Wellness: Healthy Living
Tuning in to your senior’s needs.
There’s something disconcerting about being middle-aged and watching my once-agile dog leap ahead of me into old age. No, not leap—she’s too creaky for that, stiff and slow almost overnight, it seems. She’s suddenly terrified of the kinds of storms she once danced through; she spurns a morning walk to go back to bed, circling awkwardly in an effort to get comfortable. Once down, she’ll lie there for hours on end, chin over the edge like Snoopy at his most dejected.
She’s depressed about getting old, I decide—never dreaming that it’s I who haven’t made the necessary accommodations.
“A lot of old dogs get what I call the ‘shrinking world’ syndrome,” says certified veterinary behaviorist Dr. Lore Haug. “Their owners get in a rut with them; they start walking the dog less” (gulp) “and they don’t train the dog or teach him tricks. The dog doesn’t get as much stimulation and enrichment—maybe they stop taking the dog to the dog park—and there’s a significant decline in mental and physical challenges.” Stung, I mention Sophie’s arthritis. “So maybe she can swim. Or the walks are shorter. Or maybe you just take her into a wooded park, lie down on a blanket and let her look around and sniff.”
It’s the slowing we have trouble with; we expect our dogs to be the same forever. Instead, their senses of sight and smell grow less acute, their joints stiffen, or their legs may splay like Bambi’s on slick hardwood floors. Some develop a canine equivalent of Alzheimer’s: “It’s called cognitive dysfunction syndrome,” Haug explains, “and it shows up with dementia, changes in their sleep-wake cycles—they might pace all night and sleep all day—vocalizing at night, forgetting their training. You say ‘Sit’ and they stare at you blankly.”
Other dogs develop anxiety disorders for the first time, anything from separation anxiety to storm phobias or nocturnal panic attacks. “The dog may be less social, not coming to greet you, or might get clingier with increased anxiety,” Haug says. “Sometimes they’re just disoriented; they go to the back door but poke their nose at the hinge side. Sometimes we see aggression and irritability. But because anxiety is one of the symptoms, the more you keep the dog stretched mentally, the more you are able to control some of those reactions.”
The wonderful paradox is that by working within your dog’s new limits, you can lessen the change in her responses. Choose games she can still play readily, amusements that don’t stress her, and she’ll be as eager as ever.
“Find new ways to connect with your dog,” Haug urges. “Teaching a trick is not only good for the dog’s brain, but it’s a fun, low-pressure way to do something that doesn’t require a lot of physical strength. The trick doesn’t need to be a backflip. They can bow, cover their eyes with their paws, flick their ears…” Grooming is another way to connect; so is hanging out on the porch or at the park.
It’s not just the dog who needs to learn new tricks—we do too.
Easing Their Way
“Older dogs need softer toys,” notes Catherine Frost, brand and product champion for Planet Dog. Her whitemuzzled black Lab, Ollie, is the model for Planet Dog’s line of Old Soul toys, which are made from a compound that’s gentle on dogs with older jaws, sensitive teeth, reduced “snout strength”and weakened muscles and joints. Similarly, Senior Kongs are constructed with softer rubber.
“Their olfactory sense has probably diminished, so stronger scents are good,” Frost adds, “and high-contrast colors are important so they can see the toy clearly. But the notion that they don’t want to play anymore? That’s not true at all! To be able to lie down and just chew helps them relax and keeps them from being bored. You can’t ever assume that your dog doesn’t want to play.”
Even for dogs at their healthiest, transportation can be tough, and older dogs often don’t hop into a back seat the way they used to. Haug suggests creating a surface that “provides stable footing but is not so firm that when the dog lies down, he’s uncomfortable.” For big cars and vans, there are ramps and steps; take breed and body shape into account when making your selection, however. If you have a Dachshund, you don’t want the short, steep steps, which are popular because they take up less space. Make sure the steps’ treads are deep enough for sure footing and wide enough to forgive a misstep.
It’s also a kindness to soften distractions such as sudden loud noises, and to avoid abrupt changes in routine. Older dogs can be more easily startled; as they’re less able to maneuver or defend themselves, they feel more fragile and grow more fearful, reluctant to play with new dogs or children, distressed by chaos and commotion. (Dr. Debra Horowitz, a veterinary behaviorist, notes that dogs’ neurotransmitter functions change with age—oxygen levels go down and brain chemistry is altered.)
Sometimes, the startle or anxiety is just because the dog can’t see or hear as well as he once did. Cataracts can start to form as early as age seven, for example. But overall, sensory declines are rarely as traumatic for dogs as they are for us egoridden humans; often the changes are so gradual that the dog adapts, and you might not even realize he’s blind or deaf, especially if you have other dogs and he’s following their lead. Susan McCullough, author of Senior Dogs for Dummies, says, “If you sense your dog’s hearing is going bad and he or she doesn’t already know hand signals, teach them now. If your dog is blind, now is not the time to change the furniture. Dogs are amazing, though, in their ability to compensate. I had a dog who still responded to vibrations, so I’d clap my hands and she’d come to me. Creativity goes a long way.”
Food for senior dogs isn’t as complicated as the marketers make it, according to Dr. Donna Raditic, a vet certified in alternative therapies and currently a post-grad resident in nutrition at the University of Tennessee. “Older dogs can eat the adult diets. The development of geriatric diets is a bit of marketing, plus some old beliefs that lowering protein levels spares the kidneys. Actually, we now know that older dogs and humans need more protein. The main concern for geriatrics is to watch calories, because they tend to be less active, especially in winter.”
Older dogs should be monitored for dental problems, like bleeding gums or tooth loss. Even bad breath can signal something as simple as tartar buildup or as serious as oral cancer, kidney disease or diabetes mellitus. And when dogs do fall ill, nausea can decrease their appetite. “Often owners think their dogs are being picky—they are not—they don’t feel well!” Raditic exclaims. “It can be very difficult to keep weight and condition on an old dog with a disease that affects the gastrointestinal tract.”
Glucosamine and chondroitin are thought to be beneficial for arthritis, and anti-inflammatory pain meds can help, too. How do you know when your dog’s in pain? According to Haug, the signs are pretty obvious. Look for “restlessness, crankiness, irritability when handled, difficulty getting up or lying down, looking stiff, being unstable, moving very slowly. Sometimes, if they move suddenly, their joints scrape together.” She sighs. “The thing that’s underappreciated, even sometimes by veterinarians, is how much these dogs can benefit from pain medication. Some are restless at night, only because they can’t get comfortable.”
Check Your Assumptions
Ted Kerasote, author of the acclaimed memoir Merle’s Door, is a superb athlete; when his dog Merle couldn’t do the ski runs anymore, it broke Kerasote’s heart. Then it made him examine his own impulses. “The first thing to be clear about is whom you’re indulging. Very often, because we want to run or mountain bike, we delude ourselves into thinking, ‘The dog loves this,’ and we push the dog far beyond where he needs to go. The problem is, dogs age much more quickly than we do. Say you get a dog when you’re 30, you’re now 38 and in fine shape, and the dog is possibly geriatric.”
Kerasote is currently working on a new book, titled Why Dogs Die Young and What We Can Do about It. “Most of the people I’ve spoken with who have really long-lived dogs change their dog’s food periodically, seasonally,” he remarks,“just the way a wild wolf would have different food seasonally, and the way we would.”
The biggest factor of all, though, is real engagement. “We are very self-serving: Many of us live busy urban lives, so we buy a whole passel of toys and leave the dog alone all day,” Kerasote says. “The older the dog gets, and the more he’s been left at home, the more he spirals into this kind of depression. People may need to think about budgeting for a dog walker. Or your dog might even be happier driving to work with you, enjoying the ride, sleeping in the car, going for a few short walks and driving home with you. We tend to think, ‘Oh, that’s just an old dog, he loves just lying around.’ Well, have you given the dog a choice?
“You need to find ways to perk up your dog,” he continues. “I’ve never seen a dog who preferred playing with a toy to two or three friendly peers.” Of course, as the dog gets older, the key is finding other dogs who won’t be rough or over-exuberant. But the results are worth the search.
McCullough has one final reminder: Don’t write everything off to aging. A single imperious diva bark to summon you might not be a sign of reduced mobility or altered brain chemistry; it might just be a single imperious diva bark because it’s fun to summon you. Refusal to eat or mobility issues could be signs of other problems, not age-related at all.
There’s one thing age can’t affect, she emphasizes, and that’s the bond you’ve already forged with your dog. “With a puppy, you’re still building that bond,” McCullough points out. “With an older dog, the history’s been created; all you have to do is celebrate it. Revel in it. And when you’re uncertain what to do, let love be your guide.”
More Recipes from "Dog Cookies"
Every dog deserves the occasional cookie, but some treats can trigger allergies or tummy trouble. Dog Cookies comes to the rescue with 30 easy-to-follow recipes for healthy, allergen-free treats—including vegetarian and gluten-free treats—so you can find the perfect cookie no matter your dog’s diet.
For the gluten-free Amaranth Waffles recipe, see the Summer 2011 issue of The Bark.
Baking time: 30 minutes in a pre-heated oven
Any type of fish can be used for this recipe, so use whichever your dog likes best.
Caution: Ensure all of the bones are removed from the fish.
Regardless of which fish you use, these biscuits should not be stored for too long. Salmon, for example is quite high in fat, so there is a risk it may go rancid. Store the biscuits in an airtight container, and do not keep them for any longer than two weeks.
Baking time: 30 minutes in a pre-heated oven
Wellness: Healthy Living
Pounds Off Pups
How many times has your veterinarian commented on your dog’s weight? How many times have you been told, “Here’s a bag of prescription diet food—if you feed your dog this and only this, he will lose weight.” But what if he doesn’t? And why should you care?
Clinical research has shown that losing just 10 percent of body weight will slow or prevent many life-threatening disease processes, including debilitating osteoarthritis and diabetes, and perhaps even some types of cancers. By taking a few simple measures, you may be able to add more quality time to your dog’s life, time the two of you can enjoy together.
Feed higher protein/lower carbohydrate foods (a 3:1 ratio); proteins and fats are converted to usable energy faster than starches and carbs. Think of this as the “puppy Paleo diet”! And even if you’re feeding a high-protein, grain-free variety, cut down on kibble. In general, all kibble has 60 percent more starch than canned food because starch is needed to maintain the kibble’s shape when it’s baked or extruded. Too much dry food equals too much starch, which breaks down to sugars and is stored as body fat. It’s easy to overfeed dry foods, especially if you follow the directions on the packaging.
Add water or broth to kibble to make it nicely soupy. The extra liquid will help your dog digest his food more easily and reduce his body’s need to pull water from his system to his stomach, which can contribute to dehydration.
Try gradually reducing your dog’s kibble ration by half, replacing it with more moisture-based foods such as lean meats, fish or eggs, and low-starch green and orange vegetables and fruits. I’ve found that companion animals do best with at least 50 percent of their diet fed as fresh foods—cooked, raw, dehydrated or freeze-dried—mixed with a significantly reduced volume of highgrade kibble. This keeps them satisfied and helps with the faster metabolic change that promotes weight loss. Another option is to feed him a low-carbohydrate canned food; these have less starch and more water, and therefore, fewer extra calories to stick around. Or, transition him to a complete and balanced commercial raw diet, which has very little starch.
Decreased fat content also helps with weight loss, but do not eliminate fats entirely, as they satisfy hunger; look for 4 to 7 percent fat content in canned foods. Also, avoid feeding excess insoluble fiber; among other things, it may interfere with nutrient absorption. Roughly 5 to 6 percent fiber is ideal. If stools become soft, add 1/4 teaspoon of psyllium to each meal. Make mealtime more fun with interactive feeding toys. These not only stimulate a dog’s mind, they make him work for his supper (or breakfast, or snack). Dogs eat more slowly and expend more calories. Google “how to stuff a dog-feeding toy” for helpful tips. The Kong is the granddaddy of dog-feeding toys, and there are other excellent options on the market as well, among them Nina Ottosson’s ingenious products.
Walk It Out
As your dog becomes stronger, try walking in water at the beach, up streams and against gentle currents. (The caveat here is to be aware of water temperature; very cold water can lead to achy joints.) Or, walk on sand, on grassy slopes, and up and down gentle inclines. Finally, when he’s ready for it, take him on longer hikes or try a doggie treadmill.
Keep your dog on his feet and improve his balance with some fun exercises. To work his gluteals and hamstrings, have him take several steps backward. Stepping sideways tunes up his adductor and abductor muscles. Navigating cavaletti (small hurdles set at uneven heights); threading through poles or cones; or walking on cushions, an air mattress or a thick foam pad will help him with balance and proprioception (knowing where his feet are). Sit-to-stand and lie-to-stand exercises strengthen hip and knee muscles.
Weight-shifting is another way to help your dog’s balance. Hold one of his legs off the ground for three to six seconds at a time, or have him stand with his front feet on a stair step to eat. To loosen his neck, shoulder muscles and upper spine, lure him into stretching his head back toward his body with a carrot or small lean meat treat.
So, here’s the proverbial bottom line: One—paraphrasing Michael Pollan—feed your dog real food, feed him less of it, and include a variety of protein sources and dog-safe fruits and vegetables. Two, strengthen and improve his muscle tone, balance and stamina with condition-appropriate activities. He’ll have a sleeker physique and you’ll thank yourself for making the effort.
Wellness: Healthy Living
… and how to avoid them
In my line of work as a veterinary surgeon, I don’t need a weatherman to tell me that summer has officially arrived. One glance at our list of ER admissions is all it takes. Outdoor parties and barbecues are perfect opportunities for flirty, furry, four-legged socialites to work the crowd and make new friends. The downside is that dogs’ curiosity, their heightened sense of smell and their gift for the art of scavenging can spell trouble. Use the following list of usual suspects to prepare, educate your guests or consider a change in menu plans.
Yards: With friends coming and going, there’s always a risk your dog may become disoriented or run off through an open gate. Make sure the perimeter is secure (and everyone knows to keep it that way), or have your dog stay indoors in a quiet, familiar room. And despite your desire to show off your canine Michael Phelps, if it’s a pool party, your dog should stay out of the water, as a crowd of swimmers can create panic and distress.
Bones: It doesn’t matter whether they’re from chicken wings or pork ribs, cooked meat bones cause all sorts of problems, especially if they get lodged in the mouth, throat or esophagus. Terriers in particular have been proven to be at higher risk (which is probably more behavioral than anatomical, but still true). Make sure your guests have somewhere to dispose of their carnivorous waste rather than using your dog as a trash can.
Skewers: Tasty morsels pierced by a sharp wooden skewer may be a convenient and eye-catching way to serve grilled meat or veggies, but the inedible (though deliciously aromatic) stick can prove irresistible to an inquisitive canine, and is guaranteed to wreak havoc on an unsuspecting intestinal tract. More trash bags, please!
Corn Cobs: There’s something about the size and diameter of a corn cob that makes for a snug fit in the canine small intestine, frequently resulting in an obstruction and an expensive trip to the operating room. Be vigilant about picking up leftovers and repositioning plates perched on table edges at the level of a curious snout.
Chocolate: A compound called theobromine found in chocolate can be potentially toxic to dogs, stimulating the heart and nervous system, sometimes with fatal consequences; an overdose is more likely in small breeds. If you know your dog has ingested chocolate, call your vet immediately. If your dog appears excited, or is restless, panting or vomiting, get to your nearest veterinary hospital. If ingestion occurred within two hours and you are seeing none of these signs, vomiting can be induced; administer 3 percent hydrogen peroxide, 1 teaspoon for every 10 pounds [4.5kg] of body weight, by mouth.
Fruit and Nuts: Grapes and raisins (dried grapes) can be extremely toxic to some dogs. In one report, four to five grapes were toxic in an 18-pound dog. If you suspect ingestion, call your veterinarian immediately. Apple cores can become lodged in the canine esophagus; peach pits have a knack for blocking the intestines; and macadamia nuts (plain or in cookies) can cause weakness, clumsiness, vomiting, muscle pain and joint swelling. Fortunately, most cases of macadamia toxicity can be managed with supportive care at home.
Not So Fun Stuff: The combination of a really hot barbecue grill and the desire to get to what’s on offer can overwhelm all canine self-control. Keep your dog away from the grill and nearby raw meats and seasonings. Collect trash frequently and secure it in closed containers. Come nighttime, glow sticks are fun … unless your dog chews through to the toxic contents inside. Candles (a safe distance from happy tails) are a better option.
Fireworks: Call me a party-pooper, but if you want to set off fireworks, don’t invite the dog.
Wellness: Healthy Living
Simple preventive steps can go a long way toward offsetting their threats
A few months ago, the icy breath of the north that normally tucks itself over the Arctic during the winter blasted into the Northeast, prime tick country. This prompted climate scientists to look for links between a weakened polar vortex and a warming world. But those who study arachnids were interested in other signs … like fewer ticks.
In January, Thomas Mather, PhD, an entomologist known to many as the “tick guy,” trudged through thick snow in Kingston, R.I., looking for the spot where he’d buried vials of deer ticks the day before. The overnight temperature had fallen to a tick-numbing three degrees. Locating the vials, he sprinkled the tiny black specks on his palm. They sat there like pepper. Then they began to move.
For ticks, it seems, the ice age was a snowbird’s vacation. So don’t drop your guard, warns Mather, director of the University of Rhode Island’s Center for Vector-Borne Disease and its outreach arm, the TickEncounter Resource Center (TERC). Mather has spent two decades studying the rise of the blacklegged tick—commonly called the deer tick—in Rhode Island.
“I’m pretty certain that we won’t really be able to credit winter’s serial polar vortices for whatever the ticks are or are not doing in the spring,” he says. It’s not about the weather, but cycles. In their two-year lifespan, ticks feed on the blood of hosts during three growth stages: larval, nymphal and adult. According to Mather, the deer tick problems we’re facing in 2014 were largely decided last August and September by the number of larval ticks that found infected rodent hosts. “That will determine both the summer nymph populations and fall’s adult tick abundance,” Mather says.
In recent years, those cycles have produced record numbers of nymphs at the sites his team sample each summer. So many, in fact, that he considers it a public health crisis in his state, which is part of the East Coast “tick-belt.”
Mather says that human and pet encounters with ticks are skyrocketing, and while ticks don’t always carry a disease, they may, and many of those diseases are dangerous.
Between 2006 and 2010, Veterinary Week reported a 30 percent increase in the rate of dogs exposed to tick-transmitted diseases. Among them: The aggressive lone star tick can transmit ehrlichiosis, one of the most common and dangerous tick-borne diseases in dogs. The brown dog tick and American dog tick also spread ehrlichiosis, babesiosis and Rocky Mountain spotted fever (RMSF).
Then there’s the deer tick. Although there are hundreds of species of ticks—all of which are relatives of spiders and mites, in the U.S. —the deer tick is number one on the most unwanted list. It spreads several dangerous infections, Mather says, and topping that list is Lyme disease.
Trail of Infection
The deer tick in the East and the related western blacklegged tick are the only known transmitters of Lyme disease in the United States. The trail of infection typically begins with rodents or, in the West, lizards, natural reservoirs of the Lyme bacterium, Borrelia burgdorferi. Ticks need a blood meal to reproduce, and acquire the bacterium when they bite an infected host. The next time they bite, they inject the bacterium into their unlucky meal source.
Where Lyme is found, so are deer, but the “deer tick,” as it’s commonly called, is actually the blacklegged tick, and it feeds on many different mammals, birds and reptiles. This tick has been on a tear in the Northeast, its range expanding, its pathogens mutating, ever since the disease it spreads—long known in Europe—was recognized in 1975 in Lyme, Conn.
Lyme disease was first diagnosed in a dog about 25 years ago, and now it’s one of the most common tick-borne diseases in dogs in the U.S., notes Cornell University’s Baker Institute for Animal Health. In several of the most affected states, one out of 15 dogs tested positive for Lyme disease in 2011, according to a study by the Centers for Disease Control and Prevention (CDC). And where dogs test positive, so do humans. In 2012, 95 percent of human cases were reported from 13 states concentrated in the Northeast and upper Midwest.
In parts of the Northeast, up to half of the deer ticks are infected with Lyme disease. In California, where Lyme also exists, the infection rate is far lower, with the disease mainly occurring in four northwestern counties.
A dog’s risk in such areas goes up and down. As noted on the Baker Institute’s website, even within highly infected regions, there are “hotspots of tick infestation and Lyme disease risk,” which “mingle with non-infested areas with much lower risk.” Even so, far fewer infected dogs than people develop the disease. Studies suggest that more than 75 percent of dogs in hyperendemic areas may be exposed to infected ticks, yet only about 5 percent develop Lyme. However, Lyme is only one of the diseases deer ticks spread to dogs; among the others are ehrlichiosis, babesiosis and anaplasmosis (“dog tick fever”).
There’s also a growing list of new diseases involving deer ticks, including one caused by the bacterium Borrelia miyamotoi, which mimics Lyme disease, and the rare but increasing Powassan virus and its variant, deer-tick virus. Powassan hasn’t been found in dogs, but dogs with neurological issues aren’t commonly tested for this rare disease, and such tests aren’t readily available.
In fact, even with available tests, diagnosing Lyme disease in dogs is challenging. Unlike viral diseases such as Powassan, Lyme is a bacterial infection and can be treated with antibiotics. But its symptoms, if any, mimic many other diseases. One common sign, lameness, takes two to five months to appear, according to the Baker Institute, and, unlike people, dogs don’t develop the telltale bull’s-eye rash around the bite.
A CDC study found that people in areas with a higher-than-average number of dogs with Lyme disease are at greater risk of getting it themselves. There’s no evidence that dogs spread it directly, but they may bring infected ticks into homes and yards.
And since dogs have a way of getting people outside, down that trail and—bag in hand—under that bush, it’s easy to see why the CDC says that dog owners face an elevated risk for Lyme disease.
Know the Enemy
Going outdoors is not the problem. What increases the risk of being infected is entering tick habitats. Especially if you go in thinking that ticks fall off trees. Or that they pounce, or fly. Surveys find that most people don’t know enough about ticks and their habits to ward them off.
“When it comes to tick-bite protection and disease prevention, we’ve learned that people tend to only focus on it after the fact,” Mather says.
That’s why TERC, which Mather heads, came into existence. Its goal is to entice people to learn more than they ever wanted to know about Ixodes scapularis (blacklegged or deer ticks)—ticks that carry the Lyme disease pathogen—and other species as well.
The idea for TERC began around 2004, when Mather decided to start “an aggressive, grassroots, tick-bite prevention program.” The tally wasn’t nearly as appalling back then, but by 2013, CDC estimates of the number of Americans diagnosed with Lyme disease each year hovered around 300,000, a whopping 10 times higher than anyone thought.
Although Mather felt that scientists already had solutions, “the link between science and people’s lived experiences with ticks was largely missing.” To fill this gap, his team took their fieldwork in a new direction: into tick-afflicted neighborhoods and to meetings with stakeholder groups. “People kept asking if we had a brochure or website,” he says. “After hearing that, oh, like 50 times, we started brainstorming.” They knew that brochures usually end up in the trash, but could a website reach people? “TickEncounter is what we came up with,” he says. It launched in 2006.
Today, the Internet teems with tick-related websites and information, and Mather believes it’s more important than ever to promote “a common core message” so the facts are clear to people. TickEncounter aspires to be the place people turn to for reliable and up-to-date information. The site isn’t soft on the facts; many people are susceptible, even likely to fall victim to tick-borne disease, which can be devastating. But simple preventive behaviors work. Before people can take action, Mather says, they need to believe in their own ability to successfully use those practices.
TERC’s unique graphic interface empowers users to snitch on the tiny army, ratting on its whereabouts and force-strength by season and region. The TickSpotters program, which includes crowd-sourced surveillance, recently added veterinary clinic reporting. Every two weeks, participating clinics send in patients’ ticks for identification. “These data are informing our ‘Current Tick Activity’ databases,” he says. Posts are updated every two weeks for nine U.S. regions. They plan to add an online dashboard with a map of results to show tick trends across America.
In February 2014, the TickSpotters page reflected the effects of the frigid weather, showing low tick activity in New England. Things were heating up on the West Coast, however, home to the western blacklegged tick. In fact, it’s always tick season somewhere, and people and pets can get Lyme disease even in winter.
“Pet owners seem most [affected] by adult ticks because they can see them,” Mather says, but the nymphs “are potentially more dangerous.” Nymph season is May through August, months during which people and dogs tend to spend the most time outside. Nymphs lurk in moist leaf litter in or near the edge of wooded areas. Because they’re so tiny at this stage, nymphs attach to small mammals near ground level, such as mice, which often carry Lyme. According to the Baker Institute, only repeated exposure to nymphs causes infection in dogs.
Adults, being larger, tend to bump into their hosts at higher altitudes. They wait aboard grasses and bushes, closest to animals’ largest body surface. They’re mainly a threat to dogs in fall and early spring. In winter, they only seek hosts when temperatures rise above freezing. Adults also transmit Lyme, babesiosis and anaplasmosis.
Despite the threats ticks pose, it’s not easy designing public education programs that work for everyone, health officials say. The problem is different for places in which ticks are entrenched and those with an emerging infestation. The bad news is, the number of the latter is definitely growing.
More Ticks, More Diseases
According to the U.S. Geological Survey, the temperate, humid, northeastern U.S. is a favorable place for ticks. More so all the time, it seems.
Ninety percent of canine Lyme cases now occur in the Northeast, according to the Companion Animal Parasite Council, whose website includes a “parasite prevalence” map by state, with confirmed canine cases by county. Lyme disease has also shown up in Northern California and on the Oregon coast, but there isn’t much evidence of spread.
The deer tick has even moved into Canada, where average temperatures have increased by 2.5º F over the past 60 years. One study suggests that tick-inhabitable regions in Eastern Canada will expand from 18 percent to more than 80 percent by 2020.
A 2013 study by researchers at the University of Toronto found that in the U.S., Lyme disease is shifting northward; the study noted large increases in 21 states between 1992 and 2007. This may be due “at least in part to the effects of climate change,” wrote the researchers. A Yale study also found links between Lyme disease outbreaks and milder weather in the Northeast. The 2004–2007 survey found the greatest risk in southern Maine through Washington, D.C., Minnesota and Wisconsin. Newer hotspots appeared to be cropping up in Illinois, Indiana, Michigan and North Dakota.
Warmer winters, which allow ticks to breed throughout the year, may be a factor, the researchers say. Warm, moist air may also extend their life cycle. They dismissed the Southeast as a location for Lyme disease, only acknowledging the lone star tick. But some say there’s growing evidence of a Lyme or Lyme-like infection there, too. In North Carolina, Lyme disease is up slightly, with a few cases diagnosed per year, but other diseases are being reported. RMSF cases rose 50 percent in 2012 compared to 2011. In June 2013, a child died from RMSF.
In 2009, the Ixodes affinis tick, native to South America and previously seen only in coastal Florida and Georgia, was found in North Carolina. Recently, the more southerly Gulf Coast tick, which transmits canine hepatozoonosis, was spotted there as well. This disease affects muscle cells and results in a debilitating and usually fatal condition. The aggressive lone star tick, historically found in southern and south-central states such as Texas and Florida, has been marching north and east for decades, scientists say. It has even worked its way into Maine and Ontario, Canada.
According to the CDC, cases of RMSF, mainly found in the Southeast, cropped up in an area of eastern Arizona where it had never before been seen—mostly in communities with many free-roaming dogs, who likely carried the brown dog tick. Newer deer tick pathogens are expanding their range, as well.
Many things are tipping the balance, scientists say, and they’re all wrapped together. They include the prevalence of deer, invasive plants, bird migration and traveling pets. Then there’s the sprawl of suburbs into woodlands, which exposes more people and pets to tick-borne diseases.
Some point to dwindling biodiversity, as animals that keep tick numbers down are increasingly shut out of their habitats by development and other human activities. Though ticks aren’t known to be any animal’s food source, opossums—rarely welcomed in the suburban landscape—groom themselves meticulously, and in the process, kill ticks by the thousands. As Rick Ostfeld, senior scientist at the Cary Institute of Ecosystem Studies, remarked, “Many ticks try to feed on opossums, and few survive the experience.”
Warmer weather and drought may be causing oaks to overproduce acorns some years, creating a boom in the white-footed mouse population. More acorns, more mice; more mice, more ticks. When the acorn crop crashes, fewer mice reproduce, and ticks are driven to seek fresh blood.
Some scientists think ticks migrate, following animal hosts that may be moving with the shift of plants.
And they may find perfect habitat in a dog’s backyard.
Tools to Stem the Tide
Farmers who take a sustainable approach often use a technique known as integrated pest management (IPM) to control pests and avoid toxic chemicals. Pet owners can learn from these farmers’ practices, which combine a range of methods and as few synthetic chemicals as possible. The U.S. Environmental Protection Agency’s website describes IPM as “an effective and environmentally sensitive approach” that can be applied in homes and gardens.
In fact, surveys find that homeowners in suburban neighborhoods in the Northeast are reluctant to spray chemicals to kill ticks. And at any rate, ticks are adapting to traditional pesticides. A recent CDC study found that spraying bifenthrin in a suburban area failed to reduce tick bites. Homeowners do widely accept methods such as brush and leaf-litter control or landscape barriers, which experts say offer medium levels of control.
TERC doesn’t rule out pesticides to control deer ticks, but suggests careful targeting to limit their use. Their recommended approach combines host-specific “Tick Tubes” and habitat-specific perimeter sprays. They also discuss many other ways to keep ticks in check, including their web-based TickEncounter Risk Calculator. By answering questions about their landscaping and other factors, people can use it to help determine the risks their yards offer, and can receive customized action plans.
At a 2013 EPA conference on tick-borne disease and IPM, Mather discussed his work, including the top protective actions people can take. Among them are knowing the ticks in your area and how to identify their life stages and seasonal patterns; taking protective actions, such as daily tick checks; and, of course, including pets in the plan. Even when a tick finds a dog, it has to be embedded for 24 to 48 hours to spread infection; quick removal drastically reduces the risk. TERC is also working on a vaccine for people, pets and wildlife.
So, the key to successful tick control lies in your own back yard, where about 75 percent of tick bites are said to occur. Seeing one tick is not enough to launch weapons. Signs of deer near your home, though, may be an important clue. To discourage ticks and their hosts, mow regularly, remove weeds and leaves, and make sure garbage and composting containers are rodent-proof. Prevention might also mean removing exotic vegetation or other welcoming habitat. Invasive bush honeysuckle and Japanese barberry, for example, attract white-tailed deer and mice (and thus, their ticks), a study found. Managing the growth of these plants significantly reduced the abundance of infected ticks. Paving or laying down gravel in heavily used areas also helps limit tick turf.
There is no one perfect solution to what seems to be nature's new normal. Come heat or hail, ticks are on the march. As summer unfolds, they’re sure to be out in force, seeking the most inviting habitats and hosts. Dog owners just have to think more like farmers … and tick guys.
Wellness: Healthy Living
Is there something more we can do to help our pups?
Warmer days tempt us to spend more time outdoors, frequently in the company of our dogs, who enjoy running and rolling in the grass and sniffing the flowers. The downside of this wonderful time of year is the potential for all of those lovely growing things to provoke allergic reactions.
Like us, dogs develop environmental allergies. Is this a condition we just have to contend with year after year, or is there something more we can do to help our pups?
In an allergic condition, the immune system overreacts to a perceived invader. Normally, a dog’s immune system can distinguish between a threat and a nonthreat. Pollen and other mild allergens are essentially non-threats and really shouldn’t cause an immune reaction, but in some dogs, they do, for reasons not yet fully understood.
Allergy symptoms come in many forms, from increased sneezing and running eyes to itchy skin and rashes. Humans reach for tissues, but dogs don’t have this option, so they rub their face on the floor or ground and paw at their eyes. In cases of atopic dermatitis, a skin disorder, increased ear-scratching and foot-licking are common; all of this scratching and licking can result in secondary bacterial skin infections, which further complicate the overall problem.
Veterinarians traditionally rely on either antihistamines or corticosteroids to ease the symptoms, and prescribe antibiotics in cases of infection.
Antihistamines, which are not as effective in dogs as they are in people, commonly have side effects—drowsiness or, occasionally, hyperactivity. Steroids are often used as well; many dogs are put on a low-dose regimen to control clinical signs associated with allergies. Other treatment options include medications such as cyclosporine and hypersensitization injections. Regardless of the strategy, we need to consider whether we are correcting the problem or just covering it up. In most cases, we are simply managing the clinical signs; once medications are discontinued, the problem resurfaces. Antihistamines work directly against a type of immune cell called a mast cell. Mast cells contain histamine granules that, when released, trigger symptoms such as itching and nasal discharge. Steroids act directly on the immune response; their mission is to suppress the immune system or put it into sleep mode so that it doesn’t react to nonthreat invaders (for example, pollen). The problem with steroids is that they have many side effects, ranging from increased appetite and weight gain to greater susceptibility to infection and even the possibility of organ damage when used long-term.
Tissue in the intestinal tract is thought to have an important immune-system function. Thus, a faulty immune response may be linked to poor gastrointestinal (GI) health, or what has been termed “leaky gut syndrome”; I tend to approach my allergy patients from this perspective. The GI tract normally maintains a distinct barrier between the bloodstream and what is ingested. Poor GI health, thought to be the result of chronic inf lammation, compromises that barrier and allows many different antigens, bacteria and proteins to cross it. This elicits an ongoing inflammatory and immune response and precipitates allergies as well as a host of other health conditions.
Repairing this gut barrier takes time and, in most cases, requires a total change of diet as well as the use of supplements. I ask owners to switch to home-cooked diets that incorporate a variety of protein sources as well as fruits, vegetables and some starches. Many commercial dog foods are full of preservatives, dyes and other additives that contribute to the problem, but a home-prepared diet ensures that the dog is getting only what is needed, and also aids in the delivery of vital nutrients.
Fed this way, many dogs respond within 30 to 60 days, but others require additional support, which usually correlates to the severity of the damage. Among the supplements that I have found useful are various mushroom polysaccharides, which help modulate the immune response; curcumin; green tea extracts; and a variety of antioxidants as well as other nutritive-type herbs such as spirulina (blue-green algae). Human research points toward the value of L-glutamine, an amino acid that has been shown to help repair the GI barrier as well as enhance overall immune response, and I often add this to an allergic dog’s regimen.
In the end, allergies are, unfortunately, common in both dogs and their people. Those who are willing to dig down and address the root cause of the allergic response may be able to not only improve the immediate condition, but also have a dramatic impact on their dogs’ health and longevity as well as reduce the need for many prescription medications.
Wellness: Healthy Living
A fast-growing rehabilitation option
In February 2012, cheri wells adopted Duncan, a Rottweiler with lupus, from the Pasco County Animal Shelter in Land O’Lakes, Fla. Thin and frail, Duncan was almost too weak to stand up when he urinated.
Wells, determined to find a way to combat Duncan’s progressive autoimmune disorder, first consulted a holistic veterinarian. The next stop was Rocky’s Retreat Canine Health and Fitness Center in Orlando, where she hoped that hydrotherapy could help her pup regain muscle strength and just generally feel better overall. In choosing this option, Wells (and Duncan) took advantage of a form of physiotherapy long used by humans and more recently applied to animals.
Canine water therapy takes place in either a heated lap pool or a smaller Plexiglas® tank with an underwater treadmill; whirlpools are also sometimes used. In the lap pool, the therapist may swim with the dog, who is usually strapped into a life vest, or manipulate and exercise the dog’s limbs while he or she rests in the warm water. The therapist may also join the dog in the treadmill tank, though here, the role is to guide and keep the dog on track. The dog enters the empty tank via a ramp; once the door is closed, the tank is filled with warm water to a depth appropriate for the dog’s size and therapy needs. The treadmill is then activated, and the dog walks at a steady pace, supported by the water’s buoyancy, which unloads weight on the joints and encourages a full range of motion.
Pool or tank, both approaches effectively increase circulation and joint flexibility and decrease pain. Essentially, fundamental physics makes hydrotherapy effective. Water’s resistance increases the demand placed on the muscles as they propel the limbs through the water, making it effective for building strength. In addition, the viscosity of the water— its frictional resistance—is thought to increase sensation and limb awareness, thus helping a weak dog find his or her balance.
Horses were among the first animals to benefit from hydrotherapy; those in the equine rehab field would swim their patients in large pools to restore them to their former galloping glory. Following their example, Greyhound trainers also employed the method. Today, rehabilitation (much of which focuses on hydrotherapy) is among the fastest-growing areas in vet medicine.
“What we originally thought would be a ‘boutique’ area of veterinary medicine has become very popular. We use it frequently, especially for the treatment of chronic arthritis, cruciate ligament surgery [post-operatively] and neurological deficits. Virtually any neurological or orthopedic problem can benefit from aquatic therapy,” says Darryl Millis, DVM, DACVS, professor of orthopedic surgery and director of surgical service at the University of Tennessee, Knoxville. UT is one of only two educational facilities in the U.S. to offer a certification in canine rehabilitation. (The Canine Rehabilitation Institute in Wellington, Fla., is the other.)
In 1993, Dr. Millis and David Levine, PhD, a board-certified physical therapist who teaches at UT, Chattanooga, began to consider alternative rehabilitation methods. “We were trying to think of ways to incorporate exercise and aquatic therapy for dogs, and we needed an aquatic therapy modality other than swimming, which can be too much activity for an early postoperative patient or a very arthritic dog,” explains Millis.
“We ran across an underwater treadmill for people while searching the Internet for rehabilitation products. I called the company and asked if they would consider making one for dogs. We worked together to modify the human treadmill for canines, and were the first to have a self-contained unit. One of the key concepts that we contributed was the open appearance of the treadmill; dogs will not walk into a solid wall. We also learned that [being able] to closely monitor the water level and carefully control variable speeds were important in the rehab process,” he says.
Marti Drum, DVM, PhD, who works with Dr. Millis at UT, became interested in animal rehab and sports medicine when she was just 12 years old. “I saw some cutting-edge therapies being done on U.S. equestrian-team horses, and it seemed like something I would like to do. I believe that the water is very efficient in providing targeted exercise to the affected limb. In general, a joint has greater overall range of motion when the water level is at or just below the joint,” she says.
Many conditions lead pet owners to try hydrotherapy, among them, issues associated with aging, arthritis complications, paralysis and mobility, chronic pain, pre- and post-surgical rehabilitation, obesity, dysplasia, and behavioral modification. Conditions such as hip dysplasia and osteochondritis can be aggravated by weight-bearing exercise, but greatly benefit from the relative weightlessness of water. Practitioners like Sherri Cappabianca, Cathy Chen-Rennie and Bobbie Werbe utilize Millis’ design daily. Cappabianca, who owns Rocky’s Retreat, worked with Duncan. Since opening her company in September 2011, her growing list of tank triumphs has only strengthened her resolve to promote hydrotherapy in her community.
“We have had incredible success with dogs who were so arthritic when they came to us that they couldn’t walk. Dogs who deal with obesity or suffer from fear and aggression issues benefit immensely from learning to swim. Some clients tell us that we give them their puppies back,” explains Cappabianca.
Chen-Rennie opened The Rex Center in Pacifica, Calif., in 2009 to serve San Francisco Bay Area dogs in need of safe, nurturing exercise options. Onethird of her clientele are elderly dogs. She loves the way they just relax and enjoy the warm water. “You see dogs who used to love to swim. We have a 13-year-old Lab who literally leaps an inch when he sees the pool,” she says. Werbe, who’s an RVT and Certified Canine Rehabilitation Practitioner, is affiliated with Circle City Veterinary Specialty and Emergency Hospital in Carmel, Ind. She and her clients have zero doubt about the restorative, lifechanging power of aquatic therapy. Kim Tikijian took her 14-year-old yellow Lab, Maggie, to see Werbe after her hind legs began failing. Calcifications along Maggie’s spinal column were short-circuiting messages from her brain to her legs. At Circle City, Werbe developed a plan to strengthen the muscles surrounding Maggie’s problem spots.
“Maggie is much stronger than she used to be and only rarely has symptoms of weakness. She naps long and hard after sessions but wakes refreshed and ready to romp with her siblings. I truly believe that Maggie would not [be] able to support her weight if it had not been for Bobbie and the treatment she provides,” says Tikijian. As with most things, people have adapted to this aquatic trend as the benefits and results presented themselves. Millis says that various veterinary schools have begun rehabilitation services at their teaching hospitals within the last five years. “Many colleges have sent technicians and veterinarians to our courses and facilities to learn. In fact, we had administrators and vets come in from Thailand [earlier this year],” he says.
To ensure that momentum furthers progress already made, the next wave of veterinary professionals must embrace rehab and hydrotherapy as a mainstay. Dr. Jennifer Au, assistant professor of small-animal surgery at Ohio State University, says she occasionally runs into people in the field who don’t understand the efficacy of this approach. “As an orthopedic faculty member, I talk to all of my clients about rehab, and I lecture as much as possible about it in classes and at continuing education seminars,” she says.
While education is no doubt the most serious component, UT has its own public-relations poster girl to teach the value of the underwater treadmill. Mabel, a plucky, 67-pound, fiveyear- old Beagle mix, was left at a Knoxville animal shelter in December 2011. Angela Witzel, DVM, PhD, DACVN and chief of nutrition services at UT’s Veterinary Medical Center, adopted Mabel and promptly put her on a slim-down plan that involved both calorie restriction and exercise.
Mabel spends 30 minutes every other day on the underwater treadmill. She initially struggled, but the water helped her drop some of her bulk, and she was able to move more easily. Now, Mabel has lost almost 42 pounds, and her new, lean body has inspired many. She has her own Facebook page, and several local news channels have covered her journey to health. Pictures posted around campus show a happy hound running with smiling students, and videos document a disciplined girl in the tank walking off the pounds that piled on during her days of overeating.
“I am thrilled that people seem to care so much about her story, because [reducing] pet obesity is my passion. Mabel loves to go for walks now,” says Witzel. “We gave her a break from the underwater treadmill and her weight loss plateaued, so it was back to the pool. Let there be no doubt, the UTCVM rehab department works.”
Beyond tank design and the science of motion, hydrotherapists work to restore their patients to optimal health. Worried pet owners, searching for options and answers, turn to this new modality to relieve their dogs’ discomfort. In Duncan’s case, Cappabianca gave Wells four beautiful months with her Rottie before he died of a severe infection. The experience had such a profound impact on her life that she founded LoveyLoaves Rescue (lovey loaves.com), a nonprofit organization dedicated to rehabilitating disabled dogs.
“Every milestone Duncan reached was celebrated, and he was so proud. His life touched everyone he met. You really have to have an experience with aqua therapy in order to believe and appreciate the amazing healing that occurs through the rehab process,” says Wells.
with a dog as your muse
There was a piece in the New York Times recently that provides us with yet another reason why living with dogs is so good for us. Gretchen Reynolds, their Phys Ed columnist, reviewed a current study that show how wonderful walking is to our creative process—a form of exercise that all dog people can relate to (at least 2 to 3 times/day). The salubrious effects of exercise, in general, have been found in “multiple studies that have shown that animals and people usually perform better after exercise on tests of memory and executive function, which is essentially the ability to make decisions and organize thoughts.”
But how about our more creative thoughts? So while we all have experienced thought-bubbles popping up while showering, it also seems that a leisurely walk can also stir creative juices.
Dr. Marily Oppezzo a researcher at Stanford studied this recently. She found that the students who were tested after a walk generated about 60 percent more uses for an object, and the ideas were both “novel and appropriate.” She thinks that “It may be that walking improves mood” and that perhaps creativity blooms more easily within a buoyed-up mind. Or walking may divert energy that otherwise would be devoted, intentionally or not, to damping down wild, creative thought, she said. “I think it’s possible that walking may allow the brain to break through” some of its own, hyper-rational filters, she said. (Bring on those doggies!)
Has a walk with your dog inspired any special creative idea?
Wellness: Healthy Living
Searching for the ideal vet
We don’t ask for much.
For starters, we want you to have the brains of Einstein, the compassion of Mother Teresa and the patience of Job.
In terms of medical skills, we’d like you to possess the sleuthing abilities of television’s Dr. House, the empathy of Dr. Dolittle and the bedside manner of Marcus Welby, MD (but not be so ancient that you remember that kindly TV doctor).
While we appreciate old-school wisdom, charm and values, we don’t want our dog’s doctor to be behind the times. Instead, he—or far more likely these days, she—should be a fairly recent graduate of a respected veterinary school, possess a search-engine-like ability to stay on top of all the latest medical developments and technology, and constantly be attending seminars, preferably without ever leaving the office.
As for those offices, we’d like them to have the accessibility of a ’round-the-clock convenience mart, the cleanliness of an operating room, the aroma of a gentle spring rain and the affordability of a dollar store. In your waiting room, we’d prefer not to wait.
We appreciate communication skills (including the all-important ability to close one’s mouth and listen). We want you to explain things clearly and simply, and lay out options—all while taking your time, with our dog and with us, so we don’t feel like we’re being rushed through an assembly line.
We want you to have confidence, but not such an excessive amount that you don’t seek input from others. We want you to admit when an educated guess is an educated guess, and refrain from predicting the unpredictable. Don’t give our dog needless and expensive tests, or vaccinate them unnecessarily. Don’t encourage us to prolong their lives at all costs. Don’t look at us with dollar signs in your eyes, even though we are the source of your income.
We want to be comfortable in your presence, and our dogs to be, too. We want to like you, and trust you. You should like us too, and be absolutely bonkers about our dog. You should be genuinely thrilled—don’t even try to fake it—every time you see him or her.
Validate, if you would, our parking, our dogs and us.
Remember our dog’s name, and ours, and be there for us through all the ups and downs, all the joy and heartache, right up to the end, maybe most importantly at the end.
At that time, we want you to treat our dogs, and us, as we’d hope you have all along the way: honestly, compassionately, straightforwardly and with dignity.
On second thought, we ask for a lot.
Our strong emotional attachments to our dogs lead us to have some pretty high standards—and go to some pretty great lengths—when it comes to choosing a veterinarian. For most of us, the nearest one won’t do. A competent one isn’t enough. We want the vet of our dreams.
As a nation, we’ve grown more dog crazy, and more dog savvy; on the road to becoming better-informed dog owners, we’ve also become more demanding ones.
Given all those factors, it’s understandable that we have such great expectations of veterinarians. But those high hopes are also an indication of continuing public faith in the profession. Part of the reason we’re willing to invest time and research in seeking Dr. Right is that we’re pretty sure he or she is out there—findable, accessible and maybe even affordable.
The day may come, if it hasn’t already, when our high regard for veterinarians—our view of them as altruistic sorts, on our side and not solely after money—starts to fade, just as it has over the years for lawyers, politicians and (though less drastically) doctors.
Medical care for our dogs is becoming more like the human system, which many might argue is no model at all, what with its exorbitant costs, its overly comfy relationship with pharmaceutical companies and all the corporate ordered protocols aimed at getting the most money out of ailing humans in the least time.
As with the human system, veterinary offices are becoming increasingly corporate. That tends to lead to more rushed and impersonal treatment; longer waits; shorter visits; and doctors who are prone (or ordered from above) to sell you and your dog on every imaginable diagnostic test, vaccination, medication, surgery or treatment.
At the same time, we and our dogs are hanging around the planet longer in part due to all those new drugs, tests and procedures. The longer life is prolonged, the more tough decisions we face, weighing questions about the promise of technology, risks and side effects, the quality of life, when to try to buy more time, when enough is enough, and how to afford it all.
Managing our dog’s health care seems well on the way to becoming as tortuous and frustrating a struggle as managing our own.
Many of the procedures and services once available only to human patients —once seen as unimaginable or frivolous when applied to canines (except to test on them first to make sure they’d be okay for us)—are now routinely offered for dogs. They are referred to specialists. They go to psychiatrists. They undergo chemotherapy. They receive bone-marrow transplants, and dialysis, and “bionic” prostheses.
Many of these carry price tags so frightening that increasingly, we’re turning to health insurance for our dogs. We fear that, just as with our own health, it would only take one medical disaster for our dog to bankrupt us.
Obamacare for dogs? It may be laughable now, but will it still be in 50 years? Truth be told, some old-school veterinarians have long been practicing a version of it (unofficially and without the aid of insurance companies or websites), charging clients, of all things, what they can afford.
With independent veterinary practices dwindling and facing more pressures, such kind-hearted vets are becoming harder to find, and are finding it harder to be kind-hearted. Veterinary care is becoming colder, more complex and more expensive, a big business that, if it’s not careful, may soon come across as looking that way—as being much more concerned with its bottom line than all those creatures great and small.
Between our high expectations and veterinary medicine’s changing realities, a shift in our generally favorable view of veterinarians wouldn’t be all that surprising. On the other hand, they help animals, and we love them—nearly unconditionally—for that. Maybe that’s enough to keep vets from falling out of our good graces and joining the ranks of other once-beloved professions.
In any case, a new era has clearly dawned for veterinary medicine, one that includes corporately owned mega-practices, pricey technology, life-prolonging treatments and its own almost-as-perplexing version of health insurance. It’s enough to make some pine, at least a little, for the days of James Herriott, the semi-fictional country vet who, though he never attempted anything as cutting-edge as stem cell therapy, could always be counted on to be gentle, to be considerate, and to be there.
For now, based on some nonscientific opinion gathering by The Bark, most dog owners still seem to think that while not all vets are perfect, the perfect vet is out there. We think we know what makes him or her perfect. And, based on comments solicited from readers, most of us still manage, eventually, to find him or her.
“Why is my vet perfect? He is knowledgeable and experienced … unfailingly gentle and kind with animals and courteous to their owners,” wrote a reader named Frances. “He always explains everything in detail and is never, ever patronizing or dismissive of anxieties … [He] always comes across as someone whose priority is the welfare of the animals in his care, not profits or kudos. If I had to choose just one criterion upon which to base a choice of vet, it would be trust—trust in their expertise, their advice and their ability to care for my animals.”
When The Bark asked readers to describe their ideal veterinarian, they responded in large numbers, and quite passionately. They seemed, nearly unanimously, to appreciate a vet who hears them out, realizing the value of their observations and opinions about their companion animals. Most veterinary clients would rather feel part of a team, as opposed to following the dictates of a vet who comes across as one not to be questioned.
Based on the comments (read them all at thebark.com/finding-dr-right), dog owners place a priority on reasonable rates, as well as accessibility and flexibility. Readers also seemed to appreciate the veterinarian who offers weekend hours and is willing to stay open late, or go the extra mile … or 15 … or 20.
A reader named Robin said she chose a veterinarian who exhibited superior listening skills and a high degree of dedication to her job. Because Robin’s pup, Ali, suffers seizures and gets stressed out by office visits, Robin made an appointment with a mobile vet. Despite some dauntingly inclement weather, Dr. Joan showed up.
“So there she was, on my birthday, when we had a surprise snow storm overnight, and the snow was approaching hip height,” Robin said. “And she backed her trailer up our driveway for a NAIL TRIM …”
While accessibility, technical know how and communication skills were among the qualities readers listed as most important in a veterinarian, compassion may rank even higher. Dog owners want a veterinarian with heart. They put a premium on empathy, and perhaps rightly so, given that a vet’s patients can’t talk. Dog owners get some reassurance when they see vets connect with their dogs in a non-verbal way.
A reader named Jen said the vet of her dreams has a good reputation for his surgical skills, and his office has low staff turnover, another good sign, she says. But “first and foremost” is “his genuine affection, care and liking for the animals he works with. He gets down on the floor and hugs them if they are comfortable with that, lets them lick his face and talks to them before any examinations or procedures …
“My most recent favorite Dr. Todd tale was when I took my dog, Inca, in for a checkup. The day before, she and my other dog, Domino, had discovered an old slug trap in the strawberries filled with sour beer and rotten slugs. Unbeknownst to us they (delightedly, I’m certain) rolled in it … When I warned Todd not to hug Inca this time and told him what she had done, and that we hadn’t been successful in getting the stink off her, he got down on the floor, hugged her, looked into her eyes and said, ‘Good dog, Inca!’ In other words, ‘way to act like a dog.’”
We don’t expect to feel the love when we go to our own doctor; we do at the vet’s office.
Why? In part, it’s because we’re jaundiced by our own medical experiences, conditioned to not expect the surest, swiftest, most compassionate and fairly priced service. Most of us wouldn’t dream of asking our family doctor to meet us after hours at the office, much less grant us a same-day appointment, make a house call, cut us a break on the price of treatment or let us run a tab. We don’t require our pediatricians to “ooh” and “ahh” over our human babies, or to pat them on the head or toss them a treat. But a vet who treats our dog aloofly may be on the way to becoming our former vet.
Rightly or wrongly, we tend to see veterinarians as a warm-hearted bunch —people who got into their field not for the money, but because of their deep and abiding love for animals. We’re not so sure that a love for humans is what motivates most doctors.
Maybe that’s one reason veterinarians in the past decade have generally shown up above doctors in polls ranking professions for honesty and ethical standards. Dr. Nancy Kay, recently retired from veterinary practice, and author of the books Speaking for Spot and Your Dog’s Best Health: A Dozen Reasonable Things to Expect from Your Vet, is among those who sense that a shift is under way in the public’s perception of veterinarians.
“Maybe we’re still held in higher regard than medical doctors, but not by very much,” she says. “It used to be veterinarians were revered and given the benefit of the doubt.” Now, she says, it’s more common to hear criticism from people who feel vets are “not embracing enough of a holistic approach” and are “out for the money.”
Kay also says that, in some cases, the criticism is merited.
The average vet school student graduates with $150,000 worth of debt, according to Kay. They go into a job earning maybe $50,000 a year. Meanwhile, clients are turning elsewhere for some of the products and services that traditionally brought in profits for veterinary practices—to low- or no-cost clinics for spaying, neutering and rabies vaccinations, or to Wal-Mart and online discount stores for prescriptions.
Add in the high cost of keeping up with technology, and conditions get even riper for questionable behavior, such as a vet recommending a procedure or test that might not be necessary.
Kay says vaccinations are a good example of that.
The American Animal Hospital Association (AAHA) revamped its list of recommended vaccinations, and the intervals at which they should be administered, 11 years ago. But, Kay notes, some vets still routinely over vaccinate based on the old recommendations. Many a client, after receiving a cute reminder postcard in the mail, still brings his or her dog in annually for distemper and parvovirus vaccinations, even though the AAHA now recommends those vaccinations be given at three-year intervals.
The AAHA also now recommends that vaccinations for parainf luenza virus, bordetella and leptospirosis be administered only after looking at an individual dog’s risk of exposure. But some vets—either not up on the changes or not wanting to pass up potential profits—tend to take a more blanket approach to vaccines.
“Some vets either don’t know better or they want the money,” Kay says. “They over-vaccinate to subsidize their other services, disregarding the potential risks to the animals, and people are catching on to that.”
As they do, suspicion can spread and public faith can erode, just as it can in any occupation. A few bad apples, uninformed apples, careless apples or greedy apples, can—especially in the Internet age—taint how the public sees the whole barrel.
So how do you find Dr. Right— that vet who’s the perfect combination of compassion and clear-headedness; one who, when it comes to finding answers, isn’t wholly holistic or wholly high-tech; one who exhibits not simply heart, and not simply brains, but that much-desired combination of the two?
Two things to keep in mind: First, one pet owner’s Dr. Right may not be every pet owner’s Dr. Right. Second, you might have to go through a few Dr. Not-Quite-Rights along the way.
Let your own head, and your own heart, be your guide.
Do some research. Get input from friends. Get input from strangers. Pick the brains of your fellow dog-park denizens. Ask people not just if they like their vet, but why they like their vet. Volunteer at your local humane society, and see whom they trust and turn to. Check into complaints filed with state veterinary boards or Better Business Bureaus. Go online and read customer reviews, but take them, like everything else on the Internet, with a grain of salt. Visit and interview vets. Chat up the support staff. Bring a notepad. Ask vets where they got their training. Do they have a dog? Do they do any pro bono work, such as helping homeless dogs in the community? Are they, when it comes to technology, up on the latest or living in the past? See if you feel a connection, and—as perhaps you might do with a potential suitor—let your dog give them a sniff and offer an opinion.
Some vets might be smooth talkers who say all the right things but fail to make a connection with your dog. Other vets might have a near-magical ability to empathize with your dog, but no people skills at all.
One paradox of veterinary medicine is that many of those who go into it do so because they prefer dealing with animals to dealing with people. They find out pretty quickly—year one in most veterinary schools—that it’s not going to work that way. While they examine animals, they have to communicate with humans—often, anguished, demanding or sobbing ones.
“What all vets have in common is we love animals, but the majority of our time is spent dealing with their humans,” says Kay, who spent 32 years in private practice. Some veterinarians are better at that than others.
As with medical doctors, veterinarians generally adopt one of two styles of communication. In the paternalistic model, the doctor is clearly in charge, does most of the talking and, generally, keeps some emotional distance. Under what’s called the relationship-centered model, the vet looks at the bigger picture— the dog and the dog owner, and the bond between them. Clients are encouraged to share facts, express opinions and help decide on a course of action.
What leads a vet to become one or the other is probably a mix of factors, including personality type, sociability and the training they received in school. Some might assume that, under a paternalistic style (with the doctor taking the reins) clients can be shuttled in and out more quickly and efficiently. Kay says studies have shown that’s not the case.
Readers who shared their thoughts on what makes for the ideal veterinarian seemed to prefer the relationship centered style, even if they didn’t call it by name. They want a vet who comes across as warm, and a vet who listens. “No vet can possibly know as much about my dogs as I do, from living with and observing them closely day by day,” said a reader named Lynda. “That’s okay—I don’t expect the vet to know that—but I do expect the vet to listen to me and take my observations and instincts into account in the diagnosis.”
That, she added, “requires a third characteristic—not too heavy on the ego, please. I don’t want a vet who tries to play God or take over my primary responsibility for my dog’s well-being. I want someone who doesn’t feel threatened by my input.”
“A good vet is a professional who outright would let a dog lick her, a cat be her hissy self [and] a pet parent speak about their furry four-legged child before coming up with conclusions,” said a reader named Carmen. “A vet should love what she is there for, the pets …”
Several commenters said the ideal vet doesn’t let rules or protocol trump compassion, and isn’t so wrapped up in cutting-edge technology that he or she gives no credence to more natural treatments.
“I appreciate a vet who is willing to work with me and consider both clinical and alternative healing, which includes holistic and palliative care in certain circumstances,” said a reader named Marilyn. “I believe my companion animals, much as humans, want to be with their loved ones and not in a hospital cage during their final days/ hours. I think vets are, at times, too wedded to vet-school protocols to the exclusion of the human-animal bond. Pity.”
A reader named Susan in Tucson said she’d never forget how her veterinarian let her lay on the floor with her dog Luka as he received IV fluids in a last ditch effort to save his life.
“Her heart is so big that she knew if I could do this myself, it would mean the world to my big mama’s boy, and it would mean everything to me. He was very ill with chronic kidney disease, which [had been] diagnosed the day before, though [he was] only six years old. The next day, I had to make the hardest decision ever, and I’d not have been able to do it without her. I spent another couple of hours in a private room, talking quietly to Luka, my Malamute, and then we did have to let him go.”
Several commenters said they seek veterinarians who feel a connection with the dogs they treat, the humans they encounter and the community they’re in. A vet who volunteers his or her services to help less fortunate dogs is seen as one who likely has the compassion and dedication they’re looking for.
“Two things stand out for me,” wrote Tom. “I want a vet (and have one, thankfully) who knows about all the shiny new diagnostic tests s/he can perform, and who doesn’t recommend them just because they exist … Second, I want my vet to be active in animal welfare. Frankly, I think the veterinary community at large has been strangely, sadly absent from the humane movement— at least in any organized way. At best, that’s a huge lost opportunity to improve the conditions of the companion animals whose brethren they treat, and to end unnecessary shelter euthanasia.”
A reader named Nina echoed those opinions: “I look for someone who defines what they do as a service rather than strictly a business. They show compassion and respect for all animals and their families. The vet volunteers his or her services at an affordable clinic; they board and protect pets of abused women while [the women] are looking for a new, safe home; they get involved in community fundraisers … This way of seeing and operating in the world informs everything they do— from hiring staff who are knowledgeable, kind and efficient to encouraging their clients to make informed decisions about issues such as vaccinations and other treatments.
“One of the vets I frequented for almost 20 years I am leaving because they are changing their paradigm from service to business,” she added. “The front desk is no longer attended by caring staff, and making money seems to be the major concern. Needless to say, they are losing clients, including me.”
Call a medical doctor when you’re seriously ailing and, with some luck, you’ll get an appointment—say, three weeks from Thursday. Call a vet about your seriously ailing dog and you’re likely to hear “bring ’em right in.”
Visit that medical doctor—arrive 30 minutes before your appointment, please—and the receptionist may or may not issue a friendly greeting, and may or may not make eye contact before handing you multiple forms to be filled out while you wait, 45 minutes or so, before being shown into an exam room, where you wait some more.
Visit that vet and you and your dog will more likely be greeted with some excitement, get a pat on the head, maybe get a treat, and have but a brief wait to see not just an assistant, but the actual doctor—all of which sometimes happens, unlike with human medical care, even before the question is asked: “How are we going to be paying for this?”
In some ways, at least from a consumer perspective, human medical care could benefit by becoming more like traditional veterinary care.
From all indications, though, the opposite is happening.
With large corporations running a growing percentage of veterinary practices, with those practices becoming larger, with treatments becoming more sophisticated and expensive, with pet insurance creating more hoops to jump through, with everybody running to keep up with technology, there seems less time for niceties, or empathy.
The way things are heading, one often doesn’t get to choose a veterinarian these days as much as a veterinary practice. You might find the veterinarian of your dreams, but then actually get an appointment with the one who’s available. As pet health insurance slowly catches on, you might find the practice of your dreams, only to learn it doesn’t honor the particular brand of pet insurance you’ve purchased.
And, as veterinary practices become more like big businesses, that quality time you spend with your vet might dwindle—maybe at that vet’s choice, maybe due to corporate orders.
“It’s not the profession I went into 25 years ago,” says Nick Trout, a staff surgeon at Angell Animal Medical Center in Boston and a contributing columnist for The Bark.
Traditionally, Trout says, vets have been seen as “having an animal’s best interest at heart rather than being out to make money.” Given that their patients can’t talk, vets spend more time examining them, “as opposed to the seven minutes you seem to have with an MD who’s watching the clock and having to crank through on the cases.” Vets, generally, have been seen as more accessible, patient and understanding than the average medical doctor.
Trout, who has authored three nonfiction books, has also written two novels. In the first of those, The Patron Saint of Lost Dogs, the main character, Cyrus Mills, a veterinary pathologist whose career has kept him in the laboratory, takes over his father’s small town veterinary practice and, through connecting with dogs and people, finds his life changed for the better. In its sequel, Dog Gone, Back Soon, slated for release this spring, Mills copes with pressures stemming from what Trout calls the “corporatization” of veterinary care.
While the book is fiction, the trend is real, and global.
For example, Trout says, “Small mom-and-pop practices no longer exist in Sweden; they’ve all been bought out by corporations” that operate under a “colder, more clinical” business model. “What worries me is that takes away that one-on-one, that ability to put in more time with an individual … When you’re accountable to a bigger business model, you’re not going to get away with that.”
Technology is playing a big role, too. Keeping up with it can require large investments—the kind that small, independent veterinarians are hardpressed to make.
“Pet owners demand higher technology,” Trout says. “The days of a single general-practice vet being the only one you’re going to need are getting lost. We as humans demand specialization, and pet owners are not different … We kind of want it both ways. We want the James Herriott style, but we want the state-of-the-art technology.”
With veterinary schools packed and graduates competing for jobs, Trout says, many will find that, to get a job, they’ll need to put a lid on their idealism and toe the corporate line: “You will work for us in the way we work— you will do this test, this test and this test,” Trout says.
He doesn’t think this bodes well for the profession.
“We’re losing that personalized touch, that one-on-one, that sort of relationship you get between a dog and a vet and an owner—that sort of love triangle that goes on through the animal’s lifetime.”
To many of us, the search for the veterinarian of our dreams involves a lot of the same considerations as our search for a mate: it’s largely, but not entirely, a matter of the heart.
We want someone we can trust.
We seek kindness, sensitivity and compassion. We avoid those with angry streaks, those who are unpredictable or who might just be after our money.
We value honesty, dependability and dedication, and we like someone who, while keeping up with the times, still has some good old-fashioned values.
We prefer them to be, if not tail-waggingly happy, at least pleased to see us come through the door.
We want a good communicator, who knows how to listen and isn’t distant or aloof—someone who, when he’s there, is actually there and when he’s not, is only a text or phone call away.
And once we have found them, we tend to never let them go—at least, not until we have to move to a new town and start all over again.
We don’t require our vet to like long walks on the beach at sunset, but we do appreciate one who will be there when needed—not to lecture, dictate or nag, but to be supportive and help us solve the problems that come up in life.
And, it goes without saying, they must love dogs.
News: Guest Posts
How Does the Loss of a Dog Impact the Wellbeing of other Dogs in the Household?
I recently came upon the link for a pet loss survey through social media. My summer of 2013 had far too much pet loss. Curious, I went to the website, which is sponsored by the Washington State University College of Veterinary Medicine. I met the study criteria: over 18 years of age; have lost a pet from my household due to death, temporary or permanent absence; and at the time of the loss, had at least one other pet that is still in my household today.
I took the survey, a process of about twenty minutes. Many questions were quickly answered by filling in the appropriate multiple-choice bubble; others could be answered with additional detail typed into a box.
I was impressed with the topics covered by the survey; having so recently lost two of my three dogs, I felt they were spot-on based on my experiences. Clearly the study delves into questions and concerns that many of us have about how our pets grieve but presently have no real answers for. We simply hope we’re doing the right thing for them.
I lost Maia, the oldest of my three dogs to old age last June (she was 14). Then quite unexpectedly I lost Meadow, age 12, to bone cancer just six weeks later. I found myself in troubling new territory with no guide. How do I help the surviving dogs through their grief? How is their grief impacted by my own? Was Finn, my youngest (age five) and now sole remaining dog going to be traumatized by losing two housemates in such quick succession? What could I do to make the losses easier for him, even while I was a wreck from grief?
There are websites addressing the issue of pet loss. Believe me, I visited several last summer. There are suggestions about helping us handle loss, helping children grieve, or responding to family, friends and co-workers who don’t understand why you’re a wreck and say, “It’s just a pet.” A few websites offer suggestions for helping other pets grieve, but there’s no research, no science behind the information. I didn’t want to make things worse for my dogs. I remember struggling mightily with whether to let the surviving dogs/dog see and smell the departed dog’s body. I searched for answers online, but couldn’t find anything concrete. I decided to let them come into the room after their housemate was gone. I only hope I made the right choice. It would be nice to have some research saying I did, or if not, what to do differently in the future.
Leticia Fanucchi, DVM and a Ph.D student, is working to bring us the science that will help us help our pets through the dying and grieving process when they lose household members (animal or human) to which they’re attached. As Dr. Fanucchi notes, there’s been some anecdotal data about the grieving process of other animals—elephants, apes, chimpanzees, marine mammals—but no systematic research regarding them or our companion animals. She aims to correct that, conducting controlled studies to help us and our vets better understand pet loss and grieving. Dr. Fanucchi describes this research as her career-long project.
Dr. Fanucchi currently has two surveys going—the pet loss survey I took, and a control survey for pet owners who aren’t experiencing loss. The data she collects will form the basis for the next stages of her research: measuring changes in behavior and diet when a pet loses another pet or a person in their household, and whether the grief of the owner impacts the grief of the pet. To gain early data during the next stage, Dr. Fanucchi will observe in the lab the brief separation (two minutes) of two pets sharing a household, to determine if the pair are attached or not. “If they are attached, then I can assume they will grieve.”
Eventually her research will involve finding pets actually going through the grieving process. The WSU College of Veterinary Medicine sees many animals that are old or have cancer or other life-threatening diseases. “Eventually, sadly, we lose animals,” said Dr. Fanucchi. “They will be the samples we study.” Dr. Fanucchi will seek owners willing to let her visit the pets and family in their home, observing and video-taping behaviors and measuring eating before and after loss to detect changes and influences.
Dr. Fanucchi anticipates analyzing the current pet survey data this summer and publishing the results by the end of this year, although the surveys will stay up all year. Thereafter, as she moves forward through research stages and collects additional data, she will try to publish annually so that new information is shared regularly. So far, some 700 people have responded to the pet loss survey, and another 500 to the pet behavior without loss survey.
You can help this important research by responding to whichever survey applies to your household:
Pet Loss Survey: www.opinion.wsu.edu/petloss
Pet Owner (without loss) Survey: www.opinion.wsu.edu/petbehavior
Participation is voluntary and anonymous. If questions make you uncomfortable, you can leave them blank. If the pet loss survey causes any distress, counseling services are available through the WSU College of Veterinary Medicine Pet Loss Hotline (website and phone numbers provided before you enter the survey).
I urge you to take the small amount of time needed to complete one or the other survey. The more data collected, the better the results and subsequent research, leading to information that, sadly, we will all need at some point in our lives shared with animal companions.
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