Cleaning Up Eye Goop

dog eyes

Last week I took calls from pet families on SiriusXM “Doctor Radio,” which is broadcast from NYU Langone Medical Center. Although I answered numerous calls during the one hour show, one question stood out in my mind for its pure practicality: “What products are safe for me to use around my pet’s eyes?”

Dirty Eyes
Pet families have many reasons to want to clean their pet’s eyes. The first might be a bit of debris, twig, or other foreign object that has found its way into your pet’s eye causing discomfort and possibly an injury. During allergy season, itchy eyes cause pets to rub their face with their paws or on furniture. The resulting ocular discharge adheres to the fur around the eyes and can even lead to dermatitis in that area. Some dogs develop tear staining around their eyes when bacteria reproduce in the moist fur. The brown staining is unsightly but not a health concern.

Flushing the Eye
To remove debris, a twig, or other foreign object that has found its way into your pet’s eye, sterile saline used by contact lens wearers is easily obtained and safe for pet eyes. In fact, you should keep an unopened bottle in your pet first aid kit for use in an emergency.

Cleaning the Fur
When ocular discharge adheres to the periocular fur, warm water and a washcloth or gauze pads can be used to moisten and wipe away the discharge. If more than warm water is required to clean the area, one drop of no-more-tears baby shampoo in a cup of warm water makes an eye-safe cleaning solution. This solution can also be used to remove the bacteria causing brown tear staining, which is especially noticeable on white dogs. Daily washing around the eyes also decreases pollen on the face, a major cause of allergic conjunctivitis. For those on the go with their pet, little packets containing individual eyelid wipes can be found in the eye section of the drug store, and work well in pets.

Have more questions about eyes? Read about common eye conditions, your dog and cat’s third eyelid, and dry eye.

Coping with the Grief of Pet Loss

pet loss

Recently, one of my friend’s dogs developed cancer. Although I am not her veterinarian, she and I had a long talk about the grim prognosis and the treatment options. A few weeks later, after her beloved dog had crossed the Rainbow Bridge, I overheard a mutual friend, who is not a pet person, saying something like, “You have to stop thinking about her; you can always get another dog.”

Changing Attitudes Toward Pet Loss
The comment above was crushing to my friend and would be to any pet lover who has recently lost a pet. Sadly, comments like this one are not uncommon coming from someone lacking personal experience in the grief associated with the loss of a beloved pet. A recent Scientific American article highlighted the intensity of the loss experienced by pet families. Not only has the family lost a companion, but their daily routine changes, social interactions decrease, leaving them rudderless. The typical social norms applied when a parent or other human family member dies do not always apply to a pet’s death. Because you cannot always depend on your friends for comfort after the death of a pet, here are some suggestions to cope with your grief.

Find a Pet Loss Support Group
For some bereaved pet owners, their family can serve as their pet loss support group. For those without family support, I Googled “pet loss support group” and found a myriad of different services. Some groups, like the one at AMC, meet in person. Other pet loss services are virtual. There are also individual counseling sessions available. For those who are inconsolable after the death of their pet, a number of pet loss hotlines are open to provide an immediate resource. Here is a list of pet loss hotlines and their telephone numbers.

Read Books
A quick search of Amazon.com found several books which might be helpful in the period after a pet’s death. The authors Mary and Herb Montgomery have written several books on pet loss. A Special Place for Charlee: A Child’s Companion Through Pet Loss helps parents guide their child through the grief process. One interesting book is A 30 Day Guide to Healing from the Loss of Your Pet by Gael Ross. This book is part workbook, part journal and was written to facilitate the healing process after the death of a beloved pet. These are by no means the only books on pet loss and you will know when you find the book that speaks to you.

Make a Memory
While your pet was alive, you made thousands of memories. Make a scrapbook, a Facebook video, or a photo collage featuring your pet. Read a couple previous blogs for other ideas to honor or memorialize your pet. Remember it is ok to feel sad and recognize that some days will be better than others.

The Animal Medical Center’s Usdan Institute for Animal Health Education is helping those who have recently lost pets remember them and celebrate the lives they’ve lived on Thursday, September 13, 2018. Register today!

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.

Everyday Medicine: Is it Vomiting or Regurgitation?

megaesophagus

“Everyday Medicine” is an intermittent series of blog posts highlighting tests, treatments, and procedures common in daily Animal Medical Center practice. Some past examples of this type of blog post include “Cytology” and “Packed Cell Volume.” Today’s post focuses on the question: Is it vomiting or regurgitation?

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

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

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

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

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

Making the Most of Your Pet’s Microchip

microchip

The annual Check the Chip Day is Wednesday, August 15th. This pet health event reminds pet families to have the microchip in their pet checked by the staff in their veterinarian’s office to be sure it is working, as well as to update any information in the microchip database which links your pet’s microchip number to your contact information.

Microchip Basics
A microchip provides a permanent method of identifying your pet; it is not a GPS device. A microchip is about the size of a grain of rice. A veterinarian implants the chip under the skin over the shoulders. The microchip has no battery or moving parts, but emits a unique radiofrequency code and is designed to last for up to 20 years. Animal shelters and veterinary offices have microchip scanners to “read” the chip. Watch Nugget get his microchip scanned below. A microchip is typically a prerequisite for international pet travel.

And Also a Collar and Tag
A microchip is essential because many pets are not wearing a collar when they are separated from their family. But a collar with an ID tag displaying your phone number will get your pet home faster since anyone can read an ID tag, but only some have access to a microchip scanner. You might also consider putting your pet’s microchip number on their collar, but some folks choose to keep that information private.

The Power of a Chip
One of my patients escaped out the window when a workman inadvertently left the window open after doing repairs. Despite canvassing their neighborhood and following other suggestions for finding a lost pet, Sneezy was nowhere to be found. The little guy was MIA for two months until someone in the neighborhood noticed a scrawny, but very friendly cat they had not seen before. The kind neighbors scooped him up and delivered him to the local shelter. It took all of about ten minutes for the shelter staff to scan Sneezy, find his microchip and contact his jubilant family.

To make your lost pet story have a happy ending like Sneezy’s, be sure your pet’s microchip registration is up to date. If you only know the chip number, look up the company online. Also check the information on your pet’s ID tags and replace them if the information is out of date. If you want to keep your pet’s microchip information handy, download and print out this postcard from AMC’s Usdan Institute and keep it with his/her records.

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.

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.

Immune Mediated Thrombocytopenia

immune mediated thrombocytopenia

I recently wrote about the concept of immune disease – those disorders where the immune system goes haywire and attacks normal cells in the body. In a more recent blog, I wrote about one of the important canine immune diseases, immune mediated hemolytic anemia (IMHA). Today’s blog post focuses on a disease similar to IMHA, immune mediated thrombocytopenia (ITP or IMTP).

Defining ITP
The cell targeted by the out of control immune system in ITP is the platelet or blood clotting cell. The platelet is a powerhouse of coagulation. Under the microscope, a platelet is the smallest of the blood cells, yet the sticky platelet provides the first level of defense against hemorrhage. Platelets are in a large part responsible for the formation of a scab when you cut your skin while chopping vegetables or scrape your knee in a bike accident. Dogs, and the rare cat, with ITP can’t form a blood clot if nicked by the groomer because the immune system has destroyed their platelets. The lack of platelets can also result in spontaneous hemorrhage.

Recognizing ITP
You, as the healthcare advocate for your pet, may be the first one to recognize clinical signs of ITP. The hallmark of a low platelet count is little pinpoint hemorrhages on the skin, in the mouth or on the whites of the eyes. Hemorrhage may occur internally making the stool dark like tar or the urine bloody. One of my patients with ITP recently relapsed and came to the ER with a bloody nose. But, not every pet with a low platelet count or bleeding has ITP.

Causes of ITP
There are many other causes of low platelets that must be investigated before a diagnosis of ITP is made. Infectious disease tops the list of potential diagnoses for low platelets. Diseases transmitted by ticks top the list. Ehrlichiosis, Rocky Mountain spotted fever and Anaplasmosis may resemble ITP, but some readily available laboratory testing can quickly identify these diseases. Cancer, especially lymphoma or hemangiosarcoma can cause low platelet counts. Occasionally a reaction to a drug like an antibiotic can cause ITP. When a veterinarian cannot find an underlying cause of a low platelet count and a diagnostic evaluation is unremarkable, by the process of elimination, the diagnosis is ITP.

Treatment of ITP
Even though the blood cell affected in ITP is different than in IMHA, the treatment is similar since the overactive immune system needs to be suppressed to prevent more platelets from being destroyed. The first line therapy involves the use of drugs like prednisone to suppress the immune system. A chemotherapy drug, vincristine, when administered to dogs with ITP increases platelet release from the bone marrow and helps normalize their platelet count faster and shortens hospital stay. Dogs are often hospitalized for several days in case hemorrhage is severe enough to warrant blood transfusion. Most dogs recover from ITP, but some require additional drugs to suppress the immune system long term.

Other diseases affecting the immune system include polyarthritis and a variety of immune mediated skin diseases which will be the topic of a future blog post.

Heatstroke

heatstroke

It’s that time of year when the Animal Medical Center’s ER prepares to see dogs and cats with heatstroke. Heatstroke occurs when the ambient temperature overwhelms the body’s cooling mechanisms. Both heat and humidity contribute to the development of heatstroke. When humidity is high, pets cannot cool themselves by panting, a form of evaporative cooling. When the air is full of water, evaporation from panting occurs slowly and cannot keep the body temperature in a safe range.

Too Hot
The normal body temperature of dogs and cats is 100-102°F. AMC’s ER does not become concerned when a fever is as high as 104 or 105°F. Heatstroke is a body temperature 106-108°F. When the body gets that hot, multiple organs begin to fail.

Hot Pets
While heatstroke can happen to any pet, certain dogs are at greater risk. Snub-nosed dogs are unable to use evaporative cooling via panting as well as dogs with longer noses, and thus are a greater risk of developing heatstroke. Dark-coated dogs, golden retrievers, Labrador retrievers, overweight dogs, and those not acclimated to the heat are also at increased risk.

Heatstroke Symptoms
Hot skin, vomiting, panting, distress collapse, incoordination, and loss of consciousness are all indicators of heatstroke. If your pet is developing heatstroke, you will notice nonstop panting, hot, red skin and weakness. This may progress to incoordination, collapse and loss of consciousness. At the first hint of heatstroke, head to your local animal ER.

Head to the Animal ER
If you suspect heatstroke, go immediately to the closest animal ER, do not delay. Experts say trying to cool your pet off on your own wastes valuable time. But, if on your way out the door you can grab ice packs or frozen food from your freezer, put the frozen food on your pet in the car on the way to the ER.

Heat Injury
The extent of illness may not be apparent upon arrival in the ER. Heatstroke is a multi-organ system disorder. Pets experience circulatory shock from fluid loss from panting. Heat damages normal tissues like the brain and other vital organs. Damaged brain neurons cannot be replaced and may result in cognitive decline following an episode of heatstroke. Abnormalities in blood clotting and kidney function may not become apparent until hours after arrival in the ER.

Tips to Prevent Heatstroke
Preventing heatstroke is critical since data indicates half of pets suffering from heatstroke don’t recover.

1. Don’t exercise in heat of the day, only early or late. Heatstroke occurs most often in the afternoon.
2. Don’t leave pet in a hot car, even with the windows cracked. In one study, a hot car was the number one cause of heatstroke.
3. Provide access to cold water. Consider choosing a water bowl designed to keep water cool or add ice cubes to the bowl.
4. Provide shade with an umbrella or a covered kennel.
5. Try out a cooling jacket or mat.

Click for more suggestions on keeping your dog cool during the hot summer months.

Fun Feline Facts

cats playing

For my final blog post of Adopt A [Shelter] Cat Month, I am going to be less medical and more fun. To that end, I am going to share with you my latest collection of fun feline facts.

Purring Pussycats
One of the most endearing qualities of cats is their ability to purr. In my mind, there is nothing better than a cat on my lap, snuggled in and purring away. Everyone can recognize purring, but I suspect few can define it. In Mammal Review, purring is defined as a continuous sound produced on alternating (pulmonic) egressive (breathing out) and ingressive (breathing in) airstream. Purring results from neural oscillation – neurons which turn on and off rapidly causing rhythmic contraction of the laryngeal muscles 20-30 times per second. Based on the above definition of purring, not all felines can purr. Those that do not purr are those that roar: the lion, tiger, jaguar, and leopard. All other felidae can purr.

Are Right-Handed Cats Nicer?
This is really two fun facts rolled into one. First, did you even consider your cat could be right or left handed? Probably not. But in a recent study in the International Journal of Neuroscience, female cats exhibited right handedness more than males when tested with a food reaching test. About 10% of all cats were ambidextrous. Although an ambidextrous cat might sound intriguing, a behavioral study found ambidextrous cats less affectionate and more aggressive than righty or lefty cats. Strongly right or left-pawed cats were determined to be more confident and affectionate than those with weaker paw preference.

Are Cats or Dogs Smarter?
The answer to this question is open to a great deal of bias depending on your affinity for felines or canines. Scientists have tried to answer this question with data rather than their heart. In a study published in Frontiers in Neuroanatomy, researchers found dogs possess about 530 million neurons in the cortex, while cats have about 250 million. Neurons in the brain often go unused, so just having more neurons does not necessarily make dogs smarter. In fact, when you think about cats, they are phenomenal hunters and can easily out hunt humans with their neuron-loaded brains. So the number of neurons in the cat brain is not necessarily related to intelligence; the answer may lie in the function of each of those neurons. This quote from Dr. Brian Hare at the Duke University Canine Cognition Center answers the question thoughtfully. “Asking which species is smarter is like asking if a hammer is a better tool than a screwdriver. Each tool is designed for a specific problem, so of course it depends on the problem we are trying to solve.”

Are you coming late to Adopt A [Shelter] Cat Month? Did you miss the first three feline-focused blog posts? Catch up here:

  • Lifestyle Factors Related to Feline Obesity
  • Explaining the FVRCP in Feline Vaccines
  • Alternatives to Catnip