Health care questions and answers about puppies and dogs

HANDOUTS TO CLIENTS

This page has a number of general instructions for
pet owners about in-home pet care after
various medical, surgical or dental procedures.

You will also find info on commonly asked dog and cat
 health topics that will assist your understanding
of pet medical problems.  You may copy these general information articles for your home or office use.


Health care questions and answers about cats and kittens



Handout Topics

 

COMMON QUESTIONS ABOUT:
     Becoming a veterinarian
     Demodex mites
     Controlling ear infections
     Diabetes in dogs and cats
     Shampooing a cat
     Shampooing a dog
     Getting rid of fleas
     Cat vaccinations
     Vaccinating pups & kittens
     Itching and scratching
     Litter box training

     Too much cortisone

     Epilepsy
 
HOME CARE INSTRUCTIONS
     Before a surgery
     After a minor surgery
     After a spay surgery
     After a pyometra surgery
 
 
 
 
 
 
 
 
 
 
 

 

 


    

 

 

 

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Microscopic view of demodex skin mite

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Handouts: 
    
    

Always check with your veterinarian first if you have a specific question about your pet's health care!


PRE-SURGICAL INFORMATION

Surgery can be a wonderful method of improving and safeguarding a dog or cat’s quality of life.  It is an inherently invasive action and requires certain protocols be followed in order to have a satisfactory outcome.  Several factors are on our presurgical checklist so we can be sure your pet is a good candidate for surgery.

  *  The general state of health of the patient as determined by the physical exam and medical and at-home history.
  *  Laboratory data may be needed so we can check for biochemical imbalances, chemical deficiencies or cellular abnormalities.
  *  Risk versus benefit discussion with the pet owner including  a reasonably accurate estimate for the procedure and related expenses.
 

PRE-OP DIRECTIONS

Withhold food, treats, and water after 8 p.m. the evening before the surgery.   The pet’s stomach should be completely empty at the time of the anesthesia and surgery.  Tell us if your pet ate or drank anything the morning of the surgery.  (If vomiting or regurgitation occurs under anesthesia its possible acidic stomach contents could be inhaled.  If this occurs a life threatening aspiration pneumonia may occur.)

If your pet is on daily medication, ask the doctor whether or not it should be given the morning of the surgery.

Before the appointment encourage your dog to have a bowel movement and to urinate.  (Bring in a stool sample if a fecal check for intestinal parasites hasn’t been done in the past year.)

Always have your dog on a leash when in an animal hospital setting!  You just may need it if someone else’s dog runs free and decides a little gnashing of teeth with your dog would be fun.  When our technician has control of your dog, take your leash with you so we don’t lose it.  We have basic, reliable, slip leashes if you need one.

Cats should be confined in a travel crate or other device that will not permit the cat to escape.  Many calm, mild-mannered cats will panic in an animal care facility; nobody can hold on to a terrified feline when it’s in run-for-your-life survival mode!

Final requests or instructions:  Be sure we understand what procedures you want done.  A last minute request for a few additional minor procedures may need clarification.  Have a written checklist for us if there are multiple surgical excisions or procedures you want done, then go over it with us before you leave.

Your contact information is vital so we can reach you at any time during your pet’s hospitalization.  Verify that all contact info on the patient chart is up to date including as a backup a secondary person through whom we can contact you.

DOCTOR'S NOTES:


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POST-SURGICAL INFORMATION

GENERAL INFORMATION
When you pick up your pet after surgery it may act perfectly normally or may still be somewhat sedated from the anesthetic.  We will show you the surgical site and let you know if any skin sutures need to be removed.  You should inspect the incision area twice a day.  Occasionally there is redness and bruising near the incision that will resolve in a few days.  A few patients need to wear an E-collar (Elizabethan collar) to prevent licking or chewing at the incision.

Pain medication, if needed, can be dispensed.  Remember, we want the patient to be kept subdued for 7 to 10 days; mild discomfort is unavoidable and helps to remind the patient to “take it easy”.  If your pet seems in pain call us!  For a day or two there may be some momentary episodes of discomfort. 

HOME CARE
Provide small amounts of food and water as soon as your pet is interested. Repeat small amounts every hour or so if no nausea occurs.  Usual feeding routine can be resumed the day after surgery.  Call us if there is no appetite by the third day post-op.

For 7 days post-op your dog should be kept under control and on a leash whenever outside.  Especially after major abdominal surgery such as a spay or bladder procedure internal tissues need time to heal and strengthen.  No jumping, running or swimming for 7 days.

You may not need to clean or apply medication to the incision after surgery.
Special instructions_____________________________________________________
_____________________________________________________________________

Call us if the incision is draining, swollen, or painful.   You may feel small lumps or bumps under the skin incision for a few months which may simply be scar tissue around subcutaneous sutures.

Call us if the pet is licking or chewing excessively at the incision or if there is any drainage, increasing redness or swelling.

Give prescribed medication as directed.  Make an appointment for a follow-up evaluation if needed.

DOCTOR'S NOTES:


 

 

HOME CARE INSTRUCTIONS AFTER A SPAY SURGERY

Veterinarians consider the spay surgery to be a major intra-abdominal procedure.   Although it is very commonly done we manage each case individually and take the utmost care during the surgery to safeguard the patient as we remove both ovaries and both uterine horns. 

 When we discharge a spay surgery patient the aftercare is your responsibility and should be taken seriously.  The following points need to be understood and followed to minimize any adverse events associated with the surgical procedure.  If you are unsure of any facet of the home care or are uneasy about how your pet is feeling during the critical seven days post-op, call us so we can advise you properly.

DOGS and CATS:

A.)   You should offer your pet a little water and food when you arrive home.  Some post-op patients will vomit or be uninterested in food until the following day.  If your pet is interested in food and water continue to offer small amounts every 30 minutes for a few hours and then simply renew your usual feeding and water availability the following day.

B.)     When you arrive home with the patient you may notice some grogginess or slight depressed alertness.  The return to alertness and reasonable energy levels should be noticeable within 12 hours.  If after a few hours at home your dog or cat is even more depressed, weak, or unable to walk you should call us.  If it is after regular office hours listen to our full recording and you will be given an emergency number to call.

C.)     Check the mid-abdominal incision daily.  The first few days post-op there may be some redness and slight bruising at or near the incision.  This will disappear in a few days and you may continue to feel slight thickening or bumpiness near the incision which is normal due to the sutures in the abdominal wall and subcutaneous tissues.

D.)   If there has been slight drainage at the incision the first two days you can gently swab away any crusty buildup with cotton and warm water.

E.)    If there is noticeable drainage, discharge, swelling, or soreness after three days give us a call.  We may want to check to be certain there is no infection present.

DOGS:
 For 7 days post-op all dogs when outdoors must be on a leash in order to limit their activity.  Using stairs and walks are permitted.  You should safeguard them against running, jumping, swimming or vigorous play activity for a full week post-op.

CATS:
Indoor activity is permitted but vigorous playing or jumping should be avoided for seven days.  Outdoor cats should be confined somehow for seven days so that you can check their incision and food and water intake.

DOCTOR’S NOTES:

 

 

HOME CARE INSTRUCTIONS AFTER A DENTAL PROCEDURE

After a dental care procedure follow-up home care of the patient is important.  The following points will assist you in maintaining an acceptable state of oral hygiene for your dog or cat.  If you are unsure of any aspect of home care, call us so we can advise you properly.

DOGS and CATS:

A.)     You should offer your pet a little water and food when you arrive home.  Some post-op patients will vomit or be uninterested in food until the following day due to sedation or anesthesia required to do the dental procedure.  If your pet is interested in food and water continue to offer small amounts every 30 minutes for a few hours and then simply renew your usual feeding and water availability the following day.

B.)      When you arrive home with the patient you may notice some grogginess or slight depressed alertness.  The return to alertness and reasonable energy levels should be noticeable within 12 hours.

C.)      Check any oral surgical sites daily.  The first few days after oral surgery or tooth extraction there may be some redness and slight bruising at or near the incision.  This should disappear in a few days.

D.)     Give any prescribed medications as directed.

E.)      Very few dogs and cats will permit actual brushing of the teeth, even if a meaty flavored “tooth paste” is utilized.

NOTE:  About 80% of advanced tartar buildup will occur on the cheek side of the upper and lower back teeth, which happen to be the most difficult to see for brushing or scrubbing.  While you clean your pet’s teeth twice a week don’t focus too much on the tongue side of the teeth; direct your attention mainly to the cheek side of the molars and premolars behind the big, pointed canine teeth.

DOGS:
A good way to provide some mild abrasion of the teeth surfaces in medium to large breeds of dogs  is to wrap gauze around a finger and scrub the cheek-side surfaces with the dry gauze.  Rubbing the gums gently will stimulate healthy gingival tissue.   Rubbing the teeth surfaces removes plaque thereby preventing tartar buildup and gum line recession. You can moisten the gauze and apply a little baking soda to assist in cleaning.  It is OK to use flavorings, too, with gauze usage and make the dental treatments more like a treat!  If you do this even twice a week long term your dog will surely enjoy better health and may never need a veterinary dental procedure again.

CATS AND SMALL DOGS:

Using the finger-wrapped-gauze trick as described above is difficult in cats and small dogs.  Instead of a small brush, try using a Q-tip as a “tooth brush”.   Any pharmacy will have cotton tipped applicators with firm wooden stems that may work better than the usual cardboard applicators.   With either kind of cotton tipped applicator, gently convince the pet that a little scrubbing with the cotton tip is fun and treats will be dispensed after the game is over. 

There are several products that can decrease the reoccurrence of tartar buildup and help keep bacterial contaminants in the oral cavity to a minimum.  Your dog or cat may not need a particular oral hygiene home treatment or medication.  If the doctor does suggest an oral care product it may be needed long term otherwise oral health problems may reoccur.

DOCTOR’S NOTES:


 

 

                 WHAT ARE DEMODEX MITES
Demodex mites are very commonly present in the dog’s skin and usually cause no visible sores or problems.  They are microscopically small cigar-shaped, eight-legged mites.  Also called mange, which is a general term used to describe any kind of mite infestation, Demodex is generally less severe than Sarcoptic (scabies) mite infestation. 

WHAT DO THEY DO
Demodex mites burrow deep down into the hair follicles and cause the hair to break away and sometimes they’ll create tiny pustular sores.  Interestingly, the patchy areas of hair loss are seldom itchy and almost never develop scabs. 

TREATMENT
Most cases of Demodectic mites are self-limiting… that is, the animal is able to arrest the reproduction and growth of the organisms and eventually repair the damage and regrow the hair.  No specific treatment is needed.  A high quality, meat based diet and a clean environment usually permits the patient to gradually eliminate the mite infestation over a period of weeks to months.

Topically applied treatments and dips are used in special cases where the dog seems unable to eradicate the mites on its own.

GENETIC FACTORS
Once eliminated, most dogs do not acquire another infestation; the dog’s immune defenses are primed to eliminate any new Demodex mites that happen to find themselves on the dog.   However, there are certain individual dogs that, because of genetic programming, do not produce the specific immune factors that will target the mites for destruction.  That specific lack of adequate immune defense against the mites is a hereditary aspect of the disease that can predispose a dog to a severe, unresponsive case of Demodex.

QUESTION:  Can Demodex mites be inherited?

ANSWER:  No.  The actual mites do not develop on the fetus while in the uterus.  However, if the mother has Demodex mites in her skin the mites can invade the new fetus’ skin immediately after birth.  Depending upon several factors such as nutrition, environmental hygiene, and temperature stresses, most newborn pups can resist mite infestation.
 


 

 

CONTROLLING EAR INFECTIONS

A critical factor in the development of ear problems in dogs is the anatomy of the external ear tissues... the pinna (ear flap), outer ear tissues, and ear canal provide a perfect incubator for the growth of organisms.  Bacteria, yeast, allergies, excess sebaceous production from the skin lining the outer ear structures all play a role in ear problems in dogs.  And moisture in the ear canal can provide extra assist for micro-organism overgrowth. 

Ear Infections
Generally, ear infections (otitis externa) are diagnosed at the vets with an ear smear.  A small amount of discharge is smeared on a microscope slide, stained, and then looked at under the microscope.  The type of ear infection is then determined and any contributing factors.  Based on what the slide shows and what an otoscopic exam of the ear canal shows, the doctor can make a determination of the best treatment.  It is putting all this information together along with the medical history and age of the patient that is needed.  Once the ear infection is cleared, regular ear cleanings and keeping the ears dry will be helpful to prevent further problems.

There are a number of issues that promote infections in external ear tissues.  (The internal ear structures are those beyond the ear drum and can be seriously affected if the ear drum is ruptured.)  Many breeds tend to have oily skin and coats.  The ear tissues including the canal are lined with very thin skin; sebaceous glands pour oily sebum onto the surface and if too much sebum is produced it collects and is invaded by yeast and bacteria.  Add a little moisture from bathing, swimming, or ear "cleaners" and any organisms present reproduce even faster!
      Most dogs can swim, bathe, and do all sorts of things and never have ear problems; others are prone to bacterial and yeast infections, scar tissue buildup, ulceration and discomfort due to anatomy, genetic predisposition, excess sebum production and innate immune competence.
      A proper diet can assist any dog in resisting infections of all sorts.  Placing cotton in the ears can help eliminate water and soap from contacting ear tissues while bathing, and gentle removal of any waxy/oily buildup in the outer ear tissues removes material on which infectious organisms thrive.   

   Assuming your veterinarian has checked your dog's ear canal with an otoscope to be certain there is no foreign matter deep in the canal, or polyps, folds or tumors, it may be time to consider surgery to open the ear canal to allow exposure to the air.
      Often in chronic cases there is a foreign body, polyp, or even a tumor that obstructs the canal and predisposes the ear to long term infection.  The longer the stresses to ear tissues continue the more inflammation causes swelling and scar tissue buildup.  Finally there is such anatomical changes that no medication... oral or topical... that will correct the problem.  
      Ask your veterinarian for a referral to a surgeon who had done the Lateral Ear Canal Resection procedure.  The surgeon will go over the medical history, examine your dog, and make a suggestion regarding the expected benefits of the surgery.

Do not...
The persistent use of "ear cleaners" in ears that are already cleaned of debris has been associated with chronic otitis in some dogs.  Routinely flooding the ear canal with ear cleaners when they aren't needed should be avoided.
 
U
se "ear medications" or home remedies without advice from your veterinarian.  If there's a problem and the ear drum is damaged the dog's difficulties will surely be compounded!

Microscopic aspects of otitis...
    
Your veterinarian may swab an infected ear, put the material onto a glass slide, stain the specimen, and look for types and numbers of infective organisms such as yeast and bacteria

Learn how to clean a dog's ears, go to www.TheAnswerVet.com/earcleaningdogs.html.


 

 

DIABETES MELLITUS IN THE DOG AND CAT

Your dog has been diagnosed with Diabetes Mellitus.  This condition is similar to a type of diabetes in humans.  We treat most cases by giving small injections of insulin via special insulin syringes.  Read on to learn more and help you gain confidence in treating your pet for diabetes.

WHAT IS DIABETES MELLITUS
Insulin is produced in beta cells in the pancreas located near the stomach and small intestine.  When the level of glucose (sugar) in the blood stream is increased, for example after eating a treat, the pancreas is stimulated to secrete more insulin into the blood stream to facilitate the uptake of the blood sugar into the body’s tissues.  If blood sugar levels fall, for example due to fasting or from exercising and burning off some blood sugar, the secretion of insulin is lessened. 

Dogs usually have Type 1 diabetes, sometimes called "juvenile diabetes", which is caused by destruction or lack of pancreatic beta cells… insulin is not produced in sufficient amounts.  Glucose (sugar) builds up in the blood but simply cannot be taken up by “hungry” body cells. 

Type 2 diabetes mellitus occurs in humans and is associated with cell resistance to the effects of insulin.  Since dogs rarely have this form of diabetes we can use injectable insulin in dogs and cats.  We essentially fool the body into acting like its own insulin is present and thereby assist the uptake of blood glucose into the body’s cells.

Think metaphorically of a diabetic patient as you would a car engine that needs fuel to run.  If the tank is full of fuel (the bloodstream is full of glucose) we need that fuel in the engine (the glucose needs to get into the cells) so we need a fuel line to transport the fuel from the tank to the engine.  Insulin (like a fuel line) is required to move the glucose from the blood into the cell.  So insulin is like a fuel line, and in fact is a life line because without insulin’s presence the diabetic patient gets progressively sicker until death results.

When the body cells have an energy source they can do their work.  Some tissues are more sensitive to lack of glucose than others; the brain and heart especially need a continuous supply of glucose for optimum function.

 WHAT CAUSES IT

Ideally we try to keep the pet’s blood sugar level between normal values of about 65 and 140 milligrams per deciliter of blood… commonly just stated between 65 and 140.  In a diabetic patient the blood sugar can climb over the 500 mark!  Interestingly, the kidneys try to keep glucose inside the body and not lose any filtered glucose into the urine.  The glucose is conserved until the blood level rises to about 200, then the kidneys can’t retain filtered glucose fast enough and sugar is found in the urine.  It is now officially wasted because wasn’t able to be used inside the body for tissue energy needs.

SIGNS OF DIABETES MELLITUS

An increased thirst and frequency of urination are hallmarks of diabetes mellitus.

Increased water intake (called polydipsia or PD) causes increased urine output (called polyuria or PU).  Because the blood is carrying too much glucose around in circulation the blood is too “concentrated”; that is, the patient’s thirst receptors in the brain perceive that more water is needed to de-concentrate the blood… the patient truly feels thirsty all the time. 

An increased appetite and food consumption (called polyphagia) occurs because in spite of food intake the brain perceives it is starving because so little energy (sugar) is present in the brain cells.  It would be like that engine telling you to fill the empty gas tank when it is already overflowing!

Low activity levels and even muscle wasting and weakness are often observed in diabetes mellitus cases.  Weight loss in spite of a huge appetite is a tip-off.  Some patients are actually dehydrated and need iv or subcutaneous fluids during the initial treatment phase.

TREATMENT

Some pets need to be hospitalized and given iv medications and fluids especially if they have become toxic.  Metabolic acids and chemicals called ketones can build up in the blood and the patient needs to have its body chemistry balanced for the injected insulin to work efficiently.  Your veterinarian will make the best recommendation for each patient.  Most can begin getting insulin injections without being hospitalized.  They are put on a feeding schedule and possibly a special “diabetic diet” at home.  The first few weeks of regulating the blood sugar level and insulin doses will require several visits to the animal hospital.

MAINTENANCE
When the patient is stabilized by use of insulin, proper dietary and feeding protocols, and regulated exercise patterns it may need blood sugar evaluation only every 4 to 6 months.  Especially in cats, some diabetic patients can be weaned off the insulin and the diabetes controlled by specially tailored diets.

EXAMPLE OF ONE SUGGESTED PROTOCOL
Each veterinarian will suggest the appropriate diabetes management protocol for the individual patient.  In general it will go something like the following:

DOGS:  Feed a measured amount and type of food early morning and late afternoon every day at about the same times each day.  In some cases free choice feeding can be done but this can make optimum blood sugar control more difficult.  Keep the physical activity consistent each day.  Keep the insulin injections and times of injection the same every day.  Retest blood sugar every few months and test the urine for infection every 6 months.

CATS:  Feed the usual way the cat is used to but the doctor may recommend a special diabetic diet for your cat.  Keep the physical activity consistent each day.  Keep the insulin amount consistent and times of injection the same every day.  Retest blood sugar every few months and test the urine for infection every 6 months.  Some cats actually have a declining need for insulin and may even be able to have their diabetes controlled by diet alone.

CAUTIONS
Watch for signs of shaking, weakness, dizziness or muscle tremors or seizure.  These are signs of hypoglycemia (not enough sugar in the blood) and may occur 4 to 8 hours after an insulin injection.  If  any of these signs are noticed, using an eyedropper or syringe slowly give by mouth 1/2 to 1 teaspoonful (3 to 5 ml) of maple syrup for pets under  10 pounds and as much as 4 tablespoonsful for a 100 pound dog.  (Don’t worry that you might give too much.)  You can also use corn syrup or melted ice cream. 

Call your veterinarian and report what has occurred; call an emergency clinic for advice if it is after usual office hours; then report to us what occurred in the morning.  Persistent signs of low blood sugar (hypoglycemia) may require emergency care.

HELPFUL  HINTS
Giving a little less insulin than recommended is safer than giving too much insulin.  

Have Karo syrup or maple syrup on hand along with a syringe to administer liquid calories if you see signs of hypoglycemia. 

Keep emergency phone numbers by the phone for quick access if you have trouble. 

If the pet fails to eat or skips a meal the amount of insulin might need to be reduced or a dose skipped.  Remember that the injection of insulin will lower the blood sugar; missing meals or failing to eat usual amounts needs to be considered before giving an insulin injection. 

Don’t shake the vial of insulin… gently tumble or roll it to thoroughly to evenly disperse the insulin in the vial.  We don’t want bubbles to get into the insulin or syringe because it will be difficult to know how much insulin you are administering.
 


 

 

SUGGESTIONS FOR TREATING DIABETES MELLITUS IN THE CAT

Your cat has been diagnosed with Diabetes Mellitus.  This condition is very similar to the same condition in humans and we treat most cases via injections of insulin.  There are a few major points of keep in mind as you gain confidence in treating your pet for diabetes.

Today’s date is ______________

For___________

Feed your cat the same way you have been feeding and keep track of how much is actually consumed.  The doctor may recommend a special diet just for diabetic cats.  Keep water available at all times and try to monitor how much water is consumed.

Store the insulin in the refrigerator and gently roll the vial to stir up the solution before extracting the insulin into the syringe; avoid shaking so that tiny bubbles don’t form. 

Give _____ Units of Insulin each morning at about the same time of day and give _____ Units of insulin each afternoon at about the same time of day.  The needle is inserted under the skin in any convenient area.

If you are unsure the full insulin injection amount was successfully administered, do not give an additional injection at that time.  Wait and simply give the next scheduled dose.  (We want to avoid giving too much insulin.)

Watch for signs of shaking, weakness, dizziness or muscle tremors or seizure.  These signs of hypoglycemia (not enough sugar in the blood) are more likely to occur 4 to 8 hours after an insulin injection.  If any of these signs are noticed, slowly give by mouth 1/2 to 1 teaspoonful (3 to 5 ml) of maple syrup or corn syrup or melted ice cream via eyedropper or syringe.  Call your veterinarian and report what has occurred; call an emergency clinic for advice if it is after usual office hours; then report to us what occurred in the morning.  Persistent signs of low blood sugar (hypoglycemia) may require emergency care.

Return to the veterinarian for scheduled blood sugar tests and urine rechecks.  Urinary tract infections (UTI) are common in diabetics and the veterinarian may prescribe an antibiotic for several weeks of therapy.  Follow-up urine tests are recommended to make sure the UTI is eliminated.

Weigh your cat at home about every two weeks and report weight changes of more than a pound.  Most cats will gain weight over several months and get back to normal body weight levels.

Your cat’s usual appetite and water intake should return to normal within two to three weeks. 

Veterinarian’s Office # _____________________________

Emergency Clinic # ________________________________
 


 

 

EPILEPSY IN THE DOG

One of the most terrifying scenes a pet owner can witness is that of a pet in the throws of a grand mal seizure.   Once seen, it will never be forgotten.  Epileptic episodes are quite common in dogs and actually show up more often in certain breeds of dogs than in others.  For unknown reasons, epilepsy in cats is rather rare.  When seen in a cat, epileptic episodes may have more serious underlying mechanisms than when present in dogs. Let’s explore this disorder a bit and we will gain a better understanding of just what is going on during an epileptic episode.

First we need to know the terms…

EPILEPSY is defined as a neurological disorder characterized by sudden, recurring attacks of muscular, sensory, or psychic malfunction with or without loss of consciousness or convulsive seizures.

A SEIZURE refers to the involuntary contraction of muscles.  Seizures can result from abnormal electrical activity in the brain brought on by infections, toxins, tumors, blood clots, scar tissue, or from chemical imbalances such as low blood sugar or nerve stimulating drugs.  Tetanus toxin poisoning can stimulate muscles to contract resulting in a seizure.   A seizure may involve all the skeletal muscles or be localized to spasms in a single bundle of muscles.

A GRAND MAL SEIZURE refers to severe, widespread cramping of the body’s skeletal muscles.  Skeletal muscles in general are those that attach to bones and allow for body movement; there are special smooth muscles that don’t attach to bone that usually are unaffected during a seizure.  These smooth muscles reside mainly in the intestinal tract, blood vessels and specialized organ tissues. The heart muscle is actually different from either skeletal muscle or smooth muscle. Grand mal seizures are rather shocking to see.

A PETIT MAL SEIZURE is now termed focal seizure; it is a less severe, short seizure where the patient still has some voluntary control of movement and coordination but where certain muscle groups are “doing their own thing” and brain electrical activity is mildly disrupted. Staggering, momentary “staring into space” and other forms of incoordination may be visible to an observer.

CONVULSION usually refers to a grand mal seizure.  Sometimes these terms are loosely applied to an epileptic episode.  We might say a patient is having an “epileptic attack” or “is having a seizure” or maybe even a “fit”.  However we describe it, the occasion will be uncomfortable for the observer and the victim.

STATUS EPILEPTICUS refers to a very dangerous situation where a rapid succession of grand mal seizures occur without periods of rest or muscle relaxation between epileptic episodes.  Status epilepticus requires prompt medical intervention.

True epileptic episodes where the triggering mechanism is not due to poison, low blood sugar or other chemical stimulants have their origins within the brain tissue.  Researchers believe that there is a locus (an area in the brain) of abnormal or damaged brain tissue.   This tiny area may be of no consequence 99.9 percent of the time.   But for various reasons this tiny locus of abnormal nerve tissue begins to send out nerve impulses.  The nearby normal nerve cells are affected by these wayward nerve impulses and respond to them.   This response then triggers other nearby nerve cells to fire and the outcome of this electrical chain reaction is an upset in the normal coordinated brain activity.  The body receives messages that make no sense and lack coordination!  

The nerves from the brain that stimulate the voluntary muscles of the body (called motor nerves) are telling the muscles to get to work but without proper supervision and control the different muscle groups are contracting without integrated coordination.  Think of this as an orchestra where all the musicians are playing the same song except that the conductor isn’t present.  Each musician starts and stops the melody at their own discretion without regard to what any other musician is doing.  Surely not a pleasant thought… harmony, coordination and melody no longer integrate the music. And so it is with EPILEPSY.  The harmonious and finely tuned integration of nerve transmission directing coordinated muscle movement is lost.  The result is a seizure. 

Fortunately most epileptic episodes are of short duration… one to three minutes is most common.  Five to ten minute episodes are getting into the more serious range of duration; and any seizure lasting longer than fifteen minutes generally requires medical attention.

A typical seizure due to epilepsy looks like this:  The dog will seem perfectly normal when, without warning, it may begin to stagger just a bit when walking.  Then it may appear to be backing up, will sit down on the hind legs and the facial muscles and eyelids will begin to spasm.  (This is termed “muscle fasiculation”).  Often the jaw muscles will spasm and the dog will appear to be “chattering his teeth” and will begin to salivate.  Breathing will begin to be forced and if the jaw is set in a closed position the forced breathing will stimulate the saliva to foam up.  Now the dog appears to be “foaming at the mouth.” 

On other occasions the jaw will be held involuntarily in an open position and appears as if the dog is trying to yawn… or even as if to scream out and no voice is heard.  This truly can be an unpleasant and scary experience for the dog and the owner!  As the event continues the dog may fall over on its side, and stretch out with legs and neck extended, eyes rolled back, mouth foaming and the entire body going into a rigid state.  Now it appears that the dog cannot breathe because of the intense muscle contractions and stiff posture.  

After a few seconds (surely seems like minutes!) the dog begins to relax, the breathing returns to normal and voluntary movement becomes more evident.  Here’s an interesting phenomenon:  If the breathing is so interrupted that the dog begins to lose consciousness, the oxygen deprivation in the brain shuts off the seizure!  So just when you think your dog is dying the seizure stops!  Anyone watching the event returns to more normal breathing, too!  After a few moments the dog will sit up, begin to “shake it off” and go back to normal activities as if to say “What was the deal with THAT?”

From start to finish the entire event may last from one to five minutes… just enough time to call the veterinarian about your dog dying.   By the time you describe what has transpired, the dog is often up and lazily walking  around with a dazed expression on his face. The veterinarian will ask you to describe what you saw and will then give you advice about what to do next.

The dog should be examined… not necessarily immediately as long as you can stay in touch with the veterinarian in the event that other seizures follow.  But surely any dog that has experienced a seizure should be examined and some blood tests run to gain some knowledge of the dog’s physical and biochemical status.

THE EXAMINATION
During the complete physical exam the veterinarian will pay close attention to the heart and neurological signs.  Often the physical exam is normal… you have a physically healthy dog who happens to scare the biscuits out of you with unannounced seizures!   During the office call your veterinarian will obtain a blood sample for laboratory tests to get an insight into the dog’s invisible metabolic goings-on.

BLOOD SAMPLE
Blood samples are a vital tool in determining whether or not chemical imbalances are at the root of the epileptic episodes.  For example, the liver has thousands different tasks to perform and if any are not accomplished properly the effects may impact the nervous system and a seizure may result.  Blood sugar concentrations have to be regulated within certain boundaries otherwise neurological and other difficulties will arise.  And electrolytes, such as sodium, potassium, calcium and phosphorus all need to be present in the blood in an interrelated and coordinated fashion for healthy neurological and biochemical reactions to occur. If the veterinarian discovers an imbalance in any of the blood chemistry values, detective work follows that may result in a diagnosis for what is causing the seizures. 

URINE SAMPLE
A urine sample can reveal infections of the urinary tract although urinary infections rarely will affect the neurological system.  Relative to seizure activity, the urinalysis may reveal sugar in the urine that suggests a diabetic condition might exist.  Ketones in the urine may be revealed which suggests the excessive utilization of protein, instead of carbohydrates or fat, for energy.   Acid, protein and bile constituents may be seen in higher amounts than normal.   Any abnormal urine factors are hints that something in the body’s chemistry in not right and further tests are needed.

Over ninety percent of dogs that exhibit epileptic manifestations will have NORMAL blood and urine values!  In fact, that is what veterinarians hope for when checking laboratory values in suspected epilepsy patients.  They want to see that everything is functioning properly. 

So now you are asking, “If all those tests are normal, what is causing the epileptic episodes?”   Veterinarians have a diagnosis for these cases… IDIOPATHIC EPILEPSY.  “Oh,” the owner responds.  “What does that mean?”  And the veterinarian replies, “That means we don’t know what the cause is.”

IDIOPATHIC EPILEPSY means the actual cause of the seizure activity is unknown. Researchers believe that if we could look all through the brain with a tiny microscope we would eventually find a small bundle of nerve cells that aren't quite normal.  It would be this locus of nerve sells that for various reasons begin to fire off impulses on their own.  Those renegade nerve firings trigger other neighboring nerve cells to respond.  This starts a cascade of nerve firings that spreads out from those renegade cells and pretty soon the whole electrical harmony of the brain is upset.  A seizure is the result. 

WHAT CAUSES EPILEPSY
What creates those little renegade bundles of nerves?  One of the theories is that a head injury resulted in a small hemorrhage into the brain.  As the blood clot resolves and reabsorbs, scar tissue can remain behind that interrupts normal nerve cell integrity.   Small tumors can be a source of abnormal nerve activity.  That’s why any case of epilepsy that seems to be worsening should have brain tumor considered as a possible inciting cause, especially in epileptic cases that have an onset in middle or old age and do not respond well to seizure control medications.

Genetic predisposition for epileptic activity has been shown in certain breeds of dogs.  The exact mechanism whereby the genetic determiners impart their influence on nerve cells is yet to be discovered.

Psychological stimuli can play a role, too.  For example the situation where the pet owner’s little dog got so stressed every time the owner was preparing for a trip (without the dog) that the little rascal would work up to an actual seizure episode!  Talk about trying anything to get your own way…

PREVENTION
What can be done to prevent epileptic episodes?  The answer depends upon a number of variables.  If the dog has had only a single episode and physical exam and lab tests are normal and the diagnosis is IDIOPATHIC EPILEPSY (we really do not know the cause), probably no medication is required.  However if the dog begins to show some sort of pattern to the episodes, let’s say that the seizures are happening about every three or four weeks, you may wish to consider starting low doses of medication to try to inhibit the seizures.   It may not be wise to medicate the dog every day to inhibit a 2 minute seizure that occurs only twice a year.

It is very important to develop a close relationship with your veterinarian on this point of whether or not to prescribe medication.  Be sure to keep good notes:  Record the date, time of day, related environmental factors, length of time the epileptic episode was evident and severity of the seizure.

If the seizures are of the petit mal variety and last just a few seconds, even if they occur fairly frequently, should the dog be medicated daily as a preventative? You see, we can’t predict when these episodes will occur so giving preventative medication is an ALL OR NOTHING commitment.  If we knew that every Saturday at five o’clock the dog would have a seizure, we could start medication twelve hours prior to that, prevent the seizure, then cease giving the medication until next week.  Unfortunately that scenario doesn’t happen.  The situation calls for an either/or commitment.  Medication is given daily for a period of time or no medication is given at all.

TREATMENT
Fortunately most cases of epilepsy can be controlled.  Cured?  Probably not, unless an underlying triggering mechanism is discovered and rectified.  Also, if the seizure activity is due to a tumor it is unlikely that attempts at controlling the seizures will be successful.  Follow-up blood analysis is recommended at selected intervals to be sure the correct levels of medication are being given and that no abnormal blood values are starting to show up.  Fortunately, many dogs that have been treated for epilepsy over a period of time can slowly be weaned off medication, and eventually not require any further medication.  (Never abruptly eliminate anti-epileptic medication!  Sudden withdrawal of medication often will trigger a long and difficult episode.)

Phenobarbital is the most commonly used medication to treat epilepsy in the dog.  If given in the lowest dose required to keep the seizures to a minimum, Phenobarbital can be a very useful medication with minimal side effects.  Many dogs being given Phenobarbital are living very normal and happy lives. 

Some pet owners are adverse to giving their dog a “drug” for long periods and look at the situation of having a pet that is “drugged-up all the time” to be unacceptable.  Most veterinarians agree, too, that if the dog requires such high levels of medication that it acts and feels “drugged-up” that this scenario is unacceptable. 

Fortunately, the majority of cases will be helped by medication with little, if any, side effects.  The “side effect” we are looking for is the elimination for those awful seizures!  A drug called Dilantin (phenytoin) has been used for years but in general has been a secondary choice after Phenobarbital.   In some cases Valium may be used when Phenobarbital cannot be utilized or when a combination of medications are prescribed. 

Potassium bromide (KBr) is being used in some dogs where response to traditional medication is unsatisfactory. Potassium Bromide had been used to treat human epileptics for over 100 years. It may be the anticonvulsant of choice for dogs with liver disease.   Sometimes veterinarians will prescribe KBr along with Phenobarbital for patients who do not respond well to Phenobarbital alone. KBr is not easily obtained and may require a pharmacist to acquire and formulate the proper dose.

Just as the brain must be in good balance with the rest of the body, so should we look for a balance in the treatment of epilepsy.  Too much medication is not good because we don’t want the pet to have dulled senses; reoccurring seizure episodes are unacceptable so we may need to use a little medication.

Any dog receiving anti-epileptic medication should have periodic blood samples evaluated for blood chemistry balance.  Since many medications are degraded and eliminated from the body via the liver, an assessment of liver function is a priority.

WHAT TO DO DURING A SEIZURE
If you happen to witness a seizure, there actually is not much you can do to get it under control.  Try to remove any objects from the immediate area that the dog may bump in to and injure himself.   Do not try to open the dog’s mouth to pull the tongue out.  Although it can happen, it is extremely rare for the dog to “swallow the tongue” and obstruct the airway.  Plus the strength of the dog’s jaws will probably prohibit any attempts you make to open the mouth to inspect the area. 

NOTE: If your dog is actually choking on something and is consciously gagging, hacking, salivating and in trouble breathing, you may need to intervene.  However this discussion concerns how to deal with the epileptic patient displaying seizure activity as described previously.

It may be helpful to gently talk to the dog, and to try to make the dog comfortable during the seizure activity by rolling it onto a blanket or padded mat.  If you try to pick the dog up you will need to be very careful because the dog will be thrashing about and you very likely will lose your grip and drop the dog.  Try to turn off any loud music or other stimuli such as bright lights and escort any screaming children away from the area.  They can watch but they need to be silent.  “Do something!! Do something!! ” is the high pitched phrase most often heard during one of these episodes! However, about all you can do is wait.

The most troubling thing you will see occurs just before a Grande Mal seizure is over.  The dog stiffens up, ceases to breathe, and just when you think death has visited the dog, he relaxes and begins to breathe again.  When those nerve cells that triggered the seizure become deprived of oxygen they shut down... and the seizure eliminates itself!

The fact is that epilepsy, though truly a challenging condition in the dog, in most cases can be dealt with successfully.  Just as each and every pet is a unique individual, every case of epilepsy should be dealt with on an individual basis.  No two cases will be exactly alike!

 


 

 

DIRECTIONS FOR SHAMPOOING A CAT

There are hundreds of kinds of shampoos marketed for use on pets.  Some have prescription medications in the ingredients and have a specific medical purpose.  Some are created to help eliminate “doggy odor”, and others are used simply to clean the skin and coat by washing away debris, oil and dirt.

A healthy oil lay over the skin is your cat’s first line of defense against potential invaders such as yeast, bacteria, parasites, pollens, dust and dirt.  Shampooing will temporarily remove this oil layer, a fact often overlooked when topical flea and tick products “don’t seem to work”.

RULE # 1:  Because all shampoos will remove some or most of the surface sebum (skin oil) if you shampoo your pet more often than about every three weeks the protective effects of skin oil are diminished.  The result can be itchiness, dry skin, and an increased sensitivity to environmental antigens and irritants. 

RULE # 2:  Rinse the cat twice as long as you believe is needed.  You must remove all the shampoo.   Leaving even a small amount of shampoo on the skin has a high potential to cause shampoo induced irritation and itching a few days later.

RULE # 3:  In medium and long haired cats while applying shampoo and rinsing it off pay special attention the very dense fur at the front of the neck, behind and inside the thighs, and around the base of the tail.  These areas sometimes do not wet easily, and after shampoo is applied properly these areas can be difficult to rinse thoroughly.

RULE # 4:  If medicated shampoo is used remember that contact time is very important.  For example shampoos containing medications to help eliminate bacteria or yeast organisms may need to be in contact with the skin for 10 minutes or more for them to be effective.  Odor controlling shampoos and oatmeal based shampoos may also require several minutes of contact time to work properly.

RULE # 5:  This probably should be rule number one but here goes… Always read and understand the directions on the label.

RULE # 6:  Use cat shampoo on cats and dog shampoo on dogs.  Some shampoo products can be safely used on both dogs and cats.  If the label does not specifically state approved for use on cats, do not use the product on a cat!

SUGGESTIONS FOR BATHING:

Well before the time of bathing the cat run warm water in the tub; try to get the temperature such that it just barely feels warm to the touch.  For an average size cat enough water to reach the abdomen when the cat is standing is just right.  Have a cup handy and gently scoop some eater up and pour onto the cat slowly.  Talk encouragingly as you try to get the kitty to sit or lay down in the water; if it won’t do this keep gently pouring water on it from the cup… the goal is to really wet the cat all over before you apply the shampoo.


 

 

DIRECTIONS FOR SHAMPOOING A DOG

There are hundreds of kinds of shampoos marketed for use on pets.  Some have prescription medications in the ingredients and have a specific medical purpose.  Some are created to help eliminate “doggy odor”, and others are used simply to clean the skin and coat by washing away debris, oil and dirt.

A healthy oil lay over the skin is your pet’s first line of defense against potential invaders such as yeast, bacteria, parasites, pollens, dust and dirt.  Shampooing will temporarily remove this oil layer, a fact often overlooked when topical flea and tick products “don’t seem to work”.

RULE # 1:  Because all shampoos will remove some or most of the surface sebum (skin oil) if you shampoo your pet more often than about every three weeks the protective effects of skin oil are diminished.  The result can be itchiness, dry skin, and an increased sensitivity to environmental antigens and irritants. 

RULE # 2:  Rinse the pet twice as long as you believe is needed.  You must remove all the shampoo.   Leaving even a small amount of shampoo on the skin has a high potential to cause shampoo induced irritation and itching a few days later.

RULE # 3:  In medium and long haired pets while applying shampoo and rinsing it off pay special attention the very dense fur at the front of the neck, behind the thighs, and around the base of the tail.  These areas sometimes do not wet easily, and after shampoo is applied properly these areas can be difficult to rinse thoroughly.

RULE # 4:  If medicated shampoo is used remember that contact time is very important.  For example shampoos containing medications to help eliminate bacteria or yeast organisms may need to be in contact with the skin for 10 minutes or more for them to be effective.  Odor controlling shampoos and oatmeal based shampoos may also require several minutes of contact time to work properly.

RULE # 5:  This probably should be rule number one but here goes… Always read and understand the directions on the label.

RULE # 6:  Use cat shampoo on cats and dog shampoo on dogs.  Some shampoo products can be safely used on both dogs and cats.  If the label does not specifically state approved for use on cats, do not use the product on a cat!


 

 

CORTISONE MEDICATION… A TWO-EDGED SWORD

One of the most often used medication in veterinary medicine is cortisone, unfortunately it is probably the most often misused drug.  The word CORTISONE is a general term indicating a class of biochemicals produced mainly in the cortex of the adrenal glands and which are necessary to sustain life.  To simply understanding the character and action of these hormones the general term “cortisone” is used in this article.

Cortisone has a wide spectrum of effects on the dog’s body and when taken up by the blood stream passing through the adrenal gland cortex.  The amount of cortisone produced is controlled by diverse organ sensors that give feedback to the adrenal glands to secrete more or less cortisone depending upon the body’s immediate requirements. The key words to keep in mind when thinking about blood levels of cortisone are that for optimal health is needs to be present in the blood stream “in the proper amount”.

EFFECTS OF NORMAL AMOUNTS OF CORTISONE
…assists in converting proteins into energy
…stimulates release of energy from muscle and liver stores
…helps suppress inflammation
…maintains proper blood pressure


…supports immune function
…regulates cholesterol metabolism
…supports endocrine gland function
…supports alertness and mental function

EFFECTS OF TOO MUCH CORTISONE
This condition is called ADDISON’S DISEASE and has three main causes… a cortisone secreting tumor of the adrenal cortex, a hormone secreting tumor of the pituitary gland where the extra hormone commands the normal adrenal glands to produce too much cortisone, or from a doctor prescribing cortisone-like drugs to the patient.  Some of the most common signs of excess cortisone in a patient are symmetrical hair loss over the back and sides, excess thirst and urinating, weight gain, persistent panting, thin skin, patches of skin crusts, chronic urinary tract and skin infections, urine leakage.

EFFECTS OF INSUFFICIENT CORTISONE
This condition is called ADDISON’S DISEASE and can be fatal if the patient does not take drugs that work like cortisone.  Some of the most common signs of low levels of cortisone in a patient are symmetrical muscle wasting, poor activity and interaction, muscle weakness, shortness of breath, low interest in physical activity, low blood pressure, immune suppression, nutritional dysfunctions,  and dulled mental function and thinning hair coat.

CONCERNS ABOUT ADMINISTRATION OF CORTISONE
Every dog needs circulating cortisone levels to stay within a narrow value.  Too little cortisone and some very serious problems quickly arise; too much cortisone and the quality and length of life decreases.  The clinical puzzle your veterinarian tries to solve is determining which and how much cortisone medication is needed so the dog doesn’t get too much nor  too little.

A classic and common situation occurs when the allergic patient is prescribed cortisone to treat signs of allergy such as itching, inflamed skin, secondary skin infections, itchy ears and hair loss.  The patient is much more comfortable but the medical cortisone administered every day lulls the adrenal glands to sleep because less is needed to be secreted because the oral or injected cortisone drugs signal the adrenals that minimal cortisone is needed.  If cortisone treatment goes on for weeks, months or years the patient can become dependent upon the drugs, and if the drugs are not available a doctor induced Addison’s Disease shows up very fast!  The patient is in very real danger.  Short term (about five days or less) continuous cortisone treatment is not a medical danger if reasonable doses are needed or if intermittent doses are given as needed.

Different types of cortisone-like medications will have different effects on the dog’s hormone balance.  Drugs commonly used are the oral dose of prednisone, prednisolone, vetalog, and dexamethasone.  These can be given, too, in short acting injections or long lasting injections of depo-medrol, betasone, and DOCA.  Your veterinarian may need to obtain blood and urine samples to help determine whether or not long acting or long term cortisone medications are needed.  Whenever possible intermittent (“as needed”) oral medications may be preferable to an injection that releases cortisone continuously for several weeks.

Let’s clear up something… the notion that “cortisone” is “bad” is not entirely factual.  Too much is not good whether it is being produced internally or taken as a medication.  Too little is not good and can be fatal.  The truth is that cortisone-like drugs are major contributors to enhanced human and animal health… they truly can work miracles.  But like a two edged sword they can cause great harm when not used wisely.

 


 

 

ESSENTIALS OF FLEA CONTROL

Fleas are tiny dark copper colored insects about the size of a pinhead.  They don’t have wings; they can hop and sometimes seem to disappear as you attempt to grab them.  They move very fast on the skin and are perfectly designed to hide and move among the thousands of hairs on an animal’s body.

If your dog or cat has fleas your first chore is to determine from where they came.  Because fleas can reside and hide just about anywhere outdoors, especially where there are ground dwelling critters such as squirrels, rabbits, raccoons, cats and dogs.  Fleas can even survive and prosper in homes with tile floors!  They avoid bright light… and without adequate light we won’t be able to see them.  In homes with carpeting there can be flea infestation in rooms where the pet never goes because the fleas will attach to shoes and clothing and become well distributed indoors.

DETERMINE THE SOURCES OF THE FLEAS
The fleas you see on your dog or cat came from somewhere; you need to do detective work and figure out where the fleas are hiding.  Typical sources are:
….. A kennel, dog park or neighbor’s dogs if your dog and their dog play together.
…..Your yard.  Fleas can survive in great numbers in sandy areas, leaf piles, dense vegetation, in the grass under trees where squirrels, mice, rabbits spend time.
…..In your home, especially in carpets, in the furniture fabric, in bedding and blankets, in dusty areas of the basement.
…..Beneath your dog’s favorite bushes where he likes to do his daily duty in private.
…..Along the route you take on your dog’s daily walks.

HOW TO DETERMINE THE SOURCE
Start with a flea free dog, then do an inspection immediately after a change of environment.  When you see fleas you’ll know they were picked up in the environment where the dog just spent time.
 Look your dog over thoroughly in a well lit area by spreading the fur apart and getting a peek at the skin surface.  Part the hair over the neck and back, check the tail and base of the tail, roll the dog over quickly and see if you discover fleas heading for cover.  Fleas prefer the rear half of the dog’s body especially over the rump.  If you are certain there are no fleas on your dog, let him outside in the yard.  As soon as he comes inside do another thorough inspection.  No fleas are a good sign… if fleas are seen, you know that at least one source of the fleas is your yard.

Another example:  Do a thorough inspection and if no fleas are seen, go on your usual walk and let the dog do all the usual nosing around.  When you get home immediately do another thorough inspection.  If you see some fleas, they were recently acquired along the walk.  (Pick a new route as you treat for fleas.)

Another example:  Before you go to bed do a thorough exam for fleas.  If none are found, recheck the dog as soon as you get up and before the dog goes outside to eliminate.  If you find fleas, they were acquired while the dog was sleeping and are present in the bedding! 

TREATMENT FOR FLEA ERADICATION:
Treat the entire house even if “the dog never goes upstairs”.  Treating only a few selected rooms will be unrewarding.  Fleas, flea eggs and flea larvae almost always are distributed throughout the house because adult fleas attach to people’s clothes and then jump off when they feel like it.  There are do it yourself home and yard flea treatments but if you take shortcuts or cut costs you’ll fail to solve the flea problem.  Best advice for in home flea eradication… call a professional exterminator.

There are a number of very effective flea control products that if the directions are followed are safe and effective as a part of the total effort to eliminate fleas.  There are no safe and effective flea repellants!  All pet anti-flea products only kill fleas after the flea is on the pet.  Most work before the flea gets a chance to bite but no product available today guarantees total immediate flea kill of all fleas as soon as they alight on the pet.


 

 

HOME CARE INSTRUCTIONS AFTER A PYOMETRA SURGERY

Veterinarians consider the spay procedure for pyometra patients to be a major intra-abdominal procedure.   Although it is often done we manage each case individually and take the utmost care during the surgery to safeguard the patient as we remove both ovaries and the infected uterus.

 When we discharge a pyometra surgery patient the aftercare is your responsibility and should be taken seriously.  The following points need to be understood and followed to minimize any adverse events associated with the surgical procedure.  If you are unsure of any facet of the home care or are uneasy about how your pet is feeling during the critical seven days post-op, call us so we can advise you properly.

DOGS and CATS:

A.)   You should offer your pet a little water and food when you arrive home.  Some post-op patients will vomit or be uninterested in food until the following day.  If your pet is interested in food and water continue to offer small amounts every 30 minutes for a few hours and then simply renew your usual feeding and water availability the following day.

B.)     When you arrive home with the patient you may notice some grogginess or slight depressed alertness.  The return to alertness and reasonable energy levels should be noticeable within 12 hours.  If after a few hours at home your dog or cat is even more depressed, weak, or unable to walk you should call us.  If it is after regular office hours listen to our full recording and you will be given an emergency number to call.

C.)     Check the mid-abdominal incision daily.  The first few days post-op there may be some redness and slight bruising at or near the incision.  This will disappear in a few days and you may continue to feel slight thickening or bumpiness near the incision which is normal due to the sutures in the abdominal wall and subcutaneous tissues.

D.)   If there has been slight drainage at the incision the first two days you can gently swab away any crusty buildup with cotton and warm water.

E.)    If there is noticeable drainage, discharge, swelling, or soreness after three days give us a call.  We may want to check to be certain there is no infection present.

F.)    Administer as directed the medications prescribed.  Call us if you do not understand the directions or have trouble administering the medications.

DOGS:
 For 7 days post-op all dogs when outdoors must be on a leash in order to limit their activity.  Using stairs and walks are permitted.   You should safeguard them against running, jumping, swimming or vigorous play activity for a full week post-op.

CATS:
Indoor activity is permitted but vigorous playing or jumping should be avoided for seven days.  Outdoor cats should be confined somehow for seven days so that you can check their incision and food and water intake.

DOCTOR’S NOTES:


 

 

COMMON QUESTIONS ABOUT “BEING A VETERINARIAN”

What made you decide to become a veterinarian?

I really enjoyed studying sciences, especially Biology.  Veterinary medical school required studying many courses in the biological sciences.  Plus, I was really interested in being able to help animals recover from diseases and injury.

How many different types of veterinarians are there and give a brief description of each?

There are veterinarians engaged in pet animal practice, called Small Animal Medicine and Surgery, and others in farm animal practice.  There are zoo animal veterinarians, veterinarians in research and pharmaceutical companies, military veterinarians, teachers, private practitioners, and more.  The American Veterinary Medical Association website has a good list of all the different categories of veterinary medical work that is being done today.  See avma.org.

Is there a specific certification needed to become a veterinarian?

A veterinarian, in order to practice veterinary medicine, needs to graduate from an accredited College of Veterinary Medicine (there are less than twenty-five in the USA) and pass certifying exams in order to be licensed in any state in which the doctor wants to practice.  Specific education and a state license is required.

On average, how much money does a veterinarian make each year?

It can be from $45,000 to over $200,000 dollars annually depending on the kind of practice a veterinarian is in.   Being an employee usually indicates less income potential than a veterinarian that owns numerous practices and employs many veterinarians.

What is the difference between a veterinarian assistant and a veterinarian?

To be a veterinarian the person has to be a graduate of the doctoral program at an approved and accredited college of veterinary medicine.  To graduate usually requires 8 years of college study.  A veterinary assistant can be anyone the veterinarian trains to assist.  A licensed Veterinary Technician needs to graduate from a two-year college level course of instruction and pass certain tests to be an accredited and to be legitimately called a licensed Veterinary Technician.

Why is it important to society to have licensed veterinarians?

Licensure protects the society from anyone who might pose as a veterinarian and who does not possess the training and education required to perform expected tasks.  Since animal health issues often impact human health, the general public is entitled to competent veterinary care so specific regulations need to be enforced.

Which classes would be most beneficial for a student wishing to become a veterinarian?

Becoming proficient in mathematics and science courses will be very helpful.  Especially, Biology and Chemistry will prepare the student for college work.

Does being a veterinarian involve long working hours on a daily basis?

Usually a veterinarian in private practice will put in a full 8 to 10 hours a day.  Often, too, weekends are taken up working on emergency cases or caring for sick patients.  Other fields of veterinary medicine, such as teaching, farm animal medicine, research and government employment will have their own time demands and restraints.

What is the hardest thing about being a veterinarian?

As a small animal practitioner, the fact that your patients often need help 24 hours a day can be the biggest strain… there often is a lack of personal free time.

What makes it worth going to work everyday?

There is a substantial satisfaction knowing that you are helping an animal patient regain optimal health.  Along with that, very appreciative and thankful pet owners can brighten up a veterinarian’s day.

REFERENCES:
You can find lots of good information at

www.AVMA.org

www.ACVIM.org


 

                                        

                                                     INFORMATION ABOUT CAT VACCINATIONS

There are a number of "judgment calls" that we veterinarians... and owners... must make regarding vaccinations.  Cats that go outside may have a much higher risk of exposure to certain diseases than cats that are always indoors.  So does it make sense to vaccinate all indoor cats for the same diseases as the outdoor cats?

(Rabies protection/prevention/vaccination is in a class of its own due to the fatal aspects of infection!) 

Do ask questions and get different opinions, then decide what makes the most sense for you and your cat regarding what to vaccinate for and how often.

 

Common vaccines for feline diseases

Feline Distemper
(Panleukopenia)

Rhinotracheitis

Calicivirus

Rabies

Feline Leukemia
(FeLV)

Feline Immune Deficiency Virus
(FIV)

Feline Infectious Peritonitis
(FIP)

Microsporum felis vaccine
(Ringworm)


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                                                    VACCINATING PUPPIES AND KITTENS

The goal of vaccinating pets is to stimulate protective immunity to a specific disease so that if the pet is ever exposed to that disease the odds of getting sick are nearly zero.  By vaccinating we expose the pet to an antigen that is very similar to a disease but that cannot actually cause disease.  The vaccine tells the pet’s immune systems into building immunity to actual disease.  Sometimes the vaccine induced protective immunity lasts for years without needing a repeat (booster) vaccination; however, some diseases need revaccination to keep immunity at a protective level.

Veterinary immunologists recommend puppies and kittens begin their vaccinations at about 6 weeks of age.  The vaccine inoculation often includes several different disease antigens combined into one injection dose.  In young animals we can't be sure that a single inoculation will stimulate a protective level of immunity so follow-up vaccinations are recommended until the pet is about 16 weeks of age.  Most healthy pets will have a good immune response to a vaccine administered at 4 months of age. 

Pet owners often ask an excellent question:  “Why not wait until they’re  4 months of age and then just give them one inoculation rather than starting a series of inoculations at 6 weeks of age?”

The answer is that if the puppy or kitten has no temporary immunity (called passive immunity) from the mother’s milk it will be highly susceptible to developing dangerous disease at their young age.  And because during an examination veterinarians have no way of knowing whether or not a puppy or kitten is still protected at that moment by temporary immunity it is safer to vaccinate than to just guess whether or not the pet still has temporary immunity from the mother.

We do know this:  If a puppy or kitten younger than 4 months of age still has temporary immunity from the mother’s milk to a disease such as Parvovirus, a Parvo vaccination will be neutralized.  Then when the maternal temporary immunity to Parvo disappears by 4 months of age the pup will be left with no protection against the disease!  Once maternal antibodies are gone dogs and cats are vulnerable to all sorts of pathogenic organisms such as parvovirus, rhinotracheitis, borrelia and leukemia.

IMPORTANT FACTS

GUARANTEES:  No vaccine has 100% probability of conferring a protective level of immunity. Because there is so much diversity of genetic, environmental, patient health status, and manufacturing factors that impact the outcome of an inoculation no one can be absolutely certain an individual will mount a protective level of immunity.  And if the vaccinated pet already has an undetected immune stress present, that particular pet may not respond to the vaccine in an expected manner.

REACTIONS:  Any individual animal including dogs, cats, mice, humans, horses, etc., could have an adverse response to any vaccine.  These vaccination reactions are almost always unpredictable, just like an adverse reaction in humans to peanuts, seafood, penicillin, or bee sting.  Because occasional individuals experience an adverse event should not brand all vaccinations as being “bad” any more than branding peanuts, seafood and bees as “harmful”!

OVERVACCINATING:  There is no well-defined, verifiable, scientifically controlled, objective data that tells us at what point an individual will be “over-vaccinated” and thereby will suffer undesirable consequences from vaccinating… except when an individual experiences an adverse reaction to a specific antigen in a vaccine.  To repeat an inoculation with an antigen known to have triggered an unfavorable reaction in that individual can and should be considered over-vaccinating in that individual.

IMMUNE SYSTEMS:  There are several ways an individual shields itself from non-self.  Healthy dogs, cats, birds, worms, insects, algae, flowers and even bacteria are alive today because they have evolved methods to cope with uncountable harmful agents.  Potential invaders are present  all the time and a reasonably healthy individual’s immune mechanisms suppress all sorts of potential invaders every moment of life.  Exposure to organisms capable of causing disease occurs continually.  Giving vaccines to pets is no more or less over-exposing the immune system than what occurs in everyday life activities.

SUMMARY:  Your veterinarian will tailor a vaccine recommendation for your individual pet.  Considering the pros and cons for administering any medication or vaccine, the goal is to safeguard and optimize a long and healthy lifetime your pet.
 


 

 

WHY DOGS ITCH AND SCRATCH AND CHEW AND LICK

One of the most common calls made to any animal hospital in America goes something like this:  “Doctor, I’ve got to get this dog in right away.  He’s driving us nuts.  All he does is itch and scratch, bite and lick and he’s keeping us up all night!”  My thought is that if the pet’s caretakers are being driven “nuts” by the dog’s scratching and licking, how awful must the poor dog feel?

This kind of call to the veterinarian refers to a fairly serious case of pruritus (pruritus means itching).  In reality there is a wide spectrum of causes and severity of pruritus in dogs with skin and coat trouble.  Some dogs can spend hours romping through fields, digging holes, and rolling in the grass and still have no after-effects at all.  Others, kept indoors and fed an excellent diet, may have severe skin disorders.

Let’s see if we can make some sense of this complicated and aggravating situation and try to answer the question “Why does my dog itch-and-scratch-bite-and-lick?”

There are six main reasons why pets develop dermatitis.  We have to find the cause… meaning we make a diagnosis… from these categories whenever a “Skin Case” is presented.  The difficulty with determining a diagnosis for dermatitis arises because very different causes can display identical signs in the patient!  Itching, for example, can be caused by scabies mites, allergy from inhaled substances, or contact with plant or common environmental materials, and even be psychological in origin.  It is very important for the doctor and client to be on the same page regarding the pathway of tests and therapeutic strategies required to sort out the different reasons for itching.

CAUSES OF ITCHING IN DOGS AND CATS:
Environmental…
airborne pollens, carpeting, wool, grass, ferns and other vegetation, plastic crates, hay, ingredients in shampoos and ear cleaners

Nutritional… food intolerances are not true allergies but some dogs may react with skin itching, blisters, reddened skin patches, facial swelling from peanuts, grains, plant material in foods, treats or supplements.


Parasitic… flea saliva can cause itchiness all over the dog from the bite of a single flea!  FAD is the abbreviation for flea bite dermatitis and is a very common source of severe itching.  Many owners find it difficult to believe the existence of an ongoing allergic dermatitis caused by only occasion flea bites.


Infectious…
on occasion infections from staph bacteria can cause skin itchiness, more common is dermatitis from overgrowth of skin yeast organisms.


Allergic…
allergy is an over-reaction to a substance where the body’s defense mechanisms go way too far in attempts to protect the body from the substance.  Dogs and cats can be allergic to oral and topical medications, vaccine antigens, food ingredients and inhaled substances.  Autoimmune disease results from the defense mechanisms actually trying to destroy the individual’s own tissue.  Any tissue in the body could be the victim of self-destruction and when the skin is involved itching, redness, scabs and sores are evident.


Neurogenic…
scratching and chewing at various skin locations on occasion are triggered by neurologic factors such as boredom, psychological frustration, discomfort or pain in joints or elsewhere in the body.  Even though initially the skin involved as the target of the self-mutilation is normal the persistent chewing, licking and scratching damage the skin.  The damage triggers local stress that creates a vicious cycle of skin damage-chewing-more damage-more chewing.

Keeping in mind that there are entire textbooks written about these categories, you might understand why veterinarians often take a deep breath before entering the exam room wherein awaits a patient with “a skin problem”.

Doctor’s Notes:  _______________________________

 

 

                                                      LITTER BOX TRAINING

Understanding why a cat won’t use the litter box can be challenging. In general we have either a medical or behavioral puzzle to solve.  Sometimes the medical problem instigates the behavioral problem.

MEDICAL ISSUES IMPACTING LITTER BOX USE
Common medical problems include bladder infections, bladder stones, bowel problems such as constipation, or an anatomical defect.  We need to analyze a stool and urine sample and possibly take a few x-rays. 

If there is discomfort passing urine or stool the cat may think something in the litter box is causing it!  The cat will then avoid the litter box and look for a more secure, less threatening spot to eliminate.  A few feline favorite elimination areas are on the couch, in a laundry basket or closet, in a sink or tub. If there are no medical problems, we need to do some behavior modification!  Medical problems usually can be corrected; then redirecting the cat to the litter box will resolved the issue.

BEHAVIORAL/ENVIRONMENTAL ISSUES IMPACTING LITTER BOX USE
Multi-cat households very commonly experience one or more cats missing the litter box. Social friction can cause a subordinate cat to avoid a dominant cat’s toilet facilities.  Even very subtle threats while using the group litter box can warn the subordinate cat to scram. Interestingly, a single event such as a crash of thunder startling the cat just as it starts using the litter box, or another cat entering the litter box in a dominant mood, could create hesitation about being confident in the litter box. 

If there are multiple cats sharing a litter box, you may have to use multiple boxes.  One should be the covered variety (for privacy, of course!) and one open for the exhibitionists.  In these cases, having two or more boxes available can help.  You also can try temporarily placing a litter box in a closet or other space the problem cat is “frequenting” .  When use of the box returns you can gradually move the box to a place you choose.

If the issue involved a single cat you need to make it unpleasant for the cat to use its favorite alternate spot.  You can temporarily place books, tinfoil or other impediments to the cat's preparation of (digging and scraping) the favorite area for elimination.  Make the litter box very inviting and accessible and the cat's favorite spot inaccessible.

Also, the litter box should have only a small amount of litter in it for those cats who want to dig to the bottom of the elimination area.  Some cats will not eliminate in a box containing litter more than an inch or two deep.  Try spreading 1 inch layer for those fussy and particular kitties.

Close doors to keep the cat out of areas it’s using for a bathroom.  Make the cat's choices few and obvious.  Always leave a little stool or urine in the box after you clean it.  Many cats need a hint of their own cat odor in the box to become comfortable with “their spot”.  Don’t overdo the cleaning; cats don’t like the odor of chlorine or ammonia or lilac-smelling perfumes in their private toilet areas.  Get a few tablespoonsful of real yard dirt and scatter it under the litter.

Use non perfumed litter and try several textures and particle sizes and, again, just use a layer about an inch deep.

Many articles and seminars have described ways and means to redirect cats' elimination behavior.  The topic could take hours to cover because insistent.  You want to make the area you select much more user friendly than the area the cat selects.


Always check with your veterinarian first if you have a specific question about your pet's health care!

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