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.

Top Tick Stories 2017

Increase in Lyme Disease Cases for 2017
According to the Companion Animal Parasite Council, canine Lyme disease is expected to expand beyond its traditional geographic boundaries in 2017. In states like New York where the disease is endemic, the number of cases will increase, thanks to a bumper crop of white footed mice, the efficient vectors of the Lyme disease-carrying Ixodes scapularis tick. Because humans and dogs can contract Lyme disease, it is going to be a tough season for all.

Powassan Virus Makes its Mark in 2017
This rare tick-borne virus made NYC metro news this spring when a young Connecticut child was diagnosed with Powassan virus disease. In our area, this virus is spread by the same tick vector as Lyme disease. Powassan virus, first identified in Canada, causes neurologic signs and can be fatal. Fortunately, the Connecticut child recovered without major long-term effects. To date, there is no information indicating dogs and cats can be affected by this virus, but without tick prophylaxis, your pet could inadvertently expose your family to ticks carrying this deadly virus. Preventing ticks on your pet makes your family safer.

Forecasting Lyme Disease
One bright spot in the nasty tick predictions for 2017 is how dogs are impacting Lyme disease forecasting. Though very complicated math,

scientists determined results of pet dog blood tests for Lyme disease in past years can forecast the occurrence of the disease in the upcoming year. This helps to alert veterinarians about the geographic expansion of Lyme disease into new areas, helping us to better prevent and diagnose the disease. Since we share outdoor activities with our dogs, the information also helps physicians to diagnose Lyme disease early.

News to Use
The continuous geographic expansion of tick-borne diseases makes protecting ourselves and our pets from tick attachment more important than ever. A three-pronged approach is necessary: manage the environment, prevent tick attachment, and remove ticks promptly and completely.

  1. To reduce tick habitat, keep grass and bushes in your yard trimmed and clean up dead leaves and branches.
  2. Talk to your veterinarian about what tick prevention products work in your locale and would be best for your pet. Collars, pills and top spot preventatives are all very effective.
  3. Check yourself and your dog for ticks after spending time outdoors. Use tweezers or a specially designed tick remover tool to remove both the body and the head of the attached tick.

Melanoma Monday for Dogs

melanoma monday

May is a busy month, cancer-wise. May has been designated as Skin Cancer Awareness Month and, more specifically, the first Monday in May is Melanoma Monday. Skin cancer is much less common in pets than in people, in part because most pets avoid tanning booths and prefer not to sunbathe. But dogs do develop malignant melanomas in their oral cavity or on their toes. In these locations, melanoma can be as deadly in dogs as it is in humans. The good news about canine melanoma is that treatment options are available to veterinary cancer specialists and these options can be tailored to your dog’s specific needs. The decision in favor or against various treatment options for melanoma depend on the location of the tumor, the extent of the tumor throughout the body and, based on a biopsy, how likely the tumor is to spread.

Surgery
Surgical removal of a melanoma serves a dual purpose – diagnosis and treatment. Removal of the melanoma is an important first step in treating the cancer. For melanoma of the toe, surgery can easily remove the toe and the tumor, resection of melanoma in the oral cavity is less simple. In the process of removing the melanoma, tissue from the tumor is submitted for a biopsy to confirm the diagnosis. Surgery may also be used to sample lymph nodes in the region of the tumor to help determine how far the tumor has spread. The extent of the tumor dictates ongoing treatment needs.

Radiation Therapy
If an oral melanoma cannot be removed, radiation therapy has proven effective in shrinking these tumors. Radiation can also be implemented post operatively if tumor cells are discovered in the lymph node biopsy or if the oral biopsy shows a melanoma has been incompletely removed. Treatment of melanoma of the toe with radiation is uncommon, but not unheard of, since surgery is usually successful at removing the tumor.

Immunotherapy
Melanoma is the first veterinary cancer to have a specific immunotherapeutic agent developed for treatment of the disease. Most of us associate a vaccine with protection against disease, but the canine melanoma vaccine alerts the dog’s immune system to the presence of melanoma and starts an immune reaction against the melanoma cells. In clinical research, this vaccine has been shown to lengthen survival time in dogs with melanoma when the vaccine is administered after surgery or radiation therapy is performed to control the primary tumor. Immunotherapy agents have also been developed for human patients with melanoma.

Chemotherapy
Chemotherapy is probably the least commonly prescribed cancer treatment for dogs with melanoma. Veterinary oncologists have studied a few drugs in this disease, but no drug consistently shrinks these tumors and prolongs survival. Drugs most commonly considered for the treatment of melanoma in the dog include platinum-based drugs such as carboplatin, doxorubicin, lomustine and dacarbazine.

While it may be comforting to know, treatment options are available if your dog develops a melanoma. Identifying the tumor and quickly instituting therapy is still critical for long-term control of the tumor. Bad breath, oral bleeding, and toe swelling can all be signs of a melanoma in your dog. If you identify one of these signs, make an immediate trip to your veterinarian.

#ThisIsDiabetes

diabetes assistance dogNovember is National Diabetes Awareness month. While dogs and cats both develop diabetes and veterinarians treat diabetic pets with insulin, I am not going to write about treatment of diabetes in pets. Instead, this blog will focus on the intersection between human diabetes and dogs – diabetes assist dogs.

Dog Noses as Diagnostic Tools
Dogs have a tremendous sense of smell. Specialized training can teach dogs to sniff out such diverse maladies and diseases as migraines, cancer, narcolepsy, seizures and diabetes. During training, the dog learns to act to protect or alert their owner to an impending attack of the disease. When alerted in advance, people can take action to minimize the impact of their disease on their health and safety.

Detecting Hypoglycemia
One of the most feared side effects of insulin treatment for diabetes is low blood sugar or hypoglycemia. Diabetes assist dogs are trained to alert their owner of an impending hypoglycemic event. Research has shown a volatile organic compound, isoprene, increases in exhaled breath during hypoglycemia, and proponents of diabetes assist dogs believe this is the compound detected by trained dogs. Whatever they detect, diabetes assist dogs are viewed enthusiastically by their owners.

The Skeptics View
Not everyone believes dogs’ noses are capable of identifying hypoglycemia in humans. We know dogs are able to sense our emotional state and when identifying an impending seizure, there are those who believe the “sniffing dog” is really sensing this emotional change. In a study in Diabetes Care, investigators used skin swabs from diabetic patients experiencing hypoglycemia to test trained diabetes assist dogs. This study could not document the trained dogs’ ability to correctly identify swabs obtained during hypoglycemia. In another study of diabetes assist dogs, trained dogs were not highly accurate in differentiating hypoglycemia from a normal blood sugar.

Whether they detect isoprene, emotional changes or something else, the value of a diabetes assist dog likely extends beyond just identification of hypoglycemia. Having a buddy when you are sick is clearly one of the best reasons for having one of these dogs.

Canine and Feline Heartworms: The Long and Skinny for Pet Owners

Just in time for spring, the American Heartworm Society has released its updated 2014 Canine and Feline Guidelines for treatment and prevention of heartworm disease. We always think about heartworms in the spring because they are spread by mosquitoes that become active at this time of year. These days, with global warming and urban heat islands, mosquitoes have expanded their season and their territory; the American Heartworm Society has amended its guidelines to provide up-to-date recommendations for your dog and cat.

Treat Your Dog Year-Round with a Heartworm Preventative
This recommendation is designed to offer your dog maximum protection against heartworms, with minimal effort on your part. Heartworm disease is a serious and life-threatening illness in dogs. Although treatment of the disease can be successful, it is far more prudent for pet owners to administer a medication that is safe and simple than to treat a dog that has contracted the disease. Here at The AMC in NYC, where we have experienced a more severe winter than in recent years, there is clearly not a mosquito around to spread heartworms. However, I have recently signed many health certificates for travel to warmer, mosquito filled climates. If these patients are on year round heartworm medication, their families have one less travel worry in preparation for a trip down south.

Get Your Dog an Annual Heartworm Test
Most cases of canine heartworms can be diagnosed using less than a teaspoon of blood and an in-clinic test. Annual heartworm screening can detect infections early, before the cardiopulmonary system has been damaged due to the presence of heartworms within the heart and the blood vessels of the lungs. Early diagnosis gives your dog the best chance of recovering from a heartworm infection.

Don’t Think of Your Cat as a Small Dog When it Comes to Heartworms
Cats are susceptible to heartworm infection, but less so than dogs and they tend to have fewer worms than dogs do; however, given the small size of cats, a few worms is enough to cause serious heart and lung disease. Heartworms persist in cats for 2-3 years and then they die. When adult heartworms die, that is when they are most dangerous for your cat. Dead heartworms can cause blood clots to form in the lungs which can be fatal. Prevention of heartworm infection in cats is critical since the Heartworm Society reports there is no treatment that prolongs survival of cats diagnosed with adult heartworms. Cats can take a monthly heartworm preventative, just like dogs do.

Follow These Simple Rules

  1. Test your dog annually for heartworms. Any dog over 7 months of age is old enough to have contracted the disease.
  2. Talk to your veterinarian about which type of heartworm preventative—pills, topical or injectable—is best for your pet’s lifestyle.
  3. Give heartworm preventative on schedule. A late dose can result in heartworm infection.
  4. Avoid taking your pet out at dusk and dawn when mosquitoes are most active, and keep them away from standing water where mosquitoes breed or tall grass where they reside.

Want more information about heartworms? Read these previous posts:

Canine Heartworm Update

Last week I was a guest on Dr. Frank Adams’ monthly pet show on NYU Langone Medical Center’s “Dr. Radio.” One of the callers asked if heartworm preventative was really necessary in her dogs. She thought (incorrectly) that since she lived in an area where mosquitoes are uncommon, her dogs would be safe against heartworm infection. My answer to her was a resounding “yes” and I added, “Give those pills exactly on time.”

Treatment versus prevention
No dog owner would ever miss a dose of heartworm preventative if they knew how difficult and dangerous treating heartworms can be. When a diagnosis of heartworm disease is made, any signs of heart failure must be immediately controlled. After your dog’s heart has been stabilized, veterinarians then administer a drug by injection to kill the adult heartworms. Strict cage rest is instituted to minimize the risk of blood clots which may form in the lungs as a result of dying heartworms. Cage rest continues for at least a month after adult heartworm treatment. Protocols for the treatment of adult heartworms are 90-98% successful and if unsuccessful, your dog will need to be treated a second time. Throughout treatment for adult worms, your dog must be maintained on heartworm preventative in case of another bite by an infected mosquito.

Heartworm review
Mosquitoes transmit heartworms. A bite from an infected mosquito injects heartworm larvae into your dog’s blood stream. Heartworm preventative kills the larvae before they mature. If unchecked by heartworm preventative, the larvae mature in the large blood vessels of the heart and lungs, leading to severe heart and lung compromise.

CAPC changes heartworm recommendations
Last month, the Companion Animal Parasite Council revised its guidelines regarding canine heartworm disease. Council members cited new evidence of resistance of heartworms from the Mississippi Delta region to heartworm preventatives, specifically ivermectin, selamectin, moxidectin and milbemycin oxime, confirming years of speculation about resistance in the veterinary community. At this time, it is not known how widespread heartworm resistance is, but it makes an annual heartworm test even more important than before.

Heartworm prevention tips

  • Year round administration of heartworm medication gives the best protection against heartworms.
  • Giving heartworm medication precisely on time is critical to successful prevention.
  • Place the stickers from the heartworm preventative medication on your calendar to remind you to give the monthly heartworm preventative.
  • Sign up for email or text message reminders on your smartphone from the website of your heartworm preventative manufacturer.
  • Get the reminder app from the website of your heartworm preventative manufacturer.
  • Mosquitoes are most active at dawn and dusk. Keep your dog indoors during peak mosquito activity.
  • Ask your veterinarian about monthly flea and tick medications that also repel mosquitoes.

Ten Tips for Dog Safe Summer Exercise

With summer just around the corner, everyone, including your dog, wants to be in shape for summer activities. Outdoor activities can be a fun way to spend time with your favorite pup. The veterinarians at The AMC have the following suggestions to make exercise safe and healthy for your dog:

  1. Have your pet examined by a veterinarian to ensure exercise is safe for your dog. Stop exercise and let your dog rest anytime he is resisting you, unable to keep up or showing other signs of distress.
  2. Always warm up your dog with a 10 minute walk prior to jogging or heavier exercise.
  3. Train your dog gradually to increase the amount of time and intensity of exercise over several weeks, just as you would train yourself.
  4. Massage your dog and provide gentle passive range of motion for all major joints. You may do this before or after exercise, but it is most beneficial AFTER exercise. In a side-lying position, keeping the limbs parallel to the body, gently flex and extend each joint of the front and hind limbs. Check out these videos on forelimb passive range of motion and hindlimb passive range of motion.
  5. Do not feed your dog a large meal for 2 hours prior to exercise. Exercising on a full stomach can predispose your dog to bloat, which can be life-threatening.
  6. Give your dog small and frequent amounts of water. To facilitate this, consider carrying a collapsible bowl or a specially made, dog-friendly, BPA-free water bottle.
  7. Avoid exercising during the warmest part of the day, especially if you have a short-nosed dog. Pugs and all types of bulldogs should stay in an air conditioned environment as much as possible and only have brief outdoor walks for bathroom breaks during peak heat. When heat and humidity are high, short-nosed dogs cannot cool themselves by panting as efficiently as their long-nosed cousins and are more prone to heat stroke than the average dog.
  8. Keep dark coated dogs out of direct sunlight while exercising. Their dark coats absorb heat, making them prone to heatstroke as well.
  9. Consider a cooling jacket for dogs exercising in summer heat.
  10. Provide your dog a shady place to rest after exercising. For elegant comfort, try these fashionable outdoor beds.

If you and your dog are running partners, consider registering for the Animal Medical Center Doggy Dash, a 5 mile run in conjunction with the New York City Triathlon.

Thanks to Dr. Leilani Alvarez from The Animal Medical Center’s Tina Santi Flaherty Rehabilitation & Fitness Service for her helpful hints on exercising your dog.

Avoiding the Knife: Preventing Pet Surgeries

At The Animal Medical Center, our board certified surgeons and neurologists perform approximately 1,500 surgeries each year. A recently released pet insurance study completed in 2012 listed the top ten surgery claims for both dogs and cats:

Since none of us want our pets to be subjected to the difficulties most surgeries pose, I will devote this blog to suggestions on how to avoid some of the most common canine and feline surgeries.

Tooth extractions

Topping the surgery list for cats and coming in at number three for dogs were tooth extractions. Keeping your pets’ teeth healthy means daily brushing and annual dental cleanings. The American Veterinary Dental College website provides good information about home dental care in dogs and cats. Remember, doggy breath often means periodontal disease, so if your pet has smelly breath, see your veterinarian for treatment before extractions become necessary.

Skin abscess, inflammation and pressure ulcers

This list of skin conditions ranks number two as a reason for surgery in both dogs and cats. Pressure ulcers generally occur in older dogs with limited mobility. Padding, padding and more padding will help prevent pressure ulcers on their elbows and thighs. Investigate orthopedic beds for your dog and try to keep him from laying on hard surfaces like the bathroom tile floor which can aggravate pressure sores. Promote mobility in your dog through regular exercise and management of arthritis with diet and medications.

Feline bite wounds

When I was a veterinarian in a more suburban area, we treated cat bite wounds on a daily basis. Preventing cat bite injuries is as simple as keeping your cat indoors. Cat bites not only cause wounds which can become abscesses, but cat bites transmit the feline immunodeficiency virus and possibly blood parasites as well. Priceless is how I define the value of keeping your cat indoors and healthy.

Aural hematoma

The tenth most common surgery in dogs was to repair an aural (ear) hematoma. Cats can develop aural hematomas too, just not as commonly as dogs. This condition is essentially a blood blister inside the ear flap. Blood accumulates in the ear flap when your dog incessantly shakes his head or scratches her ears. Usually, the shaking and scratching is in response to an allergy or an ear infection. If you see this behavior, check inside the ear for redness or discharge. See your veterinarian immediately to treat the cause of the shaking and scratching to prevent the development of an aural hematoma.

While some surgeries are unavoidable, these are prime examples of how a visit to your veterinarian for routine preventive care can help your pet avoid surgery.

Brush Up on Your Bicuspids: A Dog and Cat Tooth Tour

February is National Pet Dental Health Month. According to the American Veterinary Dental College, your pet needs daily toothbrushing and annual dental cleanings to keep their pearly whites white. Just like your visit to the dentist, where x-rays are taken to find periodontal disease or tooth abscesses, x-rays are a critical component of an annual dental cleaning for your dog or cat. Since most pet owners don’t get a chance to see their pet’s dental x-rays, I thought I would show you some from The Animal Medical Center.

Above, you see Spanky the cat’s six normal front teeth (incisors) flanked by his big fangs, also called canine teeth, even though he is a cat. Based on x-rays, the rest of Spanky’s teeth were normal and he did not have to have any teeth extracted during his annual dental cleaning.

In this x-ray you see one of Rhett Butler’s big molars. Both roots are surrounded by a dark area, instead of normal white bone. The dark area represents a periapical tooth root abscess which was the cause of his reluctance to eat and his swollen face. Once the tooth was extracted and he was treated with antibiotics, he recovered quickly.

Here you see dental x-rays of the right jaw of two different cats – Spanky on the left and Willie on the right. At first glance, the two look the same. If you look closely you will notice the third tooth in Willie’s x-ray appears moth eaten, especially on the left side of the tooth. The appearance is characteristic of a feline odontoclastic resorptive lesion (FORLS) or root resorption. Teeth with root resorptions need to be extracted as they can be painful and are prone to fracturing. The American Veterinary Dental College recommends cats affected by FORLS should be evaluated twice annually to detect and treat these lesions early.

Despite daily tooth brushing by her owner, Pippa has developed periodontal disease. You can see a pocket of bone loss around the two adjoining teeth. Both teeth had to be extracted during her annual dental cleaning.

Since I shared pictures of pets’ pearly whites, you might want to share yours!

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