Everyday Medicine: Cytology

cytology

“Everyday Medicine” is an intermittent series of blog posts highlighting tests, treatments, and procedures common in daily Animal Medical Center practice. Some past examples of this type of blog post include “The Highs and Lows of Blood Sugar” and “Blood Pressure.” Today’s post focuses on cytology.

Cytology is a very common exam room test performed by veterinarians. The test involves taking a sample – a swab of ear gook, a bit of diarrhea, or a few cells from a skin mass – and smearing a thin layer of the sample on a microscope slide. The slide might be dipped into a series of jars containing pink and blue dye. The dye colors the sample and helps differentiate the various cells and organisms in the sample when the slide is viewed under a microscope lens. Or, the slide might have a few drops of saline added in a procedure called a “wet mount.” In either case, the slide is then examined under a microscope to help facilitate a diagnosis.

Ear Gook
Every case of ear gook is not the same and veterinarians commonly use cytology to tell the difference between the types of ear infections. Black or brown discharge is common in ear infections and the presence of black discharge doesn’t tell us what the cause of the infection is. In cats, ear mites are really common causes of black discharge, especially in stray cats and kittens. Ear mites are not so common a cause of black discharge in dogs. Veterinarians mostly diagnose bacterial and yeast ear infections in dogs.

Yuck! Diarrhea
Diarrhea makes the pet patient uncomfortable and the pet family’s house a mess, so a quick fix is in order. A quick fix requires a quick diagnostic test like cytology. Using a “wet mount preparation” of a fresh fecal sample and a microscope, veterinarians can identify the eggs of roundworms, hookworms, tapeworms, and whipworms as well as protozoal organisms like coccidia, and Giardia. A second fecal sample may also be submitted to an outside veterinary laboratory for even more specialized testing.

Skin Masses
Another very common reason for exam room cytology is for the assessment of a skin lump. Keep in mind, a skin lump does not always mean cancer. Skin lumps can be abscesses, fluid filled cysts, benign fatty tumors, and yes, sometimes cancer. Knowing right now that I am dealing with an abscess means your cat gets the antibiotics she needs immediately. But, not every cytology sample can be evaluated in the exam room. Some samples must be sent to a laboratory where a veterinary specialist called a pathologist will interpret the cytology. Other samples indicate a biopsy is needed.

To learn more about lumps on your dog, review our previous blog post, “Will That Be One Lump or Two?

Holiday Pet Gift Guide 2017

holiday pet gift guide

Here it is: the Animal Medical Center’s 2017 pet gift guide. These pet products have caught our attention over the past year for their ability to stimulate the brain by engaging your pets in both physical and mental activity. Pets in more stimulating environments are happier and healthier, two great gifts to give your pet this holiday season.

If you don’t see anything on our list that is on your pet’s holiday list, check past years lists for ideas:

Usually our feline friends suffer from a lack of clever gift options, but not this year. These gifts are so engaging, I can’t wait for my cat to get up Christmas morning and find Santa has left every one of them under the tree.

A Pink Cat-illac
We all know cats love boxes. And this cat car meets your cat’s desire to have a cozy hiding place or a place to plant a sneak attack on your ankles. If pink is not your cat’s thing, try a fire truck.

Figureheads and Felines
No matter what your cat’s political persuasion, there is a Fuzzu toy for her. She will be entertained for hours by a liberals, conservatives, Democrats or Republicans without turning on the one of the 24/7 news channels or her favorite internet news outlet.

Satisfy the Scratching Urge
Scratching is a normal behavior for cats. To protect your furniture encourage appropriate scratching with catnip blasted scratching pads. If your cat likes to scratch vertically, the Lurvig scratching mat makes an easy stocking stuffer and turns any table leg into a scratching post.

Ikea for All
Since we consider pets members of the family, we want them to participate in quality family time. Ikea’s Lurvig pet products collection includes pet furniture that integrates into your living room décor. The Lurvig cat house has legs, can be wall mounted or slipped into your Ikea wall unit. The Ikea dog sofa folds out for doggie sleepovers or for more space to rest after a big hike and is attractive enough to fit in your living room.

Keeping your dog physically active helps to keep him mentally fit. To promote exercise, many pet families include their dog in activities like hiking and boating. Here are some gift ideas for active dogs.

Hydrate the Dog
The Eddy bowl is a portable, reusable, recyclable dog bowl. Lightweight and made of bamboo fibers, this bowl can be folded up and slipped into a pocket for use a bit further down the trail.

Give a Float Coat
Not all dogs can swim and even the best swimmers may find themselves in deep water unexpectedly. Float coats keep your dog afloat until they can be rescued and the bright color simplifies finding an overboard dog.

Travel Safely
Getting your dog to a hiking trail or board launch usually involves a car ride. Make sure your dog travels safely in a crate approved by the Center for Pet Safety.

Gifts for Pet Lovers
Kitten season is just around the corner and if you know a family planning on getting a kitten in the spring, this book would be a welcome addition to their library: 101 Essential Tips — Kitten or New Cat — Health and Safety by The Preventive Vet, Dr. Jason Nicholas. This book will help you create a safe and enriched environment for your cat.

Or if you have dog-loving children on your list, Hero may make then squeal with delight. This book for children 8-12 years of age tells the inspiring story of a handsome black Labrador search and rescue dog who uses his skills to save lives.

Eye Conditions

eye conditions in pets

Because your pet’s eyes are front and center every time you glimpse their cute little fur faces, abnormalities of the eyes are easy to recognize. And, of course, none of us would want our vision compromised by an eye disorder, so we worry about our pet’s eyes as well. Below are descriptions of some of the more common eye disorders in dogs and cats.

Cataracts
Older dogs commonly have a visible cloudiness to their eyes. The cloudiness is normal aging of the lens, called nuclear sclerosis. Nuclear sclerosis does not compromise vision, and is often mistaken for cataracts. Cataracts are an abnormal cloudiness of the lens caused by a buildup of protein or pigment in the lens which interferes with normal vision. In dogs, genetics and diabetes play a role in cataract development. Canine cataracts can be removed surgically, followed by placement of an artificial lens. Cataracts are uncommon in cats.

Dry Eye
The eyelove campaign on television and the internet promotes awareness of dry eye in humans. Dry eye is a decrease in tear production and occurs in dogs, especially those with bulgy eyes, like pugs. Treatment requires lifetime eye medications to stimulate tear production.

Cherry Eye
Under the third eyelid of dogs and cats is a small tear gland. In certain breeds, such as bulldogs, cocker spaniels and Burmese cats, the gland pops up and forms a red mass in the eye, colloquially known as “cherry eye.” This abnormality typically occurs in young dogs and cats. Treatment involves tacking the gland back in place with a suture.

Glaucoma
One of the most common eye abnormalities pet families recognize is a red eye. Glaucoma is one cause of a red eye. The redness results from a painful increase in pressure inside the eye. Management of glaucoma can be challenging and involves drops, ointments and even surgery.

Corneal Ulcer
Another cause of a red eye is a corneal ulcer, a sore on the clear part of the eye. Corneal ulcers are common in dogs with dry eyes, as a sequela to feline viral respiratory infections, or trauma. A dog or cat with a corneal ulcer will squint or rub their eye because ulcers are painful. Typically, application of antibiotic ointment and oral pain medication correct this condition.

Allergic Conjunctivitis
Conjunctivitis is probably the most common eye problem on the list, since allergies are common in dogs. Allergic conjunctivitis is yet another condition resulting in red, weepy eyes. Distinguishing it from red eyes due to glaucoma or a corneal ulcer requires testing the pressure inside the eye and measuring tear production. Making the correct diagnosis is critical, since the treatment for each is different. Management of allergies with antihistamines or immunotherapy, plus anti-inflammatory eye ointment usually resolves allergic conjunctivitis.

Next time your pet gazes lovingly at you, make sure they are doing it with picture perfect eyes.

The Difference Between Diagnostic Radiology, Radiation Therapy and Interventional Radiology

radiation therapy

At first glance, these three disciplines within veterinary medicine seem pretty much the same, but at the Animal Medical Center, diagnostic radiology, radiation therapy, and interventional radiology represent three different groups of veterinarians with three very different sets of background and training. What ties these three disparate groups together is their use of radiation to diagnose and treat disease.

Diagnostic Radiology
These days you are more likely to find a Department of Diagnostic Imaging in a hospital than a Radiology Department. Radiology is an older term, used when x-rays were the only testing modality using radiation available in medicine. Today, AMC’s Diagnostic Imaging Service uses not only traditional x-rays but also ultrasound, computed tomography (CT) scans, and magnetic resonance imaging (MRI) in the diagnostic evaluation of patients. AMC’s Diagnostic Imaging Service also has a fluoroscopy unit, which is like a video x-ray. This machine allows us to watch bodily functions like blood flow or swallowing in real time. To see an example of fluoroscopy, read about Molly the Ganaraskan. Every veterinarian at AMC depends on our diagnostic imaging team for their expertise in imaging sick pets and helping us to make an accurate diagnosis.

Radiation Therapy
A very accurate description, AMC’s Radiation Oncology Service uses radiation to treat tumors. Specifically, we have a linear accelerator (linac), a giant machine that creates various types of radiation depending on patient needs. Our state-of-the-art linac can make electrons for superficial treatments, produce high energy pinpoint beams for stereotactic radiosurgery, and stereotactic body radiation therapy. Diagnostic Imaging’s CT scanner interfaces with Radiation Oncology’s 3-D computer planning system. The interface allows the linac’s multileaf collimator to sculpt the radiation beam to precisely target the tumor being treated. The veterinarians working in radiation therapy have training in both the physics of radiation as well as the management of cancer.

Interventional Radiology
Specialists in interventional radiology use minimally invasive techniques to make image-guided diagnoses and also deploy high tech treatments for a variety of diseases. Using a range of techniques which rely on the use of images generated by diagnostic radiology equipment such as fluoroscopy, ultrasound, CT scan, or MRI imaging, the interventional radiologist precisely targets various organs with treatments such as stents, occluders and medications. Watch a video where AMC’s interventional radiology team uses fluoroscopy to close off abnormal blood vessels in the liver. The veterinarians in our Interventional Radiology Service have diverse backgrounds in surgery, internal medicine plus specialized training to use minimally invasive equipment.

Linked together by their use of radiation as a diagnostic and therapeutic tool, diagnostic radiology, radiation therapy and interventional radiology are just a few of the highly trained specialists at AMC working to make sick pets healthy again.

Antibiotics: Precious Medical Resources

antibiotics

November 13-19 is World Antibiotic Awareness Week. I can’t believe any of my readers need to be made aware of the importance of antibiotics in both veterinary and human medicine, but we all need to be aware of how to protect these precious medical resources.

Antibiotics have been around for less than 100 years and yet as a class of drugs, their discovery revolutionized the practice of medicine. Sir Alexander Fleming discovered penicillin, the first antibiotic, in 1928, and in 1945 won the Nobel Prize in Medicine for his discovery. Since then, dozens of antibiotics have been identified in nature or synthesized in the laboratory. Even though antibiotics save millions of people and pets every year, misuse and abuse are rendering them less effective every day. Antibiotic use should be reserved for patients who are likely to benefit from their administration and not be prescribed just because you or your pets are feeling sick. For some diseases, antibiotic treatment would be a poor therapeutic choice.

Good Uses of Antibiotics
Antibiotics are especially effective in treating bacterial infections. Common bacterial infections in pets include skin, ear and urinary tract infections. Veterinarians base their selection of an antibiotic on several factors: the location of the infection and the typical bacteria causing that type of infection. Additionally, a sample taken from the site of infection can be observed under the microscope and the antibiotic can be chosen based on the type of bacteria seen. The best indicator of correct antibiotic choice is to sample the infection, grow the causative bacteria in the laboratory and actually test which antibiotic best kills the bacteria. This takes a few days and usually we make an educated guess about which antibiotic is likely to work and prescribe that until the laboratory gives more specific results.

How AMC Uses Antibiotics
Antibiotics are some of the most commonly prescribed medications in veterinary medicine. I checked with our systems administration and for the past three years running, and probably in 2017 as well, AMC veterinarians have written over 7,000 antibiotic prescriptions per year, or 20 antibiotic prescriptions per day. This number does not include antibiotic ointments for eyes, antibiotic drops for ears, and any topical antibiotic creams. The most frequently prescribed antibiotics will be familiar to many pet owners as I suspect they are commonly used by many veterinarians: Clavamox®, Convenia®, Simplicef™ and Baytril®. Since skin disease is one of the most common reasons pets are seen by veterinarians, the antibiotics on the list are no surprise; they all are good antibiotic choices for the treatment of skin disease. The top four antibiotics prescribed by AMC veterinarians comprise over half of all the antibiotic prescriptions at AMC and should convince you how important a role antibiotics play in making your pet better.

What Antibiotics Can’t Do
Bold face name antibiotics like amoxicillin, Keflex® and the eponymous Z-pack® treat a variety of different bacterial infections. If your pet has a viral infection like feline herpes virus or canine influenza virus infection, no antibiotic will help. Viruses need to run their course in order for your pet to feel better. Using antibiotics in viral diseases only creates antibiotic resistant bacteria without improving your pet’s health.

Bad Ideas When it Comes to Antibiotic Therapy

  1. Don’t use your dog’s antibiotic for your cat, or vice versa. While not wasting this precious medical resource seems reasonable, the differences in canine and feline metabolism prevent safe swapping of antibiotics between pets of different species.
  2. Don’t use antibiotics prescribed for one pet on another, even if they are both the same species. Veterinarians carefully select the antibiotic based on the type of infection being treated and the size of the patient and you may end up doing more harm than good.
  3. Keep to the prescribed medication schedule and finish every last one of the pills. Tedious, I know, but if you are having trouble keeping to a medication schedule, confess to your veterinarian. There is a good chance a different treatment plan can be implemented.
  4. Dispose of unused antibiotics appropriately. Check the Food and Drug Administration for guidance.

Everyday Medicine: Blood Pressure

pet blood pressure

Everyday Medicine is an intermittent series of blog posts highlighting tests, treatments and procedures common in daily Animal Medical Center practice. Some past examples of this type of blog post include “The Highs and Lows of Blood Sugar” and “The Third Eyelid.” Today’s post focuses on blood pressure.

Blood Pressure Definition
Everyone has had their blood pressure taken at the doctor’s office and we all know high blood pressure, or hypertension, is bad. But what does that Velcro covered cuff really measure? The cuff measures the pressure the circulating blood exerts on the walls of the blood vessel. When your blood pressure is taken, the nurse reports a number over a number. The top number (systolic blood pressure) is the pressure on the vessel walls when the heart pumps and the diastolic blood pressure or bottom number is the pressure when the heart relaxes. The blood pressure monitors veterinarians use in the clinic for dogs and cats usually measure only the top number, or systolic pressure.

Causes of High Blood Pressure
The most common cause of hypertension in both dogs and cats is chronic kidney disease. The International Renal Interest Society recommends all pets with kidney disease have their blood pressure measured as part of a clinical evaluation. Hypertensive pets should be treated with antihypertensive agents to protect their eyes, heart, brain and kidneys from damage due to high blood pressure.

Hyperthyroidism is another known cause of hypertension, most commonly in cats. Successful treatment of hyperthyroidism typically resolves the hypertension without administration of antihypertensive medications.

Causes of Low Blood Pressure
Low blood pressure is a common problem in AMC’s ER patients. Many ER patients have fluid loss. For example, vomiting and diarrhea-producing dehydration decrease the amount of fluid in the blood vessels, as does hemorrhage. Both dehydration and hemorrhage can result in low blood pressure. A severe systemic infection often leads to low blood pressure through a complex series of physiologic events. Since so many emergency situations lead to low blood pressure, an intravenous catheter and administration of intravenous fluids is typically one of the first emergency therapies administered in an animal ER.

If your pet has recently been anesthetized, he probably has a clipped spot on one of his front legs. That spot identifies the location of an intravenous catheter placement. General anesthesia decreases blood pressure. Veterinarians monitor blood pressure during anesthesia and give intravenous fluids during anesthetic procedures to help maintain blood pressure within a normal range.

Pets with hypertension have frequent blood pressure measurements taken while their veterinarians adjust medications to normalize blood pressure. Blood pressure medication must be titrated to the proper amount to prevent low blood pressure or hypotension. Hypotension makes pets weak and may negatively impact their kidney function.

If your pet is making a trip to the veterinarian soon, don’t be surprised if one of the nurses brings out a petite blood pressure cuff and places it around your pet’s wrist, since blood pressure is an important medical test.

The Horrors of Halloween: The Pet Version

halloween pets

When witches go riding, and black cats are seen. The moon laughs and whispers, ‘tis near Halloween. – 19th century postcard

Although black cats are one of the spooky creatures connected with Halloween, many cats and dogs may not be as excited about Halloween as their families are. Halloween has become one of America’s premier holidays, and according to the National Retail Foundation, the total spending for the holiday in 2017 is expected to reach $9.1 billion. But have pets fallen under the magical spell of Halloween like their families have? Candy, costumes, witches and wizards can make Halloween downright frightful for pets.

Tricks Not Treats
About one-third of the money spent on Halloween goes towards the purchase of candy. But the trick or treat bags should be off-limits for pets. Chocolate contains theobromine, a substance similar to caffeine. The amount is lowest in white chocolate and highest in dark chocolate, but any chocolate consumption is risky in pets because chocolate causes vomiting, diarrhea and hyperactivity. Some health conscious spirits distribute little boxes of raisins as an alternative to candy. But when dogs consume raisins, these healthy little snacks become tricks, not treats, and can damage your dog’s kidneys. If your dog eats sugar-free Halloween treats containing xylitol, expect a hair-raising trip to the animal ER because xylitol can be lethal in dogs.

Keep the candy cauldron out of your pet’s reach to prevent grave consequences.

Creepy Costumes
Most pets rush to the door when the doorbell rings, but the appearance of ghosts, goblins and the Grim Reaper at your door screaming “Trick or Treat” may be your pet’s version of a zombie apocalypse. Keep your pet safely confined and well away from the front door to prevent an accidental escape when unexpected apparitions startle your pet.

Of the 179 million Americans celebrating Halloween, 28 million will purchase a costume for their pet. Not all pets think dressing up is bloody good fun. Hazardous hats and tight tu-tus may turn your pet’s Halloween into a nightmare. Do a costume trial run before the big night to prevent Halloween from becoming a bad dream.

Which Witch is Pet Safe?
To create a haunting aura on Halloween, half of Americans plan to decorate their homes this year, although not all decorations are pet safe. Jack-O-Lanterns add to the eerie atmosphere of Halloween night, but the candle inside can easily set a curious cat or dog’s fur on fire. Use battery operated flickering lights in place of the traditional candles in your carved pumpkin. I love to decorate with fake cobwebs and plastic spiders. If you have cats, I don’t recommend using this scary décor since cats love to eat anything that is stringy. Strings can easily lodge in your cat’s intestine causing a blockage.

All of us at the Animal Medical Center wish you and your pets a safe and fun Howl-oween.

Purging Your Pet’s Closet

pet closet

A common recurrent theme in magazines like Real Simple, Good Housekeeping, and Glamour is closet organization. These publications recommend purging closets seasonally to prevent accumulation of unwanted clothing and accessories. Many of us with pets have a small cabinet or closet devoted to our pet’s belongings. Taking a cue from these glossies, I am going to give some tips for cleaning out your pet’s closet.

If He Won’t Wear it, Recycle it
When you get to the back of your pet’s closet and find that really ugly sweater from Aunt Sally your dog has never worn or his favorite raincoat from when he was a puppy, but it no longer fits, cut the cord and send these unused items to a textile recycling center. Ditto for worn leashes and collars which present a safety hazard for your pet. In New York City, greenmarkets collect unwanted clothing, shoes and other fabric items for recycling.

Rid the Closet of Expired Medications
I am quite confident that when you clear out the closet you will find expired pet medications. Why? Because many of my clients call asking if they can use a medication for their pet found in the back of the closet. First thing I ask them is to tell me the expiration date on the box and usually that medication expired many months prior. The expiration date of medications is printed on the pharmacy label or the box. If you have outdated medication, use the United States Food and Drug Administration (FDA) guidelines to dispose of the drugs properly.

Toss the Expired Food
Before you replace any dog or cat food in the closet, check the expiration date on the bag or can and if outdated, dispose of it. Opened bags of dry food that have not been sealed tightly are likely to be stale or even rancid. Dispose of them as well.

No Need to Store Bones
Board certified veterinary dentists at the Animal Medical Center caution all dog owners against using natural bones or synthetic bones made of nylon as dog chew toys. Both types of bone are the cause of tooth fractures. When a tooth fractures and exposes the pulp cavity, either extraction or a costly restoration is needed. Avoid an emergency trip to the veterinary dentist by choosing tooth-friendly toys such as those made of hard rubber or fabric.

What? You Still Have Jerky Treats?
Between 2007 and December 31, 2015, the FDA has received approximately 5,200 complaints of illnesses associated with consumption of chicken, duck, or sweet potato jerky treats from pet owners. The cause of these illnesses is unknown. Since jerky treats are not a required part of your pet’s diet, veterinarians recommend selecting other types of treats for your pet. If you are feeding jerky treats and your pet becomes ill, tell your veterinarian about the jerky treat ingestion. If you believe your pet has become ill from consuming a jerky treat, please provide the FDA with valuable information by reporting it electronically through their Safety Reporting Portal or your local FDA Consumer Complaint Coordinator.

Once you have that closet cleaned, spend some quality time with your pet and play with all the fun toys you re-discovered while cleaning out your pet’s closet.

Immune Mediated Hemolytic Anemia

I recently wrote about the concept of immune disease – those disorders where the immune system goes haywire and attacks normal cells in the body. Immune mediated hemolytic anemia, better known by its acronym IMHA, is one of these types of diseases. It is most common in dogs, but occasionally we see IMHA in cats.

Defining IMHA
Let’s break this complicated term into its component parts to help explain the disease process. I defined immune mediated in the previous blog, but in the context of IMHA, the immune system targets red blood cells, resulting in their destruction at a rate faster than the body can replace them. Anemia is simply a lower than normal number of red blood cells which, in IMHA, occurs because of rapid destruction of healthy red blood cells. Red blood cells can be thought of like a little teeny bag containing hemoglobin, the red oxygen-carrying protein. Hemolysis is the rupture of the membrane holding the hemoglobin inside the red blood cell. The red hemoglobin leaks out of the ruptured red blood cell and into the bloodstream and urine. The sample in the photograph is a urine sample from a dog with IMHA. It is red because of the release of hemoglobin into the bloodstream and excretion in the urine.

Recognizing IMHA
As a pet owner, you might recognize lethargy and weakness because your pet does not have enough blood cells to carry adequate oxygen throughout their body. You may also see discolored urine and feces. If you look carefully, your pet’s gums will be pale compared to their normal pink color. But sometimes it takes a battery of tests to the lab to determine that IMHA is the diagnosis.

Causes of Hemolytic Anemia
IMHA is not the only cause of hemolytic anemia. Certain dogs have a genetic defect that makes their red blood cells weak and prone to rupture. For some unexplainable reason, dogs, especially puppies like to eat coins. Pennies contain zinc, which damages red blood cells and causes hemolysis. Blood parasites, transmitted by ectoparasites, are another cause of hemolysis. Occasionally hemolysis is the result of an undiagnosed cancer. With this lengthy list of causes, it is no surprise your pet will need a battery of tests to determine a diagnosis of IMHA.

Treatment Can Be Tough Going
Treatment of IMHA involves suppressing the immune system with drugs like prednisone and azathioprine. When anemia is severe enough, blood transfusion is required. Because dogs with IMHA are critically ill, they are most often hospitalized for several days in AMC’s intensive care unit where their condition can be monitored minute by minute. The first two weeks after a diagnosis of IMHA are the most perilous. But if a dog makes it through the first two weeks, they are likely to live for many more months with ongoing therapy.

In a future blog, I will tackle another hematology disorder, immune mediated thrombocytopenia.

Why New York City is Better Than #97 When it Comes to Pets

NYC pets

The New York Times is frequently an inspiration for my blog posts. Typically, my posts are to alert readers to breaking news about a disease like leptospirosis, to give a hint about how readers might better handle pet-related issues, or to highlight a recently published interview.

But today I am going to disagree with an article published in the Real Estate section of the Times. In this article, New York City is ranked number 97 on a list of 100 pet-friendly cities. Using 21 variables, including the pet-friendliness of the rental market; average home size; preponderance of single-family detached homes (in other words, housing likely to have a yard for the dog); the cost per capita of veterinary care; local animal protection laws; and the availability of dog parks and other outdoor spaces and, of course, the number of pet-friendly restaurants, NYC landed near the bottom of the top 100. I think it deserves to be moved much closer to the top.

24/7 Animal Emergency Rooms
New York City hosts at least half a dozen animal ERs, the oldest here at the Animal Medical Center. Running a 24/7 operation and staffing veterinarians, veterinary technicians and support staff 24 hours a day is more costly than operating a daytime-only neighborhood veterinary clinic. Part of the reason NYC ranks low in the list is because of pet care costs. But, if your pet has an emergency and you live in a city without 24/7 emergency care, is that really pet-friendly?

Specialists Galore
In addition to multiple animal ERs, NYC has several veterinary specialty hospitals. For example, AMC has 100 veterinarians, combining expertise in more than 17 key specialties and services from anesthesia to surgery and every specialty in between. Yes, specialty care can be expensive, because specialists have more years of training and use computed tomography, endoscopes, ultrasounds, and high-tech tests to diagnose and treat complicated diseases. But, if your pet has a serious disease and you live in a city without board certified veterinary specialists, is that really pet-friendly?

Outdoor Space
New York City ranked #3 in dogs per capita. One of our strengths was outdoor space for dogs. Right near the AMC, and along the East River Promenade, we have both large and small dog runs, which are free and open to the public. Dog parks are scattered all over the city and when you are looking to rent an apartment, check this list for the dog park near you.

New York City Tips
If you are considering moving to NYC with your dog, plan ahead. Since veterinary care can be expensive everywhere, investigate insurance policies for your favorite fur baby. Renting or buying an apartment in NYC will require many personal documents. Be sure to include your dog’s dossier as part of the application process. For tips on renting an apartment with a dog, read “Getting a lease if you have a leash.

NYC is #1 in my mind when it comes to being pet-friendly. Please don’t let the New York Times ranking keep you and your pet from coming to live in the Big Apple – we love animals!