To Vaccinate or Not To Vaccinate

Recently, I was speaking with a referral client who, because of her pets health issues, we had suggested stopping all vaccines. She was in a panic and was particularly concerned that her dog would go without rabies vaccination. It was only after the call, I realized that since the owner was from India she lived where rabies was more common and people were also commonly exposed to the disease. No wonder she was worried about the risk of the disease and exposure of her family. Many countries continue to have a huge endemic rabies problem. The disease is not only a risk to wild and domestic animals, but the human population as well.

Earlier this fall a case of a human infected and dying from rabies occurred in Michigan's Upper Peninsula. They had been exposed to a rabid bat their cat caught. Although we may live in a part of the world were exposure to zoonotic diseases (diseases that can be spread from animals to humans)is less common, they are still a threat.

Rabies, distemper, parvo virus and feline leukemia are all still out there, vaccines are still necessary, however I think we have gotten a lot smarter about their use. Our hospital designates certain vaccines as core vaccines, the distemper combination(distemper, hepatitis, parainfluenza, adenovirus and parvo virus) and rabies for dogs and the feline distemper (feline calici, rhinotrachietis, panleukopenia and chlamydia) and rabies vaccines for cats. We consider leptospirosis, bordatella and feline leukemia to be necessary additional vaccines based on the patients life style. We also recommend that vaccine schedules be reduced as the patient ages (distemper and rabies every 3 years) and in geriatric pets the distemper vaccines can be discontinued. Outdoor cats for example should have regular vaccines as well as the feline leukemia vaccine. Dogs that board or are regularly groomed the bordatella, kennel cough , vaccine is indicated. Dogs that live in rural environments or go to the park regularly should be vaccinated for leptospirosis. Also, vaccine titers can be performed that may help us decide if a vaccine is even necessary. Of course, like the dog I mentioned earlier there is a population of animals that have had cancer or other immune mediated diseases that should no longer be vaccinated and they should be managed in such a way to limit their exposure to the diseases they are no longer vaccinated against.

Like everything in life it is a matter of balance and finding the vaccine protocol that works best for your pets. The goal is to avoid contracting controllable diseases, while balancing the risk of vaccination and ultimately keeping your pet and your family healthy.

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Canadian Goose

About a week ago I did some over night ER shifts at the hospital. The staff joked that I appear to be a magnet for all the busy late nights and unusual cases. Anyways, I saw a few wildlife cases those 3 nights. One was a screech owl that had been hit by a car. An owl with vertigo is quite and sight. Another case was a young Canadian goose that had been shot with an arrow. Fortunately, the arrow had pierced through his breast and exited out the other side, not piercing his thoracic cavity or abdomen. He had been caught by an area wildlife rehabilitator and brought to the hospital to see if we could help him. Radiographs were taken, the patient was anesthetized and the arrow removed. He recovered uneventfully and was sent off the next morning to recuperate with the rehabiltator. I was happy to help him, but more than a little disappointed in my fellow human.

I find this type of gross disregard for a living creature to be incredibly upsetting.It really doesn't matter if it is a field mouse, a turtle or a deer. Frankly it is all the same regardless of their size or perceived value. And this is not about whether hunting is appropriate or not, I can assure you the person who did this was no hunter since a capable hunter would never leave an animal to suffer and die a miserable death.

We have so much natural space around us in these little towns. We are fortunate. Hopefully, people can think twice before inflicting senseless harm on another living creature since their actions hurt all of us.

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Diabetes and Your Pet

Presented by J. A. Hass DVM, MS
A client seminar presented on 13. October, 2009
Hector and Jimmy’s Restaurant
Milford. MI 48380

Diabetes is a term used to describe diseases that cause polyuria (increased urine production). Diabetes mellitus is a chronic syndrome of impaired metabolism resulting in insufficient secretion of insulin or insulin resistance. In humans there are two major type of diabetes, Type 1 and Type 2. Diabetes mellitus in veterinary patients, although similar in behavior as human diabetes, is more accurately categorized as Insulin dependent (similar to type 1 in people) and Non-insulin-dependent (similar to type 2 diabetes). Dogs more commonly are insulin dependent, or require insulin therapy to remain normoglycemic. Cats can be either, about 30-50 % of feline diabetics are non-insulin dependent. There is no test that distinguishes the insulin-dependent pet from the non-insulin-dependent, the differentiation between the two is made through careful evaluation, observation and management.

There are many factors that may predispose your pet to becoming diabetic. Genetics can play a roll in predisposing a dog or cat to diabetes, just as it does in humans. However, at this time we do not understand the relationship of genetics in the diabetic dog and cat. We do appreciate that diabetes is more common in certain breed groups and as we investigate further the genetic link and how it triggers diabetes, we will develop a better understanding of the familial and genetic influence on diabetes in the dog and cat.

The role of other illnesses and environmental factors in causing diabetes are better understood. Pets that develop pancreatitis, an inflammation of the pancreas, can develop diabetes as a result of damage to the beta cells that produce insulin. Repeated bouts of inflammation can cause permanent damage of beta cells and decrease insulin production.

Amyloid, a polypeptide, deposited within the cells of the pancreas is another mechanism of beta cell damage and decreased insulin production. This occurs more commonly in cats and humans. Amylin is secreted along with insulin and aides in decreasing glucose intake and appetite. However, in obese patients this substance is produced in excessive amounts and results in amyloid deposition within the islets of the pancreas and further damage and altered insulin production.

Obesity is another factor in creation of a diabetic pet. It causes the pet to be resistant to the effects of insulin and eventually leads to diminished insulin production. Cats that become diabetic as a result of obesity, if treated promptly, may be managed through diet, oral glycemic control medications, and weight loss.

Certain medications can also lead to weight gain and poor glucose management. Steroid use can aide in creating a diabetic pet. The use of oral, topical or injectable steroids can mimic an illness called Cushing’s Disease (hyperadrenocorticism). Cushing’s disease is an endocrinopathy, or hormonal imbalance, that leads to excessive cortisol or steroids in the body. This causes insulin resistance and hyperglycemia. Other endocrinopathies like hypothyroidism may predispose a patient to developing diabetes.

As a pet develops diabetes there are common clinical signs (symptoms) that may be noted very early in the disease process. Noting these signs in your pet and seeing your veterinarian as soon as they are noticed may prevent having to manage diabetes for the rest of your pet’s life or it may prevent more serious health issues from developing. There are four signs that are common to the diabetic patient; increased thirst, increased urination, excessive appetite and weight loss.

When a diabetic is not treated or their diabetes is inadequately controlled additional health issues can develop. Cataracts result in an irreversible clouding of the lens of the eye. Cataracts are treated through a surgical procedure that is performed by a veterinary ophthalmologist. Secondary skin and urinary tract infections also can occur when an individual has diabetes. Diabetic neuropathy causes weakness and difficulty ambulating. This disease is most often noted in the feline diabetic, but can be seen in dogs. Pancreatitis, often a contributor to the development of diabetes, and hepatic lipidosis, an abnormal deposition of fat in the liver and subsequent liver dysfunction, are common sequelea of diabetes. Ketoacidosis, a medical emergency, causes a metabolic acidosis, life threatening electrolyte shifts and ultimately, coma and death. Most of these conditions, like ketoacidosis, are treatable, but there is always the risk of complications and deterioration of the patient’s general condition as a result of multiple illnesses. It is always best and more economical, to avoid compounding an already serious health issue, like diabetes.

Diabetes mellitus is an illness that is managed via a variety of techniques. First, the diet is altered. The patient is placed on a regular feeding schedule. Carbohydrate levels in the diet are reduced and the patient is given a diet that is higher in protein and fat with reduced calories when appropriate. There are many diets that are formulated for the canine and feline diabetic. Each one must be chosen based on the needs of the individual animal. Many commercially available canned cat foods, composed mostly of meat proteins, have helped reduce insulin requirements in some of my feline patients. Careful choices regarding the patient’s diet and feeding schedule can prove pivotal in managing a diabetic successfully.

Insulin therapy is another very important key to diabetes management. Most insulin therapies are administered by injection, twice daily, after the pet has eaten their meal. Insulin administration should remain on a very regular schedule. The type of insulin that is chosen by your veterinarian is decided by whether your pet is a dog or cat, the severity with which they are affected and their pattern of hyperglycemia. Each insulin product has a different time of maximal effect and a different degree of glycemic control. NPH insulin is most often prescribed for dogs and PZI insulin is most commonly chosen for cats.

Oral medications that stimulate insulin secretion from the pancreas can be utilized with patients that still have functional beta cells. These medications are only successful in patients that can still produce insulin and therefore are not insulin dependent diabetics. Glipizide, a sulfonylurea, is one of the more commonly used oral hypoglycemic drugs.

Regular exercise and activity is important for both the feline and canine patient. Certainly it is easier to get your dog out for regular walks. But cats can be encouraged to begin new routines and you can make a point of having them with you and interacting with you on a daily schedule. This also allows you to monitor their response to therapies.

Our therapeutic goal for the diabetic patient is to reduce the visible signs of diabetes. The diabetic patient should begin to drink less, urinate less often, eat more regularly and appear more robust with good stamina. As we manage the patient more successfully, long term, we avoid cataracts, neuropathies, liver, kidney and heart disease.

Certainly, the obvious improvements in a diabetics condition are helpful indicators of success, but these occur over time and may not be as accurate techniques of monitoring from week to week or day to day. Other tests can allow us to monitor diabetic management and base our decisions on tests that quantify and qualify the treatments success.

Fructosamine levels can be tested from a single blood sample. Fructosamine is a protein synthesized after the binding of glucose to proteins. Fructosamine concentrations are a marker of blood glucose levels over the past 2-3 weeks. It will not be influenced by stress induced glucose changes and normal levels have been established for the diabetic dog and cat. If glucose levels have been too high over the past 2-3 weeks, the fructosamine will be elevated.

When an animal has high blood glucose, the glucose will leak through the kidneys and can be found in the urine. Urine glucose monitoring allows us to have an indirect indicator of the pet’s blood glucose. Urine glucose monitoring works best with dogs that urinate regularly under circumstances where we can collect samples. Urine glucose can be influenced by a variety of factors that make it a less accurate technique than blood glucose monitoring.

Blood glucose monitoring can be performed both in the hospital and at home. This is the most accurate technique to monitor the patient’s response to therapies and to gauge the quality of glucose control. Blood glucose monitoring gives us numbers that can be held in comparison from day to day. Certain blood testing machines or home glucometers are more accurate that others and careful attention to maintaining a consistent testing technique is necessary.

Blood and urine monitoring allows your veterinarian to aide you in making better decisions regarding insulin dosing as well as deciding which insulin type should be utilized. Visible signs (symptoms) and long term side effects of diabetes can be more consistently avoided through judicious and accurate monitoring.

Additional benefits of monitoring at home include removing the influence of stress of being at the veterinary hospital for glucose testing, called the white-coat phenomena. Stressed animals can have transient hyperglycemic episodes that may interfere with the accuracy of testing. Home testing also allows the pet owner to communicate accurately and in a timely manner regarding changes in the patient’s condition.

Accomplishing the technique of home monitoring, using properly calibrated equipment, accurate record keeping and prompt and complete communication to your veterinarian are the keys to successful long term management of your diabetic pet.

Abbott Laboratories has developed one of the most user friendly and accurate home glucose monitoring divices for the canine and feline diabetic. AlphaTRAK®Blood Glucose Monitoring System Features; fast results (within 15 seconds), less costly home testing that may help prevent expensive and lengthy hospital stays, small sample amounts and tests that are calibrated and validated for the dog and cat. Read more about the AlphaTRAK system and see examples of techniques in collecting samples for testing at
http://www.abbottanimalhealth.com/ad_ah_com/url/content/en_US/20.30.30:20/general_content/General_Content_0000009.htm

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Dogs Playing Poker Run for Community Sharing's Pet Pantry

If you live anywhere in Metro Detroit, please get your dog and join us in Milford, MI. We are holding a Poker Run with a pet friendly twist. The players are going to be walking through our beautiful down town, with their dogs and collecting their cards from merchants. They will end up at Central Park where the winners will be announced.
Milford has a picturesque downtown and some incredible shops and restaurants (we have a great dog bakery! Just Dogs Gourmet). It is a wonderful place to visit and an even better place to call home. Like the rest of Michigan we have been hit hard by the economic down turn. We have been hit longer than the rest of the US too. Our area food bank, Community Sharing, is over whelmed. What is extraordinary about Community Sharing is that a few years ago they began recognizing the need for the family pets and they have aided in preserving that human animal bond through good economic times and bad.
I have been lucky to have the chance to work with this organization over the past year. Between food, vaccines, spays and neuters, we have cared for over 750 animals! I think its great that we can focus on keeping these pets in their homes rather than adding to the already epidemic problem with stray and homeless dogs and cats.
Please come and get some exercise, walk your dog, meet new people, see our wonderful town and help a worthy cause.

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Taking Responsibility for the Wildlife in Our State

I have the good fortune of making an annual pilgrimage with my family to Cape Cod in the summer. Last summer I was on the beach and noticed an injured Sea Gull. Attempts were made to catch the bird, but he was too wily for that. The other sea gulls were beginning to appreciate that their comrade was injured and they were beginning to attack him. Gulls, being as they are, will attack injured birds and destroy them. I called the local animal control office and to my surprise they took my call and very cheerfully aided me. I explained that I realized this was ‘only’ a gull, but it appeared that shortly the other gulls would gang up on our injured beach comber and do him in. Within a half an hour a member the Animal Rescue League of Boston was at the beach, equipped with nothing less than a wildlife rescue ambulance, fully equipped for the task at hand. Together, we caught the bird and confirmed that his wing was broken. I later found that this was the result of children throwing rocks. I again explained to the rescuer that I realized that sea gulls were probably not a high priority in the sea-life rescue world, but I hated to see the animal suffer. The young man was a little surprised. He replied, of course they would rescue the poor gull and its fracture will be repaired by a veterinarian and hopefully he would be released! An organized community of individuals working together to aide injured wild life, how cool.

What prompted me to recall that event last summer was something that happened a few weeks ago. Two young men came into the hospital explaining that they had an injured and very ill juvenile raccoon. They had called animal control for our county; they had called the Michigan Humane Society, area veterinarians, and the local nature center, all of which refused to aide the boys. I suspect that the reasoning for these responses was the following: First, raccoons are essentially considered the equivalent of rodents, a nuisance and second they carry communicable diseases that can be spread to humans and domestic animals. The difficulty I have with this philosophy is that this small creature was being left to suffer by these animal welfare advocates and two young people, that were trying to do the right thing, would be left to watch the animal suffer and die or worse, they may try to destroy the animal themselves.

I explained that I could not allow it to suffer and would sedate the raccoon to be able to examine it to be sure that it could not be released and, if it was suffering, euthanize the creature. The young men were relieved. I found the little coon was very ill and infested with maggots. We humanely euthanized him.

I argue that we in Michigan have not remained focused on being good stewards to wildlife. Sure we have a department of natural resources, but they really function as advocates of hunting in Michigan, and animal population control, not caring for the wildlife within our state boundaries. Our Michigan Humane Society, although very well funded, much like the Animal Rescue League of Boston, has no wildlife rescue system. And the network of people that do rehabilitate animals are poorly funded and over taxed and they function, for the most part, autonomously, not as an organized group. Many veterinarians, like myself, try to help, but unless facilities are set aside for wildlife away from our patients we risk exposing our patients to serious diseases.

Michigan is a great state, with beautiful waterways and wonderful outdoor vistas, very similar to Cape Cod. The challenge I see for us is to become better stewards of our wildlife, to focus on and care for one of the things that makes or state great, the wildlife. I am not saying that this is going to necessarily involve any significant expense, there are many of us out there that want to help. What we need is a humane organization to step up and help weave us together, make a network of concerned veterinarians and rehabilitators. Maybe someone on the state level that would aide in refocusing the DNR (Department of Natural Resources) to be more of an advocate of wildlife.

I am happy to report that last I heard, that poor little sea gull is back on the beach, filling his ecological niche no matter how valuable or disposable we might think he is.

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WALK YOUR DOG!!!!!

Your dog has asked me to let you in on a little secret; they love to go on walks.
Short walks, long walks, rainy, sunny or snowy, they adore them.
The reason they love their walks is you.
You are the common denominator.
Whether a good day or bad.
They enjoy being with you.
Take time with a friend.
Grab that leash.
Breath deep
.



This summer I finally have had my weekends and most of my evenings free for activities other than work.
I have always enjoyed long hikes and walks.
My dog Zelda is so much happier now that she gets her walks and I don’t think that it is the actual walking that really gets her so hyped up, its being with me and whom ever else accompanies me. It is the time I spend with her. If I go without her, I have to admit its not quite as good of a walk as it is when she comes along.
Zelda and I are much happier and healthier as a result of our renewed love of the walk.

Next time you are sitting down to TV or vegetating on the couch, consider taking time for a walk, with your best friend, it will make you both

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WALK YOUR DOG!!!!!

Your dog has asked me to let you in on a little secret; they love to go on walks.
Short walks, long walks, rainy, sunny or snowy, they adore them.
The reason they love their walks is you.
You are the common denominator.
Whether a good day or bad.
They enjoy being with you.
Take time with a friend.
Grab that leash.
Breath deep
.



This summer I finally have had my weekends and most of my evenings free for activities other than work.
I have always enjoyed long hikes and walks.
My dog Zelda is so much happier now that she gets her walks and I don’t think that it is the actual walking that really gets her so hyped up, its being with me and whom ever else accompanies me. It is the time I spend with her. If I go without her, I have to admit its not quite as good of a walk as it is when she comes along.
Zelda and I are much happier and healthier as a result of our renewed love of the walk.

Next time you are sitting down to TV or vegetating on the couch, consider taking time for a walk, with your best friend, it will make you both happy.

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Unsung Animal Advocates

Late one afternoon my technician entered the busy treatment room carrying a brown paper lunch bag. It looked like it had been blown up and then tied at the top. She held it away from herself and the bag seemed to be jumping and periodically one section would pop out. The technician appeared a little concerned with this mysterious jumping bag. She thrust the bag in my direction, unwilling to set it down since it was already very mobile. ‘Some ladies found this at the park, birds were pecking at it’, she said dryly. I opening the bag cautiously and inside discovered an extremely disgruntled and indignant fledgling bird. With some difficulty the small bundle of energy was removed from the bag and examined. One eye was indeed abnormal, but the baby looked to be in otherwise good health. I replaced it in its bag and walked to the phone. In on few moments I was speaking with our area wildlife rehabilitator. In a short time, Pat was at the hospital and taking our little bird into her expert care.

I think we would all agree that these times are tough, jobs are few, and housing expensive, day to day living is a full time obligation. Yet there remains a large population of really exceptional people that volunteer their time, energy and finances towards the care, feeding and rehabilitation of animals, both wild and domestic. People like Pat, with Southeastern Michigan Wildlife Rescue, who devotes her time around the clock feeding fledgling birds, orphaned deer and other wildlife then being sure that they are rehabilitated and released. My friend Sharon, donates part of her boarding kennel towards the care and housing or rescued Bull Terriers, until they too are rehabilitated and can find a new home. Then there is the army of people that are caring for orphaned kittens right now (this is ‘kitten season’), getting up at all hours, transporting kittens to work so they can be fed on a lunch hour, and then finding homes for each one when they are ready for adoption.

Literally, an army of animal advocates is out there. Their work is unending; each animal is given their unwavering commitment and attention.

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You Are Never Too Old

Selma is a 12 year old Golden Retriever owned by a friend. She is in excellent condition and has been healthy throughout her life. Recently she and my friend were visiting. My friend explained that she was concerned because every time Selma was evaluated by her general veterinarian he recommended a dental. I looked at Selma’s mouth, some tartar, but not seriously diseased, I suggested a good cleaning sometime in the next 6 to 8 months. She looked surprised and exclaimed ‘she’s too old! The anesthesia will kill her !’.

‘Age is not a disease’, is a mantra we often recite at our office. Selma’s owner was gently reminded that Selma’s age does not prohibit anesthesia or the procedures that may help prolong her life, but as pets age other health issues do develop. Prior to any anesthetic or surgical event, we collect a baseline of information to be sure that the patient has no other conditions that could cause problems under anesthesia. Selma would have a blood panel, chest radiographs and her blood pressure checked prior to anesthesia. As long as these tests were normal she would be cleared for her dental. My friend looked skeptical, I think she was glad to have eight months to consider her options.

Over the years, I have seen patients that have not received dental care or other minor surgical procedures for only one reason, they were too old. The majority of these animals were well cared for, well loved members of the family. If not for the urban legion of age + anesthesia/surgery = death, they would receive the care they needed. I would argue that in many cases the pets would have lived longer and happier lives with the benefit of these procedures.

The anesthesia and surgical techniques used in veterinary medicine have advanced significantly, particularly over the past 10 years. We use short acting anesthetic agents that have fewer side effects. Veterinarians are also very aware of the need for pain management and we have a plethora of medications available to assist dogs, cats, and exotic pets with post operative pain. Surgical skills have also become more refined with lasers, laparoscopes, endoscopes and other instrumentation allowing less invasive (and less traumatic) techniques and shorter anesthesia times.

A colleague and I were discussing a case she had recently referred to me. The dog was geriatric, but he had been healthy and active up until recently. After extensive tests we had found only one significant health problem, a single tumor of the lung. My colleague asked, ‘how do you handle the issue of the pet’s age in discussing surgery with this owner?’ I explained that I do not feel that I should be factoring the pet’s age into my decision making. We had essentially ruled out any other major health issues. It was now time for the owner to consider the pets age and whether they will want to make the financial and emotional investment in caring for their pet, recognizing that the dog is geriatric and that he may live two more years after the surgery or six more months. Make no mistake, I will always be available to discuss the factor of the pet’s age, but ultimately it is the owner’s decision. The bottom line is, your pet is never too old to receive care, as long as excellent medical practices and good communication from your veterinarian create a sound foundation for your decision making.

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Ashtons Story

Aston McCabe walked willingly out of his crate. He surveyed the exam room and looked disdainfully at each of the occupants. Then he sat on the examination table facing his owner and with his back, squarely directed towards me. Ashton had visited my office frequently over the past year and a half. Ashton is a cat and he was not going to embarrass himself, he would cooperate, have his blood drawn and blood pressure checked, but he did not need to be happy about it.

Ashton is one cool cat alright, but about a year ago he was at my hospital in renal failure. After renal biopsies, blood transfusion and intravenous fluids he went home. We monitored his progress closely with regular check-ups and blood tests. Now his visits are every 6 months! A few weeks after Ashton’s initially hospitalization his owner mentioned that he felt badly that Ashton had become so ill. He went on to explained that he should have recognized that Ashton was getting more sick based on the data he was recording. In fact, he had spreadsheets (he was an engineer) with recorded dates and parameters such as Ashton’s body weight, appetite, etc. You could actually appreciate when Ashton began to decline as his body weight gradually dropped once by once, just a few weeks prior to his hospitalization. I explained that this sort of data was fantastic and we could use these observations to our benefit to avoid another illness. The clients keen observation skills and meticulous record keeping was just what we needed to be sure that Ashton remained healthy.

One of the frustrations every person that lives with an animal experiences is their inability to communicate verbally, particularly when it comes to their health. In many cases we rely on intuition, wives tails and we anthropomorphize. Some of this is helpful and some of these techniques can get in the way of the observation skills we all have.

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Companions Are Priceless During Difficult Times

Companions are priceless during difficult times


Julie A. Hass DVM, MS
Veterinary Care Specialists
Milford, MI
248.684.0468



Rosemary is a cancer survivor. Recently, when I saw her, she was calmly surveying a makeshift auditorium. She sat patiently on her mistress’ lap waiting for the ceremony to begin. The chatter and general hubbub that surrounded her was familiar. Rosey was an elder states woman at this event and I was her fortunate guest. Despite unpleasant weather I and about 100 other people attended the Celebration of Life at Michigan State’s Veterinary Teaching Hospital.

Approximately 78 patients, both living and passed, were recognized and they each had their own, very special story. It appeared they were selected for a variety of reasons. They may have struggled bravely against disease or adverse circumstances or they may have served their owners valiantly prior to their illness. Some appeared to have extraordinary personalities and charm that won the hearts of the veterinarians and staff. But, to be sure, each had their story and during the presentation some of the stories were shared.

What struck me about each of these animals, whether it was a horse, cat, dog or ferret, was that they were all exceptional companions. They were members of closely knit families, beloved confidants of children, or hunting companions. They, in turn, were embraced and loved for the contribution that they made to the people surrounding them. When illness struck, the families did every thing within their means to ease the pets suffering and return them to good health.

Based on my own experiences as a veterinarian, I know that the stories that I heard that day are not uncommon. Almost every pet and owner I meet has a special bond and an equally interesting story. I think most pet owners would say that their pet provides a priceless commodity, companionship, and that they would do what ever is within their means to care for that pet.

Companionship is most often appreciated when times are the darkest. The silent, non-judgmental, friendship that a pet offers can be most comforting.

Over the past month I have been involved in a food drive for a group called Community Sharing. Not only do they provide food for the humans within a family, but they also have a pet pantry to aide the pets within those families. During the early phases of the food drive I eagerly took on the responsibility to organize the pet food collections. When I met with the representatives at Community Sharing one woman explained that she was concerned that by collecting pet food they might be taking food resources away from area rescue groups. I was impressed by this thoughtful observation. However, I quickly suggested that their program is also supporting the rescue groups who are already over burdened with pets surrendered by people who can no longer care for them. By keeping pets at home, healthy and fed, the folks at Community Sharing are helping decrease the number of pets within the shelter system.

There is an even more important contribution that is being made by keeping pets in their homes. Children, concerned with what each day may bring, will still have their cat to cuddle and the dog’s owner will have a reason to take time for a short walk each day. These pet owners, just like the ones I met with Rosemary, would most likely do what ever they could for their pet because they are family, friends -companions.

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Learning How To Fall Off The Horse

My 8 year old daughter had her first horseback riding lesson a few weeks ago. My friends TJ and Barbara own the Crown V Ranch and operate the riding stables at Highland Recreation Area. TJ is an accomplished horseman and he is fond of pointing out that he has never had a formal riding lesson. His lack of experience with riding instructors has lead to a novel approach to the new rider and one that I, as a parent, appreciated greatly. Isabella’s lesson consisted of learning how to lead a horse on a rope, walk around a horse, without startling the animal or putting herself in harms way, and, most importantly, how to fall off a horse. Essentially, it was disaster preparedness for the horseback rider. I have taken my share of riding lessons, and never have I been taught how to fall off. I have to admit Isabella was tentative at first, but eventually she became accomplished enough for uncle TJ to declare that lesson complete. However, she was only done once the horse was brushed and ready to be turned out to the pasture. Talking with my dad a few days later, I told him about her lesson. In his early life he was a cowboy, he smiled and agreed that it was awfully important to learn how to fall rather than to learn about falling by accident.

I recently have been reading a book by Temple Grandin, Animals in Translation. She talks about how animals perceive their environment differently than humans and how humans commonly miss the fact that the animals perspective on events happening around them is totally different than our own. The obvious result from these differing perspectives is miscommunication. It is these little misunderstandings between human and animal that leads to accidents, injuries and general mayhem. An example would be the friends meeting on a walk with their dogs, they stop and chat, the dogs introduced for the first time appear inquisitive, but one begins to shy behind the owners legs. The owner pushes it away, insisting it needs to be friendly, after all the other dog is a nice dog. Then the shy dog gets pushed too far and it attacks that nice, but pushy, dog . The dog fight was actually created by the humans misunderstanding of the cues given by the dogs. Both the dogs went to the emergency room and the owners were uncertain if their pet was aggressive or mean. Neither one has an aggression problem. They were just acting like dogs.

So what does this have to do with falling off a horse? It is about misunderstandings, miscommunications that then lead to injuries or worse. The small child that wants to hug the dog, but as he wraps his arms tightly around the dogs neck, the dog senses not the fondness the child has for him, but restraint and confinement. If the dog cannot wriggle free then it resorts to biting. So that is why the 8 year old, first time on her horse, learns to fall. Because shortly there will be a misunderstanding and her horse will give her a hard time and off she may go. That is why my children, since they were very small were taught how to approach a cat or a dog, how to pet them and respect them. Even now that my children are older I watch them closely when they are interacting with animals whether they are our family pets or not.

Animals are integral parts of our families and our leisure activities. They are such a part of the fabric of our lives that we assume that they perceive our actions and our environment just like we do. It would be wise to remind ourselves that we are still learning about speaking our pet’s language and understanding their communications. We are on the steep side of that learning curve and we should always expect the unexpected.



Crown V Riding Stables is having its open house and ribbon cutting ceremony on the April the 18th beginning at 12 noon. Come out and visit us at Highland Recreation Area.

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An Ounce of Prevention......

I have been besieged with car problems recently. My Suburban has served me well, but now that its age is in the double digits, I have had to visit the town mechanics shop a little more often than I would like. The owner of the shop is very kind, every time I pick up the Red Bus, he reminds me of the regular maintenance and daily care that would help the old car run a little better and keep the parts from wearing out so quickly. I have to admit, I am not good at preventative car maintenance. Of course, this personality flaw is what makes me one of his better customers.

I think that we understand that an ounce of prevention, early intervention, and preventative maintenance are all excellent philosophies for keeping mechanical as well as living organisms happy and healthy. But, we all have so much going on in our lives that it can be hard to put them into practice. Top this challenge off with our current economy, every one being short on funds, life can become a little over whelming. My recent experiences with the Red Bus have led me to think a little about some of my recent conversations with my clients.

Last week our surgeon and I, sat down with a client with a geriatric pet. She had two masses, or tumors, that needed to be removed. They were both most likely benign. They were also still small enough that they could be removed easily. However, it would not be long before they would be large, most likely infected, and much more difficult and costly to remove. The owner listened to our well reasoned arguments and went home to consider her options. Often I see patients through the emergency service that have pets with slow growing masses that, for what ever reason, the owners have chosen to wait on removing. Quietly it grew until its removal seemed too complicated, then it broke open and became necrotic. Next there came the struggle of what to do, since now the problem was far more complex.

Recently, we performed a dental on a patient that had such severe disease, that only a few teeth were salvaged. The dog had been ill and not eating well. He had been lethargic and inactive. As any one with a cavity or a broken tooth can tell you, dental disease can be painful. Fortunately he had been spared the serious infections and damage of the kidney and heart that can occur as a result of such a remarkable bacterial infection. He came back to visit us this morning. He was a new man! Tail wagging, head held high. The owner mentioned she was amazed at the difference in his demeanor since the dental.

The first step towards the successful management of all of these patients was a wellness examination. Not an appointment just for vaccines or flea control products, but a visit to the veterinarians with the goal of discussing and evaluating the health of your pet. This could also be the time, if a few problems are identified, when treatments and diagnostics could be prioritized and procedures could be planned so the financial burden would be less severe. My proposal to any of these clients, if I had the benefit of seeing them months before, would have been the following: 1.Age is not a disease, otherwise healthy, older pets can have surgeries and other procedures. 2. Small tumors, moderate dental disease, mild kidney dysfunction are all much easier to treat than large, infected masses, severe, necrotic dental disease or kidney failure. 3. Taking care of these problems early is much less expensive than when the diseases are advanced.

I will be picking up my car tomorrow from Brian’s auto repair shop and I have learned my lesson. More frequent oil changes and don’t run the gas tank to empty. Hopefully, I won’t have to see him for awhile, except for the Red Bus’ regular check ups!

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Some advice for the prospective puppy owner

About 2 years go my friend Karen arrived at my hospital with a new puppy. He was a gorgeous Cocker Spaniel. I was a bit surprised since she had not mentioned getting a pup. Then she explained that he was from the pet shop. She had seen him while she was shopping and fell in love. I stared at her. She became a little uncomfortable. I was preparing to launch into a lecture on the evils of puppy mills, when in the nick of time, she said she knew it was wrong, but she had to save him. It is hard to be upset with your best friend and so little Gus got a thorough examination and went home to live happily ever after.

Puppy Mill is the term applied to places where dogs are bred indiscriminately and maintained in kennels (not in a home environment) and bred frequently, often with no concern for their health. The cruelty and essential barbarism of this industry is difficult to comprehend. These poor dogs are kept in conditions that are so horrific that I can not appreciate how any human being could be party to these operations. Then when you consider the total disregard and disrespect of the dogs, the lack of medical care, socialization, feeding or exercise, it should really make us all a little ashamed that these operations persist in our country. The puppies that leave these operations are the fortunate ones. The pups are transported by trucks, with no heat or air conditioning and are seldom fed, watered or cared for during the trip. Pups can arrive at their destination dead or gravely ill.

It is hard to imagine that the puppy mill industry is able to thrive when our humane organizations, rescues and shelters are overflowing and so many dogs are being euthanized for lack of a home. Often puppy mill puppies are sold for exceptionally high prices. Frankly, the industry of mass puppy production and sales depends on our humanity for its success. Whether it is the strong impulse we feel to rescue that cute puppy from a cage at a pet shop or our unwillingness to research our purchase before we make it, our human nature, our desire and empathy, draws us towards that immediate gratification and the purchase of that new pup.

Here are some suggestions that may help you avoid supporting the Puppy Mill industry:

1. Take time to research the type of dog you want. Never make an impulse purchase.
2. Always take time to visit local rescues because they may have a wonderful mixed breed dog or pup that meets or exceeds all your expectations.
3. Contact local rescues, shelters and humane societies to see if they have breeds for adoption that you are interested in. You would be surprised how many purebred dogs are available at the local shelters.
4. Visit with local breeders. Almost every breed group has a regional club. Those club members are active advocates for the breed and can be, quite literally, a fountain of information.
5. ALWAYS see where your puppy came from. Try to meet at least one of the parents.
6. People that breed often and breed multiple different breeds of dog should be held suspect of operating a Puppy Mill.
7. And most importantly - Remember, this is a new member to your family. They will be living with you for 10 or more years. Make a careful and well researched decision.

If you would like to learn more about Puppy Mills visit humanesociety.org/puppy or http://network.bestfriends.org/campaigns/puppies-arent-products

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Exercising the Privilege of Euthanasia

One of the sad tasks that I perform as a veterinarian is euthanasia. The loss of a life and the loss of the companionship of a friend is a sad event. As I remind owners, euthanasia is never meant to be an easy decision or an easy procedure to perform. I am glad that my profession has the privilege to end suffering.
Clients will often ask if their pet is suffering. For me, as a clinician, suffering occurs when a patient is experiencing pain and distress with no hopes of recovery. These are exactly the patients that deserve the right to be relieved of their burden. Clients often take weeks or months with their chronically ailing pet, making sure that their decision is made carefully and at exactly the right time. In other instances clients are faced with acute illnesses or traumatic events that lead them to consider humane euthanasia.
There are times when I feel that euthanasia is inappropriately utilized. An example is when it is used to control healthy populations in shelters and at humane organizations and then there are the instances that we at our hospital call 'convenience euthanasia'. I was presented with a convenience euthanasia just this past week. It was an older dog, he was brought in through our emergency service, he had severe dental disease and some other mild, chronic issues. He was walking and alert, he was eating and drinking. He desperately needed a dental, but otherwise he appeared healthy and stable. I had never seen this pet or these owners before so we had no long term relationship to use as a reference. I explained to the owners that I could not euthanize such a healthy individual. I offered teeth cleaning and other management options. They were irate saying that I was taking advantage of them since I felt I could make more money off of treating their pet than euthanizing the little dog. They stormed out of the office in search of another veterinarian to assist them.
It certainly is true that treating illnesses is my business and it is more profitable to make a patient well than to kill it. But that is not my motivation for my decisions and I take grave exception to those that think otherwise. I feel it is more ethical and humane to make a pet well rather than to euthanize it. That is why I am a veterinarian.
Fortunately, the vast majority of the patients that I assist in passing are owned by conscientious and well informed owners that take care in making the tough decision to allow their pet to pass away peacefully. For those clients I can be there for them and their pets.

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Not All MRI's Are Ceated Equal....

I have been performing MRI's on my patients since I left my residency in the early 1990's. Back then we utilized human facilities when they were closed. The trips to an MRI facility were clandestine events, in the dark of night, entering at the back door or loading dock of the facility. Basically the MRI's that we performed were run by skilled, trained technicians and they were of the same quality as the MRI's that were being produced by the facility for people. All the MRI'sd that I had the experience of performing were of excellent quality. The techs would even joke that they preferred our patients over the humans, because our patients were, in general, much easier to deal with! Then, over time, the human MRI facilities became so busy that they began to run 24/7 and there was no time to squeeze in the veterinary patient during off hours when no human patients would be bothered.

In a way it was a relief to not have to get up at 3 AM to deliver a patient to the MRI facility and manage its anesthesia then to arrive back at work to start my clinic day. But along with all that extra sleep time there came a new problem, where were we going to take the patients that needed an MRI? Slowly, facilities developed that provided MRI and CT to veterinary patients, we began using The Lawson Imaging Institute , www.MBVS.CA. This facility is awesome. It is run by a group of individuals that are devoted to providing the highest quality images and patient care. I can say that I have never had a bad experience or customer complaint about their services except that they are along drive away in Mississauga , Canada. These folks have the very best equipment and they price their studies (including anesthesia and interpretation) at about $ 1,500 US. Many members of this operation are scientists, engineers and physicists. They understand the way that the MRI works and the need for the best quality equipment to achieve the most acurate study. Although I would love to have a MRI within our facility, I have always said that we would only consider it if we could provide a similar service to the one provided by our colleges in Canada and for a similar cost. Otherwise, sending my patients to Mississauga, where they can get the best study for the best price, is the right thing to do.

As time went on otherlocal hospitals got MRI's. These were small mobile units or even less powerful machines that were far inferior to what was provided across the border and they were charging 2-3 times more. Colleagues were impressed by these other hospitals providing a MRI service, but very few were able to appreciate, or they didn't care to address, the differnces in study quality.

A few months ago my partner forwarded an article from the New York times explaining how how MRI machinary can vary and the quality of studies can vary to such an extent that misdiagnosis' can occur. Take a look at this article entitiled 'The Scan That Didn't Scan', http://s.nyt.com/s/NbdAuJZ. I was very pleased to see that someone was trying to eduacate the general public regarding the differences in MRI services. I hope that over time veterinary clients too will become more informed consumers. Just because a tool is in a hospital it does not mean that it is the newest or best quality and sometimes you do not get what you pay for!

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The Changing Face of Family Medicine

It has been a long time in the making, but we have officially kicked off a new phase to our hospital. We call it a family medicine service or a wellness clinic. The focus of VCS Pets First is to provide the routine, day to day, veterinary care that all pets need within a facility that houses an emergency service , a specialty hospital and hopefully, in the future, many other pet orientated services. This gives the client and the pets access to some incredibly skilled individuals, both doctors and staff, as well as access to the hospital 24/7 and all of its advanced equipment.
What is really exciting about developing this service now, are the chages that are occuring within our industry. We are setting the foundations for a service at the same time that our profession is realizing that vaccines are not necessary every year or even every other year. We are starting to see that the annual visit should be a time to focus on wellness, physical examinations, early diagnosis of health issues and, in general, preventative medicine that really, only includes vaccines as a minor aspect of patient care. This is exciting to me because I have always felt that we as a profession had made a fatal error in trying to use vaccines and dispensing drugs as the focal point of general practice and its revenue. Veterinarians are so much more than administrators of shots and drugs and we had been, in my etimation, selling ourselves short.
I recently had an opportunity to attend a lecture about vaccine protocols in veterinary medicine. It was great to hear that our professional organizations like ACVIM, AAHA and even the drug companies are recommending vaccines every 3 years after the 1 year -old cat or dog receives its booster and that after 7 years of age our cats and dogs may only need a rabies vaccine every 3 years. It is quite possible that we will learn over the next few years that we will extend the interval between vaccines even further.
Don't think that that means your pet should visit the veterinarian less often though, its those regular visits and examinations that will keep you pet healthy and make you aware of health issues that you might not have noticed if it were not for t he annual wellness examination with your family veterinarian.

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