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 If you have outdated medication, use the United States Food and Drug Administration (FDA) guidelines to dispose of the drugs properly.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Before you replace any dog or cat food in the closet, check the expiration date on the bag or can and if outdated, dispose of it.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!

World Rabies Day 2017: Zero By 30

world rabies day

September 28th is the annual celebration of World Rabies Day. Promoted by the Global Alliance for Rabies Control, this day raises rabies awareness. In 2017, the theme “Rabies: Zero By 30,” highlights a common goal of eliminating human deaths from canine rabies by 2030, an agreement supported by the World Health Organization, World Organization for Animal Health, UN Food and Agriculture Organization and Global Alliance for Rabies Control.

Keys to Reaching Zero By 30
Rabies is an entirely preventable disease. By vaccinating our pets, we prevent rabies from entering our homes. In the United States, we have been successful in decreasing rabies in pets by mandatory vaccination programs. The same is not true worldwide and 50 to 60 thousand humans die of rabies annually. Most are under 15 years of age and nearly all contract rabies from a dog bite.

In New York State, there were no canine rabies cases recorded in 2012-2014, and the same is true for New York City. Cats are a different matter and both New York State and City have seen feline rabies cases during the same time periods. If we eliminate the risk of rabies in our pets, we are safer from the disease.

Avoid wildlife
In New York State and City, more cases of rabies are found in wildlife than in domestic animals. While that raccoon you spy in Central Park is really cute, getting close enough to give it a snack is a really bad idea. In other parts of the country, bats, skunks and foxes are the wildlife reservoir of rabies. According to the Centers for Disease Control, a significant number of the human rabies infections diagnosed in the United States are actually contracted outside the country from foreign dogs and wildlife. So it is not just our wildlife you should avoid, but also the wild animals you see when you travel.

Pet owner responsibility
Rabies laws vary from state to state. To check the requirements in your state, go to rabiesaware.org, a website compiling rabies information on a state by state basis. On this website you can check the rabies laws for your state and also the rabies surveillance data. Rabies vaccination provides critical protection not only for your pet, but also your family by decreasing the risk of human exposure to a rabid animal. In a recent New York Daily News article, the anti-vaccination movement may be spreading to pet owners. The 2015 current measles outbreak was thought to be fueled by unvaccinated children. In most states, puppies and kittens can be vaccinated for rabies as young as 12 weeks of age, so do your part in reaching Zero By 30 and make sure your pets are up to date on their rabies vaccination.

Successfully Switching Your Pet to a Prescription Diet

prescription diet

All veterinarians, not just the specialists at the Animal Medical Center, use specially formulated prescription diets to help manage a variety of diseases in pets. For example, low protein diets are used in pets with liver shunts and kidney disease. Pets with arthritis benefit from diets rich in anti-inflammatory nutrients. But, pets don’t always want to give up their favorite brand of food for something you define as “better for them.” Here are some suggestions on how to get your favorite fur baby to accept a new diet.

Go Slow
Many diseases requiring a prescription diet occur in older animals that may be more set in their ways than a young puppy or kitten. Put out a spoonful of the new food on a separate plate from your pet’s regular food. It might take a few days for your pet to sample the new offering, but if she does, gradually increase the amount offered while decreasing the regular food. If your veterinarian recommends a prescription diet, ask if there are different brands or flavors available so you can change up the food while still getting the benefits of a prescription diet. Warm food stimulates the taste buds, so try microwaving the food for few seconds before offering it to your pet.

Keep it Fresh
If you feed canned food, recommended for pets with urinary tract problems or bladder stones because canned food has a high water content beneficial in these diseases. But after an hour or two of sitting in a bowl on the kitchen floor, the food gets crusty as the beneficial water evaporates. There are now bowls with an automatically opening and closing lid. As your pet approaches, the lid opens and allows your pet to consume fresh, soft and tasty food. When your pet finishes eating, the bowl automatically closes. How you store your pet’s food also impacts the taste. For tips on storing pet food to optimize freshness read this information from Hill’s Pet Nutrition.

Tasty Topping
Some pets need a bit of encouragement to try a new diet. Pretend the new food is a treat and use it as a reward. Once your pet readily takes the new “treat,” start putting it in her bowl. Other pets need a jumpstart of tasty food on top of the new food. Tasty bonito tuna flakes or powder make for a low-calorie taste sensation. Consider spicing up the prescription food with some of the new pet food condiments like Petschup or Meowstard or one of the commercially available gravies. Before you add anything to a prescription diet, make sure your veterinarian approves of the choice.

The Other Pet
Inevitably, the pet you want to eat the prescription diet refuses and the pet that doesn’t need it licks the bowl clean. If you have this problem, look into bowls that use radio frequency identification transponders aka your pet’s microchip to unlock a bowl containing the prescription diet. This ensures your healthy pet will not steal the prescription diet intended for your sick pet.

Once you get your pet eating the prescription diet, he will soon be on the road to recovery.

September is National Preparedness Month: #PlanAhead

National Preparedness Month

With the events of Hurricanes Harvey and Irma fresh in our minds and the anniversary of 9/11 this week, disaster planning has been on my mind. FEMA sponsors National Preparedness Month annually in September. This is a good opportunity to review the contents of your pet’s go-bag for an emergency evacuation.

A go-bag, whether it is for you or your pet, is a small, sturdy portable bag which you pre-pack to have ready in case of an urgent evacuation order from government officials. It contains both personal items and official documents.

Pet Documents
Create a document with your name and contact information, your pet’s veterinarian, your pet’s microchip number, and a photo of you and your pet. This photo can be used to create lost pet fliers if your pet gets lost during the emergency. Include your pet’s age, sex, breed and color in this document. Get a printout of your pet’s vaccinations and medications from your veterinarian. Laminate or enclose these documents in a waterproof envelope.

Pet Supplies
Many of the items in your first aid kit can be used to treat an injured pet,
but you will need to carry any medications prescribed for your pet as well as their monthly flea, tick and heartworm preventatives. Both cats and dogs should have an extra leash that attaches to their collar or harness in their go-bag. Cats need a litter box and litter. Plastic bags for waste disposal are key to keeping your temporary shelter clean and tidy. If your car has plenty of room, a collapsible pet crate and a blanket for your pet will come in handy.

Food and Water
Check your local pet emporium for collapsible bowls and water dispensing attachments for bottled water and select some for the go-bag that are light and pack easily. Experts recommend carrying a 3-day food supply in your pet’s go-gag. Easy to do for cat families; less so if you have a Great Dane. But perhaps the Great Dane can carry their own go-bag in a dog saddlebag backpack.

Double Check Data
While you are working on your pet’s go-bag, take the time to make sure their microchip is registered properly with the chip registry and that your veterinarian has the microchip number recorded in their files. Microchips
are responsible for many happy reunions of pets and families. If you need to evacuate, make sure your pet also has a collar with ID tags.

To find more on emergency preparedness, follow these hashtags on Twitter: #NatlPrep #PlanAhead.

Memorializing Your Pet

memorialize a pet

Since antiquity, humans have memorialized animals. Dog and cat graves have been found in Germany, Cyprus, and China dating from nearly 10,000 years ago. Ancient Egyptian tombs contain mummified remains of dogs, cats, and pet birds. The oldest, continuously operating pet cemetery is just north of the Animal Medical Center in Hartsdale, New York and has been in operation since 1896. At AMC, we often make a clay paw (shown here) to memorialize our patients. Sunday, September 10th is National Pet Memorial Day and to help honor pets who have crossed the Rainbow Bridge, I have collected some ideas for you on how to memorialize your favorite fur baby.

Create a Memory
Use the jangling mass of tags from your pet’s collar to form the basis of a memory bracelet. Hunt down animal-shaped charms or ones that remind you of your pet – like a fire hydrant, tennis ball, or the mouse your cat lovingly left for you on the back porch. If you already have a charm bracelet, have a custom charm made incorporating your pet’s photograph.

While nothing can quite fill the hole left in your heart after your pet dies, a Petsie or Cuddle Clone may help fill the hole. Both are custom, plush, stuffed animal look-alike of your pet. Might be fun even if your pet is healthy!

The Other Pet
An interesting study from Australia and New Zealand asked the question, “Do pets grieve?” By surveying pet families using a specially developed questionnaire, the researchers identified behavior changes in the surviving pet after the loss of their animal companion. The questionnaire evaluated ordinary animal behaviors like feeding, sleeping, vocalization, elimination, aggression, affection, and territoriality. The study found both dogs and cats were more affectionate, clingy or needy after the death of the companion animal. Both dogs and cats exhibited territorial behavior and changes in appetite for up to six months after the companion animal died.

Many pet families ask me if they should allow the surviving pet to view the body of the deceased pet. This study could find no difference in the behavior change between pets who viewed the body and those who did not. But, the changes in the behavior of the surviving pet may be interpreted as their way of grieving.

Children and Pet Loss
Children may be particularly close to the family pet, and the death of that pet can be very upsetting. This topic was addressed in a recent New York Times “Well” blog post. Be sure to read the comments as they also have important observations and ideas on how to memorialize a pet. If you are a parent, teacher or just know a child who has recently lost a pet, this one-page handout will be very helpful to you as the loss of a pet may be a child’s first experience with death.

News from the Service Dog World

service dog

September is National Service Dog Month. We have all seen those hard-working service dogs out in our communities. A service dog is one that has been specially trained to help someone with a disability. Service dogs serve various purposes, such the guide dog for those who are blind, or a dog who works for someone with a hearing impairment, or one that alerts a person with diabetes to a falling blood sugar level. Service dogs are critical to the day-to-day functioning of those humans with disabilities who depend on their dog as much as they depend on a wheelchair or cane.

Service Dogs Do More
In a preliminary report of a study from the Organization for Human-Animal Interaction Research at Purdue University, disabled people paired with a service dog had a higher quality of life as well as better emotional, social and work function than those on a list awaiting arrival of their service dog. The benefits of these service dogs extended to the other family members in the home. Those family members worried less about the disabled person’s health because of the dog.

New Job for Service Dogs
Physicians at Duke University are studying the impact of therapy dogs on pediatric cardiology patients. These poor kids have congenital heart abnormalities and need frequent echocardiograms. To get clear and accurate images, children often require sedation. Enter the therapy dog, calming and relaxing the anxious children. The study will investigate the quality of the echocardiogram images with sedation and with the dog to see if the all-round experience is better with a dog or with sedation. My bets are on the dog.

Healthy Service Dogs
A recent publication in the American Journal of Infection Control found many hospitals and other healthcare facilities had no policy covering the health of animals and safety of the humans participating in animal-assisted visits. Particularly concerning was a lack of a rabies vaccination requirement in 7% of facilities studied. If you and your pet are involved in animal assisted interventions, you might check this resource in the Journal of Hospital Infection Control and Epidemiology on minimizing risks associated with animal assisted interventions or talk with your veterinarian about the health of your therapy animal.

The American Veterinary Medical Association has more information on the legal definitions of the various types of assistance animals on their website.

What Gives a Dog a Pain in the Neck?

pet neck pain

Here, you see my cute Yorkie patient, Amort, looking good, but the past week has been anything but a good one for him. He lost his appetite and at first, we thought it was his chronic pancreatitis, but his family figured out he would eat if his food was held up off the floor, making us wonder if his neck was painful.

Neck Problems in Dogs
The neck is a series of small bones connected by ligaments and separated by thin cartilage plates called discs. Aside from some sort of traumatic injury to the neck like a bite wound or sporting injury, neck pain in dogs is most commonly caused by a disc that slips out of position and presses on the spinal cord or one of its branches. Breed plays a big role in canine neck pain. Small breed dogs suffer from two developmental abnormalities of the first two neck bones. The abnormalities, atlanto-axial malformation and cranial occipital malformation syndrome (COMS), can result in severe neck pain. Large breed dogs, like Doberman pinschers and Great Danes have neck pain because of cervical spondomyelopathy also known as “wobbler syndrome.” In addition to neck pain, all four of these conditions can cause an abnormal gait.

Intervertebral Disc Disease (IVDD)
“Slipped discs” are quite common in dogs, especially dachshunds, toy poodles, beagles, Labrador retrievers and Doberman pinschers. At AMC, we care for many French bulldogs with IVDD due to their popularity in our city. The term “slipped disc” is not very accurate. Herniated or ruptured disc is often used, but if you have ever seen a disc in the operating room, the term “exploded” might be more descriptive. The neurosurgeon often has to remove pieces of disc from all around the spinal cord. Some dogs with IVDD can be managed with strict cage rest, which seems to many folks to be preferable to surgery, but I am sure putting your dog in a crate for 4-6 weeks is really hard on the entire family.

Cervical Spondomyelopathy
The term cervical spondmyelopathy is a mouthful. No wonder veterinarians simply call the disorder “wobbler syndrome.” Large and giant breed dogs are prone to developing wobbler syndrome which is characterized by a “wobbly” gait: short and choppy in the front legs with the hind legs held widely apart. In wobbler dogs, two different mechanisms cause the neck pain and gait abnormality. Either the discs between the neck bones press on the spinal cord or the neck bones expand, causing a problem. An MRI is used to diagnose wobbler syndrome, and in some dogs, surgical decompression of the spinal cord is necessary to alleviate the clinical signs.

Atlanto-Axial Malformation
The connection between the first and second neck bones depends on a tenuous little projection of the second neck bone called the dens. In small breed dogs such as the Chihuahua, Yorkshire terrier, Pomeranian and Pekingese, the dens does not always develop normally, creating an unstable connection between the skull and the first two bones of the neck. Severe instability can lead to extreme pain and paralysis from pressure on the spinal cord. Some dogs can recover with strict cage rest and a chin to chest neck brace; other dogs require surgery to stabilize the neck and decrease the pressure on the spinal cord. The AMC’s neurologists use a Kishigami technique to correct this disorder.

Cranial Occipital Malformation Syndrome (COMS)
Similar to atlanto-axial malformation, COMS results from abnormal formation of bone, but in this syndrome, the skull bone is too small to adequately accommodate the brain. This results in an accumulation of spinal fluid which puts pressure on the back of the brain and spinal cord, causing pain. Dogs with this syndrome scratch at their face and ears – thought to be due to neuropathic pain. The poster dog for COMS is the Cavalier King Charles spaniel but King Charles spaniels, Brussels Griffons, Yorkshire terriers, Maltese terriers, Chihuahuas, and a host of others are also prone to the disorder. Not all dogs with the skull malformation show clinical signs. Diagnosis requires an MRI, but breeds known to suffer from COMS may be treated with pain medications and other drugs to decrease fluid accumulation without an MRI.

Tips for Preventing Neck Injuries in Dogs
• Use a harness, not a collar.
• Keep your dog’s weight on the lean side to limit the physical stress on the neck.
• Don’t let your dog jump on or off the furniture.
• Carry your dog up and down the stairs.
• Feed your pet from an elevated bowl.

Those Irritating Hot Spots

hot spot

Hot spots are double irritating. First, they are irritating to your dog because he has an itchy sore on his skin. Second, they are irritating to you because not only do you feel bad for your dog, but you also have to make a trip to your veterinarian’s office because your itchy, scratchy pup has made his skin look like freshly ground meat. If you haven’t seen one before, the photo is a hot spot on the side of a West Highland white terrier’s tail.

Causes of Hot Spots
Scientifically, a hot spot is known as acute moist dermatitis. But this terminology does not give a hint regarding the cause of the hot spot. Most hot spots occur in the summer months because seasonal allergies are the underlying cause of many hot spots. Summertime biting insects, fleas, ticks and flies, can also trigger a hot spot. If your long-haired dog gets matted, a hot spot can form under the mat where moisture collects allowing skin bacteria to proliferate. Whatever triggers the itch-scratch cycle, your dog will start gnawing at the skin, causing inflammation. Once they have chewed the skin raw, bacteria take over and turn the skin into a weepy, red mess.

Treatment of Hot Spots
Last week I saw Hazel, a lovely golden retriever with hot spots on both ankles. As an aside, Golden retrievers and West Highland white terriers are just a few of the dog breeds prone to hot spots. Poor Hazel has just arrived in New York from California and we suspect some allergen here, that was not there, triggered the hot spots. Her ankles and lower legs were swollen, red and oozing. Although her partner, Huey, was trying to help by licking her ankles, he succeeded only in making things worse.

I gently clipped the fur over the inflamed area and then cleaned the skin with an antibacterial solution. Since the hot spot was so large and causing so much swelling, I put her on oral antibiotics and prescribed daily foot and ankle soaks. A week later, she had only a few scabs in the previously inflamed areas. I was surprised at how quickly she recovered, but if she had not recovered well, a short course of steroids might have been needed to take down the last of the inflammation. I tend not to use topical ointment for hot spots since, in my experience, most dogs just want to lick off the ointment. But, some hot spots need topical medications to control the bacterial infection.

Preventing Hot Spots

  • In Hazel’s case, this hotspot may have been an isolated incident as she has never had a problem before and she is nearly ten years old. But if your dog has recurrent hot spots, treatment of allergies using medications that block the itch-scratch cycle or allergy shots can help calm allergies and prevent hot spots.
  • Preventing flea and tick infestation has become so simple these days; there is no excuse for not using a highly effective pill, top spot or collar on your dog. By using one of these products, you eliminate a major cause of hot spots.
  • Finally, keep your dog’s coat brushed, clean and free of mats which could initiate an irritating hot spot.