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.

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!

Having a Heart to Heart Talk with Yourself About Your Pet’s Cancer Diagnosis

Cure Pet Cancer

November is National Pet Cancer Awareness Month. One in every four dogs and one in every five cats will develop cancer in their lifetime and @amcny is doing its part to raise pet cancer awareness by tweeting to #CurePetCancer to raise awareness.

Since cancer diagnoses are common in pets, many of my readers will face the difficult task of choosing cancer treatment decisions for their pet. Here is a list of questions you should ask yourself as you work through that decision-making process.

What kind of cancer specialist does my pet need?
Veterinary cancer specialists are not all the same. At AMC, we have three different types of cancer experts for pets: those that focus on administering chemotherapy, some who specialize in delivering radiation therapy, and the third type have special training in surgical oncology. We all know the basics of cancer treatment principals, but have different strengths within that core information. Your pet may need a consultation with one of us or all of us, depending on the type of cancer that has been diagnosed. The answer to this question lies in the biopsy because the type of tumor your pet has dictates the treatment options.

What kind of treatment is the oncologist recommending and is it right for my pet?
There are three main treatments for cancer: surgery, radiation and chemotherapy. Not every treatment is appropriate for every type of cancer and based on the biopsy, an oncologist will discuss what options are available to your pet and the expected outcome for each treatment option. Chemotherapy and radiation therapy require multiple treatments over several weeks to months. Surgery typically requires only a few visits to the hospital and has the highest chance of curing certain cancers. Cancer is most common in older pets and the grey muzzle set is also most likely to have other medical conditions which have to be taken into consideration in making the decision to pursue cancer treatment.

Do I have the resources to undertake the recommended treatment?
This question isn’t just about money, although cancer treatment can be costly. Another consideration when making the decision to treat your pet’s cancer is your time. Sometimes a trip to the surgical oncologist is all that is needed and other times 20+ trips are required for a course of chemotherapy. Be sure you understand what is required for the recommended treatment protocol. Your emotional resources count too. Maybe you are also caring for a seriously ill human family member and cancer treatment for the pet is more than you can handle. Or maybe it is the other way around and you can’t bear to lose two family members at once.

What is the prognosis for my pet with and without treatment?
This is a loaded question. The question is fair, but pet families who choose not to treat their pet’s cancer don’t often consult with an oncologist. That means oncologists, like me, don’t always have a good handle on the prognosis without treating many types of cancer.

If you have decided to make an appointment for a consultation with a veterinary cancer specialist, read about fancy cancer words that we try to keep out of our conversation with you, but sometimes accidentally slip into a conversation about treating your pet. Being prepared for a visit with a specialist will help to make sure all your questions are answered.

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!

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.

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.

Catnip and its Alternatives

catnip

June is Adopt a [Shelter] Cat Month and every blog post in June will focus on some aspect of our furry feline friends. Today’s topic is catnip and other plants cat families can use to enrich their cat’s home environment.

Catnip
Those of us who have had more than a few cats in their lifetime know not all cats react to the herb Nepeta cataria, colloquially known as catnip. Passion for catnip depends on a cat’s age and genes. Kittens less than about 8 weeks of age do not respond to catnip. In the population of cats at large, 25% of cats are not genetically programmed to respond to neptalactone, the substance in catnip that induces a kitty high – rolling, rubbing, sniffing, and chewing. Since not all cats enjoy a catnip high, a recent article in BMC Veterinary Research provides some suggestions of other plants which your cat may safely enjoy.

Silver Vine (Actinidia polygama)
This plant, also known as cat plant, is native to China and Japan. The plant can grow to a height of six feet and has pretty white flowers. Nearly 80% of cats responded positively to sliver vine. I found several products on pet websites containing silver vine, including sticks and dried leaves. In case you have a green thumb, you can also purchase seed packets to be used in a do-it-yourself cat garden.

Tatarian Honeysuckle (Lonicera tatarica)
You might find this Siberian import in your yard or nearby woods as it is considered a noxious and invasive species. Tatarian honeysuckle is a bush with pretty pink flowers found in hardy to Zone 3 areas. Some feline-centric websites offer honeysuckle sticks for your cat. Fifty percent of cats appear to enjoy the olfactory stimulation provided by honeysuckle.

Valerian (Valeriana officinalis)
Valerian-based products can easily be found in health food stores because the plant has a long history as an herbal therapy for promoting sleep. About half of cats given valerian root have a positive response. Directions on how to grow Valerian in your garden and prepare the roots for your cat can be found here. Both you and your cat will enjoy this plant since the flowers are dramatic balls of white flowers which will be lovely in a vase on your table.

Catnip, silver vine, Tatarian honeysuckle and valerian all provide safe olfactory entertainment for your cat, but not every houseplant or flower is feline-friendly. Check this list of plants toxic to cats and avoid having them in your home.