Medical Machines: Infusion Pumps

Fluid Pumps

“Medical Machines” is a new series of blog posts highlighting the equipment AMC veterinarians use to provide state-of-the-art care to thousands of pets annually. These machines save lives, but pet families rarely ever have the opportunity to see them up close and personal. This series will give readers a glimpse into the equipment AMC veterinarians rely on every day.

The machine for today is an infusion pump, sometimes called a fluid pump.

Not Just for Fluid
Infusion pumps, fluid pumps, and IV pumps are commonly used terms to describe a device which delivers a precise volume of liquid over an exact period of time. The pump can be used to administer a wide variety of liquids including intravenous fluids, antibiotics, or pain medications. Pumps are also used to deliver liquid feeding solutions into the stomach or intestine and for blood transfusions. Pumps free the nursing staff from monitoring fluid delivery rates for more important duties. If the infusion rate varies from the setting, the pump beeps to alert the nursing staff of a problem.

How They Work
AMC has two types of pumps: peristaltic and syringe pumps. In the peristaltic pump, the tubing for the fluid fits between rollers which compress the tubing as they roll. This rolling action forces the liquid through the tubing. Peristaltic pumps are commonly used for IV fluids. AMC also uses syringe pumps. A syringe loaded with medication is placed in a slot on the pump and a motorized screw turns to push the syringe plunger at a controlled rate to deliver the fluid. Syringe pumps are commonly used for very small patients or for very small volume infusions. Above, you can see a puppy receiving a blood transfusion via syringe pump.

A Machine of Major Importance
Infusion pumps don’t really impress like a CT scanner or linear accelerator.
But what pumps lack in size, they compensate for in sheer numbers. Our best estimate is that AMC has over 200 peristaltic pumps and at least 50 syringe pumps. Our ICU has enough peristaltic pumps for each patient to have two at all times, plus some extras. Our animal ER has about 10 peristaltic pumps which they use to deliver fluids at a very high rate in patients with shock.

In researching infusion pumps for this blog post, one of our senior nurses who remembers a time before infusion pumps remarked, “Infusion pumps revolutionized patient care at AMC. We no longer had to stand by each patient’s IV line counting the number of drips per minute; we simply set the pump to the correct rate and were then free to take care of the patients, not the fluid infusion.”

Infusion pumps are one of AMC’s most valuable medical machines.

Cleaning Up Eye Goop

dog eyes

Last week I took calls from pet families on SiriusXM “Doctor Radio,” which is broadcast from NYU Langone Medical Center. Although I answered numerous calls during the one hour show, one question stood out in my mind for its pure practicality: “What products are safe for me to use around my pet’s eyes?”

Dirty Eyes
Pet families have many reasons to want to clean their pet’s eyes. The first might be a bit of debris, twig, or other foreign object that has found its way into your pet’s eye causing discomfort and possibly an injury. During allergy season, itchy eyes cause pets to rub their face with their paws or on furniture. The resulting ocular discharge adheres to the fur around the eyes and can even lead to dermatitis in that area. Some dogs develop tear staining around their eyes when bacteria reproduce in the moist fur. The brown staining is unsightly but not a health concern.

Flushing the Eye
To remove debris, a twig, or other foreign object that has found its way into your pet’s eye, sterile saline used by contact lens wearers is easily obtained and safe for pet eyes. In fact, you should keep an unopened bottle in your pet first aid kit for use in an emergency.

Cleaning the Fur
When ocular discharge adheres to the periocular fur, warm water and a washcloth or gauze pads can be used to moisten and wipe away the discharge. If more than warm water is required to clean the area, one drop of no-more-tears baby shampoo in a cup of warm water makes an eye-safe cleaning solution. This solution can also be used to remove the bacteria causing brown tear staining, which is especially noticeable on white dogs. Daily washing around the eyes also decreases pollen on the face, a major cause of allergic conjunctivitis. For those on the go with their pet, little packets containing individual eyelid wipes can be found in the eye section of the drug store, and work well in pets.

Have more questions about eyes? Read about common eye conditions, your dog and cat’s third eyelid, and dry eye.

Coping with the Grief of Pet Loss

pet loss

Recently, one of my friend’s dogs developed cancer. Although I am not her veterinarian, she and I had a long talk about the grim prognosis and the treatment options. A few weeks later, after her beloved dog had crossed the Rainbow Bridge, I overheard a mutual friend, who is not a pet person, saying something like, “You have to stop thinking about her; you can always get another dog.”

Changing Attitudes Toward Pet Loss
The comment above was crushing to my friend and would be to any pet lover who has recently lost a pet. Sadly, comments like this one are not uncommon coming from someone lacking personal experience in the grief associated with the loss of a beloved pet. A recent Scientific American article highlighted the intensity of the loss experienced by pet families. Not only has the family lost a companion, but their daily routine changes, social interactions decrease, leaving them rudderless. The typical social norms applied when a parent or other human family member dies do not always apply to a pet’s death. Because you cannot always depend on your friends for comfort after the death of a pet, here are some suggestions to cope with your grief.

Find a Pet Loss Support Group
For some bereaved pet owners, their family can serve as their pet loss support group. For those without family support, I Googled “pet loss support group” and found a myriad of different services. Some groups, like the one at AMC, meet in person. Other pet loss services are virtual. There are also individual counseling sessions available. For those who are inconsolable after the death of their pet, a number of pet loss hotlines are open to provide an immediate resource. Here is a list of pet loss hotlines and their telephone numbers.

Read Books
A quick search of Amazon.com found several books which might be helpful in the period after a pet’s death. The authors Mary and Herb Montgomery have written several books on pet loss. A Special Place for Charlee: A Child’s Companion Through Pet Loss helps parents guide their child through the grief process. One interesting book is A 30 Day Guide to Healing from the Loss of Your Pet by Gael Ross. This book is part workbook, part journal and was written to facilitate the healing process after the death of a beloved pet. These are by no means the only books on pet loss and you will know when you find the book that speaks to you.

Make a Memory
While your pet was alive, you made thousands of memories. Make a scrapbook, a Facebook video, or a photo collage featuring your pet. Read a couple previous blogs for other ideas to honor or memorialize your pet. Remember it is ok to feel sad and recognize that some days will be better than others.

The Animal Medical Center’s Usdan Institute for Animal Health Education is helping those who have recently lost pets remember them and celebrate the lives they’ve lived on Thursday, September 13, 2018. Register today!

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.

Making the Most of Your Pet’s Microchip

microchip

The annual Check the Chip Day is Wednesday, August 15th. This pet health event reminds pet families to have the microchip in their pet checked by the staff in their veterinarian’s office to be sure it is working, as well as to update any information in the microchip database which links your pet’s microchip number to your contact information.

Microchip Basics
A microchip provides a permanent method of identifying your pet; it is not a GPS device. A microchip is about the size of a grain of rice. A veterinarian implants the chip under the skin over the shoulders. The microchip has no battery or moving parts, but emits a unique radiofrequency code and is designed to last for up to 20 years. Animal shelters and veterinary offices have microchip scanners to “read” the chip. Watch Nugget get his microchip scanned below. A microchip is typically a prerequisite for international pet travel.

And Also a Collar and Tag
A microchip is essential because many pets are not wearing a collar when they are separated from their family. But a collar with an ID tag displaying your phone number will get your pet home faster since anyone can read an ID tag, but only some have access to a microchip scanner. You might also consider putting your pet’s microchip number on their collar, but some folks choose to keep that information private.

The Power of a Chip
One of my patients escaped out the window when a workman inadvertently left the window open after doing repairs. Despite canvassing their neighborhood and following other suggestions for finding a lost pet, Sneezy was nowhere to be found. The little guy was MIA for two months until someone in the neighborhood noticed a scrawny, but very friendly cat they had not seen before. The kind neighbors scooped him up and delivered him to the local shelter. It took all of about ten minutes for the shelter staff to scan Sneezy, find his microchip and contact his jubilant family.

To make your lost pet story have a happy ending like Sneezy’s, be sure your pet’s microchip registration is up to date. If you only know the chip number, look up the company online. Also check the information on your pet’s ID tags and replace them if the information is out of date. If you want to keep your pet’s microchip information handy, download and print out this postcard from AMC’s Usdan Institute and keep it with his/her records.

Suffocation Risks for Pets

pet suffocation

Last week I noticed a recall on a pet water dispenser from the popular furniture and home accessories giant IKEA. Although I can’t quite wrap my head around how two pets could get their head caught in a water dispenser and die, IKEA is doing the right thing by recalling the product and refunding the cost of the water dispenser to prevent more tragic deaths.

Most pet owners would think suffocation is an uncommon cause of pet death, but Prevent Pet Suffocation and The Preventive Vet would argue otherwise.

Dangerous Bags
The bags supplied with snack food, pet food and treats, and breakfast cereal pose a serious risk to your pet. Even your average zipper bag can be lethal if your pet’s head becomes trapped in a bag which is impervious to air. As your pet tries to get the last chip crumb from the taco chip bag, every breath forms a tightening seal around your pet’s head, preventing her from getting oxygen. It takes only a few minutes for hypoxia and suffocation to occur.

Any Pet is At Risk
The IKEA recall warns about a danger to small dogs and cats, and the memorials to pets lost to bag suffocation show no boundaries. Most of the tributes are photographs of dogs, but all types and sizes: dogs with flat and pointy noses, big and little dogs. There are even a few cats who have succumbed to this preventable death.

Protecting Your Pet Against Suffocation

  • Don’t leave bagged food on the counter or anywhere your pet might get access to a bag
  • When disposing of empty chip, cereal, and zipper bags, cut off the closed end to open the bag and allow airflow if your pet finds the bag in the trash
  • Consider transferring food to plastic containers rather than storing them in bags
  • Be extra vigilant when you and your pet visit friends who might have bagged food unsafely stored
  • Use trash cans with locking lids
  • Alert your guests to the risk of bagged food or empty food bags
  • Sign up for pet product recalls and follow the manufacturer’s recommendations if you own a product that is recalled. A couple of suggestions are @AVMARecallWatch on Twitter and PetMD Recalls.

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.

Fun Feline Facts

cats playing

For my final blog post of Adopt A [Shelter] Cat Month, I am going to be less medical and more fun. To that end, I am going to share with you my latest collection of fun feline facts.

Purring Pussycats
One of the most endearing qualities of cats is their ability to purr. In my mind, there is nothing better than a cat on my lap, snuggled in and purring away. Everyone can recognize purring, but I suspect few can define it. In Mammal Review, purring is defined as a continuous sound produced on alternating (pulmonic) egressive (breathing out) and ingressive (breathing in) airstream. Purring results from neural oscillation – neurons which turn on and off rapidly causing rhythmic contraction of the laryngeal muscles 20-30 times per second. Based on the above definition of purring, not all felines can purr. Those that do not purr are those that roar: the lion, tiger, jaguar, and leopard. All other felidae can purr.

Are Right-Handed Cats Nicer?
This is really two fun facts rolled into one. First, did you even consider your cat could be right or left handed? Probably not. But in a recent study in the International Journal of Neuroscience, female cats exhibited right handedness more than males when tested with a food reaching test. About 10% of all cats were ambidextrous. Although an ambidextrous cat might sound intriguing, a behavioral study found ambidextrous cats less affectionate and more aggressive than righty or lefty cats. Strongly right or left-pawed cats were determined to be more confident and affectionate than those with weaker paw preference.

Are Cats or Dogs Smarter?
The answer to this question is open to a great deal of bias depending on your affinity for felines or canines. Scientists have tried to answer this question with data rather than their heart. In a study published in Frontiers in Neuroanatomy, researchers found dogs possess about 530 million neurons in the cortex, while cats have about 250 million. Neurons in the brain often go unused, so just having more neurons does not necessarily make dogs smarter. In fact, when you think about cats, they are phenomenal hunters and can easily out hunt humans with their neuron-loaded brains. So the number of neurons in the cat brain is not necessarily related to intelligence; the answer may lie in the function of each of those neurons. This quote from Dr. Brian Hare at the Duke University Canine Cognition Center answers the question thoughtfully. “Asking which species is smarter is like asking if a hammer is a better tool than a screwdriver. Each tool is designed for a specific problem, so of course it depends on the problem we are trying to solve.”

Are you coming late to Adopt A [Shelter] Cat Month? Did you miss the first three feline-focused blog posts? Catch up here:

  • Lifestyle Factors Related to Feline Obesity
  • Explaining the FVRCP in Feline Vaccines
  • Alternatives to Catnip

Catnip and its Alternatives

catnip

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 catnip and other plants cat families can use to enrich their cat’s home environment.

Catnip
Those of us who have had more than a few cats in their lifetime know not all cats react to the herb Nepeta cataria, colloquially known as catnip. Passion for catnip depends on a cat’s age and genes. Kittens less than about 8 weeks of age do not respond to catnip. In the population of cats at large, 25% of cats are not genetically programmed to respond to neptalactone, the substance in catnip that induces a kitty high – rolling, rubbing, sniffing, and chewing. Since not all cats enjoy a catnip high, a recent article in BMC Veterinary Research provides some suggestions of other plants which your cat may safely enjoy.

Silver Vine (Actinidia polygama)
This plant, also known as cat plant, is native to China and Japan. The plant can grow to a height of six feet and has pretty white flowers. Nearly 80% of cats responded positively to sliver vine. I found several products on pet websites containing silver vine, including sticks and dried leaves. In case you have a green thumb, you can also purchase seed packets to be used in a do-it-yourself cat garden.

Tatarian Honeysuckle (Lonicera tatarica)
You might find this Siberian import in your yard or nearby woods as it is considered a noxious and invasive species. Tatarian honeysuckle is a bush with pretty pink flowers found in hardy to Zone 3 areas. Some feline-centric websites offer honeysuckle sticks for your cat. Fifty percent of cats appear to enjoy the olfactory stimulation provided by honeysuckle.

Valerian (Valeriana officinalis)
Valerian-based products can easily be found in health food stores because the plant has a long history as an herbal therapy for promoting sleep. About half of cats given valerian root have a positive response. Directions on how to grow Valerian in your garden and prepare the roots for your cat can be found here. Both you and your cat will enjoy this plant since the flowers are dramatic balls of white flowers which will be lovely in a vase on your table.

Catnip, silver vine, Tatarian honeysuckle and valerian all provide safe olfactory entertainment for your cat, but not every houseplant or flower is feline-friendly. Check this list of plants toxic to cats and avoid having them in your home.

Lifestyle Factors Related to Feline Obesity

Buster Brown

June is Adopt-A-Cat Month and every blog post in June will focus on some aspect of our furry feline friends. Today’s topic is obesity.

I saw one of my favorite patients the other day. Okay, I admit, all my patients are my favorite. Buster Brown is a mink-coated Tonkinese cat, just a bit over one year of age. Because he is young and healthy, I haven’t seen him since before he was neutered and was a bit shocked when I put him on the scale. He had gained three pounds during the five months since I had last seen him. When his family saw the numbers on the scale, they asked, “How did this happen?” Below, I have outlined a few of the contributing factors to feline obesity that cat families can use to keep their furry friend at an ideal body condition.

But My Cat is Big-Boned
You are right, the significance of weight gain depends somewhat on the size of your cat. A slinky Siamese can gain less weight and still have a good body condition than the king of cats, the Maine Coon, but adding three pounds is probably too much for just about any cat. When I assessed Buster B’s body condition score, a scale which looks at a cat’s distribution of fat in various parts of the body, he scored 8/9, which is considered obese for a cat of his size.

Fixing Him, Even Though He’s Not Broken
Although Buster B is extremely handsome, he is a pet and was not going to make babies. Thus, he was neutered before he had a chance to start spraying urine on the furniture or drapes. Male cats that have not been “fixed” have very stinky urine and for that reason, pet cats are typically neutered. Neutering is a known risk factor for obesity in cats and portion control is a good practice after neutering. Decreasing a cat’s food intake by approximately one-third after neutering surgery is a good rule of thumb to prevent unwanted weight gain.

He Likes Crunchies and I Hate Those Smelly Cans in the Fridge
I am with you on this point. Cats like what they like and I find those little cans of congealed salmon and tuna pate revolting sitting next to my kale and organic chicken breasts. But, a diet of more than 50% dry food has been shown to be associated with obesity. If you feed your cat dry food fed free choice, without regard for portion control, your kitty can pack on the pounds. Ditto for treats; limit how many your cat consumes per day since snacking predisposes cats to obesity.

Kitty Gymnasium
In a recent scientific study published in Preventive Veterinary Medicine, risk factors for obesity in cats at two years of age were identified. Cats kept indoors were more likely to be overweight or obese. I suspect this is related to exercise or the lack of it in a confined space like your apartment. While research indicating cat calisthenics helps to keep weight off is lacking, exercising your cat with a laser light, fishing pole toy or encouraging them to run up and down the stairs can’t hurt. Better yet, provide a cat tree for climbing as cats love to be up high.

One third to one-half of American cats are considered overweight or obese. Be proactive and keep your kitty slim and trim by controlling his food portions, including some canned food in his diet, and making sure he gets plenty of exercise.