Diet has a major impact on many disease processes. This
is a sensitive issue among some pet owners. Most people feel that it is
important to feed only a dog or cat food and that failing to do so is somehow
wrong. Therefore, they are unwilling to tell the vet that they feed Duchess
baked chicken breast with sour cream topping once or twice a week, just
because she likes it. Feeding of table scraps is under reported for the
same reason. Personally, I don't see much wrong with letting pets have
some treats, but that is beside the point. When you tell your vet what
your dog eats, it is important that you include not only the things you
think are good for your pet, but everything else your dog eats, too. Try
to be as honest as you can about the possibility that your pet has access
to food that you don't give it. Many of the pets we have seen who have
eaten rat or mouse poison were reported by their owners as having absolutely
no access to this sort of thing. It isn't until they start bleeding excessively
that some pet owners finally admit that their pet does tend to wander the
neighborhood and they are not sure what it eats "out there". When you are
asked what your pet eats, tell the vet what you know. If your pet does
stay at home, you control the diet and it is under your control at all
times that is very important. If you feed your dog or cat in the morning
and then may not see him again until the next morning at feeding time,
that is important, too.
Your vet can tell a lot about the cause of diarrhea if
you are able to accurately report two things. How frequently does your
dog have a bowel movement and how much volume, compared to "normal", does
each bowel movement contain? Frequent bouts of diarrhea with small volumes
of diarrhea being produced at one time usually represent large intestinal
diarrhea. Normal frequency bowel movements with large volumes of diarrhea
normally represent small intestinal diarrhea. This isn't a foolproof rule
but you can help your vet quite a bit if you report this situation accurately.
Food allergies are very hard to diagnose. One of the reasons
for this is that clients do not really understand the information that
their vet needs to make it possible to diagnose and treat a food allergy.
Dogs and cats with food allergies usually have a sensitivity to one ingredient,
or to a very small number of ingredients. Beef is a common food allergy.
Any food that contains beef will set off the allergic response. So food
allergies are not to whole foods, like "Alpo" or "Pedigree" but to one
particular ingredient contained in those foods. It is critically important
that your vet know every possible food ingredient that your pet has ever
eaten, in its lifetime, when trying to rule in or rule out food allergies.
It is best if you make a list, in advance, with all family members helping,
when food allergies must be sorted through.
You have to tell your vet what medications you are giving
your vet when an illness is present. If you are using St. John's wort to
make your dog less anxious about your mother-in-law's visit or you are
giving aspirin for hip pain, you must tell your vet. Don't worry about
your vet's feelings towards herbs or the fact that you are giving your
dog Valium prescribed for you by your physician. Tell your vet what medications
might be in your dog's system. Include heartworm prevention medications
and flea and tick products, as well. This is important to avoid complications
with medications your vet might prescribe and to aid in the diagnostic
process.
If your pet is totally inside, that is an important factor
in building a list of possible illnesses. If your pet stays outside, that
is equally important. Don't mislead your vet, though. Any access to the
outside, at all, is important in the medical history. If your cat is mostly
an indoor cat but goes outside when you are home, that still makes it an
indoor/outdoor cat from the standpoint of a medical history.
If you have other pets in your household, this could impact
on your pet's health. Let your vet know if you have two other dogs that
you take to a different vet or if your husband has a cat that has to see
the vet your husband took him to before you married him. If your vet does
not realize that there are other pets in the household, it could contribute
to missing a diagnosis of a communicable disease that might affect all
the pets. It is also important to let your vet know if you live on a farm
and your pet is exposed to many other species, such as cattle, pigs and
horses. It isn't very often that this matters in a medical history but
it can be very important in some circumstances.
Once in a while I have a client who clearly understands
that their pet has important information to its medical history but they
can't get that across because they are sidetracked by less important details.
You can try to tell your vet too much. Just like other folks, vets often
have limited attention spans for stories about why you were visiting Key
West. Just let your vet know that your pet was there and any medical history
that occurred on the trip. Make sure your vet knows that you fed your dog
part of the turkey but go easy on the details about the shopping trip to
get it. Just remember that your vet is trying to find the important details
in the history you provide so don't hide them in details like "I remember
the last time he threw up, because Aunt Martha was visiting and she only
visits on Tuesdays, because that's the day Uncle Ted plays golf."
If you have your own theory about what is wrong with your
pet, that is OK. Tell your vet. Provide the supporting argument but don't
make the classic mistake of selling yourself so strongly on what you believe
that you fail to relate conflicting information or exaggerate signs like
pain or lethargy. This is particularly important when it comes to making
psychological connections to pet disorders, such as diarrhea. I don't think
that there is any question that stress causes some dogs to have diarrhea.
If your pet only gets diarrhea when your fiancé comes to the house
to visit, that is an important factual detail. But make sure you state
that and not something less clear, such as "my dog doesn't like my girlfriend".
Sometimes a picture is worth a thousand words. It is really
useful to see a video of unusual behaviors. Lameness evaluation is a lot
easier if there is a videotape of the activities that lead to lameness
. More than few of our patients aren't lame in our office, despite being
lame at home. A video allows evaluation of these pets in the office with
good working knowledge of the problem that is occurring. Sometimes taking
a video of seizure activity allows the episode to be timed accurately.
Many clients are really surprised at how short a time the actual seizure
is when time can be accurately measured. If you have a camcorder, you may
be able to help your vet understand a condition that you couldn't possibly
explain.
You are your vet's link to understanding the individual
circumstances that your pet encounters, compared to the general pet population.
Hopefully, your vet is skilled at asking questions that bring out the facts
he or she needs to know to diagnose a particular disease. You can help
your vet, though. Don't provide misleading information and make sure your
vet knows about travel history, other pets in the household, medications
being administered, or anything else that might have a bearing on your
pet's illness. You can make your vet's job easier or you can make it much
harder. Try for easier, as often as possible!
New Stuff
Fort Dodge Animal Health has updated its Duramune line
of vaccines to include the serovars (types) of leptospirosis that have
been incriminated in most of the recent outbreaks. If you live in an area
in which leptospirosis is a concern (the latest outbreaks were on Long
Island and in California), it would be worthwhile to ask your vet if vaccination
with these new vaccines would be prudent. These vaccines are manufactured
using "sub-unit" technology that should help reduce reactions to the vaccines,
which has previously been a problem with leptospirosis vaccinations. The
two serovars added to the vaccine are grippotyphosa and pomona.
I know that some of you are very interested in pet nutrition.
The new edition of Small Animal Clinical Nutrition, by Hand, Thatcher,
Remillard and Roudebush is available now. I have not yet seen this book
but the authors are good and the previous editions have been excellent.
It is available from the Mark Morris Institute, 1-800-800-9930.
Hypertrophic cardiomyopathy (HCM) was found to be inherited
in Maine coon cats and American shorthairs, based on a study by Mark Kittleson
published in the December 1999 issue of DVM Magazine. Findings were
consistent with an autosomal dominant mode of inheritance with 100 percent
penetrance. Stillborn kittens from matings in the study were identified
as homozygotes that died in utero. Affected kittens usually did not show
phenotypic signs before six months of age, developed HCM during adolescence
and developed severe HCM during young adulthood. Some of the studied cats
died suddenly while others exhibited signs of heart failure first. There
is not a genetic screening test at the present time. While most vets suspected
this disease was sometimes genetic it is good to have confirmation of this.
It is likely that other breeds have some form of inherited HCM, as well.
The Center for Veterinary Medicine (part of the FDA) has
issued a warning about handling meat derived dog treats. Apparently there
have been a number of cases of Salmonella infection in humans in Canada
that have been traced to meat-basted dog chews. The CVM is also concerned
about other dog treats, such as pig ears, which they believe may also be
contaminated. While this may be an isolated problem with one or two manufacturers,
it is something to think about before purchasing and handling dog treats
made with meat coatings or of animal parts.
Placing a feeding tube into the esophagus, rather than
the stomach or jejenum (intestine) is much easier and is as effective,
according to published reports (Crowe, et. al, Journal of the American
Animal Hospital Association, Sept. 1997). Complications occur with this
technique but they seem to be less severe than those associated with other
feeding tube placements. If your cat or dog ever requires tube feeding,
it may be a good idea to ask your vet if he or she is familiar with this
method of tube placement.
Due to an article in the Tufts newsletter, a client asked
me to look into the side effects of Rimadyl (Rx), again. In the process
of doing this, I was able to talk with the technical staff at Pfizer and
to clarify some information that I was unsure of. The article suggested
that reactions to Rimadyl increased with time on the medication. It was
my understanding that the severe reactions, which have included death in
at least nine dogs, were thought to be an individual sensitivity to the
medication, similar to what happens with acetaminophen (Tylenol Rx) in
some humans. These reactions usually happen very early in administration
of the medication. This has been Pfizer's experience. However, they do
note that in aged patients, decreases in renal function or liver function
could eventually lead to problems with processing Rimadyl and they suggest
periodic lab work, as often as every three months, to rule out these problems,
as there is the possibility of some detrimental effect later in administration
of the medication, as well. The severe reactions to the medication have
occurred with as little as one tablet, so it is vitally important that
you discontinue administration of Rimadyl if your dog is lethargic, stops
eating or shows any sign of being ill after administration of Rimadyl.
On the other hand, Rimadyl has a very low overall incidence of side effects
and is still considered to be one of the safer medications for the long
term treatment of osteoarthritis in dogs. It is just necessary to be aware
that problems could occur, to stop the medication promptly if they seem
to occur and to contact your vet as soon as possible after noticing problems.
Several studies published over the last couple of years
have indicated that puppies and kittens are more likely to be euthanized
at animal shelters or to be abandoned, than to suffer fatal diseases such
as feline leukemia or parvovirus. The major reason given for abandonment
at shelters is behavioral problems. Your vet can help, or help you find
help, for behavioral problems. Seeking help early can make a big difference
in the quality of life with a pet and may even save the pet's life.
A new test has been developed to detect bladder cancer
from transitional cell carcinoma in dogs. The test isn't perfect, with
only a 78% specificity for identifying this cancer in a mixture of healthy
dogs and dogs with urologic disease but it is still much better to have
a noninvasive test for bladder cancer. If the test is negative (cancer
is not present by test results), it is correct about 95% of the time, making
it very useful to rule out transitional cell cancer, which is the most
common form of bladder cancer and is a fairly common cause of prostate
cancer in dogs, as well. The test is distributed by Polymedco, 1-800-431-2123.
A recent study by the University of Florida indicates
that injecting kittens who may not have received colostrum from their mother
with serum from adult cats will give them antibody protection similar to
that found in kittens who did receive colostrum. Poor immune protection
may be responsible for many deaths in kittens less than two weeks of age.
As this information is developed further it may be possible to cut down
on the number of early kitten deaths dramatically by providing serum injections
to kittens suspected to have colostrum deficiency.
We have had good luck recently in treating lick granulomas
on dogs with a new product, Facilitator Liquid Bandage (Rx) from Blue Ridge
Pharmaceuticals. It is a topically applied medication, hdroxyethylated
amylopectin) that forms a liquid bandage over the lick granuloma and allows
it to heal. It has to be applied once a day to work effectively, based
on our experiences, so far.
Experiences with hurricane Floyd here in Virginia and
North Carolina and other natural disasters over the last couple of years
have made it clear that the biggest risk to pets in floods, hurricanes
and other big-scale natural disasters is being left behind when owners
evacuate. This can happen because pets aren't home when evacuation orders
come or because pet owners have to resort to staying in shelters which
do not allow pets. The best advice is to leave early and take your pets
with you to some place that they can stay with you. I know this is contrary
to the instinct to stay home with the pets that many people feel, but if
you are truly concerned, early evacuation in the face of a natural disaster
is probably better for pet owners who wish to be as careful as possible
about their pet's chances for survival.
Free Stuff
Auburn University and State Farm insurance have produced
a brochure on preventing dog attacks that is available from their website
(www.statefarm.com) or by calling 877-254-3436.
What was his name?
Usually, I change the names of the people and pets that
I write about. This is necessary because I sometimes combine stories or
traits of people and their pets. However, this time, I am going to use
the real names of the person and pet, because they are just too much part
of the story to change them.
Mrs. Tomkins was about 85 years old when I first met her.
She had an air of aristocracy about her. Aristocracy that was a little
worn around the edges. She came from Richmond and I assumed she had grown
up in one of the old Richmond families that have been in Virginia's capitol
for generations. She was the wife of the nephew of Captain Sally Tompkins,
the only woman to be a commissioned officer during the Civil War and Mathews
County's most famous Civil War hero.
Mrs. Tompkins had either been overly honest all her life,
or she had finally reached the age where she felt it unnecessary to shade
the truth at all when she spoke. It was easy to tell when Mrs. Tompkins
was in the waiting room, because her pronouncements were always startling.
Usually, they consisted of something like "Am I going to have to wait long
while that young vet sees that fat woman's dog over there in the corner?"
For some reason, it was easy to overlook this part of
her personality. She didn't show favoritism at all in her comments. Some
people are mean to my staff but very nice to me. Mrs. Tompkins was just
the same with everyone. She usually remembered to tell me that I really
ought to buy a pair of real shoes instead of those sneakers I wore as to
work. On the other hand, if she liked someone or something, she always
said so, too. Most people realized this pretty quickly and didn't get too
upset about the odd harsh word. Somehow, she just didn't come across as
malicious, even though she said things no one else could get away with.
Mrs. Tomkins spoke rather loudly. On our first visit,
I had to keep moving back from her to give myself some aural relief. As
I backed around the exam room trying to exam the huge Labrador that she
had with her, I finally got around to asking his name. "I call him Stud,"
she said.
I'm pretty sure everyone in the waiting room heard her
just about as well as I did. We keep the door open between our exam room
and waiting room most of the time and I could see a couple of people laughing.
I had to leave the room. The image of this elderly woman, with the loud
voice and the aristocratic bearing calling "Here Stud!" just overwhelmed
me.
Stud was a great dog for a veterinary practice. He was
bigger than any dog for miles around and he truly lived up to his name.
He fathered more puppies over an eight mile radius from his home than it
seemed possible for one dog to manage. He had to swim the East River, about
a mile in width, to get to some of his liaisons but that didn't come close
to stopping him. He won every fight he was ever in until he was about twelve
years old and I sutured up a number of his victims. Mrs. Tompkins paid
their bills as the price for letting him run free. She told me flatly that
God intended dogs to run free and hers was going to do that, even if it
cost her a fortune.
I felt sorry for Stud and for Mrs. Tompkins when he finally
did get old enough for time to take its toll. He was a really proud dog
and it was obviously really hard for him when he started to be on the losing
end of fights. Of course, I did see the justice in this, especially since
his main rival and the new king of the dogs on his street had earned the
title after numerous battles in which he had been the loser.
Mrs. Tompkins and Stud both died within a short time of
each other. Our office was a lot quieter after that but I sometimes still
miss her. There aren't that many people who say exactly what they are thinking
without filtering it at all. It was refreshing to listen to her, sometimes.
Of course, the tip of my tongue was sometimes sore from biting it after
she left, but I knew that if I thought about what she said, there would
be at least some truth to it. I miss Stud, too. I can't even come close
to condoning letting a dog as aggressive and effective at fighting as Stud
run free, but it does sometimes seem like a less exciting world without
a dog like him around.
Reviewing Stuff
We have added a number of new subscribers in the last
two to three months. We sincerely appreciate all the support that our subscribers
have given us. Whenever projects grow, there is some confusion. So, just
to review:
To ask Dr. Richards a question, please send the question
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If you lose your username or password, we can supply them
or create new ones. We didn't add this information to our database until
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you have any difficulty signing on. At present the subscriber area mostly
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you find valuable there.
Dr. Richards will not answer any questions over the phone.
We try very hard not to get into any situations in which we might violate
practice laws and medical ethics by providing a specific diagnosis for
a patient without seeing that patient. We want to have both the question
and answer in written form of some sort --- we will answer faxed questions,
letters sent by post and e-mail inquiries from subscribers. It is much
easier for us to be sure we don't violate our ethical standards when questions
are submitted and answered in writing, so we feel strongly about the policy
of not taking questions over the phone.
You can ask as many questions as you would like. It helps
if you check the search engine to see if a topic has already been covered
in detail, but I will review topics again if a subscriber requests information.
Once again, we do appreciate your support in our endeavor
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Opinions expressed are solely those of Michael Richards,
DVM, author.
This page was last edited 06/15/04
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