Wednesday, October 22, 2014

A cautionary tale of chocolate toxicity for Halloween


Lilly dressed as a bunch of grapes
With Halloween coming up and the holiday season just around the corner everyone will have more candy around the house than usual and this is an invitation for curious pups to steal a snack.  My dogs Sparkle and Lilly have volunteered to be used as an example for what can happen if your dog eats too much chocolate, they would never dream of doing this in real life…

I brought Sparkle and Lilly into Friendship Hospital for Animals for treatment after they had broken into the Halloween candy stash one afternoon.  Milk chocolate, which consists mostly of cream and sugar, is generally not a huge concern unless massive amounts are consumed but dark chocolate is another story.  Among other treats there was a bag of dark chocolate M&M’s missing and I was not sure how much each dog consumed.

An injectable medication was used to induce vomiting in both dogs so we could empty their system of as much chocolate as possible. Sparkle was the prime suspect as her heart rate was in the 200 beats per minute range, which is much too fast and she was very agitated.  Chocolate contains theobromine and caffeine, which are both classified as methylxanthines. Unfortunately, dogs are sensitive to the effects of methylxanthines which can cause hyperactivity, increased heart rate, gastrointestinal upset, tremors, seizures and potentially death when ingested at a toxic dose.

Lilly vomited a moderate amount of chocolate but was not showing any clinical signs of chocolate toxicity.  She was given activated charcoal by mouth, fluids under the skin and an injection of Pepcid to help settle her stomach.  The fluids would help flush out her bladder which is important since the methylxanthines are excreted through the urine and can actually be reabsorbed if allowed to collect in the bladder.  Lilly was brought home with instructions to take out frequently to urinate and monitor for any vomiting or diarrhea.

Sparkle vomited slightly more chocolate than Lilly but since she was showing clinical signs of chocolate toxicity which required more aggressive treatment.  We started her on IV fluids and gave her a medication to help slow down her heart rate.  Overnight we checked her heart rate every hour in case it crept back up again and she needed any additional medication.  Sparkle was also given oral activated charcoal to bind any of the chocolate that wasn’t expelled when she vomited.  Other than being anxious and whining all night she did great and I brought her home the next morning.

There are a few take home messages in this tale.  First keep the candy far away from nosey dogs, even if you don’t think they are interested in eating it.  Second, know what kind of chocolate your dog has been exposed to.  The higher the cocoa content or the more bittersweet the chocolate, the smaller amount it takes to reach a toxic dose.  For example, a small amount of baker’s chocolate is much more concerning than a larger amount of milk chocolate.

A handy phone number to have is the ASPCA’s Animals PoisonControl Center at (888) 426-4435.  For a minimal fee you can speak directly to a veterinary toxicologist to determine if your pet needs medical attention.  Finally if your dog does eat chocolate seek veterinary care immediately so we can induce vomiting to remove as much as possible from their system.  Most of the time they do not need to stay in the hospital and can go home with you immediately.

Happy Halloween and please keep that candy away from nosey paws!


Sparkle and Lilly

Tuesday, September 9, 2014

How Little Things for Our Pet's Make the Biggest Difference

As a veterinarian and pet parent to four dogs and two cats I have plenty of experience caring for pets both at the hospital and at home. While annual wellness exams, vaccines and monthly preventive medications for heartworms, fleas and ticks are essential to your pet’s health, there are also many things you can do at home to keep your cat or dog healthy and happy.

Frank, Poppy, Sparkel and Lilly

Start by Choosing Quality Pet Food and Treats


The old adage "you are what you eat" doesn’t just apply to humans. Choosing the right food and treats is the cornerstone to good pet health. Look for a high quality diet that is formulated for your pet’s specific lifestage and lifestyle. This will ensure that your pet is getting the proper nutrition to keep them fit and healthy. For example, I don’t feed my 13-year-old rat terrier, Sparkle, the same food as my 4-year-old Labradoodle, Frank. Sparkle needs a senior diet that is lower in protein and calories to keep her kidneys healthy and her figure slim. Meanwhile, Frank is a big, active guy that burns through more calories a day and needs a higher protein level to maintain his sleek, handsome physique. So I choose a different diet for each of my dogs that meet their individual nutritional requirements. You should talk to your vet about what's right for your pet.

Channel Your Inner Hairstylist/Hygienist


Have you established a grooming routine for your pet yet? If not, you better get on it ASAP! This should include frequent brushing of the haircoat and teeth as well as nail trims and ear cleanings.

My golden retriever-Australian shepherd mix, Poppy, has a very dense undercoat that requires weekly brushing to prevent her from getting matted and shedding ALL over my house. I make our weekly grooming routine a happy experience where she gets treats and we spend some quality one on one time together.


Lilly and Sparkle
Brushing your pet’s teeth multiple times a week is another essential part of maintaining healthy living. Take my Chihuahua, Lily, for example. She has a history of dental disease so I make sure to focus on that aspect at home. She also gets annual dentals cleanings under general anesthesia so we can perform a complete oral exam that includes probing under the gum line for any diseased teeth that need to be removed. To maintain her dental heath in between the cleanings, I brush her teeth regularly and feed a dental diet. At first Lilly wasn’t a huge fan of our brushing sessions, but I started slow to ease her into the routine and found a tasty pet toothpaste (beef flavor – yuck!) that she really likes. 


Make Pet Toys Work for You!


Watching my pets joyfully play with their toys never gets old to me. While they have plenty of balls and chew-toys to chase and tear apart, I also like to keep them entertained with feeding toys. This group of dog toys has been designed to dispense treats or food while your pet plays with them. It is a great way to stimulate your pet’s mind and make them work for their food, which is much more rewarding than just inhaling a bunch of kibble out of a bowl. 

Furla and Vegas
Don’t let the kitties miss out on this fun. Cats have an innate hunting instinct and feeding toys are a great way to satisfy that as well as help keep them slim. My cats were a touch overweight and no matter what food I fed them or how strictly I limited their calorie intake they were still not losing weight. I started giving them their dry food out of a feeding ball so that they had to actually move around to get their food rather than just plop in front of a bowl and chow down. This, combined with the right diet and strict calorie control, really made a difference in helping my kitties lose those extra pounds.

With any toy or treat that requires chewing it is critical to know what kind of chewer your pet is. My dogs love ripping apart their stuffed toys to find the squeaker; thankfully they never attempt to eat the stuffing. If one of them ever showed any interest in consuming part of their toys I would either eliminate this type of toy from the house or only allow them to play with it while strictly supervised. The same should be applied to rawhides and other bones as well.  Ripping off a giant piece of rawhide or bone and swallowing it whole is extremely dangerous as it can become lodged in the gastrointestinal tract and cause an obstruction.




Our pets bring so much joy to our lives through their companionship and unconditional love. In order to keep them as happy and healthy as possible, try to introduce a few of these tips to help maintain their wellbeing and form a stronger bond that will last a lifetime. 

Wednesday, September 3, 2014

Choosing the right food for your pet (and holding pet food companies to higher standards)

Frank asking for dinner
Choosing what to feed your dog or cat is a very important decision for pet owners and one that can be overwhelming given the countless choices out on the market today.  Stores are stocked with row after row of different pet food brands containing clever marketing slogans to convince you they are the best for your pet.  As a veterinarian and obsessive pet owner, I am especially interested in nutrition because what you choose to feed has a direct result on the overall health and longevity of your cat or dog. 

For example, the type of food a puppy is given can affect how his bones grow and whether or not he may develop arthritis later in life.  This is even more important with large and giant breed puppies.  For these not-so-tiny guys, it is critical to choose a food that has been specifically formulated for their unique nutritional needs during the growth phase of life.  Feeding large breed puppies something that is too high in protein or has inappropriate calcium to phosphorus ratio may result in abnormal joint development.

Where it gets tricky is that even though a bag might claim it is formulated for large breed puppies, there are no specific regulations on what constitutes a large breed puppy formula.  This is why it is important to find a brand of food that you have researched and determined that they really know how to make a high quality diet.  Anyone can purchase a formulation for pet food, manufacture a product and sell it without ever feeding it to an actual dog or cat.  It is very difficult to tell from looking at the catchy logo on the pet food bag whether or not that diet has any research to back it up.

Pet owners should look to their veterinarians for specific recommendations on what food would be ideal for their particular pet’s lifestyle and life stage.   Both owners and veterinarians alike should call a pet food company and verify that they are following the minimum standards for developing and selling pet food.  What are those minimum quality standards?

What All Pet Food Companies Should Do


I feel that pet food companies should have veterinarians and veterinary nutritionists on staff developing their diets. Companies should perform feeding trials and extensive research on their diets to ensure that it is actually complete and balanced to meet the nutritional needs of the pets it was created for.  There should be safeguards in place to ensure contamination from toxins or pathogenic bacteria are not reaching our pets in the marketplace.  A pet food company should also have its own manufacturing plant to control exactly how a food is made, packaged, stored and shipped.

Finding a brand you trust is the first step, then you need to find a diet that fits your pet’s unique needs.  Again, this is where a consultation with your veterinarian can be so helpful.  You need to make sure that your pet is not overweight or obese. If so, perhaps he would benefit from a diet that is lower in calories.  Or maybe your senior kitty would benefit from some canned food to help increase her moisture intake to better support kidney function. 

Good nutrition is the foundation to a long, healthy and happy life with your pet.  Choosing a high quality food that best supports your pet’s particular lifestyle and life stage is the best way to achieve this.

***


To better help pet owners find that perfect diet for your beloved pet, Hill’s Pet Nutrition is offering a $10 off promotion on select Hill’s Science Diet products.  They have several foods within their product portfolio to meet your pet’s special needs and help you provide a healthier and happier life.  From weight loss, to oral care, to hairballs or joint health, they have a food to help manage your pet’s special situation or condition.  Check out www.ScienceDiet.com/GetHealthyHappy to download your rebate today!

Thursday, August 28, 2014

Frank update

I have put off writing this blog because I didn’t want to jinx anything, but after almost two months I think I am safe saying that Frank is 100% back to normal!  In my post from May 7th I reported that he was on the mend but he really wasn’t back to doing all his normal Frank activities.  After several weeks on Prednisone it was in mid-June I accepted that he still wasn’t himself and decided to move forward with an MRI to make sure there was nothing else going on. 

We headed out to Animal Scan in Virginia and under the exceptional guidance of neurologist extraordinaire Dr. Lauren Talrico, Frank had his MRI.  We found that he had some very mild changes in his spinal cord consistent with intervertebral disk disease (IVDD) and Wobbler’s syndrome.  Dr. Talrico believes that both of these changes are causing him pain in addition to the meningitis that he was initially diagnosed with.  Poor Frank!


Frank helping Dr. Talrico read his MRI

IVDD is a condition in which one or more of the cushions that exists between each vertebra comes into contact with the spinal cord causing an array of clinical signs.  These can range from irritation that results in pain to compression that can lead to weakness and paralysis.  Wobbler’s syndrome is a collection of abnormalities that occur in the cervical spine (neck) that affect how the vertebrae line up with one another.  This is turn can also result in neck pain and spinal cord compression.

Thankfully Frank’s condition was not severe enough to require surgery so we started pain management with pregabalin (also know as Lyrica) and physical therapy.  Unfortunately the underwater treadmill is not yet up and running at Friendship but our wonderful physical therapist Janay gave me several exercises to work on at home with Frank.  One of these exercises was cavaletti work - you can see in the video below how much he enjoys it!

video


I am incredibly relieved and delighted that Frank appears to be pain free off all his medications and is now back to his usual antics.  What has been the most surprising to me is how this situation crept up on us.  For several weeks before we noticed he clearly wasn’t feeling well that he had stopped doing many of his usual adorable Frank activities.  He had all but stopped picking toys up and asking us to play with him.  He would no longer body check my husband to get out the back door so he could accompany him to take out the trash and run around outside.  He used to wrestle with Poppy every day, often times so loud you couldn’t hear the television over their play growling.  For the last few months that he has been back to normal all of these behaviors have returned and I can’t believe that I didn’t pick up that something was off earlier. 


Happy after a swim at the beach


We will always have to keep an extra close eye on his behavior in case one of his three conditions flair up again.  He will never receive another vaccine as this can cause his meningitis to come out of remission.  He can’t roughhouse anymore and we need to continue his physical therapy long term to maintain his muscle conditioning.  Once the underwater treadmill is installed he will be first in line for therapy sessions.  Friendship will also be offering acupuncture soon and this is an excellent therapeutic option for Frank.  I am incredibly thankful that Frank has responded so well to treatment and is back to being his normal, wonderful, lovable self!

Tuesday, August 19, 2014

The Key to a Happier, Healthier Pet: Annual Vet Checkups

Want to know why veterinarians are always reminding you about annual checkups? Because they are one of the easiest things you can do to help keep your cat or dog happy and healthy for many years to come. Unfortunately, it's also something that can easily be forgotten or pushed off for another time.

In fact, according to a recent petMD poll nearly 2 in 10 pet owners hadn't visited their vet for a routine checkup in the past year. Take it from a veterinarian — that's a big deal!

Missing Just One Annual Exam Can Still Be HUGE


The reason the standard recommendation for cats and dogs to visit the veterinarian once a year for a checkup is because missing even one yearly exam for your pet is roughly equivalent to you, a human, not seeing a doctor for five years! These wellness checkups not only allow us to catch certain diseases at their onset, which can prevent them from getting worse, but they also potentially save you money in the long run. That's a definite win-win situation.

Dental disease in both cats and dogs is the perfect example of this.  During your pet’s annual exam your veterinarian will assess their degree of dental disease and recommend yearly dental cleanings. 


Sherman, a 6-year-old Yorkie-Chihuahua mix, came to me for his initial exam shortly after being adopted by his new family at 3 years old. He had moderate tartar with minimal gingivitis, but I didn't notice any obviously diseased teeth. Nevertheless, given the heavy tartar and stinky breath, I recommended a dental cleaning and oral exam to be performed under general anesthesia.

We were shocked to discover during the cleaning that Sherman had severe dental disease and needed to have 13 teeth extracted. That's the funny thing about dental disease — things may not look so bad on the surface, but once you start poking under the gumline the disease may be running rampant and unchecked.

Fortunately, Sherman felt like a new dog after having all of his painful and diseased teeth removed. He now gets annual dental cleanings to minimize bacteria buildup on his teeth and monitor for new disease under the gumline. We also started him on a dental diet to help keep tartar to a minimum to maintain his healthy new smile.

Vet Checkups are Even More Important in Your Pet's Senior Years


Veterinarians often recommend senior dogs and cats undergo yearly baseline bloodwork in order to screen for metabolic abnormalities. Elevations in your pet's liver or kidney values, for example, can indicate one of these organs is compromised and needs to be addressed. Senior cats often have issues with kidney function as they age.

Take Charlie, a 12-year-old kitty that is a patient of mine. During his annual exam Charlie's owner reported that he was doing well at home but perhaps drinking just a bit more than usual. Charlie's physical exam was unremarkable overall, but he had lost just a touch of weight compared to the year prior.

We submitted a chemistry panel, complete blood cell count, thyroid level and urinalysis. This is the standard baseline that I check on all senior cats. The urinalysis is essential to alerting us to diminished kidney function and increased thyroid levels, which are often to blame for weight loss in cats. In Charlie’s case he had dilute urine and very mild elevations in his kidney values on the chemistry panel, an indication that his kidneys were not working well and confirmation he had chronic kidney disease (CKD). 

Had Charlie not come in for an annual exam, the CKD would have gone unmanaged and further complicated his health. Fortunately for Charlie and other cats with CKD, the quality of life can be improved when steps to maintain kidney function are implemented—therapeutic kidney-friendly diet and increased water intake, to name a couple of changes. Charlie's annual exams were also bumped up to every six months so that we could
closely monitor his blood work and blood pressure for unusual changes.

Annual Exams: A Great Way to Answer Your Pet Health, Too


I could write story after story about patients of mine that greatly benefited from a yearly checkup. But these appointments are also the best time to discuss with your veterinarian any concerns you have regarding your pet’s health. It can be something as subtle as tips to help your dog lose a few pounds; which supplements are best for preventing joint disease or diet suggestion to help senior pets ward off dementia. 

By working with your veterinarian during annual wellness checkups, your pet can better stay happy and healthy…so you can love them longer!

Wednesday, June 25, 2014

Amelia's Kittens

Friendship was very proud to send eleven of our team members off to veterinary school last fall.  Below is a report from Amelia who was the indispensable assistant to our Chief of Primary Care, Dr. Kuehn.  We all miss Amelia very much (especially Dr. Kuehn!) but it certainly sounds like she is making the most of vet school - Enjoy!

Kittens are very fragile creatures. They are born unable to see, hear, or eliminate on their own. When orphaned or separated from their mothers prematurely, they require very involved care. At many shelters, kittens prematurely separated from their mothers are not prioritized and may even be euthanized because of the intensive care they need and the number of older cats also looking for homes. When I began veterinary school this past fall, I became involved with a club called the Orphan Kitten Project, which fosters these babies while they are so helpless (requiring bottle feedings every two hours at first), until they are old enough to be adopted.
When I received the carrier containing my first two foster kittens, I wasn’t really sure what to expect. These little guys only weighed 10 ounces and fit into the palm of my hand. I had never seen kittens so small. They looked like little aliens. The woman who kept them for a few days before me described one of them as “feisty and demanding;” I wondered vaguely if they were giving me an evil kitten. But after a day of caring for them, I was completely hooked. Watching them grow was incredibly rewarding; each day they accomplished new feats that were impossible for them only the day before (climbing over baby gates, climbing up my entire body to sit on my shoulder, leaping onto anything really).
A few days later, one of my kittens got really sick. She began to vomit suddenly and then went completely limp, like a rag doll. Feeling the profundity of my ineptitude and lack of experience weighing heavily, I decided to rush to the nearest emergency hospital. When kittens are so small, they can crash very quickly and there’s often nothing anybody can do. The technicians quickly took her to the treatment room. Unfortunately, there were many animals that arrived in emergent situations at the hospital that night, and we had to wait in the exam room for several hours, while the veterinarian came in and out three or four times. She offered a plethora of diagnostic tests and treatment options, all of which I have heard explained to clients many times (as a prior veterinary assistant at Friendship Hospital for Animals). Even though everything was incredibly familiar, it was overwhelming to decide what to do for her. On one side, I had my boyfriend muttering at me not to spend any money on a kitten I don’t even own. On the other side, I had a near-death kitten trusted to my care, and felt devastated at the thought of not doing everything I could for her. Even though I knew she was receiving excellent care at the hospital, I wondered if she was cold or lonely in the treatment room.



Fortunately, kittens can recover almost as quickly as they become sick. My little baby was back to her normal, rambunctious nature within a few days. Being a client rather than an employee at a veterinary hospital in an emergency situation taught me the most valuable lesson I have learned in vet school so far: as a veterinarian, regardless of how many times you have seen a particular situation or disease, every single patient is completely unique. Likely, it is the first time the client (owner of this patient) has experienced anything like this situation. While these realizations may seem obvious, they are vital lessons that should be kept at the forefront of a veterinarian’s minds every day. With this knowledge, a veterinarian can provide guidance to clients in a truly compassionate and understanding manner, and I hope to be able to do the same.

Wednesday, June 18, 2014

Introducing Nexgard!

There is a new oral flea and tick product on the market and we are all very excited about it here at Friendship.  Nexgard is a monthly chew that protects dogs against fleas and ticks.  It is absorbed into the blood stream and kills parasites when they bite your dog and begin a blood meal.  Due to this mechanism of action you may still find dead ticks attached to your dog, the fleas probably just fall right off (Ick!). 

Like Frontline it does not offer any repellant protection, the bug has to feed before it can be killed.  Unlike Frontline you don’t have to deal with the greasy spot they get on their fur after application or worry about how bathing and swimming will affect protection. We will not be selling Frontline Plus anymore but you can still find it online and at retail stores if that continues to be your product of choice.

If you are interested in a product with repellant properties we also carry the Seresto collar for dogs and cats.  This is worn all the time and lasts for five to eight months depending on how often your pet is bathed or enjoys a swim.  My only complaint with this product is that I find the collar itself a bit unsightly on shorthaired dogs.  This is a fairly superficial reason and should not detract you from considering it, especially if you have a hard time remembering to give the chew monthly.


 
For parasite protection of kitties we will continue to sell Advantage Multi topical spot-on treatment that protects against heartworm, fleas, ear mites, roundworms and hookworms.  I feel this or Revolution (we do not sell this particular product) are the best choices for cats because they provide heartworm prevention.  Dogs of course get their monthly heartworm prevention in the form of monthly Heartgard chews.


The products we sell at Friendship are a small subset of the multitude of monthly preventive products out there.  If you have questions about any product in particular please don’t hesitate to discuss them with your veterinarian.  I hope this helps you muddle through the options available for purchase at the hospital.