mobile, which allows the joints to benefit from the "physical therapy" benefits of simple activities such as walking and running.
Wednesday, March 30, 2011
Cats That Pee On The Floor
I love cats. I have three at my house! Having said that, for some animal-lovers, the point of choosing a cat instead of a dog is to avoid dealing with the whole housebreaking thing. Cats use litter boxes, therefore no one needs to be home to let them outside to "do their business." Ah, but as with so many things in life, the cat doesn't always stick to the plan. At our hospital we see several cats a week for what we term "litter box avoidance."
We can generally classify the causes of litter box avoidance as either due to bladder pain (physiologic), or due to environmental factors (behavioral). Most of us who have ever had a UTI can relate to the bladder pain issue. These cats feel pain which they associate with urination, which they associate with the litter box. So they avoid the litter box. They also may feel like they have to "go" all the time, and they just can't make it to the box. We can usually tell which cats fall in this category based on the history (frequent, small-volume urination; vocalizing when urinating), and urinalysis results which show evidence of inflammation in the urine (usually increased red or white blood cells).
Once we determine that a cat has a bladder problem, we can bet that it's one of four things: an infection (UTI), a stone, a tumor, or "interstitial cystitis" (IC). You all know what the first three are, but probably haven't heard of interstitial cystitis. "IC" goes by many other names (Feline Urologic Syndrome, Feline Lower Urinary Tract Disease, Idiopathic Cystitis) which usually means, as in this case, that not much is known about it. The disease causes pain and inflammation in the bladder (including the presence of blood, crystals, or other substances), and in male cats can lead to urethral obstruction and the life-threatening inability to urinate.
Current thinking is that IC is a stress-associated condition which only occurs in certain predisposed cats. But we really don't know. There is no good treatment, but the symptoms often run their course, sometimes to reoccur later. The best therapy in my hands is feeding canned food exclusively (preferably Science Diet C/D --I really think it helps!) and the anti-anxiety drug amitriptylline. Encouraging a cat's natural predatory instincts (hunting, stalking prey) also seems to help. This can be accomplished by letting the cat chase a string, toy mouse, etc...
Diagnosing IC is also challenging. Here are my guidelines for diagnosing/treating cats with bladder inflammation. First of all, I know that UTI's and IC are far more common than stones and tumors; furthermore, UTI's are more common in old cats (and diabetic cats), while IC is more common in young cats. So if the cat is old or diabetic, I will try antibiotics first and see if things get better. If the cat is young, I will treat for IC first. If treatment is not successful (in either case), I will take an X-Ray to look for a stone. If there is no stone, I might do a urine culture to verify the presence or absence of bacteria (UTI). If all tests and treatments are unsuccessful, and the cat still has blood (or other stuff!) in the urine, I will recommend an ultrasound to look for a tumor. Again, with IC, all tests will be normal.
One thing that bothers me is when vets automatically put all cats with blood in the urine on antibiotics. If the cat is young, it probably does not have a UTI. When the cat is rechecked a few weeks after the antibiotic, it may be better. This is not due to the antibiotic, but because of the waxing-waning nature of IC. Even though antibiotics are generally safe, their indiscriminate use can lead to the development of resistant strains of bacteria. And that is becoming a big problem in our country.
As I mentioned at the beginning, some cats who have "litter box avoidance" have normal results on their urinalysis. I generally classify these cases as behavioral. They may be avoiding the box because they don't like the box (it's not clean enough, they don't like the cat litter, they don't like sharing it with other cats, it is not in a "private" enough location, etc...), or something else has upset them and they are showing their displeasure by urinating in inappropriate places. This might be due to a new pet or person in the house, a strange cat in the yard (cats love to look out the window), or some other change in their routine. It could also be due to the cat not feeling well. Sometimes the first sign of serious illness in a cat is litter box avoidance. For this reason, these cats should always be checked out by a vet.
Believe it or not, litter box avoidance is a fairly common cause of euthanasia in cats. I hope this blog helps shed some light on the issue.
We can generally classify the causes of litter box avoidance as either due to bladder pain (physiologic), or due to environmental factors (behavioral). Most of us who have ever had a UTI can relate to the bladder pain issue. These cats feel pain which they associate with urination, which they associate with the litter box. So they avoid the litter box. They also may feel like they have to "go" all the time, and they just can't make it to the box. We can usually tell which cats fall in this category based on the history (frequent, small-volume urination; vocalizing when urinating), and urinalysis results which show evidence of inflammation in the urine (usually increased red or white blood cells).
Once we determine that a cat has a bladder problem, we can bet that it's one of four things: an infection (UTI), a stone, a tumor, or "interstitial cystitis" (IC). You all know what the first three are, but probably haven't heard of interstitial cystitis. "IC" goes by many other names (Feline Urologic Syndrome, Feline Lower Urinary Tract Disease, Idiopathic Cystitis) which usually means, as in this case, that not much is known about it. The disease causes pain and inflammation in the bladder (including the presence of blood, crystals, or other substances), and in male cats can lead to urethral obstruction and the life-threatening inability to urinate.
Current thinking is that IC is a stress-associated condition which only occurs in certain predisposed cats. But we really don't know. There is no good treatment, but the symptoms often run their course, sometimes to reoccur later. The best therapy in my hands is feeding canned food exclusively (preferably Science Diet C/D --I really think it helps!) and the anti-anxiety drug amitriptylline. Encouraging a cat's natural predatory instincts (hunting, stalking prey) also seems to help. This can be accomplished by letting the cat chase a string, toy mouse, etc...
Diagnosing IC is also challenging. Here are my guidelines for diagnosing/treating cats with bladder inflammation. First of all, I know that UTI's and IC are far more common than stones and tumors; furthermore, UTI's are more common in old cats (and diabetic cats), while IC is more common in young cats. So if the cat is old or diabetic, I will try antibiotics first and see if things get better. If the cat is young, I will treat for IC first. If treatment is not successful (in either case), I will take an X-Ray to look for a stone. If there is no stone, I might do a urine culture to verify the presence or absence of bacteria (UTI). If all tests and treatments are unsuccessful, and the cat still has blood (or other stuff!) in the urine, I will recommend an ultrasound to look for a tumor. Again, with IC, all tests will be normal.
One thing that bothers me is when vets automatically put all cats with blood in the urine on antibiotics. If the cat is young, it probably does not have a UTI. When the cat is rechecked a few weeks after the antibiotic, it may be better. This is not due to the antibiotic, but because of the waxing-waning nature of IC. Even though antibiotics are generally safe, their indiscriminate use can lead to the development of resistant strains of bacteria. And that is becoming a big problem in our country.
As I mentioned at the beginning, some cats who have "litter box avoidance" have normal results on their urinalysis. I generally classify these cases as behavioral. They may be avoiding the box because they don't like the box (it's not clean enough, they don't like the cat litter, they don't like sharing it with other cats, it is not in a "private" enough location, etc...), or something else has upset them and they are showing their displeasure by urinating in inappropriate places. This might be due to a new pet or person in the house, a strange cat in the yard (cats love to look out the window), or some other change in their routine. It could also be due to the cat not feeling well. Sometimes the first sign of serious illness in a cat is litter box avoidance. For this reason, these cats should always be checked out by a vet.
Believe it or not, litter box avoidance is a fairly common cause of euthanasia in cats. I hope this blog helps shed some light on the issue.
Monday, March 28, 2011
A Tribute To My Staff
I have to say, I really love my job. It is a rare day that someone doesn't tell me they've wanted to be a veterinarian at some point in their life. As an animal-lover, nothing could be better than going to work to help sick pets or keep pets from getting sick. But among veterinarians, I think I am more blessed than most, thanks to the people I work with every day.
I try to be a guy who appreciates all his blessings, but a particular incident last week really made me realize how cool it is to work at Horseshoe Lake Animal Hospital. I was doing a physical exam on a cat, and talking to her owner when we heard a bit of commotion coming from the back of the building. We stopped talking to try to figure out what the noise was.
At first it was difficult to discern, but after a few moments we realized we were listening to female voices singing, and the singing was, well, enthusiastic. As we listened more closely, the client looked at me and said, "You give love a bad name." I was definitely thrown off by her remark and said, "Excuse me?" "You Give Love A Bad Name. The Bon Jovi song. That's what they're singing," she said. Ok, that was a relief; and as I listened to them, I couldn't help but laugh out loud.
I have no idea what prompted the singing, but my client looked at me and said this must be a really fun place to work. My tech and I had to agree that it was. The people who work here are seriously underpaid - they're all here because they love what they do. It is pretty stressful at times, because our standards are high, and we take our responsibility to our patients and their owners very seriously. Not to mention this is a ridiculously busy place. But in spite of it all, we really like each other, and our jobs.
I'm also a drummer in a rock 'n roll cover band, and whenever we play out, about twenty or more people from work show up to socialize and dance. I love the show of support for me, and the fact that after spending a whole week together, these folks want to hang out. They get a little crazy sometimes, but that just makes me all the more impressed by the serious work they do at the hospital. It is the perfect example of knowing when to have fun, and when to bear down. And it makes me one lucky veterinarian.
I try to be a guy who appreciates all his blessings, but a particular incident last week really made me realize how cool it is to work at Horseshoe Lake Animal Hospital. I was doing a physical exam on a cat, and talking to her owner when we heard a bit of commotion coming from the back of the building. We stopped talking to try to figure out what the noise was.
At first it was difficult to discern, but after a few moments we realized we were listening to female voices singing, and the singing was, well, enthusiastic. As we listened more closely, the client looked at me and said, "You give love a bad name." I was definitely thrown off by her remark and said, "Excuse me?" "You Give Love A Bad Name. The Bon Jovi song. That's what they're singing," she said. Ok, that was a relief; and as I listened to them, I couldn't help but laugh out loud.
I have no idea what prompted the singing, but my client looked at me and said this must be a really fun place to work. My tech and I had to agree that it was. The people who work here are seriously underpaid - they're all here because they love what they do. It is pretty stressful at times, because our standards are high, and we take our responsibility to our patients and their owners very seriously. Not to mention this is a ridiculously busy place. But in spite of it all, we really like each other, and our jobs.
I'm also a drummer in a rock 'n roll cover band, and whenever we play out, about twenty or more people from work show up to socialize and dance. I love the show of support for me, and the fact that after spending a whole week together, these folks want to hang out. They get a little crazy sometimes, but that just makes me all the more impressed by the serious work they do at the hospital. It is the perfect example of knowing when to have fun, and when to bear down. And it makes me one lucky veterinarian.
Wednesday, March 9, 2011
Pig Ears Recalled Due to Salmonella
This just in...
Associated Press
The following recalls have been announced:
JONES NATURAL CHEWS PIG EARS
DETAILS: Pig ear dog chews manufactured by Jones Natural Chews Co. of Rockford, Ill., and shipped to distributors and retailers in Connecticut, Iowa, Illinois, Massachusetts, Maine, Michigan, Minnesota, Missouri, Montana, North Carolina, North Dakota, New Jersey, New Mexico, New York, Pennsylvania, Virginia, Washington and Wisconsin.
WHY: The chews may be contaminated with salmonella, which can cause nausea, vomiting, diarrhea or bloody diarrhea, abdominal cramping and fever in people, and cause pets to feel lethargic and have diarrhea or bloody diarrhea, fever and vomiting.
INCIDENTS: None reported.
HOW MANY: 2,705 boxes.
FOR MORE: Call 877-481-2663.
Associated Press
The following recalls have been announced:
JONES NATURAL CHEWS PIG EARS
DETAILS: Pig ear dog chews manufactured by Jones Natural Chews Co. of Rockford, Ill., and shipped to distributors and retailers in Connecticut, Iowa, Illinois, Massachusetts, Maine, Michigan, Minnesota, Missouri, Montana, North Carolina, North Dakota, New Jersey, New Mexico, New York, Pennsylvania, Virginia, Washington and Wisconsin.
WHY: The chews may be contaminated with salmonella, which can cause nausea, vomiting, diarrhea or bloody diarrhea, abdominal cramping and fever in people, and cause pets to feel lethargic and have diarrhea or bloody diarrhea, fever and vomiting.
INCIDENTS: None reported.
HOW MANY: 2,705 boxes.
FOR MORE: Call 877-481-2663.
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