Veterinarian Shea Cox has enjoyed an indirect path through her professional life, initially obtaining degrees in fine arts and nursing. She later obtained her veterinary medical degree from Michigan State University in 2001 and has been practicing emergency and critical care medicine solely since that time. In 2006, she joined the ER staff at PETS Referral Center in Berkeley and cannot imagine a more rewarding and fulfilling place to spend her working hours. In her spare time, she loves to paint, wield her green thumb, cook up a storm and sail. Her days are shared with the three loves of her life: her husband Scott and their two Doberman children that curiously occupy opposite ends of the personality spectrum.
Wellness: Health Care
Company explores pain-relief potential for pets
March 7 2012
Last year, a company called Medical Marijuana Delivery Systems, LLC (MMDS) acquired the rights to a patent for a transcutaneous (through the skin) delivery of medical marijuana to humans and animals. Since our pets suffer from many of the same debilitating illnesses that we do, and with many states legalizing the use of medical marijuana, it doesn’t seem like such a stretch to apply this concept of care to our pets. This “pot patch for pups” has been given the trade name Tetracan, and the goal is for public availability by the end of 2012.
At first blush, the thought of canine cannabis sounded a bit over the top to me. However, current research shows this new marijuana patch is a very reliable delivery system. The maker of this product ensures that only the pain relieving effects are transmitted to the patient and that it will not make your pet “high.” (See my earlier blog post about dogs brought into the ER after eating marijuana.)
This transcutaneous patch is being developed to help patients manage pain, nausea and anxiety but without the psychotropic effect of marijuana. Seattle-based MMDS is also working on topical applications for animals in place of the patch; it would be similar to applying the monthly flea and tick treatment with which many pet parents are familiar.
Of course, to buy the patches or ointment, you’d need to be a medical marijuana patient yourself since dogs can’t get authorization from a veterinarian. That is, at least, not yet. The company is pressing for changes in state laws to permit veterinarians to prescribe medical cannabis for pets.
What does the American Veterinary Medical Association think of Tetracan? At this time, the association has not released a position statement on the use of medical marijuana on animals, but it has done extensive studies on the use of fentanyl patches for pain relief. Dispensing fentanyl, a highly controlled substance and potent synthetic narcotic, is well within normal veterinary practice standards.
Fentanyl is 100 times more potent than morphine and needs to be used cautiously in geriatric, very ill or debilitated pets, especially those with underlying respiratory issues. This leads the medical devil’s advocate to ask, “Why not try to integrate a more natural, plant-based approach?” Harnessing the pain relieving effects of marijuana may prove to be a safer alternative for these pets.
While the patch does conjure up visions of pups frolicking in fields of poppies and wanting extra helpings of kibble, I have to say that I can see several potential benefits if it is carefully researched and brought to market. It will be interesting to see how the medical and legal aspects of its use develop. It may prove to be a potential alternative to chronic pain in our pets, especially when some chemical pharmaceutical painkillers can be harmful, sometimes even fatal, in weakened pets.
► What do you think about medical marijuana for pets? If it were deemed safe for dogs, and was recommended by your veterinarian, would you consider using a marijuana patch on your dog?
Wellness: Health Care
Update on toxic treats from China
February 29 2012
[Update, 3/9/12: The FDA has released new product safety information about chicken jerky treats from China. Update, 3/14: The FDA has just released the TOP 3 brands cited in chicken jerky poisoning cases: Waggin’ Train (Nestle Purina); Canyon Creek Ranch (Nestle Purina); Milo’s Kitchen Home-style Dog Treats (Del Monte)]
China has been in the news repeatedly for problems related to the production of chicken jerky treats thought to be responsible for illness and death in our canine companions.
The connection between China and toxic pet food and treats first surfaced in 2006, when melamine-contaminated food additives imported from China triggered a nationwide recall of dog food items from a variety of manufacturers. The illness and deaths of thousands of dogs and cats were linked to the melamine.
In 2010, problems returned with 50 reports of a Fanconi-like syndrome (more on that in a second), thought to be linked to the ingestion of chicken jerky treats from China, with this number increasing to more than 70 reports in 2011.
In November 2011, the Food and Drug Administration (FDA) finally issued an official warning to pet owners that chicken jerky food products imported from China may cause a Fanconi-like syndrome in dogs who routinely consume them or in cases where treats make up a large part of a dog’s diet.
Just last week, the FDA announced it is now analyzing products upon import for both melamine and diethylene glycol (another suspected toxin) because of an increase in pet owner complaints. Ready for the numbers? There have been 467 reports concerning toxicity placed with the FDA since it issued the official public warning in November 2011!
Just what is “Fanconi-like” syndrome?
This uncommon condition affects kidneys, causing them to leak glucose (sugar) and other electrolytes into the urine. Dogs who have this condition will usually be very thirsty and urinate excessive amounts. The most common finding in laboratory tests is that the dog has glucose in the urine, but has a normal blood glucose level. Symptoms of this illness include drinking a lot of water, urinating a lot or more frequently, decreased energy, diminished appetite, diarrhea and vomiting.
The spectrum of illness and recovery is broad. Some dogs go into renal failure and die while others will have only an increase in thirst and urination and go on to recover fully within a few weeks of stopping the chicken jerky treats.
Until more is known, these are the specific recommendations made by the FDA:
My recommendations are a little more straightforward:
What should I do if I suspect my pet has been affected?
Have your veterinarian examine your dog and perform blood and urine tests. These tests will help determine if the Fanconi-like syndrome is present, or if your pet has other possible medical issues such as Cushing’s disease, diabetes or kidney disease.
You should report cases of illness associated with pet foods to the FDA Consumer Complaint Coordinator in your state, or you can go to the following website for further instruction on how to report a pet food complaint: http://www.fda.gov/petfoodcomplaints.
Frustratingly, there has yet to be a specific causal link or contaminant identified. To date, scientists have not been able to determine a definitive cause for the reported illnesses (hence, no recall yet), but they do continue to perform extensive chemical and microbial testing on products.
Politician and pug parent U.S. Senator Sherrod Brown of Ohio has become the latest unofficial champion for pooches all across America. The sympathetic senator took to the Senate floor the first week in February and urged swift action on the part of the FDA to step up their investigation.
Lets hope others follow in his footsteps, and in the meantime, let’s keep spreading the word about keeping imported treats out our pet pantries.
Wellness: Health Care
Common cents caution for pets
February 22 2012
Humans aren’t the only species with money troubles. Did you know that pennies can be hazardous to your dog’s health? One-cent coins used to be made from 100 percent copper, which is nontoxic. In 1982, the government began minting pennies that were made mainly from zinc (much cheaper) and coated them with a thin layer of copper, keeping the look of a penny. When swallowed, the copper coating of the newer penny dissolves in the stomach acids, leaving a wafer of toxic zinc.
A few years back I saw a dog who had been vomiting for two days and his blood work revealed both anemia (low red blood-cell count) and elevated kidney values. There are many causes for this type of presentation, including infectious disease, immune-mediated disease, inflammatory disease and toxins, just to name a few.
His owner had no idea if he’d eaten anything out of the ordinary. X-rays revealed a round metallic object in the stomach. You guessed it, a penny. The penny was removed non-surgically with an endoscope, and the dog recovered during the course of the week with intensive supportive care—a very expensive penny.
The clinical signs and potential problems caused by zinc toxicity include:
If an object possibly made of zinc is seen on a radiograph, it should be removed promptly. Supportive care then becomes crucial and includes fluid therapy to keep circulation to the kidneys adequate, helping to prevent failure. A blood transfusion may be necessary to combat anemia. Anti-nausea medications are indicated, as well as stomach protectants (antacids and “coating” medications), due to the corrosive nature of zinc. Researchers are still actively looking at methods for binding excess zinc in the circulation, similar to the way lead poisoning is treated, but this is not yet available.
Other sources of zinc include hardware, such as nuts and bolts, dietary supplements, and (surprisingly) zinc oxide–based skin creams, such as diaper rash ointment and sunscreen.
Prevention of zinc toxicity:
Many people are unaware of this syndrome and do not realize that pennies are far more dangerous than a “simple” foreign body. This is a recently described disease process and many questions are still unanswered. As always, prevention is best: ”Penny wise, pound foolish” has a whole new meaning.
Wellness: Health Care
Understanding hemorrhagic gastroenteritis
February 15 2012
One of the more common problems I see on an emergency basis is a disease process called hemorrhagic gastroenteritis, also known as HGE. I recently treated Sam, the little Beagle in the photo, for a severe case of this disease.
The history I hear from owners is always the same: “My dog started having diarrhea and then, all of a sudden, it became very watery and bloody.” This can be horrifying to first-time observers and usually prompts a trip to the ER.
Hemorrhagic gastroenteritis is a potentially life-threatening intestinal condition, which manifests as a sudden onset of bloody, watery diarrhea, with vomiting often being part of the syndrome. Sloughing of the lining of the intestines occurs from severe inflammation leading to “chunks” of tissue in the otherwise watery stool. We describe this as “raspberry jam” diarrhea. This process is extremely dehydrating—much more than you would think from the amount of diarrhea observed—and dogs can go from “near normal” to “near death“ in a frighteningly short time. If HGE is not promptly treated, the massive loss of fluid can cause life-threatening shock.
Smaller dogs seem to have a predisposition towards HGE, and it should be noted that the smaller the dog, the more dangerous the condition. Small dogs just don’t have the same bodily reserve as a larger dog; it simply doesn’t take much for them to become severely dehydrated.
Thankfully, there are no long-lasting bodily effects of HGE, however, some dogs that have sensitive GI tracts to begin with can have the syndrome recur in the future.
What causes HGE?
Stress, sudden dietary changes and hyperactivity seem to be predisposing factors, but the actual cause remains unknown. A bacterium called Clostridium is also thought to play a role. In short, the condition is truly another medical mystery, and I can relate to an owner’s confusion and frustration when they ask, “Yeah, but what actually caused it?” I cannot point to an exact cause in more than 80 percent of HGE cases I treat.
How is this condition diagnosed?
There are no specific tests for HGE but a test called a packed cell volume (PCV) is helpful in narrowing down the diagnosis. Using a few drops of blood, the test measures the percentage of blood volume made up by the red blood cells. A normal packed cell volume for a healthy dog is between 37 and 55 percent, meaning that 37 to 55 percent of the blood volume should be red blood cells (the rest of the volume is fluid and white blood cells).
When the patient becomes very dehydrated, there is less fluid in the bloodstream and the percentage of blood fluid drops, and consequently the percentage of red blood cells increases. A dog with HGE will generally have a PCV greater than 60 percent.
The measurement of the PCV also includes a measurement of total protein (sometimes called total solids). In HGE, the total protein measurement from the blood sample is low or normal.
A very high PCV, low total protein and acute onset bloody, watery diarrhea can point to a diagnosis of HGE.
From a medical standpoint, one of the things that makes diarrhea difficult is that no matter what the underlying cause, the clinical picture looks exactly the same. Because of this, we may still recommend that additional tests, such as radiographs, a fecal exam (that includes a parvovirus test) and blood work, be performed to make sure there is not a more serious problem causing the clinical signs.
HGE really becomes a diagnosis of exclusion: When blood work, radiographs and fecal exams are normal, we highly suspect HGE as the cause.
What is the treatment for HGE?
The heart of therapy is very aggressive fluid replacement with intravenous fluids. The goal is to get the packed cell volume back to the normal range and keep (or get) the patient out of shock. Food is withheld for at least 12 to 24 hours and then gradually introduced after the vomiting has resolved. Symptomatic treatment for nausea and belly discomfort is typically included, as is antibiotic therapy. One to three days of hospitalization is commonly required for treatment.
With early and aggressive treatment, life-threatening complications are generally avoided and dogs return happily home. In the case of Sam, he unfortunately required four days of intensive care, including nutritional support through a feeding tube as pictured, but I am happy to report that he made a full recovery and went back home to Mom and Dad!
Wellness: Health Care
Causes and responses to a choking pet
February 8 2012
Having “something stuck in the throat” is a common problem for our pets due to their curious natures and indiscriminate eating habits. Recently, I saw an adorable Bernese Mountain Dog named Clover after she had gotten a little over-exuberant with her tennis ball. She’d actually swallowed it. She presented for difficulties with both swallowing and breathing, and X-rays revealed that her distress was toy-induced.
True choking is actual interference with breathing caused by foreign material in, or compression on, the trachea (windpipe). Choking can occur due to an obstruction of the airway from a foreign object in the throat, severe swelling of the throat or constriction of the neck.
In order for a foreign object to cause choking, it must obstruct the opening to the airway—either directly (i.e., actually in the airway) or indirectly (i.e., compressing on the airway), as in the case of Clover. Clover managed to swallow the tennis ball, but the ball was large enough to cause compression on her trachea, making breathing difficult.
Severe throat swelling can also cause choking and is usually associated with an allergic reaction or response to trauma. The tissues within the throat can swell and block the opening to the airway.
Constricting neck injuries are usually associated with collars and ropes. Dogs whose collars become tangled can choke due to the constriction of the neck from the tightness of the collar. In severe cases, dogs and cats can hang from collars, leashes and ropes.
When I lived in Colorado, my immediate neighbor came home one day to find that her two dogs became “hooked” together by collar and jaw; the larger dog’s mouth slipped under the loose collar of the puppy while playing and they couldn’t get free; the struggle resulted in strangulation of the puppy. This was a devastating experience for everyone. Please take this moment to check your pets’ collars and ensure that they are the proper size.
Common signs of choking:
If you observe any of the above signs, seek veterinary care immediately.
If you live far from veterinary care or do not have immediate transportation, the following measures may buy you some time while you are arranging for medical attention:
If you notice that your pet is choking, remove any item that may be constricting the neck, such as a tight collar. If you can do it safely, examine the inside of the mouth and remove any foreign object you see, but do not attempt to remove an object unless you can see and identify it.
If you cannot easily remove the object, lift and suspend a small animal with the head pointed down. For larger animals, lift the rear legs so the head is tilted down (like a wheelbarrow). This can help dislodge an item stuck in the throat. Another method is to administer a sharp hit with the palm of your hand between the shoulder blades, which can sometimes dislodge an object.
If this does not work, a modified Heimlich maneuver can be attempted. Grasp the animal around the waist so that the rear is nearest to you, similar to a bear hug. Place a fist just behind the ribs. Compress the belly three to five times with quick pushes. Check the mouth to see if the foreign object has been dislodged.
If your pet is unconscious, perform a finger sweep. Open your pet’s mouth and do a finger sweep by placing your finger along the inside of the mouth, sliding it down toward the center of the throat over the base of the tongue, and gently “sweeping” toward the center to remove any foreign material. Warning: There is a structure deep in the throat (the Adam’s apple) that feels like a smooth bone. Do not attempt to pull it out!
Melanie Monteiro, author of The Safe Dog Handbook, demonstrates these techniques.
What else could it be?
More times than not, what people believe to be choking, is actually an attempt to vomit or cough. Many pet owners will seek veterinary care because they believe their pet has something stuck in its throat, however, it is far more likely that your pet has something mild and infectious, such as tracheobronchitis (also known as kennel cough), and he or she is coughing rather than choking.
Choking versus coughing: With choking, the pet has difficulty inhaling; with coughing, the pet can inhale almost normally.
A few tips to help prevent a trip to the ER:
Clover and her experience prompted me to write this blog. I hope it will help prevent, or save, another pet in the future. Clover made a full recovery following the endoscopic removal of the tennis ball that she swallowed and she continues to do well!
Wellness: Health Care
Chasing their tails, eating grass and rolling in garbage—should you worry?
February 1 2012
From humping to “targeted” sniffing, our pups have a plethora of odd habits—at least to those of us who walk on two legs instead of four. While no one knows for certain the exact “why” behind these behaviors, we do have some theories. And until dogs learn to speak human, divulging their best-kept secrets, we’ll just have to continue to make educated guesses about this weird-but-true realm of doggy deeds. The key is recognizing if a behavior signals poor health.
When puppies chase their tails, it’s like babies grabbing their toes—and this is a normal way for them to explore their bodies. But like anything in life, moderation is key, and problems can arise if this behavior becomes compulsive. So, how do you determine if your pooch has a case of Canine Compulsive Disorder? It comes down to whether you can distract them from this behavior. If your dog would rather chase her tail than go for a walk, she may have a compulsive disorder and veterinary assessment may be needed.
It can be common for dogs to drag their bottoms across the ground after doing their business, particularly if their stool is loose. But if this behavior is noted frequently throughout the day, this may be a sign of impacted anal glands, a condition that can have serious complications if left untreated.
Watching your dog get personal with his stuffed toy can make you want to look away, but it’s not abnormal. Many dogs discover that humping feels good, it can relieve stress or serve as an outlet for excessive feelings of exuberance and excitement. Both males and females are known to partake in this behavior, though males do it more often.
People often think that dogs eat grass when their stomachs are upset or they are ill. However, a good ol’ lawn actually serves as a gourmet snack to many dogs. As omnivores, they like to eat their meat and veggies, too. Eating grass in moderation is a normal part of a dog diet, and a walk in the park for my dogs always includes a stop at the grass buffet. That said, if all of a sudden you see your dog frantically binging on grass, this could be the sign of distress, and a call to your veterinarian is in order.
It is general custom for Spot to greet Rover with a sniff of the behind, but why share this custom with us? Bad manners? Well, not according to the canine code of conduct, as this is a perfectly acceptable way of collecting personal information about one another, including humans. So the next time you are surprised by a nosey nudge, just know that you are being greeted and assessed (and don’t worry, dogs generally won’t be offended if you just give them a pat on the head in turn).
[Recently, Bark columnist Julie Hecht, MS, took a light-hearted look at the phenomenon.]
Gross, right!? I’m asked about this all of the time and all I can do is give an empathetic cringe of the nose and a shrug of the shoulders. (I know the score: My dog Mickey used to raid the cat’s litter box, proudly returning with “kitty cigars.”) As stomach-turning as this is, eating excrement is a surprisingly normal behavior for dogs. In the early stages of domestication, dogs performed a hygienic function of cleaning up their own feces. Additionally, their digestive system is very efficient and they can actually get some quality nutrients out of it—although I can think of much better sources.
Rolling in garbage
When we see a decaying animal or a pile of garbage, our first inclination is to step around it … waaaaay around it. But, keeping true to our dog’s oddities, it is their greatest desire to jump right in, getting a good coating of ick with a strategic roll. The more foul the smell, the stronger the lure, and the more joy that is experienced by our now perfumed pups. One theory is that dogs like to cover their own scent with horrible odors to make it easier to surprise prey. You probably can’t curb your dog of this desire, so your best hope is to spot smelly things first and steer your pal in a different direction.
I hope this has shed some light on a few odd dog behaviors. Funny, as I sit here, I find myself looking over to my own dog, Bauer, wondering if he is looking back at me thinking, “Wow, there she goes again, sitting in front of that computer when she could be outside playing with her ball. Now, that’s just weird.”
Wellness: Health Care
Rethinking paper products with Super Bowl approaching
January 31 2012
Just when I think I’ve seen it all...
Paper towels? Causing an obstruction in the intestines? There’s no way! Those were my first thoughts as I started to read about a dog named Sydney, who recently ended up at the Pet Emergency & Specialty Center of Marin. A surgeon there saved the life of the 13-year-old Australian Shepherd/Chow mix with an intestinal resection, during which she remove a wad of paper towels that Sydney had apparently swallowed during a football party. [UPDATE: Here's a link to the original PESCM story.]
I have officially headed into my eleventh year of practicing emergency medicine, and I just when I think I’ve seen it all, I promptly get schooled in the possibility of the seemingly impossible. I frequently receive calls from worried pet parents saying that their dog ate some toilet paper or a paper towel containing irresistible food tidbits. I go on to say in a reassuring manner, “That should pass right on through with no troubles, just keep an eye out for any vomiting or diarrhea.”
Well, I suppose you can still teach this “older” dog a new trick! Although paper towels should pass without difficulty, I have never (until now) taken into account the invention of industrial strength paper towels. You know, the kind that soak up a gallon of liquid and still safely work as a hammock for two. The new breed of towels with “cloth-like durability” has opened up a whole new way for canines with indiscriminate eating habits to get into trouble. These industrial strength paper towels are essentially cloth, which can get stuck in the intestines and cause an obstruction, because they don’t “break down” in water (or stomach fluids) like weaker paper products.
I can now say one thing with certainty: the quicker picker-upper can turn into the quicker problem-maker, so please take extra precautions with these commercial-strength products should you use them in your home. And while we can’t prevent messes from happening, we can choose how we clean them up, so may I suggest using recycled paper products, such as Seventh Generation. Made from recycled paper, these towels are not only better for the environment, but they will break down into passable pieces should our furry pals sneak a piece while we are not looking!
Wellness: Health Care
There’s more to it than meets the nose!
January 25 2012
As much as we might hate to admit it, flatulence is a normal biological function. A surprising amount of air is swallowed just with the simple act of eating, and if this is not burped out, it must exit through the other end. The amount of air swallowed tends to be increased when dogs feel they must eat quickly or in brachycephalic breeds (dogs with a compressed upper jaw and a short muzzle) that tend to breathe more by mouth than by nose.
Flatulence comes from an excess of gases in the intestinal tract. These gases may represent air that has been swallowed, gas produced in the biochemical process of digestion, gas diffusion from the bloodstream or gases produced by the bacteria that populate the intestinal tract. Contrary to popular belief, more than 99 percent of the gases that pass from the intestinal tract are odorless (whew!).
Dietary fiber in pet food is not easily digested by the pet’s own enzyme systems, but it is, however, readily digested by the gas-producing bacteria that live in the colon. As fiber is broken down here, hydrogen sulfide is produced, which is the cause of the really stinky gases. Therefore, a diet that is heavy in fiber further promotes a “happy environment” as well as “food” for the bacteria, ultimately producing more gas.
Helping clear the air
Offering your pet a highly digestible, low-residue diet is one of the major ways to combat flatulence. A low-residue diet is designed to reduce the frequency and volume of stools, while prolonging transit time through the intestine. It is similar to a low-fiber diet, but includes restrictions on foods that increase bowel activity. Changing to a low-residue diet means that most of the nutrients of the food are digested and absorbed by the pet before they reach the colon, where the gas-forming bacteria live. Less food for the bacteria equals less bacteria, which equals less gas formed.
Sometimes just going through a case and/or bag of such a low-residue diet solves the problem and the pet can return to a regular food afterwards. If necessary, the therapeutic diet can become the pet’s regular food. Low-residue diets are available through your veterinarian, pet supply stores or can be cooked at home (boiled white rice, skinned chicken, cottage cheese and balanced with vitamins and minerals constitute low-residue ingredients).
Other easy changes that can help include:
Are there some medical conditions that can increase flatulence?
Changing the diet and ruling out actual intestinal disease are of primary importance in addressing flatulence. Some disease processes that can cause an increase in flatulence include:
Medications and herbal and botanical supplements
Sometimes medication can help. Although there are many products available, most are unfortunately not as helpful as they are touted to be, or not labeled for animal use. There are more than 30 herbal and botanical preparations available to reduce gas in the stomach and intestines; however, the dosage, safety and efficacy are unknown.
If further therapy is needed, the following products have some basis and support that they may be of help for flatulence:
Some popular, but more questionable, products with regards to treating excessive flatulence include:
While flatulence is a normal part of everyday life, if the problem persists or seems severe, it is recommended that you consult with your veterinarian. Even our pets sometimes need a smog check!
Wellness: Health Care
Lay the groundwork for quick, low-stress treatment
January 18 2012
Working in the ER, I see a full range of preventable predicaments that complicate addressing a pet’s immediate health crisis. I’d like to highlight four simple measures you can take as a pet parent to prevent distress and concern should an emergency arise while you are away or if you need to seek care outside of your normal veterinary relationship.
Records!! Keep a copy of every medical record, radiograph and diagnostic test in a file. It allows a new veterinarian to quickly understand your pet’s health status. This is especially important if your pet has a history of illness such as kidney failure, cancer or multiple/ongoing disease processes.
Your pet file should also include a copy of vaccination records. I often get last-minute calls to fill out a health certificate for airline travel, but am unable to do so because owners do not have proof of their pet’s rabies vaccination. As is the case with most emergency hospitals, I am unable to administer another vaccine because we don’t keep any in stock (this is an area of health care that is left to general practitioners).
Advanced directive: I strongly recommend that every pet owner have in place an advanced directive with regards to their pet’s continued care in the event of physical decline in their absence. [Here’s a copy of an advanced directive form we provide that you can download and print.] This is especially important if you share your life with a geriatric pet or one who has ongoing medical issues or failing health. Discuss with your pet sitter, family members and your veterinarian your wishes and have a clear understanding of treatment limits in the event you cannot be reached.
I cannot tell you how many times I have seen family members or caretakers struggling to make the difficult decision of euthanasia in the event a pet is suffering and the owners are out of contact.
Pre-arrangement for payment in case of an emergency: Along the same lines as an advanced directive, pre-authorization for treatment is strongly recommended. It is not uncommon for owners to leave their pets in the care of a boarding facility, an in-home pet sitter or a family member during vacation, and then something goes wrong. It is heart-wrenching to navigate a situation where the temporary guardian brings in a pet and has no means of payment or way of contacting the owner to obtain approval for a treatment plan. We try to work as best as we can with these situations, but you can only imagine how heavy these decisions can be for everyone involved.
A common example is a pet who has been hit by a car. Although severe trauma can have an excellent outcome with treatment, the cost of stabilization and management can quickly reach thousands of dollars. Financial responsibility and decision to pay for this level of treatment is a big burden to place upon your sitter. I would give anything for this to be a world without financial concerns, but the hard reality is that emergency hospitals generally will not extend credit on good faith, especially if you have no previous relationship with them.
So before leaving town, stop by your local emergency clinic and your regular veterinarian to sign a release of payment in case of emergency. Your credit card number can be kept on file with your signature authorizing treatment in event of an emergency; you can also set the parameters of care at that time.
Plan ahead and anticipate medication shortages: I get many calls from owners asking to refill a pet’s medication because they are leaving town the next day and their regular vet is closed. What many people are not aware of is that legally we are not able to provide this service unless we perform a full physical examination on the pet, and with that, comes the cost of an emergency exam fee.
Although it can be understandably frustrating to have to pay an exam fee for an otherwise healthy pet for a “simple refill” of a medication, legally, hospitals cannot serve the role of a dispensing pharmacy. By law (and risk of our veterinary license) we cannot OK a refill of a medication without examining your pet, no matter how benign or common the drug. Because of this, I recommend keeping an extra bottle on hand, or getting in the habit of refilling your pet’s prescriptions when the bottle is approaching three-quarters empty.
Another tip: If you fill your medication at a human pharmacy, and it is a drug and dose that stays constant for a well-controlled disease state (such as medicated drops for eye disease or phenobarbital for seizures), ask your veterinarian to write an additional refill on the written prescription.
I hope these four simple proactive steps help raise awareness of potential situations that can arise while you are away, and help you to formulate a plan well in advance should any situation unexpectedly arise.
Wellness: Health Care
Good basic tool for tracking calories
January 4 2012
Got a portly Pug, a meal-loving mutt, or perhaps a chubby Chihuahua? How about a Labrador who loves lounging a little too much or a rambunctious Rat Terrier always raring to go? How do you figure out how many calories they need?
The new Doggie Dietitian app by Dr. Sheri Cone is designed to take some of the guesswork out of calorie-counting with a program calibrated to your dog’s breed, weight and activity level.
I feel this could be an especially useful app for people who have growing puppies. You can easily reenter their rapidly changing body weight and adjust their food amounts to meet their nutritional needs as they grow.
I found it was not easy to go back and add a treat to the list of the day’s food intake, which can be somewhat of a nuisance if your dog’s food intake changes each day. For example, if you feed 2 cups of kibble and 1 broccoli stem, but later add a slice of deli turkey and want to figure where you are calorie-wise for the day, you have to go back and reenter the amount of kibble, the broccoli and then add turkey. This would not be an issue if your dog’s daily food and treats remained steady each day.
If you find you are over- or under-feeding your pet, the app only gives you the option of adding or taking away a portion of dry food. I prefer to give additional “people foods,” so this fell short for my needs.
The app has a very limited list of people foods and I would beg for a more extended reference.
Finally, I feel this app would not be quite as useful for people who fully prepare home-cooked diets and treats from scratch. However, the app would give even home-cooks a target calorie range that they should be feeding.
One size doesn’t fit all
The Doggie Dietician offers a database of hundreds of dog breeds with their ideal weight. While this is good information, take the “ideal” weight loosely because every dog is different. For example, the ideal weight for a Doberman came out as 88 pounds. My boy, Bauer, is slim and trim at 97 pounds, while my girl, Dharma, begins to verge on voluptuous if she is over 72 pounds.
Putting it to the test
I gave this app a go using my two Dobies as, well, guinea pigs. I “plugged and chugged” the app’s recommendations of breed, sex, weight and activity level and compared it to the actual calories I feed my dogs on a daily basis. Here’s what I found as I worked through the process:
The formulation I use to calculate my dogs’ daily caloric needs can be found in my previous blog (Weight Management Made Simple). This is a formula for “obesity-prone” dogs and is therefore a little more calorie-conservative than the app’s formulation.
For example: Bauer’s calorie requirements using my formula equates to needing 1,370 calories per day, while the Doggie Dietician recommends I should feed him 1,885 calories per day. Although the app accurately calculates a pet’s daily requirement needs, I can say from experience that if I fed the caloric amount recommended by the app, that he would begin to pack on a few pounds.
However, I don’t think that this should deter its use; I only mention this to highlight the point that it may take some adjustment to find your dog’s daily caloric “sweet spot.” I feel the app is a good starting point that will allow you to get a big picture and then you can fine-tune from that point based on your pets’ weight gains or losses.
I get asked all the time, “How much should I be feeding my dog?” This app allows me to quickly and easily calculate the cups of food an owner should roughly be feeding his or her pet right while I’m in the exam room.
Although it’s a more basic app, I feel that it is one worth fetching, and for just under two bucks, I give it two paws up.
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