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.

Everyday Medicine: Is it Vomiting or Regurgitation?

megaesophagus

“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 “Packed Cell Volume.” Today’s post focuses on the question: Is it vomiting or regurgitation?

Veterinarians Ask a Lot of Questions
The first part of any patient visit to the veterinarian is a Q&A called history taking. We ask the pet family questions about their pet’s health. You know the drill – How is his appetite? Do you send him to the boarding kennel? Do you have other pets? We adapt the questions to the situation. In the animal ER, the Q&A will be truncated and may only be, “Where did he get hit by the car?” rather than a lengthy set of questions about diet and exercise. In dogs or cats with vomiting, we often probe further to differentiate vomiting from regurgitation.

Vomiting
You know the sound of vomiting. First you hear a horrible gagging sound right before you find the big spot on the carpet. Always on the carpet because no self-respecting pet would vomit on the linoleum where clean-up is easy. Vomiting is an active process and you see contraction of the abdominal muscles a split second before the stomach empties.

Regurgitation
Until I went to veterinary school, I thought regurgitation was a more sophisticated word for vomiting. Not true. Regurgitation does not have the forceful expulsion of food from the stomach typical of vomiting. The food seems to fall out of the mouth rather than exploding from the stomach. Regurgitated food never makes it to the stomach because of poor esophageal function, and if undigested food seems to fall out of your pet’s mouth, he may be regurgitating. Regurgitation is much less common than vomiting and is associated with a disorder called megaesophagus.

Does the Answer Matter?
The short answer is yes. If a veterinarian can determine a patient is regurgitating rather than vomiting, then she will follow a different path of diagnostic testing. If your veterinarian suspects vomiting, an abdominal x-ray is commonly obtained. Because regurgitation suggests esophageal dysfunction, a chest x-ray will be part of the initial testing to see if the esophagus appears abnormally filled with air. Special movie x-rays called fluoroscopy can be used to identify esophageal dysfunction typical of megaesophagus.

To learn more about megaesophagus, watch this video interview by Insider.

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.

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.

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.

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!

Housekeeping Tips to Prevent Fleas and Ticks

fleas and ticks

Summer is officially here, and everyone is looking forward to the next few months of outdoor activities. For those of us with furry family members, summer is the time of year when they drag unwanted visitors, like fleas and ticks into our homes. The “yuck factor” for these critters is high, but fleas and ticks can expose human family members to serious diseases. Here are three housekeeping tips to prevent a home infestation with

Va-voom the Vacuum
Fleas spend very little time on your pet, which means if you see a flea on your pet, you can assume there are plenty of fleas in your carpet, furniture and bedding. The sight of a flea should send you straight to the closet for your vacuum cleaner. By vacuuming carpets and upholstery, you will remove not only adult fleas but flea eggs as well. Vacuum extra diligently in pet areas like near their beds, crates or the cat tree where fleas and ticks are most likely to fall off your pet. Once vacuuming is completed, throw away the vacuum cleaner bag. If you leave the bag inside the vacuum, the flea eggs will hatch and only make your infestation worse.

Washer Workout
Rather than vacuum your pet’s bedding, just throw it in the washer. The hot water cycle and detergent will kill fleas and ticks in the bedding. Ditto for soft pet toys like stuffless dog toys. While you are cleaning up, use your dishwasher to clean your pet’s food and water bowls and hard toys. You wouldn’t eat off dirty dishes and neither should your pet.

Tidy the Yard
Any fleas and ticks on your pet come from the outdoors. If the outdoors your pet experiences is your yard, these simple gardening tips can decrease the flea and tick burden in your yard. Fleas and ticks prefer cool, moist, shady places. Prune bushes, trim trees and mow the lawn to create an environment hostile to fleas and ticks. Allow your lawn to dry out between waterings as fleas love moisture. Make sure all leaf litter, branches and any clutter is removed from your yard so it does not harbor ticks, fleas and their eggs. If you are an ambitious gardener, create a border of cedar chips around your yard. The smell of cedar helps to keep fleas away and the border provides a zone of protection between the perimeter of your yard and the lawn to restrict flea and tick migration.

Protecting Your Pet
A recent survey of pet owners says one-third of pet owners do not regularly give the flea and tick medications prescribed by veterinarians like me. In part due to global warming, both the habitat and season for fleas and ticks is expanding. My final tip is to give these critical medications to protect your pet against fleas and ticks so everyone has a healthy and parasite-free summer.