Should I give CBD supplements to my pet?

CBD in PetsThere’s a huge interest in cannabis products for pets. Based on the queries from my patients, most of the interest is in CBD-containing supplements. While the internet and local pet stores may have well-stocked shelves of CBD chew treats, oils and creams, pet owners should exercise caution if they chose to administer such products to their favorite fur person.

Marijuana basics

The marijuana plant contains nearly 500 different organic compounds, but the two most important are tetrahydrocannabinol (THC), the psychoactive cannabinoid, and cannabidiol (CBD). CBD is touted as safer because it does not have the euphoric effects of THC in humans, but CBD does affect the nervous system, and its mechanisms are largely a mystery to scientists. Additionally, CBD’s effect on cats and dogs remains poorly studied.

The Drug Enforcement Agency classifies marijuana or extracts from the plant as Schedule 1 controlled drugs. This classification prevents veterinarians from prescribing medical marijuana and also restricts our ability to research the drug’s effects in different diseases. Despite its Schedule 1 classification, CBD containing products can be purchased in stores and online.

Hemp

Some products on pet store shelves contain “CBD from hemp.” Industrial hemp is legal; however, the Drug Enforcement Agency has issued a clarification that while they indeed recognize industrial hemp research and its products as legal, this protection does not extend to CBD products, which remain illegal, regardless of the source of the CBD. Recent legislation may ease the use of CBD from hemp, but until the federal regulations are written, prescribing CBD appears to be off limits to veterinarians like me.

What is the dose?

Despite the huge interest, there isn’t a correspondingly large body of scientifically collected information on the impact of CBD in pets. Most of the information veterinarians have available to them comes from emergency room studies of pets accidentally ingesting marijuana. This means I, and my colleagues, cannot be very helpful to you regarding dosing your pet with CBD products, because of a lack of information.

The lack of information regarding dosage is compounded by the fact that many CBD-containing products don’t contain the amount of active ingredient indicated on the label. The FDA has quantified CBD levels in some products and found many did not contain the advertised levels of CBD. Some “CBD” products contain very little CBD, while others contain more. For these reasons, the FDA cautions consumers regarding the purchase and use of CBD products as the effects may be unpredictable in their pets.

More information soon

Although information about optimal dosing of CBD and the diseases most amenable to CBD therapy are lacking, more information may be coming. According to a recent article in the American Animal Hospital Association’s Trends Magazine, approximately a dozen studies of CBD products are underway in dogs, cats, horses, monkeys and birds. When the results of those studies become available, pet owners and veterinarians will have much better information on which to base therapeutic decisions for their pets and patients. Until then, the many unanswered questions regarding CBD continues to limit its utility in pets.

Pyometra: A Life-Threatening Infection

Pyometra imageEvery morning at about 5 am, the overnight team of ER doctors at the Animal Medical Center sends an email with the list of the overnight admissions. Last week, two canine patients were listed as being admitted with a diagnosis of pyometra. Both dogs were so sick they underwent emergency surgery in the middle of the night to treat their pyometra.

What is pyometra?

Pyometra is a bacterial infection of the uterus. The most common bacterium identified in pyometra is E. coli, which probably originates in the stool and ascends into the uterus. It often occurs about one month after a dog or cat has been in heat. In both dogs and cats, middle-aged females are at risk. About 25% of unspayed dogs will develop pyometra before age of 10. Oriental purebred cats have a higher risk of pyometra than non-purebred cats. Oriental purebred cats and Sphynx, Siberian, Ocicat, Korat, Ragdoll, Maine Coon and Bengal develop pyometra at a younger age than the general cat population. If your cat is an unsprayed female of a high risk breed, the next paragraph is a must read.

How would I know if my dog or cat has pyometra?

Early in the course of pyometra, there may not be any clinical signs. As the infection worsens, dogs may stop eating, act lethargic, vomit, drink lots of water and urinate excessively.

You might notice a white or bloody vaginal discharge. As the uterus fills with pus, your dog’s tummy might look bloated. If these clinical signs are missed, the infection progresses and can spread throughout the bloodstream. Ultimately, your veterinarian will make the diagnosis based on an abdominal x-ray or ultrasound. An x-ray of a dog with pyometra is shown above.

Because cats are not simply little dogs, pyometra looks different in the cat. Female cats are much less likely to act sick when they have pyometra until the infection is advanced and the uterus is very large. Because of the fastidious nature of cats, vaginal discharge is easily missed. Cat or dog, pyometra can be so serious that emergency surgery is required and your pet could end up in ICU.

How is pyometra treated?

The short answer to this question is surgical removal of the uterus. But the severity of illness may require extensive treatment prior to and following surgery. Pets with pyometra are frequently dehydrated, febrile and may have low blood sugar that must be corrected before surgery. In preparation for surgery, intravenous fluids, antibiotics and glucose may be administered. Veterinarians reserve non-surgical treatment of pyometra for valuable breeding animals.

Will my pet recover from pyometra?

Despite the urgency of surgery to remove the infected uterus from a critically ill pet, nearly all will make a full recovery. Fatalities in dogs tend to occur when the uterus is leaking pus into the abdominal cavity.

Since pyometra is a uterine infection caused in part by the normal reproductive cycle of cats and dogs, one of the advantages of spaying your female cat or dog is prevention of pyometra.

Pyometra can be found in many species, including this recent report about a white Bengal tiger who was successfully treated by veterinarians at Oregon State University.

Everyday Medicine: What is a spay?

“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 fecal analysis and vomiting or regurgitation.

Since February 26, 2019 is World Spay Day, today’s post focuses on spaying a healthy dog or cat as a method of contraception rather than as a treatment for a disease.

What is a spay?

Spaying is a surgical procedure that makes pregnancy impossible in a female dog or cat. Traditionally, both the ovaries and uterus are removed during a spay, but recent advances in veterinary surgery make removal of the ovaries without removal of the uterus a more common procedure.

What are the benefits of spaying my female dog or cat?

Most female pet dogs and cats are spayed to prevent unwanted litters of puppies and kittens. Removal of the ovaries also halts a female dog or cat’s reproductive cycle and prevents them from going into heat. When dogs are “in heat,” their vaginal discharge can be messy around the house. A female cat “in heat” yowls, cries, and is generally very disruptive to the humans in the household, especially those trying to sleep. “In heat” female dogs and cats attract undesirable male suitors. Spaying prevents all of these issues.

Additionally, dogs (and less commonly cats) can develop a life-threatening uterine infection called pyometra. Because spaying removes the ovaries, it removes the ovarian hormones and prevents pyometra from occurring. Finally, spaying your dog before the first heat cycle decreases their risk of breast cancer.

How is a spay performed?

There are two primary methods for performing a spay. The traditional one is through an incision in the middle of the abdomen; although spays can also be performed through an incision in the flank. However, minimally invasive methods of spaying, via laparoscopic surgery, have recently become more popular and more widely available. Laparoscopic surgery employs a tiny, high-resolution camera inserted through a small incision in the abdomen to perform surgery. The main difference between an abdominal surgery and laparoscopic surgery is the former removes both ovaries and uterus while the latter only the ovaries.

Finally, contraception is not just for girls and the surgical birth control procedure in males is often referred to as neutering.

Dental Don’ts in Celebration of National Pet Dental Month

Pet Dental Health Month: Slab FractureDuring a routine examination of your pet, your veterinarian will look in the mouth to assess his pearly whites. During National Pet Dental Month (every February), veterinarians and pet owners alike should remember to focus just a little bit more on healthy teeth. This concern for animal dental health is nothing new. In a recent article from the Proceedings of the National Academy of Sciences, archeologists from the Max Planck Institute have found evidence of equine dentistry in Mongolia as early as 1150 BCE.

To help you celebrate National Pet Dental Month using the most up to date veterinary oral hygiene recommendations, this blog post points out some common pet dental mistakes to avoid.

Don’t use human toothpaste

Fluoride-containing toothpaste has helped to revolutionize dental care in humans. But there is something drastically different about pets when it comes to toothbrushing: spitting. Dogs and cats don’t spit. This means toothpaste gets swallowed when you brush your pet’s teeth. Chronic ingestion of toothpaste can result in fluoride accumulating in your pet’s body, which can be toxic. Some toothpastes contain xylitol, an artificial sweeter. Dogs are exquisitely sensitive to xylitol and just a little bit can cause dangerously low blood sugar and liver damage. Way better to use the meat flavored toothpaste from your veterinarian’s office or get some nice dental wipes at your local pet emporium. Not sure how to brush your pet’s teeth? Watch our video featuring AMC board certified dentists.

Don’t chose anesthesia-free dental cleaning

The Animal Medical Center board certified dentists administer general anesthesia to all pets undergoing a dental cleaning. During this procedure they can clean both the cheek side and the tongue side of the teeth as well as beneath the gumline to prevent periodontal disease.

Anesthesia-free cleaning is currently in vogue in pet dental care. However, even the most well-trained pet will not tolerate dental instruments in their mouth and under the gums. Anesthesia-free dental cleanings just can’t provide the level of care your dog or cat deserves.

The American Veterinary Dental College has a policy statement on anesthesia-free dentistry in companion animals.

Avoid a nasty slab fracture of your dog’s tooth

The photo above shows a slab fracture (circled in red) of a canine premolar. This type of tooth injury is common and completely preventable. Dog’s given the opportunity to chew on bones, hooves, antlers, nylon dog chews and similar objects tend to crunch down on these hard, inflexible objects, cracking off half of their premolar. If the central pulp of the tooth is exposed, an infection can easily develop. AMC’s dentists either must repair or extract these fractured teeth.

By avoiding these dental don’ts, you will accomplish a major dental do – better oral health for your favorite fur person.

10 ways your family can enjoy animals without owning a pet

pet ownershipIn every family without a pet, there’s at least one child begging for one. But for health reasons, finances, travel or time in the daily schedule, a pet may not fit into your family’s lifestyle. But there are other ways, that you can bring animals into your family’s life without owning a pet of your own. Here are my top ten tips to add the fun and rewards of animals in your life without actually owning a pet:

  1. Attend a local animal show. The owners of dogs, cats, birds and reptiles love to show off their pets and talk to children about responsible pet ownership. In New York City we have the annual Westminster Kennel Club Show and Meet the Breeds. Local, smaller shows are great fun as well.
  2. Volunteer to walk dogs at your local shelter or to help socialize the cats residing there. Our friends at Animal Haven Shelter have a great webpage on how kids can help shelter animals.
  3. Be a foster pet family. My local rescue group is always looking for host families for cats in need. I wrote about my experiences with my foster cat family several years ago and since that time we’ve hosted more than 60 kittens or cats in our home.
  4. While it sounds a bit low tech, there are plenty of books on being a veterinarian for children of all ages. Here’s a really nice list of some of them.
  5. If your child loves dogs, but doesn’t love reading, sign up for one of the therapy dog programs where children read to dogs. This might be in a library, school or animal shelter. Participate in your library’s reading program featuring certified therapy dogs to promote reading skills in children. Reading Education Assistance Dogs (R.E.A.D.) has local programs nationwide. Therapy Dogs International sponsors “Tail Wagging Tutors.” A program like this might transform your child’s reading skills.
  6. Volunteer to pet sit for a neighbor while they are on vacation. This could be a really fun family project.
  7. Become a member of your local zoo. Many zoos have an area where children can pet the animals. In the New York metropolitan area, the Wildlife Conservation Society — which includes the Bronx Zoo, the Queens Zoo, the Central Park Zoo, Prospect Park Zoo and the New York Aquarium — has hands-on programs for various age groups, as well as educational exhibits and free demonstrations daily. Some zoos even have sleepovers and summer camp!
  8. Volunteer at a pet outreach program at your local hospital, Ronald McDonald House or senior citizens home. Ask the program coordinator if they know of a pet volunteer who you can “borrow” for the visits.
  9. Check out veterinary camp. Besides camps at zoos, many camps like the ones on this list are run by colleges of veterinary medicine. Most are for high school age students, but some accept students as young as 10 years of age.
  10. If your child dreams of being a veterinarian, it is never too soon to start planning. For tweens, Vet Set Go provides age appropriate resources and fun games. The American Association of Veterinary Medical Colleges has information online for prospective students in high school and college.

I hope these suggestion will help fill the gap in your pet loving child’s life until the time is right for your family to love a pet of its very own.

Making your cat live to be 100!

This photo is my patient, Jake, celebrating his 18th birthday which is approximately 86 in cat years.  But Jake is not my longest-lived patient, Sparky, an orange gentleman at 18 and a half takes that prize.  Weezer, a stripey spring chicken is the runner up at nearly 16 years.  What do these three elderly cats tell us about aging in our feline companions?

Many diseases, one cat

Research stemming from a Swedish pet insurance database indicates that cats like Jake represent the typical older feline patient.  In the Scandinavian cohort of cats, cancer, kidney disease and intestinal disease increase in frequency as cats age. Medically speaking, Jake has intestinal lymphoma, recurrent kidney infections, heart disease, pancreatitis and an occasional flare up of diabetes, all of which are currently under control.  Older cats, with a myriad of medical conditions, need a plethora of carefully titrated drugs to keep their problems well controlled.   From my veterinary viewpoint, these cases are incredibly challenging because one disease may need a medication like steroids while another disease like diabetes can flare up with steroid therapy.

Intestinal lymphoma

One diagnosis common to all three of these cats is cancer.  Jake, Sparky and Weezer all have lymphoma and for that matter, the same form of lymphoma, gastrointestinal small cell lymphoma.  This little fact should give you hope since all three cats have exceeded the reported average lifespan of cats which is 14 years, despite a diagnosis which is expected to send their owners into a blue funk.  Gastrointestinal small cell lymphoma has become the most common form of lymphoma diagnosed in cats and carries a good prognosis when treated early.  The take home message here is if your cat has a cancer diagnosis, despair should not be your first emotion.

Good news, cats are living longer

Sparky, Weezer and Jake reflect a new trend in cat lifespans.  Information from the Swedish pet insurance database I mentioned above suggests that cats are living longer.  For example, between 1998 and 2002, 58% of Birman cats lived on average 12.5 years and between 2003 and 2006 68% of Birman cats lived 12.5 years.  An increase in longevity was seen across the spectrum of cats including other purebreds and domestic cats.  The reason for this increase is currently a mystery.

How can you get your cat to live like Weezer, Sparky and Jake?

To have a geriatric cat, you first need your young cat to be healthy. Some very simple lifestyle modifications will help that happen.  Neutering has been shown to be associated with an increased lifespan.  Since trauma is a big killer of young cats, make your cats indoor ones.

Another killer of young cats is infectious disease.   Keeping your cat indoors will help protect your favorite fur person against contracting an infectious disease like FeLV and FIV, but vaccinations are another important component of protection against infectious disease.

Finally, feeding the right food will also help your cat grow old, but not too much, since overweight cats have a truncated lifespan.

Taking Medical Photos of Your Pet

The smartphone has revolutionized much of life today. Not only can we stay in constant contact with family and friends, but we can also listen to music, watch sporting events, and record life’s important moments in photographs and video. In a previous blog post, I suggested how you could use your smartphone to keep your pet healthy.

Smartphones have also revolutionized veterinary care via apps, access to scientific journals, and rapid communication with pet families. Your smartphone has improved my ability to care for your pet when you use it to send me images to keep me abreast of changes in your pet. Some photos are more helpful than others. Here are my suggestions to help you take the best medical photos possible.

Focus
Below is a very crisp, clear photograph of a healing incision. The photographer owner was concerned the incision was red on one end of the incision. I agreed with her assessment, but it was not severe enough for a trip to the ER, and the over the next two days the skin around the incision became normal again.

crisp photo

Compare the previous photo to this one. You can see it is out of focus and because it was out of focus I could not determine what the owner was trying to convey using this image.

fuzzy incision

Zoom In, Zoom Out
Sometimes, two photos would be helpful. The first photo should show where the problem is on the body, and the second should be closer in to show what the area in question actually looks like. On left is a photo of the elbow of a pug. The wider scope of the photo helps me see where the lesion is and how big it is. On the right is a close-up and I can readily see a bald patch without infection or swelling. If you send me only the second photo, I am at a loss as to the location of the abnormality.

zoom photo

Title Your Photo
Sometimes you are so worried about your pet, you snap a photo and send it to me without a label or caption. Without more information, I am at a loss as to what I am looking at or how I should respond. For example, the heading in the email said “Rosie today”. I couldn’t figure out what I was looking at. Turns out the photo was an out of focus close up of a stool sample with a fleck of blood on it. If the title was “Rosie’s poop today”, I could have grasped the owner’s concern.

And because a picture is worth 1,000 words, you can tell me a lot more about your pet with one well taken photograph rather than a very long email. So get clicking and start sending, but focus, title and frame those photos!

Finding the Right Sitter for Your Pet

pet sitter

In my last blog post, I wrote how smart devices like automatic feeders and pet cams make pet families lives easier. Technology is a poor substitute for a human being who watches over your pet while you are away on a business trip or vacation. Since I recommended a human pet sitter and not a robotic one, I thought I should give my readers some guidelines for selecting the right pet sitter.

Sleepaway Camp or Stay-cation
One of the first decisions you should make about care for your pet is where your pet will be taken care of: at home, at someone else’s home, or at a boarding facility. Each of these options has its pluses and minuses. A stay-cation might be great for your sedentary, octogenarian cat, but a puppy who needs exercise and training might be very bored and potentially destructive if left alone except for daily walks during your two-week vacation. If you have a dog who is the life of the party, a boarding facility will provide the perfect opportunity for a sleep away stay. The introverted dog will probably find a week at a friend’s house more to his liking.

Credentials and Qualifications
The pet-loving neighbor kid might be a good person to feed your young, healthy cat while you are away for a couple of days; on the other hand, the neighbor kid is definitely not qualified if your cat needs medications while you are away. The skill level required of a pet sitter increases dramatically when medications are involved. Your veterinarian’s office will likely know of an experienced veterinary technician or assistant who can both feed your pet and administer medications while you are away. Some veterinary hospitals will also do “medical boarding” which can be a good solution to the pet care problem. If you use a boarding facility, check on their policies regarding medication administration. Don’t forget to alert the boarding facility if any heartworm or flea/tick preventive medications are due while you are away.

God Forbid, an Emergency
Another point of inquiry is how the facility handles medical emergencies. If the boarding facility uses an emergency clinic, be sure the boarding facility knows who your pet’s regular veterinarian is and also notify your regular veterinarian regarding your pet’s boarding schedule. It wouldn’t hurt to make a quick one-pager on your pet’s current medications, health concerns and your contact information while you are away. You might also consider designating a medical proxy to make decisions in the event you cannot be reached at a critical moment.

With a bit of advanced planning, both you and your pet can have a wonderful time away even if you are apart.

Diabetes: Pets and People

Stone - Diabetes

November is American Diabetes Month. To highlight how veterinarians care for pets with diabetes, I thought I would tell the story of one of my patients, a fluffy, grey and white cat named Stone.

Stone is a youngster, just under two years of age. He came to see me because his owner had noticed weight loss and excessive drinking. Weight loss and excessive drinking are common clinical signs of diabetes, but Stone was much younger than the typical cat with diabetes. Hyperthyroidism can also cause weight loss and increased drinking, but typically occurs in older cats.

Another cause of weight loss and excessive drinking is chronic kidney disease, but again, typically in older cats. I wasn’t really sure what was wrong with Stone until the blood tests showed sugar in his urine and an elevated blood sugar.

Dogs and cats have different forms of diabetes. Dogs commonly have Type I diabetes, which is a total lack of insulin production by the pancreas. Cats have Type II diabetes which occurs most commonly in middle to older overweight cats. Unlike humans with Type II diabetes, cats require insulin injections where humans can often manage Type II diabetes with oral medications and diet. Strangely, with weight loss, insulin therapy, and a special diet, some diabetic cats will become normoglycemic again and no longer require insulin. This happened to my own cat and he stopped needing insulin for a year. Then became permanently diabetic and required insulin for the rest of his life. I think chronic inflammation of the pancreas (known as pancreatitis) was the likely cause of the diabetes.

Stone was in to see me just a few days ago. On twice daily insulin therapy, he has gained back some of the weight he lost and is eating his special diabetes diet with gusto. Blood tests indicate his blood sugar is well controlled and his owner notes it is getting harder for her to test his urine to measure the urine sugar level. I am suspicious he may be heading for a period of diabetic remission.

To help my readers understand the similarities between their own diabetes and that of their pets, I included a table below with a comparison of the common features of the disease.

Comparison of diabetes between people and their pets:

  Cat Dog Human
Occurrence 0.58% of cats 0.35% of dogs 9.4% of Americans
Type I diabetes No Yes Yes
Type II diabetes Yes No More than 90% of diabetes
Diabetic retinopathy No Rare Yes
Diabetic nephropathy No No Yes
Association with pancreatitis Yes Yes No
Oral treatments No No Yes
Insulin injections Yes Yes Yes
Spontaneous remission resolution Yes No No
Diabetic cataracts Rare Yes Yes
Linked to obesity Yes Yes Yes

Paw-o-ween: Halloween Animal Myths

Halloween dog

Halloween is a mystical holiday, full of supernatural creatures with magical powers. The spirits inhabiting All Hallows Eve and the Day of the Dead, have given us some animal myths. In this blog post, I dig deeper into the myths and determine if they are fact or fiction.

Chicken Halloween Costumes are the New Trend
Halloween spending in the United States is expected to top $9 billion in 2018, many of the dollars spent on costumes. Two weeks ago, I saw a post on Facebook with chickens in Halloween costumes. The idea seemed over the top, but harmless until I received an email entitled, “CDC calls foul on Halloween costumes for backyard chickens.” The CDC warns chicken owners not festoon their fowl for Halloween amid an outbreak of drug-resistant Salmonella. The CDC also says people should not cuddle chickens and should sanitize surfaces that have come into contact with raw poultry in order to protect themselves and their family against Salmonella from their feathered family members.

For tips on raising backyard poultry safely, read the CDC backyard poultry guidelines.

Black Cats are Bad Luck
This legend apparently started in England. Charles I had a black cat so prized, it was given its own security guard. The cat took ill and died the day Charles I was arrested. Across the pond in America, around the time of the Salem witch trials, black cats were thought to be witches in disguise, to carry demons, or to possess special powers and abilities. The rational person believes this is a total myth, but probably doesn’t know cats and also dogs with black coats are less likely to be adopted from a shelter than those dogs and cats with brown, white or multicolored coats. Animal protection organizations report black cats are often mistreated around Halloween. So, in fact, this is not a myth, a black cat is unlucky, but to himself not to us!

Pumpkin is Good for Pets
If you are one of the millions of pet owners feeding pumpkin to your pet, you know it makes a world of difference to your constipated cat or dog with fiber responsive intestinal disease. All this happens safely, inexpensively, and without drug therapy. Leading up to Halloween, every NYC farmer’s market, bodega, and grocery store is loaded with pumpkins for carving into Jack-o-lanterns. After the trick-or-treaters have come and gone, the pumpkins will linger on the front porches and stoops of our neighborhoods becoming moldy and rotten. Pet families should be sure to throw away the spent pumpkins before one of your pets decides to nibble on the decorative gourd and induce a bout of gastrointestinal upset.

Wishing all our readers a happy and safe Howl-o-ween!