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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VCS Patient Has A Nose For Success!

Scarlett celebrated her 5th birthday at a nose work competition

(C-WAGS Scent Trials) in Garden City last Sunday. She qualified in two trials by finding an essential oil scent in one of eleven closed boxes--cypress in the first trial and birch in the second. If she can qualify in two more trials, she will earn a Scent Detective Level 1 title and move on to the next level. She has been working really hard at school so we were very happy. There is a picture of her attached along with her ribbons and toy prizes. She was a very good girl at the competition. She only tried to eat two big dogs who were both very rude and she barked at the judge who changed position in the ring during the second trial . For Scarlett that was exceptionally good behavior!

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Frugal Pet Care ?

Recently, I was listening to the Today Show as I was getting ready in the morning. They presented a segment about the cost of pet ownership and how to cut pet care costs. They discussed the usual, cost of foods, cost of adoption, when they turned to the topic of medical care my interests were peeked. The commentator explained that there are ways to save on medications. The example she used was a comparison of Frontline (a non-prescription product, available through veterinary offices as well as stores) and another brand (which I cannot recall). She went on to describe that these flea and tick control products were the same, but the other brand was a fraction of the cost. However, she followed that statement with the provision that Frontline was able to eradicate more stages in the flea life cycle. Obviously, the products were not the same. Thank goodness she did not launch into other ways to save on the pets health care, I was already incensed! After that she discussed pet clothing, sweaters costing 95.00, and designer leashes and collars. It certainly seems this would be an area where cost cutting could be instituted a little more readily.

Last year, as we were discussing the need to order heartworm, flea and tick control products for our hospital, a representative of a drug company visited with us touting a product to control fleas and ticks that was less costly, sold exclusively to veterinarians and as good as products like Frontline and Advantage. Believe it or not, we veterinarians are always interested in trying to provide our clients with the most economical alternative. We want to be sure each of our clients can afford the best care possible for their pet. So we listened carefully and before we decided to purchase this product I spoke with some folks that had dispensed the product from their hospital and I heard stories of increased reactions to the medications and white dogs developing green discoloration of their coats. The medication may very well kill fleas and ticks, but the potential consequences of using it seemed too high a price to pay. 

So in response to the economically minded commentator on the Today Show I would say,’ when it comes to health care, don’t make your decisions based on what you read on a label’. Ask questions of your veterinarian. We are very interested in helping you make good choices for your pet, we want your pet to remain healthy and safe. If there is an economical and safe alternative, we will help you in deciding the best choice for your pet’s care. Just because the label or the commercial says that something is ‘just like’ name brand X, it may not be true. You may end up with a green dog or worse, a dog or cat that has fleas and ticks or a pet that has contracted one of the many serious illnesses these pests carry.

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Dogs and Cats Are Not For Everyone

I cannot imagine living in a home without pets. I am sure my house would be much cleaner, my gardens more pristine, but it just would not be the same without them.  It would be so quiet, so dull. The sound of the cats as they move about. The dogs as they jostle for position on the couch. The sound of the sugar gliders on their wheel. Yes, I said sugar gliders. We have two and two tortoises as well. 

There are so many different animals that you might adopt, depending on who appeals to you the most.The first thing to remember about the exotic pet is that there is more care and up keep than your average dog or cat. Just because they are not as demanding and they live in a cage this does not mean that they don’t require daily care. They need companionship, variety in their environment, special diets, and often specific environmental temperatures in order to flourish. Typically, these pets are not appropriate for children since they are fragile and need special care. If you are planning on caring for the pet with your children, making it a group project, that’s great! But remember, many of these pets, as long as they are well cared for, can live for 10, 20, 50 + years. Make sure you all are prepared for a long term commitment.  

Exotic pets, just like dogs sand cats, require regular veterinary care with annual examinations and check-ups when ever you feel they are not well. As I mentioned these creatures are fragile and get sick very quickly. Nutritional deficiencies are common problems and are difficult to correct once the pet is sick. Visiting with a veterinarian that has special training in exotic pet care can help get you and your pet on the right track. 

At our hospital there are staff members that work with reptile and amphibian rescue groups. It is amazing how many of these expensive and at times rare pets are surrendered or even released by owners that were not prepared for the responsibility of caring for these pets. Be sure you are well educated and willing to accept all the responsibilities that are included in caring for another living creature!

Here is some brief information about some of the exotic pets we see at our office. It is certainly not a complete list and be sure to visit many web sites and check out books at your local library so you are well informed. Let’s begin with the sugar gliders, ours are named Violet and Lizzie.

Sugar Gliders are nocturnal and marsupials. They are originally from the rain forests of Australia, Papua New Guinea and Indonesia. However, they are bred in captivity here in the U.S. They have a furry section of skin that extends from their ankles to their wrists and it allows them to glide through the air. They can be very tame and great companions, but they must be handled and entertained often. They are very social and it is best that they be housed with other gliders. They can live 12-14 years in captivity. They need a diet that has a great deal of variety, eating fruits, nuts, commercial kibbles, and protein from worms and eggs. Sugar gliders need a large cage with lots of toys and room to climb and jump (or glide!). When angered or stressed they do bite and even as youngsters you must work to acclimate them to being handled. I would suggest purchasing from a private breeder that hand raises the gliders or adopting from a rescue. 

The tortoise is an ancient species that can live more than a hundred years. Turtles can live several decades as well. Each animal needs a very specific environment with strictly controlled temperature and moisture. Diets must also be very specific and they must be fed, cleaned and interacted with daily! Tortoises enjoy getting outside or roaming the house, but safety measures must be taken. No animal wants to be confined to a cage all day, every day. All enclosures and tanks have to be sized appropriately and they need the appropriate bedding or water filtration for their 'house'. Make sure you understand the needs of the type of turtle or tortoise you are adopting. Some can be very difficult  and costly to maintain. 

Chinchillas can live 10 to 20 years and are originally from South America. They prefer a warm environment and enjoy the periodic dust bath. They too are nocturnal and require a special cage, periodic teeth trimming and a specific diet. They are very social. Rabbits are also social and live 10-15 years. They too do best when kept indoors and in a regulated environment. They enjoy being out with their people, but like chinchillas and sugar gliders, they must be supervised. Both have commercially available pelleted diets. The chinchilla enjoys hay and does not tolerate great variety in it's diet. Rabbits are able to have additional vegetables, hay and fruits. 

Snakes and lizards are very popular pets. I think they are among the ones that are either the most poorly cared for or the most likely to be surrendered. This is usually as a result of their owners tiring of them or the pet has become ill due to mismanagement. Snakes can live decades. They require special housing, temperature regulation and regular cleaning. They are typically fed live food. Lizards can be vegetarians or eat meal worms, bugs and sometimes birds, other lizards and snakes! Some lizards can live up to 50 years. They require very specific housing, temperature regulation and diets. 

Birds are wonderful pets and have very specific cage, temperature and feeding requirements. Birds, particularly parrots can be so long lived they survive longer than their original owners. They can be very social and enjoy interacting with people. Many birds can be taught to talk and sing songs. However, they are delicate and stress, poor diet and drafts can be fatal for birds.

The fact is, no pet is without major responsibilities. However, for all your hard work you can reap the benefit of their companionship. Be sure you do your homework before adopting one of these pets and have appropriate housing and food available for them when they arrive at their new home. Also, have them examined by a veterinarian skilled in caring for exotic pets and review with them how you are caring for your new pet, making sure you are both getting off to a good start.

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Suggestions for some Purr-fect Holiday Gifts

When I was young and the holidays were approaching, I made sure that all the animals in our household had a stocking and some treats, even my horse. That was a long time ago and gifting your pets was not as popular as it is today. In 2010, the Associated Press reported that 56% of all pet owners gave holiday gifts to their pets. Currently, according to the American Veterinary Medical Association, 36% of all US households have dogs and 30% own cats. This translates into a huge amount of gift giving. Both to the pets and to the myriad of pet lovers.

Since I have such a long history of being a pet-gift-giver, I thought I might provide my top ten gift suggestions.

1. Give the gift of safety. Be sure that your household is pet safe and make sure that the gifts you give and the items you take to other households are pet safe. Remember that ribbons and tinsel, potpourri, Poinsettias, chocolates, alcohol, Lilies and many other hostess gifts can prove fatal to pets. Also, pets love to get into purses and bags left on the floor. Be sure all medications, sugarless gums and cigarettes are sealed and kept away from pets. Also, raw dough and antifreeze are common potential toxins. Visit www.aspca.org for more information.
2. Give a gift in the name of your favorite pet or animal lover. Donate to a charity or rescue in your area that benefits animals.  Community Sharing’s Pet Pantry, Meals on Wheels Pet Feeding Program, and local animal rescue organizations (I prefer no-kill shelters) are always in need of your help. Remember, there are horse and exotic pet rescues too!
3. Water. Give a pet water fountain. Pets, particularly cats, enjoy fresh, moving water. Cats are attracted to the flowing water and staying well hydrated is essential to feline health. 
4. Make sure any pet that is lost can be found. Microchip’s allow pets  to be identified and reunited with their owners. They are inexpensive, safe and easy. We recently microchipped a clients tortoise!
5. A Fur-ever Friend. Pets should never be given as surprise gifts. The addition of a new pet should be well researched. Always remember to visit pet adoption groups and rescue leagues to find a new pet.
6. Pretty as a picture. Consider giving your favorite animal lover and their pets the gift  of  a  professional photo session. 
7. Michigan Made products. As they say, Keep It In The Mitt! There are some great Michigan companies that make pet products. I am a big fan of Troys Treats ( ph 248.688.4530), they are locally made with Michigan products and Darwin (my dog) says they are Great!. Visit www.michigan-made/pets/  or http://www.mi-made.com/category/Pets to be inspired by other Michigan Made products.
8. Toys !!! We can’t forget that we all need to have a little fun! Laser pointers for cats and mechanical mice encourage exercise and these toys keep their minds nimble. Be sure dog toys are sturdy and not easily destroyed. Remember, rawhide toys and other ‘food related’ toys, are not appropriate for pets with food allergies.
9. Buckle Up! Using dog seat belts will help prevent injuries that might land you and your dog in the emergency room. Also,  be sure cats are secured in a crate to limit injuries in a car accident. 
10. Finally, give the gift of wellness. Every pet owner would appreciate a gift certificate for pet care at their preferred veterinary hospital. Preventative medical care will help keep everyone happy and healthy.

Have a peaceful and happy New Year!

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Taking Ownership of Our Pets Weight Problems

Pet obesity has become a major concern, like its human counterpart, it is considered an epidemic. The epidemic is becoming more and more obvious at our practice. The cause of this serious health problem is multi-factorial. Here is my view of what the main factors are:

1. Lack of portion control- Our pet foods are better made than ever. They are yummy and are low in residue (meaning less poop for us to pick up), but we have to be very careful to follow the feeding guide lines. Did you realize that every food has a different set of guide lines?  This better, yummier food cannot be free fed. You have to feed your pet a fixed amount daily. Did you realize that the average house cat needs about 180 calories daily ? That is a 1/2 a cup of Meow Mix dry or if you are a fan of the more premium brands a 1/4 cup or less of their dry foods daily. If you feed canned food you might give your cat 2- 3 oz cans of Fancy Feast daily or 1/3rd of a 5 oz can of one of the premium brand foods, but no dry! Now think about this carefully, does that seem like a significant amount less than what you feed?  I know when I began measuring my dogs food with an actual measuring cup, they began shedding the pounds! 
2. Changing pet foods is OK, but you have to adjust how you feed -As you read above, each food contains a different number of calories per can or scoop. Read the labels and do the math! 
3. No schedule- Leaving food available through out the day can make pet care much easier. However it makes your pets health care very difficult. Our pets rely on us to provide their health care, that means knowing what a they are eating, if they are eating  and how much. Decreased appetite is often one of the first signs of illness and a free feeding schedule, particularly in a multiple pet household, makes an appetite change hard to appreciate. Regular, moderate meals may also aide in house training, preventing gastrointestinal upset, and increase the frequency of  your interaction with your pet. 
4. Lack of Exercise - Our dogs and cats are leading more sedentary lives, just like we are. They look to us for their activity. If we are busy at the computer or at work, they are content to stay at rest. We have to be sure that they are staying mobile. Cats are the most challenging. However, playing with them, using toys to entertain them, moving food bowels so they have to seek out their food, and even taking them outside for fresh air and a stroll in the garden can help keep you both active. Regular play and walks for your canine friends  can benefit them as well.
5. Inappropriate standards - Did you know that the average house cat should weigh between 8 and 10 lbs? Seems kind of small doesn’t it?  I think we have adjusted our expectations, thinking that the 12 pound and 15 pound cat is the new normal. Take a look at your dog. Can you feel its ribs as you pet him long the side of  his chest? You should feel the general contour of his ribs and when you look down along his back he should have a slight waist, it should not be straight line from shoulders to hips!

Our pets are completely dependent on us and we are responsible for their health. By ignoring the fact that this extends beyond the purchase of the newest, freshest and most organic pet food and not considering how much, when, and why the food is fed we are helping create problems like arthritis (this can be caused by obesity), cancer, hypertension, diabetes, joint injuries, heart disease, respiratory disease, skin conditions and a shortened life expectancy. Once these conditions have developed, it is far more difficult to correct them and the obesity that helped cause the illness. 

Along with changing how we attend to our pets diets and feeding schedule, we also need to be sure that they are getting exercise. We need to spend time with them, appreciating changes in appetite, body weight and conformation. These observations may not only tell us that they are gaining weight, but may alert us to changes in their health. Early identification of illness and avoiding health problems related to obesity could allow you both many happy years of companionship. 

Visit www.petobesityprevention.com  to read more about managing your dog and cats weight, calculating their caloric requirements and find out the caloric content of your favorite pet food. 

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Beware of Practitioners of Negativity

As in any profession, there are as many different approaches to the practice of veterinary medicine as there are veterinarians. No one method is wrong, however some may be better than others. I am a big believer in education of the client, walking them down the path of understanding the condition that is affecting their pet and explaining the best plan and the potential outcomes. It may seem intuitively obvious to you that this is the way any medical consultation should be handled, but it is not everyones approach. There are practitioners that do not take the time to create a complete plan and provide a picture of the reasonable expectations for the patient. They tend to take short cuts and, if they are not careful, they can become practitioners of negativity.

As my parents have aged, I have become increasingly aware of certain doctors making treatment choices based on their age and seemingly lowering their expectations for their patients.  How often have you heard of a veterinarian saying that the pet was too old, or the condition too ‘bad’ to treat?

“It’s too serious” or “ poor prognosis” with out an explanation or a discussion of options is quite frankly a cop out. I do not mean to imply that every disease can be cured. Unfortunately, ultimately, some disease does eventually lead to the demise of every organism. The issue at hand is how do we fend off disease and how well will the patient fair during that treatment process and how acceptable is the plan to it’s owners . I like to refer to it as our philosophical approach to the patients illness.  With each patient, each set of clients, and each disease process  a philosophy for the management of the illness has to be developed. This is even more important in veterinary medicine where the cost of the services, the amount of at home care the patient will need, and the cost of medications all play a roll in developing that ‘philosophy’. 

It takes a considerable amount of effort, continuing education, experience and time to be able to allow owners an idea of what is wrong with their pet, why it is an issue, what can be done and how their pet will recover. I recently had this discussion with an emergency doctor. I had  noticed that a number of her cases where given a grave prognosis and the owners had elected either euthanasia or ‘hospice-type’ care. There was a common thread among these patients, they all were older and they each had a hemoabdomen (free blood in the abdomen). We discussed these cases and what I appreciated was that her scope of understanding regarding possible causes and outcomes was limited. She needed to go beyond recognizing the condition was serious and realize what options were available. Now she is realizing that there are diagnostics that can define just how serious the condition is and identify the cause. Once this is understood the owners can be educated about the choices they have and potential outcomes. Some of these patients can go on to live normal lives, just because it ‘looks bad’ on initial presentation.

I have a friend that had an geriatric cat that had a number of illnesses. I tried to help her as best as I could long distance. She visited with specialists that appeared to be unenthused about managing a geriatric with multiple health problems. They provided palliative treatments. Here is where they really failed my friend, they did not explain that by following this conservative approach a certain outcome was to be expected. They also did not provide an over view of the potential benefits and risks of a more aggressive approach. My friend quickly became disenchanted with this practitioner. Later, when the pet was failing even more, she visited another veterinarian who played the ‘it’s bad’ card and recommended euthanasia. Again, that may have been a very appropriate choice under the circumstances, but it is a choice. A choice made by the owner with information and options, that is what a good practitioner owes their clients. 

Over my career I have managed patients that other clinicians had declared to have a poor prognosis or a serious condition. These owners wanted more choices, and we together crafted the plan that met their expectations and their pets needs. Many of these pets lived on, very happily, to far exceed their previously poor prognosis. 

Painting an inappropriately rosy picture is wrong, but educating and providing options is definitely the name of the game. Even with the benefit of information some clients are going to choose conservative plans, and that is alright. The important thing is they made educated decisions. 

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Are Vaccines Still Necessary?

Vaccines, whether they are for people or animals, have become a very controversial subject. They serve to protect us and our pets from life threatening illness. However, like any medication, they can also cause side effects in certain individuals. Basically, vaccines expose the patient to a small infection. This ‘infection’ then triggers the immune system to respond by developing antibodies or immunity to the infectious organism. Then, when the patient is exposed to a full blown infection, their body can effectively fend off the disease. Vaccines are created in such a way that they trigger that immune response, but spare the patient the illness necessary with a natural infection. 

One of the main reasons we do not see diseases like polio, canine distemper, and rabies in our communities is because of vaccinations. Vaccines reduce our risk of illness when we travel and prevent us from spreading those diseases. Even though certain diseases are uncommon or absent in our community, vaccination may remain necessary. 

The vaccines that are selected for a patient are variable, depending where they live and what our pets do and where they travel. Veterinarians have become better at selecting vaccine protocols to fit our patients. We have also become more prudent recognizing that yearly vaccine protocols are rarely warranted and that vaccine titers can be used to assess whether vaccination is even necessary. We have also become careful about how vaccines are administered. All these efforts help in limiting potential side effects.

Vaccine reactions are rare, however vaccination does carry inherent risks. Just as in people, minor allergic reactions, local inflammation, pain, local tumor growth, or even life threatening shock and anaphylaxis may all occur as a result of vaccination. These events are very uncommon and are far outweighed by the risks of disease. We have learned that vaccines should not be administered to patients that have previously suffered from immune mediated diseases or cancer since vaccines could cause these patients harm. 

Vaccines are important because infectious diseases still exist. The viruses and other infectious organisms we vaccinate against are a constant threat and they are changing and developing all the time. Vaccines and vaccine protocols are changing too. Also new diseases are emerging that warrant completely new vaccines. Major veterinary groups such as AAHA, AVMA and ACVIM have responded to the changing canvas of infectious diseases in our country and our expanding knowledge about our pets immune systems, by creating carefully crafted vaccination protocols. 

We at Veterinary Care Specialists and VCS Pets First have considered all the available scientific data and created a series of vaccine recommendations for the life of your dog or cat. These protocols can be found at www.vcsmilford.com or www.vcspetsfirst.com. Please visit these sites and, as always, feel free to call, email or visit our office to ask questions and learn more about the vaccines, the diseases they prevent, and what would be the best choice for your pet. 

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Pet Health And Safety Fair At Veterinary Care Specialists This Weekend!!

The fair is this Saturday from 12 noon to 2 PM. We are focusing on services that are orientated towards keeping your pets healthy and safe in the summer months. We will be offering the placement of microchip identification at a 50% price reduction, this means a one time fee of $25.00. Microchips identify your pet even when collars, leashes, and fences fail.
There will be other pet health care professionals, yard care and invisible fence services represented as well.
We are also excited to welcome Rachel Cullen who will have beautifully crafted collars and leashes that are being sold to benefit a group that provides specially trained dogs for military members recently returned to the United States.

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Dogs Playing Poker, June 4th, Starting at the Milford Powerhouse

The Third

Annual Dogs Playing Poker Event Takes Place In Milford June 4^th!!

The event begins at 11 AM with contestants able to enroll until 2 PM at the Historic Milford Powerhouse. All the proceeds will go towards the Community Sharing Pet Pantry. The Pet Pantry is the first of its kind in Michigan. They provide pet food and basic veterinary care to the clients of the Community Sharing Food Bank. The Pet Food Pantry feeds 400-500 pets each month. Through their efforts, pets that might otherwise be abandoned can remain with their families and serve an important function of support and companionship to family members during difficult times.

How Does it Work? Each participant purchases at least one hand, this allows them to walk through beautiful downtown Milford collecting cards at participating businesses. When they return to the Powerhouse they then present the collected cards and this allows them to select their hand and, if they choose, they can purchase additional cards to improve their poker hand. The best poker hands win fabulous prizes donated by area businesses. This event not only benefits Community Sharing, but our wonderful area businesses and the Historic Powerhouse!!

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Laryngeal Paralysis And A Reminder - Things May Not Always Be As They Appear

Max is an old dog. He is the constant companion of Nancy, who works at home, and Jake, her husband. Max arrived at my office on New Years Eve. Nancy and Jake explained that Max had been previously diagnosed with laryngeal paralysis.* They said that Max was coping well with this disorder of the respiratory system, but recently had begun to vomit, did not want to eat and would periodically pant and appear upset. Max was up and walking, but obviously not feeling well. He was thin and ‘lumpy’, like so many older dogs, he had many fatty masses all over his body. It was evident that he had peripheral nerve disease and that his laryngeal paralysis was advanced, but it looked like there was more going on.

Most dogs with ’decompenstated’ laryngeal paralysis present to the emergency room, struggling to breathe, not able to walk, loud respirations, blue gums, high body temperatures, generally in dire straits. Max just stood there with pink gums and steady respirations. Although he might need surgery sometime soon, I felt he was presenting today for another, possibly related, problem. Max was admitted to the hospital, we took radiographs (x-rays), checked blood work, and most importantly observed Max closely. He did not have pneumonia; his blood work looked awfully good. Then we took him for a walk, a very short one, outside to urinate. When he returned it was obvious he was having difficulty breathing, but his gums were still pink. Standing, he extended his neck, stood very still and he took long slow breaths. Max looked like he was concentrating hard. As I watched, I began to appreciate that those long slow breaths were barely moving his chest. I sedated Max so I could look at his laryngeal folds and I was amazed when I saw those two doors essentially closed, not moving at all, just a slit of an opening between them. The tissue was not red or swollen like most dogs in this condition, but a very normal pink! Max had so successfully compensated for his difficulty; he had seemingly ‘thought’ this situation through, no panic or distress. He would very slowly breathe, like a person underwater with a straw, through that narrow airway no matter what. I thought this was amazing! Certainly, Max had managed to fool me; he definitely did need a laryngeal tie back, and soon. Max was placed on oxygen and did well through the night. On New Years Day, he had his surgery and a few days later he returned home to his family.

One of the diagnostic tools that I, as a veterinarian (a doctor treating essentially mute patients), rely on heavily is my observational skills. In my estimation, clinical observation and history taking are the key to achieving an accurate diagnosis. It is in our nature as humans to begin cataloging and grouping our experiences and as clinicians we look for certain signs that are associated with particular diseases, fitting our patients into categories whenever possible. But sometimes we are surprised, nay humbled, by the unpredictability of living organisms, like Max. I remain amazed by how he appeared to have given his condition such careful attention and that he had mastered it so capably. While other dogs would have had to be treated far earlier, Max had found a way to manage his illness.

Every day and each patient and client, is a new experience.Each pet and owner comes with their own experiences, their own personal reality. The minute I forget this, or become too self-absorbed, I receive a not too gentle reminder, like my experience with Max. Diagnosing and treating Max reminded me of how things can stay the same and yet be very different. You have to put yourself in the patient’s position, see things from their vantage point because, just like Max, each patient’s coping skills and their perspective is different. Every patient (yes even animals) comes with a different set of experiences and skills that brought them to my examination room.

What I find interesting is this lesson is equally applicable to dealing with people. So many clients come to the hospital scared, anxious, and even angry. No one wants to be in the position of having a sick pet, seeing a family member ill, worried about expenses or outcome. Yet I tend to interpret the way they behave as an indication of the whole of their personality. That is way too judgmental. Just like Max, they have developed their reactions, their coping skills, based on events that I am unfamiliar with. Currently they may have additional factors that are influencing their choices that I cannot begin to understand. Maybe, in the future, I should apply the lesson Max has taught me and step back, observe closely, contemplate and use previous experiences, as well as, being open to new lessons, in order to figure out the right plan or the correct approach to the person before me. Maybe if we take a moment and avoid snap decisions about the people before us we can all be a little more successful.

*Laryngeal Paralysis is a dysfunction of the larynx (also called the voice box). The larynx sits at the juncture of the pharynx, esophagus and trachea, behind the soft palate. It consists of two ‘folds,’ they behave as doors on either side of the airway that allow air to move into the trachea and when they close they prevent food and saliva from going into the trachea. It provides very important protection for the trachea and lungs. The larynx allows us to make noise. In people it is the organ that allows us to speak, in dogs and cats it is what creates their voice, barking and mewing. Laryngeal paralysis is a dysfunction of those important folds or doors. The doors no longer work properly; they do not open and close as they should. As the condition progresses the doors close more and more, eventually cutting off the movement of air into the lungs. One of the first signs that an affected pet demonstrates is a change in their voice and a louder than normal pant. Owners may notice their pet coughing or choking when eating and drinking. As time passes and the condition worsens, the patient has progressively more difficulty breathing and does not tolerate exercise. Patients are often presented to the emergency service because of acute respiratory distress. This happens after the dog has exercised or become excited, or possibly the pet has just gone from the cold to a warm house, or just started coughing. Seemingly small events will serve as a trigger that will create a life threatening situation.As the pet struggles to breath rapidly, the vocal folds hit each other and they become inflamed (swollen and red) then the airway becomes even more occluded. Now the pet’s condition begins to spiral as it struggles even harder to breathe. Obviously, the situation becomes quickly more life threatening. The potential of rapid decline for these patients underscores the importance of the veterinarian identifying the early stages of laryngeal paralysis and their educating the client as to how to manage their pets and what signs to watch for.

Laryngeal paralysis occurs as a result of a dysfunction of the peripheral nervous system. The nerve that makes the larynx work (makes the doors open and close) is the longest nerve in the body, so when the nerves of the body are diseased this is often the first nerve that demonstrates signs of not working. Diseases like Myasthenia Gravis and Hypothyroidism can also lead to laryngeal dysfunction. Often times, in older dogs, laryngeal paralysis is a sign of a degenerative nerve condition that we do not fully understand and does not have an effective treatment. Some animals have laryngeal paralysis as a result of a genetic defect. The treatment for laryngeal paralysis is either correction of the underlying illness or surgery. The surgery is called a laryngeal tie back and it involves tying one of the vocal folds (doors) back, out of the way so the airway can remain open. There are obvious draw backs to this procedure the most significant being an increased risk of aspiration pneumonia. This is why we only consider the surgery once the patient’s condition is so advanced we have no other choice than to tie the vocal fold back.

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