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.

My Cat Just Ate a Mouse! Should I Be Proud or Worried?

cat and mouse

I received an email from a cat patient’s family. They have recently moved to the suburbs and with the move came a mouse! The mouse problem didn’t last too long since Tigger killed and ate the mouse right in front of the entire family. While their initial reaction was pride at Tigger’s new found prowess as a huntress, they soon realized a rodent repast might not have been a healthy meal choice on Tigger’s part.

Here are my answers to their concerns about a mouse meal for their cat.

1. If the mouse ate poison, could it be dangerous?

Since mice are small compared to your cat, veterinarians believe a cat would need to eat several poisoned mice to develop toxicity from mouse bait, but it is not impossible to do so. If you have mouse bait out in your home, place it out of range of your cat. One type of mouse bait causes internal bleeding and the other elevated blood levels of calcium. If you have mouse bait in the house and your cat is ill, be sure to tell your veterinarian since you may not know your cat has been lunching on poisoned mice. A better alternative would be to trap mice in mechanical traps rather than poison them.

2. Can I peppermint oil my entire apartment to keep mice away and will the peppermint oil be safe for Tigger?

Recently, there has been concern expressed by experts about toxic effects of essential oils in cats. Cats lack the enzymes required to process essential oils and can become ill if exposed to the oils via ingestion, contact or inhalation. In a previous blog post, I suggested using peppermint oil soaked cotton balls as a mouse deterrent, but think I should redact that statement in the light of new information.

3. They sell sonic pest repellents; would she be okay with one?

As far as cat safety, these devices seem to be okay. The jury is out on the efficacy of the devices when it comes to pest control.

4. Obviously, the mouse wasn’t cooked. Could Tigger get sick from the raw mouse?

The short answer is yes, and one of the reasons to try and keep your cat from eating mice. Mice can be infected with roundworms, which can in turn infect your cat. Mice also carry Toxoplasma gondii, the agent of Toxoplasmosis. Toxoplasmosis is a greater risk to human family members than to feline family members, but since the health of the entire family is important, keeping mice out of the home is also important.

If you have a serious mouse problem requiring an exterminator, mention your cat and follow their directions on post-extermination clean up to protect your cat.

Does My Cat Need a Biopsy?

cat pawsThe Animal Medical Center’s webmaster received the following electronic query: “My cat has a mass on its toe and my veterinarian has recommended amputation of the toe. Should the mass be biopsied instead?” Here is my response:

Maybe Not a Biopsy
Given how small a cat toe is, a biopsy might not be possible. Once the surgeon removes a small piece of the mass for submission to the lab, the skin over the mass needs to be sutured closed. The skin on a cat’s toe is very tight and closing up a biopsy site may not be possible in this particular location. Hence, an amputation of the toe removes the tumor and the excised tissue can be submitted for biopsy.

Maybe a Biopsy
If the biopsy site can easily be sutured closed, then a biopsy will provide a diagnosis and expected outcome and also direct future testing and treatments.

Biopsy Alternatives
Malignant tumors of the toe often destroy the toe bones. This can be seen on an x-ray. If there is evidence of bone destruction on an x-ray, then the mass is likely malignant and the toe should be amputated to give the best chance for complete tumor removal. Another method of determining whether or not the mass is malignant would involve sedating the cat and using a needle to remove a few cells from the mass. The cells can be analyzed in the laboratory and may give an indication of malignancy.

Should Any Other Testing Be Performed?
Any pet with a mass, should also have the lymph nodes in the area of the tumor evaluated by using a needle to remove a few cells from the mass and having a pathologist evaluate the cells under the microscope. In a cat with a hind toe mass, we check the lymph nodes behind the knee; in a front toe mass, we check the lymph nodes in the armpit. Because toe tumors can be malignant, a chest x-ray to check for tumor spread to the lungs should be performed in any pet with a possible tumor.

Read this cancer survivor story about a dog with toe tumors.

Arthritis: Not Just a Single Disease and Not Just a Single Joint

arthritis in dogsI examined the most handsome four year old Labrador with a blocky, square head the other day. Being a very athletic dog, he normally jumps up on the sofa in the waiting area. The other day, he needed help to jump up and couldn’t seem to get comfortable once he was on the sofa. Based on my examination, he did not have any broken bones, no torn ligaments, but his gait was stiff and his lymph nodes were a little enlarged. The nurses drew blood for analysis and we prescribed a short course of an anti-inflammatory medication. I told the family one of the potential diagnoses was polyarthritis or inflammation of multiple joints. The family only heard “arthritis” and was distressed that a four year old dog could have arthritis.

shoulder arthritis
Arthritis in the shoulder of a canine

What is Arthritis?
The word originates in Greek: arthro- meaning joint and -itis which is both Latin and Greek for inflammation. Arthritis describes the problem, but gives no information about the affected joint, cause or treatment required.

Most Common: Osteoarthritis
The most common type of arthritis in dogs is osteoarthritis, which may affect as many as one in five dogs. The typical dog with osteoarthritis is an older large breed dog, but small breed dogs and cats can also have osteoarthritis. As the cartilage overlying the bone in the joints deteriorates, the bones rub together causing inflammation, pain and swelling of the joint. Hip dysplasia leads to osteoarthritis, and a joint injury can also result in osteoarthritis of the hip joint. Non-steroidal anti-inflammatory medications are the mainstay of treatment for long-term management of osteoarthritis.

Many Joints: Polyarthritis
Because he was walking funny, I was concerned my handsome Lab patient had inflammation of multiple joints, or polyarthritis. Bacterial infections can spread to the joints via the blood stream or multiple joints may be inflamed because of an aberrant immune process. Blood tests, x-rays and removal of a few drops of joint fluid for analysis in the laboratory help to make a diagnosis. When a bacterial infection occurs in the joint, it is called septic arthritis.

Familial Shar-Pei Fever
Chinese Shar-Pei dogs suffer from a strange form of arthritis. Dogs with the disease have recurrent fevers and joint swelling. The disease results from a derangement of the body’s immune system and causes unchecked inflammation. In affected dogs, the hocks, the joint just above the ankles, are most commonly involved. In this type of arthritis, other organs also become inflamed, leading to kidney and liver problems.

And the Diagnosis is…
The screening test for tick-borne infections came back positive for a bacteria called Anaplasma. Antibiotics were prescribed and immediately the handsome Lab felt better. A more sophisticated test identified the DNA of Anaplasma phagocytophillum as the cause of the illness.

Steps for Pet Owners
Diet is critical to maintaining an ideal body weight and limit stress on sore joints. Specially formulated diets can also help to mitigate clinical signs of arthritis. Exercise designed to minimize stress on joints such as swimming or walking on an underwater treadmill often benefits dogs with osteoarthritis.
To prevent tick-borne illness, use medications or collars designed to protect against ticks and check your dog daily for ticks. Review what to do if you find a tick on your dog before you remove it. Finally, never give your own arthritis medications to your dog; you might make him extremely ill.

Controlling Household Pests Safely When You Have Pets

pet safe pest controlAt one time or another, every home becomes infested with a household pest such as ants, cockroaches or rodents. Ridding your home of these noxious creatures can involve using equally noxious poisons which may not be safe for your pets. Here are some pest control treatments that do not involve poisons and are pet safe.

Talcum Powder
A mineral composed of magnesium silicate, talcum powder has been touted for the treatment of household ants. Shake talcum powder where your find ants and then once they are gone, vacuum up the residual powder. This method has the potential to get messy if your pets walk through the pile of powder on the floor, so keep them out of the treated area.

Building a Safer Mouse Trap
Controlling rodents can be downright dangerous for your pets. According to the Pet Poison Helpline, intoxication with rodent poison is number two on the list of dog poisonings and number 10 on the list for cats. Even though the labels indicate the refillable bait stations are dog proof, the manufacturers seem not to have met some of the more creative and persistent patients we see in New York City who are able to thwart the protective bait station, allowing them to feast on the contents. The most common type of rodent poison intoxication seen at the Animal Medical Center is life-threatening hemorrhage caused by anticoagulant rodenticides such as d-CON or Tomcat. Less common are rodent poisons that drive up the level of calcium in the body and cause kidney failure. Even glue traps can get stuck on a curious cat and require an animal ER visit for removal. Safest for pets would be the mechanical mouse traps which trap the mouse without any poison.

Keeping Mice Away
Of course, having no mice in your apartment would be better than having to set traps! I have steel wool around the openings in the floor where the heat pipes come into the radiators. The steel wool prevents mice from slipping through the hole and is not very chewable. Another pet safe mouse deterrent is peppermint oil. Apparently, mice don’t like the smell and it keeps them from coming into the apartment. Cotton balls soaked with peppermint oil from the health food store should be placed near the opening where the mice are entering. Part of me wonders if you could put the peppermint oil on the steel wool, but fortunately, I haven’t had reason to test this hypothesis.

Boric Acid
Often used as an antiseptic for minor burns and cuts, boric acid has also been approved for decades as an insecticide for cockroaches and ants. I found insecticide products containing boric acid on the shelf of my local drugstore. At first glance, boric acid seemed like a good choice for a pet safe insecticide, and although boric acid is used medicinally, the warning labels on the insecticide take boric acid off my list of pet safe insecticides. For minor cuts and burns, the boric acid crystals are diluted in water making the concentration very low. Based on the warning labels, I suspect because the concentration in the insecticide is much higher compared to the antiseptic solution.

Contact a Professional
If these simple pest control methods don’t work, consider engaging a professional pest control company and be sure to follow their directions regarding restricting your pet’s access to the treated areas in your home. You could also board your pets or have them spend the night at grandma’s house while your home gets treated.

George, the Notorious Toy-Eating Cat

During the day, The Animal Medical Center buzzes with activity. Patients coming and going. Pets being anesthetized and recovered after surgical procedures. Consultations happening in our 20 examination rooms. Things do quiet down at night, but if a sick pet needs us, were are here 24/7 for urgent interventions. Last night was one of those nights. Nine patients were admitted overnight; one, George the cat, needed an emergency procedure, a toy-ectomy.

George’s family suspected there might be something stuck in their cat. Previously, he had surgery to remove a gastric foreign body and he had now been vomiting for the past two days. The ER veterinarians suspected the same. All the vomiting and loss of stomach acid in the vomit, made George’s blood pH alkaline.  Because George is a round cat, the ER veterinarians could not feel anything stuck in him, but the x-ray revealed a spiny object in the stomach’s outflow tract.

This is a photograph taken with the endoscope’s camera of the toy stuck in George.Dr. Sylvia Lesnikowski, the on-call veterinarian for endoscopy that evening, started working to remove the object just shortly after 10 pm. Although AMC veterinarians use endoscopy to obtain biopsies and remove foreign bodies routinely, the object stuck in George was particularly difficult due to its irregular shape and how tightly it was lodged in the junction between the stomach and intestine. After two hours of making little progress, Dr. Lesnikowski almost gave up and called in the surgical team, but one final tug dislodged the toy and spared George a surgical intervention. The spines of the toy caused ulceration of the intestinal lining, but George was discharged the next morning on medications to help the ulcers heal.

George's toy after surgical removalAre you worried because you cannot find your cat’s favorite toy and you noticed your cat vomiting and not eating? X-rays and ultrasounds are quick, non-invasive tests to help determine if the missing toy is lodged in your cat’s stomach or intestine.

Be sure to select toys that seem to be too large for your pet to ingest.  Keep in mind, AMC veterinarians remove pieces of toys as well as entire toys. They also remove needles and threadpen caps and sometimes just garbage.

Above right: This is a photograph taken with the endoscope’s camera of the toy stuck in George.
Above left: This is the actual toy after it was pulled out of George’s stomach with the endoscope.

Treatment of Allergies in Pets

Spring officially arrived nearly three weeks ago, but the onset of allergy season may not arrive too soon this year, given our harsh winter. But once it warms up, pollen, dust mites, fleas, grass, weeds and mold will kick off allergy season in pets.

Clinical Signs of Allergies
Does your dog rub his face along the front of your sofa or scratch incessantly? Has your cat scratched all the fur off her head and made is scabby? Are you constantly putting in ear drops or giving antibiotics to treat skin infections? All these represent clinical signs of allergies in pets.

Control Parasites
One of the top causes of canine and feline allergic skin disease stems from an allergic reaction to flea saliva. A flea bites your dog or cat, setting off an allergic reaction. This disease presents a double-whammy to your pet: discomfort from fleas crawling all over its skin and the discomfort of being itchy. Fortunately, numerous options for control of fleas are available and your choice of product can be tailored to your pet’s exact needs.

Modify the Diet
Food allergies are typically an ongoing problem, not seasonal like pollen, grass or flea saliva allergies. Veterinarians think the allergen in food is the protein source contained in the diet, but it may be other ingredients as well. The standard method for determining if food is the cause of skin disease is a food elimination trial. Elimination diets contain a limited number of ingredients and protein sources not typically found in common pet food and not previously fed to your pet. Novel protein sources include bison, herring or rabbit. Some elimination diets avoid common carbohydrate sources and include potatoes or oats, rather than corn or soy. An elimination diet requires determination on the part of the pet owner, as the skin improves slowly in response to a diet change. Patience is required to tough out a month or more of strict diet control.

Administer Immunotherapy
Immunotherapy, a medical word for allergy shots, involves specialized testing to determine whether it is pollen, dust mites, fleas, grass, weeds or mold revving up your pet’s itch-scratch pathway. Once the cause of the allergy is determined, a custom allergy vaccine can be developed for your pet. You learn to give the injections at home one to two times per week. These injections contain minute amounts of the offending antigen (pollen, dust mites, fleas, grass, weeds or mold) which trains your pet’s immune system to be tolerant of these agents.

Quell the Immune System with Drugs
A variety of drugs can be used to turn off the allergic reaction underlying the itch-scratch cycle in your pet. The most well-known, but not necessarily the most effective in pets, is antihistamines. Steroids can be very effective and rapidly reduce the clinical signs of allergies, but have unpleasant side effects, such as increasing water drinking, urination and appetite, as well as increasing the risk of infection. Another effective drug for allergy management is cyclosporine, although cost is a concern. New to the market, oclacitinib, inhibits the cells initiating the itch-scratch cycle by attacking allergies at the cellular level.

With so many options to manage pet allergies, no pet should have their summer fun spoiled by constant itching and scratching. Watch The AMC’s Dr. Mark Macina talk about managing allergies in pets.

Nicotine Intoxication: A Danger for Pets of Smokers

This week, March 15-21, 2015, is National Poison Prevention Week. I am using this week’s blog to alert dog owners of a new toxin found in our homes – nicotine. Nicotine has been around a long time, but the new nicotine substitutes, designed to help people stop smoking, are poisoning dogs. A recent article in the press highlights the dangers of nicotine from e-cigarettes.

Sources of Nicotine
If you smoke around your pet, she will develop an increased concentration of nicotine in their blood stream, but the increases will not reach toxic levels. Ingestion of an e-cigarette or the super concentrated nicotine liquid used to refill the e-cigarette can cause serious and even fatal toxicity. Due to their indiscriminate eating behavior, dogs may help themselves to nicotine-containing gum or candies from your bag or backpack. Another source of nicotine toxicity is discarded nicotine patches snatched from the bathroom trash basket. Cats can also develop nicotine toxicity, but are more likely to find a discarded patch inadvertently stuck to their fur after you have removed it from your skin. Cats will ingest the nicotine while trying to remove the sticky patch by grooming.

Signs of Nicotine Toxicity
If your pet ingests one of these nicotine products, she will show signs in less than an hour and possibly in minutes if the dose is high. Common clinical signs include: vomiting, diarrhea, agitation, elevations in heart and respiration rate, depression, tremors, ataxia, weakness, seizures, blue gums, coma, and cardiac arrest. Just one e-cigarette cartridge can make a big dog really sick and can be lethal in a small dog.

Prevent Pet Poisoning

Bladder Stones: Now You See Them, Now You Don’t

The two x-rays seen below are from the same canine patient, taken one month apart. The one on the left shows two bladder stones. On the right you can see the stones are no longer present in the bladder. How did this magic happen? Surgery? Laser therapy? Antibiotics? Food? Magic wand?

Nope. Surgery may be the fastest and most common treatment for bladder stones, but for this lucky duck dog surgery was not necessary. Bladder surgery is performed under general anesthesia. The surgeon makes an incision in the abdomen near the back legs and finds the bladder just inside the body wall. Because the bladder is a hollow organ, it will collapse when the surgeon makes an incision in the bladder wall. Special sutures are placed in the bladder to hold it up and keep it open while the stones are scooped out of the bladder with a bladder stone spoon.

Huh? This acronym stands for per cutaneous cystolithotomy. Using laparoscopy equipment, a pinhole incision is made in the bladder. A small camera is threaded into the bladder and its magnifying properties are used to visualize the tiniest stones. Using this non-invasive method, stones are busted up using the laser and then easily removed.

Laser therapy?
Guess again. For dogs of the right size with not too many stones, non-invasive bladder stone removal is possible. Stones can be fragmented using a special laser which is passed up the urethra and into the bladder. Once the stones are broken into small enough pieces, they are either flushed out of the bladder or removed with a special stone-removing basket which is passed up the urethra and into the bladder to gather up the stone fragments.

Yes, but only in part. I can hear you saying, “Wait a minute, this makes no sense. Stones are hard chunks of mineral. Antibiotics treat bacterial infections, they do not dissolve stone.” But, this dog’s urinalysis showed an infection in addition to the stones. The infection played a role in the development of the stones and without treating the infection, the stones will not disappear.

Stones form in the bladder as a sequel to infection and also because there are too many minerals in the urine. Drinking more water dilutes the minerals and helps dissolve the stones. Taking advantage of that information, a diet was formulated to promote water drinking in dogs fed the special stone dissolving diet. The diet is also low in magnesium and phosphorus, the building blocks of a type of bladder stone called struvite. This diet does not work in every type of bladder stone, only the struvite ones. Antibiotics are necessary since as the stone dissolves, it releases bacteria, and thus the dog needs antibiotics until the stones are completely gone. Antibiotics alone will not dissolve the stone and diet won’t work unless the infection is controlled, so the correct answer for the magical disappearance of the bladder stones in this dog is diet AND antibiotics.

Signs of bladder stones
Dogs with bladder stones urinate more frequently than is normal, have accidents in the house and blood in their urine. If you see any signs like this, be sure to have your dog evaluated immediately by your veterinarian. View a prior blog post on bladder stones to see diagnostic images of stones.

Pumps and Valves: February is American Heart Month <3

In February, we celebrate Valentine’s Day with flowers and candy hearts. February also focuses on another type of heart – the one beating inside your chest! This is American Heart Month, raising awareness of heart disease. Both dogs and cats get heart disease, but the common type in each species is different. Cats’ hearts have pump problems and dogs’ hearts have valve problems. Although the problems are different, the outcome for both pump and valve problems is heart failure, or inadequate delivery of blood throughout the body for normal function to continue.

Poor pumping = heart disease in cats <3
The heart is a sophisticated muscle, but it still performs the basic muscle function – contract and relax. When the heart relaxes, the pumping chambers fill. The next muscular contraction expels the blood from the heart into the blood vessels. When the heart muscle is diseased, it can do one of two things – get thicker or thinner. Both are bad. A thick heart pumps less blood with each beat since the thick muscle occupies space inside the heart where the blood to be pumped normally collects. When the heart is thin, the muscles are weak and do not adequately pump blood. Thick or thin, neither heart pumps blood well.

Leaky valves = heart disease in dogs <3
A normal dog heart consists of four chambers, and the flow of blood between chambers is controlled by little valves. Normal valves remind me of alabaster: translucent and white, but unlike alabaster, they are flexible. Especially in small dogs, the valves degenerate as a dog ages, becoming thick and lumpy and inflexible. The distortion of their shape prevents them from closing normally. Abnormal valves leak and blood is not pumped efficiently through the rest of the heart and blood vessels. Over time, the portion of blood leaking out of the heart chambers increases and blood pumped to vital organs decreases.

Congestive heart failure <3
Even though the underlying heart problem in dogs and cats is different, the result is often the same. Poor pumping in cats and leaky valves in dogs can lead to congestive heart failure. These disparate problems both decrease the blood flow to vital organs, such as the kidneys. To compensate, the kidneys retain fluid and when the fluid reaches a critical level, it floods into the lungs, causing pulmonary edema. Acute congestive heart failure is a common reason for admission to the hospital from The Animal Medical Center’s ER. Congestive heart failure can be treated with medications to remove fluid, help the heart pump more vigorously and dilate the blood vessels, allowing them to hold more fluid.

Keeping your pet’s heart healthy <3
I know you want to keep your pet out of the animal ER, so here are some tips for being heart healthy:

  • Keep your pet at an ideal body weight. Obesity increases stress on the heart and it has other negative effects on health as well.
  • Exercise daily with your pet. Folks who walk their dog daily have better heart health themselves.
  • Ask your primary care veterinarian if a consultation with a board certified cardiologist could benefit your pet. Changes in heart valves and muscles cannot typically be reversed; new medications can prolong good quality of life in both dogs and cats with heart disease.