VMDiva

“Christmas waves a magic wand over this world, and behold, everything is softer and more beautiful.” -Norman Vincent Peale

From VMDiva to you and yours, Merry Christmas!

The University of Pennsylvania’s Matthew J. Ryan Veterinary Hospital is in the News for its free pet loss support group for owners of animals grieving the death of their furry family member.

The loss of a pet affects owners in different ways. The most important thing to remember is there is no right or wrong way to grieve. Some owners grieve by reliving happy memories and others need extra time to adapt to their loss.  For those who need some outside help, a pet bereavement group can provide a circle of friends who understand the emotions associated with the death of a pet. You don’t have to go it alone.

Check out these Pet Loss and Grief Support Websites

• Paws 2 Heaven
• Association for Pet Loss and Bereavement
• Rainbow Bridge

With the holiday season upon us, it’s important to remember our furry friends and keep them safe! Below is a adapted list of holiday hazards from the American Animal Hospital Association. With a little preparation and pet proofing, the holidays can prove as enjoyable to your pets as they are to you!

Common Holiday Pet Hazards

Bones: The holiday turkey or chicken will leave a lot of tantalizing bones, but don’t feed them to your pet. Beware of steak bones, too. Small bones or bone chips can lodge in the throat, stomach, and intestinal tract.

Holiday Plants: Holly and mistletoe are extremely poisonous when eaten. The lovely poinsettia may not be truly poisonous but its milky white sap and leaves can certainly cause severe gastric distress. With so many hybrid varieties available each year, the best approach is to keep the plants out of your pet’s reach. Don’t forget lilies are toxic to our feline friends!

Electrical Cords: Holiday lights mean more electrical cords for kittens and puppies to chew. Be sure you have cords secured and out of the way.

Candles: Lighted candles should never be left unattended and that is even more important if left at kitty’s eye level or within puppy’s chewing zone. An exuberant tail or a swat of a paw can turn candles and hot wax into an instant disaster. Anchor candles securely and away from curious faces and feet.

Pine Needles: Check around holiday trees frequently. Ingested pine needles can puncture your pet’s intestines.

Christmas Tree: Make sure your tree is well secured. If you have a tree-climbing cat or large dog with a happy tail, anchor the top of the tree to the wall, using strong cord or rope. Preservatives often used in the water in a tree stand can cause gastric upsets, so be sure it is inaccessible or not used. Avoid sugar and aspirin additives in the water as well.

Ornaments: Sharp or breakable ornaments, dreidels, and even aluminum foil should be kept out of reach. String objects, especially tinsel and ribbons, are to be safeguarded at all costs. They are thin and sharp and can wrap around intestines or ball up in the stomach.

Stress and Company: With everyone coming and going, watch out for open doors and sneaky pets. Make sure your pets have updated collars and tags on in case of escape. Microchipping your pet will also help if your pet escapes. All pets should have at least two forms of id on them at all times. Ask guests to keep an eye out for pets under foot and remind them that sometimes your normally friendly dog or cat may be less than willing to deal with enthusiastic children and rooms full of unfamiliar people. Provide a special quiet place with a blanket and fresh water for your pets to retreat to when the festivities get too stressful.

• Before traveling with your pets, make sure they have all required vaccinations and health papers. If they are on medications, have enough to last  through the trip plus an additional 5 day supply to be safe.
• When traveling by air, be aware of airline restrictions regarding outside temperature and number of animals allowed per flight. Someone may have already booked a pet, and there are no more allowed. Each airline handles pet differently, please contact your carrier for more information.
• Remember that even the most gentle and trusting pet may bite when in pain. Train your dog to a basket muzzle by placing treats in the bottom of it. Basket muzzles provide protection for you and anyone else helping with your pet and allow them to pant and breathe easily. You can also use a soft towel or cloth strips and remove it as soon as possible so the pet can breathe more easily. When dealing with cats simply placing a thick towel over their head may calm them down and decrease the chances of being bitten.
• Too many treats during the holidays can expand your pet’s waist line, so monitor the amount of goodies and remember that food is not love and extra attention will give you the same reaction as a treat.

The recent ban on cat declaws in Berkeley and the current legislative efforts to create bans in other California towns may have unintended consequences. The concern with elective procedures such as cat declaws is a topic of debate within the veterinary profession.  Most veterinarians still perform declaws nationwide and help cat owners decide whether to pursue a declaw or not. Many owners who elect the have their feline friend declawed do so with full disclosure to the discomfort the cat will feel postoperatively. It is not a decision to be taken lightly. It is also not a decision to be made by bureaucrats.

Cats are destructive of no fault of their own. Cats sharpen their claws on the best available substrate, which unfortunately many times is your new sofa, clothing, moulding, etc. In a Utopian world, owners would have infinite tolerance for cat scratches and destructive behavior. We don’t live in Utopia. One can argue right or wrong but the issue remains. I fear many more cats will be forced outdoors where they face the perils of cars, predators, and disease. It is known outdoor cats have a significantly shorter lifespan than indoor cats. I also fear that more adult cats, and therefore less adoptable cats, will end up in a shelter situation. The repercussions of an influx of cats into a shelter will most likely result in an increase of euthanasias. I predict a repeal of the ban in several years.

Too often, as pets age, our mindsets change regarding how much financial and medical commitment we are willing to provide them. I hear all too frequently: “Well, he’s getting pretty old so I don’t want to run a bunch of tests. He certainly doesn’t need his vaccines and I don’t see the point in heartworm preventative.” While we can justify this line of thought, I challenge pet owners to approach their pet’s golden years from a different perspective.

Senior pets, just like senior citizens, require close monitoring to ensure their health does not fail prematurely. An old adage in veterinary medicine is that ‘Old Age is Not a Disease’.  Dogs are typically considered senior between 6-8 yrs of age with large breed dogs aging faster than small breeds. Cats are considered senior at 8 yrs of age.  Senior pets are more likely to develop common aging diseases such as heart disease, dental disease, osteoarthritis, thyroid disease, and early kidney disease. As pets age, their immune systems typically weaken preventing them from fighting infection as well as in the past. They slow down, spend a majority of their days sleeping, and sometimes struggle on cold days. They may develop a medical condition or two. But, with proper care, you can extend your pet’s quality of life by addressing these issues before they becoming life threatening. Below are a few ways you can stay on top of your senior pet’s health.

Twice Yearly Appointments

As you can imagine, an animal with a life expectancy of 12-14 years will age much more rapidly than a person with a life expectancy of 75-80yrs. Many health changes can be detected by your veterinarian based on your pet’s history and physical exam. At these appointments, do not be afraid to mention Fido’s difficulty getting up or Fifi’s ravenous appetite. Things you may think unimportant could signal disease to your veterinarian.

Senior Bloodwork

I cannot stress the importance of routine bloodwork enough. General health screen typically includes blood sugar, kidney and liver values, blood counts, thryoid values, and urinalysis. This bloodwork can detect sub-clinical disease processes like early kidney disease, mild thyroid disease, anemia, diabetes, among many others. This bloodwork is generally affordable and can prove invaluable if disease is detected early. Many diseases are treatable or manageable when detected early. A urinalysis can detect kidney disease before it is evident in bloodwork. Use a sealable plastic container to collect urine from your pet the morning of your appointment and take it along with you. Ask your veterinarian about screening bloodwork.

Vaccines and Preventatives

Vaccination protocol is not without controversy. There are several schools of thought concerning frequency of vaccinations in veterinary medicine, however, the vast majority of veterinarians agree that all pets should be vaccinated if their health allows. Senior pets are no exception. At minimum, all pets must be rabies vaccinated. This is the law. Even without the legal impetus, pet owners should ensure their senior pets are up to date on their rabies vaccine. A sad fact is that many animals will develop some degree of neurologic signs, from abnormal behavior to seizures, prior to their deaths. If your pet is not vaccinated for rabies, your veterinarian must consider the disease as she treats or euthanizes your pet. Rabies testing may be recommended. This is an avoidable scenario.

Heartworm and flea/tick preventatives are recommended irregardless of age. Discuss the remaining vaccinations and preventatives with your veterinarian to determine what protocol is best for your senior pet.

Follow Up!

If your sick senior pet sees the veterinarian, follow up! Stick with prescribed medications and, if financially feasible, pursue diagnostics. Call your veterinarian if you don’t understand the diagnosis or reason for testing. You and your veterinarian should work together to formulate a plan on how to extend your senior pet’s quality of life.

As pet’s age they rely on their owners to ensure a smooth transition from adult to senior life. Don’t undervalue the benefits of prompt and proactive care.

At the close of Veterinary Technician week, I want to extend a thank you to all the men and women who perform the duties of a veterinary technician. Technicians provide the backbone for veterinary work and without them I would not be able to perform my job as a veterinarian. Techs come from a variety of backgrounds. Some have little education while others have become certified after a couple of years of studying. Education level does not always indicate the quality of veterinary technician. Many non-certified techs practice at a level comparable to the best certified techs.

In the span of a day a veterinary technician may induce and monitor anesthesia, draw blood and place an IV catheter, wrestle a fractious dog, calculate and administer the correct dose of medication, and explain post-surgical instructions to pet owners. All this while running the risk of cat and dog bites and standing in the way of every bodily excrement imaginable.

Hats off to you, veterinary technicians!

Canine parvovirus (CPV) is a highly contagious virus affecting puppies and unvaccinated young dogs in the United States.  Since evolving via a series of viral mutations in the early 1980′s, CPV has maintained a mortality rate of up to 30%. The advent of the parvovirus vaccine has dramatically decreased the incidence of disease. CPV specifically targets intestinal cells thus causing severe diarrhea, vomiting, dehydration, and weight loss.  Infections also cause bloodwork abnormalities including leukopenia with a neutropenia (low white blood cell counts). This makes infected dogs more susceptible to sepsis and subsequent cardiovascular collapse and hypoglycemia. Other complications include hypovolemic shock, disseminated intravascular coagulopathy (DIC), and acute respiratory distress syndrome. Dr. Linda Schell, DVM, DACVIM notes that “in experimentally affected dogs, mortality without treatment has been reported as high as 91%. However, with prompt recognition of dogs infected with CPV-2, and aggressive in-hospital supportive therapy of severely affected puppies, survival rates may approach 80-95%. ” At risk breeds include all dogs but Rottweilers, Dobermans, Pit Bulls, Labradors, and German Shepherd Dogs are most susceptible.

Clinical Presentation

• Gastrointestinal – vomiting, diarrhea, inappetance, weight loss
• Hematologic – immunosuppression secondary to depletion of lymphoid tissue, bone marrow
• Cardiovascular – hypovolemic shock with circulatory collapse (poor pulses, pale mucous membranes, poor tissue perfusion), hypercoagulability, DIC, rarely viral myocarditis
• Other clinical signs involving liver, kidneys, and central nervous system secondary to sepsis, dehydration, and endotoxemia

Diagnosis

• Fecal ELISA, also known as the Parvo Snap Test, tests for parvoviral antigens in the feces. False negatives occur due to short period of viral shedding. False positives can occur if the dog has been vaccinated within the past 5-15 days although research from Idexx, makers of the snap test,  has indicated that 0 of 64 recently vaccinated beagles tested falsely positive.
• Other tests include: virus isolation, PCR, electron microscopy, culture, and serologic studies for hemagglutination inhibition. These tests are not commonly performed.

Incubation/Infectious Periods

• Virus can be found in blood 3-5 days following infection
• Incubation period is 7-14 days, though animals can shed virus in feces prior to any clinical signs
• Fecal shedding can occur for up to 10 days post-viremia
• Virus is stable in environment for months to two years in the environment after fecal shedding but can be destroyed by a 1:30 bleach solution (See Environmental Decontamination below)

Treatment
Depending on severity of disease, any number of treatments may be necessary and include:

• Intravenous fluid therapy including colloidal fluids and potassium/destrose supplementation
• Blood transfusions for severely anemic animals
• Antibiotic therapy to combat secondary bacterial infections
• Antiemetics like maropitant, metocloprimide, and odansetron
• Gastrointestinal protective agents like famotidine, sucralfate
• Dr. Schell provides information on Tamiflu (oseltamivir phosphate): “Tamiflu is a neuraminidase inhibitor. Neuraminidase is a protein found on the surface membrane of many viruses that allows the virus to bud from the host cell to infect other cells; it is required for the virus to pass through mucous to reach non-infected cells. Unfortunately, the CPV (and the canine distemper virus) does not have neuraminidase. However, it has been theorized that the improvement seen in Tamiflu-treated CPV cases is because of inhibition of neuraminidase activity related to inflammation and bacteria (secondary sepsis). Tamiflu’s use is controversial for several reasons. By the time symptoms of CPV infection appear, the disease may be too far along for the drug to be useful. There are no proof of efficacy studies. It is expensive. Appropriate dosing is unknown. Finally widespread use of it in veterinary medicine could result in development of resistance mechanisms that would make this drug less useful in the event of a human influenza pandemic.”

Recovery

• Recovery is dependent on when the disease is diagnosed and how aggressively it is treated.
• Dogs who recover from CPV have immunity from reinfection for years or even their lifetime.

Prevention

• Ensure your new puppy has been vaccinated appropriately against CPV. Talk to your veterinarian to find out if your dog has been adequately protected.
• Keep your puppy away from unfamiliar dogs and out of dog parks until it is fully vaccinated.

Check out this great article on Environmental Decontamination

Check out this video from Dr. Manny Alvarez, Managing Editor for foxnewshealth.com, about service dogs and Canine Partners for Life!

Influenza viruses are a specific class of virus with assortments of proteins on the surface.  Canine influenza virus (H3N8) acts much like other influenza viruses in that it causes fever and respiratory disease. This influenza can mimic bordetellosis (aka Bordetella bronchiseptica infection, kennel cough, infectious tracheobronchitis). It is most common in groups of densely populated dogs, like seen in shelter situations, and was first recognized in a colony of racing greyhounds in Florida. The incubation period for development of disease is 2 to 5 days and the course of infection is between 2 to 4 weeks. Canine influenza virus is NOT related to Swine Flu (H1N1).

Because this is a relatively new disease, many dogs have little to no immunity to it. Therefore, infection rate is high with up to 80% of dogs developing clinical signs of disease. Some studies indicate 20-50% will naturally clear the infection without any signs of illness. Dogs with signs of infection may present to their veterinarian with fever, coughing, nasal discharge, and lethargy. A vast majority of infected dogs will recover with appropriate supportive treatment (antibiotics, nebulization, etc.). A small percentage (up to 20%) of dogs will get a secondary bacterial pneumonia and supportive care must be more aggressive. Most of these dogs will recover as long as they receive proper care. Dr. Melissa Kennedy, Clinical Virologist at the University of Tennessee College of Veterinary Medicine, states the mortality rate is “less than 10%, probably less than 1%. Most infections are mild and self-limiting.” This information contradicts some news reports of 100% mortality.

The CDC recently released a statement noting upwards to 30 states have confirmed cases of canine influenza. Testing is available at veterinary diagnostic centers but is not widely performed at this time. The CDC reports, “The tests can be performed using respiratory secretions collected at the time of disease onset or using two blood samples; the first collected while the animal is sick and the second 2 to 3 weeks later.” Ask your veterinarian about testing options.

A vaccination has been developed by Intervet Schering-Plough. Dr. Alice Wolf, a well recognized expert in small animal veterinary medicine, notes,”This is a killed virus vaccine that apparently provides non-sterilizing immunity. Information says that it “lessens the frequency and severity of lung lesions, reduces viral shedding, and reduces duration of coughing.” In other words, it does not prevent infection nor does it completely prevent clinical signs of infection.” She notes it is “definitely” not a core vaccination for every dog but also concedes it “maybe something to consider for shelter animals IF there is an outbreak in (the) shelter.” This vaccination will not provide immunity until 2 weeks following the second booster vaccine which can be given 2-4 weeks following the first. Therefore, this vaccine does not confer rapid immunity and is not useful for dogs immediately entering a boarding kennel or shelter situation.

Canine Influenza will most likely spread to the remaining states in the years to come. Diagnosis may become easier but the treatment modalities are similar to those for moderate to severe infections with Bordetella or other respiratory pathogens.  Awareness without panic and sensationalism is key.  Vaccination is not widely accepted in the veterinary community at this time except in areas of crowded canine populations. Vaccinations are being given to dogs who will be boarded in areas of known outbreaks.  It is merely a matter of time before boarding facilities require this vaccination along with Bordetella for admittance. Even in those situations, the efficacy of this vaccination remains to be proven.

Cats are near and dear to my heart and I am not alone.  There are over 82 million cats in American homes! Unfortunately, these cats are receiving less veterinary care and less research than their canine counterparts! “Morris Animal Foundation’s (MAF) Happy Healthy Cat Campaign is an unprecedented global effort to eliminate suffering and premature death in cats. It will significantly increase funding for feline health research and training of new scientists.”

Check out the Happy Healthy Cat Campaign sponsored by Morris Animal Foundation!