Vetinfo Digest                May 1998

This issue

Searching for Veterinary Information
Problems with Pets You Can Avoid
Beware of Advertising
Sandy
If your cat has elimination behavior problems...
 

Searching for Veterinary Information

You are luckier than most people when it comes to searching for veterinary information. Michal and I will be glad to assist you in finding information if we can. All you have to do is write to us at mervet@inna.net for me or vetinfo@vetinfo.com  and for Michal and we will do our best to find current relevant information on veterinary medical problems that you need help with. If you are not able to connect with us by e-mail it is OK to write to us by U.S. mail at P.O. Box 476, Cobbs Creek, VA 23035, too. We do not find all the information on a subject, though. When you really have a strong need to know everything there is about a subject, we are only part of the search. What other sources of information are available?

Do not overlook your vet as a source of research information. Many people are afraid to approach their vet and ask for help searching for additional information on a problem their vet is assisting them with. It takes time to help a client understand information they find and to explain which sources of information are generally valid and which ones are more questionable but it is worth doing this most of the time. Once in a while a vet will get irritated when a client persists in asking questions generated from research but usually it is just an indication of a bad day. Almost all vets have good reference libraries at their practices and most also subscribe to several journals. If your vet is really up-to-date he or she is probably a member of NOAH, the AVMA's online information service, or a member of the Veterinary Information Network (VIN), which is a private online service for veterinarians. These are very useful services. The information on them is copyrighted and much of the information on VIN is from bulletin board exchanges between veterinarians that can not be printed for clients, but there is no reason your vet can't summarize the information for you. If your vet is not yet online you might even want to offer some assistance in getting connected, if you can help. Many veterinarians are unfamiliar with computer technology or reluctant to take the time to learn new programs and it is entirely possible to stay current in veterinary medicine without the use of the computer online services, it's just a little harder.

Continuing education seminars are held all over the country for veterinarians. These are an excellent way for vets to learn new skills and information. Often, there are good notes or a proceedings package that summarizes the speaker's points and provide additional information on resources available to veterinarians to study a particular topic. Your vet may have a whole stack of these notes stored in the practice library. These can be a very good source of information.

Veterinarians are usually willing to let clients read their books in their office but rarely willing to let clients take them home. Journals may or may not be available, depending on whether your vet reads them at home or at work. I have saved many year's issues of several journals but most vets probably get rid of journals after a few months unless they contain a particularly valuable article. One journal that most vets save consistently is the Clinics of North America series, probably because they are hard-bound and easier to put on a shelf. This series varies between pretty arcane and very useful, depending on the month and topic. If your vet subscribes he or she will probably have the old issues, which often cover a specific topic each issue (it is quarterly journal) in great detail.

It is hard to compile a list of the best veterinary reference books, because books that are good for a practicing veterinarian may not have the detailed explanations necessary for someone who is just starting to look into a disease or condition. In spite of that, I'd like to point out the books I like so that there is a starting point for a search through the veterinary literature. The book I like the best for medical problems is Dr. Rhea Morgan's book "Handbook of Small Animal Medicine". It doesn't go into much detail but it provides a good overview of the diagnosis and treatment of conditions. In most cases it provides a good list of differentials for an illness. This is very valuable since knowing what can mimic a disease may be critically important if the treatment doesn't seem to be working properly. Dr. Slatter's "Textbook of Small Animal Surgery" has the best descriptions of why conditions occur that can be treated surgically and also has very good explanations of the surgical procedures and expected outcomes. Feline practitioners tend to rely heavily on Robert Scherding's book " The Cat, Diseases and Clinical Management" which also goes into extensive detail on how medical conditions arise and what can be done for them, at least for cats.

Your vet has access to the technical representatives of pharmaceutical companies, vaccine manufacturers, dog food companies and government agencies. If you are suspicious of a problem with a pharmaceutical ask your vet to call the manufacturer's technical vets and see if the problem has been reported elsewhere. Most of the technical representative vets are helpful even when there is a chance their product is causing medical problems. Sometimes the companies are willing to pay for labwork that will help to prove or disprove their product's influence on an illness. Other times they can provide insights into the nature of drug interactions, breed or individual idiosyncrasies in medication applications or usual reactions to medications that general practitioners just don't have. Lots of times calling the companies isn't helpful but it is almost always free and it sometimes helps a great deal. Ask your vet to call the company if you think a drug reaction is a possible cause of your pet's illness or if a product is not producing the results your vet expects.

You can often find a company website if you look. I find a lot of them just by typing the name of the company and .com, such as iams.com. This works a good deal of the time. Once in a while I find really interesting websites that have nothing to do with the product I am seeking information on, though. If you know the manufacturer you can search for their name using any of the Internet search engines, as well. Pharmaceutical companies value their customers as much as any other business and most will try very hard to be helpful if you have concerns about their products.

In many states the veterinary schools are very happy to help with problems. They are usually more comfortable talking to the veterinarian than to the client about complex issues but many have staff members who do devote a lot of time to discussing problems with pet owners. It is worth calling to see if help is available or asking your vet to call. If you find you aren't getting anywhere talking to the veterinary school telephone operators it is sometimes helpful to ask to be transferred to the librarian. I find that many librarians, including those at veterinary schools, really like people to ask them for research help. Most are very good at locating information resources and are often willing to help locate a particular book or journal.

There are veterinarians at work in most state health departments and many federal health agencies. If a problem involves public health these vets are often extremely helpful sources of information. Their jobs usually revolve around getting accurate health information out to as many people as possible. Asking them questions helps them do their job and they are often willing to provide pretty detailed information on issues like diseases that are transmitted between pets and humans or nutritional requirements of pets. Many organizations also have good information on pet care, such as the American Veterinary Medical Association. This is another area where using a web browser and typing in an address like <www. fda.gov > or <www.avma.org > often works well. Just remember that government agencies usually have a .gov listing and non-profits or other organizations probably have a .org ending. Our website has a search engine that can help you to locate pages with a particular word or phrase. This can turn up pages you wouldn't think of looking at using our index. Another very good site for searching for information is the PubMed site located at < http://www.ncbi.nlm.nih.gov/PubMed >. It is necessary to use the search engine to find articles on this site but it does a full text search so it is easier to use than sites with keyword searches only.

After you find as much information as you can it is still important to remember that your vet usually has more experience in identifying symptoms, using medications and in evaluating health related problems than the average pet owner has. This experience is very important and has to be weighed heavily in any decision making regarding the health of your pet.
 

Problems with Pets You Can Avoid

We see a lot of problems in veterinary practice that could be avoided easily or treated easily if pet owners were informed of the risks. This is a partial list of these problems with suggestions for avoiding them.

Several times a year we have a small long-haired dogs or cats come into our clinic with a history of difficulty having a bowel movement despite obvious straining. In many instances there is complete blockage of the rectum caused by stool catching in the long hair around the rectum and forming a stool and hair cap over the rectum. We clip the hair and removed the stool/hair mat in order to relieve the obstruction. Many of these pets have significant inflammation around their rectum and require medication to relieve this and make having a bowel movement more comfortable. If you own a long-haired dog or cat it is a very good idea to check under its tail once in a while to be sure that stool is not accumulating in the hair or to keep the hair in this area trimmed. If you see straining to have a bowel movement check for an obstruction right away.

When a dog or cat paws frantically at its mouth, rubs its face on the ground, drools excessively or refuses to eat it is a good idea to open their mouth and look carefully at the roof of the mouth for evidence of a stick or other foreign object wedged between the upper teeth. This is a common problem in dogs that chew on sticks and we have seen several cats with objects caught across their hard palate between the upper teeth, as well. If your pet will let you remove the stick the problem is solved. Be careful when you do this, though. It can be painful and frightening to the pet when this situation occurs and a pet may not be cooperative about removal of the stick or foreign body. If your pet resists, just call your vet and arrange for him or her to remove the object. We have seen sticks, corn stalks, bones and even a king crab leg caught across the roof of the mouth and causing off behavior or pain in pets. Another version of this problem is a dog that gets a round ham bone caught around its lower jaw. I have seen this problem two or three times. It is important to be very very careful when attempting to remove these bones as these dogs are usually frantic and may bite inadvertently

Summer is coming and with it cases of heat exhaustion. For some reason this is less of a problem in cats than in dogs but it can occur in either species. We usually see our first cases of heat exhaustion on the first semi-warm days of summer, rather than the really hot days that follow. A lot of these cases involve pets left in cars on sunny days that are slightly cool but not cool enough to keep the car from heating up. We also see cases in which the pet and its family haven't done much in the way of exercise all winter and then decide to go on a big outing to the park, hiking or some other strenuous activity on the first few warm days. Remember to acclimate you pet to activity gradually as the weather warms up and don't leave any pets inside cars on sunny warm days -- and especially not on sunny hot days.

The Chesapeake Bay is about two miles from my practice, so we see a lot of dogs that swim a lot in the summer. Some of these dogs are prone to "swimmer's ear". A good preventative measure for avoiding problems with ear infections in dogs that swim a lot is to rinse the ears after swimming, or several times a week, with a 50:50 mixture of white vinegar and water. A bulb ear syringe is ideal for flushing this mixture into the ear but just pouring it in with a measuring cup is OK, too. Also, once or twice a year we see heat exhaustion in a dog from swimming hard. If your dog falls overboard, don't assume it is OK to let him swim to shore or follow the boat for any length of time in warm water. Being in the water does not always stop heat exhaustion caused by the exertion of swimming.

Long haired cats get mats in their haircoats pretty frequently. These mats can be frustrating for cat owners and many resort to removing them with scissors. Cat skin is very mobile and pretty thin. At least once a year we see a cat with a recently removed mat and a large hole in its skin where the mat was. In most cases the owners are unwilling to believe that they removed the skin with the mat because the cat didn't cry, scratch or show signs of pain when the skin was removed. I can't explain why these cats are so stoic but I do know that the injuries occurred and that the mat cutting is the most likely explanation for the missing skin. Be very very careful when removing mats from cats. If mats occur under the arms or in the folds of the flanks it is usually better to get a groomer or veterinarian to remove them if all you have to work with is scissors. Using a hair clipper is much better.

Dogs with long noses tend to accumulate tartar on their canine teeth. Often, these big "fangs" are the only teeth with tartar. If it is ignored the gums tend to retract and eventually this leads to loss of the tooth and often a fistula between the mouth and the nose where the tooth was. It is usually possible to brush these teeth more easily than back teeth. This should keep the tartar down. If not, keep track of the accumulation of tartar on these teeth and get your vet to clean them regularly.

Cats with extra toes and dogs with dewclaws will sometimes suffer when the nails on these toes grow long enough to grow in a circle, finally growing right into a footpad or the skin around the nail. Many times people do not notice that this is happening. If your cat has extra toes or your dog has dewclaws make sure you check their nails occasionally to be sure this isn't happening.

When dogs and cats stop eating suddenly, for any reason, it seems to be a strong instinct in people to try to give them something extra tempting to induce them to eat. Usually people pick foods that can complicate illnesses by causing further problems. Milk is a common treat item. It causes diarrhea in many pets and if they already have a gastrointestinal problem it can make the problem worse. High fat treats are also popular and these can cause worsening of pancreatitis and other conditions. If a pet doesn't want to eat it is best NOT to tempt them with tasty treats. Use their interest in their normal food to gauge the serious of a problem. If they won't eat their normal diet after 24 hours or so, take them to your vet.

Don't leave bait on a hook after fishing. It is just too tempting for some dogs and cats to resist. We see several pets each year with fishhooks dangling from their lips or tongues. If your pet does get hooked don't try to pull the hook out. Push the point of the hook through the other side of the lip far enough that you can be sure there isn't a second (or third) barb. After figuring out where the barbs stop, cut the hook just past the last barb and then pull the remainder out. Many pets have already driven the hook through the skin and it is possible for owners to remove these hooks. Other times, the hook is buried in the skin and a little anesthesia helps a lot in removing the hook without getting bitten or causing undue stress for the pet.

Ethylene glycol antifreeze is toxic to pets. If you have a summer home and use antifreeze in the plumbing during the winter be sure to flush the plumbing system prior to letting pets in the house. Don't drain the antifreeze from the car where pets might get into it.

Rat and mouse poisons are much more toxic than they used to be. The new poisons can cause illness as long as three weeks after ingestion. If you use a rat or mouse poison it is extremely important to keep the bait in a place your pets can not get to it. If you see your pet ingest a rat or mouse poison call your vet immediately. Making the pet vomit up the bait is very helpful in avoiding toxicity problems from these poisons.

Just one note on non dog and cat pets. Guinea pigs are extremely susceptible to Vitamin C deficiency. It is possible to avoid this problem by feeding dark green vegetables or fruits, like green peppers, spinach, kale, dandelions and parsley. It is also possible to supplement the water supply with Vitamin C but guinea pigs seem to like having the veggies and they are a more natural source of the vitamin.

Tapeworms are a constant problem for some pets. In most cases tapeworms are acquired by ingestion of fleas. The new flea products, TopSpot (Rx), Advantage (Rx) and Program (Rx) are very good at controlling fleas and therefore tapeworms.

Lots of pets get sick after parties, family reunions and holiday dinners because guests at these events feed them excessive quantities of treats. If you are planning a big event and know that your guests won't be able to resist feeding Fido or Spike, keep them out of harm's way by restricting them to another part of the house or even boarding them until the event is over.
 

Beware of Advertising

The makers of Control (TM) have been running a series of ads claiming that their product works as well as "the expensive products sold by veterinarians only" for flea control. This product is a concentrated permethrin product, similar to but less concentrated than ProTicCall (TM), which was previously sold as Defend (TM). I believe that this is deceptive advertising. We have carried Defend and then ProTicCall since they first came out. These products are much better than most of the shampoos, sprays and dips but not nearly as effective as the new products like FrontLine TopSpot (TM), Advantage (TM) and Program (TM) for fleas. They may be more effective against ticks when used every couple of weeks, though. If your pet is allergic to fleas or has a severe flea problem you are much better off using one of the newer products.

 

Sandy

Veterinarians usually try pretty hard not to get too emotionally involved with their patients. It is hard to be objective and hard to participate in some procedures when there is an emotional attachment to a pet. Still, there are at least a few pets who do manage to work their way into every vet's heart. Sandy, a yellow Lab is one of the patients whose joy for life and indomitable spirit will always strengthen my own spirit.

She was first brought to our practice by her second owners. They adopted her at about 2 years of age after realizing that she was pretty much living on her own. Sandy was severely crippled. She had rigid rear limbs that were terribly atrophied, almost making her appear to be walking with aid of crutches in the rear. It was obvious that nothing I could do was going to improve the condition of her legs. Sandy didn't appear to be too bothered by them, though. She had perfected a technique for heaving herself forward on her front legs that caused her two rear limbs to swing under her and then she just used them for balance while providing all the power for walking through the use of her front legs. She got around pretty well in this manner.

I had never seen a dog with this much atrophy of the limbs. I didn't even really know where to start in making a diagnosis. I took X-rays and it looked to me as if her rear limbs had never worked correctly. She had almost no depth to her hip joints, probably indicating that they were not functioning normally as she grew. This didn't help too much in determining what was going on, though. We tested her blood and except for the presence of heartworms, the blood work came back normal.

At a loss, I called Dr. Linda Shell, a neurologist at the Virginia-Maryland Regional College of Veterinary Medicine. She suggested that the condition might be toxoplasmosis or a disease I hadn't even heard of, neosporosis, caused by an organism called Neospora caninum. She suggested I call an expert on the condition, Dr. Dubey. He arranged to have blood samples tested for this newly discovered condition. Soon he called me to tell me that Sandy's blood would be valuable for research on this condition because she had the highest titer to Neospora caninum that he had seen to date. He wanted to know if we would do a muscle biopsy in the hopes of confirming that she did have this condition.

Neosporosis was thought to be uniformly fatal. Not necessarily because dogs couldn't live with the organism but because many couldn't and the rest were usually euthanized due to the severe disabilities induced by the parasite. To the best of anyone's knowledge at the time, Sandy was the only adult dog functioning happily as a normal pet with neosporosis. She didn't know she was supposed to be too disabled to function so she was doing it anyway. She survived the heartworm treatment and lived for a number of years after the diagnosis was made. She regularly gave blood and her serum was used to help identify other dogs suffering from this same condition. We were never able to prove that she had neosporosis despite doing the muscle biopsy and her case was never reported in the medical literature due to this. I thought it was important to let people know that dogs can survive with the disabilities induced by neosporosis and was disappointed that the paper I wrote about her case was never published. It was partially my fault, though. I let my emotional attachment to her interfere with a scientific approach to her death and mishandled her necropsy exam. Despite years of caring for her pretty well I felt I let her down a little in the end. Then one day last year I ran across Sandy's record as I was sorting through files on my computer. I realized that Sandy was extremely lucky to find the people who cared for her and that they had a special relationship with her that probably was unusual enough that there won't be too many Sandys, even if many more people do realize that there is a reward in working with disabled pets. I have come to accept that it may not be all that important to get her case in the medical literature. There are special people for special dogs and I have been fortunate enough to know and treat a special dog who actually found its special people. And that was much more than a medical miracle.

Sandy
 

 

If your cat has elimination behavior problems...

There is an excellent series of articles in the April 1998 issue of Veterinary Medicine, by Dr. Karen Overall, on behavioral problems in cats relating to urination and defecation. If your cat has this problem, please ask your vet to let you read this article if he or she subscribes to this journal. There are about 32 pages of detailed information on the origins and treatments for this problem. I am sorry that I can not adequately summarize it for you but it would honestly be a disservice if you need the information.
 
 

Michal and I have had a number of commitments outside of veterinary medicine and the VetInfo website and newsletter this spring. I am preparing for my oldest daughter's graduation from high school and trying to follow my youngest daughter's crew team around Virginia and the Eastern seaboard. My family will be in Philadelphia, PA for the Stotesbury Regatta and in Camden, NJ for the Nationals next month. Michal will be unable to work the website for a month or so. We both hope to be back at work at the usual pace on the website and the newsletter as the summer progresses. In the meantime, we thank you for your support once again and we do intend to do our best to see that our subscriber's questions are answered as quickly and as informatively as we can.
Thanks!
Copyright, TierCom, Inc., 1998
Tiercom, Inc.
P.O. Box 476
Cobbs Creek, VA 23035
 
The opinions expressed in this newsletter are solely those of the author, Michael Richards, DVM, unless otherwise noted in the text. Michal Justis is our web designer and graphic artist.