A Vet’s Guide To Life

Mary asks a good question…

If I have barbecue, is it safe to allow my dog to eat the bones afterward? 

The quick answer is “nope, definitely not”.  Here’s the long answer.  Bones in general are not good for dogs.  Yes, that may be a surprise to many people, as it’s the traditional thing we give dogs and you can even buy them in pet stores.  But just because it’s “always been done” or “my parents did it” doesn’t mean it’s right.  It was common for many centuries for doctors to bleed their patients, believing that doing so helped fix any imbalances in their bodies.  This was the height of medical knowledge, yet it resulted in some people’s death (including George Washington), and never really helped.  Fifty years ago scientists just described the structure of DNA.  Current medical knowledge is always changing.

There are a number of bad things about bones in general and barbecue in specific.  Bones have a chance of splintering, which can cause severe irritation to the stomach and intestines when swallowed.  Many types of bones are harder than teeth, and it’s possible to fracture teeth while chewing on bones (I’ve seen it happen many times).  I’ve also seen situations where small pieces of bone have mixed with a dog’s feces, creating a sort of cement-like substance that has caused constipation and even intestinal impaction.  Yes, dogs like bones, and yes, chewing on hard substances like this will help keep tartar off teeth.  However, I believe that the risks far outweigh the benefits.

Barbecue is very bad for dogs.  It is rich and fatty, which can at a minimum cause diarrhea, vomiting, or even just an upset GI tract.  In more severe situations (usually when a lot of fatty food is eaten, or the dog is small) it can cause an inflammation of the pancreas called pancreatitis.  Pancreatitis can be life-threatening, and often requires hospitalizaiton and intense treatment.  No, it’s not going to happen every time, and I know there are plenty of people who will read this and think of plenty of times their dog has eaten things like this and been fine.  I can’t really argue with that.  But as a doctor I have seen many, many situations where it hasn’t been fine, and the pet has needed medication or hospitalization.  Is it worth it to you to risk it in your pet?

Lastly, please remember that dogs don’t have any innate sense or instinct for what is best for them.  They’re like a 3 year-old child, and react to merely what makes them happy.  When it comes to food, they simply like what tastes best, not what’s healthiest for them.  I’m sure you wouldn’t let your toddler go into the kitchen and eat whatever they wanted.  Have the same attitude towards your dog.

Obesity is a major problem among Americans, and is often called an epidemic. So it shouldn’t be a surprise that there is a similar problem among American pets. And like in the human owners, this is a problem that is usually completely preventable and cureable, though it takes effort. So here are a few hints and tips in how to recognize obesity and how to manage it.

First, let’s address how to tell if your furry friend is carrying a few extra pounds. There are three characteristics that I look for when I’m examining a pet, and it holds true whether I’m looking at a dog or a cat. The ribs should not be visible, but when running your fingertips lightly over the chest, you should be able to feel each rib individually. The chest should be the widest part of the body. As you move from the ribcage to the hips, there should be a slight but noticable narrowing, making a “waist”. If you look at your pet from the side, the chest should be the lowest part of the body, and as you move your hand towards the hips, it should move upwards into the abdomen (what is called an “abdominal tuck”). If you can’t feel the ribs or if there is a straight line from the chest to the hips, then your pet is overweight. Now the exception is in many cats. It’s common that after being spayed or neutered a cat will develop an accumulation of fat under the skin of their abdomen, even if they are nto overweight. However, the other characteristics should apply, even if this fat pad eliminates the abdominal tuck.

Realize that if your pet is overweight, there can be many health consequences. In cats, obesity increases the risk for diabetes, liver disease, skin problems, and arthritis. In dogs, you have a much higher risk of arthritis and other joint disease. Pets don’t get the same kinds of heart disease, clogged arteries, or increased cholesterol like overweight humans, but there are still potentially severe health consequences.

So what can you do if your dog or cat needs to loose a few pounds? Like in humans, the best success is a combination of diet and exercise. DO NOT “free feed” your pets. That’s a common practice with cat owners, where they will often leave the food bowl full. I have yet to see this not turn into a weight problem when there are multiple cats present. You will need to provide measured meals (get a measuring cup and feed a specific amount) at regularly scheduled intervals. And you will need to feed your pets separately. I’ll be a bit blunt and direct here and say that if anyone says they can’t feed pets individually, they are simply being lazy. You can get separate bowls for each pet, put a measured amount in each bowl, and monitor their eating. If they get into each other’s food, put them in separate rooms. And nobody can tell me that they “can’t” do this. It’s always a matter of peole not wanting to make the effort. At one point I had three cats, each on a different food. It took me an extra 5 minutes per day to feed them separately. Not that hard.

Be very careful with treats! You will be surprised how many calories a dog treat or biscuit can add, especially in small pets. Even a little bit can make a huge difference.

In many cases you will need to feed a special diet food recommended by your vet. Yes, these are more expensive. But if your vet says it’s necessary, then please do it. In cases like this it’s not simply a method of providing nutrition, but a medical therapy for a health problem. I know people who will spend $60 per month on pills for their pet, but think it’s too expensive to buy a $50 bag of food.

Also try to increase the activity level of your pet. For dogs, that can mean walking, playing, and so on. Cats are harder to exercise, but you can use a laser pointer, dangling cat toy, or even toss the pieces of food and have the cat chase after them.

If you have a dog and have tried everything your vet has recommended, and followed a plan to a “T”, but your pup still has a weight issue, there is still hope. There is a new medication, Slentrol, available by prescription that can cause weight reduction in dogs. This is a pretty strong medication, so it isn’t used unless all other attempts have failed. Sorry, kitty-owners, this is currently for dogs only.

Though it may take a lot of work, getting your pet to a healthy weight is worth it. Studies have shown that overweight pets live shorter lives and have more health problems than pets kept at a normal weight. So get those jogging pants on and talk to your vet about your pet’s weight! You have the ability to determine whether your pet is svelte or a fatty!!!

Most people in the US have dogs and cats as pets.  But there are rapidly increasing numbers of so-called “exotic” pets.  Exotics pets include pretty much anything you can have in a standard home besides the canines and felines.  These animals could be lizards, snakes, hamsters, rabbits, ferrets, frogs, turtles, fish, hedgehogs, and many others.  These pets can be very interesting and rewarding, but are much different than having a traditional pet.  They require special care and housing requirements, and many people get these animals on impulse without properly researching them.  It’s estimated that 80-90% of health problems in exotic pets are related to husbandry (housing and diet).  That means that the majority of illnesses in exotics are very preventable.

Now, going into the ins-and-outs of disease in every kind of species is pretty much impossible.  What I’m going to try and do is give a few quick pointers if you have one of these pets or are considering getting one.

The first and foremost recommendation is to research the species carefully.  Buy or rent a book on their housing and care.  Many people don’t know or realize the specialized conditions under which these pets need to be kept, or what they will be like as adults.  For example, did you know that a major cause of disease in green iguanas is improper lighting and calcium metabolism?  Or that full-grown iguanas can be over five feet long?  These are the kinds of things you want to know ahead of time.

Second, call around and find a vet who has the knowledge and experience to care for the species.  Even though we receive some basic education in most species, proper medical care and surgery of these pets requires more than the basics covered in veterinary school.  And not every vet even wants to see exotics.  Ask many questions about your vet’s qualifications and experience, and what they are equipped to handle.  In my own case, I can do many basic avian diagnostics and procedures, but do not feel comfortable doing major surgeries on birds, especially large and expensive ones.

Lastly, be prepared for the responsibility.  It’s easy to find boarding for dogs and cats, but exotic pets are more difficult.  Who will take care of your pet when you go on vacation?  Some pets, such as birds, can live for many decades, and can rival a human’s lifespan.  What will happen to your pet if it outlives you?  The newness of the pet can fade away as the long-term care becomes more difficult.  Do you really want this pet for it’s whole life?

Having an exotic pet can be extremely fun and rewarding, but only if you’re prepared for it.

Here in Georgia, like may places nowadays, we are able to vote before the official date. I did that today.  I think way too many people in our country take voting for granted, which is why the numbers are so low.  And I’m not sure that I completely understand it.  I’ve voted in every major election since I turned 18, and have found it even more important to do so as I get older (now *shudder* twenty years later).

Going along with yesterday’s post, it’s so important for everyone to be involved in this process. Like my parents taught me, if you don’t vote, you don’t have any right to complain.  What I’m really worried about in this election is that many people will vote, but will do so for emotional reasons rather than looking at the issues.  When I was preparing to vote, I got a copy of the ballot online, and looked at all of the races.  I then went to the website of every candidate I could find and looked at their stances on various issues.  Many places also have sites where you can compare candidates’ answers to the same question, and I encourage you to find those out.  My point is that I didn’t just vote down a party line, and didn’t just vote for or against the incumbent candidate.  Whether or not you agree with my choices, I actually spent the time trying to learn what each candidate stood for, and whether or not I agreed with their stances.  THAT is how you’re supposed to vote.  And that’s why I voted for a mixture of incumbents and newcomers, and had three different parties represented on my ballot.

This is a historic election for numerous reasons.  We might elect the first black president or the first female vice-president.  We may give the presidency and both houses of Congress to a single party.  Whatever choices we make will guide our country for years, if not decades.  And those choices are OURS to make, not the politicians’.  So make those choices wisely, folks.  Take the time to go beyond the ads and sound bites and really delve into what the candidates want to do and HOW they want to do it.  But above all, get out there and exercise your right to vote.  Not everyone in the world gets that privilege.

My family has discovered a bit of a problem with our current American government’s system of taxing. Earlier this year I was teaching at a local college, and my wife was working as a bank teller. With our combined income we were making considerably less than when I was a practicing veterinarian. However, we still managed to make ends meet by scrimping and saving every penny. For a number of reasons, I left teaching to go back to practicing medicine and my wife quit work to stay home with the kids. In doing this, our household income jumped by around $10,000 annually. Pretty good, right? Obviously we’re doing much better, right? Well, wish I could say that was true. Actually, we’re bringing home (net income) about $500 less than when our gross income was lower! Now how in the heck can that be right? I make a lot more money, yet our take-home pay goes down!

It comes down to two factors….taxes and insurance. Previously, I was working for the state university system, so my health insurance was really good and really inexpensive. Now that I’m with a private (though very large) practice, my insurance costs more. Secondly, we are now in a higher tax bracket, and therefore pay more in taxes. And we’re not high enough in that new bracket for the higher pay to offset the taxes. How is that right and fair? To us, that shows how the current system punishes initiative, education, and hard work. Our family would actually be better off financially if my wife and I were both working, making lower salaries, and relying on family to take care of our kids. What kind of a messed-up system encourages this kind of family lifestyle????

So, this being an election year, I decided to look at the candidates. John McCain doesn’t have a tax calculator on his web site, so I can’t figure out how much savings I would get if he becomes president. Barack Obama has one of these calculators on this site, and according to it, under his plan, I would save $1800 in taxes and McCain’s plan would save me $122. Now, I’m going to take that with more than a few grains of salt, as I don’t know how realistic his plan is. Sounds good, but I’m not sure how it will be paid for, and I’m not a fan of overly taxing wealthy people (that gets back to my beef with a system that punishes and discourages people from making more money).

For well over a year I’ve heard about the FairTax proposal. So I decided to check out their site (www.fairtax.org), and I went through their calcuator. According to it, I would pay $9170 less in taxes per year! Sounds pretty good. And everything I’ve read and heard makes the FairTax system seem very appealing. And frankly, I’m sick and tired of our current way of raising money for government (my problem with what the government then does with the money is a whoooole ‘nother issue!). I think that we need to completely re-think our way of handling the money going from us to our governments, and start putting pressure on our legislators.

Take a look at your next or most recent paycheck. Look at the lines for your FICA and other income taxes. Now look at your gross pay. Sit down and pretend to write out a check to the federal government for the amount of taxes. What would it be like if you had to actually write out a check yourself for that amount on every paycheck? Would you be pretty upset about having to write a check that large? Then why in the heck are we all sitting down and doing nothing simply because it automatically comes out and all we really see is the final net income?

This is an election year, and a very important one. The approval ratings of Congress and the President are at historical lows. People are pretty darn fed up with both Democrats and Republicans. Well, why are we going to take it? WE have the power to make the changes! Don’t let 545 people make the decisions for 300 million! Instead of simply voting for a party, take a really good look at the candidates. I mean a really good look, not simply watching or listening to their advertisements. And when it comes to tax situations, start to look at candidates that support the FairTax. I know I will.

We can make a difference in this country. It’s not up to our President, Senators, or Representatives. It’s up to us.

Excuse me while I rant.  Today I had to face my other pet peeves (see September’s entries for my first one).

Pet Peeve #2
When you go to a doctor’s office, do you expect to be in and out in a matter of 10-15 minutes?  I’m talking about any human doctor.  Of course, this is a pretty ridiculous expectation.  When I go to the doctor, I take a book and consider myself phenomenally lucky if I get out in less than 30 minutes.  Yet for some reason, people expect this speed from veterinarians.  I can’t for the life of me figure out why.

Today I had a client scheduled for a 2:00 appointment.  She came in at 1:30 and was checked into the computer shortly after.  We’re at lunch from 1-2, so she had to wait until we came back.  She was back in the room at 2:00, and came out complaining about the wait at around 2:10.  By 2:15 the pet nurse was in the room.  She came out and was putting her notes in the medical record when I came out of another room.  She and I were discussing the case, when the receptionist came to the back saying that the client was asking if anyone was coming in the room.  The pet nurse had just gotten out and was telling me what the pets were there fore!  I was getting ready to go in the room when the client got fed up at the wait and left.  She was furious that she had been waiting for so long without being seen by a doctor.  This was all less than 30 minutes after her scheduled appointment and after a pet nurse had been in the room!  And I was getting ready to go in and see her pets!  Anyone else think that she was being really unreasonable?

Pet Peeve #3
When can you go to your own physician and expect to be seen just before closing?  And do you as patients or clients realize that doctors have lives and families also?  At about 30 minutes until closing today someone we had never seen before called up and said that they had picked up a stray that had a problem with the leg.  We said that by the time they got there we wouldn’t be able to do any x-rays or lab tests if they were necessary.  We recommended taking the dog to the emergency clinic or come in tomorrow morning when we had the time.  The client hung up and called back 10 minutes later wanting to come in.  This was now 20 minutes until closing, and the client was still on the phone with us.  We kept telling her that even if she came in, we would only have time to do a brief exam, and then would have to refer her to the emergency clinic or get the dog back the next day.  At 6:45 (we close at 7:oo) she insisted on coming in, despite our warnings and recommendations.  We told her that she needed to be there within 10 minutes in order to be seen.  I walked out at 6:58 without her having shown up.  My wife, kids, and I had planned a “family movie night” for when I got home.  Is it really so unreasonable of me to want to go home to my family on time after having been at work for 10 hours?

I wish I could say that these were rare occurrences.  Unfortunately, they’re not.  Things that people would never ask or expect out of their own doctors, they routinely ask and expect from vets.  We work hard and really try to be there for their pets, but sometimes there are people with totally unreasonable expectations that want us to be a drive-thru doc.

So here’s the lesson for the day, folks.  Be nice and patient to your veterinarian.  Realize that they are highly educated and skilled doctors that deserve common courtesy and respect.  And don’t expect to walk in just before any business closes!

Brac is a papillon that is a patient of mine, weighing only 5.6 pounds. For the last couple of months, she has had a problem with recurring blood in the urine. Antibiotics didn’t seem to help, so we took some x-rays. Look at what we found (I’ve highlighted the area of interest).

If you look carefully, you can see two small objects in the back part of the abdomen. They will be small, irregular, and slightly more white than the surrounding tissue (the urinary bladder). These are bladder stones. And this is what they looked like after I removed them surgically today.

Bladder stones are a common cause of recurring urinary tract infections (UTIs), especially if there is blood in the urine. If a UTI keeps coming back or doesn’t seem to want to go away, veterinarians will usually want to do x-rays or ultrasound of the abdomen. If this recommendation is made, listen to your vet. Stones can cause much irritation to the bladder, and can be very uncomfortable. Small stones or pieces of stones can even lodge in the lower urinary tract, especially in males.

Several things can cause stones to form. Some breeds are particularly prone to them (such as dalmations and schnauzers) due to how their kidneys process and filter material in the blood. Some diets have been shown to increase the risk of stone formation if a dog or cat is prone to it. Usually the process begins with a simple UTI, and a cluster of bacteria forms. Microscopic crystals then collect around that bacterial cluster, eventually growing larger. At some point, the stones can cause further irritation to the bladder, leading to further infections or simply bleeding in the urine.

Most stones have to be removed surgically, though some can be dissolved with special diets or medications. If you suspect this might be a problem, check with your vet.

Oh, and Brac came through the surgery just great, and is expected to make a full recovery.

Ear infections are one of the most common problems I see in dogs. Sometimes it’s an occasional problem, and with other patients it’s chronic. Now, the first thing I want to make clear is that ear mites are uncommon to rare in dogs. Yes, it happens. But if your dog has itchy, smelly, dirty ears, odds are that it’s NOT ear mites. See your vet for certain, and don’t waste your money on over-the-counter medications.

The main thing I want to address today is the problem behind continual or chronic ear infections. If your dog has two or more ear infections in a year, then we consider this a chronic problem. Please understand that in these situations the infection is not the problem. The ear infection is the symptom, and there is some underlying problem that is causing the infections. You need to figure out why this is happening, and not just treat the infection. Let’s say that you’re a fireman and a house catches fire. You go and put it out as quickly as possible. Now let’s say that a few months later another house catches fire in the same neighborhood. A few months after that, another house on the same street catches fire. This continues, every few months a new house in the same neighborhood burns. Of course, as a fireman, you would put out the fires when the happen. But when so many happen in the same neighborhood in such a short period of time, you will probably start suspecting an arsonist. To truly fix the problem, you need to find that arsonist, and stop him from setting the fires. Now take this analogy to chronic ear infections. Yes, you want to treat the problem, but then you need to find out why they keep happening.

There are numerous causes for chronic ear problems.

*Breed–Dogs with heavy ears that hang close to their head are more prone because lack of air circulation keeps moisture in the ears. Cocker spaniels are the worst breed for this problem.

*Hypothyroidism–Low thyroid levels can lower the effectiveness of the immune system, as well as make the skin more susceptible to infections.

*Excessive moisture–Dogs who have been bathed, swimming, or running through sprinklers can have an increased risk of infections because of water in the ears.

*Allergies–This is probably the #1 reason for chronic ear infections. Allergies can be related to fleas, food, pollens, mold, dust mites, and numerous other reasons. Inflammation from the allergies can make the skin (including in the ear canal) more susceptible to infection.

If you have a dog with chronic ear infections, please don’t simply keep getting more medicine for the ears. Talk to your vet about the possible underlying causes, and treat them instead. If your vet doesn’t seem interested in this kind of a discussion, consider getting a second opinion. Not truly treating the real problem can lead to permanent damage to the ears. Think about what is best for your furry friend.

Most dog owners are at least somewhat aware of heartworms. These are parasites carried by mosquitoes, and can be fatal. The worms are around 10 inches long when mature, filling the heart and vessels leading to the lungs with up to 30-50 worms. This can cause severe inflammation in the lungs, and lead to congestive heart failure. Dogs with advanced heartworm disease die slowly and painfully. Luckily, this can all be prevented with a monthly pill and annual testing. The testing is important because in the early stages of the disease there are no outward signs or symptoms.

But did you know that dogs aren’t the only ones susceptible to heartworm disease? We are seeing an increase in the number of cases of heartworm disease in cats. It’s been known for years that cats can contract the disease, but we as veterinarians haven’t done a good enough job of letting clients know about this. Heartworm disease is different in cats than in dogs. Felines are naturally more resistant to heartworms than dogs, but they’re not immune. Cats also get different symptoms than dogs, and it takes fewer worms to cause serious illness. Additionally, it’s much harder to diagnose heartworms in cats than in dogs.

Ferrets are another pet that can get heartworms, and are as susceptible as dogs. However, like cats, it’s hard to detect it. That’s why most veterinarians don’t require annual testing in species other than dogs.

Heartworm disease has been diagnosed in every state in the US, though since it’s carried by mosquitoes, the incidence is higher in locales with high heat and humidity. Just because you live in a desert state, or a state that gets very cold winters, doesn’t mean that you don’t need to put your pets on prevention. No matter what the situation, prevention is better than treatment. Depending on the size of your pet, prevention will cost anywhere from about $40-80. Treatment for a dog can cost $800-1000. There is no approved treatment for cats or ferrets (which is why I tell my clients that though cats are less likely to get heartworms, if they do become infected it’s a much worse situation than in a dog).

There are many different brands of heartworm prevention for dogs, and every vet will carry some. There are also several different brands approved for cats (Advantage Multi, Heartgard, Revolution, and Interceptor), and every cat should be on it. Personally, I prefer the topical preventions in cats due to the difficulty in getting a cat to eat a pill. Heartgard (and similar products like Iverhart, Wormshield, and many others) is safe to give ferrets, though not specifically approved.

So regardless of whether you have a dog, cat, or ferret, your pet is at risk of contracting heartworm disease. Do you really want this to happen? If not (and I hope that’s your answer), see your vet right away.

There is a young man in our church named Joseph (everyone calls him Jo-Jo). He has always been very nice to everyone, and the kind of person that always smiles at you. He didn’t always live his life the best he could, but in the last year has been turning that around. He has been one of our most regular members, became a Christian, and was baptized. His heart truly changed, and he began seeking to be closer to God. He already had a young son, and earlier this year his second son was born. Two weeks ago he married his fiance.

Yesterday Jo-Jo was killed coming home from work when a car ran into him on his motorcycle.

That has really made many of us think about ourselves. Here was a young man (in his 20s) who was really trying to turn his life in a better direction. He had two young children and a new wife, and had his whole life ahead of him. Being in good health, nobody expected anything to happen. Yet it did. In an instant he died, and the lives of those around him changed forever.

Do you ever want to do something, or tell someone something, but always think you have time? I fall into that trap very often. I always think that we have plenty of time ahead, and can get around to doing things. But truthfully, we don’t know how much time we actually have. We may not have another day, or even another hour. Heart attacks, aneurisms, accidents, and many other things can take us suddenly.

So here’s what I want you to do. Is there someone you’ve been meaning to say “I love you” to but haven’t? Do it immediately. Is there someone you’re mad at? Forgive them immediately. Is there a family event that you’ve been meaning to do? Get it done right away. And most importantly, have you thought about what will happen to you after you die? Many haven’t, and that can be a very bad thing. Start looking into it right away. I would seriously suggest reading the Bible and listening to Jesus. The only thing on the line is eternity.

Jo-Jo leaves behind a young wife, two young sons, a sister, and many other family members. Please pray for them. If you died tomorrow, what regrets or unsaid things would you leave behind? Figure that out, and correct them right away. You really don’t know if you have enough time.