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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