INTRODUCTION:

The dog and cat page is my effort to inform pet owners of some of the more common problems we see in our practice and a few other problems which are less common but still of interest. For specific issues related to AZ please see the Arizona page and for further pet information please see the library page.

VACCINE THEORY:

The pet and veterinary community has hotly debated the correct vaccination protocol for our pet dogs. In the past it was thought that any disease that a vaccine available to fight it should be given to our pets. As a backlash to this rational many articles in the pet community portrayed vaccines as the enemy and a likely cause of disease. The opinion of the veterinary community and certainly my opinion is a mixture of these two thoughts. And this article is intended to provide a rational for safe and reasonable vaccination of our pet dogs.

Okay, so what a vaccine is:

There are many types of vaccines available in human and animal medicine but currently many of our dog vaccines are modified live vaccines. This means that the scientist has slightly altered the virus so that it will still stimulate immunity but will not be able to cause disease in the patient, thus creating a safer vaccine. Immunity is just the body’s natural defense against infection.

What a vaccine isn’t:

Vaccines do not prevent disease in those animals already exposed to the virus. The vaccine must be present prior to exposure to provide time to grown adequate memory cells to aid in defense of the body. So, if you have a puppy that was exposed to parvo virus but not yet ill a vaccine will NOT prevent disease.

How vaccines work:

So many of us haven’t always understood why we need to vaccinate our pets (or children) we are just doing what is recommended by the doctor in an attempt to keep our loved one safe. As a veterinarian, I believe that it is important that owners understand why we vaccinate so that they have informed consent and know what they are protecting their pet with and against. By giving a vaccine we are attempting to stimulate the dog’s immune system to create memory cells that will be saved in the body to fight the virus if they encounter it in the future. On the initial exposure to a virus (antigen) the immune system will create a few short lived memory cells but will not create lasting immunity. Therefore, we always provide one booster in 2-3 weeks to give a second boost to the immune system and create millions of long lived memory cells in the body. These cells are constantly circulating in the body looking for foreign invaders to attack and destroy thereby defending the body and providing the pet immunity to the virus.

Why are puppies given several vaccines?

Neonate puppies or those recently born, receive all of their immunity from their mother through the uterus and the milk. The amount and level of immunity they receive is entirely dependent upon the mother’s vaccination and immunity status. Therefore a mother who has been poorly vaccinated, or even never vaccinated, will give poor immunity to her pups and those pups are at a very high risk of contracting and dying from very early infections such as parvo virus. So, the mother’s immunity is very important in providing her pups early immunity from disease. The mother’s immunity will also block and prevent our vaccine from providing vaccinated immunity to the puppy. Also, based on her level of memory cells the mother’s immunity may last from a few weeks in the pups to as long as 4 months. This means that your newly purchased 8 week old puppy may or may not have immunity to infection. Without several costly blood tests, the best way of ensuring the puppy is protected is sequential vaccines over time.

But as we’ve said the mothers immunity blocks our vaccines so how do we know when her immunity is low enough for our vaccine to work but not so low that the pup is entirely unprotected? As we’ve learned puppies early in life are likely to be protected even from an infrequently vaccinated mother, therefore we do not typically need to vaccinate prior to 6 weeks of age. So we know that the best time to begin vaccines is from 6-8 weeks of age catching those pups that have limited or short term immunity. However some of these pups may have long immunity preventing our vaccine from working and preventing the puppy from receiving long lasting immunity to disease. The best way around this is to do sequential vaccines every 3 weeks for a series of 4 vaccines up to age 4 months. By doing this we are ensuring that the pups who have lost early immunity are protected at the proper time and we are also ensuring that the pups with longer lasting immunity are vaccinated long enough for our vaccine to work and a boosters to be given.

Summery to why sequential vaccines are needed in pups:

• Start vaccines at 6-8 weeks
• Vaccinate every 3 wk up to 4 months old
• This will ensure early protection
• This will ensure the best lasting immunity
• Provide an additional vaccine booster at 18 months of age.
• It is important to understand that even though there is a debate in our community about vaccinating adult animals that debate should not involve immature animals. The ONLY way of ensuring protection from deadly disease in puppies is to vaccinate them properly up to 1 year of age. At that point we have given them long lasting memory cells and may consider extending the subsequent intervals to every 2-3 years depending on the level of exposure and the vaccine used. Please vaccinate your puppies.

The most common or core vaccine: Da2p-cpv:

Distemper virus is an often deadly upper respiratory and neurological virus of dogs.

• Adenovirus type 2 is a hepatitis virus of dogs
• Parainfluenza is a respiratory infection often involved in kennel cough complex
• Parvo Virus is often a fatal gastrointestinal infection of all poorly vaccinated dogs.

This is the core combo vaccine that is given to puppies every 3 weeks until 4 months of age. It protects against the worst diseases that often are life threatening to puppies.

1. Canine Distemper Virus: is a disease of dogs only (although dogs can infect ferrets). The disease causes a variety of clinical signs from purulent (pus) nasal discharge and eye discharge with coughing to vomiting, diarrhea and seizures. Infected pets are often febrile (fever >103F) and very depressed/lethargic. The prognosis is very poor.

2. Canine adenovirus type 2: is also called canine infectious hepatitis and is a very serious disease that often isn’t seen in our area due to vaccination, but once was very common. There is also a type I vaccine that we don’t use because type 2 will protect against both types and type I vaccine causes eye inflammation commonly called blue eye.

3. Parainfluenza: is a dog disease that is part of the kennel cough complex. The virus works with the bordetella bacteria to cause a harsh unproductive cough. These pets typically have a history of exposure to other dogs (often in a kennel situation) and are typically normal except for a cough. They often respond well to treatment and supportive care.

4. Canine Parvo Virus: Is a life threatening disease of puppies and potentially of unvaccinated adults. The virus infects the rapidly growing cells of the intestine and causes severe liquid bloody diarrhea, frequent vomiting and very depressed/lethargic puppies. Puppies that are not treated will usually die. This disease can be prevented by vaccination.

Additional Vaccines (many and varried depending on where you live in the US and thus your pet’s exposure to disease). A few commonly used:

• Corona Virus: This is given twice to puppies 3 weeks apart. The virus causes a disease of vomiting and diarrhea in very young puppies. This vaccine is typically not given to adult dogs.
• Bordetella Bacterin:Protection from kennel cough complex. Is given as nose drops in our hospital and only to those dogs at high risk such as boarding dogs, those that attend puppy school and those that frequent doggie parks should also be vaccinated.
• Rabies:Frequency will vary by state. In AZ it is given to puppies and a booster is given in 1 year of age and then again every 3 years.

Spaying and neutering puppies:

All pet animals should be altered to prevent reproduction.

Terminology: We commonly call an ovariohysterectomy a spay and a castration a neuter.

PROCEDURE

During a spay, an abdominal incision is made allowing access to the ovaries and uterus which are both removed. Recovery time is about 2 weeks during which the dog should be kept quiet and prevented from running or jumping. During a neuter the testicles are externalized though the skin and just above the scrotal sac. The testicles are then ligated over the spermatic cord and removed from the body. Again, recovery time is about 2 weeks for actual healing, but the dogs usually act normal within a few days.

WHY Alter your Pet?

Believe it or not I still will occasionally have clients tell me that they don’t intend to alter their pet’s reproductive status because they think it is good for the children to witness the birth. The reasons are endless, but the end results remains the same – thousands of unwanted animals left to be put to sleep in shelters. Owners typically believe that they will find good homes for all the pups so this reasoning doesn’t apply to them. However, many puppies end up in shelters shortly after that new owner takes them home. Reasons such as behavior problems (AKA lack of training), and housing or apartment limitations are commonly given to shelters when the pups are abandoned. So, the most important reason for altering pet dogs is to decrease the many euthanasias taking place in shelters across the United States on a daily basis.

Still, there are many other reasons to alter your pet and many of these reasons are directly related to the current or future health of our pet.

For Females: Just a few of the concerns…

• Mammary Cancer -It has been shown that female dogs spayed prior to their first heat will have almost no incidence of mammary (breast) cancer later in life. This is because by spaying your dog you are eliminating the estrogen hormonal surge that occurs with each heat cycle. Studies have also shown that dogs spayed after their 3rd heat cycle are at a greater then 90% or better risk of developing this cancer. Therefore, by spaying your pet early you will be able to prevent this type of cancer.
• Pyometra: Intact female dogs are at risk of developing a potentially life threatening uterus infection called pyometra. If not caught this infection can make the dog extremely ill and can result in death.
• Dystocia: Pregnancy will commonly result in problems during parturition or the act of giving birth. Any type of dog can develop dystocia (stuck puppy). Dystocia often requires the mother to undergo a surgical procedure to remove the puppies (many of whom die) called a caesarian section.
• Prevention of the estrus cycle. Intact females will cycle about every 6 months and this will result in vaginal bleeding for 2-3 weeks and unwanted attention from the boys.

For Males: just a few…

• Trauma – In my mind the most important reason of all! Intact male dogs are the number one trauma victim. They not only end up in dog fights, but they nose their way into trouble by escaping the house or jumping fences in the hunt for a girl. Unfortunately, many of these wanders end up hit by a car or impounded into a shelter.
• Behavior: Intact male dogs are more likely to be aggressive to others including both dogs and people. Additionally, they are more likely to exhibit such behavior as urine marking.
• Prostatic Disease including: Abscesses, Infection, Cysts – Occur only in intact males.
• Testicular cancer is eliminated

Please, if your dog is to be a pet there is NO valid reason NOT to neuter him or spay her.

PARASITES:

Parasites can be both internal and external and the type of potential parasites will vary from one region to another. As an example we see few fleas in Arizona because of our hot and dry climate, but areas higher in humidity often have severe flea infestations requiring year round preventatives.

External Parasites: Include fleas, ticks and mites.

Fleas: These are blood sucking organisms that will feed on your pet’s skin and can be seen moving or jumping through the fur. They can be any place on the dog, but are often present around the face and neck. Fleas will also infect the environment with eggs and larvae. Some pets have an allergy to the flea saliva and become extremely itchy with only a small number of fleas present. Heavy infestations of fleas, especially on small pets, care result in severe anemia. If fleas are crunched and eaten by the pet they can transmit tapeworms – an internal parasite infection. Many products are available for flea control and prevention. The best control involves treating both the pet and the environment. Environmental control should include cleaning and vacuuming all carpet, washing all bedding and spot treating as needed. Also, good flea control requires the use of a product that is both an adultacide (kills adult fleas) and also an insect growth regulator (prevents the development of immature fleas). Many variations exist on how the medication is delivered to the pet. Topical products such as Advantage, Revolution, or Frontline are commonly used and require the placement of a few drops to the skin once monthly. Ingestion of a pill such as Capstar, for treatment and prevention is also available. And lastly, a long acting injection ( lufenuron) is available. Older means of treating external parasites include a variety of insecticides in a dust, dip or shampoo. These insecticides are often carbamate, organophosphate or pyrethrin based and can result in toxicity if used improperly.

Summary:

• Fleas infect both the pet and the environment
• Treatment of the environment and the pet is required to eliminate infestations
• Fleas can transmit tapeworms to dogs and cats and can also cause anemia and allergies.
• Flea control should include a product that kills adults and also inhibits development of immature stages (insect growth regulator).

Ticks:

Many different types of ticks are present and the type found in your state may vary from other states. Ticks are small, round, brown, blood sucking insects that will bite the dog and stay stuck on the skin at that location. You will not see them moving quickly as fleas do. With heavy infestations ticks may be seen crawling in the environment, often up walls to ceilings. Also, on heavily infected dogs numerous bumps will be felt when the pet is stroked. Ticks cause numerous diseases such as Lyme disease and E. canis/ tick fever and many others. In Arizona the most common problem we see is tick fever (E.Canis infection) and skin infections, but anemia can also occur especially with puppies that are heavily infested. Often treating the pet is enough to eliminate infection, but if the yard or house is also heavily infested, regular spraying will be needed. Commonly used products for ticks are similar to those discussed above for fleas, with many of the products serving a dual purpose. For more information on tick fever please see my Arizona page.

Mites (ear):

Otodectes – are an ear mite that can infect both cats and dogs but often is more common in cats or young puppies. These mites appear as thick black crusty debris in the pets ears. Diagnosis is via microscopic identification of the mite or eggs. Many treatments are available and very effective including the application of Revolution to the skin and various ear drops. (please note – an adult dog with black debris in it’s ears is unlikely to have mites and is much more likely to have a yeast infection)

Mites (mange/skin):

Two types of mites are Sarcoptes (scabes) and Demodex mange mites:

Both types of mites infect the skin of the pet and cannot be seen with the naked eye. They will cause varying degrees of alopecia (hair loss) and pruritus (itchy skin). Typically sarcoptes is thought of as the infectious mange mite spreading easily between dogs, causing severely itchy skin, and even biting humans. Demodex is typically described as the non-infectious mange mite. Pets with demodex are often young dogs with an immature immune system that has allowed a increased number of mites to develop and cause disease. Typically, just a few spots of alopecia are seen, but generalized (whole body) infections can occur and are often seen with very immunosuppressed pets. Diagnosis of both mites occurs by scraping the pets skin with a blade coated in mineral oil and applying it to a slide for microscopic viewing. Demodex is vary easy to diagnose in this way, but scabes can be very difficult to find on a skin scraping and suspected pets are often treated empirically. The topical product, Revolution, is affective at treating scabes, but Demodex is more difficult to treat. Pets with demodectic mange are typically treated with regular Amitraz dips over several weeks until negative skin scrapings occur. The prognosis for both types of mites is good with the possible exception of generalized demodex. Always remember that for most diseases there are a wide variety of possible treatments. My attempt here is to name some of the more common treatments and those which we use at our hospital, however many other medications may be equally effective and all treatments should be discussed with your veterinarian.

Internal Parasites:

Internal parasites are a large and varied group of organisms that live in various organ systems within the animal. Many, but not all, parasites are located in the intestinal tract but some can also be found in the lungs, urinary bladder, kidneys, heart and other organ systems. Veterinarians will typically look for internal parasite infection by performing a fecal examination with a fecal float. This test mixes feces with a solution that allows eggs in It is important to understand that even if you don’t see worms in your pet’s feces they may still be infected. The parasite may be located in areas other then the gastrointestinal tract or they may not be shedding (laying) eggs yet. Either of these situations would result in a false negative fecal float examination. Because of the potential for a false negative fecal exam and the high incidence of infection in puppies and kittens, most veterinarians will routinely deworm all young pets. Additionally, some of these parasites may pose a health hazard to humans and children in particular which further necessitates a prophylactic deworming program. There are a small number of cases reported in the U.S. each year of children infected with roundworms (called visceral larval migrans) and hookworms (cutaneous larval migrans). Therefore, all puppies and kittens should be dewormed by a veterinarian. It is important that a veterinarian deworm the pet to ensure that the correct drug, dose, and frequency is given. One type of medication will NOT kill all types of worms. Your veterinarian will need to determine what your particular pet is infected with to determine the best treatment.

A few of the internal parasites of dogs & cats include:

1. Nematodes

a. Roundworms

• Toxocara canis
• Toxocara cati
• Toxascaris leonine
• Baylisarascaris procyonis (raccoons)

Roundworms are a common parasite of puppies and kittens and they can be transmitted to children from the environment (fecal-oral transfer). The roundworm eggs are passed in the pet’s feces and become infectious in the environment (yard). Once in the environment the ova or eggs live for extended periods of time and remain infectious. This organism is very difficult to eliminate from the yard. Therefore, it is recommended that all puppies and kittens complete a deworming program that will kill this parasite. Many medications are effective against this parasite. Most infected animals show no sign of disease. However, some puppies will have a pot-belly from the mass of worms and intestinal blockage is also possible.

b. Hookworms

• Anclystoma caninum
• Uncinaria stenocephala

Hookworms are another common parasite of dogs and cats. They live in the intestines and eggs are passed in the feces. Severe infections can cause anemia (low red blood cell count) in young animals. The medications effective against roundworms are also effective against hookworms.

c. Heartworms:

• Dirofilaria immitis

A parasite that is transferred to the dog or cat by the bite of an infected mosquito. The immature stages of the parasite then travel the pet’s body for about 6 months finally reaching the heart where they infect the pulmonary artery (large blood vessel form heart to lungs) and right atrium of the heart. Heavy infections lead to heart failure. This parasite is most common in areas of the country with high mosquito populations but is thought to be spreading throughout the country. Several cases occur in each year. Theses worms are large worms that can live several years in the heart. If a dog is infected the worms can be killed but the pet may still have problems due to the dead worms in the heart. It is extremely inexpensive and easy to prevent this parasite with a number of products that can be given once monthly. A couple of common products (among the many available) include Revolution applied topically to the skin between the shoulders once monthly and Heartgard chewable pills given once monthly. The medications commonly given to puppies and kittens for roundworms and hookworms do not kill or prevent heart worms. However, both Heartgard and Revolution in addition to other preventatives do include a gastrointestinal dewormer to kill roundworms and hookworms and thus serve a dual function.

d. Whipworms

• Trichuris vulpis

Whipworms are uncommon in our area of the country but occur with much higher frequency in warm wet areas such as the south. Whipworms can cause intermittent diarrhea in addition to other signs. Adults live in the cecum and eggs are passed in the feces.

e. Lung worms

• Capillaria aerophilia

An infection that is uncommon in this area of the country. Adults live in the large airways and lay eggs that are coughed up and swallowed by the dog to pass in the feces. They may cause coughing and are diagnosed by a fecal exam or trans- tracheal wash.

f. Bladder worms

• Capillaria plica

Adults live in the urinary bladder and eggs are passed in the urine. This worm is an uncommon parasite which may cause signs of urinary tract infection.

g. Stomach worms

• Physaloptera

Another uncommon parasite that lives in the stomach and eggs are passed in the feces. Diagnosis is by endoscopy or fecal examination. Maybe a rare cause of vomiting.

2. Cestodes: Tapeworms

a. Dipylidium caninum

A tapeworm that lives in the small intestine and passes proglottids that are reproductive segments which contain eggs. Proglottids look like rice grains often stuck to the pet’s anus or found in bedding. It is important to remember that the pet can only get this parasite by ingesting a flea (commonly) or dog louse (uncommon). Therefore, the pet must also be treated for fleas.

b. Taenia pisiformis

A tapeworm carried by rabbits but NOT passed in rabbit feces. The dog must actually eat the rabbit to ingest this parasite. The diagnostic stage is again the proglottid which looks identical grossly to Dipylidium.

The above is just a sampling of tapeworms, in reality there are many different types. But the important thing to remember is that the many of the common puppy and kitten deworming medications do not kill tapeworms. If you find fleas or proglottids or know that your pet has eaten rabbits or rodents (mice) you should advise your veterinarian.

3. Trematodes: Flukes

Very uncommon in this area of the country but are seen in wet areas such as WA. Pets need to ingest the intermediate host of this parasite to become infected. Hosts include other creatures such as snails, crayfish, frogs, fish… Flukes can carry the organism responsible for Salmon Poising in the Pacific Northwest. These are not seen on standard fecal exams and often require special techniques to find them.

4. Protozoa

Many parasites are included in this group and some are common and other are very rare. Only a few of the more common protozoa are listed.

• a. Coccidia

  Very common in young puppies. Will cause diarrhea with or without blood and sometimes vomiting is also seen. Requires a fecal examination for diagnosis and is treated with a special antibiotic that also has a good spectrum for protozoa. Not all antibiotics kill this organism. You must contact your veterinarian for diagnosis and proper deworming. The typically deworming medications for young puppies will not eliminate this organism.

• b. Giardia

  A common organism found in dogs that have been playing in and drinking from ground water contaminated with feces. Fecal contamination of food can also be a source of infection. This parasite is infectious to humans and other animals. Pet’s and people with a weak immune system are particularly at risk. Diagnosis is by serology (in hospital test-kit available) or fecal examination. The infection can be treated by your veterinarian.

• c. Toxoplasmosis

  This is an infectious organism of cats that has been shown to cause spontaneous abortion in pregnant women. Cats become infected from eating infected rodents or raw meat. Not all cats are infected and not all infected cats will pass eggs in their feces. However, the general recommendation is that pregnant women should avoid handling the litter while pregnant. The best prevention of this is to keep your cats indoors to eliminate hunting and don’t provided raw meat. Diagnosis is by fecal exam or serology (blood testing).

In conclusion, remember that parasitic infections are treatable conditions and with proper veterinary care your new puppy or kitten will NOT pose a health risk to you or your children. Part of caring properly for your new puppy or kitten must involve a visit to the veterinarian for examination.

Senior Care:

DIET:

Senior dogs often require lower calories to prevent obesity resulting in stress and strain on older hips and knees.

• Many senior diets are fortified with glucosamine to encourage better joint function as well as anti-oxidants to scavenge free radicals that are causing joint damage
• Small volumes and good digestibility are important
• Often a prescription diet is required based on a particular disease state

Patients with kidney disease require very low protein diets

Periodontal Disease:

Dogs that have not had dental care up to this point will often develop severe oral disease

• Abscessed teeth, excessive tooth wear, severe gingivitis, and fractured teeth are all very common in senior pets.
• Extractions are often the end result of years of tooth neglect and are often needed to relieve pain and infection.
• Veterinary dentists are utilized to help save such diseased teeth with procedures such as root canals.
• Depending on the level of oral disease, dental cleaning/periodontal therapy may be needed very 6 months or more.
• Oral tumors can develop more commonly in our senior dogs and are often fist detected during a routine dental cleaning. Regular home dental care will help the owner become familiar with their pet’s mouth and help identify early changes.

As always – The key is preventative care prior to this stage of life

Organ Disease and/or Failure:

Kidney, liver, heart, gastrointestinal, pulmonary disease all become more common in seniors. Problems can include infections, cancer, dysfunction and failure of particular organs.

• Regular blood screening is vital in early identification of many organ dysfunctions
• Regular exams, laboratory testing, EKGs, and radiographs in seniors will help to identify heart and lung disease early in the process, allowing for better treatment or resolution.
• Senior pets should have a complete veterinary examination every 6 months. At this age, change in the body is occuring rapidly and early detection is the key to providing the best care.
• Dogs at risk for develping heart disease such as boxers, great danes, and dobermans should have a chest x-ray and EKG at least yearly.

ARTHRITIS:

Arthritis is a common problem in seniors and is addressed further under common disease conditions below. Many people see their older pet slowing down, taking short steps with the back legs, having difficulty raising their hind end after resting, or moan and groan when laying down. Often this is incorrectly attributed to normal aging and treatment is not provided. It is important to realize that all of the above signs indicate that your dog is in pain and pain should not be considered a normal part of aging. Unfortunately, in many of our older large breed dogs arthritis often becomes a life ending disease. Many of these big dogs will be unable to get up or around due to the pain and owners often have to euthanize them. However, in other seniors, medical therapy with a non-steroidal anti-inflammatory can be very rewarding, will improve quality of life, and allow for a longer life in those dogs that are now able to function normally. Owners will notice that their pet begins to act more like a young dog when their pain is treated with the appropriate medication. If your senior dog is very slow to get up in the morning or circles many times and appears painful upon laying down, than I encourage you to have your pet examined by your veterinarian. As always, ideally we wish to prevent disease altogether and the best way to do this is by preventing obesity, providing moderate exercise, and treating pain and inflammation as they occur or as needed.

Commonly used arthritis medications – work by reducing inflammation

• Carprofen (Rimadyl®, Novox) – chewable tablet
• Etodolac (EtoGesic®) – chewable tablet
• Deracoxib (Deramaxx) – chewable tablet
• Meloxicam (Metacam®) – liquid given in food
• Tepoxalin (Zubrin®) tablet

More below…

Health Concerns: various life stages:

Dental Disease: Periodontal Disease

Dental disease is a common problem in our pets and involves gingivitis and tartar build-up. Gingivitis is seen as red/inflamed gums above the tooth line that will often bleed easily with little irritation. Tartar is seen as the hard, thick, yellow build-up on the tooth surface. Tartar will usually start at the top of the teeth and eventually progress downward to cover the entire tooth surface.

Other Problems with oral disease:

Periodontal disease can result in significant pain for the pet and unfortunately, if your pet does not see his/her veterinarian on a regular basis, will go unrecognized until the disease is very advanced. Also, all the thick yellow tartar is full of bacteria (disease causing organisms) that could potentially result in systemic disease. Many veterinarians are concerned that severe periodontal disease can result in infection of the heart valves and lead to heart disease. Older pets and pets with existing heart disease are routinely placed on antibiotics just prior to a dental cleaning to help protect them from the bacteria that may enter their blood stream. Most pets with periodontal disease will have halitosis (oral odor) that is caused by the bacteria in the oral cavity. Other problems with periodontal disease include abscessed teeth that may be seen as facial swelling, tooth loss and exposed tooth roots. Again, periodontal disease can be very uncomfortable for our pets and should be prevented or at least treated when recognized.

Tooth Cleaning or Prophy

Once periodontal disease has developed the teeth cannot be adequately cleaned at home and the pet will require a complete dental cleaning under general anesthesia. Essentially, the pet will be placed under general anesthesia to allow easy access to all tooth surfaces and than a cleaning and examination procedure similar to what we would have done at our dentist will be completed. The teeth are cleaned of all tartar on the tooth surface and under the gum line and thoroughly polished. Next, all the teeth are examined and probed for potential dental disease and the gums are examined for disease such as tumors. If diseased teeth are suspected, x-rays are taken to confirm the disease and the owner is consulted on the appropriate course of action for their pet. The treatment can involve many different options including extraction, root canals, crowns and many more. If needed, the pet can be referred to a veterinary dentist for more specialized care. Prior to completion of the dental procedure fluoride is applied to all the teeth and the pet is allow to awaken.

Home Dental Care

Home care now becomes more important and may vary depending upon your individual pet. Regular brushing of the teeth with a pet toothbrush and toothpaste are always the best option for keeping the teeth in their new polished condition. Many pets will not tolerate brushing immediately so many owners will start by gently applying the flavored tooth paste to their finger and lightly brushing over the gums on each side. Once the pet tolerates this, the owner can advance to using a brush and gradually increasing the brushing time. Ofcourse, the best course of action is to start tooth brush training in youngsters, but any can pet can potentially be taught. If your pet declines to allow tooth brushing, there are other antibacterial products on the market that your vet may prescribe. The easiest products are a liquid or gel based antibacterial solution that can be flushed or applied onto the gums.

Dietary therapy

Diet can also be an important tool in avoiding periodontal disease. Typically, dry diets will cause less tartar build-up on teeth and canned, moist, semi-moist and human foods will result in significantly more tartar. Therapeutic diets are also available and the principle behind most of these diets is the formation of a large dry kibble that doesn’t immediately shatter when chewed but rather acts as a brush to help clean the tooth’s surface. So, regular dry diets will only contact the tips of the teeth and the therapeutic diets are designed to actually contact the upper surfaces of the teeth. Science Diet t/d or Royal Canin D/D are commonly used dental diets that are well tolerated by most pets, but there are many other diets available based on the same principle. Please consult with your veterinarian prior to any diet change and she/he will help you with the appropriate selection for your pet. Also, all diet changes should be made slowly to avoid gastrointestinal disease.

Lick Granulomas

Defined: Obsessive licking of areas on the feet around the joints of the carpus/tarsus (wrist/ankle). The licking often causes hair loss with skin irritation and ulceration. Commonly the pet will have thickened skin and a lump at the site of licking. Lick granulomas can be extremely difficult to treat and are usually an accumulation of many causes, some of which include:

1. Behavior

• Stress
• Anxiety
• Boredom

2. Infection/Inflammation

• Hair follicle infection
• Secondary skin infection
• Allergies

3. Joint Pain

• Arthritis

Because there are multiple possible causes, there are also multiple ways to treat this condition. No one treatment is curative or correct for every dog. Response usually involves using the correct selection of treatments for the specific individual.

Some treatments currently used include

1. Calming/anti-depressant medication

• Clomipramine – is widely used for various canine anxiety disorders and is generally considered one of the safest of these types of medications. However, with all medications regular blood work should be done to monitor organ status.

2. Antibiotics:

• Often these are needed for a long course of treatment (6+ weeks).
• These are generally needed for secondary skin infection created by licking.

3. Protection of wound from licking:

This is one of the most important aspects of treatment and often the most frustrating for the owners Elizabethan collars- commonly used to keep the patient from having access to the wound. Bite-Not collars – (think of a whip-lash type neck collar) Bandaging – is often used but only successful if the patient doesn’t remove the bandage.

4. Steroids and Non-steroidal anti-inflammatory drugs (NSAID):

Steroids are potent reduces of inflammation and they help relieve itchy skin. Many different kinds of steroids are commonly used. These are all used on a limited basis due to the many potential side-effects they can produce with long term use. The steroids commonly used in veterinarian medicine are glucocorticoids and not anabolic steroids (the type misused by some athletes). Common names include cortisone, cortisol, and hydrocortisone.

Steroids

• Prednisone – an oral pill or an injections, also often used in topical products
• Temeril P – pill with low dose prednisone + antihistamine + cough suppressant
• Methylprednisolone – pill or injection
• Triamcinolone – injection only, long lasting
• Dexamethasone – Both Azium and SP – injections
• Hydrocortisone – commonly used in topical medications

NSAID

• * Carprofen (Rimadyl®, Novox) – chewable tablet
• * Etodolac (EtoGesic®) – chewable tablet
• * Deracoxib (Deramaxx) – chewable tablet
• * Meloxicam (Metacam®) – liquid given in food
• * Tepoxalin (Zubrin®) tablet

Many others are available

* Steroids and NSAIDs should never be used together.

5. Topical Medications

These often include a combination of an antibiotic and steroid.

• Many types are available
• Best to place on just prior to feeding to prevent pet from licking it off or to use Elizabethan collar.

6. Removal:

• Surgical Removal: Does not guarantee a cure and the incision site must be protected from licking while healing.
• C02 Laser: This as been proposed by some to be helpful in removing the lesion and also decreasing the itch.

7. Allergies:

Food allergies are thought to play a role in some lick granulomas. Therefore, many dogs are placed on a food allergy diet trial for 8-12 weeks. The thought is to give a unique protein and/or carbohydrate source that the pet has not yet had a chance to develop allergies to. If the pet has improved he/she can stay on the allergy diet or they can gradually (every 3 weeks) have one new item introduced into their diet to determine the specific allergies involved. Common allergy diets include IVD and Science Diet z/d, but there are many others available from your veterinarian.

8. Behavior Modification:

• This is an extremely important aspect of therapy
• Often includes working with a trainer to give the dog a more structured environment and to build confidence.
• More difficult cases can be referred to a veterinarian specializing in behavior.
• Interactive toys are important such as:
  • Balls in which dry dog food is placed and the dog has to roll the ball to get the food to fall out.
  • Kong toys with canned dog food or peanut butter placed up inside and can even be frozen to provide hours of positive licking time.
  • Exercise is extremely important to the physical and mental health of your dog and should be provided daily

Joint Disease – Osteoarthritis

Many large dogs will develop various degrees of arthritis in their joint as they age. Commonly this is seen as stiffness or pain upon first rising and then gradually working out of the stiffness with movement. Dogs will frequently have difficulty getting from a sitting to standing position with hip pain and may circle frequently very slowly go down with elbow pain. Muscle atrophy or a lack of muscles will often be noted in these pets. Large breeds and obese dogs are predisposed to developing arthritis.

If your dog seems to be getting weak or painful a complete veterinary examination should be done to rule out other causes such as cancer, Valley Fever, Tick Fever, and various other diseases. Often radiographs (x-rays) are needed for an accurate diagnosis and to assess the degree of joint disease.

Treatment of arthritis involves weight loss, continuation with normal level of activity, and medications. Many veterinarians will prescribe a nutritional supplement which contains glucosamine and condroitin sulfate. A commonly used product in dogs is Dasuquin® Soft Chews from Nutramax labs. These products are intended to provide the building blocks of cartilage and the theory is that they will help to restore the cartilage and are anti-inflammatory as well. While they are listed as dietary supplements, I’ve found them to be extremely helpful with many dogs showing great improvement when pleased on these types of supplements. So, in my experience, they do often seem to help to pets and are very safe for long term use. A drug based on a similar principle is available but is actually labeled as a drug (research supports efficacy) and is given by injection only.

Frequently non-steroidal anti-inflammatory (NSAIDs) are needed to control the pain. Common examples are Rimadyl and Metacam. Currently we are fortunate that there are a large number of these medications available for our pets but it is important to remember that all medications should be given only under a doctors supervision. Use of NSAID’s can cause liver disease in some patients and can also cause gastrointestinal tract ulceration. Pets on these medications should have their liver enzymes monitored on a regular basis and should be monitored for vomiting, diarrhea or loss of appetite. It is important to remember that all medications can potentially cause problems in some individuals and if your pet is in constant pain the small risk is often well justified by improved quality of life.

Commonly used meds (never use together)

• * Carprofen (Rimadyl®, Novox) – chewable tablet
• * Etodolac (EtoGesic®) – chewable tablet
• * Deracoxib (Deramaxx) – chewable tablet
• * Meloxicam (Metacam®) – liquid given in food
• * Tepoxalin (Zubrin®) tablet

Dry Eye (KCS – keratoconjunctivitis sicca)

The condition keratoconjunctivitis sicca is commonly called dry eye because the disease is actually a dysfunction of the glands of the eye that produce tears, causing a dry eye. Tears are responsible for keeping the cornea healthy and without tears the cornea becomes diseased. The condition is most common in dogs with large round eyes such as Shih-Tzus but can occur in other breeds as well. Signs include very red inflamed eyes with a thick ropey type of mucus on the surface of the eye. The pets are often very uncomfortable and will frequently rub their face on the carpet. The corneas will often ulcerate and the pet will squint from the pain. A simple test called a schimer tear test can be done quickly in the office and will provide immediate diagnosis allowing for quick treatment. The test involves placing a small paper strip (that has a numbered scale on it and blue dye at the bottom) under the lower eyelids. If adequate tears are present the dye will wick up the paper and the number is recorded. If KCS is present there will not be enough tears to wick the dye up to the proper level and KCS is diagnosed. Once diagnoses pets are treated for with a medication called optimmune (various strengths) the ointment is applied into the eye daily for the life of the pet. With most pets this treatment alone is enough to control the disease as long as the owner understands that it is a lifelong treatment and continues the administration of the medication.

Anal Glands

Anal glands are glands that are located on either side of the rectum and produce a liquid secretion used for scent marking when stool is passed. The secretions drain by a very small duct that if inflamed will easily become blocked causing the secretions to continue to build up and the glands to overfill and become uncomfortable to the pet (both dogs and cats but more common in dogs). Typical signs of blocked anal glands are frequent licking of the rectum and scooting or dragging the bottom on a rough surface. If these signs are seen the pet should be taken to a veterinarian for expression and flushing. Occasionally a gland will become overfilled and infected and will abscess or rupture through the skin. At this point the pet will have a visible wound on the rectum and they are often very painful. If presented to a veterinarian the condition is easily treated but unfortunately many pets are subject to repeated blocking of these ducts. Increasing the fiber in the diet often helps to naturally express these glands.

Weimaraner Puppies and Potential Concerns with Vaccination:

A small percentage of Weimaraners have a tendency to develop Vaccine related disease: Many Weimaraners are vaccinated and never develop any form of disease related to their vaccination. However, it appears that Weimaraners as a breed may have an increased risk of developing problems related to vaccination. Unfortunately, puppies that are not vaccinated face the very real potential of becoming infected with canine distemper virus or canine parvo virus and potentially dying from the infection. So the goal is to vaccinate Weimaraner puppies but attempt to do so safely.

Known information about this subject is still limited. The current thought is that these puppies may become sick based on one of 2 theories:

• The affected Weimaraners have a weaker immune system which actually allows them to become infected by the vaccines (modified live vaccines) and develop an active infection.
• The affected Weimaraners are developing a type of inappropriate immune reaction to the vaccines much like an allergy and becoming sick as a result of an over active immune

Of the two theories #1 seems to be the most accepted, but research is still ongoing with this condition.

What Happens?

Again, most Weimaraner pups are safely vaccinated and never develop illness. But, some Weimaraner pups will become ill shortly after a vaccination. The length of time to develop illness will vary from a few days to a week or more. Affected puppies can develop a variety of problems including gastroenteritis, pneumonia and bone/joint pain and swelling. Symptoms can be very mild and self limiting to sever and life threatening.

What is the treatment?

Supportive care based on the clinical signs is the most accepted means of care. Glucocorticoids are also recommended by some clinicians but their use is controversial because they may actually decrease the immune system further and could potentially worsen the disease.

How do we avoid this?

With the current types of vaccines available prevention may not be possible A few options are to try to give the fewest number of vaccines possible to your puppy at each visit and use killed and monovalent vaccines when/if available.

This can actually be very difficult because most widely available vaccines are multi-component and are modified live vaccines. As an example, distemper, parvo, parainfluenza and hepatitis vaccines are typically combined into one multi-component vaccine. All are important and provide needed immunity but attempting to find individual vaccines and/or killed vaccines for each is often not possible.

• Only give those vaccines that are absolutely necessary.
• Often lepto, bordetella and lyme vaccines can be avoided all together.
• After 1 year of age do blood testing to check your pet’s level of immunity and the need for additional vaccines.

Under no condition should you skip the vaccines. The likelihood that your pet will become ill with a virus is very high and certainly MUCH higher than the potential for vaccine induced disease.

Summary:

• 1. Weimaraners as a breed may develop post vaccine induced HOD and gastroenteritis
• 2. They are most likely to develop this as puppies
• 3. They are most likely to have problems with multiple antigen vaccines
• 4. The reactions occur when modified live vaccines are used
• 5. The thought is that weimaraners have a inherited tendency towards a poor immune system and in some of these dogs when they are vaccinated with a modified live vaccine the vaccine reverts to a virulent (infectious) state and causes disease.
• 6. Weimaraner dogs may present with multisystemic inflammatory/infectious disease at 12-15 weeks of age that can become chronic and recurrent in nature
• 7. There is no cure for this condition, affected animals are treated symptomatically and may improve with glucocorticoid therapy.
• 8. Vaccine protocols for affected and at-risk dogs may be modified
• 9. The underlying pathogenesis may involve a primary congenital immunodeficiency state (failure to produce normal concentrations of immunoglobulin, particularly IgG and IgA), with an additional trigger being provided by the administration of multicomponent, modified live viral vaccines
• 10. In one study of 11/13 dogs, disease onset was within days to weeks of receiving a vaccine booster

Recommendations:

The most important thing you can do is to discuss this issue with your veterinarian. He or she will be in the best position to advise you of what you pet is most likely to be exposed to and which vaccines are the most needed in your area. Some general guide lines include:

• Use a monovalent vaccine when available
• Avoid giving a weimaraner pup multiple vaccines if possible
• Don’t vaccinate weimar pups for lepto (or vaccines known to be of higher risk of reactions) unless there is a high risk of exposure
• Attempt to use killed virus vaccines when available
• After their first yearly vaccines check titers yearly and vaccinate only when

DIAGNOSTICS

Diagnostic testing for animals will vary greatly depending on the age, species, sex and medical condition of the pet. Veterinary medicine has evolved to the point that we are able to provide exceptional quality medical, surgical and diagnostic procedures which allow us to provide the most up to date standard of medical care for your pet. Unfortunately, financial concerns often arise when discussing diagnostic testing and this is most common during an emergency when you are least able to prepare for the additional expense. Because of this, I strongly recommend purchasing pet health insurance. At the very least, insurance will provide you with additional assistance during an emergency, and at the most, it will allow you to provide your pet with life saving care. I’ve provided a few links for pet insurance below and I strongly recommend that all pet owners research the insurance plans available.

It is not possible to cover all types of diagnostic tests available to our pets, but I do intend to include information on the most common diagnostic procedures available and will add additional information over time.

BLOOD TESTING: The basics

1. CBC:

complete blood cell count – This is a measure of the red blood cells which carry oxygen to the organs, and the white blood cells which are responsible for fighting infection. A CBC will also include information on blood protein and platelets (cells needed for clotting blood). The report will give an estimated count of all the individual cell types in your pet’s blood sample. This will allow your veterinarian to determine information such as:

• Anemia – reduced RBC count
• Increased WBCs – often indicates infection
• Reduced WBCs – can be due to viral infections or stress
• Reduced platelets – can be due to sample handling or an actual reduction for a variety of reasons, very low platelets will place the pet at risk of bleeding, many dogs (greyhounds) will normally have a lower count
• Elevated protein – can indicate dehydration
• Reduced protein – can be due to hemorrhage, lack of production, of loss through the GI tract or kidneys
• Elevated percentage of red blood cells – normal in some breeds such as greyhounds, pet’s living at higher elevations, dehydration

2. Chemistry Panel

The blood chemistry panel will provide information on organ status (liver, kidneys, and pancreas), blood protein, immunoglobulins and electrolytes.

3. Thyroid Level (T4):

The thyroid level is often added to the chemistry panel for both cats and dogs. While cats often have problems with a thyroid level that is too high, dogs are just the opposite and can have very low thyroid hormone production. A few of the more common signs of hypothyroidism are dry skin, thin hair coat, dry coat, lethargy and weight gain. Dogs with low thyroid levels can be treated with thyroid replacement medication which is inexpensive and safe. For more information on hyperthyroid cats see cat section under links below.

4. In-house Viral/infectious organism testing:

These are pre-packaged tests that require the application of blood or urine and positives show various color changes much like a home pregnancy test.

• (dogs) 4DX test: checks for lyme, tick fever (E.canis), anaplasma, and heartworms
• (dogs) Heartworm test: tests only for heartworms
• (cats) FeLV/FIV – Tests for feline leukemia virus and immunodeficiency
• (cats) Feline Combo test – Felv, Fiv, and now heartworms
• (dogs) Parvo Test – tests for parvo virus infections in dogs

URINE TESTING:

1. Urinalysis:

A sample is collected from your pet by holding a cup in the urine stream (free catch) or by using a needle directed into the bladder to collect a sterile urine sample. Collection by needle is called cystocentesis and is quick, safe and relatively painless. We prefer to utilize an ultrasound to allow us to see the bladder and actually see the needle enter the bladder, allowing for easier collection.

Information obtained can include:

• Urine Concentration – can indicate kidney disease or dehydration
• Bacteria Count: should be zero when collected by cystocentesis
• RBC – higher with cystocentesis, can indicate inflammation
• WBC count – and bacteria can indicate infection
• Presence and type of urinary crystals
• Presence of glucose (sugar) – can indicate diabetes
• Information regarding liver status – bilirubin

2. Urine Culture and Sensitivity

Urine is collected directly from the bladder by cystocentesis and the sample is plated and incubated in an attempt to grow bacteria. If bacteria are grown, tests are run to indicate the actual type of bacteria and than the bacteria are challenged with various antibiotics to determine the effectiveness of the medications against that specific type of bacteria.

FECAL TESTING: Fecal examinations are commonly done on puppies, kittens and pets with diarrhea.

Routinely used to float parasite eggs to the surface of a liquid where they are collected on a slide coverslip and examined under a microscope. Fecal Direct Smear: Directly plating feces on a slide and examining for moving organisms such as Giardia and smaller ova. Fecal Cytology: Feces are applied to a microscope slide and stained with a dye to allow viewing of cells such as bacteria, RBC and WBC. Fecal cytology can be helpful with diagnosis of gastrointestinal inflammation, microscopic bleeding, and bacterial enteritis.

RADIOGRAPHS:

Commonly called x-rays Allow the veterinarian to see a grey scale image of your pet’s chest, abdomen, and skeletal structures. The size and shape of heart and organs can often be determined and a large amount of useful information can be obtained from radiographs. However, they are not perfect and don’t allow the clinician to see everything. Only structures that are large enough to be seen with the naked eye are seem on x-rays. Many times we will get very poor detail in thin pets or pets with fluid in their abdomen. Also, only the more dense foreign bodies will be seen and items such as cloth will not be seen at all.

Advantages:

• Readily available in most veterinary hospitals
• Can often provide a quick in house diagnosis
• Excellent for viewing skeletal structures
• Can often provide supportive information to help confirm a diagnosis

Disadvantages:

• Viewing in shades of gray and is not the same as actually seeing the structures
• Abdominal detail is influenced by the degree of fat and reduced by fluid
• Only structures large enough to be seen with the naked eye will show up
• Biopsy is often needed for a more specific diagnosis of organ disease

ULTRASONOGRAPHY:

The same as a pregnancy ultrasound but also used for viewing structures in the abdomen and the thorax (chest). An ultrasound of the heart is called an echocardiogram and is an excellent tool for diagnosing the type and severity of heart disease. Abdominal ultrasounds can be used for those pets that have poor abdominal detail on radiographs or for a guided biopsy of organs or a mass.

ENDOSCOPY:

A long flexible or rigid tube made of mirrors that allow the veterinarian to actually view the interior of the patient. The endoscope can be inserted into just about an area of the body and small biopsy samples can be taken or foreign bodies (i.e. fish hooks) collected.

Advantages:

• Allows a direct view of internal structures
• Allows for possibility of a quick and non-surgical diagnosis
• Allows for a non-surgical biopsy
• Can collect photos or videos of internal structures for later review

Disadvantages:

• Limited by the size of the tube, very small scopes needed for some areas
• Can only collect small and often superficial biopsy samples
• Often able to make a diagnosis but surgery may still be needed for cure

ECG or EKG:

Leads are attached to the body and measure the electrical activity of the heart. Information on heart rate and rhythm is collected.

BLOOD PRESSURE:

• It is vitally important that blood pressure be measured while a pet is under anesthesia A frequently used tool in older cats suspected of having hyperthyroidism or heart disease. Or in dogs with conditions such as Cushings. Blood pressure cuffs come in different sizes and it is important to select the correct size for the patient. The width of the cuff needs to be about 0.3-0.4 times the diameter of the limb. To quickly check the fit of the cuff align the cuff with the limb lengthwise and the cuff should go less than half way around the limb diameter and at least a quarter of the diameter. A cuff size that is too wide will result in a lowered blood pressure reading.

We also like to place the pet in a darkened room on a comfy bed and have the owners talk to the pet while we are measuring the blood pressure. All these procedures help to calm the pet and result in more accurate readings. Regular blood pressure measurements can be useful for cats with kidney disease and hyperthyroidism.

ANESTHESIA

Many people are concerned about anesthesia and allow this concern to prevent their pet from getting needed treatments and diagnostics. While there is always some risk with any general anesthetic procedure, there are many things both you and your veterinarian can do to dramatically lessen the risk.

What you can do: You are your pet’s advocate and are directly responsible for making decisions to provide your pet with a safer anesthetic procedure. Some of these decisions include:

• Choosing to have the procedure preformed with your regular veterinarian rather than the low cost clinic down the road. This is important for a few reasons, but most importantly is that your doctor knows your pet and therefore is better able to predict potential problems andpick the best anesthetic protocol for your pet. Additionally, while many low-cost clinics practice excellent medicine, unfortunately some are able to provide lower cost because they cut corners in other ways such as less expensive anesthetic gas, few injectable anesthetics, less pain control, reduced staffing and less (or no) monitoring of the pet under anesthesia.
• Choosing to have pre-anesthetic blood work completed on your pet. Some hospitals will require that pre-anesthetic blood work be completed on all pets, some will only require it on geriatric (senior) pets, and some will leave the decision entirely up to you. Pre-anesthetic blood work provides the veterinarian with a picture of the health of your pet at the time of the procedure. The picture includes information on general organ status, potential infections, ability to clot blood, and anemia. Frequent problems identified include diabetes, liver disease, kidney disease and clues to infections or parasites. Young pets are generally assumed to be healthy and therefore owners often elect to forgo blood testing. Most of the time this is a relatively safe bet, but it is a gamble and occasionally even a young pet will have unidentified disease that will increase the anesthetic risk. If disease is identified the anesthesia may be postponed or the anesthetic protocol may be altered to increase the margin of safety for your pet. When asked to choose pre-anesthetic blood work for your pet, always ask yourself if you would want this checked on you prior to surgery.
• Choosing to have an IV catheter placed and have your pet maintained on IV fluids Again, many hospitals require the pet be placed on IV fluids during the procedure, but you may be asked to make this decision for your pet at some hospitals. An IV catheter provides an immediate entry to a vein in the case of an anesthetic emergency and allows for the immediate administration of potentially life saving medications. Additionally, the catheter allows for the administration of IV fluids which support the pet’s blood pressure during general anesthesia and this helps to keep good blood flow to the kidneys which is important for all pets, but essential for those pets with early kidney disease.
• Allowing for safer types of anesthetics recommended by your veterinarian

We are fortunate in veterinary medicine to have a large variety of anesthetics available to us which allows us to choose the safest anesthetic for your pet. As an example, some anesthetics are just inhaled and others are injectable. Often a combination of the two is used. Even the injectable drugs have large differences between them that can alter the safety of the procedure. Some anesthetics cause longer periods of anesthetic before the pet can awaken, some cause much more suppression on heart function and respiration, some have more of an affect on the liver or kidneys, and some shouldn’t be used in particular breeds of animals at all. At the time of this writing one of the safest and most adjustable anesthetic gasses is Sevoflurane. It is considered a human grade anesthetic gas and allows for very rapid changes in anesthetic depths.

Many times, if the veterinarian determines that your pet needs a specific type of drug it will just be implemented. However, occasionally a specific anesthetic will result in a higher expense and again you may be asked to make a decision depending upon the hospital olicy. Your veterinarian should always explain why a particular drug is recommended and provide you with the correct facts to help with the decision.

What Your Veterinarian Can Do:

Your veterinarian is ultimately responsible for the safety of your pet under anesthesia and will be able to ensure the safety in many ways.

Physical Exam and history

Your veterinarian will read through your pet’s medical chart to help determine the health status and any existing potential anesthetic problems or allergies. A complete physical exam will be done on all pets prior to anesthesia to again look for potential disease problems which may alter the anesthetic protocol needed. As an example, short nosed breeds of dogs (pugs) & cats (Persians) will have a delayed extubation which means that the breathing tube will be kept in the pet as long as possible when the anesthetic gas is shut off and the pet is maintained on oxygen. Brachycephalic or short nosed breeds are likely to have more problems breathing when awakening from anesthesia and delayed extubation resolves those problems by providing an open airway until the pet is more awake and better able to breathe normally.

Anesthetic choices

Veterinarians have various means of providing general anesthesia for your pet and this allows us to determine the safest choices for him/her.

The choices can include:

• Using gas anesthesia to induce (cause the pet to sleep) the pet vs. using injectable anesthesia to induce the pet.
• Injectable induction is the most common method and is the fastest and easiest on your pet.
• Pets with liver or kidney disease may be induced with gas alone via a mask or an induction box. Pets maintained on gas alone will awaken quickly, but also take a little longer to induce and their blood pressure must be monitored very carefully.

Types of injectable anesthetics used

Again, there are many choices here as well. At our hospital we typically will induce with telazole or a combination of ketamine and valuim. These both have proven very safe for us and have minimal suppressive effects on cardiovascular or respiratory function.

• For very short anesthetic procedures in which we would like the pet to be able to go home quickly, or for geriatric pets with organ disease, we will often use a drug called Propofol. This anesthetic is very safe and extremely short acting. Pets will typically awaken fully in 5-10 minutes and they awaken easily as if they had just been snoozing.
• Other injectable anesthetics include those that provide a combination of pain relief and anesthesia and allow for reversal of the anesthesia with a second injection. These can have some suppression of blood pressure and are only reserved for young healthy pets undergoing very short procedures.

Types of anesthetic gasses used

Once again, veterinarians have the ability to choose the type of anesthetic gas used on your pet. Some of the older anesthetic gasses are much less expensive but also can cause problems in older pets, can result in liver disease and cause slower changes when the pet’s level of anesthesia needs to be adjusted. An example of an older type of anesthetic gas is halothane. The newer and of course more expensive anesthetic gasses include isoflurane and sevoflurane. These gasses are extremely safe and are commonly used in geriatric pets. They also provide the ability to quickly change the depth of anesthesia. I recommend using only one of these gasses.

Monitoring (really the MOST important aspect)

Monitoring of your pet’s vitals (depth of anesthesia, respiration, temperature, heart rate, blood oxygen saturation, blood pressure) should be done by one designated individual throughout the procedure and the results should be recorded throughout the procedure. Monitoring allows the person performing the procedure to focus on completing the procedure to the best of their abilities without dividing their attention between the task at and and anesthetic monitoring. Good monitoring also allows for the correct level of anesthesia to be chosen throughout the procedure. Most hospitals will provide some way of monitoring your pet, but the way the pet is monitored and the values monitored may vary depending upon the equipment and the staff available.

Recovery from anesthesia

The recovery or awakening period is just as important as the actual anesthetic procedure. The pet should be closely monitored during this time, the temperature should be taken and warmth should be provided if needed, the pet should have delayed extubation if needed and the pet should be supervised until fully awake.

for more information on pain control read below…

Research has shown that pain is self perpetuating and that each episode of pain triggers the next, making it easier to experience the pain. Therefore, after the animal begins to experience pain it is much more difficult to control because the pet is already cycling through this pain loop. Additionally, research studies indicate that pain will not only cause the animal stress but that the stress will release steroids which will delay healing and recovery.

Interpretation of pain in the various animals we care for can be extremely problematic. In the veterinary field we not only deal with various animal personalities but also various species that show pain differently. As an example, a budgie that is painful will often just sit quietly and appear slightly fluffed, but a Husky will often vocalize at the smallest pain stimulation. Animals, like people, have various levels of pain sensitivity and some animals will be very vocal with minimal pain stimulation whereas others will never show pain sensitivity even though we know they are experiencing a painful condition.

Because of the difficulty of interpreting pain in various animals/species and because of the difficulty of halting pain once it has begun, veterinarians, as your pet’s health care provider, must control pain before it starts. We know if certain procedures are likely to cause pain and we can administer pain control prior to the procedure to prevent the pet from 1) experiencing the pain, & 2) entering the difficult to control pain cycle.

The importance of multi-modality pain control should also be addressed. We are fortunate to have a large spectrum of analgesics (pain medications) available to us in the veterinary field, and by combining different types of analgesics we can often get additive effects, where the combination of drugs work better together than either one alone. A good example of this is the use of a non-steroidal anti-inflammatory drug (NSAID) and a true analgesic such as a morphine derivative. The NSAID will eliminate the swelling and the morphine derivative will directly control the pain providing a broader spectrum of pain control.

In conclusion, veterinarians understand that animals do experience pain much like we do, but the presence of pain and its control are subjective and difficult to interpret. Therefore, my ideal pain control involves the administration of analgesics prior to a painful event and the prevention of any discomfort. Veterinary medicine of the past poorly understood this concept and approved drugs were not available, however, veterinary medicine has changed and today pain control is an important part of our acceptable standard of care for your pet.

One of the best web sites providing owners with information about specific disease states is veterinary partners: http://www.veterinarypartner.com/

American Animal Hospital Association Pet library http://www.healthypet.com/library.aspx

CATS & DOGS

Anatomy for the pet owner: WSU http://www.vetmed.wsu.edu/ClientED/anatomy/

ASPCAhttp://www.aspca.org/site/PageServer

Animal Poison Control: ASPCA http://www.aspca.org/site/PageServer?pagename=apcc

About.com Pet Toxicologyhttp://vetmedicine.about.com/od/toxicology/

Pet Diabetes http://www.petdiabetes.com/

Pet Diets 101 http://www.petdiets.com/

Association of Pet Loss and Bereavement http://www.aplb.org/frameset4.htm

Coping with loss

Animal Cancer Center http://www.csuanimalcancercenter.org

Microchip Identification Information http://www.akccar.com

FDA – pet medication http://www.fda.gov/cvm/default.html

E-Vet http://www.e-vet.com/

The Pet Center.com http://www.thepetcenter.com/

Greer Lab: Animal Allergy Site http://www.greerlabs.com

Pet Behavior Web Site: dog and cat http://www.petbehaviorproblems.com/

Canine and Feline Nephrology and Urology Page http://vetsites.vin.com/Kidney/KMJkid.html

DOGS

Behavior – dogs http://www.uwsp.edu

Canine Heartworm Disease http://www.heartwormsociety.org/

Canine Inherited Diseases http://www.upei.ca/

Rimadyl and the senior dog project http://www.srdogs.com/Pages/rimadylfr.html

VSPN page of breed specific links http://www.vspn.org/LIBRARY/WWWDirectory/CanineBreeds.htm

Canine Epilepsy Network http://www.canine-epilepsy.net/

CATS

Feline Hypertrophic Cardiomyopathy http://members.aol.com/jchinitz/hcm/index.htm

Chronic Renal (kidney) Failure http://www.felinecrf.com/index.htm

Vet info for CAT owners page http://www.vetinfo.com/catindex.html

Gastrointestinal Parasites of Cats – Cornell http://web.vet.cornell.edu/Public/FHC/parasite.html

Aging Chart

Gastrointestinal Parasites of Cats – Cornell/ for pet owners //www.vin.com/WebLink.plx?URL=http://web.vet.cornell.edu/Public/FHC/parasite.html

The Cat Site.com – everything cats including behavior http://www.thecatsite.com/

Feline Grooming Disorders and Obsessive Compulsive disorders

//www.vin.com/VINDBPub/SearchPB/Proceedings/PR05000/PR00026.htm

DENTAL:

1. dacross.net: An excellent dental resource for veterinarians and pet owners alikehttp://www.dacross.net/

2. All Pets Dental http://www.dentalvet.com/

3. UC Davis Client Dental Information:http://www.vetmed.ucdavis.edu/vsr/dentistry/dentalcare.htm

4. Animal Dental Center Client info: http://www.animaldentalcenter.com/html/client-frameset.html

5. PetDental http://www.petdental.com/pet_dental/pet_index.jsp

Pet Insurance:

PetsHealthhttp://www.petshealthplan.com/

Veterinary Pet Insurance http://www.petinsurance.com/