ABVP CERTIFIES VETERINARIAN IN CANINE/FELINE PRACTICE

ABVP CERTIFIES VETERINARIAN IN CANINE/FELINE PRACTICE

Hello!  The Michigan Veterinary Blog took a back seat to the certification process, but I hope to provide much more content on a regular basis.  ~ Julie

NASHVILLE, TN -- Julie Ann Hass, DVM, MS of North West Oakland County  has been certified as a Diplomate by the American Board of Veterinary Practitioners (ABVP) specializing in Canine and Feline Practice.

Dr. Hass mastered a rigorous and demanding application process and certification examination in order to obtain Diplomate status. To qualify to sit for the extensive, two-day examination, a veterinarian must complete either a residency program or six years of clinical veterinary practice. In addition, two case reports, references, descriptions of practice procedures, and professional education records must be submitted and pass review. This year's examination was given on October 29th and 30th in Nashville, Tennessee.

Dr. Hass is a graduate of the Michigan State College of Veterinary Medicine and has completed a internship in small animal medicine and surgery at Virginia Maryland Regional College of Veterinary Medicine as well as received a Masters of Science from The Ohio State University and completed a residency in veterinary neurology. She practices and is co-owner at Veterinary Care Specialists and VCS Pets First located at 205 Rowe Road in Milford for over 17 years. The combination of Veterinary Care Specialists and VCS Pets First creates a 24/7 full service community hospital that provides specialty care, emergency care and general medicine and surgical care under the same roof. 

The American Board of Veterinary Practitioners was established in 1978. It is one of twenty-one veterinary specialty groups accredited by a special committee of the American Board of Veterinary Specialties, a division of the American Veterinary Medical Association, to recognize excellence in clinical practice through the certification of species-oriented specialists. Over 900 veterinarians worldwide are certified in one of ABVP’s ten practice categories: Avian, Beef Cattle, Canine and Feline, Dairy, Equine, Exotic Companion Mammal, Feline, Food Animal, Reptile and Amphibian and Swine Health Management. For more information about ABVP, please visit www.abvp.com.

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New Application Helps Better Manage Diabetic Pets

We recently received some exciting information at our office from Abbott Animal Health, the makers of the AlphaTrak Glucometer, a product made specifically for home monitoring blood glucose of both dogs and cats.

Abbott Animal Health has created a data management program for veterinary diabetic patients. This is something that has long been available to human diabetics and has been desperately needed in veterinary medicine. The AlphaTraker, Electronic Data Master, is a very simple to use program that you can download to your PC (we did not try it on a iPad or other tablet). The program can be used if you do not use an AlphaTrak Glucometer, which is great since many clients choose to use different brands of glucometer. If you do not have an AlphaTrak you will choose manual entry. If you do have an AlphaTrak the glucometer can be attached to your computer with a cable (this is sold separately) and will automatically download the glucose readings for your pet.
What this application allows you to do is enter your pets glucose readings, times they ate, what they ate and time and dose of insulin administered for each day. You can also keep track of other laboratory testing, other medications being administered and veterinary appointments. The program easily converts this information to graphs that allow you to quickly identify trends and, most importantly, it allows you to share this information very succinctly with your veterinarian.

I feel that the key to successful long term management of most diabetics is communication between the owner and the veterinarian. No matter how diligent the owner, it is difficult to accurately communicate the day to day minutia like appetite, activity, etc. I also see many clients assume that once they establish an insulin dose and a home regimen they are on autopilot and they can either stay the course or adjust insulin doses as they see fit. This can lead to disasters or at least a poor long term outcome (shortened life expectancy, diabetic neuropathy, etc). The AlphaTraker program appears to have helped solve this issue.

Take a look at the site and download AlphaTraker and give it a try!   http://alphatraker.software.informer.com/

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The Tale of Two Frogs

This January a woman called our office rather upset. She explained that she just noticed that her house plant had two, tiny frogs living in it! Obviously, it was not the right time of year to just release them and she didn't know how to care for them. Could we help?

Fortunately, we not only have Dr. Schmidt Dexter, who is highly trained in exotic pet care and wildlife rehabilitation, but we have a technician, Edi, who is a herpetologist. They assured her that they could help and encouraged her to bring the frogs to the office. When the tree frogs arrived they were very inactive, which was appropriate for the time of year, and they appeared healthy. They were identified as Gray Tree Frogs, a species indigenous to the area (meaning that they normally inhabit the wetlands of Michigan) and once spring came they could be released. The duo went home with Edi so they could safely continue their hibernation.

About a month ago Edi told me that the little frogs, whose cage was being kept in her bedroom,  suddenly began to sing. It appeared that the pair consisted of a male and a female and the male has a very shrill chirp (you can hear it on YouTube by searching Gray treefrog calling) that woke her abruptly from a deep sleep and left the whole house a little startled. Evidently it was getting close to time for their release.

Once the evenings were more consistently warm, the pair returned to our hospital for release. We are lucky to sit adjacent to a wetland and it seemed only right that they enjoy the beautiful habitat around our hospital. The hospital has extensive gardens, we don't use any chemicals on our lawn or flowers and during summer evenings our windows are literally plastered with all kinds of frogs. The charming couple was successfully released in the evening about 2 weeks ago. We  hope that they continue to thrive and reproduce. Who knows maybe we will see them on our windows, catching bugs, one evening this summer!

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Preparing Your Pets For Your Vacation

Where did everybody go?

Spring is around the corner! However this long winter has many of us planning travel to a warmer climate. We all know that preparing for even a short trip is an ordeal. As our families and our households grow so do the’ to do’ lists that we generate before leaving. Often taking our pets with us is not an option and arrangements must be made for their care. One of the important items on any pet owners travel preparation list should be a thorough assessment of your pets health and a complete plan for their care while you are gone.

Each holiday travel season, our emergency service will see numerous cases of pets who become ill at boarding facilities or are found seriously ill at home by their caregiver. In retrospect, most of these animals manifest signs of illness before their owners leave on vacation. Many of these often tragic events could be avoided by following some simple recommendations. 

1. Any older pet (dogs over 6-7 years, cats 10 years or older) or any pet that has been recently ill should be evaluated by a veterinarian prior to your trip and given a clean bill of health before you leave. 
2. Try to not make any major changes in your pets routine or heath care before you leave. Don’t change their diet, routine or initiate a new treatment regime, just prior to leaving. 
3. Listen to your intuition, if your pet, regardless of their age, has been having a ‘few upset stomachs’ recently, has ‘been less active’  or has been ‘acting different’, don’t make up excuses for why this is happening, have them examined. I have recently seen a few cases where the pets were demonstrating subtle  signs that they were ill prior to their being boarded and the owner even mentioned this to the boarding facility, but it was not pursued. Unfortunately, the pets ended up critically ill in the hospital while the owner was far away on vacation. Remember, even though pets may be seriously ill, early identification could allow them to survive the illness successfully.
4. Cats do not do well being left home with a big bowl of dry food and the neighbor checking  on them once in a while. Cats reclusive tendencies make it hard for periodic visitors to know if the cat is acting ‘normally’. Changes in appetite and litter box use may be hard for a visitor to appreciate as well. Make sure any caregiver is aware of your cats routine, usual food consumption and letterbox habits. Litter boxes should be cleaned daily (this allows easy monitoring for urine output and stool quality). Cats should be interacted with at least twice daily. Detailed instructions should be provided to the caregiver or boarding facility as to how to care for your cat. 
5. Communication is key! Be sure your caregiver or boarding facility has your permission to seek medical care of your pet should they become ill. Have a clear understanding of where your pet will be taken and what level of care will be provided. Be sure that they have your veterinarians contact information.  If you will not be available by phone 24/7, be sure you have a family member or friend designated to be your proxy. 

Following a few easy steps such as, being sure your pet is well prior to leaving, providing thorough instructions to caregivers and being confident there is a clear plan for your pets care should they become ill, will help to make your trip enjoyable for everyone. 

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What Is Cystitis?

Cystitis (sis-TI-tis) is the medical term for inflammation of the bladder. 

The bladder is shaped like a pouch or bag. It consists of a muscle with a very fragile inner lining called the mucosa. The bladder is part of the lower urinary tract. It serves as a point for urine collection. Urine is produced by the kidneys and drains through hollow tubes called ureters that run from each kidney to the bladder. From the bladder, urine flows to the urethra and then outside the body. 

Cystitis can be caused by a variety of conditions. Bacterial infections are the most common cause for cystitis, however viral infections, trauma, tumors, parasites, non-infectious or sterile inflammation (most commonly seen in cats), medications and stone or crystal formation in the bladder can also trigger extensive bladder inflammation. 

What are the signs of cystitis ? 

When our pets have cystitis it causes signs, or symptoms, like  increased frequency of urination (polakiuria), straining to urinate (stranguria), blood in the urine (hematuria), or otherwise discolored urine with inflammatory cells or crystals (pyuria or crystaluria).

Dogs and cats with cystitis are uncomfortable just like we would be, and they may demonstrate this discomfort by excessively grooming or licking their vulva or penis, scooting or licking and pulling the hair off their abdomen (their belly). Most likely due to their discomfort pets may urinate inappropriately in the house (dysuria) or just outside the litter box. 

Sometimes patients with cystitis can  have such severe inflammatory disease that they are unable to urinate. Inability to urinate due to a urethral obstruction can lead to life threatening toxemia and renal failure. Any patient with cystitis should be watched closely for signs of urinary obstruction and should be evaluated immediately if they stop urinating.

How is cystitis diagnosed ?

If you feel your pet is suffering from cystitis you should have them evaluated by your veterinarian. Cystitis can progress to renal disease, renal failure and urinary tract infections can spread to other parts of the body causing septicemia. Early diagnosis and  treatment is key to preventing other, more serious illnesses. 

 Based on a thorough history and physical examination performed by your veterinarian diagnostic tests will be recommended. A urinalysis is an evaluation of the urine. Urine samples are often collected in a sterile manner by cystocentesis or catheterization so that cultures of the urine (to identify bacterial infections and what antibiotics the bacteria will be sensitive to) can be performed. Measurements like specific gravity (how concentrated the urine is), pH, and protein levels are made as well as a cytologic or microscopic examination to look at the cells, crystals and other organisms that might be in the urine. 

Struvite Crystals (Magnesium ammonium phosphate)

Urine bacterial cultures and sensitivities are important to identify if there is an infection, name the type of bacteria and find the antibiotic that will kill the bacteria the most effectively. 

X-rays or radiographs of the abdomen and bladder allow visualization of the bladder and the rest of the urinary tract, kidneys and ureters. The shape and size of the bladder as well as the presence of stones in the bladder can be easily assessed. Introduction of a dye or contrast agent into the bladder can be performed to aid in further radiographic evaluation of the bladders position and contents. 

Ultrasound examinations of the bladder allow more detailed examination of the bladder wall, the contents of the bladder and the structure of the bladder, attachment of the ureters and urethra. 

Urinary stones or calculi form  for a variety of reasons. They range in size from microscopic crystals to large rocks. Calculi can form due to metabolic  defects or infections. Samples of calculi can be sent for analysis, once stones are analyzed treatment plans can be crafted to avoid stone reformation. 

Other tests, like cystoscopy (the use of a fiberoptic scope to examine the urethra and bladder) and surgery (cystotomy) can be utilized to retrieve biopsies, remove stones, and remove polyps or masses.

How is cystitis treated?

There are many different treatments for cystitis. Treatment plans are designed based on the underlying cause. Antibiotics, diet changes, urinary acidification or alkalization, analgesics (pain medications), glucosamine,  antidepressants, chemotherapy, surgery and cystoscopy are all treatments used for the management of the many different causes of cystitis. 

Prevention ~

As with so many health issues in our pets, the key is to follow your veterinarians recommendations, administer all medications and diets as prescribed and, most importantly, follow up with your veterinarian in the prescribed time to be sure that the cystitis was resolved.

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Getting Your Pet Safely To the Veterinary Hospital

With the majority of the continental United Sates is in the deep freeze, my thoughts turned to the issue of safely transporting our pets by car. Not only do we have to concern ourselves with the road conditions and the subzero temperatures, but precautions are necessary to prevent the loss of a pet during the transportation process either in the car or while moving from house to car or from the car to the veterinary hospital. This is particularly important since many of our pets, if lost, would not be able to survive the current weather conditions. However, the following recommendations are important to consider whether it is summer or winter. Safe transport is key to not only your pets survival, but yours as well. 

So many times we see a client walking into our hospital clutching a terrified cat to their chest or with an unleashed dog walking at their side. Usually there is a collective gasp at the front desk and we run to assist the owner. Many people are surprised by our alarm. But, we have seen pets wrestle free of their owners grasp or pop out of poorly designed makeshift carriers (our favorite is the two laundry baskets, one inverted over the other, tied together with twist ties containing a wild eyed feline) to be set loose in our parking lot. Fortunately we have never seen a pet injured, but there is a very busy road in front of our practice and a  quick dart of a terrified pet in the right direction could mean tragedy. 

Sometimes the danger lies in the trip to and from the hospital in the car. Distracted driving is a leading cause of car accidents in the US and pets have been listed as number 8 in the top 10 causes for distracted driving.¹ According to researchers at the University of Alabama at Birmingham, slightly more than 50% of all drivers, at some time, will take a pet with them in the car. In a study published by the journal, Accident Analysis and Prevention, among drivers over 70 years of age, driving with a pet doubled their chance of an accident. These statistics clearly illustrate the need to have our pets secured in the car so they are not a distraction. Crates, seat belts and other sundry carrying devices can go a long way towards keeping the whole family safe. 

How to keep your pet safe ~

• Carriers -
  
  It’s important that you have an appropriately sized carrier that is in good repair for each of your pets. Be sure that they are functional, doors open and lock and it is sturdy, able to support the weight of your pet. You should have a carrier for each pet. Remember that although you may not bring all four (for example) of your cats to the hospital at one time (hopefully you aren’t that ambitious!), you may have a household emergency that requires evacuation of all of your pets which would be impossible without a carrier for each animal. Birds, pocket pets, snakes and tortoises need transportation as well. A visit to your local pet store can help you find the right carrier for your pet. 
  

• Leashes and Collars -

Before leaving the house, be sure that your dogs collar fits snuggly. Remember your pet may not be a willing travel companion and loose stationary collars (buckle-type collars)  may allow him/her easy escape. Chain or choke collars, slip leashes, and gentle leaders provide better control and security.

• Seat belts -
  
  Seat belts and carriers keep pets confined during travel and minimize distractions for the driver and reduce the risk of injury of both the pet and occupants in the event of an accident. The American Society for the Prevention of Cruelty to Animals recommends that all pets traveling by car be restrained. Remember, even carriers can be secured using seat belts.  This fall the Center for Pet Safety in Reston, Va. tested pet seat belts. They found that only Safetypods Clickit three point safety harness to be the only harness of the 11 tested that performed adequately. Soon Subaru will be offering Safetypods harness as one of their vehicles accessaries.
• Warm up the car and cover the carrier - Small dogs, cats and exotic pets are typically much less tolerant of cold and drafts. Be sure that the car is warmed before you take them outside and cover their carrier with a warm blanket or towel to prevent exposure.

These few easy measures will help make the next trip to the veterinary hospital safe for both of you and assure that you all return home in good form. 

1. Parker, Akweli.  "10 Most Dangerous Distracted Driving Habits"  01 February 2012.  HowStuffWorks.com.   04 January 2014.

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Ten Signs Of A Sick Pet

' Does my pet need to see the doctor?’, I think that this is the most commonly asked question by my clients. I hear our receptionists and technicians answering this question at least 10 times a day. Many times clients arrive voicing regret for not having visited with us sooner. They admit that they had recently wondered if something was wrong with their companion, but then the pet seemed fine later that day. However, a few days later, their pet is now  gravely ill. 

It is a daily challenge for veterinarians to sort out the subtle cues that pets share with us when they are ill. Animals express their illnesses in far different ways than people. They are obviously less vocal (ie. they don’t talk about their discomforts like we do) and they are far more tolerant of their aches and pains than we are. Over the years I have developed a strong awareness of the subtle signs that animals use to indicate whether they are in pain, feeling unwell or distressed. However, this is my profession and I have been practicing my craft for quite a few years. Here are some of the things that I suggest owners look for when deciding whether their pet needs veterinary care. Generally, these rules apply as well to a snake as they do for a cat, dog, rabbit, etc. 

1. Listen to that little voice in your head   Your intuition is a powerful tool. If you have that nagging feeling that your pet, that individual you interact with every day, is not well, then you are most likely right and you should follow through and have that pet evaluated. The best thing that can happen is that you leave the hospital with your pet, a clean bill of health for Fido or Fluffy and the peace of mind that everything is ‘OK’. 
2. If you cannot find them they are probably in trouble  Dogs, cats and even exotic pets often seclude themselves when they are in pain or sick. This harkens back to a primitive defense mechanisms with the pet seeking shelter and safety away from predators or other members of their pack that might injure them. However hiding makes it a lot harder for us to see that they are ill and sometimes leads to the pet deteriorating even further before interventions are applied.
3. An unkempt pet is an unhappy pet  Just like us our pets groom themselves daily. Also, just like us, pets do not give attention to their cleanliness and appearance when they don't feel well. Cats that are ill will have a slightly greasy texture to their coat and they may have mats in their fur. Dogs too may become matted and have dirty coats and greasy skin. Even reptiles and birds may develop abnormal skin colors, scaling and may traumatize themselves and pull out feathers when they are sick or distraught. Any change in your pets coat can be an indication of serious health issues. 
4. Changes in appetite and water consumption Most pets eat regularly and on a regular schedule. Sure your dog or cat may have a tendency to turn his or her nose up at a meal now and again, but this is part of their normal pattern of behavior. If you begin to recognize that their appetite is consistently poor or excessive or their water consumption has escalated, this is not normal. Pets, just like people are creatures of habit. When their good appetite and ‘normal’ water consumption are interrupted get them in for a much needed check up. 
5. Sleepy and slow are not normal Pets that have become unusually quiet and sleepy are most likely not well. Many people arrive at the hospital explaining that their dog or cat had stopped jumping, playing or climbing stairs and they had attributed this to the pet getting older.
   
   Certainly all animals slow down with age, but is should never be abrupt and it should never be a complete refusal to perform normal activities, like climbing stairs or asking to go outside. Remember, our pets are capable of suffering a great deal of discomfort silently. It's our job to be observant caregivers. 
6. Pets do not fall victim to the common cold! Pets do not acquire colds like their human housemates and they do not catch them from or give them to people. Sneezing, coughing , nasal congestion and ocular and nasal discharge may be due to viral infections (particularly in cats) and these may be mild and self limiting. However, it is typically the old and the young that are commonly affected and they can become very seriously ill, very quickly. Nasal tumors, abscessed teeth, foreign objects in the nose, eye infections, fungal infections, pneumonia and a myriad of other things can cause very similar signs.  Remember that cats, in particular, when deprived of their sense of smell will stop eating and this can lead to other serious consequences like hepatic lipidosis and renal failure that might be avoided with prompt treatment of the upper respiratory signs. 
7. Accidents in the house House trained and litter trained pets do not just spontaneously stop using the litter box or stop asking to go out. If your cat urinates outside of its box or the dog is not able to get to the door in time to ask to go out, something is wrong. 
8. Strange behavior warrants immediate attention 
   
   Changes in character like acting aggressive or unusually passive, pacing, circling, sleeping in strange places, becoming easily agitated, refusing to go up and down stairs, bumping into walls or going to the wrong side of the door when asking to go out are all significant changes that should send you and your pet directly to the veterinary hospital. Remember, be careful to not anthropomorphize (give your pet human emotions and motivations), if your pets behavior has changed remarkably, they should be evaluated by a veterinarian. 
9. Vomiting and diarrhea are serious problems This seems like an obvious fact, but often pets arrive with lengthy histories of vomiting and diarrhea and by the time the pet is presented to the hospital they are profoundly dehydrated, may have low blood sugar, renal compromise and many other secondary issues. Again, the very young and the geriatric animals are the most likely to become critically ill quickly. Addressing a minor gastrointestinal upset early may save money as well as your pets life. 
10. Weight loss or weight gain can be signs serious illness Monitoring your pets weight is one of the best ways of monitoring their well being. Often small changes in body weight may be among the very first signs of serious illness. I think this is especially helpful with cats and exotic pets who often make it very challenging to appreciate the early signs of illness. 

The last thing to remember: If you feel your pet is not well and you visit your veterinarian and he/she does not take the time to listen to your concerns, does not evaluate your pet thoroughly and does not have a thoughtful discussion about the issues you have raised, don't be discouraged or feel embarrassed. But, do find a new veterinarian! Remember, early treatment of most health issues is the key to the most successful outcome possible.

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