Wellness: Health Care
The A-Bee-C’s of Acute Allergic Reactions
I kicked off my Saturday morning shift by treating the cutest puffy-faced puppy; he was experiencing his first acute allergic reaction. Like many dog owners, this puppy’s mom had never witnessed this kind of sudden reaction, and arrived at our ER in a panicked and perplexed state exclaiming, “he was normal just a minute ago!”
Acute allergic reactions are a common emergency, and the culprits are generally bees, wasps and spiders. This typically happens when our curious canines can’t resist a good sniff and inspection of the interesting creature moseying along the ground or floor.
Bites and stings can cause clinical signs that range from mild to life-threatening reactions. Mild reactions are generally limited to a swollen or puffy face, swelling and redness around the eyes, lumps and bumps over the skin, redness of the skin, head shaking and itchiness.
Severe reactions are called anaphylactic reactions, which are nearly immediate and can lead to life-threatening alterations in the body. These symptoms can include vomiting, diarrhea, staggering, pale gums, swelling of the larynx leading to difficulty breathing, and sudden collapse. Most pets that I see for anaphylaxis are reported to have vomited once followed by collapsing, and when I perform my physical exam, I generally observe pale gums and a poor pulse indicating a state of shock.
Veterinary attention is required if your pet is showing any signs of an allergic reaction. While seeking medical care, follow these steps:
What to Do:
“A” is for assist: If your pet was stung, see if the insect and stinger are still attached. If so, try to remove the stinger by scraping it out with a credit card or other stiff material. Alternatively, use tweezers by grasping the stinger, which is located below the venom sac.
When a honeybee stings, its stinger becomes detached from its body and the bee then dies. What’s left in the pet’s body is the stinger and a tiny piece of fleshy looking tissue, which is the venom sac. (Here’s a short video demonstration.) Wasps or bumblebees, on the other hand, can sting over and over again because their stingers do not become detached from their bodies.
“B” is for baking soda: To help neutralize some of the acidic venom, apply a paste mixture of baking soda and water to the sting area.
“C” is for cool compress: Apply a cool compresses to the area to help reduce the swelling and pain, as well as to help with constricting the blood vessels to “slow” the spread of the insect venom.
Have your pet examined immediately by your veterinarian if there are any signs of facial swelling, vomiting, breathing difficulty or collapse. Mild clinical signs can progress to severe clinical signs in a short period of time and early treatment will generally prevent continued progression of the reaction
What NOT to Do:
Can Anaphylaxis be Prevented?
In general, there is no way to predict which animals will have an allergic reaction, whether it will be mild, or whether it will progress to life-threatening anaphylaxis. Some pets have no reaction to a sting one time, and then have a severe reaction the next. The “Bee Gods” are not kind to my own baby girl, and one hones in on her bald little butt at least three or four times a year. Luckily, she has yet to develop a reaction.
For animals who do have an established history of being allergic to insect bites, I often get asked about giving Benadryl, which is part of the treatment protocol in allergic reactions. In the hospital setting, Benadryl is given by injection into the muscle, which works much faster than giving the medication orally. However, owners who are out on hikes and away from veterinary care often raise the concern about needing more immediate treatment. In these cases, you can carry with you, and give if needed, one milligram of Benadryl for every one pound of body weight (for example, a 50-pound dog can get 50 mg of Benadryl). This is not a substitute for veterinary care, but it can be helpful at “buying time” as you make your way to your veterinarian for evaluation.
You can also ask your veterinarian about getting a prescription for an “epi-pen” if your pet has experienced a true anaphylactic reaction in the past. This is a special syringe and needle filled with a single dose of epinephrine, and is similar to the type used for people who are highly allergic. You can carry this with you on trips or hikes and use if your pet experiences another severe reaction.
If you suspect your pet is experiencing a reaction from an insect bite, whether it is mild or severe, please contact your veterinarian or local emergency hospital for guidance and advice.
Dog's Life: Lifestyle
One in three dogs will be affected by cancer
I still remember when I first heard that cancer affects one in three dogs. I was at an agility trial fundraiser for canine cancer research and the organizers asked anyone touched by the disease to raise their hand. Almost everyone had their hand up.
It's a scary statistic that hit home recently. Three of my friends have lost dogs to cancer in the last month. The disease has become so commonplace that last week there was an Internet hoax last week about a canine hero who was diagnosed with Hemangiosarcoma.
So I thought it was a good time to review the National Canine Cancer Foundation's 10 early warning signs of canine cancer:
News: Guest Posts
Why we spent $6,500 this month … and counting
For the month of August, my husband and I have spent $6,500 on veterinary care for two of our four dogs. What I find particularly maddening is how we have done everything possible to ensure our dogs stay healthy, and yet, do we really know if it made a difference? I naively thought that by giving my dogs the best of everything—a raw diet, vitamins, supplements, holistic treats, mentally stimulating toys, daily exercise—they would remain immune to illness or injury.
Shelby had been acting strange for five months. My senior Pit Bull mix spent more time apart from the rest of the pack. Though never much of a food hound, she always came running for meals. This had changed; she’d either come at a walk or not at all. Eventually, she preferred to eat her meals outside instead of her usual spot in the kitchen. When I offered a treat, she’d gingerly pick it up out of my hand, then drop it to the floor before tentatively mouthing it. At nearly 10 years old, we suspected hearing loss and tooth decay, but it was neither. She had cancer.
My seven-year-old Dalmatian, Jolie, should’ve been at her healthiest. Between agility, Rally obedience, and hikes along the river, she was a compact, muscled 38 pounds. But for eight months, she suffered chronic lower back pain. Chiropractic adjustments, acupuncture, massage and laser treatments helped ease the pain, and she returned to normal activity. Two weeks ago, she woke up unable to move her head to the left. When she attempted to lay down, her high-pitched cries brought me to tears. A neurosurgeon solved the mystery: She had a bulging disc that required immediate back surgery.
After months of speculation and worry, we’re relieved to know what exactly is wrong with Shelby and Jolie. But now a new anxiety grows, like a storm cloud. Will they survive their respective journeys to wellness? How do we know that the decisions we make will improve their quality of life? Would we have been better off feeding a premium kibble, skipping the vitamins and supplements, and taking fewer agility or Rally classes so we had more money to feed these insatiable vet bills?
News: Guest Posts
Foster volunteer chronicles her pup’s heartworm treatment
For the past month, I’ve been following a blog about a nine-year-old foster dog named Mila, who is undergoing heartworm treatment. It’s written by Jean, who fosters dogs for Big Hearts Big Dog Rescue in Western New York. Mila is the third heartworm-positive pup to come into Jean’s care.
I’ve never really appreciated the challenges or devastation heartworm, and I’ve never known a dog treated for it. It’s a rare, though not unprecedented, occurrence in my part of the country, where nighttime temperatures aren’t generally hot enough for the heartworm larvae to mature in the mosquito host.
Following Mila’s journey has been an eye-opener—both in terms of the commitment of the caregiver and the challenges of the treatment, in particular, the need to keep the canine patient calm for a month at a time. We’ve asked Jean to check in with us about Mila’s progress.
In the meantime, check out BigDogsBigHeartworm.com to learn more about Mila, the treatment and some myth-busting about heartworm.
► Do you have a heartworm story to tell?
Wellness: Health Care
A vet’s perspective
Skin lumps can be tricky. we stick them with a needle, suck up some cells, smear the sample on a slide and take a peek down a microscope, but sometimes we still can’t make a diagnosis. This leaves us with the option of surgery on a lump of unknown provenance and the dilemma of how wide an excision to make. If the culprit is benign, the surgery need not be radical. But what if the lump is malignant? Should the surgeon be aggressive, just in case? How on earth do we strike the perfect balance?
From time to time, I am presented with precisely this kind of case. Hannah, a Shar-Pei, was seven years old when her owner noticed an innocuous but slightly pigmented and raised skin mass on her left forelimb. The referring veterinarian had performed a local excision and in doing so, achieved his foremost objective: a diagnosis — in this instance, the troubling discovery of melanoma.
“The margins were dirty,” said Hannah’s owner, Barbara. “Do you think you can get what was left behind, given the location?”
On the extremities of the body, particularly the face and limbs, loose skin is at a premium compared to the chest and abdomen. When doing surgery, a veterinarian’s natural tendency is to take less to ensure that the hole left behind will close. On occasion, some owners will question whether the original surgeon was at fault. Barbara was not one of those owners.
“Sure,” I said, pinching an inch around the scar. “It’s always difficult to decide how aggressive you should be when the lump is a mystery. But now that we know it’s a melanoma, Hannah can also reap the rewards of a treatment not even available in human medicine.”
Barbara looked confused.
I was talking about the first fully licensed anti-cancer vaccine to be approved by the USDA: the canine melanoma vaccine, Oncept™.
“You mean Hannah could have been vaccinated against melanoma?”
“Not quite,” I said.
“The vaccine is therapeutic, not preventive.”
I went on to tell Barbara that melanoma cells express large quantities of a protein called tyrosinase. The vaccine incorporates DNA that expresses a gene for the human version of tyrosinase. When the dog’s immune system recognizes this human protein as a foreign substance, it mounts a response. Fortunately, the human version is similar enough to its canine counterpart that the stimulated immune system attacks the melanoma tumor cells.
“Why not vaccinate all dogs?” asked Barbara.
“Malignant melanoma is quite common, affecting about one in every 20 dogs with cancer, but it’s still not common enough to justify widespread vaccination.”
“So when do we get started?”
“We don’t, or at least I don’t — I’m not allowed. For now, only board-certified oncologists can administer the vaccine: four doses, inside of the thigh, every two weeks, and then a booster every six months. I’ll have you meet with one of our oncologists and she’ll give Hannah her first treatment once she recovers from the surgery.” And this was what we did for Hannah after the pathologist confirmed that my surgical margins were clean.
While the vaccine is primarily aimed at oral melanoma, especially where the tumor is locally invasive or has spread to local lymph nodes, many oncologists are keen to reap its benefits for melanomas in other locations. One of the appealing features of the treatment is its lack of side effects. Some dogs may develop a low-grade fever, but that’s about it. The biggest deterrent may be the price; in our hospital, an initial course of vaccinations will set you back around $2,000.
It is important to bear in mind that the vaccine is not a cure. For dogs with early-stage melanoma, like Hannah, survival times greater than three years can be expected. For dogs with more aggressive types, a median survival of one year might be more realistic (but much improved from the previous expectation of only two to three months with other therapies). Oncologists have also seen periods of remission in dogs with visible spread of the cancer to the lungs.
One of the lessons I learned from my experience with Hannah is that the vaccine appears to be more effective the earlier it is given; sometimes the disease will progress while you are waiting for the immune system to kick in. In removing a bleeding but benign skin lump on a 16-year-old Jack Russell named Charlotte, I snipped off a small lip mass in the spirit of “while you’re at it.” As so often happens, the seemingly incidental lip mass turned out to be the more serious concern when the pathology report came back: malignant melanoma.
“Charlotte’s way too old for chemotherapy or radiation therapy,” said her owner, Ann. I didn’t even try to argue, but I did mention the vaccine.
Guess who booked the first available appointment with oncology!
*Bergman, P. J., et al. 2006. Development of a xenogeneic DNA vaccine program for canine malignant melanoma at the Animal Medical Center. Vaccine 24(21): 4582–85.
Wellness: Health Care
What not to do at the vet’s office.
Most dog guardians love their vets and, for the most part, the feeling is mutual. After all, we’re working together for a common goal: good health and happiness for our best friends. Most vets accentuate the positive. Dr. Susan Wagner, a veterinary neurologist and author of “Through a Dog’s Ear,” praises the thoughtful generosity of her human clients. “The good ones will even take out checkbooks and pay for a person in need,” she says. “They more than make up for the bad ones.”
Every now and then, however, people make their vets’ lives more difficult. We asked vets to share some of their “pet” peeves, which are rarely about the pet and mostly about, well, us.
Not surprisingly, no-shows, lateness and general rudeness are high on the list. Dr. Nancy Kay, author of “Speaking for Spot,” explains, “Arriving late for appointments is a biggie, especially for new clients who need to fill out paperwork. Our receptionists always advise arriving a bit early but, invariably, some clients arrive late and then wonder why we can’t fit everything we need to do into the office visit that day.”
“We probably average about one missed appointment a day,” says Dr. Arthur Wolfheiler, an Ohio vet. Sometimes clients walk in without an appointment or even bring along an extra pet. Adding insult to injury, they may also try to wiggle out of paying for the additional exam. Dr. Bruce Coston, author of “Ask the Animals,” has had the same experience. “This trashes our schedule and makes other people wait unnecessarily,” he observes.
A failure to communicate (à la “Cool Hand Luke”) ranks as the biggest peeve inside the exam room. Perhaps from embarrassment, clients may neglect to mention that their dogs are aggressive or particularly nervous in vets’ offices, and some — amazingly — laugh when the dog bites. “Getting bitten or scratched hurts! It’s not funny. That’s why we place muzzles on your fractious pets,” says Dr. Coston.
Dr. Nick Trout, author of “Ever by My Side,” agrees. “No one likes to hear, ‘Oh, I forgot to mention, he tends to bite’ when you are checking to see if you just lost a finger.” The vets suggest that you speak up before the dog bites, and if your dog does bite or scratch, don’t laugh. An apology is in order.
To facilitate communication, remember that you should be doing the talking, not your dog. “Probably one of my biggest peeves,” says Dr. Trout, “is when I’m trying to have a discussion with an owner and their dog refuses to stop barking. The owner seems quite happy to talk over the barking as though only I can hear it.”
All conversation should be directed, of course, to the vet and not to your cell phone. Here’s how Dr. Wolfheiler handles cell-phone rudeness: “When people take a call while I’m examining their dog,” he says, “I start questioning the dog: ‘How’ve you been feeling? Got any complaints?’ I hope the people take the hint.”
Communication problems also arise when a friend or neighbor unfamiliar with the dog’s history brings the pet in for an exam. Dr. Kay lists “Thou shalt be present” as one of her 10 commandments of veterinary visits. “Given the choice,” she writes, “your dog would absolutely, positively want you to be by his side! So do not ask your mother, your brother, your housekeeper, the kid next door or anyone else to pinch-hit for you.”
"And husbands,” Dr. Wolfheiler adds —“98 percent of the time it’s the wife who brings the dog in. The husband often doesn’t have a clue.”
These vexing problems demonstrate the challenge of getting an accurate medical history. Dr. Trout comments, “Obviously, our inability to communicate directly with the patient means we rely on the owner for chronology and detail so we can be methodical and thorough in our examination.” He describes listening in frustration as married couples argue over their dogs’ symptoms and habits.
Finally, we humans sometimes just don’t answer a simple question. “For example,” Dr. Kay explains, “I might ask whether the person has had to fill the water bowl more or less than usual. This should evoke a ‘yes’ or ‘no’ response, followed by an explanation. Instead, I might get a response like, ‘Oh, he’s always loved water,’ or ‘I only give him bottled water.’”
Acquiring information needed to diagnose our dogs’ problems and assess their needs is often the vet’s greatest hurdle. To illustrate, Dr. Wagner relates the following story. A colleague was questioning a client on the phone, trying to discover a cause for his dog’s anemia. Explaining that sometimes a swallowed metal object is the culprit, the vet asked, “Has your dog swallowed anything unusual?” No response. “Maybe a coin?” No dice. Feeling desperate, the vet asked, “Could we take an X-ray?” The guy on the other end suddenly said, “Hold on,” and shouted, “Hey, Ma! When’d he eat the doorknob?”
Dr. Wagner offers this wry piece of advice: if your dog has swallowed a doorknob, you might want to mention it to your vet.
Dog's Life: Lifestyle
New prosthetics give dogs a normal life
Dogs are amazing creatures who are able to live in the moment and adapt to anything that comes their way. I've met dogs missing one or two legs who barely seem to notice that they are different from the other pups. We definitely have a lot to learn from the canine mindset!
Recently a Red Heeler named Naki'o became the first dog to be fitted with a complete set of bionic legs. The prosthetics are built to mimic muscle and bone to allow dogs to run, jump, and swim. The prosthetics were designed and fitted by Martin Kaufmann, founder of Orthopets.
Just after they were born, Naki'o and his siblings were abandoned after their family's home was foreclosed. Weakened by malnourishment and the harsh Nebraskan winter, Naki'o got his paws stuck in freezing water and developed severe frostbite at the tender age of five weeks old.
Soon after, the puppies were rescued, but not before Naki'o lost his paws, leaving all four of his legs with rounded stumps. Amazingly, Naki'o adjusted by crawling around on his belly.
After Naki'o was adopted, his new family organized a fundraiser to pay for two prosthetics on his back legs. Naki'o took to his new legs so well that Orthopets decided to fit his front legs free of charge. It was the first time Orthopets set up an animal with a complete set of bionic legs.
There was an adjustment period, but just a few days later Naki'o was already running around. Now Naki'o routinely beats Christie's other dogs to the ball!
Dog's Life: Lifestyle
Exposure to dogs can be beneficial for developing immune systems
I don’t currently have kids, but one of my fears is that my future children may become allergic to my dogs. Fortunately, a new study found that having pets in the house could potentially lessen the risk of developing allergies.
The study, led by Ganesa Wegienka, MS, PhD, of the Department of Public Health Sciences at Henry Ford Hospital, set out to answer one of the most popular questions parents have—whether pets will increase their baby’s risk of developing allergies.
Researchers followed 565 children from birth through the age of 18. They found that boys who lived with a dog during the first year of their life had about half the risk of developing allergies as compared to those without a dog in the house.
Interestingly the study did not find a connection with girls and dogs, but both sexes had a smaller risk of developing a feline allergy if they lived with a cat. Researchers have determined that the first year is the most important exposure period when it comes to allergies.
What has been your experience with kids and pet allergies?
Dog's Life: Lifestyle
IRS denies request
Tank was diagnosed with cancer. When his guardian, Victor Mills, attempted to withdraw money from his retirement plan to pay for treatment, the request was denied. Withdrawals for certain types of emergencies are allowed, but the American Bulldog’s cancer was not considered a qualified “unforeseeable emergency.”
Mills says he told his plan administrator that it made no sense that he could have used the money to play for a roof, a furnace or a sidewalk but not a living creature.
He is appealing the ruling with the Internal Revenue Service, though it’s already too late for Tank. He passed away at the end of May.
News: Guest Posts
Whistleblower questioned product claims, fired
In response to a 2009 class action lawsuit against Merial, Ltd., over the effectiveness of its popular heartworm preventative, Heartgard Plus, Kari Blaho-Owens, Ph.D., claims her employer asked her to destroy a document pertaining to the lawsuit and to stop analysis of data from an internal investigation that she suspected was inaccurate.
In her own lawsuit against Merial, Blaho-Owens says she was fired in July 2010 when she refused to follow the company directives. She served as the "global head of pharmacovigilance" and in the course of her independent research, says she "discovered that Merial had been aware of serious lack of efficacy adverse events reported regarding 'Heartgard Plus' since as early as 2000." Allegedly, the U.S. FDA's Center for Veterinary Medicine was questioning whether its FDA-approved label that Heartgard Plus was 100 percent effective should be changed, which could put Merial at a competitive disadvantage.
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