71 Bring Your Cat to the Vet Day

National Take Your Cat to the Vet Day is August 22.  That is next week.  I would argue EVERY day should be “Take Your Cat to the Vet Day”, but this gives me a chance to wrap up my feline exam & vaccination series.

Today I performed a routine exam and vaccinations on my new nurse’s (Larissa) cat name Dandi.  She has been anxious in the past going to the vet and usually growls.  We know that growling is a sign of fear and anxiety.  She has had a lot of dental work and extractions, so maybe her fear was based on good reasons!  To help avoid anxiety, Larissa gave Dandi a dose a gabapentin this morning on her food before going in the carrier & coming to work.  We scheduled her on a light day, no barking dogs.  She was transferred from carrier to cage while we did our morning cases.

At lunch, we moved Dandi to the cat room, with the pheromone Feliway diffuser, and covered her with a towel that had been sprayed with Feliway.  Dandi never growled, , no dilated pupils, no ears laid back, and seemed comfortable throughout.  We did our whole exam and vaccination without ever triggering fear or anxiety.  Put that in the WIN column!

Dandi is a textbook example of how Fear Free can make a difference.  Let us try it on YOUR cat.  And tell Larissa how cute her cat is.

https://www.catvets.com/public/PDFs/Content-Articles/Cat2VetDayInfographic-2016%20FINAL.2.pdf

https://www.catvets.com/public/PDFs/Content-Articles/Benefits-Routine-Vet-Visits.pdf

https://www.catvets.com/public/PDFs/ClientBrochures/Cat-to-VetHandout.pdf

70 Free Fear Feline Exams

So how do you get a stressed out cat to the vet? My sister-in-law would grab the cat, no carrier, place it in the back of her hatchback car, and drive fast to the vet. Her cat was always anxious, and she had trouble getting her in the carrier. She did what she thought best at the time. Now, in 2018, we have a few tricks to make this easier for cats AND their owners.

Trick #1- CARRIER– Cats will be less stressed in a clean, familiar carrier, either hard sided or the new soft sided kind. Some cats prefer a top opening. For best results, leave it out in house all the time, not just before a trip to the vet. Let Fluffy get used to it, and not just associate it with “going to the vet.” Place treats & catnip in it to make it a happy place. Pheromones like Feliway wipes or spray can help create calming/relaxing atmosphere.

Trick #2- ANTI ANXIETY MEDICATION-Prevet visit medications like RX gabapentin or OTC Feliway pheromones can really help a cat with previous anxiety problems at the vet. I compare it to taking a valium before a visit to the dentist if you are afraid of dentists. It isn’t sedation, but it does help reduce the fear so maybe Tigger won’t have another fearful & anxious experience.
So what is this gabapentin (Neurotin), and how the heck to do I give it to my cat?  Gabapentin is an inexpensive medication originally developed to control seizures in humans. It is also used to control neuropathic pain in humans, dogs, and cats. While it is not labeled for use for anxiety, it is increasingly used for that purpose in human and veterinary medicine. The powder in the capsule does not have a strong taste and is usually well accepted by cats when the capsule is opened and sprinkled over wet food, 90 minutes to three hours before the car trip.
What is Feliway? Feliway is a pheromone (hormone that travels through the air) that goes straight to brain and triggers other hormones. Most people have heard about sex pheromones or fear pheromones. These are calming and marking pheromones. The cats react to them, without drugs, and humans can’t smell them.

Trick #3-THE CAR TRIP– Once in the carrier, the best place for it is on the floor behind the driver. There is less motion & less visual stimulation. You can even cover the carrier with a towel for less stimulation. Some pets respond better to soft music on the radio, not loud Rock or Rap.

Trick #4- THE EXAM– Ask to be scheduled at a time when it isn’t crowded so you can go straight into an exam room. Carry the carrier with 2 hands (don’t swing by the handle) . Don’t place the carrier on the floor- keep at seat or table level. It is great if owner bring a favorite treat or toy from home what we coax them out of carriers with, and use a reward after the exam. Some cats even prefer their own towels from home.

Trick #5 – Chose a Cat Friendly Vet, and one certified in Fear Free practices. Here at Garden Ridge Animal Hospital, we have a “cat room”, use Feliway diffusers , soft yoga mats on tables, spray our towels with Feliway calming pheromones, and handle cats gently, and trying to avoid triggers. We are able to do so much more with cats since we adopted these principals. Most owners are amazed that a few tricks can make such a difference. And often that success builds with each visit, as the cat doesn’t have scary experiences. Because one day, that cat will get sick, need to go the vet, and already be stressed from the illness.

So now you know HOW to set the stage for Fear Free cat visits to the vet. Call us to set up your cat’s annual well check exam, and maybe some vaccines. If you do these steps, YOU will be less stressed.

69 Feline Injection Site Sarcomas

You may have hear or read on the internet that vaccines cause cancer in cats. It is enough to scare any caring cat owner into rethinking about the safety of these lifesaving vaccines. It is true that a rare cat will get a true “allergic” reaction to a vaccine, just like dogs or humans. Vaccines have foreign proteins that we inject into their bodies. But it is also true that injections (any injection) CAN cause a reaction that can lead to a sarcoma in a rare cat. Lots of epidemiological studies have to done in the last 25 years to find out WHAT is causing the inflammation, WHICH vaccines, WHAT manufacturer, and WHY cats might develop this terrible disease

The current thinking is that individual cats may respond to inflammatory changes in a manner that predisposes to sarcoma formation. Current studies to investigate the cytogenetics of injection site sarcomas may provide more information. Up-to-date information regarding research can be obtained from the Vaccine Associated Fibrosarcoma Task Force.
What is the incidence of injection site sarcomas? Most studies agree it is 10-100cats with sarcomas/100,000 cats vaccinated, so about 0.1-1% of vaccines. There does seem to be some regional variation, but they are reported worldwide.

What injections area associated with sarcomas? All vaccines, long acting steroids, subcutaneous fluids, and antibiotic injections
At first vets thought it was only vaccines, and we saw a higher incidence with killed vaccines (Rabies and Feline Leukemia Virus also called FELV) , and especially if aluminum was used as adjuvant. So Garden Ridge Animal Hospital switched to recombinant non -adjuvented FELV and Rabies by Merial like many other vets. Later we saw that all vaccines types made by all the manufacturers have some association. If a cat received all the vaccines in same location, like the neck, there was a higher incidence of sarcomas, so we split them up now. The recommended sites are NOT the neck anymore, but Rabies on Right rear leg, Leukemia on Left rear leg, and FVRCP on the Right foreleg.

Why do cats make sarcomas at injection sites? One theory speculated about a viral helper to FELV, the Feline Sarcoma Virus, but only a few cats with sarcomas test positive for FELV or FIV. Another theory is gene mutation, oncogenes, and mutations in tumor suppressor genes. Approximately 75% of injection sarcomas were found to contain p53 and c-kit oncogene. Approximately one third of tumors contained both p53 and mdm-2, and these tumors were histologically more anaplastic, perhaps explaining the aggressive biologic behavior of some injection site sarcomas.
Any injection can cause local inflammation, usually in first few weeks after the injection. If a bump is present less than 1 month, it should get checked out with a needle biopsy. If the biopsy is “suspicious”, then aggressive surgery is indicated and maybe presurgical radiation therapy. These Injection Site Sarcomas are scary because they are aggressive, large (greater than 4 cm), invasive, and can metastasize to other parts of the body.

There is a lot we still don’t know about Feline Injection Site Sarcomas. I have seen 3 or 4 in my 28 years at Garden Ridge Animal Hospital. One was a cat that I had vaccinated, but not exclusively. But over my 35 years as a vet, I have seen many more cases of Feline Leukemia, Distemper, respiratory infections and even feline Rabies. We also vaccinate less frequently than years ago, and we talk about a risk assessment at our yearly exams. For examine, I don’t recommend FELV vaccine to indoor only adult cats. FVRCP is every three years once they are adults, but Rabies (required by state law and a real threat in Denton county) is still annually with the non-adjuvented Merial Purvax.

I know vaccines save kitty lives and improve quality of life a hundred fold over the risk of Injection Site Sarcomas. If you are still worried, please come in with your cat and we can at least perform a yearly health checkup. Vaccines are always optional, and not the only reason to see a vet.  Our staff is standing by.

For more information
https://www.catvets.com/guidelines/practice-guidelines/feline-vaccination-guidelines

68 Should we vaccinate cats?

The topic of cat vaccination has stirred up quite a controversy in the last few years. Are we over vaccinating? Under vaccinating? Does it cause cancer? How can I get my cat to the vet without stressing him/her out? Why is a yearly exam so important?

Fortunately, this topic has gotten a lot of controlled research, and feline experts came together in 2013 to update the AAFP( American Association of Feline Practitioners) vaccine guidelines.

A quote from Dr Scherk, the editor of the Journal of Feline Medicine and Surgery, regarding her conclusions about feline vaccines is “We’re not over-vaccinating; we’re actually under-vaccinating cats.” Her explanation starts with the many cats that NEVER see a vet until they are very sick, so they aren’t candidates for vaccines then. The other hurtle is that many cat owners have heard about vaccines causing cancer, so they just opt out. Plus cost can be another reason.

The Guidelines recommend we break the different vaccines into 2 categories: Core and Noncore.  Examples of Core are Feline panleukopenia (FPV)(also known as distemper which is not to be confused with dog distemper), Feline herpesvirus-1(FHV-1), and Feline calicivirus (FCV). These are usually combined in the FVRCP vaccine, which is given as a series for kittens, boosted at a year, then every 3 years after that per manufacturer’s recommendation.

Rabies isn’t considered core by AAFP, but every other vet organization considers Rabies a core vaccine, and a legal requirement in the State of Texas. I consider it core vaccine. I have seen a cat with rabies, and we definitely have active rabies in Denton County. Plus the rabies vaccine is a killed viral vaccines, is super safe, not a combination injection, and we use the non-adjuvented Merial Purevax rabies.
I have been vaccinated for rabies and needed a booster when I was pregnant with my daughter, so my pediatrician researched it and concluded it was safe to receive even during pregnancy.

Noncore vaccines Feline leukemia virus (FELV), chlamydophiia felis , Bordetella bronchiseptica, Feline infectious peritonitis ( FIP), and Dermatophyte vaccines. At Garden Ridge Animal Hospital, we only carry FELV in this Noncore category, and we only give it to cats with risk factors like outside cats, cats that fight, or cats in households with some outside cats. We also follow the AAFP recommendation for all kittens to get a series of 2 FELV vaccines, so they have some lifetime protection.

The questions about injection site sarcomas and how to transport cat to the vet require long answers and will be future blog topics.

So my challenge to my cat owners is “are all your cats up to date on their vaccines? Even the old ones that never go outside?” And it not, call the staff at Garden Ridge Animal Hospital at 972-436-2199 and set up an appointment.

For more links on recommendations; https://www.wsava.org/guidelines/vaccination-guidelines

http://www.aavmc.org/data/files/other%20documents/ppphfelineguidelines_proof1.pdf

67 AAHA – Accredited Hospital Day- July 22, 2018

Every year on July 22, the American Animal Hospital Association celebrates hospitals that are accredited. Nationwide, less than 15% of animal hospitals are accredited. Garden Ridge Animal Hospital is Lewisville’s only AAHA Accredited animal hospital. I build it in 1990, with the eventual plan to be accredited. In 2005 we were accredited, and have passed every inspection since then. I had the good fortune to work in two AAHA accredited hospital before opening Garden Ridge. My first experience was with Dr Thomes in Irving, at his hospital on 183. It grew to become VCA Metroplex Animal Hospital, a big 24 hour multi-doctor referral hospital. I worked there as an intern in 1982 and later as one of the night doctors in the winter of 1989/90. After graduation in 1982 until 1989 I worked at Hines North Animal Hospital, which was also AAHA accredited. I remember referring to the AAHA charts of standards as we got ready for inspection. They have standards in anesthesia, dentistry, pain management, patient care, surgery, client service, safety, medical records, laboratory, imaging, and housekeeping. I compare it getting ready for a visit from your loving Mother- in -law. You want everything to be ship shape. The other thing I remember was the constant “raising of the bar” with standards. One time something was optional, and later it was mandatory. The goal is constant improvement.
AAHA motto is The Standard of Veterinary Excellence and its tagline is Champions for Excellent Care. That is the goal for Garden Ridge Animal Hospital, too. Our mission is Quality Care for Quality Lives, for pets, owners and staff. AAHA does more than inspections. It sponsors some awesome Continuing Veterinary Educations, for management and medicine. And they publish lots of training tools and books that help manage a small hospital like mine to the same standards as a large hospital. It also helps us stand out and reach new clients. When I have an existing client that is moving, I always suggest they look for the AAHA Logo in their new locale to find consistently excellent hospitals.
We expect to be celebrating Monday, July 23, after our inspection! Until then, stay cool!! Stay inside & drink lots of water.

https://www.aaha.org/pet_owner/about_aaha/default.aspx

66 Dilated Cardiomyopathy associated with Grain Free Diets

There have been disturbing reports, mostly in Golden Retrievers that are eating grain free, legume (pea) based diets that are developing Dilated Cardiomyopathy. This is a heart muscle disease that causes enlarged hearts, most commonly seen in cats that are eating diets deficient in taurine. Taurine is an amino acid present in most meat and milk. It has been well known that deficiencies in cats can cause dilated cardiomyopathy, but has been rarely seen in dogs until now.

Most of these cases seen by veterinary cardiologist have been on “boutique”, homemade, or raw diets, not the major pet food manufacturers. Some universities are looking for more patterns, but it has been seen most often in Golden Retrievers. https://www.avma.org/News/JAVMANews/Pages/180801e.aspx?utm_source=email-optin&utm_medium=javma-news-180801&utm_campaign=animal-health&utm_term=link&utm_content=pet-diets-heart-disease

I am amazed daily by the number of clients that proudly boast their dog is on a grain free diet. Many think that grain free means no carbohydrates, and that just isn’t the case. To manufacture the kibble, they need some carbohydrates, so the makers use potato, peas, and other legumes instead of wheat, corn, barley and oats. I myself try to eat low carb to manage blood sugar, but I can’t do No carb. I am not gluten intolerant, so I do enjoy my home made sour dough bread in small quantities, especially when it is fresh out of the oven. I have met very few dogs that are gluten intolerant, but there are definitely a few. There are compelling studies for dogs with inflammation in skin or gastrointestinal tracts that benefit from gluten free diets. Gluten is a protein in found in wheat, barley and rye.
I think we need to be careful when we choose pet foods and not buy into fads. Look for the AAFCO label, which means the diet meets all the known standards for nutrients in the diet. And look for a reputable manufacturer. Currently, I am most familiar with and recommend Hills, Purina, Iams/Eukanuba, and Blue since these companies all make good veterinary therapeutic diets. There are probably others that are top notch, but just don’t make therapeutic diets.

To feed grain free or not isn’t black and white. It might be very appropriate for some pets, but we need to watch these new cases of dilated cardiomyopathy in Golden Retrievers that might be related to grain free legume based diets.

https://www.fda.gov/NewsEvents/Newsroom/FDAInBrief/ucm613355.htm

https://www.texvetpets.org/article/grain-free-diets/
https://weethnutrition.wordpress.com/2014/11/04/the-myth-of-the-natural-diet/
https://weethnutrition.wordpress.com/2017/09/03/pet-food-basics-dr-weeths-top-tips-for-feeding-your-new-dog/

65 Early July 4th advice on Noise Phobias

Almost daily, I hear from owners that they have dogs (and occasionally cats) that are noise sensitive, to a small or large degree. This can happen with ANY noise, but especially thunderstorms, fireworks, vacuum cleaners, or noisy vehicles like motorcycles, trucks, and buses. I even had one this week that barks if the microwave beeps. A mild noise phobia (fear) is some whining, or pacing, or aversion to the noise (running away to hide). A severe phobia has dogs scratching up doors, jumping through windows, digging to get under covers. I had one client whose large Labrador would hide in the upstairs bathroom during thunderstorms. One time he got wedged behind the commode, and started shaking and busted loose the water supply line to the toilet. The next thing the client saw downstairs was water leaking through the ceiling! So we need to look seriously at the effects of noise and anxiety on own individual pets.

Noise is hard to avoid, but there are some tips that might help. Ideas include staying inside during thunderstorms and planned firework displays. My clients in Flower Mound complain about the weekly Friday night fireworks from the Gaylord Hotel in Grapevine upsetting the dogs. This year I see many cities are planning events on July 3. Some sounds can be masked by a TV or soft music. There have been lots of studies on calming music for dogs. There are even playlists that shelters use! https://www.aspcapro.org/blog/2017/05/04/turning-page-music-shelters; http://rescueanimalmp3.org/;   http://throughadogsear.com/free-music-to-shelters/ 

There are some non-drug therapies that I recommend for mild to moderate noise phobias. The first is calming pheromones (hormones that travel through the air). The brand I recommend is Adaptil,  and is designed after the natural pheromone a momma dog makes between her breasts to calm puppies. It is available as a 30 day diffuser/plug in, a spray (like on a neck bandana, towel, or bedding), and is available at local pet stores or Amazon. The second is the Thundershirt idea, which is just like swaddling a baby. I actually find my noise sensitive sheltie does pretty well with a Thundershirt, so we can all sleep at night when storms pop up unexpectedly. The third therapy is aroma therapy, like lavender. I love essential oils, but I am very cautious about using them topically across the board on pets. Use a diffuser, and keep it out of range of licking or eating.

Lastly, we have prescription medicines. The two medicines I most commonly use in 2018 are Trazadone and Sileo. Trazadone is a human drug, originally an antidepressant, but most commonly used as a sleep aid now. I prescribe Trazadone for all forms of anxiety in my canine patients, to be used intermittently for anxious situation to help them not be scared and have a positive experience (like at the vet). It takes 90 minutes to work, causes only mild drowsiness, and lasts 6-8 hours. This might be overkill for a 10 minute thunderstorm, but Fido still might appreciate it. The other drug, Sileo, is an oral paste based on an injectable sedative we commonly use. It works great, easy to administer by mouth, only lasts 2-3 hours, but can be redosed if needed. The downside is once the multidose syringe is opened, the paste is only labeled for 14 days.

So as we come down to the week before Independence Day, think about your pets needs and contact our staff at 972-436-2199 if you need advice or medicines. We will be closed July 4th only, and reopen July 5, 2018. Have a happy and safe Independence Day.

64 Corporate Speak vs Vet Speak

I got an interesting email this week from my business insurance provider, The Hartford. It was about the 60 corporate “buzzwords” to stop using. I found about 20 that we use in veterinary medicine, but with entirely different meanings.

Back end/Front end– “Doc, he has a sore on the front end, and is weak in the back end.”
Bring to the table – “Nurse, can you pick up the cat and bring it to the table.”
Circle back– “Doc, sometime he just chases his tail and circles back endlessly.”
Client facing– This is after I do my exam, type my notes then turn to face the client to talk.
Cutting edge– The edge of the scalpel that I don’t put my finger on.
Drinking the Kool-aid– So you have some injured wildlife that is dehydrated. It is important to get it to drink the Kool-aid, especially punch flavored.
Elephant in the room– This is what we think when we have a hugely overweight dog in the room. But I am going to discuss it.
Getting our ducks in a row– Yes I see birds, and an occasional duck. If someone had multiple ducks, I might say this.
Going viral– What we fear when we have a Parvo outbreak. That is why we vaccinate pets and disinfected cages and table tops.
Hack-“Doc, when he wakes up in the morning, he hacks like he has a hairball.”
Heavy lifting– Something we try to avoid, use a lift table, or do team lifts. Usually it is a 100+ plus dog on the Xray table.
Killing it– Something we do humanely, when the quality of life is gone, and all options have been exhausted.
Low hanging fruit– “Doc, my puppy has been throwing up rotten peaches that have fallen off my neighbor’s tree branch over my backyard”
Move the needle– What we do when we have trouble collecting blood from a wiggly vein.
Ninja, Rockstar, Wizard– What really cute names for kittens or ferrets!
Ramp up– What we do to help large dogs with arthritis get into a car or SUV.
Socialize– a very important skill for all puppies & kittens

https://sba.thehartford.com/business-management/60-business-buzzwords-to-delete-from-your-vocabulary/?cmp=EMC-SC-SBA-36776353&eml=1

63 Father’s Day

So Father’s day is coming up, and what gift shall Fido or Fluffy give Dad? This website has some cute ideas:
https://www.hgtv.com/design-blog/entertaining/fathers-day-gifts-for-pet-lovers
There are mugs, socks, hats, cufflinks, journals, tee shirts, and artwork.
Or why not do a picnic at the dog park? Or try some of the local restaurants that allow dogs outside on the patio like Twisted Root in downtown Lewisville?
Or if it is Dad’s chore to walk the dog, pick up the backyard (you know what I mean), or clean the litterbox, why not do those chores for him for Father’s day?
One of my favorite hobbies is photography with my fancy digital camera, but anyone can take some good portraits of pets & people. Why not take some pictures of your man with Max and Missy? Your boyfriend with Buddy and Bella? My secret trick- get in really close! Take lots and shots- you only need 1 good one. And use natural lighting- like through a window, or just go outside. For more pet photography tips- https://digital-photography-school.com/top-10-pet-photography-tips-techniques/;
https://digital-photography-school.com/9-pet-photography-tips/
I would love to see some of your pet photos. Please email them to me (drpam@gardenridgevet.com), and I will put them on the website (with your permission).

62 Fruit and pets

I had the good fortune recently to be gifted with 60-80 # of small plums. They weren’t all ripe, so I was able to process then in several “batches” as they ripened. First I made plum wine (8 gallons), and then I made plum jelly (31 jars). Later I made Chinese Plum sauce, and lastly I made some plum jam with extra flavorings like cinnamon & orange zest. I went “plum crazy” and got “plum tired”. At one point I had a gallon pail of discarded plum pits and skins that I was planning to throw out, but still kept adding to it. I wondered what would happen if my Sheltie decided to eat the plum parts. After a little extra reading, I was glad he didn’t and I threw them away immediately.
I figure there are some common fruits that our pets might encounter: apples, bananas, strawberries, peaches, plums, cherries, nectarines, grapes (raisins), watermelon (melons), and avocados. Most are very healthy for humans and dogs. I didn’t mention cats because they seldom choose to eat fruit, but if they did the same comments apply.
Health benefits: tasty, sweet treats with high fiber
Health hazards: pits, intestinal obstruction, GI upsets, extra calories. Stone fruits like peach & plum have cyanide in the pits. Raisins, grapes and currants can to be toxic, causing kidney failure. Avocados contain persin, which isn’t toxic for dogs and cats, but can be for birds. Those big avocado pits could be a problem with obstruction even for big dogs.
Fortunately, I seldom see any of these. I have seen puppies get a good belly ache from eating rotting peaches and crab apples that fell from trees.
So enjoy your fruit, share it in moderation with your pets, but be careful with those pits. Go “plum wild!”
https://www.onegreenplanet.org/animalsandnature/5-fruits-and-veggies-that-are-toxic-to-your-dog/
http://www.petpoisonhelpline.com/poison/raisins/

Avocado