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.

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.

Do you really need a cat sitter?

catsitter

This week marks the beginning of the 2018 holiday season and with the holidays comes travel for celebrations with family and friends. Grandma may not have your cat on the holiday guest list, and other cats are just homebodies. With all the smart devices available to cat lovers, is a cat sitter really necessary when your cat is not traveling with you?

Remote Feeders
One of my very tech oriented millennial clients stopped by for new food and medication for his cat. We discussed the exact amount of the new food she should eat. After we settled on one quarter of a cup three times daily, he simply sat in the chair in my office and used his cat’s smart feeder app on his phone to dispense the exact amount of food from the feeder’s dry food reservoir. Get a water fountain at your local pet emporium and you don’t even have to worry about refilling the water bowl.

Robotic Litterboxes
For those that hate scooping poop, a self-cleaning litter box eliminates that chore. These litter boxes also allow you to leave your cat home unattended but maintain their litter box in pristine condition, at least until the waste drawer is full. Robotic litter boxes require a power source and are bigger than traditional boxes, so you will need the right space to take advantage of their convenience. Cats must weigh over a certain amount (>5 pounds) to trigger the automatic scoop function, so this might not be a good choice for petite cats.

Treat Cams
Smart technology using cameras and microphones will allow you to check in on your cats and talk with them via Bluetooth as long as you have a Wi-Fi connection. Some smart cams have additional functionality and can dispense treats, spritz aromatherapy, and stream video from the internet. With all this connectivity, will your cat even miss you?

Who’s in charge while you’re away?
While smart technology will allow you to provide food, water, a clean litter box, and some remote human interaction, some glitches could thwart your best laid plans for a sitter-free holiday. If your cat needs medication, smart technology may not be able to ensure your favorite feline isn’t spitting out the pills just out of camera range. Since all these devices depend on internet service and electricity, a winter storm that knocks out the power could leave your cat hungry and thirsty and in the dark. All your smart devices will make the cat owner’s life easier, however nothing can replace what your cat craves most, you. So give your cat a special holiday gift, her very own cat sitter!

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!

Should I Adopt an Older Dog?

Adopt a dog

October is Adopt a Dog Month or Adopt a Shelter Dog Month. Either way, I hope your family is thinking about whether or not adopting a dog is the right move. Keep in mind, adopting a dog at the wrong time or without considering its impact on your family is always a bad idea. Adopting a puppy, with her big eyes and fluffy coat, is easy until the little devil comes home. Adopting an adult dog, may circumvent some of the puppy-raising challenges puppy families face.

Advantages of a Grown-Up Dog
In my mind, adopting an adult dog bypasses one of the biggest challenges of having a puppy: housebreaking. Adult dog adopters shouldn’t expect perfection from the new arrival, but after a few days, most housebroken dogs will realize how they go “out.”

Teething is another puppy milestone avoided by adopting an adult dog. Last week, one of my teething puppy patients ate some shoe trees, a bottle of Zantac, and a box of tissues after letting himself into the bedroom. Other puppy patients have eaten woodwork, chair legs, and shoes. Once a dog hits about one year of age, their indiscriminate chewing tends to subside.

Last spring, one of my mature clients got a new puppy. Both of his aged dogs had died over the winter. The new puppy was delightful, except for the stubborn Giardia infection. In a moment of diarrhea-related frustration and puppy induced exhaustion, he asked me to find her a new family. Now that the diarrhea is cleared up and she is approaching her first birthday as a much calmer grown-up dog, there is no chance of him giving her up, but this vignette shows how trying puppies can be.

Points to Consider When You Adopt Any Dog
Puppies require a series of visits to the veterinarian for vaccinations and other preventive health care procedures. While these medical expenditures will not be necessary in an adult dog that is already well vaccinated and spayed or neutered, all pets need medical care. Your family needs to consider not only the cost of preventive care but how you will manage a catastrophic illness or injury. Other ongoing costs to include in budget planning are food, treats, grooming, boarding, and the inevitable wardrobe of seasonal collars, leashes, and bandanas you just can’t resist at your local pet emporium.

Adopting is Not for Everyone
Some families need the predictability of a purebred dog. Certain breeds are easier for people with allergies, making the decision to have a purebred dog a medical decision. Those of us living in apartment buildings face restrictions on dog size and breed. A cute puppy with an unknown family tree may result in a lovely pet that exceeds the size limit set by the building’s board of directors. Who needs that kind of heartbreak?

Did this blog post make your choice between a puppy and a dog easier or more difficult? Whatever your decision, consider adopting, not shopping.

Immune Mediated Neutropenia

Schnauzer

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 more recent blog posts, I wrote about two important immune diseases: immune mediated hemolytic anemia (IMHA) and immune mediated thrombocytopenia (ITP or IMTP).  Today’s blog post focuses on a third immune disorder of blood cells: immune mediated neutropenia.

Neutrophils Fight Infection
Neutrophils are the first responders of the immune system. When you get a splinter in your finger, neutrophils rush to the site to start cleaning up bacteria and other nasties. The accumulation of neutrophils in a focal site is known as an abscess. Without neutrophils, the immune system cannot inactivate infectious agents, and patients run the risk of developing a life-threatening systemic infection.

Immune Mediated Neutropenia
Neutropenia is just a fancy way to say a low neutrophil count. Similar to dogs and cats with IMHA and IMT, the immune system of pets with immune mediated neutropenia destroys blood cells, specifically, neutrophils.

Recognizing Immune Mediated Neutropenia
Immune mediated neutropenia is much less common than either IMHA or IMT and is less common in cats than in dogs. A recent study found dogs with immune mediated neutropenia saw their veterinarian because of poor appetite, lethargy or fever, which are all very non-specific clinical findings. A complete blood count is required to identify a low neutrophil count, but if neutropenia is identified, your veterinarian will recommend a battery of tests to evaluate your dog or cat’s low neutrophil count. In addition to immune mediated destruction, low neutrophil counts can result from an infectious disease like ehrlichiosis, a fungal disease such as histoplasmosis or a bone marrow disorder.

Treatment of Immune Mediated Neutropenia
Like the other immune blood cell disorders, initial treatment of dogs and cats with immune mediated neutropenia involves suppressing the immune system with steroids. According to recent research, most dogs with immune mediated neutropenia responded quickly to steroid administration, while a few required additional immunosuppressive agents to correct the neutropenia. While I hope your dog or cat never gets immune mediated neutropenia, the majority of pets diagnosed with this disorder survive for an extended period of time.

Veterinary Neurological Conditions

AMC's neurology team

The Animal Medical Center has 36 board certified specialists in 17 different specialties. Neurology is a critical specialty at AMC and we are lucky to have three experienced specialists in veterinary neurology who are available to AMC patients seven days a week. The Neurology Service also trains the next generation of veterinary neurologists and currently has three residents in training. Many readers might not be familiar with common neurologic disorders of dogs and cats, so I will highlight them in this blog post.

Top Neurologic Conditions
The most common problems managed by AMC’s Neurology Service include seizures in dogs and cats, disc problems in the backs of dogs, and vestibular disease. A seizure occurs because the electrical system of the brain goes haywire. Seizures occur in all breeds of dogs and cats. Intervertebral disc disease has clear breed predictions. If you have a French bulldog, a dachshund, or a cocker spaniel, your dog is at increased risk of developing a slipped disc. All dog owners should be aware of the problem of slipped discs in dogs and seek emergency care if their dog suddenly can’t walk. When the disc slips out of its normal place, the disc pushes on the spinal cord causing pain and affecting the nerves controlling the back legs. Vestibular disease may also result in the sudden inability to walk, but dogs tend not to be painful, just very dizzy and often nauseous.

Intersection of Medicine and Neurology
Certain medical conditions can mimic neurologic ones. For example, a low blood sugar level deprives the brain of necessary fuel and can result in a seizure that is different than a seizure caused by epilepsy or a brain tumor. Fainting might look like a seizure or an episode of vertigo, but in cats, fainting is commonly caused by heart disease. Pet owners might think shaking is a neurologic condition, but the causes of shaking in dogs include hormone disorders, low calcium levels post-partum, and ingestion of toxic substances.

Neurology Diagnostic Tools
AMC has both a CT scanner and an MRI. Neurology typically uses the MRI to diagnose disorders of the brain and spinal cord. Dogs with back problems have an MRI, often in the middle of the night, before surgery to remove an out of place intravertebral disc. An MRI scan is also the test of choice in patients with seizures. Neurologists may also perform a spinal tap in seizure patients to evaluate the fluid around the brain to determine the cause of the seizures.

If you have a pet with a neurologic condition or want to learn more about veterinary neurology, tune in to “Ask the Vet” on SiriusXM Stars channel 109 on Friday, September 7 at 1pm EDT to hear an interview with AMC’s chief neurologist Dr. Chad West.

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.

Suffocation Risks for Pets

pet suffocation

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

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

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

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

Protecting Your Pet Against Suffocation

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