National Bring Your Cat to the Vet Day

Bring Your Cat to the Vet Day

Even though it is the dog days of summer, Wednesday, August 22nd is National Bring Your Cat to the Vet Day. Only half of American cats see a veterinarian on a routine basis. The lack of medical care means feline health concerns remain unaddressed until the condition is severe and more difficult to treat. #Cat2VetDay is a gentle reminder to cat families that their favorite feline deserves preventive health care just like the family dog.

Barriers to Vet Visits
A survey of cat owners, conducted by the pet food company Royal Canin, identified four common excuses cat families use for skipping cat checkups. The barriers include:

  1. Difficulty getting your cat to the veterinarian – read “My cat hates its carrier.”
  2. Belief in the urban myth that cats need less veterinary care than dogs.
  3. Reluctance to ask for time off work to make a trip to the veterinarian.
  4. Cost of veterinary care.

Overcoming Barrier #1
This is the easiest barrier to overcome. First, leave the carrier out all the time, fill it with a soft, comfy fleece bed and a catnip toy or two, and usually the problem solves itself.


If your cat is really difficult about the carrier, check with your veterinarian about safe, effective and cost-conscious drugs to use when transporting your cat.

Overcoming Barrier #2
The fact that you are reading this post is overcoming the dangerous myth that cats require less health care than dogs. Because sick cats can hide their illness until they are nearly dead, it is easy to see how this myth has been perpetuated. Undoing the myth is a challenge and part of the reason for Bring Your Cat to the Vet Day.

Overcoming Barrier #3
Since over 30% of American households have a feline member, there is a good chance your boss has a cat and will understand if you need to leave early for a veterinary visit. If your boss is not feline-friendly, then look for a cat clinic with evening or weekend hours.

Overcoming Barrier #4
A routine preventive health care visit for your cat is designed to identify problems before they become big expensive ones or require an animal ER visit. To help manage pet health care costs, check with your employer’s human resources office to see if pet health insurance is an option in your benefits package. If not, consider purchasing a policy after reviewing these insurance FAQs answered by AMC’s Usdan Institute for Animal Health Education.

Celebrate #Cat2VetDay by using the steps above as a road map to getting your cat to see their veterinarian annually. Check out these additional resources to help make your cat’s veterinary visits a positive experience for everyone.

Distemper in Pets

canine distemper

This week, the New York City Department of Health and Mental Hygiene issued a veterinary alert about canine distemper virus infections in Central Park raccoons and both Fox 5 News and ABC 7 News visited Animal Medical Center to talk about the story.

An alert from the Health Department about sick raccoons dying from a dog virus may seem a bit outside their normal purview, but the alert is important to dog families and humans alike.

What is Distemper?
Although named canine distemper virus, this virus can affect a wide number of species, hence the sick raccoons in Central Park. Canine distemper occurs worldwide, especially in regions of the world where vaccination is uncommon. Veterinarians in the United States rarely diagnose canine distemper since the vaccine is very effective. In the United States, stray dogs are those most likely to be unvaccinated and ultimately diagnosed with canine distemper.

Recognizing Canine Distemper
Canine distemper virus infection has a wide range of clinical signs. Early in the disease, dogs have runny noses and red eyes, with some vomiting and diarrhea. Severe cases may develop pneumonia. As the disease progresses, dogs and raccoons exhibit neurologic signs like paralysis, twitching, and a wobbly gait. A strange type of seizure called a “chewing gum” fit is common. Some dogs appear to recover from distemper only to develop neurologic signs months to years later. This syndrome is called old dog encephalitis.

Why Are Officials Concerned?
Because distemper has a wide range of clinical signs, this disease can resemble other important infections, most notably rabies. The rabies virus circulates in NYC in cats, raccoons, and this week in a fox.

Both rabies and canine distemper can cause neurologic signs, making it difficult to differentiate the two diseases without specialized testing. New York City has recently experienced a dog flu outbreak.

To further complicate the picture, early distemper may resemble canine influenza and also “kennel cough.”

Protecting Your Dog
Veterinarians consider distemper vaccine a “core” vaccine. Core vaccines are those veterinarians recommend for every dog. Current best practice for distemper vaccination is a series of puppy shots, a booster around one year of age, and then triennial boosters. Check with your veterinarian to confirm your dog is up to date on his distemper vaccine. Distemper virus is transmitted via bodily fluids from an infected animal. If you are walking your dog, avoid contact with raccoons and consider keeping your dog on-leash to prevent him from coming in contact with urine or feces from an infected raccoon or the remains of a deceased raccoon.

Diet-Related Canine Heart Disease

dog diets

Last week, the United States Food and Drug Administration (FDA) announced an investigation into diet-related heart disease in dogs.

I suspect most dog families would be surprised to learn diet may play a role in the development of heart disease in their favorite fur baby. Here is a summary of the FDA announcement.

Heart Disease in Dogs
Veterinarians diagnose three main types of heart disease in dogs. The most common is degeneration of the valves between the chambers of the heart, leading to congestive heart failure. The least common form is congenital heart abnormalities. This form of heart disease might be considered a birth defect. The third form of canine heart disease is an abnormality of the heart muscle called dilated cardiomyopathy (DCM).

Dilated Cardiomyopathy
Canine DCM is a disease of a dog’s heart muscle and results in an enlarged heart that can easily be seen with a chest x-ray. The enlargement is due to thinning of the heart muscle, making the pumping action of the heart ineffective. The heart valves become leaky, leading to a buildup of fluids in the chest and abdomen. Like heart valve disease, DCM often results in congestive heart failure. Breeds that are typically more frequently affected by DCM include large and giant breed dogs, such as Great Danes, Boxers, Newfoundlands, Irish Wolfhounds, Saint Bernards, and Doberman Pinschers. There are also two small breed dogs prone to DCM, American and English Cocker Spaniels. The underlying cause of DCM is not truly known, but is thought to have a genetic component because of the strong breed associations. If caught early, heart function may improve in some cases that are not linked to genetics.

This Type is Different
The FDA initiated the investigation last week because the dogs recently identified with DCM are breeds not appearing on the list above. The cases that have been reported to the FDA have included Golden and Labrador Retrievers, Whippets, a Shih Tzu, a Bulldog, and Miniature Schnauzers, as well as mixed breed dogs. The other common finding in the recently diagnosed dogs is their diet. When the families of the dogs recently diagnosed with DCM were interviewed, they reported their dog’s diet contained potatoes or multiple legumes such as peas, lentils, other “pulses” (seeds of legumes), and their protein, starch and fiber derivatives early in the ingredient list, indicating that they are main ingredients. Early reports from the veterinary cardiology community indicate that the dogs consistently ate these foods as their primary source of nutrition for time periods ranging from months to years. High levels of legumes or potatoes appear to be more common in diets labeled as “grain-free,” but it is not yet known how these ingredients are linked to cases of DCM.

If You Are Worried About Your Dog or Your Dog’s Diet
Check with your dog’s veterinarian before changing his diet. The FDA encourages pet owners and veterinary professionals to report cases of DCM in dogs suspected of having a link to diet by using the electronic Safety Reporting Portal or calling their state’s FDA Consumer Complaint Coordinators. Please see “How to Report a Pet Food Complaint” for additional instructions.

Immune Mediated Thrombocytopenia

immune mediated thrombocytopenia

I recently wrote about the concept of immune disease – those disorders where the immune system goes haywire and attacks normal cells in the body. In a more recent blog, I wrote about one of the important canine immune diseases, immune mediated hemolytic anemia (IMHA). Today’s blog post focuses on a disease similar to IMHA, immune mediated thrombocytopenia (ITP or IMTP).

Defining ITP
The cell targeted by the out of control immune system in ITP is the platelet or blood clotting cell. The platelet is a powerhouse of coagulation. Under the microscope, a platelet is the smallest of the blood cells, yet the sticky platelet provides the first level of defense against hemorrhage. Platelets are in a large part responsible for the formation of a scab when you cut your skin while chopping vegetables or scrape your knee in a bike accident. Dogs, and the rare cat, with ITP can’t form a blood clot if nicked by the groomer because the immune system has destroyed their platelets. The lack of platelets can also result in spontaneous hemorrhage.

Recognizing ITP
You, as the healthcare advocate for your pet, may be the first one to recognize clinical signs of ITP. The hallmark of a low platelet count is little pinpoint hemorrhages on the skin, in the mouth or on the whites of the eyes. Hemorrhage may occur internally making the stool dark like tar or the urine bloody. One of my patients with ITP recently relapsed and came to the ER with a bloody nose. But, not every pet with a low platelet count or bleeding has ITP.

Causes of ITP
There are many other causes of low platelets that must be investigated before a diagnosis of ITP is made. Infectious disease tops the list of potential diagnoses for low platelets. Diseases transmitted by ticks top the list. Ehrlichiosis, Rocky Mountain spotted fever and Anaplasmosis may resemble ITP, but some readily available laboratory testing can quickly identify these diseases. Cancer, especially lymphoma or hemangiosarcoma can cause low platelet counts. Occasionally a reaction to a drug like an antibiotic can cause ITP. When a veterinarian cannot find an underlying cause of a low platelet count and a diagnostic evaluation is unremarkable, by the process of elimination, the diagnosis is ITP.

Treatment of ITP
Even though the blood cell affected in ITP is different than in IMHA, the treatment is similar since the overactive immune system needs to be suppressed to prevent more platelets from being destroyed. The first line therapy involves the use of drugs like prednisone to suppress the immune system. A chemotherapy drug, vincristine, when administered to dogs with ITP increases platelet release from the bone marrow and helps normalize their platelet count faster and shortens hospital stay. Dogs are often hospitalized for several days in case hemorrhage is severe enough to warrant blood transfusion. Most dogs recover from ITP, but some require additional drugs to suppress the immune system long term.

Other diseases affecting the immune system include polyarthritis and a variety of immune mediated skin diseases which will be the topic of a future blog post.

Heatstroke

heatstroke

It’s that time of year when the Animal Medical Center’s ER prepares to see dogs and cats with heatstroke. Heatstroke occurs when the ambient temperature overwhelms the body’s cooling mechanisms. Both heat and humidity contribute to the development of heatstroke. When humidity is high, pets cannot cool themselves by panting, a form of evaporative cooling. When the air is full of water, evaporation from panting occurs slowly and cannot keep the body temperature in a safe range.

Too Hot
The normal body temperature of dogs and cats is 100-102°F. AMC’s ER does not become concerned when a fever is as high as 104 or 105°F. Heatstroke is a body temperature 106-108°F. When the body gets that hot, multiple organs begin to fail.

Hot Pets
While heatstroke can happen to any pet, certain dogs are at greater risk. Snub-nosed dogs are unable to use evaporative cooling via panting as well as dogs with longer noses, and thus are a greater risk of developing heatstroke. Dark-coated dogs, golden retrievers, Labrador retrievers, overweight dogs, and those not acclimated to the heat are also at increased risk.

Heatstroke Symptoms
Hot skin, vomiting, panting, distress collapse, incoordination, and loss of consciousness are all indicators of heatstroke. If your pet is developing heatstroke, you will notice nonstop panting, hot, red skin and weakness. This may progress to incoordination, collapse and loss of consciousness. At the first hint of heatstroke, head to your local animal ER.

Head to the Animal ER
If you suspect heatstroke, go immediately to the closest animal ER, do not delay. Experts say trying to cool your pet off on your own wastes valuable time. But, if on your way out the door you can grab ice packs or frozen food from your freezer, put the frozen food on your pet in the car on the way to the ER.

Heat Injury
The extent of illness may not be apparent upon arrival in the ER. Heatstroke is a multi-organ system disorder. Pets experience circulatory shock from fluid loss from panting. Heat damages normal tissues like the brain and other vital organs. Damaged brain neurons cannot be replaced and may result in cognitive decline following an episode of heatstroke. Abnormalities in blood clotting and kidney function may not become apparent until hours after arrival in the ER.

Tips to Prevent Heatstroke
Preventing heatstroke is critical since data indicates half of pets suffering from heatstroke don’t recover.

1. Don’t exercise in heat of the day, only early or late. Heatstroke occurs most often in the afternoon.
2. Don’t leave pet in a hot car, even with the windows cracked. In one study, a hot car was the number one cause of heatstroke.
3. Provide access to cold water. Consider choosing a water bowl designed to keep water cool or add ice cubes to the bowl.
4. Provide shade with an umbrella or a covered kennel.
5. Try out a cooling jacket or mat.

Click for more suggestions on keeping your dog cool during the hot summer months.

Explaining the FVRCP in Feline Vaccines

cat vaccine

June is Adopt a [Shelter] Cat Month and every blog post in June will focus on some aspect of our furry feline friends. Today’s topic is one of the “core” feline vaccinations, FVRCP.

Vaccines for cats are categorized as core and non-core. Core means veterinary infectious disease and public health experts recommend all cats receive vaccines considered core. Rabies vaccine is considered a core vaccine for both dogs and cats. The other core vaccine for cats is FVRCP or feline viral rhinotracheitis, calici virus, and panleukopenia. The rhinotracheitis virus and calicivirus are the top two causes of feline upper respiratory infections. The panleukopenia virus causes a severe viral diarrhea.

Basis for the Core Designation
One of the reasons FVRCP is considered a core vaccine for cats is there are no specific treatments for feline viral rhinotracheitis, calcivirus or panleukopenia virus. The diseases must run their course and veterinarians can only treat symptoms: fluids for dehydration, antibiotics for secondary bacterial infections, eye ointments for corneal ulcers. It’s better to prevent these diseases with vaccination than to have your cat suffer from one of these debilitating viral infections. Should you fall in love with a shelter cat suffering from an upper respiratory infection due to rhinotracheitis virus and calicivirus, the cat is likely to make a full recovery and become a lovable member of the family.

The FVR
Feline viral rhinotracheitis is caused by a herpes virus. Similar to herpes virus infections in humans, once a cat is infected with a herpes virus, the virus will lay dormant until a cat is stressed and then clinical signs can flare up. Clinical signs of rhinotracheitis include lethargy, sneezing, conjunctivitis, and ocular and nasal discharge. Severe cases can have corneal ulcers and pneumonia. Young kittens are often the most severely affected.

The C
Feline calicivirus causes clinical signs similar to rhinotracheitis, but much milder. Cats with an upper respiratory infection due to calicivirus are likely to develop oral ulcers, especially of the tongue. Some cats develop joint inflammation leading to lameness but the lameness lasts only 1-2 days. Occasionally, a more virulent strain of calicivirus circulates in feline populations resulting in severe systemic disease.

The P
Panleukopenia is the medical way to say “a very low white blood cell count.” Closely related to the better known canine parvovirus, the feline panleukopenia virus infects the rapidly dividing cells of the bone marrow and intestinal tract. The impact on the bone marrow is a low white blood cell count which leaves panleukopenia virus-infected cats open to severe infection. Infection of the gut cells leads to severe diarrhea. Once a cat is infected with the panleukopenia virus, successfully treating this disease becomes very difficult. Fortunately, vaccination works well to prevent panleukopenia.

As part of your family’s celebration of June’s Adopt a [Shelter] Cat Month, check with your cat’s veterinarian about the need for FVRCP vaccination for your cat, the best type of vaccine and the schedule of administration.

Canine Influenza Q&A 2018

dog flu

Recently the Gothamist, an online New York City-centric news site, reported on a canine influenza outbreak centered in the borough of Brooklyn; although veterinarians expect the outbreak to expand to other boroughs. Compared to diseases like rabies and distemper, canine influenza is a relatively new disease, first described in 2005. Because many dogs have never been exposed to canine influenza, they have no immunity and the disease can spread like wildfire through entire neighborhoods. Drawing on prior blog posts, I will answer common questions about canine influenza.

What causes canine influenza?
Canine influenza is a viral disease, and two different strains of canine flu virus have been described – the original H3N8 and H3N2, first described in 2015.

What are the symptoms of canine influenza?
Canine influenza causes an upper respiratory illness with runny eyes, sneezing, and a runny nose. Most dogs with the flu have a cough. If the flu causes a fever, dogs typically are not very energetic. Occasionally, dog flu progresses to pneumonia which can be life-threatening. This list of clinical signs is not specific for canine influenza and could be due to a bacterial infection or allergies.

How do dogs get the flu?
Dog flu spreads when the virus is coughed or sneezed into the environment or onto an uninfected dog. Keeping your dog away from other dogs will help to protect them against contracting canine influenza. Humans can transport the virus on their hands or clothing. The virus is wily because dogs can transmit the virus before showing clinical signs and continue to shed the virus after clinical signs have resolved. This means a dog that looks healthy could give the flu to your dog.

Can dogs get flu shots?
Humans get flu shots in the fall because influenza in humans is seasonal. Since I am writing about canine influenza in May, you have probably guessed canine influenza is not seasonal and can occur any time of the year. The canine influenza virus does not change annually like the human flu virus and vaccines against both H3N8 and H3N2 are available from veterinarians year round.

All of us at the Animal Medical Center wish the flu-stricken dogs in Brooklyn a speedy recovery and hope all healthy dogs stay that way!

Is Your Pet’s Water Bowl Half Empty? Disorders of Water Drinking

cat drinking water

A common reason pet families bring their pets to the veterinarians at the Animal Medical Center is an increase in water consumption, or polydipsia in doctor speak. If the pet family doesn’t mention water consumption, the veterinarian will usually ask about any changes in water drinking habits. In today’s post, I outline some of the more common causes of increased water drinking. While an increase in water consumption may signal a serious medical condition, sometimes the increase is a normal physiologic condition.

Too Much In Or Too Much Out?
Increased drinking can occur because of excessive loss of fluid in the urine or because of a condition that increases the stimulus to drink water. The former is much more common and, from a veterinary perspective, much easier to diagnose than the latter.

Drugs
A number of drugs frequently prescribed for dogs and cats increases water intake. They include: prednisone (or any steroid), phenobarbital and Lasix® (furosemide), which is a diuretic. Obviously, Lasix® increases urine output, causing your pet to drink more water. Similarly, steroids impact the kidney’s ability to conserve water resulting in increased thirst. Why phenobarbital, an antiseizure medication causes polydipsia is unknown.

Hot Dogs, Cool Cats
On a hot day, your dog pants to cool off. Panting evaporates saliva from the mouth, but leaves your dog very thirsty to replenish the body’s water supply. Fever will do the same thing. Your dog or cat loses body fluids through panting or their sweaty little paws and they will drink more to compensate.

Food
Increased water intake frequently happens with a diet change for your pet. Canned food is approximately 75-80% water. Switching from a canned diet to a dry diet will cause a noticeable increase in water drinking. Swap your pet’s canned food for dry and your dog or cat will need to replace the water previously consumed in food by drinking more. Switch from dry food to canned food and you will notice you need to fill the water bowl less often.

A prescription diet to dissolve bladder stones works in part because it has been formulated to promote water consumption. Increasing urine production lowers the concentration of stone-forming minerals in the urine and dissolves the bladder stones. The stone-dissolving diet contains low concentrations of minerals found in bladder stones and must be used under the guidance of a veterinarian and with proper patient monitoring.

Pyometra
In unspayed female dogs, pyometra, or a severe uterine infection, causes increased loss of fluid through the kidney and a compensatory increase in water consumption. The bacterium associated with pyometra is E. coli. This bacterium produces a toxin that impairs the kidney’s ability to regulate water and increases urine output. Female dogs with pyometra often come to the veterinary clinic because the family notices an increase in water intake in response to the increased urine output.

Other well-known diseases associated with increased water intake include: Cushing’s diseasediabeteskidney disease, and feline hyperthyroidism.

If you think your pet is drinking more water than normal, see your veterinarian as soon as possible and take along a urine sample from your pet. Your vet will thank you.

Doc, My Dog Has a Rash

itchy dog

Last month, Nationwide Pet Insurance announced the top pet insurance claims for the 650,000 pets they insure. The top four are skin issues. Number one and four are both skin diseases. Allergic dermatitis and pyoderma (skin infection) result in a skin rash which is the topic of this blog post.

Atopic or Allergic Dermatitis
Allergies are common in dogs and can be seasonal or non-seasonal. About this time of year, dogs with seasonal allergies start scratching and itching because pollen, mold or some beautiful spring plant is the source of their allergies. If your dog scratches year round, then the allergen might be dust, wool, feathers, or even the family cat! The itch-scratch cycle makes the skin red and inflamed. The itch-scratch cycle also sets off a cascade of events that can lead to infections in the hair follicle. Hot spots are a localized inflammation of the skin stemming from allergies. A severe hot spot can become infected with bacteria or yeast.

Bacterial Infection
A bacterial infection in the hair follicles is called pyoderma and was the number four most common insurance claim paid by Nationwide in 2017. If your dog has pyoderma, you will see a red, bumpy rash Pyoderma occurs most commonly as a result of allergies. Puppy pyoderma can be found on the tummy of puppies, likely because their immune system is not quite grown up yet. Flea bites, mange, clipper burn, and hair mats can also incite a skin infection. Licking and scratching a skin infection can make it much worse and is why veterinarians often recommend the dreaded cone in patients with skin infections.

Yeast Infection
Fungal or yeast skin infections are another allergy-induced skin problem. Certain breeds, like the West Highland white terrier, are predisposed to yeast skin infections, but any dog can get one. Face folds or skin folds in general hold moisture promoting the overgrowth of yeast which can be very itchy.

Ears Are Really Just Skin
The ear flaps are actually skin folded over on itself. Number two on the list of insurance claims is ear infections. Like skin infections, ear infections are tied to allergies. Follow your veterinarian’s instructions on managing the allergies and the ear infections will abate. Occasionally we see ear mites causing infections in dogs, but bacteria and yeast are much more common organisms causing an infection.

While clearly allergies are the most common cause of skin rashes, keep in mind systemic diseases such as Cushing’s disease and hypothyroidism may trigger a rash.

Everyday Medicine: Physical Examination

physical exam

“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 “Cytology” and “PCV.” Today’s post focuses on the physical examination.

A physical examination is the foundation of your pet’s medical care. Abnormalities of the eyes, ears, skin, and mouth are easily visualized during an examination. A physical examination identifies any deviations from normal, such as pale gums or weight loss which require further testing, like blood counts or x-rays. If the examination is normal, your veterinarian will recommend preventive care like a heartworm test, fecal analysis or vaccinations.

Head
When I examine a patient, I try to follow a set order. I usually start at the head, open the mouth, look at the teeth and under the tongue. Then I use a special light and lens to look inside the cat or dog’s eyes. The same light has an adapter which allows me to look inside the ears.

Chest or Thorax
Examination of the thorax involves using a stethoscope. During examination of the thorax, I count the heart rate and respirations. I listen to the heart in several different places to identify heart murmurs. Then, I feel the pulse on a hind leg and listen to the heart at the same time to confirm the pulses match the heartbeat. Each heartbeat should generate one pulse. Next, I move my stethoscope around on both sides of the chest to listen to the sounds made by the lungs.

Abdomen
Depending on the size of the patient, I can feel the kidneys, intestines, liver, spleen, and bladder. In really big dogs or really obese patients, I can’t feel too much. (Another good reason to keep your pet trim is that they get a better physical examination!). In vomiting pets, we might be able to feel a stuck toy or a tumor of one of the abdominal organs. In dogs, I typically do a rectal examination. Cats are not big fans of this procedure and only in select cases will I do a rectal examination on a cat. Sometimes this procedure requires sedation. A rectal examination is critical in cases of diarrhea, constipation or when a pet is excessively licking at their rear end. If necessary, I can also obtain a fecal sample or express the anal glands during a rectal examination.

Skin
While I am working my way from nose to toes, I look at the skin, feel for lumps and also run my hands down the legs feeling for any swellings or lumps. Being an oncologist by training, I can’t resist checking the lymph nodes under the chin, in front of the shoulders, in the armpits, and behind the knees.

Exam Room Testing
In the exam room, I perform some small tests like measuring a pet’s temperature and body weight. I will also look at the pet and determine the cat or dog’s
body condition score which is a veterinarian’s version of a BMI. I might also sample the ears or skin and look at it under the microscope to determine the cause of an infection.

Once the examination is completed, all the information collected is recorded in your pet’s medical record for comparison to last year’s findings and next year’s findings. Monitoring trends in a pet’s status helps veterinarians recognize subtle but important changes so we can keep your pet in tip-top health.