Category: illnesses

148 Covid 19 and Garden Ridge Animal Hospital

As this pandemic reaches the US, Texas, and now Dallas, I have four concerns:

1) This is an airborne human virus. We are ramping out our sanitation even more than usual. I am sure no one wants to get sick or infect their loved ones. People might not have symptoms and still be infectious. Please don’t be offended if we not only sanitized the exam table, but also the chairs, doorknobs and light switches. I won’t be shaking hands or hugging people for a while. We will have Clorox wipes out for clients to use at the checkout counter, and our credit card Point of Sale Debit terminal can use “tap” as well as chip insert, if your phone or card is enabled. I want our clients to be assured we are doing everything we can to keep our hospital virus free.

2) We might be short staffed if we get sick. We are a small business and will soldier on. We might have to get creative (telemedicine) for rechecks and refills of medicines. If we have to close temporarily, we will post it on the website- www.gardenridgevet.com

3) We might have future drug shortages. The AVMA is monitoring the manufacturers closely, but there could be interruptions in our supply lines. If your pet is on a prescription medicine or diet, you might try to keep a 30-60-day supply at home “just in case”.

4) There might be fears that dogs (or cats?) might be “carriers” of the disease. As of March 4, 2020, there was one asymptomatic dog in Hong Kong that has tested positive twice whose owner is sick with Covid 19 . Pet hair could certainly carry this aerosolized virus around. If you get sick, it is recommended you let another family member take care of the pet and avoid contact.

147 Lessons from the Parvo Epidemic in 1970s

All the news about the human novel Corona virus outbreak is bringing back faint memories of the Canine Parvo Epidemic in 1978/79. Actually, dogs do get a Corona virus, mostly with mild GI signs like mild Parvo. It was never contagious to humans. Humans get a  respiratory parvo disease, called Fifths Disease, that has a rash like a face that has been slapped.

Way back in the dark ages of 1979, I was just being accepted in the Texas A&M Veterinary College, so I wasn’t in clinical practice yet. There was a mutation of a suspected feline or mink parvo virus, CPV2, that ran through dogs of all ages all over the world with severe vomiting, bloody diarrhea, shock, and death if not aggressively treated. It stripped the linings of the gut, allowed for bacteria to enter the bloodstream, caused septicemia, and wiped out the white cells that fight infection, which often lead to death because NO dogs had any immunity. It hit puppies and even old dogs, with a high fatality rate. Fortunately, Parvo is mostly an unvaccinated puppy disease. Many of us seasoned citizens remember with horror how devastating this disease was. And how bad it smelled.

First we discovered it was transmitted from the vomit and diarrhea, not airborne. We had to figure out the incubation (5-10 days), and how long the recovered dogs shed virus AFTER recovery(2-3 weeks!). We had trouble getting good confirmatory tests and the treatment (though mostly fluids and antibiotics for days) was expensive and cost prohibitive for many. Many dogs died. Fortunately, it didn’t affect people or cats. Some vets had whole parvo wards. I treated a 12-year-old dog for parvo in 1981 at vet school. We had a special Isolation Ward for highly contagious cases. We used a lot of bleach to disinfect cages, so we wore gloves and boots. We were worried about tracking around the hospital or bringing it home to our own dogs.

Initially, vets reached out to the only vaccine we had, feline panleukopenia. It was for the wrong species and didn’t work well. It was several years before we had good vaccines, that had lasting immunity. I remember when we vaccinated every 6 months for parvo. The technology for diagnosis took years to mature, but now we have a quick in-house swab test that gives us results in minutes. It still has flaws, and have false negatives early in the disease, or if the puppy is still nursing and has maternal antibodies. We even rarely see a false positive for a few days after vaccination. The virus had a few more minor mutations over the last 40 years, so we do see occasional outbreaks, but we have it mostly under control now. Some breeds seem more susceptible, like the Rottweiler, Doberman Pinscher, Labs, and Pit bulls.

I hope and pray we get this Covid 19 virus under control quicker than we did Canine Parvovirus. I am optimistic about improvements in testing, treatments, and vaccination. But I am realistic, so for now am focusing on sanitation and avoiding this novel virus in humans.

https://en.wikipedia.org/wiki/Canine_parvovirus

146 Early Spring

The calendar still says February, but everything outside is saying it’s Spring. And that means bugs and allergies (for some). We are already seeing fire ants, and next will be the fleas and ticks. Ticks really don’t die in the Winter and in some parts of the country are worse than Spring for deer hunters.

So, this is a reminder to everyone who has pets that go outside- start you flea and tick medicines NOW. Don’t wait until you are picking them off Fluffy, yourself, or your children. The new modern class of oral insecticides (isoxazolines) like Credelio, Simparica, Nexgard, and Bravecto are effective, safe, and easy to give. Here at Garden Ridge Animal Hospital, we carry Credelio since it pairs with Interceptor for larger rebates and makes it the least expensive per dose. The other products are made by different manufacturers, are excellent as well, and I wouldn’t hesitate to use them on my own pets. If your dog is on Trifexis, remember that it kills fleas, heartworms, and many intestinal parasites, but NOT ticks. You can easiy order any of these products on our online pharmacy through VetSource. They are priced comparable to Chewy.

Topical flea and tick medicines like Frontline and Vectra also work but are a little less effective than the oral meds in heavy infestations. Just be very careful NOT to apply a dog product on a cat. It can be fatal. And make sure you have the right weight range on the box if it is an OTC product. When I used topical products years ago, I chose to apply just before bedtime so I wouldn’t be accidentally petting the dog and removing it with my hand.

Not all dogs are at risk for ticks. If Fido never leaves the yard, doesn’t walk around wooded areas, doesn’t go traveling/camping, and you have never found a tick on him, you probably don’t need tick prevention. But always be on the lookout. I have had many pet owners complain over the years that they suddenly got ticks in their yards/fences, and usually blame the neighbor. Ticks don’t hop and jump like fleas, but the do climb up on trees, shrubs, and fences and then “drop” on to pets. And many bugs hitch a ride on wildlife like squirrels, rabbits, possums, and stray cats that come into our yards when we aren’t looking.

Cat certainly can get fleas and ticks, but we just don’t see them on the pet as often because are such awesome groomers. Many times, I think the indoor/outdoor cat is the culprit that brings bugs into the house, where we then find them on the dog (or baby). We are using Revolution Plus on cats for topical flea and tick prevention, and it get some intestinal parasites, ear mites, and prevents heartworms from mosquitos! Bravecto also makes a topical product for cats.

So enjoy the Spring weather outside, but protect your pets.

145 Blog Review of Texas laws on Rabies Vaccination

I have been getting quite a few hits on my blog website about rabies vaccinations, and it’s been a while since I have written about it. Here is an updated review of Texas laws concerning Rabies.

All dogs and cats in Texas must be vaccinated for rabies by 4 months of age by or under the direct supervision of a licensed veterinarian using a vaccine licensed by the USDA. The vaccine must be approved for that species and given after the minimum age requirement and by the right route of administration. There are no exemptions to this requirement, even for medical reasons or by demonstrating measurable rabies antibody titers.

Animals should be boosted according to the recommended interval as established by the manufacturer, unless limited by local ordinances. Most rabies vaccines are boosted at one- or three-year intervals. For a USDA licensed triennial (3 year) vaccine, the typical interval is booster 1 year after initial vaccination, and then every 3 years. For a 1-year vaccine, boosters are given annually. As far as I know, all the local cities and counties recognize the 3-year vaccine interval.

What is the minimum age for dogs and cats to be vaccinated for rabies?This is usually regarded as 12 weeks. The sweet spot is to vaccinate for rabies between 12-16 weeks of age.

What vaccines does Garden Ridge Animal Hospital use? For dogs, I use Defensor 3 by Zoetis, approved for dogs, cats, and ferrets, has a 3-year label, and have use it for over 20 year with no problems. But for cats, I currently use Purevax Feline Rabies by Merial  since it is adjuvant free, but it only has a 1 year label. The non- adjuvant vaccine is recommended to reduce inflammation at injection site and prevent injection site sarcomas. No one wants their cat to get cancer because of a vaccine, but it can rarely happen. For ferrets, the Defensor 3 is approved with annual boosters.

What about very old pets or “inside only” cats? The law is clear that they must be vaccinated and stay vaccinated. Realistically, an inside only cat isn’t going to spontaneously get rabies, but if they bite or scratch a human a series of events will happen that puts your unvaccinated cat in rabies quarantine for 10 days, usually at a shelter. If a vaccinated pet bites a human, the quarantine time can often be served at home. All rabies vaccines are killed, dead, not alive. They seldom make pets even run a fever. The human rabies vaccine that I have been given is so safe I could get boosted even when I was pregnant. (Yes, vets are vaccinated against rabies)

What if my pet was vaccinated over 3 years ago, and overdue a booster? Upon receiving a single dose of vaccine, they will be considered current, and assigned the maximum vaccination interval based on the license of the vaccine.

Why does the state care about rabies vaccination and no other diseases like parvo and distemper? Rabies affects humans, is 99.9% fatal, no cure, and the other diseases don’t. We vaccinate pets to protect humans.

How does the state test for rabies in an affected animal that is euthanized? The head (brain) is sent off to the state laboratory. There is no blood test to confirm rabies for pet, livestock or wildlife.

How can I find out if my pet’s rabies vaccines are up to date? If you pet was vaccinated at Garden Ridge, we have record. You can access your pet’s vaccines history online through our Pet Portal, found on our website. You do have to log in the client number that is on your receipts, and then create a password. Many clients who board their pets elsewhere or use doggie daycare find the online portal convenient and always available.

For more information:
https://www.dshs.texas.gov/idcu/disease/rabies/vaccine/pets/
Actual legal state regulations; https://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac_view=5&ti=25&pt=1&ch=169&sch=A&rl=Y

142 February is National Pet Dental Health Month

Good oral health is more than just a pretty smile.

Poor dental hygiene can put both your pet’s health and your pocket book at risk. “Dog breath” – or a cat with a foul-smelling mouth – can be a sign of untreated dental conditions. If left untreated, you may put your pet at risk for greater problems such as periodontitis or heart disease.

Routine cleanings can help prevent periodontal disease and save money in the long run. A 2014 analysis conducted by Veterinary Pet Insurance Co. showed that the average cost per pet to prevent dental disease is just one-third of the average cost of treating dental disease.

More importantly, a complete oral examination can detect hidden health problems. Even if your pet’s breath smells fine, there still could be dental conditions that are hard to spot without a complete veterinary exam.

Schedule your pet’s dental checkup with us now. We’ll do a thorough checkup to make sure your pet is at optimum health. We also can show you how to brush your pet’s teeth in between exams. Brushing is the single most effective thing you can do to keep your pet’s teeth healthy between dental cleanings.

We’re committed to your pet’s health and wellness, and we know that you are as well. Book your appointment today!

Periodontal disease video-https://www.youtube.com/embed/j6gNkXpRZkE
How to brush your dog’s teeth- https://www.youtube.com/embed/wB3GIAgrTPE

140 How Much Should My Pet Eat?

I get this question almost daily. The answer is “it depends.”

We have a complicated formula to calculate the Resting Energy Requirements (RER) of dogs and cats in kcal/day. It isn’t a straight-line graph, but we have chart. Some points on this chart is the RER for a 10-pound critter is 218 kcals/day, 20# is 366 kcal/day, 30# is 497 kcal/day, 40# is 616 kcals/day, 50# is 729 kcals/day. My chart goes up to 200#.

The number we really want is the Daily Energy requirements (DER). This represents the average daily energy expenditure of animal, depending on life stage and activity (work, gestation, lactation, and growth). To get DER from RER, we multiple RER with a number from 0.8 to 4.0, depending on the species, growth vs maintenance, obese vs weight loss, light work vs heavy work.

For examine, for an average 20# house dog with normal weight, we multiple 366 kcal/day x 1.6=586 kcal, but it is already obese and need to lose weight at 20#, we multiple by 1.0 for just 366 kcal/day. If this was a fat 20# cat needing to lose weight, we multiple by 0.8 for only 293 kcal/day.
So how many cups of food is that? First, we need to know the calorie density of the food. I seldom see it on the bag, but it should be available on the manufacturer website. My young dogs eat a Science Diet adult food for tiny dogs, and the website lists the calorie density at 291 kcal/cup. So, my little guys should eat about 2 cups/day each. I do meal feedings so each should eat about a cup, twice a day. Right now, I feed them together, but if one starts getting chubby, and the other thin, then I will need to feed them separately. I checked the feeding guide on the website, and it suggested 1 .5 cups/day. Usually I find the feeding guides to be “generous” in their portions, but it never hurts to do the math.

Another part of the equation is that not all days have equal activity. If you have a high energy dog, that gets walked every day, that is great. Many have different activities depending on the day of the week and the weather. The weekend walker or dog park goer could have a little more on those high energy days but remember to cut back if we have a run of nasty weather with no playtime. Mine get extra chow on the high energy days after running around the pasture chasing cows or digging for hours after gophers (not sure if they are eating gophers, hard thing to calculate).

The last part of the equation is how any “extra” calories a day they get in treats or food from the table (or stolen from kids). A quick search on Chewey for popular dog treats listed Milk Bones Large original at 125 kcals/treat, Denta Sticks at 76 kcal/treat, and Pup-peroni at 28 kcals/treat. Just like fun sized Snickers bars, they are that many calories, but they can add up over time.

So, the short answer is “it depends.”

137 Pet Insurance Update

It is almost that time of year when we must sign up for next year’s health insurance for ourselves and our family. My brain is hurting from all the options, and I don’t like the price of any of it.

Pets can get insurance too. The process is much simpler, and it can be affordable, especially is you start when they are young. For example, I just looked up the monthly premium for my little terrier mix, Sally, who just turned a year old. On Pet Plan, endorsed by the AAHA, based on her size and age and my zip code, she would cost me $20/month. That’s $240/year. That is much less than 1 emergency visit or sick visits with labwork and xrays.

If I were to have a claim, it is an easy 3 steps. First, I seek treatment at any vet I wish and pay them directly. Next, I submit my receipt on my phone app to the insurance company. Lastly, I get reimbursed, usually about 80% of my bill.

All pet insurance covers illnesses, lab work, surgery, emergencies, specialists (no in-network/out of network), but some have exclusions of hereditary diseases, and many won’t cover old dogs or cats.

With the AAHA Pet Plan insurance,
• sick office exams are covered
• dental /oral procedures are covered
• all ages can be insured
• all conditions even chronic and hereditary diseases
• it can’t be cancelled
• alternative treatments are also covered.

I know that health insurance is expensive, but it just takes one trip to the emergency room, and pet insurance could easily pay for itself. I find owners that have pet insurance aren’t worried about the costs because they have peace of mind that they will be reimbursed. They can focus on getting their fur baby medical help to get better.

https://www.gopetplan.com/partners/aahapetinsurance?c=AAHA

135 Cytopoint- the “new” injection for itching

All dogs itch once a while. Some dogs have seasonal allergies, and have seasonal itching and scratching. These are pretty easy to manage with oral histamines, weekly bathing, and parasite control. A few have severe allergies to pollen, parasites, or even food, and they are miserable. All that scratching and itching traumatizes the skin, it becomes inflamed, and it can get infected. In the “old days” we use steroids like prednisone to stop the itching, but it can have bad side effects. About 8-10 years ago we started using Apoquel (oclacitinib tablet), which is potent like steroids, but is not steroidal, so there is no suppression of immune system. Many of these cases used to be sent to the dermatologist for allergy testing, but Apoquel controls the inflammation quickly and orally.

Now there is an injection for itchy dogs called Cytopoint. CYTOPOINT helps interrupt the itch cycle; allowing dogs to stop scratching so damaged skin can heal. And it works by an entirely different mechanism. Instead of blocking histamine and other pro-inflammatory compounds, Cytopoint neutralizies IL 31, a cytokine that mediates the itch cycle, not the inflammation. It is the first monoclonal antibody (mAB) therapy for chronic canine allergic and atopic dermatitis. I think of it more like a vaccine for itch than inflammation.

Cytopoint won’t magically heal red or infected skin. It doesn’t stop the allergic reaction but breaks the itch cycle, which is monumental for some dogs. Allergic dogs may still need bathing to control exposure, and infected skin will still need therapy, but that darn scratching will go way down. No more constant licking feet or hearing that collar jingle from scratching face or ears ( if it is atopy triggered).

How do we assess itchiness? As vets, we ask the owner to rate the itchiness on a scale of 0-10. Zero is not itchy at all. Ten is the worst imaginable, round the clock, can’t sleep, can’t eat, bleeding skin. My clients often rate the severely affected dogs as 8 /10. Apoquel and Cytopoint should reduce the score to 3-4/10. Apoquel is a tablet given once to twice a day, safe for dogs over 12 months of age. Cytopoint is an injection that lasts 4-8 weeks, so it can be more cost effective for some dogs. And if the Cytopoint isn’t enough by itself, it is safe to also give Apoquel since they work by entirely different mechanisms.

So if your itchy dog isn’t well controlled on Apoquel, or the cost of being on it daily is cost prohibitive, come and let’s see if Cytopoint would be a better choice. At least we have options before sending you to the veterinary dermatologist.

134 What’s New with Diabetes in Pets

The role of diet in treating and possibly preventing diabetes in dogs and cats is undergoing lots of scrutiny lately. The old thinking on treating diabetes was to use insulin, decease simple carbohydrates to prevent blood glucose spikes, and eat high fiber diets to smooth out the whole glucose curve. Higher fiber diets could also help pets lose weight since obesity is often associated with the onset of diabetes, even though they might be sick and skinny at the time of diagnosis.

The latest theories on cats with diabetes is that free feeding high carbohydrate dry food to inactive indoor cats can lead to obesity, higher glucose levels after eating, and higher insulin concentration. These blood levels of glucose and insulin are believed to lead to pancreatic cell failure and ultimately diabetes. We know that weight loss to an optimum weight will help manage the diabetes, and sometimes can lead to remission of diabetes in cats. The weight loss ideally is slow and steady, ~ 1%/week, usually on a high protein/low carb diet to maintain muscle mass.

The latest studies on dogs didn’t show much difference between normal fiber and high fiber diets in regulating glucose levels on diabetic dogs. The most successful study was feeding any diet the dogs would eat consistently before in insulin, with no snacking between meals. Of course, weight loss in obese diabetic dogs is always recommended, but that is another whole can of worms about the “best diet” to lose weight.

On a high tech almost sci-fi note, I have one patient who has the human Libre Freestyle Sensor implanted under the skin of her back and the owner can track her glucose with her cell phone app! It isn’t approved for dogs and has to be replaced every 14 days, but it is a big leap in glucose monitoring technology.


To learn more about diabetes in pets https://www.avma.org/public/PetCare/Pages/Diabetes-in-Pets.aspx


https://catfriendly.com/feline-diseases/diabetes/

http://www.pethealthnetwork.com/dog-health/dog-diseases-conditions-a-z/november-national-pet-diabetes-month

129 Pumpkin, Pumpkin everywhere

You can’t go to any store without seeing Pumpkin Spice flavored everything. It is a seasonal gourd that is usually harvested in the fall, so it is plentiful about now. What does this have to do with dogs and cats? The answer is Fiber.

Cats and dogs don’t need much fiber for normal GI health, but occasionally they can get a gastrointestinal/colitis problem that will benefit from fiber. The usual sources of fiber are OTC weight loss diets, Metamucil, Miralax, bran (like in high fiber breakfast cereal), and canned pumpkin. Diet food is boring, Metamucil has a weird texture, and bran just tastes like sawdust to me. Miralax is a tasteless powder and works even in tiny (1/8 tsp) amounts for our pets. Canned pumpkin (not pie filling) is sweet and most cats and dogs will eat it willingly. Who knew? You never see a dog or cat stealing pumpkins out of the garden.

Not all GI problems need fiber, and some will get much worse with it. A lower GI or colitis case with straining, frequent mucoid stools, or constipation usually will benefit from added soluble fiber like pumpkin. The recommended amount to add to a meal varies, but usually 1 TBP/can of cat food, or 1 TBP /meal for large dog, or 1-2 tsp/meal for smaller dogs. I find most pet owners only have to do this for few days to get a case of stress colitis resolved. If one has to do this for days or weeks, one trick to keep the can from spoiling after opening is to fill an ice cube tray with the puree, freeze, then only pop out a “cube” to add to the food.

Now you CAN buy a pumpkin, scoop the seeds out, cut it up, cook/bake it and then puree it, OR you can just buy a can of cooked pureed pumpkin at the grocery store. If you buy the pie filling, use it for Thanksgiving dinner dessert, not the cat.

for more information-  https://now.tufts.edu/articles/people-giving-pets-pumpkin-it-good-them