Thursday, February 7, 2013

Ipsa Scientia Potestas Est (Knowledge, Itself, is Power)

Have you ever heard this saying before? If not in the Latin, then most likely you have heard it in the English form. Another form might be “Forewarned is Forearmed.” We all see this in daily life and often make decisions, or change decision based on this premise. A simple traffic report on television or the radio may alter your route to work today. Knowing your friend has had too much to drink would make you take away their keys and get them a cab. The weather forecasts shape our wardrobes, choice of transportation, and our vacation destinations. In essence, the more you know the better choices you can make and the more negative experiences you can avoid.

We see this daily in veterinary medicine as well. The cleaner a pet’s teeth are kept, the fewer kidney, liver, and heart diseases they tend to have. They also have less oral pain when eating, feel generally better, and are less “offensive” to the nose to have around! The more we in the profession can educate owners about dental health issues, the better off the animals are.

Let’s face it. We are all busy. Between our families, our jobs, our hobbies, our pets, our educations, our health, and just daily living we are all stretched very thin. I personally do not have the time, energy, experience, or training to know the best way to fix an electrical problem at the clinic: that is why I pay an electrician to do those things. I am not up to date on all of the changing tax laws: that is why I have a CPA. I cannot fathom all of the nuances of the federal and state laws: this is why I have an attorney. In all of these cases I rely on the knowledge of another in a particular field to help guide certain important decisions in my life.

In our profession, a large part of what we do is education. Part of my philosophy has been that in the end, it is each owner’s decision as to what they do or do not do with their pet. I believe that it is our job to do all we can to make any such decisions about your pet as informed as we possibly can. Part of that education is verbal, but part is diagnostic.

We have an incredible arsenal of diagnostic tools at our disposal in veterinary medicine. We have the basic physical exam which helps us narrow down our choices quite a bit. Then we have x-rays, ECG, ultrasound, blood work, urinalysis, bacterial culture, biopsy, cytology, and in the more advanced cases we have CT and MRI in town!

We routinely recommend testing based on the symptoms found during our exam of your pet; but there are times when testing without symptoms can be invaluable! We often recommend wellness diagnostic testing for just this reason. Some people take advantage of it, some do not. That is their decision of course. I would like to relate a few cases of owners who chose to take advantage of this service. The knowledge obtained gave them the power to better the lives of their pets.

Case 1 is a middle aged small breed dog that was in for routine vaccinations. When presented with the wellness diagnostics, the owner said it sounded like a good idea. The dog was outwardly asymptomatic. The wellness testing revealed he had a life threatening, rapidly progressing condition called immune mediated hemolytic anemia (IMHA). In this condition, the immune system decides one day that the red blood cells are foreign invaders and it starts attacking and destroying them. We were able to stop this in its tracks with the proper medical therapy and avoid a bad negative outcome because we had the knowledge to do so in a timely manner.

Case 2 is a female large breed dog who was less than a year and a half at the time of presentation. Again this one was asymptomatic and the testing was run with the intent to set a baseline for future reference. After the testing, we determined that the dog had a raging bladder infection. But further diagnostics showed that she had bladder stones which had set the environment for the infection. Surgery and antibiotics fixed both issues. But the owner had no idea at the outset that there was a problem.

Case 3 is a large breed male dog who again had routine wellness testing. There appeared to be an issue with the liver, but outwardly one would never know. After basic treatment, there was no improvement in the lab values, but the dog was again outwardly fine. After sending to the specialist for an ultrasound, they determined that the live looked very abnormal. One biopsy later and it is revealed that the dog has severe cirrhosis of the liver and is a lot sicker internally than he appears externally. Although the liver disease cannot be cured and cannot be reversed, it can be slowed and the quality of life improved for a longer quantity of time that if we did not have this information.

Case 4 is an older female dog who, although not in for the full wellness testing, was about to undergo a dental cleaning. The pre-surgical blood work (about 75% as comprehensive as the wellness package) hinted at a leukemia. This was confirmed at the specialists and chemo has been started. The foreknowledge gained by these tests has most likely helped us to extend what might have been 3-6 months of time to 1-2 years of good quality life.

To some people “ignorance is bliss,” but I suspect that to these owners, knowledge is far more valuable and they are much happier for having run the tests. So keep that in mind the next time you are presented with the opportunity to run screening heath tests on your pets, or yourself.

Thursday, July 12, 2012

Cats Are Not the Immortals They Pretend to Be!

Anyone who has known a cat, cared for a cat, coexisted with a cat, or been owned by a cat (what…you didn’t know the true owner-pet nature of your relationship?) understands their apparent innate attitude of superiority. They present themselves as the regal, aloof, disinterested gods and goddesses of all they survey. They allow us to house and feed them to give us a sense of purpose, but they REALLY don’t NEED humans. Just ask them and their expressions of strained tolerance for our insolence is quite evident.

For this next part, I suggest you coax them away from your screen with a favorite toy, a SMALL tasty treat, or an unoccupied sunbeam so they do not read the rest of this blog themselves and destroy your screen in a fit of feline rage.

They gone yet?

Good, here goes!

I am here today to expose their little secret: cats are NOT immortal. They are NOT super heroes. They are NOT indestructible.  Cats suffer fear, disease, pain, and illness just as their canine underlings do. Human myths or assumptions about these regal beasts can make health issues more severe much more rapidly than they do in the dog. Some of these perceptions are as follows:

·         MYTH = “Cats are can take care of themselves, they are basically self sufficient.” Give them enough food and water and a clean box and they appear basically labor-free for days. The fact that they can do a lot for themselves usually means the owners are not aware of changes in food and water intake or eliminations until they have been problematic for days.

·         MYTH = “Cats just naturally as a species have fewer diseases than dogs.” If they are seen less often and their symptoms are not noticed as soon or as often as they are in dogs, then less diagnostics are run so they SEEM to have fewer illnesses.

·         MYTH = “Only outdoor cats get diseases or have health problems. Cat problems come from the outdoors.” This assumes that all illnesses are environmental in origin. Indoor only cats still deteriorate internally, can still suffer significant trauma and falls inside the house, can still be exposed to parasites inside the house, and are actually at a higher risk of poisoning from human medications and cleaning supplies than are their outdoor counterparts.

·         MYTH = “Cats show signs of illness just like dogs do.” Cats are very stoic and aloof by nature, but that does not mean they do not experience pain and suffering the same as dogs do; they just show it differently. Cats are more likely to hide, move less, eat less, and be less interactive or less mobile when sick. The degree of their symptoms does not always correlate with the severity of their condition. They do not tend to whimper and whine like a dog might.

·         MYTH = “Cats get more stressed than dogs during visits to the doctor.” This keeps owners out of the hospital because they feel the stress of the visit is worse than whatever disease or condition may be going untreated. Often dogs when stressed become more reserved; whereas, many cats get more aggressive making it appear they are more stressed.

·         MYTH = “Cats are more difficult to handle during an exam.” Cats can be more difficult to hold if they really want to get away simply because they have the tools to do more damage in a shorter period of time and there is less to hold onto. Their teeth and claws can seem to be everywhere at once and they do not necessarily like to be “cuddled” and held like dogs do. With a slow and steady hand and a lot of patience the average cat does fine. With that being said, there are still those that may need special restraint or even sedation techniques to get the job done, but this is true for some dogs too.

Here are some interesting (to some) statistics about cat ownership. (I hear that data are the leading cause of statistics):

  • There are 82 million pet cats in the U.S., but only 72 million pet dogs.
  • Cats average 1.1 visits to the veterinarian a year vs. the dogs’ 2.3 visits per year.
  • Of those cats who did visit, only 22% received vaccinations for any disease other than rabies.
  • In the U.K., only about 10% of cats are strictly indoor, whereas according to a HSUS study about 75% of cats in the U.S. are strictly indoor or only go outdoors for short periods of supervised time.
  • The American Animal Hospital Association (AAHA) and the American Association of Feline Practitioners (AAFP) both agree cats should have a general wellness exam (not including sick exams) AT LEAST once a year, and more frequently if they are senior, geriatric, or have chronic or significant medical problems. 

Most practitioners recommend at least twice a year WELLNESS examinations. Cats are so good at hiding illness until it is much progressed. This means that more frequent exams are crucial to finding these issues early on. Most clinics practicing a higher quality of medicine recommend wellness diagnostic screens at least yearly as well. Many problems and diseases can be detected in the blood or urine or similar diagnostic methods much sooner than they can be detected on physical exam alone. In medicine as in many things, forewarned is forearmed.

Cats who go outdoors or who are exposed to cats that go outdoors are at a greater risk of catching more infectious diseases from stray and feral cats. These two classes of cats definitely need routine vaccinations to help protect them.

Another thing to consider is that many cats who succumb to disease do so through liver or kidney failure. These two organs are so proficient at what they do that it is possible to destroy up to 50-70% of the function of these organs with NO OUTWARD SYMPTOMS if the damage is done slowly enough! This is a natural adaptive mechanism that allows the species to continue on even if some vital organs are significantly damaged. The rest of the organ just works overtime to make up for the loss from the damaged part. This means that often what appears to be an overnight problem has actually been brewing for months or years, there was just nothing visible to the owners outwardly until it is too late to effect change.

Cats can do a lot for themselves, but they cannot tell us what is wrong or when there is a problem. They cannot make the appointment themselves, get themselves to the doctor, or medicate themselves. They rely on us for all of that. They may act indestructible, but that is far from the truth (don’t tell them I said so…they have sensitive egos!)

I think the following sums it up for cats, and this has been posted so many times on so many sites that I wonder who the original author really is:

The dog looks at you and thinks to himself,
"You feed me, you shelter me, you love me. YOU must be GOD!"

The cat looks at you and thinks to himself,
"You feed me, you shelter me, you love me. *I* must be GOD!"

Oh and if your feline friend has come back from their much deserved nap and is reading the rest of this blog, let me close by saying:

“Thank you to all of the divine creatures that are cats who condescend to allow us lowly humans to coexist with them on their planet!
Thank you for offering us the opportunity to care for you!
What a magnanimous species you truly are!”

Friday, June 22, 2012

Don't Let the Dogs Days of Summer Cost You Your Best Friend!

It happens every year. No matter how much education there is, no matter how much the news media covers it, there is always the case of a child or pet left in a hot car who succumbs to heat exhaustion. This is a totally preventable problem if people would just slow down and think things through. Check the car before you leave it. Bring the dogs in during the heat of the day.  We still see several cases every summer. I do not want to beat up on those to whom this has happened; rather I want to try to prevent it from happening to anyone again .

This is the time of the year when life threatening heat exposure and heat stroke happen commonly. Often the pet is left in a hot car or left outside with little to no access to water or shade. Here is some information that may help you understand just how quickly heat can kill. And cracking a few windows open does not change these numbers any significant amount as there is not enough air flow to cool the inside of the car.

Heat exhaustion/heat stroke can cause organ failure of any major organs or systems, brain damage, and  uncontrolled clotting of the blood in the body. This then leads to loss of the ability to clot which in turn causes bleeding and life-threatening blood loss. This mechanism is called disseminated intravascular coagulopathy or DIC. 

How Long Does It Take For A Car to Get Hot? *
Outside Temperature
Temperature In Car
Time it Takes to Reach
10 minutes
30 minutes
5 minutes
7-10 minutes
30 minutes
15 minutes
?       compiled by DFPS from various national sources
Taken from this web site:

Canine Cooling Mechanisms

It is important to remember that dogs cannot control their body temperature by sweating as humans do, since they only have a relatively small number of sweat glands located in their footpads. Their primary way of regulating body heat is by panting.  

Remember back if you can to physics class (yes I know this hurts but bear with me) and basic thermodynamics.  Temperature tries to equal out all the time. Heat runs to cold, or cold runs to heat, or however it is best for you to remember. If your dog is overheating and her body temperature is 103°F and she is able to pant in 90°F weather, then she breathes in 90°F air which meets the 103°F air in her body. Heat exchanges and she breathes out air that is between 90°F and 103°F. With each pant the total heat exchanged increases and her temperature drops.
The cooler it is outside the faster she can cool.

Also the more liters of air she can move per minute, the faster she cools.

As she drinks cool water, the heat moves from the body to the water (very simplistic explanation but you get the picture). When she urinates, that body temperature water moves out and brings heat with it as well. 

If she has no access to water, or if the water is hot, then she loses this mechanism of cooling. If the air outside is 100°F or greater, then the panting mechanism does not work as well either.

Other Less Commonly Known Causes of Heat Stroke 

Other common causes of heat stroke include being left in a yard without access to shade or water on a hot day, and excessive or vigorous exercise during hot temperatures. Excited or excessively exercised dogs are sometimes at risk even if the environmental temperature and humidity does not appear hot. This is particularly true if they are kept in a poorly ventilated environment or dog house.

Dogs that are muzzled for any reason can be at greater risk since their ability to pant is restricted by the muzzle. (Decreased air flow)

Dogs with a restricted airway such as the brachycephalic breeds (flat faced dogs such as pugs, boxers and bulldogs) are at greater risk as clinical signs of heat stroke can occur when the outside temperature and humidity are only moderately elevated. (Decreased air flow)

Heat stroke is a medical emergency and needs to be treated ASAP with controlled reduction in body temperature.
Temperatures that get too high for too long often result in irreversible damage to the body or even death.
If your dog likes to spend a lot of time outdoors, you may consider providing a "kiddie" pool with water in it for  them to play in or stand in. It is best if this is kept in the shade as well. This water should be changed daily.
How Hot is it Really?
The following chart was borrowed from the National Weather service and one can see that humidity can play a big part in heat exhaustion as well!

How Much Water Does My Dog Need?
The average dog needs about 30 ml of water/ pound of body weight (or about 80 ml/kg) per day. This is basic maintenance and does not take into effect the increased need for heat, activity, or certain medical conditions such as liver or kidney disease or diabetes, or replacement needs for increased loss from medications such as steroids or diuretics.
When the body is stressed with exercise, work, or heat exposure, the water requirement can easily double or triple. It is a good idea to allow your dog access to 2-3 times the daily requirement of fresh water throughout the day if they exercise a lot or are exposed to the heat commonly. Please don't let the water sit in the sun and get hot as they may not be able or willing to drink it then. Also account for some dogs' tendency to play in the water. Also, dogs who have been exercising a lot should be allowed the water in gradual increments as rapidly drinking can lead to other problems such as "bloat." Water intake can be allowed but slowed in these instances by adding ice to the water. This makes the dog either eat the ice or wait as it melts.
Below is a chart to help determine water needs for your dog. These are a basic rule of thumb, but your dog may need more for their specific condition or metabolism. These should be considered minimums.
Please remember that there are 8 ounce in a cup / 16 ounces in a pint / 32 ounces in a quart /128 ounces in a gallon.

Body Weight Daily Maintenance Water Requirement "Stressed" Water Requirements (3X Maintenance)
Pounds Milliliters Ounces Milliliters Ounces
5 182 6 545 18
10 364 12 1091 36
15 545 18 1636 55
20 727 24 2182 73
25 909 30 2727 91
30 1091 36 3273 109
35 1273 42 3818 127
40 1455 48 4364 145
45 1636 55 4909 164
50 1818 61 5455 182
55 2000 67 6000 200
60 2182 73 6545 218
65 2364 79 7091 236
70 2545 85 7636 255
75 2727 91 8182 273
80 2909 97 8727 291
85 3091 103 9273 309
90 3273 109 9818 327
95 3455 115 10364 345
100 3636 121 10909 364
105 3818 127 11455 382
110 4000 133 12000 400
115 4182 139 12545 418
120 4364 145 13091 436
125 4545 152 13636 455
130 4727 158 14182 473
135 4909 164 14727 491
140 5091 170 15273 509
145 5273 176 15818 527
150 5455 182 16364 545
155 5636 188 16909 564
160 5818 194 17455 582
165 6000 200 18000 600
170 6182 206 18545 618
175 6364 212 19091 636
180 6545 218 19636 655
185 6727 224 20182 673
190 6909 230 20727 691
195 7091 236 21273 709
200 7273 242 21818 727

How Much Water Does My Cat Need?
Cats are "desert species" by nature meaning that they often require less water for maintenance of their body functions. They have very efficient kidneys which work to conserve water (as long as the kidneys are healthy).Cats' prey in the wild is often 70%-80% water so that they very seldom will drink water by itself in the wild unless overheated. Most canned foods match this as well. Most dry foods however are about 8% water. Fresh palatable water must be readily available at all times if feeding a dry food. Cats daily still need about 20-30 ml/pound of body weight per day, but this is combined intake of food and water moisture.

Cats do not have a very strong thirst drive. This often means that they have a more difficult time adjusting for excess water loss from heat than dogs do. Even when offered water, cats on dry food often do not drink enough water to make up for what is lacking in the diet. When you combine water intake from food and water, the cat on dry food often takes in about half of what the cat on canned food takes in per day. Cats increase voluntary water intake when fed dry food but not in sufficient amounts to fully compensate for the lower moisture content of the food. In a recent study, cats consuming a diet containing 10% moisture with free access to drinking water had an average daily urine volume of 63 milliliters (ml). This volume increased to 112 ml/day when fed a canned diet with a moisture content of 75%. Several studies have shown that dry cat foods contribute to decreased fluid intake and urine volume. These often lead to kidney disease, kidney failure, or urinary crystal/stone production.
So, ideally, canned cat food is actually more beneficial to cats as it most closely mimics the diet they would get in the wild. It is higher in protein and water and lower in carbohydrates ... just like a mouse. Can a cat be maintained on dry food? Yes it can, but it is at a higher risk for obesity, diabetes, and urinary tract disease. More specifics on dry vs. canned food for your cat should be addressed one to one with your veterinarian.

Armed with this knowledge, let us all be more aware of the heat for our pets and keep our hot dogs in the bun!