Poppy is just about six months old and her adult canine teeth are just starting to appear - the time to spay her is here! I always advise people to wait until the adult canines have erupted before their puppy goes to surgery. Retained deciduous teeth, meaning that the baby and adult teeth are present at the same time, requires extraction of the baby teeth so the dog's bite does not become adversely affected. The removal of any remaining baby teeth must be done under anesthesia so it makes sense to do this at the same time as the spay/neuter surgery.



If the reasons above do not move you, let us consider the tragic pet overpopulation problem in this country. The Humane Society of the Unites States estimates that 6-8 million dogs and cats enter a shelter every year. Of that number over half are euthanized, that is 4 million dogs and cats put to death every year. The average fertile female cat can produce about 12-18 kittens per year and female dog 12-20 puppies. Shelters and rescue groups work tirelessly to find homes for these pets but they just can’t keep up with the number of animals entering the shelters.

Sherman is a ten-year-old kitty whose owners brought him in to see me for his annual exam. Overall, Sherman looked good, but I noticed that he had lost almost two pounds since last year and had developed a heart murmur. I asked his owners whether they had seen any changes in Sherman’s appetite. Was he eating more than usual? Did he always seem hungry? They assured me that Sherman’s appetite was unchanged.


Weight loss in a senior cat can mean many things, but given the new heart murmur I was strongly suspicious of hyperthyroidism. We submitted bloodwork, including urine and a thyroid test. Sherman’s bloodwork confirmed that he had an elevated thyroid level. This was most likely responsible for the weight loss and heart murmur.

The thyroid gland plays a key role in regulating the body’s metabolism and when enlarged it produces an increased amount of hormones which can then affect multiple organs. Symptoms include increased thirst, urination and appetite, vomiting, diarrhea and weight loss. Cardiovascular side effects also occur: when a cat’s metabolism increases, the heart is stimulated to pump faster and more forcefully. This leads to thickening of the heart muscle, resulting in abnormal blood flow, which is heard as a murmur. High blood pressure - also known as hypertension - is another result of the cardiovascular changes that can occur. This can result in neurologic abnormalities, kidney disease and retinal detachment, which results in blindness.

We checked Sherman’s blood pressure, which fortunately was normal, and started him on a medication called methimazole that lowers the amount of hormones the thyroid produces. Our cardiologist, Dr. Braz-Ruivo, conducted an ultrasound to evaluate Sherman’s heart murmur. This was done to evaluate if any heart disease was present and make sure he didn’t need any additional medication to help his heart work more efficiently. Sherman responded very well to the thyroid medication and did not develop any underlying kidney disease, which often shows up after the thyroid is properly regulated.

Though Sherman’s owners chose to manage his hyperthyroidism with medication, another option was available: Radioactive iodine therapy is a procedure that attacks the overactive thyroid cells and produces permanent results. This is generally considered the gold standard of treatment for feline hyperthyroidism. It works very well but is expensive. Also, regardless of blood pressure, if any underlying kidney disease is present, the patient could develop chronic kidney disease once the thyroid is corrected.

Now that summer is here, I have a crucial recommendation for dog owners: Please don’t run with your dog during hot, or even warm, weather. In my opinion the danger is just too great.

Consider this: as you are jogging in your shorts and lightweight t-shirt, your dog is wearing a fur coat and no sneakers. Humans cool their body temperatures by sweating, which we do over our entire body. Dogs, on the other hand, can only cool themselves by panting and heat loss through their paws. Warm weather means roasting-hot pavement, which eliminates a dog’s ability to lose heat through their paws, and can quickly contribute to heat stroke.

Heatstroke can be fatal - even with aggressive immediate treatment. Because your dog’s main concern is keeping up with you, she is not going to self-regulate and tell you when she is too hot to keep going. All too often, runners will only stop when their dogs actually collapse or refuse to go any further.

In fact, heatstroke is just one of the reasons to avoid running with your dog. Even when the weather is cooler, the constant jarring over long distances on hard surfaces is guaranteed to result in arthritis and chronic pain for your pet. Unlike humans dogs do not wear fancy running shoes to absorb the shock to their joints that occurs from pounding the pavement. If you must run with your dog, do it only in the cooler temperatures and never run for more than one mile at a time.

Clearly dogs need exercise during the summer, just like they do during the rest of the year. Healthy options include taking a walk in the woods, or heading to the dog park in the early morning or evening when it is cooler.

If heatstroke does occur seek veterinary care immediately. DO NOT submerge your dog in water or douse her with a hose--this will lower the body temperature too quickly. If you would like to start bringing down your dog’s temperature, wet her paws with cool (not cold) water and place a cool, damp towel over her. You can check her temperature with a rectal thermometer; anything over 104 should be seen by a veterinarian immediately.

I realize this is a strongly worded post, but having a pet die of heat stroke is especially devastating because it can easily be prevented. So the next time you lace up your running shoes, please stop and consider if going for a run with you really is the best thing for your dog.

Sam is a 10-year-old Doberman mix, who presented on emergency one night with a sudden onset of retching accompanied by a distended and painful abdomen. Abdominal x-rays confirmed our initial suspicion: Sam was suffering from a potentially fatal condition called gastric dilatation-volvulus (GDV). To help prepare Sam for surgery, we immediately started him on intravenous fluids and pain medication.

More commonly known as “bloat,” GDV occurs primarily in large breed, deep-chested dogs such as Great Danes, standard poodles, Doberman pinschers, boxers and German shepherds. For reasons that remain unknown, the dog’s stomach fills with air and rotates, restricting blood flow to and from the abdomen. This lack of blood flow can quickly lead to shock, resulting in tissue death of abdominal organs. In addition, when the heart is deprived of blood, it cannot pump as effectively, and the heart muscle begins to die, causing cardiac arrhythmias.

When I opened Sam’s abdomen his stomach was severely distended and twisted. My first step was to check the condition of the stomach tissue, to see if it had started to die which would require resection. Sam was lucky: his stomach tissue still appeared healthy. I quickly reached in and de-rotated the stomach back into its appropriate position.

Next, I assessed Sam’s spleen. Since it is closely attached to the stomach, the spleen can rotate along with stomach and often must be removed. Once again, luck was on our side: while initially Sam’s spleen was enlarged and an angry purple color, it returned to a normal size and color just a few minutes after his stomach was repositioned. Sam’s other abdominal organs were healthy in appearance.

After correcting the positioning of the stomach and emptying it of all the trapped gas and fluid, I performed a gastropexy. This procedure literally attaches the stomach to the body wall within the abdomen and thus prevents the stomach from twisting. After surgery Sam was started on a constant rate infusion of pain medication and was hooked up to an ECG so we could monitor him for any cardiac arrhythmias. Sam recovered quickly from surgery and was sent home two days later to his very happy owners.

Anyone with a large-breed dog should be aware of GDV and watch their dog carefully for non-productive retching and abdominal distension. These signs can also be accompanied by hyper-salivation, restlessness, inability to stand and depression. A GDV or bloat is one of the few true surgical emergencies. It is essential to get treatment for your dog as quickly as possible is essential. Lucky for Sam, his owners knew what to look for and acted immediately.
This is Sam with his buddy Murray who was also very relieved to have him home.