tag:blogger.com,1999:blog-27221519625348336912024-02-20T23:12:32.422-08:00ACCES for Pet Health - A Veterinary BlogACCES Animal Critical Care and Emergency Services is committed to educating pet owners about current information in the veterinary world.Unknownhttp://www.blogger.com/profile/09328319891800106430noreply@blogger.comBlogger45125tag:blogger.com,1999:blog-2722151962534833691.post-446002366061439872013-11-21T13:49:00.000-08:002013-11-21T13:49:17.441-08:00National Pet Diabetes Awareness Month<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi5GTTPkhfARvKMFqa7RJFv5NwUmDlNoP2hqhxlellZ46MQdx6PBtrctRyxXQzmVYOaJQRo4xi5HwpbTErXeHCH2h6K6dpZ2RC7L1R5IIGm77XffVLVl9hAxN5uaVc6Nro8umM_bj7b2wCt/s1600/cateye.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="132" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi5GTTPkhfARvKMFqa7RJFv5NwUmDlNoP2hqhxlellZ46MQdx6PBtrctRyxXQzmVYOaJQRo4xi5HwpbTErXeHCH2h6K6dpZ2RC7L1R5IIGm77XffVLVl9hAxN5uaVc6Nro8umM_bj7b2wCt/s200/cateye.jpg" width="200" /></a></div>
<div class="MsoNormal">
<span style="font-family: Arial;">By Brianna Backlund, DVM, DACVIM</span></div>
<div class="MsoNormal">
<span style="font-family: Arial;">Thursday, November 21, 2013</span></div>
<div class="MsoNormal">
<span style="font-family: Arial;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: Arial;">As the holiday season
approaches, thoughts of pumpkin pies, gingerbread houses and sugar plum ferries
occupy a lot of our free time. I’ve heard many people joke about going into a
diabetic coma after taking in too much sugar. You may not realize that,
although it’s not quite as straightforward as that, our canine and feline family
members too can have serious consequences from an imbalance in blood sugar
levels. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial;">Is your cat or dog drinking
a lot of water and urinating more than usual? Is your dog losing weight despite
a good appetite or is your cat overweight? If so, then you might take them to
your primary care veterinarian for screening for diabetes mellitus. Cats and
dogs can also develop diabetes, just as humans can. One in 50 to one in 500
cats have diabetes and one in 100 dogs reaching 12 years of age has diabetes. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial;">Diabetes mellitus results
from the body’s cells not being able to use glucose taken in from food or made
by the body for energy. This disease can develop due to a variety of underlying
causes that can make the disease more complicated, but with uncomplicated
diabetes mellitus, its original diagnosis is actually quite straightforward. In
order to make the diagnosis, your veterinarian will simply need to collect
blood and urine samples for testing with the goal of identifying high blood
glucose levels with glucose in the urine. Just like people, diabetic pets often
need a diet change as well as injections of insulin to allow glucose to enter
the cells and provide them with the needed energy to function. Many of the
insulin types used are the same as those used for human diabetics. As you can
imagine, it is difficult to manage a human with diabetes. It can be just as
difficult, if not more so, to undertake this care for a diabetic dog or cat.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial;">As a general rule, this is a
chronic disease condition that can respond well to appropriate insulin
injections. If these subtle signs however have gone unnoticed for an extended
amount of time, the body can only cope for so long without an appropriate
supply of energy to the cells and your pet can develop an emergent condition
called diabetic ketoacidosis (DKA). When your pet becomes very ill with DKA,
they will most likely need to be taken to the ER for hospitalization, monitoring,
supportive care, and starting insulin therapy. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
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<span style="font-family: Arial; font-size: 12.0pt; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "MS 明朝"; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-fareast;">If you have worries about your pet and feel that
they are demonstrating some concerning signs, please take them in right away to
your veterinarian for evaluation and to discuss diabetes mellitus in more
detail.</span><!--EndFragment-->
Unknownhttp://www.blogger.com/profile/09328319891800106430noreply@blogger.com0tag:blogger.com,1999:blog-2722151962534833691.post-81501542887021609762013-11-11T09:00:00.000-08:002013-11-11T09:00:40.615-08:00New Warnings from the FDA on Raw Food Diets
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi0gBn0uMc0hSBi612fRsIYqd1_jzko4JZqEXCSWeJ0KVr4Juswh5VZa84JFeXDwLYa0z72qtFOsydOtJJMSZP9juaOxTW8nIKhaJmKIgiC2G1ku6PV-MKCQAAGHCgbp2Oq6UzV9FIZI-MW/s1600/dog_cat_fridge.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi0gBn0uMc0hSBi612fRsIYqd1_jzko4JZqEXCSWeJ0KVr4Juswh5VZa84JFeXDwLYa0z72qtFOsydOtJJMSZP9juaOxTW8nIKhaJmKIgiC2G1ku6PV-MKCQAAGHCgbp2Oq6UzV9FIZI-MW/s200/dog_cat_fridge.jpg" width="129" /></a></div>
<div class="MsoNormal">
<span style="font-family: Arial;">By Emilio E. DeBess, DVM,
MPVM, State Public Health Veterinarian, Oregon Department of Human Services<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial;">November 2013<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal">
<b><span style="font-family: Arial;">FDA warns about feeding
your pet a raw-food diet</span></b><span style="font-family: Arial;"><o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Arial;">In a new study, compared
to other types of pet food tested, raw pet food was more likely to be
contaminated with disease-causing bacteria, the FDA said<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Arial;">“The Food and Drug
Administration (FDA) is cautioning pet owners about feeding their animals raw
diets, warning that those who do may have a higher risk of getting infected
with Salmonella and Listeria monocytogenes.”<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial;">In a new study, compared
to other types of pet food tested, raw pet food was more likely to be
contaminated with disease-causing bacteria, the agency said.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
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<span style="font-family: Arial;">The new warning was issued
after a two-year study, in which the FDA Center for Veterinary Medicine (CVM)
screened more than 1,000 samples of pet food for bacteria that can cause
foodborne illnesses.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial;">In the study, CVM sampled
196 commercially available raw dog and cat food. The center bought a variety of
raw pet food online from different manufacturers and had the products shipped
directly to six laboratories for analysis, according to the FDA. The raw
pet-food products were usually frozen in tubelike packages and made from ground
meat or sausage.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial;">Of the samples analyzed,
15 were positive for salmonella and 32 were positive for listeria.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial;">The study “identified a
potential health risk for the pets eating the raw food, and for the owners
handling the product,” said Dr. Renate Reimschuessel, a researcher at CVM’s
Office of Research and one of the study’s principal investigators.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial;">The FDA said the best way
to prevent infection is to not feed your pet a raw diet; however, the agency is
aware that some people prefer this type of food and offers some tips to prevent
salmonella and listeria:<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial;">Thoroughly wash
your hands with soap and water (for at least 20 seconds) after handling raw pet
food, and after touching surfaces or objects that have come in contact with the
raw food. Potential contaminated surfaces include countertops and the inside of
refrigerators and microwaves. Potential contaminated objects include kitchen
utensils, feeding bowls and cutting boards.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial;">Thoroughly clean
and disinfect all surfaces and objects that come in contact with raw pet food.
You can also run items through the dishwasher after each use to clean and
disinfect them.<o:p></o:p></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 6.0pt; mso-layout-grid-align: none; mso-list: l0 level1 lfo1; mso-pagination: none; text-autospace: none; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial;">Freeze raw meat
and poultry products until you are ready to use them, and thaw them in your
refrigerator or microwave, not on your countertop or in your sink.<o:p></o:p></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 6.0pt; mso-layout-grid-align: none; mso-list: l0 level1 lfo1; mso-pagination: none; text-autospace: none; text-indent: -.25in;">
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</span></span><!--[endif]--><span style="font-family: Arial;">Carefully handle
raw and frozen meat and poultry products. Don’t rinse raw meat, poultry, fish
and seafood. Bacteria in the raw juices can splash and spread to other food and
surfaces.<o:p></o:p></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 6.0pt; mso-layout-grid-align: none; mso-list: l0 level1 lfo1; mso-pagination: none; text-autospace: none; text-indent: -.25in;">
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separate from other food.<o:p></o:p></span></div>
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cover and refrigerate what your pet doesn’t eat or throw the leftovers out
safely.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial;">If you’re using
raw ingredients to make your own cooked pet food, be sure to cook all food to a
proper internal temperature as measured by a food thermometer. Thorough cooking
kills harmful foodborne bacteria.<o:p></o:p></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 6.0pt; mso-layout-grid-align: none; mso-list: l0 level1 lfo1; mso-pagination: none; text-autospace: none; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial;">Don’t kiss your
pet around its mouth, and don’t let your pet lick your face. This is especially
important after your pet has just finished eating raw food.<o:p></o:p></span></div>
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</span></span><!--[endif]--><span style="font-family: Arial;">Thoroughly wash
your hands after touching or being licked by your pet. If your pet gives you a
“kiss,” be sure to also wash your face.<o:p></o:p></span></div>
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<br /></div>
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<br /></div>
<!--EndFragment--><br />
<!--EndFragment-->Unknownhttp://www.blogger.com/profile/09328319891800106430noreply@blogger.com0tag:blogger.com,1999:blog-2722151962534833691.post-74507968370219560072013-11-08T13:33:00.000-08:002013-11-08T13:33:39.852-08:00Case Study: Wild Mushrooms – Playing Roulette if You Eat Them for Dinner
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg9gbPw6V8ZwMLBOghDNxADl-dw981mFop2IfCVnLm8fW363E9Zy1pLQOr-6rFpwJ2IQ0G2pDx4jl_48UvJtABXIZoj_FvcXdiPEp_Z2VZx96Adjd3Vy3deb_738G0Wj61V59gIo-LUn2vK/s1600/Molly_mushrooms.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="150" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg9gbPw6V8ZwMLBOghDNxADl-dw981mFop2IfCVnLm8fW363E9Zy1pLQOr-6rFpwJ2IQ0G2pDx4jl_48UvJtABXIZoj_FvcXdiPEp_Z2VZx96Adjd3Vy3deb_738G0Wj61V59gIo-LUn2vK/s200/Molly_mushrooms.jpg" width="200" /></a></div>
<div class="MsoNormal">
<span style="font-family: Arial;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: Arial;">Friday, November 8, 2013<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Arial;">By Beth Davidow, DVM DACVECC<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial;">It’s that time of year when
all of us start seeing more mushrooms around. The combination of sun, rain, and
increased organic material on the ground is perfect for fungal growth. This
year in particular has been very good for mushrooms in the Pacific Northwest and
those mushroom hunters who know what they are doing, have had a banner year. However,
the conditions that make for amazing edible chanterelles, also lead to more of
the poisonous variety as well.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial;">Last weekend, we saw several
cases of mushroom toxicity in dogs. Molly, a six-year-old female spayed
Labrador, was seen to eat mushrooms in the yard. She vomited some mushrooms and
began having diarrhea within the hour. However, she then became wobbly when
walking and was comatose when she presented to our emergency hospital in Renton
a few hours later. Molly was intubated (tube was placed in her throat to
protect her airway) and we initiated breathing for her. We pumped her stomach
to try to remove mushrooms and also gave her enemas, which removed even more
mushrooms. She was placed on intravenous fluids as well as supportive
ventilation. She needed to be ventilated overnight but by the next morning, she
started to wake up and could breathe on her own. She continued to improve, was
fairly normal by dinnertime and was sent home that evening, about 36 hours
after arrival. She continues to do well with no organ injury.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial;">The mushrooms were
identified by a mycologist as Amanita muscaria. They are part of the family of
“death cap” mushrooms, but unlike Amanita phalloides, they do not cause kidney
or liver failure. Their appearance can vary making identification tricky. While
the signs caused by Amanita muscaria are extremely dramatic, all the dogs we
have treated with this ingestion have done well, but needed 24-48 hours of very
intensive care. More information on this mushroom type can be found :<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Arial;"><a href="http://en.wikipedia.org/wiki/Amanita_muscaria">http://en.wikipedia.org/wiki/Amanita_muscaria</a><o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial;">Amanitas are not the only
poisonous mushrooms in this area. Other toxicities seen with mushrooms can
include severe tremor syndromes, dangerously low heart rates, and severe
gastrointestinal signs. Our veterinarians have treated pets with all of these
different syndromes.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial;">A general rule is that if
your pet gets sick very quickly after eating a mushroom, they probably won’t
have longterm damage but if they get sick hours later, it could be extremely
serious. If you see your pet eats a mushroom, it is best to contact your
veterinarian right away. If there are other similar mushrooms in the same
vicinity, you can use a paper bag to pick a few for identification. Mushrooms
are very tricky to identify but it is easier when they are stored in paper
rather than plastic bags. The best way to keep your pet safe is to get rid of
any mushrooms you see in your yard and to prevent them from eating any
mushrooms they might find on a walk. <o:p></o:p></span></div>
<!--EndFragment-->Unknownhttp://www.blogger.com/profile/09328319891800106430noreply@blogger.com0tag:blogger.com,1999:blog-2722151962534833691.post-33799040513438633262013-10-09T10:26:00.000-07:002013-10-09T10:26:25.197-07:00Why Fat Cats and Dogs are a Problem
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgA5mpt1_9wwJFore8WlMoXX-5R9x1ZABdSfP6sJcsDpTLkNw572gC_9pTOqn3f0qqS_dkE9udpkl3qWPJJJDk156xKpFNGfEUXKTdpEpDxWz0H7rq_URTMi4cwHYhUBaZpIagInOEhvowC/s1600/FatPug_Scale.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="221" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgA5mpt1_9wwJFore8WlMoXX-5R9x1ZABdSfP6sJcsDpTLkNw572gC_9pTOqn3f0qqS_dkE9udpkl3qWPJJJDk156xKpFNGfEUXKTdpEpDxWz0H7rq_URTMi4cwHYhUBaZpIagInOEhvowC/s320/FatPug_Scale.jpg" width="320" /></a></div>
<div class="MsoNormal" style="text-align: left;">
<b><span style="font-family: Arial;"><br /></span></b></div>
<div class="MsoNormal" style="text-align: left;">
<b><span style="font-family: Arial;">By Beth Davidow, DVM DACVECC<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: left;">
<b><span style="font-family: Arial;">Wednesday, October 9, 2013<o:p></o:p></span></b></div>
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<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial;">As the fall sets in, I
always feel that I really want to eat more. The colder weather means we are
inside, closer to the kitchen. I find I’m baking more and thinking about
desserts for upcoming holidays. As we eat more, and spend more time in the
kitchen, our furry companions tend to join us and they know just how to meet
our eyes, do tricks and convince us, that they too need a little extra
something yummy.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial;">But just as extra pounds can
be problematic for us, extra pounds can also be problematic for our pets. Because
they are smaller than us, we sometimes don’t realize how much the percentage
gain really is. While if we average 150 lbs and then went up to 200 lbs over
the winter, we would probably be very concerned with our weight gain, we
sometimes don’t bat an eye when our 15 lb cat suddenly becomes 20 lbs, a
similar proportional gain.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial;">Obesity is a huge problem
for animals and has been an increasing problem. As in humans, obesity in our
pets can lead to bone and joint problems, increased risk for certain cancers,
increased heart and lung problems, increased urinary issues, and much increased
risk for diabetes. <o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial;">At our emergency hospital,
one common life-threatening emergency in cats is urinary blockage. There are
good studies that show that overweight cats are at a much higher risk for this
condition than cats in good body condition. In small dogs, a large portion of
the dogs with severe respiratory problems are also overweight. Many of these
patients present on emergency needing oxygen and end up on many medications. If
owners are successful in having these dogs lose weight, many end up requiring less
medications over the long haul. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial;">So why do dogs and cats
become obese? In the vast majority of
cases it is because caloric intake is in excess of the calories burned during
the day. In a few cases, they have an underlying problem such as hypothyroidism
but this is the exception not the rule. Thus, to keep thin, pets either need
less calories or more exercise. As in people, often the culprit is not the
meals but the in between meal snacks. Remember that if your 10 lb dog usually
gets a ¼ cup of food twice a day, two large milk bones probably increased his
calories by 10%.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: Arial;">This fall, try not to
succumb to that cute little face cocking their head at you to share your muffin.
Although extra treats may show them you love them in the short term, the consequence
may be higher vet bills and more trips to the emergency room. Instead, pick up
their leash, brave the rain, and take them for a walk. You will both be happier
and healthier in the long run. <o:p></o:p></span></div>
<!--EndFragment-->Unknownhttp://www.blogger.com/profile/09328319891800106430noreply@blogger.com0tag:blogger.com,1999:blog-2722151962534833691.post-72668970366832943272012-12-05T12:21:00.000-08:002012-12-05T12:21:21.742-08:00Parvovirus – An update
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<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh-qkzsrPHVfAz7LKcM0NyYHLHkIzDrM7L7C9S0R8WVLxs7daIbtUP1J_PMiMMQTNIaGiQ_mXbCeu6cV1NJb7h85N5-2WOj7hTYkAQQU_yPf3ZxSJ-Pg_W2hC-9uQj6qPwKVp2ZBg4Fn3zX/s1600/Beth_Davidow.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh-qkzsrPHVfAz7LKcM0NyYHLHkIzDrM7L7C9S0R8WVLxs7daIbtUP1J_PMiMMQTNIaGiQ_mXbCeu6cV1NJb7h85N5-2WOj7hTYkAQQU_yPf3ZxSJ-Pg_W2hC-9uQj6qPwKVp2ZBg4Fn3zX/s200/Beth_Davidow.jpg" width="160" /></a></div>
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<div class="MsoNormal">
<span style="font-family: 'Franklin Gothic Book'; font-size: 15px; text-align: center;">By Beth Davidow, DVM DACVECC</span></div>
<div class="MsoNormal">
<span style="font-family: "Franklin Gothic Book"; font-size: 11.0pt;">ACCES
Medical Director<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: "Franklin Gothic Book"; font-size: 11.0pt;">A
week ago, we alerted referring veterinarians in the area to an uptick in the
number of parvovirus cases we were seeing at ACCES’ two referral hospitals
(Seattle and Renton). Word quickly spread to the greater community setting off
an unexpected scare.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: "Franklin Gothic Book"; font-size: 11.0pt;">Parvovirus
is a virus that causes vomiting and severe diarrhea. In addition, it can suppress
the immune system and put animals at risk for secondary infections. It mainly
affects puppies and can cause death if not treated appropriately. With
treatment, which includes intravenous fluids, anti-nausea medication,
antibiotics and plasma in severe cases, survival is 90%. Adults dogs can get
the infection as well but often are less sick or may shed virus and not have
clinical signs.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal">
<span style="font-family: "Franklin Gothic Book"; font-size: 11.0pt;">The
virus is shed in stool and can live in the environment for weeks to months. It
is extremely hardy and not killed by standard disinfectants – bleach is most
effective. The virus can be passed from an animal shedding the virus, picked up
on clothes, shoes, and other objects, and then carried to another animal.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal">
<span style="font-family: "Franklin Gothic Book"; font-size: 11.0pt;">Parvovirus
is not a new infection. It is a virus we have known about for a long time and
one of the first diseases for which we developed a vaccine for dogs. The
vaccine is extremely effective when administered properly. Puppies need to
receive vaccines every three to four weeks from eight weeks of age until they
are over 16 weeks of age, again at one year and then every three years
thereafter. <o:p></o:p></span></div>
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<br /></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 11.0pt;">The
difficulty with this disease is that puppies often get sick in the window after
they have had one vaccine but not the full series. If puppies are in
environments where the virus has been shed by asymptomatic carriers, they can
pick up the virus. Health for the dog population relies on compliance by
everyone – a concept known as “herd immunity”.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 11.0pt;">This
year we have seen an uptick in the number of parvo cases. We see an average of
16 cases a year and have diagnosed 28 this year, eight in the last three weeks.
The virus does ebb and flow so this may just be a high year. Cases have been
from a number of locations and have been mostly young, incompletely vaccinated
dogs. However, it is also possible that the move away from vaccines has led to
less herd immunity and more shedding of virus. Speaking to other hospitals in
the area, some are also seeing more cases but other clinics north of us are
not.<o:p></o:p></span></div>
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<br /></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 11.0pt;">Our
recommendations are:<o:p></o:p></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 6.0pt; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Franklin Gothic Book"; font-size: 11.0pt; mso-bidi-font-family: "Franklin Gothic Book"; mso-fareast-font-family: "Franklin Gothic Book";">1)<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Franklin Gothic Book"; font-size: 11.0pt;">VACCINATE
– make sure your puppy gets the full SERIES of vaccines up to at least 16 weeks
of year. Make sure the vaccine is boostered one year later and then every three
years after that.<o:p></o:p></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 6.0pt; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Franklin Gothic Book"; font-size: 11.0pt; mso-bidi-font-family: "Franklin Gothic Book"; mso-fareast-font-family: "Franklin Gothic Book";">2)<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Franklin Gothic Book"; font-size: 11.0pt;">Do
not take incompletely vaccinated puppies to dog parks or other high traffic
areas. Dog parks are great places to socialize but only after the full series
of puppy shots have been given. <o:p></o:p></span></div>
<div class="MsoListParagraph" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 6.0pt; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Franklin Gothic Book"; font-size: 11.0pt; mso-bidi-font-family: "Franklin Gothic Book"; mso-fareast-font-family: "Franklin Gothic Book";">3)<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Franklin Gothic Book"; font-size: 11.0pt;">If
you have a dog with vomiting and diarrhea, have them seen promptly. Early
diagnosis and proper treatment does lead to a good long term outcome. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
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<b><span style="font-family: "Franklin Gothic Book"; font-size: 11.0pt;">If your dog is
fully vaccinated, there is no reason to avoid the dog parks – let your dogs
play if we have a sunny day. <o:p></o:p></span></b></div>
<!--EndFragment-->Unknownhttp://www.blogger.com/profile/09328319891800106430noreply@blogger.com2tag:blogger.com,1999:blog-2722151962534833691.post-78328816853522809072012-11-09T14:09:00.000-08:002012-11-09T14:09:57.789-08:00Parvovirus; Think Outside the Box<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s1600/Guerra.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s200/Guerra.jpg" width="133" /></a></div>
By Dr. Beth Guerra<br />
<br />
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<span style="font-family: "Times New Roman"; font-size: 12.0pt; line-height: 115%;">Quite a few years ago, I evaluated a one year old schnauzer
for an acute onset of vomiting and diarrhea. He had no known medical problems
and had not eaten anything unusual that could have caused his symptoms. The
owner allowed me to do a complete workup, including x-rays and bloodwork. There
were very few abnormalities except for a very low white blood cell count, which
can indicate overwhelming infection or inadequate bone marrow response to
infection. I was wracking my brains for a cause that would also explain his
symptoms, when I noted in the chart that the owner had acquired him as a very
young puppy and that he was not yet neutered.
When I asked why she had not neutered him, she said he had never visited
a veterinarian. That set off a bell in my head, and I questioned her about
vaccine status. She reported he had never had any vaccines or boosters and that
the breeder did not mention that he was given any before she acquired him. I
immediately set up a parvo test, and it was a strong positive.<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman"; font-size: 12.0pt; line-height: 115%;"><br /></span></div>
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<span style="font-family: "Times New Roman"; font-size: 12.0pt; line-height: 115%;">Veterinarians tend to think of parvovirus as a disease of
very young puppies, usually under 16 weeks of age. The general public knows of
parvo as “the puppy killer” because it is highly contagious and often affects
young dogs that are not fully developed and therefore have an immature immune
system. What I had failed to think of in this case was that even though this
dog was a year old, he had never been vaccinated and therefore was still at
risk for contracting the virus. We just had another case present this week with
a severe parvo infection who is 4 years old, but again, had not been fully
vaccinated. In our current case, he had
a single puppy shot and not the full series needed to produce immunity.<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman"; font-size: 12.0pt; line-height: 115%;"><br /></span></div>
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<span style="font-family: "Times New Roman"; font-size: 12.0pt; line-height: 115%;">Parvovirus is ubiquitous in the environment and very
difficult to kill with normal disinfectants; prolonged contact with a bleach
solution is required. It is highly contagious and can remain in the environment
for many months. Transmission between animals is via oral exposure to feces
containing the virus, however, objects such as bedding and toys can also
transmit the virus. Infection can be widespread in environments such as pet
stores or breeding facilities due to close contact between animals. Incubation
within the body can be up to two weeks and the virus can continue to be shed in
the feces after infection has resolved.<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman"; font-size: 12.0pt; line-height: 115%;"><br /></span></div>
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<span style="font-family: "Times New Roman"; font-size: 12.0pt; line-height: 115%;">The virus targets specialized crypts in the intestinal
lining where new cells are rapidly produced. These cells die off and the
intestinal lining becomes more permeable, allowing for loss of vital blood
proteins and electrolytes and also letting harmful bacteria into the
bloodstream from the intestinal tract. </span></div>
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<span style="font-family: "Times New Roman"; font-size: 12.0pt; line-height: 115%;">Symptoms include vomiting, diarrhea
(often bloody), inappetance, and abdominal pain. Septic shock or disseminated
intravascular coagulation (widespread hemorrhage) can occur in severe cases.
The virus can also destroy developing white blood cells. The drop in crucial
white cells increases the risk of secondary bacterial infections. <o:p></o:p></span></div>
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<span style="font-family: "Times New Roman"; font-size: 12.0pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Times New Roman"; font-size: 12.0pt; line-height: 115%;">Diagnosis is based on presenting symptoms, vaccine history,
and test results, which can include a positive parvo test (fecal test that can
be done in house), decreased white blood cell count, or low blood albumin. Some
puppies also have intestinal parasites that are found on fecal exam. Therapy is
supportive while the virus runs its course. Intravenous fluids, anti-emetics,
and broad spectrum antibiotics are utilized to minimize secondary effects of
the virus. Some animals receive transfusions of whole blood or plasma. Parvovirus
can be rapidly fatal if left untreated and these cases usually require several
days of hospitalization on the road to recovery. Puppies that develop severe
sepsis or secondary infections, such as pneumonia, may succumb to the disease.
However, studies have shown that chance of survival with aggressive treatment
is over 90%.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Times New Roman"; font-size: 12.0pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Times New Roman"; font-size: 12.0pt; line-height: 115%;">Once infection has cleared, the puppy may have lifelong
immunity, however, vaccines are the best prevention. Puppies usually receive a
series of “combo” vaccines, which include distemper, parvovirus, adenovirus,
and parainfluenza. Vaccines begin around 8 weeks of age and boosters are
administered every few weeks until they are 16 weeks of age. Whether you obtain
a puppy from a breeder, pet store, or friend, it is important to question them
about the vaccination status up to that point. Infection with parvovirus can
occur at any time between boosters, so it is important to have your puppy
evaluated by a veterinarian and comply with the
FULL vaccine schedule.<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman"; font-size: 12.0pt; line-height: 115%;"><br /></span></div>
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<br /></div>
<!--EndFragment-->Unknownhttp://www.blogger.com/profile/09328319891800106430noreply@blogger.com0tag:blogger.com,1999:blog-2722151962534833691.post-33401988257723874162012-10-24T11:34:00.000-07:002012-10-24T11:35:24.673-07:00Antifreeze Toxicity<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s1600/Guerra.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s200/Guerra.jpg" width="133" /></a></div>
By Dr. Beth Guerra<br />
<br />
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">Ethylene
glycol, the main ingredient in antifreeze, has long been known to be toxic to
household pets. Exposure is usually from puddles under a leaking car or a
container in the garage that has been spilled or chewed up by a pet. The
minimum lethal dose is only around 2.5 tablespoons for a 20 lb dog or just one
teaspoon in a </span><span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">seven-pound
cat. The toxic component is not the ethylene
glycol itself, but rather the metabolites that form when it is broken down by
the liver.<o:p></o:p></span></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"><br /></span></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">There
are three recognized stages to antifreeze poisoning:<o:p></o:p></span></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"><br /></span></div>
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<b><span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">Stage 1</span></b><span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"> (within 30min to 12 hours
after ingestion) The pet usually experiences nausea, vomiting, lethargy, or
neurological signs and can appear ‘drunk’. Increased thirst and urination may
also occur.<o:p></o:p></span></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"><br /></span></div>
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<b><span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">Stage 2</span></b><span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"> (12 to 24 hours
after ingestion) An increased respiratory and heart rate may be noted.<o:p></o:p></span></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"><br /></span></div>
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<b><span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">S</span></b><b><span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">tage
3</span></b><span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"> (24
to 72 hours after ingestion in dogs, 12 to 24 hours
in cats) One of the byproducts of metabolism combines with calcium in the body
to form calcium oxalate crystals that damage the kidneys. These crystals can be
detected in the urine and can help confirm the diagnosis. A severe metabolic
acidosis occurs as well. Oliguric kidney failure develops, characterized by a
lack of urine production, can develop at this time. Additional symptoms may
include nausea, vomiting, and severe depression.<o:p></o:p></span></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"><br /></span></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">There
are several tests that can be used in dogs to test for ingestion of antifreeze.
Some test for ethylene glycol itself, others for the metabolic byproducts. We
do have screening tests at ACCES but usually submit the sample to a human
hospital for confirmation.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"><br /></span></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">If
ingestion was suspected but not witnessed, it is always beneficial to run a test.
Treatment varies based on time of ingestion and symptoms at presentation. If
ingestion was within 30 minutes and there are no clinical symptoms,
decontamination can be attempted with induction of vomiting. In the case of a
positive results and symptoms, immediate care should be instituted to avoid
impending renal failure. Therapy includes aggressive fluid therapy as well as
IV infusions of 4-MP. If 4-MP is not available, intravenous ethanol also works
to prevent metabolism of the ethylene glycol to its toxic compounds but causes
more side effects</span><span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">.
Daily monitoring of blood pH, fluid input, and
urination is essential. Symptoms such as vomiting, seizures, or respiratory
distress should also be anticipated and treated. Therapy is continued until the
test is no longer positive; in some cases this may be several days to weeks. In
dogs, the prognosis is favorable if treatment is within 12 to 16
hours and the kidney values are not elevated. In cats, treatment
should be within three hours. Once there are
signs of kidney failure and crystals, prognosis is grave.</span><span style="font-family: "Franklin Gothic Book";"> </span><span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">The mortality rate in
dogs is reported to be 59-70% and is thought to be even higher in cats.<o:p></o:p></span></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">If
you have witnessed your pet drink antifreeze, or think exposure has occurred,
contact National Animal Poison Control Center; (888) 426-4435 or your
veterinarian immediately. <o:p></o:p></span></div>
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<br /></div>
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<br /></div>
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<br /></div>
<!--EndFragment-->Unknownhttp://www.blogger.com/profile/09328319891800106430noreply@blogger.com0tag:blogger.com,1999:blog-2722151962534833691.post-27466026255256454732012-10-12T09:21:00.000-07:002012-10-12T09:22:24.922-07:00Full Moon and the ER<!--[if gte mso 9]><xml>
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<!--StartFragment-->
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s1600/Guerra.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s200/Guerra.jpg" width="133" /></a></div>
<div class="MsoNormal">
<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">By Dr. Beth Guerra </span></div>
<div class="MsoNormal">
<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">There are nights
in the ER where I take a moment to reflect upon the phase of the moon. This
usually occurs when I have every exam room full of potential patients and
multiple critical animals being carried into the ICU on stretchers
hemorrhaging, seizuring, or gasping for breath. Every emergency doctor, human
or veterinary, cannot shake the conviction that a full moon coincides with a
full, and often crazy, emergency room.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">I have several
friends that are human ER physicians, and we all swear by this phenomenon.
Reflecting back on my years in the ER, I can recall with difficulty the full
moon shifts where I wasn’t up to my elbows in critical patients, no matter what
clinic I was working at during that time. I even psych myself out driving to
work when I happen to glance up and notice the moon is waxing full. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">Multiple studies
have been done about this correlation, in both human and veterinary medicine,
and the bottom line is, there is no correlation. Separate statistical analyses
have failed to show any link between a full moon and the caseload in the ER
clinic. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">One study from
the <i>Indian Journal of Medical Science</i>
(2004) failed to show any positive relation between full moon days and
variables such as number of trauma patients, assaults, or attempted suicides. Another
retrospective study in <i>Resuscitation</i>
(2003) analyzed ER caseloads for six years and did not find a correlation
between the number of ER visits, the phases of the moon, or the signs of the
zodiac. A similar study in <i>Journal of
Veterinary Emergency and Critical Care</i> (2007) found no correlation between
case load and the phase of the moon (or Friday the 13<sup>th</sup>), but did
note that weekends and holidays were consistently the busiest days of the year.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">A literature
search revealed that this phenomenon has been studied extensively since the
late 1960s and has even delved into variables like number of births, dog bites,
drug overdoses, suicide attempts, surgical complications, and cardiac arrest.
In each instance, no relationship has been established that can be linked to a
full moon. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">Even with all
this evidence to the contrary, I still approach my full moon shifts with a
certain amount of trepidation. I make sure to get as much sleep as possible and
eat before I get to work; as every emergency shift worker knows, you may not
get another chance. I take a deep breath as I walk in the door and remind
myself that it’s just another day, and that no matter how out of control things
get, I can’t blame it on the moon.<o:p></o:p></span></div>
<!--EndFragment-->Unknownhttp://www.blogger.com/profile/09328319891800106430noreply@blogger.com0tag:blogger.com,1999:blog-2722151962534833691.post-21264739183739416272012-09-04T10:33:00.000-07:002012-09-04T10:33:33.066-07:00SEPTEMBER- Healthy Aging Month<div class="separator" style="clear: both; text-align: center;">
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<!--StartFragment-->
By Jennifer Waldrop, DVM DACVECC<br />
<br />
<br />
<div class="MsoNormal">
What does “healthy aging” mean
for your pet? Is it the same as for you? Basically, the answer is yes, with one
glaring difference. Your pet cannot be trusted to tell you when something is
starting to go wrong. Subtle warning signs of a problem may resemble
age-related changes. For example, increased sleeping might be a headache or
blurred vision. Difficulty rising could be arthritis, but could also be
weakness related to low blood pressure, altered electrolytes, bone pain, or
dizziness. We humans also tend to rationalize and “anthropomorphize” our pet’s
issues, which can sadly delay diagnosis of many treatable diseases. Then it
seems surprising when our pets are really sick and we hear of the degree or
chronicity of the problem. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Given the rapidity of animal
aging and their short life span, the only way to reliably monitor aging is by
frequent visits to the veterinarian with an examination and geriatric lab work
including a Complete Blood Count, Chemistry Panel and a Urinalysis. Chronic
kidney disease is one of top three diseases of geriatric pets and kidney failure is
only reliably diagnosed by checking a urine sample for concentrating ability
(urine specific gravity.) Ideally, this
should be every six months for a dog over nine to 10 years (over seven years
for Giant Breeds like Great Danes) and every year for cats over 10 years of age.
For exotic pets, these recommendations will vary depending on the size and type
of pet. This can become expensive and makes a good argument for pet insurance
to cover some of the ongoing costs. When choosing a pet insurance, take care to
check for geriatric exclusion clauses given that many pet insurance companies
are also aware that aging pets require more care.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
What else can we do to fend off some
of the preventable changes of aging? Just as in humans, a healthy diet and
exercise are crucial. Most commercial and many alternative diets are complete,
but when in doubt, your veterinarian or a veterinary nutritionist will be able
to consult on the appropriateness of the diet. Most “senior” diets do not have
significant changes in ingredients or electrolytes that make them better than
regular diets. Supplements like fish oil may have a place in treatment of
canine osteoarthritis, but their role in prevention of other diseases such as
heart disease or dementia is unknown. I still recommend them if there is no
fish in the pet’s diet. There are instances when fish oil supplements are
discouraged, specifically in some human cancers during chemotherapy.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Exercise of the body and mind are
both important to provide your aging pet. Exercising with your dog has been
found to improve health for the human in multiple research studies, and the
reverse is likely true as well. The cardiovascular and muscular strength that
moderate exercise provides is important to keep both healthy, but also serves
as a reserve when you are sick. This reserve strength will improve recovery
after accidents, surgery or other health issues. Outdoor exercise is also a
mental boost for our dogs with input into all their senses. Time spent with
their owner is also important for mental health, so part of a moderate exercise
program should include an interactive component. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Exercising a cat or exotic pet can
be a little more difficult, to say the least, but is extremely important given
the high rate of obesity in our pets. Cats may enjoy chasing a toy on a wand or
chase toys or balled up socks, but sadly some cats are not interested in
chasing. For these cats, a companion cat or dog may provide some impetus for
moving around even if it’s just to get away from the other animal. (Conflict
can provide good stimulation ;) A younger cat could keep the older cat more
active both physically and cognitively. The same is likely true for birds and
small mammals.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
At home, grooming and petting
your cat or dog provides both with the benefits of companionship. Having
friends and relationships is as important for our pets as for us. Studies in
humans have shown increased longevity and mental health for those people who
actively continue human interaction and relationships. Sometimes a pet and
their human can become isolated from the rest of the world and this is not
healthy for either individual. One of the least judgmental places for dog owners
is the dog park where dogs of all sizes, temperaments and interests congregate
with their humans of the same variability. For indoor-only cats, frequent
household visitors and companionship with other housecats should provide good
stimulation.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
The best part of living with a
pet is having a good friend who lives every day to its fullest. We can follow
their example while we age as well and continue to fully enjoy each moment. <o:p></o:p></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<i>Men do not quit playing because they grow old; they grow old because
they quit playing. </i><o:p></o:p></div>
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<i>~Oliver Wendell Holmes </i> <o:p></o:p></div>
<!--EndFragment-->Unknownhttp://www.blogger.com/profile/09328319891800106430noreply@blogger.com3tag:blogger.com,1999:blog-2722151962534833691.post-88097459136436738202012-08-06T10:28:00.000-07:002012-08-06T10:28:22.338-07:00Rabies in Washington State<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s1600/Guerra.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s320/Guerra.jpg" width="213" /></a></div>
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<span style="font-family: 'Franklin Gothic Book'; font-size: 12pt; line-height: 115%;">By Dr. Beth Guerra</span></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">I grew up in the
Midwest, where rabies was more prevalent in wildlife such as bats, raccoons, coyotes,
and skunks as well as the rare household pet. In Washington state the primary
animal that has been identified is the bat. Although the risk is fairly low
(less than 1% of bats are infected), the virus is nearly always fatal and care
should be taken to avoid exposure.<o:p></o:p></span></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">In 2011, 11 bats
in Washington state tested positive for rabies in the following counties:
Chelan, Clallam, Island, King, Lewis, Pierce, Snohomish, Walla Walla, and
Whatcom. As of July 2012, there have already been three infected bats in
similar counties. The most recent case of rabies in a household pet (cat) was
in 2002 in Walla Walla county, and the last two human cases were in 1995 and
1997. All of these cases were infected with bat rabies.<o:p></o:p></span></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">Bats that carry
rabies are usually clinically ill and cannot fly properly. This makes them more
likely to be found by humans or household animals. There have also been reports
of bats getting into houses and being found in closets or shoes. The teeth of
the bat are very small and a bite may not be easily detected, especially if a
person is bitten while sleeping. <o:p></o:p></span></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">Rabies is a
virus that affects the central nervous system. The virus is found in saliva and
transmitted via bite or scratch wounds. Household pets are exposed through
wildlife and are usually the source of exposure for humans. Early symptoms may
include headache and fever, but within two to eight weeks can progress to
confusion, paralysis, and difficulty swallowing. If exposure is suspected, the
exposed person usually begins a regimen of injections, including rabies
immunoglobulin as well as the vaccine, over a two week period. The best treatment is prevention.<o:p></o:p></span></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">As of January 1,
2012, current rabies vaccines are required for all dogs, cats, and ferrets.
Rabies vaccines are readily available at veterinary clinics and are
inexpensive. If a household pet is exposed to rabies, there is mandatory six
month quarantine, so vaccination is best.<o:p></o:p></span></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">The following
information was taken from the Washington State Department of Health:<o:p></o:p></span></div>
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<b><span style="color: #263646; font-family: "Franklin Gothic Book"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";"><br /></span></b></div>
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<b><span style="color: #263646; font-family: "Franklin Gothic Book"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">What should I do if an animal bites me?<o:p></o:p></span></b></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Clean the site of any animal bite with soap and water.
Contact your health care provider and Public Health Communicable Disease and
Epidemiology at (206) 296-4774 to determine the potential for rabies exposure,
the need for treatment, and to decide whether or not to test the animal for
rabies.<o:p></o:p></span></div>
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<b><span style="color: #263646; font-family: "Franklin Gothic Book"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">What should I do if I find a bat in my living space?<o:p></o:p></span></b></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Do not touch the bat. Close the doors and windows to the
room. Wait until the bat lands on the floor or a wall. Wearing leather or other
thick gloves, capture the bat in a can or box without touching it. Seal the
container and call Public Health Communicable Disease and Epidemiology at (206)
296-4774. The health department will help you determine if any people or pets
in your home may have been exposed and can arrange to test the bat for rabies,
if needed. “Bat proof” your home by making sure open windows have screens and
that other small entry points—such as cracks, crevices, or holes—are sealed.<o:p></o:p></span></div>
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<b><span style="color: #263646; font-family: "Franklin Gothic Book"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">What treatment is available after exposure to rabies occurs?<o:p></o:p></span></b></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Safe and effective treatment following potential rabies
exposure should begin as soon as possible after the exposure occurs. Treatment
is a series of shots. These shots, called post-exposure prophylaxis (PEP),
include one dose of human rabies immunoglobulin (HRIG) and four doses of rabies
vaccine given on a specific schedule over a 14-day period. People with weak
immune systems will also need a fifth dose of vaccine and a blood test to check
that the vaccine worked. <o:p></o:p></span></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Treatment can be arranged through your health care provider
and your local health department.<o:p></o:p></span></div>
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<b><span style="color: #263646; font-family: "Franklin Gothic Book"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">What can I do reduce the risk of rabies exposure for my family
and me?<o:p></o:p></span></b></div>
<ul type="square">
<li class="MsoNormal" style="margin-bottom: 6pt;"><span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Do not handle
wild animals, especially bats. <o:p></o:p></span></li>
<li class="MsoNormal" style="margin-bottom: 6pt;"><span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Teach your
children never to touch or handle bats, even dead ones. Have your children
tell an adult if they find a bat at home, at school, or with a pet. <o:p></o:p></span></li>
<li class="MsoNormal" style="margin-bottom: 6pt;"><span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">If you see a
wild animal leave it alone. <o:p></o:p></span></li>
<li class="MsoNormal" style="margin-bottom: 6pt;"><span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Do not keep wild
animals as pets. <o:p></o:p></span></li>
<li class="MsoNormal" style="margin-bottom: 6pt;"><span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Keep bats out of
your living space by “bat proofing” your home. <o:p></o:p></span></li>
<li class="MsoNormal" style="margin-bottom: 6pt;"><span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Pets may get
rabies if bitten by a rabid animal. Protect them and yourself by getting
them vaccinated routinely. Dogs, cats, and ferrets are now required to be
vaccinated in Washington. Consult your veterinarian for vaccine
recommendations. <o:p></o:p></span></li>
</ul>
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<span style="font-family: "Times New Roman"; font-size: 12.0pt; line-height: 115%;">Sources: Washington State Department of Health<o:p></o:p></span></div>Unknownhttp://www.blogger.com/profile/09328319891800106430noreply@blogger.com7tag:blogger.com,1999:blog-2722151962534833691.post-49158934876214708002012-07-30T13:59:00.001-07:002012-07-30T13:59:45.967-07:00Canine Pneumonia<!--[if gte mso 9]><xml>
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<!--StartFragment-->
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s1600/Guerra.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s200/Guerra.jpg" width="133" /></a></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman"; font-size: 12.0pt;">By Beth Guerra, DVM </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman"; font-size: 12.0pt;"><br /></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman"; font-size: 12.0pt;">Pneumonia
is an infection in the lower airways that causes inflammation in the lungs.
Organisms can be bacterial, viral or fungal in nature. The infection is
established when these organisms are inhaled, aspirated (from gastrointestinal
contents), or spread through the blood from other body systems. The usual
defense system of the body traps infectious organisms in the mucus lining the
respiratory tract and moves them upward where they can be expelled by coughing.
Failure of this mechanism allows bacteria or fungi to colonize the airways.
Once the infection is established, secondary inflammation can develop,
impairing normal oxygen exchange.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman"; font-size: 12.0pt;">Bacterial
pneumonia is frequently seen at our facility. The two most dominant types of
organisms are <i style="mso-bidi-font-style: normal;">Bordatella bronchiseptica</i>
and <i style="mso-bidi-font-style: normal;">E. coli</i>. In young or incompletely
vaccinated dogs, we often see Bordatella pneumonia, otherwise known as kennel
cough pneumonia, which is a contagious disease. The E. coli organism is the
most common inhabitant of the upper GI tract and infection results from
aspiration of stomach contents. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman"; font-size: 12.0pt;">Aspiration
pneumonia is by far the most common type of pneumonia we encounter in our ICU.
Patients at risk for aspiration include sedate or recumbent animals, or those
recovering from anesthesia. Pets that have vomiting, regurgitation or reflux,
or altered esophageal motility are also at high risk for aspiration. Another
condition, known as laryngeal paralysis, can also precipitate an aspiration
event. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman"; font-size: 12.0pt;">Often the
only symptom in these dogs is acute lethargy and inappetance. There may be
weight loss, fever, or a moist or productive cough. Diagnosis is made by
thoracic x-rays, but bloodwork often reveals an elevated white blood cell
count, and can also help to rule out other predisposing conditions. To further
support a diagnosis, samples of the lower airway bacteria are collected by
endotracheal or transtracheal wash, where sterile saline is introduced in small
amounts into the lower airway in an attempt to retrieve bacterial organisms for
culture. This will help direct antibiotic therapy.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman"; font-size: 12.0pt;">Dogs with
pneumonia can range from fairly stable patients that are eating and active to
patients that are severely ill and dependent on oxygen. In the former,
treatment with oral antibiotics for an extended period may be all that is
required. In the latter, hospitalization is recommended to provide more
aggressive supportive care. Systemic hydration is important to help loosen
secretions and also because the patient is usually not eating or drinking.
Intravenous antibiotics are usually given for a minimum of 48 hours. Oxygen
therapy, via nasal cannula or chamber, is needed in those patients with low
oxygen saturation. Nebulization with saline, followed by coupage, or gentle
percussion to the chest cavity, can help the patient cough up secretions.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman"; font-size: 12.0pt;">Several
years ago, we examined the records of the animals we had treated for pneumonia
over a two-year period. We treated 94 cases and were able to send home 82%. In
animals who were less than two years old, 95% went home. Most of the cases that
we could not save were found to have an underlying condition such as a
megaesophagus, laryngeal paralysis, other neurologic disease, or concurrent
diabetes.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman"; font-size: 12.0pt;">The
treatment for pneumonia often includes four to six weeks of antibiotic therapy.
Follow-up chest x-rays are very helpful in tracking the progression of the
disease. Once a patient is eating and stable without oxygen, convalescence can
continue at home with rechecks as needed. <o:p></o:p></span></div>
<!--EndFragment-->Unknownhttp://www.blogger.com/profile/09328319891800106430noreply@blogger.com2tag:blogger.com,1999:blog-2722151962534833691.post-35812980060872733022012-07-06T10:48:00.001-07:002012-07-06T10:48:07.861-07:00Salmon Poisoning Disease<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s1600/Guerra.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s200/Guerra.jpg" width="133" /></a></div>
By Beth Guerra, DVM<br />
<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhv21bcAUlxDSRlEuF1Vy4HPUt70pgQx-GgokwESD1eQoC1kMGRmk2ffwqvKi7Xulqfn6QPwYpg5mzrpikQvgbajBHIjImuh9Zq-DiPctm7pExe9c7-XyOEzuHDifWfL7qIXB0LWBrkO6Ap/s1600/Davidow.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhv21bcAUlxDSRlEuF1Vy4HPUt70pgQx-GgokwESD1eQoC1kMGRmk2ffwqvKi7Xulqfn6QPwYpg5mzrpikQvgbajBHIjImuh9Zq-DiPctm7pExe9c7-XyOEzuHDifWfL7qIXB0LWBrkO6Ap/s200/Davidow.jpg" width="133" /></a></div>
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<span lang="EN" style="font-family: "Franklin Gothic Book"; font-size: 11.0pt; mso-ansi-language: EN; mso-bidi-font-weight: bold;">By Beth Davidow, DVM DACVECC<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="mso-pagination: none;">
<span lang="EN" style="font-family: "Franklin Gothic Book"; font-size: 11.0pt; mso-ansi-language: EN;">There are a
number of foods that are now known to be toxic to pets. I tend to wonder each
time I hear of a new toxicity, “is that really true?” I often think, “Well,
I’ve seen lots of dogs who eat that who haven’t had a problem.” The growing
list of toxic foods for pets now includes chocolate, onions, grapes, raisins,
and chewing gum containing xylitol (many of the sugar free gums). Although I
read these new reports critically, working in emergency, I have now seen all
these toxicities first-hand. <o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="mso-pagination: none;">
<span lang="EN" style="font-family: "Franklin Gothic Book"; font-size: 11.0pt; mso-ansi-language: EN;">Chocolate
toxicity has been known to many of us for years. Theobromide, a methylxanthine,
is the main toxic component, and causes extremely fast heart rates, tremors,
and can lead to seizures. The darker the chocolate, the more theobromide is
contained in each ounce and the less the pet has to eat of it to cause problems.
White chocolate is actually not toxic at any amount. A 60-pound lab would need
to eat 20 ounces of milk chocolate to have moderate to severe signs but only three
ounces of dark bakers chocolate. Depending on when the chocolate was ingested,
we might recommend inducing vomiting or having us administer activated charcoal.
(Activated charcoal binds toxins that are in the stomach or intestinal tract so
they can’t be absorbed into the blood stream.) We’ve seen many dogs that
presented with agitation and severely elevated heart rates. Most have done well
but some needed 24-48 hours in the hospital on IV fluids and medication to
decrease the dangerously high heart rates.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="mso-pagination: none;">
<span lang="EN" style="font-family: "Franklin Gothic Book"; font-size: 11.0pt; mso-ansi-language: EN;">Onion toxicity
is one I hadn’t seen until a few years ago. Onions and other members of the
Allium family (shallots, garlic, and green onions) contain a compound that can
weaken red blood cells. The red blood cells break down causing anemia (lack of
red blood cells) and hemoglobin (the protein inside red blood cells) to spill
into the urine. Dog’s red blood cells have less antioxidants than people’s
making their cells more prone to damage. Cats are even more susceptible to red
blood cell damage. Ingestion of 5g/kg of onion in cats or 15-30 g/kg in dogs
can lead to clinically important hemolysis. Damage consistently happens in dogs
who ingest more than 0.5% of their body weight in onions at one time. A few years
ago, an English setter was referred to us for inappropriate urination and red
colored urine. It turns out he had eaten three cups of onions the day before –
1.5% of his body weight! The red color was hemoglobin in his urine. He became
very anemic four days after he ate the onions and needed a transfusion. To
complicate matters in his case, he also had a bacterial urinary infection. The
combination of the hemoglobin going through his kidneys and the infection,
despite antibiotics and IV fluids, led to acute kidney shut down. After 10 days
of hospitalization, antibiotics, and IV fluids, he is doing well at home.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="mso-pagination: none;">
<span lang="EN" style="font-family: "Franklin Gothic Book"; font-size: 11.0pt; mso-ansi-language: EN;">Grape and
raisin toxicity was first reported by the National Animal Poison Center in 2001.
At that time, they knew of 10 reported cases of acute kidney failure with
ingestion of quantities varying from 0.2 oz/lb to 4.4 oz/lb. A retrospective study
was published in 2005 in the Journal of Veterinary Internal Medicine involving
43 cases. Of the 43 cases, 20 died or were euthanized due to a poor prognosis. Unfortunately,
it is still not known why some dogs, but not all dogs, develop acute kidney failure
from ingestion of these foods. Pesticides, fungus and heavy metal contamination
have been ruled out as causes and it appears that the toxic principle is in the
flesh and not in the seed. Last year, we treated a dog who developed acute
kidney shutdown after eating grapes off a vine at a friend’s house. The dog
survived and is now doing well but was hospitalized for almost two weeks and
required subcutaneous fluids for many weeks afterward. We do recommend inducing
vomiting, activated charcoal and IV fluid diuresis with any grape ingestion
over 0.7 oz/kg or raisin ingestions over 0.1oz/kg. Induction of vomiting is
recommended up to eight hours after ingestion in these cases as in many of the
cases reported to National Animal Poison Center, raisins were still found in
the vomit at this point.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="mso-pagination: none;">
<span lang="EN" style="font-family: "Franklin Gothic Book"; font-size: 11.0pt; mso-ansi-language: EN;">Xylitol is a
sugar substitute that is good for people on a low carbohydrate diet, those with
diabetes or those watching calories. It is found in sugar free gum, some
toothpastes (it can prevent oral bacteria from producing acids that damage
tooth surfaces), and can be bought as a powder for cooking. Although the lethal
dose is >130 g/day in people and greater than 20g/kg in mice, the metabolism
is different in dogs. It appears that doses greater than 0.1g/kg can lead to
hypoglycemia 30 minutes to 12 hours after ingestion. This is because in dogs,
but not in people, xylitol causes a dose-related rapid, severe insulin release.
In addition, acute liver failure and bleeding problems has been reported in
eight dogs after eating xylitol containing products. Most of the dogs presented
with vomiting and lethargy nine to 72 hours after xylitol exposure. The reason
for the liver failure is currently unknown. National Animal Poison Center does
recommend vomiting induction, IV fluids, and careful monitoring of blood
glucose and liver enzymes.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="mso-pagination: none;">
<span lang="EN" style="font-family: "Franklin Gothic Book"; font-size: 11.0pt; mso-ansi-language: EN;">The NAPCC is a
fantastic resource and we recommend that their phone number be easily
accessible in your household. The Washington Poison Center now also has a
veterinary toxicologist on staff and is also very helpful especially in cases
of household chemicals or product exposure. In addition, our emergency doctors
are very knowledgeable about toxicities and are always happy to answer
questions at any time of day or night. (NAPCC, </span><span style="color: windowtext; font-family: "Franklin Gothic Book"; font-size: 11.0pt; mso-bidi-font-family: Arial; mso-bidi-font-weight: bold; mso-font-kerning: 0pt;">888-426-4435 and
Washington Poison Center, </span><span style="color: #0e0e0e; font-family: "Franklin Gothic Book"; font-size: 11.0pt; mso-bidi-font-family: "Trebuchet MS"; mso-font-kerning: 0pt;">800-222-1222)</span><span lang="EN" style="font-family: "Franklin Gothic Book"; font-size: 11.0pt; mso-ansi-language: EN;"><o:p></o:p></span></div>
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<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s1600/Guerra.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s200/Guerra.jpg" width="132" /></a></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman";">By Beth Guerra, DVM </span></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman";"><br /></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman";">In my eleven years as a veterinarian, I
have amassed quite a list of objects I have removed from the GI tract of dogs
and cats. We veterinarians all have that one item we have pulled from the
stomach or intestine that seems unique. I am constantly amazed at the ability
of our furry friends to actually swallow these objects. I have seen some
spectacular objects pass through with no problem, like straight pins and
acorns, but I more frequently deal with patients where the offending object has
caused an obstruction. Objects that make it into the stomach have two options;
either they will be vomited up or try to leave the stomach through the pylorus.
If the object is too big to advance into the intestine, it will remain in the
body of the stomach and usually causes intermittent vomiting. Objects that
advance into the small bowel will either pass without incident or cause a bowel
obstruction.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman";">Patients with GI foreign bodies can
have a variety of symptoms, including vomiting, inappetance, or abdominal pain.
Some pets will still want to eat but will vomit partially digested stomach
contents shortly afterwards. In smaller dogs or cats, the foreign object can
often be felt on abdominal palpation. Diagnosis is usually based on x-rays.
Some objects, such as rocks or metal, show up easily on an x-ray, but others
like cloth can be difficult to visualize, so a diagnosis of obstruction is made
based on the appearance of the intestines and gas patterns. Abdominal
ultrasound is used in those cases where the x-ray is inconclusive.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman";">A rapid diagnosis and treatment of GI
obstructions is ideal, especially when objects are obstructing the small bowel.
The longer an object remains in the bowel, the greater the concern for
complications such devitalized bowel or intestinal perforation. There can be
pressure necrosis, or death of the tissue, over the object. This pressure
necrosis can cause the tissue to tear and lead to leakage of intestinal
contents into the abdominal cavity. In severe cases, the compromised bowel may
need to be resected. If perforation has occurred, the resulting infection in
the abdomen, called peritonitis, can be fatal. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman";">Obstructing foreign bodies often need
surgery. In some cases where a small, smooth object is in the stomach, the
veterinarian may induce vomiting to see if the object can be retrieved.
Alternatively, endoscopy can be attempted to pull the object out through the
esophagus. If the object is sharp, very large or no longer in the stomach,
surgery is indicated. The patient is usually started on aggressive fluid
therapy to combat dehydration from vomiting, and in rare cases, this can
encourage an object to pass. If the duration of symptoms is more than several
days, or if there is concern for bowel perforation, surgery should not be
delayed. With prompt treatment, pets often recover uneventfully from these
surgeries.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman";">Ingestion of foreign bodies can be
prevented by providing your pet with toys that are adequately sized for the breed
of dog to prevent accidental swallowing. You should also consider supervising
your dog when offering treats such as large rawhides or greenies to make sure
the treat is chewed slowly and not gulped down in large chunks. If you suspect
that your pet has ingested something inappropriate or is showing clinical
symptoms, a veterinary exam is recommended sooner rather than later.<o:p></o:p></span></div>
<!--EndFragment-->Unknownhttp://www.blogger.com/profile/09328319891800106430noreply@blogger.com0tag:blogger.com,1999:blog-2722151962534833691.post-48727585755514557132012-05-23T15:22:00.000-07:002012-05-23T15:22:26.360-07:00Why Can’t Vets Diagnose My Pet Over the Phone?<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s1600/Guerra.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s200/Guerra.jpg" width="133" /></a></div>
By Beth Guerra, DVM<br />
<br />
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">Our clinic
fields numerous calls a day concerning pet emergencies. Owners will describe
clinical signs and a bit of history, and then ask what could be wrong with
their pet. Frequently, we encounter owners that are frustrated that we can’t
give advice over the phone, or tell them what medications to give or if they
can wait to see their regular veterinarian. Diagnosing a pet’s illness over the
phone is almost impossible, and, if our guess is wrong, could be life
threatening.<span style="mso-spacerun: yes;"> </span>We always want to err on
the side of caution to keep your pet safe. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">The staff at
ACCES is highly trained in phone triage, from receptionists to veterinary assistants
and technicians. They will obtain basic information, such as age, breed, and
prior medical problems, as well as current symptoms of concern. Their job is to
determine if and when a pet needs to be evaluated by a veterinarian, but they
are instructed to not try and diagnose over the phone. There are a variety of
factors that go into making a diagnosis, and the most rudimentary, and often
most important, are a basic history and physical exam by a veterinarian. In
most cases, if there is any concern about a pet’s health, an exam is
recommended.<o:p></o:p></span></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">In the
veterinary profession, importance is placed on a valid
veterinary-client-patient relationship. This means that the veterinarian has
examined the pet and taken a thorough history. It is illegal to prescribe
medications without establishing this type of relationship, which is why
medications cannot be dispensed or recommended over the phone without seeing
the pet. Even medications that are considered ‘common,' such as Benadryl, are
known as off-label medications for pets and should not be given without
direction from a veterinarian.<o:p></o:p></span></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"><br /></span></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">The most
frequent request we get from owners is advice on how to treat their pet at
home. In some cases, the owner may be financially restricted, or not able to
bring their pet in for an exam due to a busy schedule. While it may seem like
there should be a simple remedy for something like diarrhea, there can be
myriad causes. Since pets can’t describe how they are feeling and often mask
their illnesses, the owner may only have part of the picture. A history and
exam can also help guide diagnostics to rule out certain diseases.<o:p></o:p></span></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">For example, we
had a client call whose dog had been acutely vomiting. Based on the information
obtained over the phone, the technician advised that the pet be seen on
emergency. The owner was reluctant to come in and wanted to know how to treat
the dog at home. Since vomiting can be caused by anything from dietary
indiscretion to renal disease, it is difficult to determine an effective remedy
over the phone. The owner was advised to withhold food and water for an hour
and call if the dog continued vomiting. Several hours later, the owner did
bring in the dog. A history and physical exam determined that the dog was
exhibiting unproductive retching, not vomiting, and that the stomach had torsed
in a condition known as bloat. The dog did well after fluid resuscitation and
surgery, however, this condition can be fatal if undiagnosed and untreated.<o:p></o:p></span></div>
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<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Franklin Gothic Book"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">The staff members
at ACCES Seattle and Renton are available 24 hours a day to answer questions
about your pet. One of our core values is client service, and we will do our
best to provide you with helpful information. However, another of our core
values is patient care, and that means receiving a diagnosis and proper medical
care is of tantamount importance. <o:p></o:p></span></div>
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<br /></div>
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<br /></div>
<!--EndFragment-->Unknownhttp://www.blogger.com/profile/09328319891800106430noreply@blogger.com0tag:blogger.com,1999:blog-2722151962534833691.post-55263612697731355872012-05-04T11:07:00.001-07:002012-05-04T11:09:26.292-07:00A Look at Canine Hypothyroidism<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s1600/Guerra.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" mea="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s200/Guerra.jpg" width="133" /></a></div>
<div class="MsoNormal" style="margin: 0in 0in 10pt; text-align: left;">
<br /></div>
<div class="MsoNormal" style="margin: 0in 0in 10pt; text-align: left;">
<span style="font-family: "Franklin Gothic Book", "sans-serif"; mso-bidi-font-family: "Times New Roman";">By Beth Guerra, DVM</span></div>
<div class="MsoNormal" style="margin: 0in 0in 10pt;">
<span style="font-family: "Franklin Gothic Book", "sans-serif"; mso-bidi-font-family: "Times New Roman";">The thyroid gland plays an important role in the body’s metabolism. It is a bi-lobed structure located in the neck that secretes thyroid hormone. The hormone is primarily responsible for regulating the oxygen consumption of most organs, but it also promotes overall skeletal and muscle growth. Disorders of the thyroid gland can produce too much or too little of this hormone, distorting the delicate balance of the body and leading to a variety of symptoms.</span><span style="font-family: "Franklin Gothic Book", "sans-serif"; font-size: 10pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="margin: 0in 0in 10pt;">
<span style="font-family: "Franklin Gothic Book", "sans-serif"; mso-bidi-font-family: "Times New Roman";">Hypothyroidism, or subnormal levels of thyroid hormone, is recognized in dogs and humans, but rarely in cats. It usually occurs in dogs around five to seven years of age, with common breeds including golden retrievers and Dobermans. Symptoms include mental dullness, lethargy, weight gain, and heat seeking behavior. Skin conditions can also occur, such as hair loss, crusting or greasiness of skin, or recurrent bacterial or yeast skin infections. It is usually a combination of these symptoms that cause a pet owner to seek veterinary attention. </span></div>
<div class="MsoNormal" style="margin: 0in 0in 10pt;">
<span style="font-family: "Franklin Gothic Book", "sans-serif"; mso-bidi-font-family: "Times New Roman";">Diagnosis of hypothyroidism is usually confirmed by running T4 and free T4 levels on suspect patients. Certain drugs, as well as non thyroid illnesses, can cause ‘falsely’ low T4 levels, so a full history and thorough physical exam is an important part of confirming a diagnosis. Treatment is simple and involves supplementing with oral T4, however, dose and frequency of this medication can vary between patients and therefore treatment should be closely monitored by a veterinarian. Good control of the disease is achieved through a combination of normal T4 levels as well as resolution of clinical symptoms and may take up to four months.</span></div>Unknownhttp://www.blogger.com/profile/09328319891800106430noreply@blogger.com0tag:blogger.com,1999:blog-2722151962534833691.post-55693525333979990732012-04-18T12:02:00.000-07:002012-04-18T12:02:38.026-07:00The Option for Adoption<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s1600/Guerra.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" qda="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s200/Guerra.jpg" width="133" /></a></div><div align="center" class="MsoNormal" style="margin: 0in 0in 10pt; text-align: center;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: "Franklin Gothic Book", "sans-serif"; font-size: 12pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">By Beth Guerra, DVM</span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: "Franklin Gothic Book", "sans-serif"; font-size: 12pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">While browsing at a garden store the other day, I struck up a conversation with a woman who had a poodle riding in her cart. We got to talking about dogs, and I told her I had several, including a Yorkie mix. She said that she had always wanted a Yorkie, but couldn’t see spending $2500 for one. I told her all my dogs were from various shelters, and that she should look into adoption. I warned her she may not find a purebred Yorkie, but most certain could get a mix. She said she didn’t even care if the dog was purebred, she was just a fan of the breed.</span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: "Franklin Gothic Book", "sans-serif"; font-size: 12pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">This was my first encounter with someone who was not aware of pet adoption as an option instead of purchasing from a pet store or breeder. Every pet I have had throughout my childhood and adult life was adopted, either as a stray or from the local humane society. I have adopted cats, dogs, rabbits, and birds through shelters. All of them have been spayed/neutered and fully vaccinated. Plus, the adoption fee is usually less than $250!</span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: "Franklin Gothic Book", "sans-serif"; font-size: 12pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">The shelter is often thought of as a place where pets are taken when they are no longer wanted. In reality, pets end up at shelters for various reasons, but the common denominator is that they all need good homes. Due to the extensive variety of breeds, ages, and dispositions, you will rarely walk out of a shelter without finding the perfect pet for you or your family. Most shelters have a veterinarian on site, or one that works closely with the organization, to examine each pet fully and administer any medical care that may be needed. Shelter employees and volunteers often spend lots of time evaluating each pet’s personality and how it may interact with other pets and people. They work hard to ensure that each pet is adopted into the right home.</span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: "Franklin Gothic Book", "sans-serif"; font-size: 12pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">For more information on adoption, please visit </span><span style="font-family: "Franklin Gothic Book", "sans-serif";"><a href="http://www.paws.org/"><span style="font-size: 12pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">www.paws.org</span></a></span><span style="font-family: "Franklin Gothic Book", "sans-serif"; font-size: 12pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">, </span><span style="font-family: "Franklin Gothic Book", "sans-serif";"><a href="http://www.seattlehumane.org/"><span style="font-size: 12pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"><span style="color: purple;">www.seattlehumane.org</span></span></a></span><span style="font-family: "Franklin Gothic Book", "sans-serif"; font-size: 12pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">, or </span><span style="font-family: "Franklin Gothic Book", "sans-serif";"><a href="http://www.petfinder.com/"><span style="font-size: 12pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";">www.petfinder.com</span></a></span><span style="font-family: "Franklin Gothic Book", "sans-serif"; font-size: 12pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"></span></div>Unknownhttp://www.blogger.com/profile/09328319891800106430noreply@blogger.com1tag:blogger.com,1999:blog-2722151962534833691.post-17777826898923984992012-04-03T10:26:00.000-07:002012-04-03T10:26:00.778-07:00Could Pollen Kill My Cat?<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhv21bcAUlxDSRlEuF1Vy4HPUt70pgQx-GgokwESD1eQoC1kMGRmk2ffwqvKi7Xulqfn6QPwYpg5mzrpikQvgbajBHIjImuh9Zq-DiPctm7pExe9c7-XyOEzuHDifWfL7qIXB0LWBrkO6Ap/s1600/Davidow.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" dea="true" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhv21bcAUlxDSRlEuF1Vy4HPUt70pgQx-GgokwESD1eQoC1kMGRmk2ffwqvKi7Xulqfn6QPwYpg5mzrpikQvgbajBHIjImuh9Zq-DiPctm7pExe9c7-XyOEzuHDifWfL7qIXB0LWBrkO6Ap/s320/Davidow.jpg" width="213" /></a></div>By Beth Davidow, DVM DACVECC <br />
<br />
<div class="MsoNormal" style="margin: 0in 0in 0pt;">Last week, we received a phone call from an owner who saw her cat walking around with pollen on its face. She had just received a bouquet of lilies, had put them up high, but then saw her cat in that area. A quick internet search revealed that lilies were toxic and she wanted to know what to do.</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">We informed her to come in right away. Although sometimes the internet has stories that scare you unnecessarily, the danger of lilies to cats is not scary or loud enough. In a recent study of 48 households with cats exposed to lilies, only 27% of owners knew that lilies were toxic. In those cases, the owners thought the lilies were out of the way enough but the cats reached them anyway.</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">Asiatic lilies, the big beautiful ones that are especially common around Easter, are incredibly toxic to cats. The lilies that are toxic are from the <i style="mso-bidi-font-style: normal;">Lilium</i> or <i style="mso-bidi-font-style: normal;">Hemerocallus</i> species. Common names include Stargazer, Easter, Tiger lily, and day lilies.<span style="mso-spacerun: yes;"> </span>We don’t know what the toxic compound is but we do know that it concentrates in the pollen and that only a small amount is enough to cause acute kidney shutdown.<span style="mso-spacerun: yes;"> </span>Lily of the valley is not a true lily and therefore does not cause acute renal failure.<span style="mso-spacerun: yes;"> </span>It has cardiac glycosides (similar to digitalis) that can cause other symptoms.<span style="mso-spacerun: yes;"> </span>Peace and calla lilies contain calcium oxalate crystals and usually cause immediate oral and GI irritation and vomiting but do not cause kidney failure<personname w:st="on">.</personname></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">As with many toxicities, signs don’t happen instantly. With lilies, some vomiting may be seen within a few hours. Cats then often seen to be OK or a little lethargic but then become very sick again in 24-72 hours. Elevations in renal values can be detected on blood work as early as 12 hours after ingestion. If treatment is delayed for 24-48 hours, the insult to the kidneys may be irreversible.</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">If you suspect your cat has chewed on a lily, it is best to err on the side of caution and seek treatment. Your veterinarian may induce vomiting (if the cat has not already vomited parts of the plant) and follow up with a slurry of activated charcoal to bind up any remaining toxins in the GI tract.<span style="mso-spacerun: yes;"> </span>Intravenous fluids are recommended for at least 48 hours.<span style="mso-spacerun: yes;"> B</span>aseline blood work is obtained and renal values are monitored every 24 hours.<span style="mso-spacerun: yes;"> </span>If caught early and treated aggressively, the prognosis is good and no lasting damage occurs.<span style="mso-spacerun: yes;"> </span>In the study mentioned above looking at cats exposed to lilies, 90% did well with appropriate treatment but 10% did have renal damage.<span style="mso-spacerun: yes;"> </span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">In our recent phone call, we recommended aggressive treatment, the cat was hospitalized on IV fluids for 48 hours, and did fine with no long term problems.</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">So this spring, tell your friends, tell your colleagues that yes, some pollen could kill your cat. </div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">For more information on toxic plants, see <a href="http://www.aspca.org/">http://www.aspca.org/</a>.</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;">References: </div><div class="MsoNormal" style="margin: 0in 0in 0pt;">Slater MR, Gwaltney-Brant S.<span style="mso-spacerun: yes;"> </span>Exposure Circumstances and Outcomes of 48 Households with 57 Cats Exposed to Toxic Lily Species.<span style="mso-spacerun: yes;"> </span>JAAHA 2011; 47: 386.</div>Unknownhttp://www.blogger.com/profile/09328319891800106430noreply@blogger.com0tag:blogger.com,1999:blog-2722151962534833691.post-68166106257539818162012-03-28T15:36:00.000-07:002012-03-28T15:36:56.076-07:00Meet the Tripods!<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s1600/Guerra.jpg" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" dea="true" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s200/Guerra.jpg" width="133" /></a></div><span style="font-size: 12pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"><span style="font-family: Calibri;">By Beth Guerra, DVM</span></span> <div class="MsoNormal" style="margin: 0in 0in 10pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-size: 12pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"><span style="font-family: Calibri;">A while back, I wrote a blog about my three-legged poodle, Matilda. She was brought into ACCES Seattle during my first month of work, around the time I was looking to add a second dog to my household. She had sustained severe injuries to both the skin and bone on her right forelimb, and after consulting with our surgeon about several possible options, I chose amputation of the limb. She was estimated to be six months old at the time, and in the four years since then has flourished. She navigates stairs with ease, jumps on and off the bed more easily than my quadruped dog, and frequently runs 5Ks with me. I don’t think she remembers ever having four legs. </span></span></div><div class="separator" style="clear: both; text-align: center;"></div><div class="separator" style="clear: both; text-align: center;"></div><table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right; margin-left: 1em; text-align: right;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEje40Ox47ciqTGX1XH_bTLgOJMhqIqiRL3BhEommnxmOHdsXMwKaaPUuLjtUNr4jZHV-GhuHoHvAHHs5wjm3BEmEX4TV1v1TzjAKBd-Wy-8h71AOKN32esp7uK66TmOt-qXjmiYx4I6vJrf/s1600/dog1a2.JPG" imageanchor="1" style="clear: right; cssfloat: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" dea="true" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEje40Ox47ciqTGX1XH_bTLgOJMhqIqiRL3BhEommnxmOHdsXMwKaaPUuLjtUNr4jZHV-GhuHoHvAHHs5wjm3BEmEX4TV1v1TzjAKBd-Wy-8h71AOKN32esp7uK66TmOt-qXjmiYx4I6vJrf/s200/dog1a2.JPG" width="149" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Matilda</td></tr>
</tbody></table><div class="MsoNormal" style="margin: 0in 0in 10pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-size: 12pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"><span style="font-family: Calibri;">This past fall, we added a second tripod to our home. Fiona is a long haired Chihuahua mix that was brought in by the King County Animal Control after she was found as a limping stray. The x-rays showed a fractured left elbow, and the decision was made to amputate the limb. She was about three months old at the time. I came back after some time off to discover her still convalescing in the ICU, and I fell in love with her immediately. Like Matilda, she was up and walking the day after surgery, and hasn’t looked back since. While her stature, combined with a missing leg, does make it hard for her to jump off furniture and climb stairs, she is extremely active, runs at the dog park, and grapples with our other two dogs.</span></span></div><table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhng9TwQUlYCbbD-a5gLRcyJ7UDm7Aiw0GDuR9-HJfDU3X8drgvYF3CtDGV5xD0lSbdiQRr4xORAAh-Ce9t7mEkjt08M2W0e0KEfcOluSAd478LGECUwRFe-1ICu9GT5Q5T5hI9Z8P1Ywl5/s1600/dog23b.JPG" imageanchor="1" style="clear: left; cssfloat: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" dea="true" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhng9TwQUlYCbbD-a5gLRcyJ7UDm7Aiw0GDuR9-HJfDU3X8drgvYF3CtDGV5xD0lSbdiQRr4xORAAh-Ce9t7mEkjt08M2W0e0KEfcOluSAd478LGECUwRFe-1ICu9GT5Q5T5hI9Z8P1Ywl5/s200/dog23b.JPG" width="149" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Fiona</td></tr>
</tbody></table><div class="MsoNormal" style="margin: 0in 0in 10pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-size: 12pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"><span style="font-family: Calibri;">I have learned that each of my tripods has adapted to life differently. Each has a unique gait, which I did not expect. Matilda can move at slow speeds and stay balanced, but Fiona is constantly running to her destination and occasionally face-plants. Each dog chooses to present herself differently to new people. Matilda will bat you with her oversized front paw, but Fiona tends to hang back and hide. Each dog is a novelty at the dog park, and stimulates many conversations that revolve around rescuing pets and limb amputations. Although my dogs are small, and small dogs generally adapt better after losing a forelimb, I always tell people that this type of amputation does not necessarily mean a huge change in the quality of life for their pet, especially if it is a large breed dog. As they run full out at the park, my dogs are an ambassador for those pets with disabilities, proof that every dog deserves a chance, and that spirit can overcome a handicap. </span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-size: 12pt; line-height: 115%; mso-bidi-font-family: "Times New Roman";"><span style="font-family: Calibri;">For more information on three legged dogs, visit www.tripawds.com</span></span></div>Unknownhttp://www.blogger.com/profile/09328319891800106430noreply@blogger.com0tag:blogger.com,1999:blog-2722151962534833691.post-78750303120007627372012-02-09T14:28:00.000-08:002012-02-09T14:28:45.556-08:00Feline Saddle Thrombus<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s1600/Guerra.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" sda="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s200/Guerra.jpg" width="133" /></a></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="mso-bidi-font-family: "Times New Roman";"><span style="font-family: Calibri;">By Beth Guerra, DVM </span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="mso-bidi-font-family: "Times New Roman";"><span style="font-family: Calibri;">Cats can develop a particular type of heart disease, known as hypertrophic cardiomyopathy (HCM). In this type of cardiomyopathy, the left ventricular wall becomes very thickened, or hypertrophied. This differs from the canine type, which is characterized by a dilated heart with thin walled chambers. These changes can lead to a variety of systemic problems, such as abnormal heart rhythms and murmurs, decreased oxygen delivery to heart muscle, and increased blood pressure. There can also be a change in blood flow through the chambers of the heart. Several of these changes together can lead to the formation of thrombi, or clots, within the heart. These clots are sent through circulation and can become lodged in distant arteries, causing an obstruction of blood flow. One of the most common sites for these clots to end up is where the aorta divides into two major arteries supplying the rear limbs. The presence of a clot, known as a ‘saddle thrombus,' is a strong indication that there is underlying heart disease.</span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="mso-bidi-font-family: "Times New Roman";"><span style="font-family: Calibri;">Thrombus formation is acute and often the reason for presentation to the ER. Immediate symptoms include vocalization, discomfort, and paralysis of the rear limbs. Upon examination, no pulses in the limbs can be detected, the rectal temperature may be decreased (<97 F), and the rear paws may be cool to the touch or the nail beds bluish in color. Less often, a thrombus can form in one of the forelimbs, leading to similar symptoms of lameness or cold paw pads. Smaller thrombi can also shower the brain, lungs, or kidneys, leading to neurologic signs, respiratory difficult, or kidney failure. Because the saddle thrombus is nearly impossible to diagnose based on imaging techniques such as x-ray, diagnosis is usually made based on physical examination. A history of heart disease, murmur at time of exam, or arrhythmias/hypertension can also help solidify the diagnosis of HCM.</span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="mso-bidi-font-family: "Times New Roman";"><span style="font-family: Calibri;">Treatment is multifactorial, as both the thrombus and the underlying heart disease must be addressed. An echocardiogram (ultrasound) of the heart is the best way to confirm HCM. This disease in cats is not reversible; treatment is aimed at trying to prevent further thrombi from forming and can include heparin initially and then aspirin or Plavix. Other drugs may be added based on the severity of heart failure. However, there is no foolproof way to break down the pre-existing saddle thrombus with medications, although it may break up on its own over time. Supportive treatment is indicated during the initial days, and is aimed at nutritional support, pain control, and physical therapy. If circulation cannot be restored within one to two days, necrosis of the limbs can develop, ending in either partial amputation or euthanasia. Although prognosis is generally guarded, it is reasonable to support the cat for a few days with pain medications to see if circulation returns to the limbs. Survival can be up to 10 to 12 months after diagnosis, however, these cats are usually euthanized if the initial clot fails to resolve or if symptoms recur, eve n if the cat is on medication. </span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="mso-bidi-font-family: "Times New Roman";"><span style="font-family: Calibri;">For more information, visit<span style="mso-spacerun: yes;"> </span></span></span><a href="http://mysite.verizon.net/jachinitz/hcm"><span style="mso-bidi-font-family: "Times New Roman";"><span style="font-family: Calibri;">http://mysite.verizon.net/jachinitz/hcm</span></span></a><span style="font-family: Calibri;"> or </span><a href="http://www.ncbi.nlm.nih.gov/pubmed/12564730"><span style="font-family: Calibri;">http://www.ncbi.nlm.nih.gov/pubmed/12564730</span></a></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="mso-bidi-font-family: "Times New Roman";"><span style="font-family: Calibri;"></span></span></div><br />
<span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-family: "Calibri", "sans-serif"; font-size: 11pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Arial; mso-hansi-theme-font: minor-latin;">(Note: Cardiologist Dr. Anthony Tobias referenced in above source article is joining the ACCES specialty team on February 20, 2012.)</span><span style="font-family: "Calibri", "sans-serif"; font-size: 11pt; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"></span></span>Unknownhttp://www.blogger.com/profile/09328319891800106430noreply@blogger.com1tag:blogger.com,1999:blog-2722151962534833691.post-80956396704247324762012-02-02T09:03:00.000-08:002012-02-02T09:03:28.385-08:00The Subtle Signs of Pericardial Effusion<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s1600/Guerra.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><span style="font-family: Arial, Helvetica, sans-serif;"><img border="0" height="200" sda="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s200/Guerra.jpg" width="133" /></span></a></div><span style="font-family: "Times New Roman", "serif";"><span style="font-family: Arial, Helvetica, sans-serif;">By Dr. Beth Guerra</span></span> <div class="MsoNormal" style="margin: 0in 0in 10pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", "serif";"><span style="font-family: Arial, Helvetica, sans-serif;">Occasionally, as a veterinarian I must chase down a diagnosis with not much to go on. An animal presents with very vague symptoms but both the owner and I know that something is amiss. Through experience, I have learned to think outside the box in some situations and look for the ‘zebra’ diagnosis when symptoms just don’t add up.</span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", "serif";"><span style="font-family: Arial, Helvetica, sans-serif;">One of these elusive diagnoses is pericardial effusion. The heart is contained within a mostly rigid sac, called the pericardium. When fluid or blood accumulates in this space, the heart is compressed and cannot expand efficiently. Because of this, blood flow through the heart is decreased, leading to compromised peripheral circulation. To compensate, the heart beats faster to try and make up for the deficit. This compression of the heart by fluid is known as cardiac tamponade. Blood pressure drops, oxygenation is low, and the animal may experience collapsing episodes. Sometimes they have pale mucus membranes, or muffled heart sounds from the fluid that has built up. Diagnosis is based on x-ray, where a large, globoid heart silhouette is seen, or more easily with ultrasound, where fluid around the heart is directly visualized.<span style="mso-spacerun: yes;"> </span>Sometimes the ECG will show characteristic changes in the tracing.</span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", "serif";"><span style="font-family: Arial, Helvetica, sans-serif;">In a textbook situation, all of the above symptoms occur. More often, I have animals that present with subtle symptoms, such as slow, deep breathing, mild weakness when walking, or apparent abdominal pain (hunched posture, groaning). Physical exam reveals none of the classic symptoms of pericardial effusion. The history is inconclusive. Yet something tells me to look for the ‘zebra’, to systematically evaluate every body system to try and explain the symptoms. Since I have access to a portable ultrasound, in these cases I will often do a quick scan of the heart to see if there is any pericardial fluid. It is a relief when I find it, because I have a diagnosis. However, the presence of this fluid usually indicates a poor prognosis.</span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", "serif";"><span style="font-family: Arial, Helvetica, sans-serif;">Fairly frequently, animals with pericardial effusion are in distress. The quickest way to stabilize such a patient is to remove the fluid with a needle, known as pericardiocentesis. This also allows the doctor to examine the fluid to try and determine an underlying cause. The fluid is often blood, which can indicate a heart base tumor that has ruptured. Occasionally, the fluid is clear or has very little blood, which may also indicate a tumor but may also be idiopathic (unknown cause). Diagnosing tumors in this area can be extremely difficult, as they can be too small to detect on thoracic ultrasound. A CT may be recommended, especially if surgical intervention is being considered. Some owners choose to treat palliatively, draining the fluid as needed, although this does present its own risks. If a tumor is found, the overall long term prognosis is poor. <span style="mso-spacerun: yes;"> </span>In the rare instance of idiopathic effusion, some animals may do well with a surgery to remove the heart sac.</span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", "serif";"><span style="font-family: Arial, Helvetica, sans-serif;">ACCES is lucky to have a veterinary cardiologist joining our staff to help with these difficult cases.<span style="mso-spacerun: yes;"> </span>Anthony Tobias, DVM DACVIM (Cardiology) will be joining ACCES February 20, 2012.</span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><br />
</div><span style="font-family: Arial, Helvetica, sans-serif;"></span>Unknownhttp://www.blogger.com/profile/09328319891800106430noreply@blogger.com2tag:blogger.com,1999:blog-2722151962534833691.post-91297536713673023662012-01-10T16:18:00.000-08:002012-01-10T16:18:18.080-08:00Marijuana Toxicity in Pets<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s1600/Guerra.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" kba="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s200/Guerra.jpg" width="133" /></a></div><div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt; text-align: left;"><span style="font-size: 12pt; mso-bidi-font-family: "Times New Roman";"><span style="font-family: Calibri;">By Dr. Beth Guerra</span></span></div><div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt;"><span style="font-size: 12pt; mso-bidi-font-family: "Times New Roman";"><span style="font-family: Calibri;">At the emergency clinic, we commonly treat pets that have gotten into household medications, even those considered to be hidden or out of reach. For example, we often see a range of medication ingestions, from vitamin supplements to heart medications. </span></span></div><div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt;"><span style="font-size: 12pt; mso-bidi-font-family: "Times New Roman";"><span style="font-family: Calibri;">However, in the last few months, we are seeing a greater number of pets who have gotten into owners medicinal or recreational marijuana. The active compound, THC, interacts with neurotransmitters in the brain and can cause a variety of symptoms. The amount of THC varies greatly (i.e., dried product vs. oil), as does a pet’s individual response to the drug. According to the ASPCA Poison Control Database, research has shown that ingestion of 3-9g/kg of body weight can cause symptoms. Death from ingestion can occur, but is rare. A majority of cases (97%) are dogs.</span></span></div><div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt;"><span style="font-size: 12pt; mso-bidi-font-family: "Times New Roman";"><span style="font-family: Calibri;">Pets that have ingested marijuana can exhibit a variety of symptoms. The most common are walking off balance (ataxia), not reacting normally, acting depressed, hypersalivating, and dribbling urine. Pets may also have dilated pupils, can seizure, and may have a fast heart rate. Occasionally, agitation may occur. If the product has been baked into goods containing chocolate, the pet must be monitored and treated for those symptoms as well. Treatment of marijuana toxicity is focused on decontamination and supportive care. Often, vomiting is induced, especially within several hours of suspected ingestion. Several doses of activated charcoal may be given to prevent further absorption from the GI tract. In severely affected animals (i.e., overly sedate), IV fluid support and hospitalization for monitoring may be recommended until the pet is more responsive. Symptoms usually resolve within 24 hours with no lasting effects.</span></span></div><div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt;"><span style="font-size: 12pt; mso-bidi-font-family: "Times New Roman";"><span style="font-family: Calibri;">Pet owners are often reluctant to admit that exposure to marijuana is a possibility. However, it is crucial to inform your veterinarian of any possible exposure to this or other drugs. We are not required to contact the authorities about drug ingestions and only use the information to best treat your pet. Signs of marijuana toxicity can be similar to other types of issues. If we don’t know about the exposure, we may need to run tests to rule out other diseases. If we know of the exposure, we can often provide supportive care and be fairly sure of a good outcome. </span></span></div>Unknownhttp://www.blogger.com/profile/09328319891800106430noreply@blogger.com1tag:blogger.com,1999:blog-2722151962534833691.post-71705479137311377792012-01-02T09:07:00.000-08:002012-01-02T09:07:02.056-08:00New Year's Resolutions for Your Pet!<!--[if gte mso 9]><xml> <o:OfficeDocumentSettings> <o:AllowPNG/> </o:OfficeDocumentSettings> </xml><![endif]--><!--[if gte mso 9]><xml> <w:WordDocument> <w:Zoom>0</w:Zoom> <w:TrackMoves>false</w:TrackMoves> <w:TrackFormatting/> <w:PunctuationKerning/> <w:DrawingGridHorizontalSpacing>18 pt</w:DrawingGridHorizontalSpacing> <w:DrawingGridVerticalSpacing>18 pt</w:DrawingGridVerticalSpacing> <w:DisplayHorizontalDrawingGridEvery>0</w:DisplayHorizontalDrawingGridEvery> <w:DisplayVerticalDrawingGridEvery>0</w:DisplayVerticalDrawingGridEvery> <w:ValidateAgainstSchemas/> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:Compatibility> <w:BreakWrappedTables/> <w:DontGrowAutofit/> <w:DontAutofitConstrainedTables/> <w:DontVertAlignInTxbx/> </w:Compatibility> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" LatentStyleCount="276"> </w:LatentStyles> </xml><![endif]--> <!--[if gte mso 10]> <style>
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<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s1600/Guerra.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR24cfCKfJzwc8rBzuZSXOAN95IfaGl52wpzfB0bis7Ghmwy5xxy1Y_XJP46Ns_P_f75NSBIsOcFQa4LcOqLnSV5u-9UquIc1GPoBCR_B0OTwaX-6Lu9qwb_Fd1KnjtbuJmpj2Q9A9muLU/s200/Guerra.jpg" width="133" /></a></div><div class="MsoNormal" style="text-align: left;">By Dr. Beth Guerra</div><div class="MsoNormal" style="text-align: left;"><br />
</div><div class="MsoNormal"><span style="mso-bidi-font-family: "Times New Roman";">With the New Year comes the inevitable resolutions. While you are making your own list, consider making one for your pet as well. Whether it’s as simple as learning to trim your pets nails, or focusing on finally getting that extra weight off your beloved companion, remember that you are your pet’s advocate and change starts with you.<o:p></o:p></span></div><div class="MsoNormal"><span style="mso-bidi-font-family: "Times New Roman";"><br />
</span></div><div class="MsoNormal"><b style="mso-bidi-font-weight: normal;"><span style="mso-bidi-font-family: "Times New Roman";">Yearly physical exams</span></b><span style="mso-bidi-font-family: "Times New Roman";"> are important for all pets. In the past, pets usually received a yearly physical when vaccines were due. Because vaccines are not needed as often (every three years is now recommended for adult animals), yearly physicals have sometimes been skipped. Even if your pet has never had an illness, these exams are important to establish a good health baseline and can also be crucial in detecting emerging disease. A thorough exam combined with an extensive history can often aid in disease prevention or help establish a diagnostic and treatment plan early in the progression of a disease. For example, if kidney disease is caught early, a simple diet change can often prolong life for many years. <o:p></o:p></span></div><div class="MsoNormal"><span style="mso-bidi-font-family: "Times New Roman";"><br />
</span></div><div class="MsoNormal"><b style="mso-bidi-font-weight: normal;"><span style="mso-bidi-font-family: "Times New Roman";">Obesity</span></b><span style="mso-bidi-font-family: "Times New Roman";"> has become a major problem in household pets. This may be due to inappropriate diet, lack of exercise, injury, or metabolic disease. If you notice your pet has packed on a few pounds, or seems lethargic, schedule an exam with your veterinarian to discuss weight loss. It may be as simple as reducing the amount of food, switching to a lower calorie/higher fiber or high protein diet, or increasing activity. It is also important for your pet to have an exam to make sure there isn’t another reason for the weight gain, such as hypothyroidism. Consistent weigh-ins with your vet can help chart progress and identify any setbacks.<o:p></o:p></span></div><div class="MsoNormal"><span style="mso-bidi-font-family: "Times New Roman";"><br />
</span></div><div class="MsoNormal"><b style="mso-bidi-font-weight: normal;"><span style="mso-bidi-font-family: "Times New Roman";">Dental hygiene</span></b><span style="mso-bidi-font-family: "Times New Roman";"> is also extremely important. Frequent dental cleanings are recommended for both cats and dogs. Some pet owners may be reluctant due to cost and the need for general anesthesia, but the benefits often outweigh the cost. Dental cleanings focus on removing the tartar visible on teeth and can improve the health of gingiva. Problems with teeth, such as erosions, fractures, or tooth root abscesses can be detected and treated appropriately. The mouth is examined for ulcers or masses that are often not observed by the owner. And, your pet will most likely have fresher breath!<o:p></o:p></span></div><div class="MsoNormal"><span style="mso-bidi-font-family: "Times New Roman";"><br />
</span></div><div class="MsoNormal"><b style="mso-bidi-font-weight: normal;"><span style="mso-bidi-font-family: "Times New Roman";">For older pets</span></b><span style="mso-bidi-font-family: "Times New Roman";"> on medications, a yearly exam is an important part of the monitoring process. Anti-inflammatories for arthritis, thyroid supplements, seizure medications, and insulin are some examples of medications that need to be closely monitored. <b style="mso-bidi-font-weight: normal;">Bloodwork</b>, such as a complete blood count and serum chemistry, is often an integral part of the monitoring process and may be recommended yearly as well. This also helps to establish a baseline and can provide useful information for comparison if your pet becomes ill.<o:p></o:p></span></div><div class="MsoNormal"><span style="mso-bidi-font-family: "Times New Roman";"><br />
</span></div><div class="MsoNormal"><span style="mso-bidi-font-family: "Times New Roman";">For 2012, take some time to establish goals for you and your pet. Prevention is the best medicine, and it may keep your pet from having to visit the emergency clinic!<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><!--EndFragment-->Unknownhttp://www.blogger.com/profile/09328319891800106430noreply@blogger.com1tag:blogger.com,1999:blog-2722151962534833691.post-87423583194521073682011-12-27T14:32:00.000-08:002011-12-27T14:32:37.135-08:00Is it Okay for My Cat to be an Outside Pet?<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjsBqYTlQlxy2o06iLfHH4uByBGAsP1_mTohNq0LXyTTBaCcx2Uef3dVbb63URpamV3OETKPsHedp5AD0jXj8eMa8w_UqQk55UIbG1gqr4zsFaak2G9mI4KNEixT7tML43yrfrmCUMt10Ge/s1600/Miles.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" rea="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjsBqYTlQlxy2o06iLfHH4uByBGAsP1_mTohNq0LXyTTBaCcx2Uef3dVbb63URpamV3OETKPsHedp5AD0jXj8eMa8w_UqQk55UIbG1gqr4zsFaak2G9mI4KNEixT7tML43yrfrmCUMt10Ge/s200/Miles.jpg" width="133" /></a></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", "serif"; font-size: 12pt; line-height: 115%;">By Patrick Miles, DVM</span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", "serif"; font-size: 12pt; line-height: 115%;">One of the questions we ask when a cat presents to the hospital is whether they are indoor only, outdoor only or both.<span style="mso-spacerun: yes;"> </span>A few clients over the years have become defensive or felt guilty over this issue.<span style="mso-spacerun: yes;"> </span>The simple answer to the above question is yes.<span style="mso-spacerun: yes;"> </span>Your cat is your pet and your responsibility.<span style="mso-spacerun: yes;"> </span>There is not one lifestyle that is perfect for every home. Some cats are not good indoor companions due to behavior issues, allergies, house soiling, etc.<span style="mso-spacerun: yes;"> </span>There are situations in which owners felt pressured to keep their cats indoor by friends, family, adoption agencies, and veterinary professionals.<span style="mso-spacerun: yes;"> </span>We will often recommend a cat that has been ill or recovering from a surgery become an indoor pet during recovery to reduce complications risks.<span style="mso-spacerun: yes;"> </span>However, it still is an owner’s choice to allow their cat to live an outdoor life once healed.</span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", "serif"; font-size: 12pt; line-height: 115%;">As a veterinarian, the lifestyle of a cat can play an important role in addressing an illness.<span style="mso-spacerun: yes;"> </span>If a cat lives indoors, it can be much easier to develop a diagnostic and therapeutic plan simply because the possibilities causing an illness tend to be more limited.<span style="mso-spacerun: yes;"> </span>For instance, patients that present sick that live outside may not be able to answer whether there has been any trauma, vomiting, diarrhea, cough, straining to urinate, blood in stools, etc.<span style="mso-spacerun: yes;"> </span>Problems that arise with indoor cats tend to be found earlier simply because of the more intimate proximity, i.e. it’s easy to know if your cat has been vomiting when you accidently step in it or find it on the couch. </span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", "serif"; font-size: 12pt; line-height: 115%;">Risks for outdoor cats can be extensive.<span style="mso-spacerun: yes;"> </span>The risk for trauma from vehicles, dogs, other cats, raccoons and other wildlife tend to be more obvious.<span style="mso-spacerun: yes;"> </span>Infectious diseases are more common due to exposure to other cats.<span style="mso-spacerun: yes;"> </span>Feline leukemia and Feline AIDS are more common due to bite wounds from infected cats.<span style="mso-spacerun: yes;"> </span>They may ingest unknown toxins, things that can cause vomiting and diarrhea, etc.<span style="mso-spacerun: yes;"> </span>The list of risks can be extensive. Subjectively, outdoor cats tend to have a shorter lifespan than indoor cats.</span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", "serif"; font-size: 12pt; line-height: 115%;">When we ask this question, it is not to judge your decision on your pet’s lifestyle.<span style="mso-spacerun: yes;"> </span>It is to help develop and focus the approach to an illness.<span style="mso-spacerun: yes;"> </span>We may advise additional diagnostic testing for a specific problem based on the lifestyle, thus increasing the financial obligation.<span style="mso-spacerun: yes;"> </span>The issue is really one of understanding and accepting the increased risk of illness or trauma. </span></div>Unknownhttp://www.blogger.com/profile/09328319891800106430noreply@blogger.com0tag:blogger.com,1999:blog-2722151962534833691.post-40464457257854964882011-12-05T15:12:00.000-08:002011-12-05T15:12:55.884-08:00When Repeating Diagnostics Makes Sense<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhv21bcAUlxDSRlEuF1Vy4HPUt70pgQx-GgokwESD1eQoC1kMGRmk2ffwqvKi7Xulqfn6QPwYpg5mzrpikQvgbajBHIjImuh9Zq-DiPctm7pExe9c7-XyOEzuHDifWfL7qIXB0LWBrkO6Ap/s1600/Davidow.jpg" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" dda="true" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhv21bcAUlxDSRlEuF1Vy4HPUt70pgQx-GgokwESD1eQoC1kMGRmk2ffwqvKi7Xulqfn6QPwYpg5mzrpikQvgbajBHIjImuh9Zq-DiPctm7pExe9c7-XyOEzuHDifWfL7qIXB0LWBrkO6Ap/s200/Davidow.jpg" width="133" /></a></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Calibri", "sans-serif"; font-size: 11pt; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">By Beth Davidow, DVM DACVECC </span></b></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-family: "Calibri", "sans-serif"; font-size: 11pt; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Many times clients will ask why we are repeating a test.<span style="mso-spacerun: yes;"> </span>It does seem that if you have just had blood work done recently, things shouldn’t be that different.<span style="mso-spacerun: yes;"> </span>However, when an animal is sick, things can change dramatically over a period of hours.<span style="mso-spacerun: yes;"> The following case is a</span> good example.</span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-family: "Calibri", "sans-serif"; font-size: 11pt; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">A seven and a half-year-old pointer was referred to our ICU for care of a suspected reaction to a chemotherapy drug. <span style="mso-spacerun: yes;"> </span>A review of his case showed that the dog had a skin lump that turned out to be an atypical form of a cancer called lymphoma.<span style="mso-spacerun: yes;"> </span>(Lymphoma is a cancer of lymph nodes and lymphatics and doesn’t usually show up as a skin nodule.) <span style="mso-spacerun: yes;"> </span>Initial screening showed no evidence of the cancer anywhere else.<span style="mso-spacerun: yes;"> </span>The dog had been given a chemotherapy drug three weeks prior to presentation.<span style="mso-spacerun: yes;"> </span>The tumor shrank dramatically in size and he seemed to feel well.<span style="mso-spacerun: yes;"> </span>Many chemotherapy drugs can suppress the body’s infection fighting cells, the white blood cells, and this did happen seven days after the drug was given.<span style="mso-spacerun: yes;"> </span>The dog was put on antibiotics and seemed to be fine.<span style="mso-spacerun: yes;"> </span>However, three weeks after the drug was given, the dog acutely started having vomiting, diarrhea and was severely weak.<span style="mso-spacerun: yes;"> </span>He had a fever and a borderline low white blood cell count.<span style="mso-spacerun: yes;"> </span>Bloodwork, radiographs and ultrasound were done and no evidence was seen of any new cancer.<span style="mso-spacerun: yes;"> </span>It was assumed that he had an infection secondary to having the low white blood cell count.</span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-family: "Calibri", "sans-serif"; font-size: 11pt; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">When the dog arrived at ACCES, he was dehydrated, weak and had a fever.<span style="mso-spacerun: yes;"> </span>He had been started on IV fluids, antibiotics and anti-nausea medications at the regular veterinarian and those treatments were continued. <span style="mso-spacerun: yes;"> </span>However, at 10:00 pm he was still febrile and now couldn’t stand up.<span style="mso-spacerun: yes;"> </span>A blood glucose (blood sugar) was rechecked and had fallen to a dangerously low level. He was given IV glucose and was much brighter.</span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-family: "Calibri", "sans-serif"; font-size: 11pt; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Why did the blood glucose fall in only 12 hours?<span style="mso-spacerun: yes;"> </span>Normally dogs can maintain their blood sugar in a normal range even if they aren’t eating.<span style="mso-spacerun: yes;"> </span>In the face of overwhelming infection, sometimes the bacteria are “stealing” the glucose and blood values will fall quickly.<span style="mso-spacerun: yes;"> </span>Sometimes, if the body’s normal stress mechanisms aren’t working, it can also fall.<span style="mso-spacerun: yes;"> </span>Sometimes, tumors can also “steal’ glucose but we hadn’t found any new cancer.<span style="mso-spacerun: yes;"> </span>Our working hypothesis was that we still weren’t on top of the infection.<span style="mso-spacerun: yes;"> </span>We started an additional antibiotic.</span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-family: "Calibri", "sans-serif"; font-size: 11pt; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Over the next 24 hours, the glucose stayed normal and the fever resolved but the dog was still very depressed and wouldn’t eat.<span style="mso-spacerun: yes;"> </span>The next morning, 48 hours after the initial illness started, small pinpoint bruises were noted on the skin.<span style="mso-spacerun: yes;"> </span>This can be a sign that the clotting system isn’t working.<span style="mso-spacerun: yes;"> </span>We checked the clotting blood values and found that the platelets, small particles in the blood that make the initial clot, were now very low, even though they had been OK the day before.<span style="mso-spacerun: yes;"> </span>A full complete blood count was sent to the lab.<span style="mso-spacerun: yes;"> </span>A falling platelet count can also be a sign of infection or emerging cancer but the fever was under control.<span style="mso-spacerun: yes;"> </span>What was happening?</span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-family: "Calibri", "sans-serif"; font-size: 11pt; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">In the afternoon, we had our answer.<span style="mso-spacerun: yes;"> </span>The complete blood count, which had only normal blood cells 48 hours before, now showed cancer cells in the blood.<span style="mso-spacerun: yes;"> </span>The cancer, despite being gone from the skin, had lodged in the bone marrow and in a 48 hour period and multiplied fast enough to be found in the blood stream.<span style="mso-spacerun: yes;"> </span>The dropping glucose and platelets were not from a chemotherapy reaction or from infection but from the emerging cancer we couldn’t yet see.</span></div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 0pt;"><span style="font-family: "Calibri", "sans-serif"; font-size: 11pt; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Thus, repeating the same tests several times allowed us to diagnose the reemerging cancer quickly.<span style="mso-spacerun: yes;"> </span>It was a lesson of how rapidly things can change in the body.<span style="mso-spacerun: yes;"> </span></span></div>Unknownhttp://www.blogger.com/profile/09328319891800106430noreply@blogger.com0