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Wellness: Health Care
The Gift of Good-bye
Caring for dog, Hospice

What would you give to be able to spend another month, another week, or just another precious day with your best friend? Anyone who has ever loved and lost a pet has probably had such a wish.

Pets are no longer just pets; they fill the role of family, child, companion and guardian. As such, their dying process can carry a burden equal to the loss of our two-legged loved ones, and it is during this time that both pets and their people can benefit from animal hospice. Hospice allows our pet’s final journey to be experienced with dignity while surrounded by love in the familiarity of their home. It allows our pets to live out the remainder of their lives as fully as possible until the time of death, whether a “natural death” or compassionate euthanasia is elected.

As with human hospice, animal hospice exists to provide support and care for pets in the last phases of incurable disease or at the natural end of their lives. It helps facilitate the availability of resources to educate, support comfort care, manage pain and allow for a good quality of life, whether that is days, weeks or months. Hospice care also grants pet parents time to plan, grieve and say good-bye to their companions while providing a way for them to bring their pets home for their final days instead of being in the confines of a hospital setting or an unfamiliar exam room.

These are just a few reasons why I feel hospice care is so incredibly important and why it has always resonated with my heart. Prior to my veterinary career, I worked as a registered nurse, and it was during this time that I was first exposed to the concept of hospice care. Over the past several years, I have found myself drawn back to these roots, and have since started a pet hospice service within the referral hospital where I practice emergency medicine.

To highlight what a difference hospice care can make to a pet and a family, I would like to share the story of my first hospice patient, Sunny, who was one of the most loving and happy girls I have ever met. She quickly earned the nickname “Kissy Girl,” as I couldn’t be within a tongue’s length of her lest I be the receiver of her spirited attempts to lavish an endless stream of wet and cold-nosed kisses on me.

Our paths first crossed during a typical Sunday in the ER. As I was getting ready to see my next patient, who was having trouble urinating, I thought: diagnosis, UTI. But  during the physical exam, my heart sank as I realized that the source of her straining to urinate was not an infection, but rather, a tumor that was compressing her urethra. An ultrasound revealed that it was inoperable, and chest X-rays confirmed that the cancer had already spread to her lungs. Looking at that sweet and happy face, you would never guess that all that badness was living inside her.

Bad turned to worse when I found out that Sunny’s dad, Jeff, was in another state attending his own father’s funeral. Besides the devastating news of her cancer, the most difficult thing for Jeff to endure was the fact that he would not have a chance to say goodbye, nor be by her side when she passed away. He was torn: in his heart he wanted to be with her once more, while in his mind, he did not want to delay the inevitable and risk her being in discomfort. This broke my heart, and I shared his sense of helplessness.

My hospice service wasn’t set to officially begin until the following month, but I could not let Sunny pass without her dad having had the chance to see her just one more time. I offered a hospice situation for her, and helped her by placing a catheter so she could urinate despite the tumor. Jeff took a red-eye flight home that very night and reunited with her the following morning. She erupted in sheer joy the moment she saw her dad, and Jeff easily learned how to manage her urinary bag.

Hospice care allowed Sunny to have another amazing week at home—one that included heaps of love, trips to the park and her favorite beaches, and a  doggy party where filet and ice cream were served. It also allowed Jeff time to return home, spend more quality days with her and begin the process of saying good-bye to his best friend.

At the end of the week, I spent an incredible afternoon with Sunny’s family, celebrating and toasting her life, as well as getting more of those famous kisses. I helped her cross the Rainbow Bridge from her favorite sunshine-filled spot in the back yard, surrounded by those who loved her. You see, Sunny was not just “any dog”: she was also the rock who helped Jeff through the death of his first wife due to cancer.

As I reflect on my life’s path, it seems strangely paradoxical: I spent the first eleven years of my veterinary career doing everything possible to save lives in an ER setting, and now I am working just as fervently to end them as beautifully and as peacefully as I possibly can.

I am often asked, “Aren’t you always sad? Isn’t this just so difficult to do?” The short answer to this multi-layered question is “yes,” and in fact, I still cry during every euthanasia. Although it can be a heart-wrenching journey to take with another, it is through these experiences that my life becomes more blessed and made richer. For what people often don’t realize is that my tears well from being in the midst of great love, from experiencing the tremendous bond between family and pet, and from being able to give another the precious gift of good-bye.

Wellness: Healthy Living
Fighting Fleas on Pets...Safely

Scratch, scratch, scratch....
 

The sound of Cricket's toenails digging into his belly woke me last night at 3:00 AM. How annoying. The little guy has a flea, and that means today's bath day. Our dogs recognize the bath day ritual pretty quickly. When their beds get stripped and everything goes into the washing machine, they both get that worried look. Then when I put on the red running shorts, they know the time has come. In the past, Cricket - the little scamp - would try to flee and we'd have to chase him down, corner him, scoop up his 30 pounds of indignation, and carry him into the shower. Kanga had a more Gandhi-esque approach to the whole thing. She would curl up on the couch and refuse to move. Since she weighs a full 60 pounds, we'd sometimes practically need a crowbar to get her up and prod her toward the bathroom. Now they seem to recognize the inevitability, so both dogs come - heads hanging low - and submit to the indignity. Afterwards they cavort in gleeful joy for having survived yet again. That night Cricket asks to hop up on the bed, and sometimes we let him because he's so clean, fresh and fluffy...not to mention cute.
 

Lots of people ask me how to control fleas on pets, and as a pet owner I can relate. I hate fleas. But a trip to the pet store can be a bewildering experience, with all kinds of pesticide products on the shelves marketed to protect our best friends from vermin. Over the past year or so, my team of researchers at NRDC has been looking at these products and we've learned a few things that made me go with my current shower plan.
 

First of all, just because a pesticide is legally on the shelves doesn't mean it's safe. Many of these products contain potent chemicals that can have adverse effects on pets and kids. I'm especially concerned about flea collars because many of them contain really toxic chemicals - such as tetrachlorvinphos and propoxur - that should probably not be on the market anymore. The collars are designed as a 'slow release' device for the pesticide, and spread a pesticide residue across the animal's fur for weeks. That's fine unless you ever touch your pet. The problem is that the residue gets on your hands (or worse still children's hands) and then can be absorbed through the skin or accidentally ingested.
 

Even some of the "natural" flea control products can be a problem, since some of these chemicals can cause allergic reactions such as dermatitis and even asthma in sensitive people. There are lots of products out there, but we found relatively few that we can really recommend as safe. For information about specific flea control products that you use, check out the product guide on the "Green Paws" website.
 

In medical school, I took a course on the history of medicine. I learned the disgusting fact that in the past people were routinely infested with vermin such as lice and fleas. All kinds of chemicals, including DDT, were used for de-lousing humans even within the past 50 years. Fortunately, vermin on people isn't generally a problem in the United States today. That's because most of us bathe and wash our clothes on a regular basis. So why not apply this same rule to our pets? In my house, every two weeks, the dogs get a bath and all of their bedding gets cleaned. Every week the carpets get vacuumed well to remove any possible flea eggs. Guess what - it works! Every so often one of them picks up a flea at the dog park, but as soon as we see the scratching, out comes the flea comb, and that little blood sucker is soon drowned in a cup of soapy water. It's really easy once the whole family has the routine down. And it's great to have dogs that smell and feel clean.  Better still, it's great to have dogs that aren't covered with a toxic residue.

This article originally appeared on Gina Solomon's Blog on Switchboard, from the NRDC website, in Oct 2008.

News: Guest Posts
Pet Oxygen Masks Help Firefighters Save Lives

Recent news reports about house fires with dogs trapped inside are a keen reminder how valuable a pet oxygen mask can be to firefighting crews. Check if your local fire department has these tools, and if not, consider donating one to them. They're not expensive.

In Lima, Ohio, a house fire broke out the morning of January 3, 2013. An adult occupant escaped from an upstairs room, but the family dog Cola hid in the basement. Nearly fifteen minutes after firefighters started attacking the fire in the freezing cold, they discover the dog-apparently lifeless-and bring her upstairs and out onto the snow. Luckily, the Lima Fire Department had been the recipient of a gift: pet oxygen masks, made to fit the long snouts of dogs and other pets. Firefighters worked on Cola for nearly five minutes, giving her oxygen, until she started breathing again. Her emotional owner, anxiously watching nearby, cried tears of relief and gratitude.

The house fire was caught on video; toward the end, near the 16:00 minute mark, you can see the firefighters bringing Cola out of the house and laying her on the snow to start resuscitation efforts. Unfortunately the video does not extend to her successful recovery.
http://youtu.be/5U16UQHMDaY

Nearby Delphos Animal Hospital had donated the pet oxygen masks to the Lima Fire Department just a week earlier. According to news reports, they plan to donate two more, soon.

Also on January 3rd, firefighters responding to a house fire in Forth Worth discovered two dogs inside. One was alright, but the other was unresponsive. Using an oxygen mask, the firefighters were able to revive the dog.

The fire department's spokesperson noted that firefighters attempt animal rescues several times a year, and that some of their trucks are outfitted with animal oxygen masks. Otherwise, they use those made for humans.

Wouldn't it be nice if all fire trucks and other first responders were equipped with animal oxygen masks?
A quick online search brings up at least two vendors of the SurgiVet Pet Oxygen Mask, with prices ranging from $27.50 each (small, medium or large), or all three plus a carrying case for $68.75 (Yuckos) or $95 (Pets America). Pets America provides pet emergency preparedness and educational programs, so the extra cost clearly helps their primary mission.

 

News: Guest Posts
Ten Tips for Winterizing Your Pets

Oh, the weather outside is frightful! Winter weather is rapidly approaching and you’ve likely begun layering your clothing and weatherproofing your car. When organizing for winter, don’t forget to think about your pets. They too are deserving of special treatment this time of year. Here are ten tips for keeping your pets cozy, comfortable, and healthy this winter:

1.  Just as arthritis can be more problematic for us when the temperature drops, so too does this apply to our animals. If your best buddy appears stiff first thing in the morning or is more tentative when navigating stairs or jumping up and down off the furniture, I encourage you to contact your veterinarian. These days, there are so many beneficial treatment options for soothing arthritis discomfort. For your pet’s sake, make the effort to learn more about them.

2.  When the temperature drops, outdoor kitties like to snuggle up against car engines for extra warmth. Be sure to provide plenty of notice before you start up your engine lest a “kitty squatter” sustain serious injury as a result of moving auto parts. Vocalize and tap the hood a few times. Better yet, lift the hood to alert any slumbering guests of your intentions.

3.  Antifreeze is terribly toxic for dogs and cats. Even a few licks of the stuff can cause kidney failure and severe neurological symptoms, usually resulting in death. Unfortunately, most antifreeze products have a sweet flavor making them appealing to dogs. Cats are too discriminating to voluntarily taste the stuff, but should they step in antifreeze, they will ingest enough to be toxic during their grooming process. Please prevent your pets from having any access to antifreeze by checking under your vehicles for leaks and storing antifreeze containers in a safe place.

4.  Wintertime is definitely dress-up time for dogs, when the clothing is functional rather than just adorable. Just like us, many dogs are more comfortable outside when wearing an extra layer. Smaller dogs in particular have difficulty maintaining a normal body temperature when exposed to freezing conditions. If the love of your canine life happens to be an Arctic breed (Malamute, Husky, Samoyed), no need for canine clothing!

5.  Regardless of season, all animals need access to water round-the-clock. If your pet is reliant on an outdoor water bowl, strategize a way to prevent the water from freezing. Water bowl heaters work well. Additionally moving water is more resistant to freezing- consider creating a little “drinking fountain” for your pets.

6.  Sure the weather is cold, but your dogs still need plenty of exercise for their physical as well as their psychological well-being. Besides, there’s nothing quite like the feeling of relaxing by the fire with a content and tired dog at your side! If the weather is truly too inclement for both of you to be outdoors, look for an indoor dog park or consider doggie day care, assuming your dog enjoys such venues.

7.  I’m all for hiking with dogs off leash, but in winter be extra cautious around ponds and lakes for fear of thin ice. Not only is falling through the ice life threatening for dogs, it creates a situation that often becomes life threatening for the humans involved in the rescue operation.

8.  Salt on sidewalks and roads and even ice that adheres to all of that fuzzy hair between your dog’s toes can create irritation and sores. Inspect and rinse your dog’s tootsies as needed.

9.  I strongly encourage having dogs and cats live indoors. If your living situation absolutely prevents this, and there are no other viable alternatives, please provide your pet with an enclosed shelter that is warmed by a heating device and contains plenty of clean, dry bedding. Also, remember that your pet needs just as much attention from you in frigid temperatures as during the warmer seasons.

10.  ‘Tis the time of year when we humans tend to overindulge, eating all kinds of things we shouldn’t. Don’t allow your pets to become a victim of this holiday spirit. In addition to adding unwanted and unhealthy pounds, eating rich and fatty foods predisposes them to gastrointestinal upset and pancreatitis either of which could land your four-legged family member in the hospital for several days (not to mention create some significant rug-cleaning expenses for you).

What steps do you take to ensure your pets will be happy and healthy during the winter?

 

 

News: Guest Posts
Toy Alert
Study finds Hormone-disrupting Chemicals Leach from Some Plastic Toys

The toy aisle is meant to be all about fun, but recalls, toxic imports and a dearth of regulations have left dog owners facing tough choices. Many toys are made of plastic and may contain chemicals that interfere with hormones.

A new study by researchers at the Institute of Environmental and Human Health at Texas Tech University shows that BPA and phthalates, chemicals that disrupt hormones, “readily leach” from plastic or vinyl bumper toys used to train retrievers.

Philip Smith, a toxicologist and co-author of the as-yet unpublished study, uses plastic bumpers to train his Labrador Retrievers, Bindi, age 11, and Huck, age 5. He wondered if the bumpers might expose them to hazardous chemicals.

In fact, the compounds are hard to avoid. BPA, the building block of polycarbonate plastic, is found in most food and drink cans; phthalates are common in food packaging, personal care items and vinyl plastics.

“BPA and phthalates come from many, many sources” besides pet toys, Smith says. So a dog’s “cumulative exposure may be significant.”

The study, conducted by graduate student, Kim Wooten, is one of the first to examine these chemicals in pet toys. In children’s toys, some phthalates have been banned in the U.S. and the European Union. In July 2012, the U.S. Food and Drug Administration banned BPA in baby bottles and children’s drinking cups.

Although their health effects in dogs are unknown, the hormones they interfere with regulate many biological functions.

Studies done mostly with rodents have linked BPA and phthalates to impaired development of reproductive organs, decreased fertility, diabetes and obesity, cancers, and behavioral and attention problems.

No, dogs are not mice. There are “species sensitivity differences” in regard to toxics, Smith says. For example, dogs are at greater risk than humans from eating chocolate. But while their sensitivity to synthetic chemicals may also differ, “we are unaware of specific reasons why they might respond in a significantly different manner.”

Available data suggests that the most vulnerable pets may be pregnant females “and perhaps young animals like puppies.”

According to a 2012 pet health report by Banfield Pet Hospital, some cancers and other diseases in dogs are increasing. “The rate of overweight and obese pets has reached epidemic levels in the U.S., affecting approximately one in five dogs and cats.”

The causes are unknown, but Smith says it’s possible that endocrine-disrupting chemicals, including phthalates and BPA, play a role.

Certain aspects of canine cancer suggest that dogs are sensitive to them, he says. For instance, exposure to estrogens raises the risk for mammary cancers. For metabolic disorders such as obesity and diabetes, researchers are finding that some hormone-disrupting chemicals appear to “affect metabolic endpoints, in addition to reproduction and behavior.”

For the toy study, the researchers tested orange and white bumpers from two unidentified makers, using artificial saliva to simulate a dog chewing a bumper. The amount of toxics released in a dog’s mouth couldn’t be determined due to the use of simulated saliva,

But what is a high exposure in dogs?

“We are not aware of any exposure guidelines pertaining to these particular chemicals and dogs,” Smith says.

They suspect the levels released from the bumpers would be very high, though, compared with children’s toys.

The study also examined BPA and phthalates from ordinary plastic pet toys sold in stores. The bumpers leached more, but the results suggest that the other toys might have released other hormonally-active chemicals.

Smith highlights the uncertainty that shoppers face, saying the bumpers might have been made from different materials, or perhaps the packaging limited the release of some chemicals before the experiment.

Or, the less affected toys may have involved “materials that are also used in the manufacture of children’s toys.”

“We’re not really sure, but intend to pursue the question further.”

Good thing for pet owners.

“Given the extent of plastics in the human-canine environment,” Smith says, avoiding the chemicals entirely may not be possible.

But not all plastics are the same. When it comes to leaching of chemicals “each type is very different.”

“That is why studies on individual products are important.” Pet owners need the information “to make thoughtful decisions.”

Some pet toy makers say they use BPA-free plastics.

But owners may wonder why it’s even a question. Why should they have to worry about chemicals in toys or migrating from cans, even into “organic” food, to add to their dog’s exposure?

At least—at last—it is being studied.

Smith’s team plans to continue studying the exposure of pets to chemicals. “We think there is a great deal to be learned about potential pet and human health impacts from chemicals in the environment,” he says.

And as they learn, Smith says they hope to yield the data needed “to inform decisions about how we manufacture pet products, which ones we buy, and what we allow our pets to chew.”

Wellness: Recipes
Bread Baking Delights
Hooked on No-Knead
1. Dough after rising 12 hours. 2. Dough after the second rise. 3. Loaf flipped

This past year I have discovered the joys of “fermentation” in the guise of yogurt-making and bread-baking. At the start of the year, I dusted off a yogurt maker that had been long forgotten at the back of the cupboard, and have been keeping all of us (including the dogs, who love it) supplied with this probiotic-loaded, highly nutritious food, you can find the directions to make your own here. I put a spoonful of it to top off the dogs’ meals, or let them lick it right off the spoon.

And, despite living in one of the country’s artisan-bakery hubs, it’s now been over a year since I’ve bought bread. And I must admit I always was a die-heart bread fanatic. So when I heard about the ease of baking your own bread that came via Jim Lahey from the Sullivan Street Bakery (NYC) and his able acolyte, Mark Bittman of the New York Times, I was intrigued.

With my very first loaf turning out great, I was hooked and have been busy baking our own whole wheat, country-style bread using his “no-knead” method, a trend (ahem) rising in kitchens everywhere.

For as long as I can recall, when it came to bread making, the need to knead was my downfall, so the idea of “no-knead” was an enticing come-on. I couldn’t be more thankful for what this simple recipe has given us. Not only does it fill the house with the nothing-better-than aroma of freshly baked bread, it also provides the crunchy delight of olive-oil-laced crouton snacks for our pups and abundant, tasty breadcrumbs for their turkey meatloaf.

Lahey’s basic white bread recipe, which started this craze, can be found here. But whole wheat bread is not only better for you, but one that I especially am fond of, so I was pleased to see that he also has a great cookbook, aptly titled, My Bread, that goes into detail about “pane integrale” whole wheat, rye and many other varieties. This recipe is so simple, not only is there no kneading, but you don’t have to “test’ the yeast, or punch down the rising loaf.

So I suggest that you view the video to learn about the basic technique, but recommend you try the whole wheat version first. The basic difference with the recipe for the white bread version (featured in the video) and the whole wheat (or rye) one is that instead of using 3 cups of bread flour, you use 2 cups of bread flour (be sure to use bread flour and not all-purpose) and 1 cup of whole wheat or rye. I’ve adapted the recipe slightly, so I combine 3 different flours—about 2/3 c of whole wheat, a couple of tablespoons of rye and topping it off with spelt flour (all 3 different types together equal one cup). I also add another tablespoon or so of water, to the 1 1/3 cups of water.

Whole Wheat bread recipe:
(Adapted from Jim Lahey)

2 c bread flour

1 c whole wheat (or a mix of whole wheat, spelt, rye) flour

1 ¼ tsp. salt

½ tsp instant or active dry yeast

1 ⅓ c (plus a scant tbsp.) cool water

Directions:

Put all dry ingredients into a medium sized mixing bowl, and using a wooden spoon or your hands, mix all the dry ingredients, making sure that the flours are well integrated. Then pour all the water into the bowl, not in one place but over the top of the flours to cover as much as you can. Then mix that it all with a spoon or your hands. That should take only 30 seconds or a minute or so. Cover the bowl with plastic and let rise for 12 to 18 hours at room temperature.  It should double in size. (The warmer the room the less rising time, but 12 hours is always the minimum amount of time for the bread to ferment slowly—an important aspect of this recipe.)

After the dough has gone through that first rise, generously flour a surface (like a cutting board or counter top, use white flour for this) and your hands, and remove all the dough from the bowl. It might stick to the bowl, but be sure you get it all out in one piece. You can also use a plastic bowl scraper, but you want to remove all the dough in one piece. With your well-floured hands (to keep them from sticking to the dough), shape the dough by folding and refolding (a few times) and then forming it into a round form (it will be around 6 inches in diameter in a nice round ball form). Gently move the dough unto a well-floured tea towel (do NOT use terry cloth, and you can use cornmeal, or bran instead of flour), cover with either another tea towel or the edges of the towel. Let the dough rest for 1 to 2 hours in a draft free spot. The dough is ready for baking when, after a gentle poke with your finger, it leaves a slight impression. It if doesn’t, wait another 15 minutes and test it again.

Here’s the important part of what makes the magic of this simple baking method work—Lahey’s “oven within an oven” discovery. You will be baking the bread in either a heavy covered 4 ½ quart to 5 ½ quart pot, like an enameled cast-iron Dutch oven, or a 5-quart Lodge cast-iron pot. I like the clay ware La Cloche cooking bell best because I find it easier to place the dough loaf onto it, instead of “flinging” the loaf into a higher sided pot. It is very important that whatever pot you use, that pot stays covered during the preheating and the first part of the baking process. This is the "oven within the oven" trick created by Lahey and, as he describes it, “It accomplishes what classic domed brick ovens do: it completely seals in the baking process so the steam escaping from the bread can do its work to ensure a good crust and a most crumb.”

Half way through this second rise, preheat the oven to 475 degrees. To accommodate a large pot or a La Cloche you will probably need to remove all the racks from the over, except for one on the lower third portion that you’ll be using. I start the preheating ½ hour after the loaf was shaped, so even if it does take 2 hours for the dough to be ready, at least the oven and the pot are nice and hot.

When the dough is ready, carefully remove the pot from the oven, making sure not to place the pot on a cool surface (especially if using a La Cloche), remove the cover, then working quickly, gently flip the loaf over into the pot, so the “bottom” of the dough becomes the top of the loaf. You might have to flour your hands to do this, to avoid the dough sticking to your hands. Don't worry if the “bread,” at this point, looks flat and blob-like. Cover the pot, and again, working quickly, place it on the middle of the oven rack.

Bake for 30 mins., at 475 degrees, the first blast of heat causes the fermenting dough to become “bread” in what is called “over spring.” After 30 mins. remove the lid from the pot and bake the bread for another 10 to 20 minutes. At this point it will definitely look like a loaf of bread. The time depends on how hot your oven is, and how dark you like your crust. By this time your kitchen will be drenched in that lovely, fresh bread aroma, savor it as your loaf cooks.

Remove the loaf from the pot and cool on a rack—while it should be easy to remove it from the hot pot, you might need to use a spatula to gently pry it up from the bottom. I know it is irresistible, but do not cut into the loaf until it is fully cooled, it is still “finishing” the baking process even out of the oven. The bread is said to “sing” at this cooling period, but the “singing” is evidence of the last phase of cooking.

Storing Bread:

A couple of things to note about storing bread, never ever store it in plastic, it is best just to place the loaf, once you slice it, on the cut side down on an enamel plate. You can store it in a paper bag but do NOT seal it. Or you can use wax paper too.

Recommended Ingredients:

Yeast: It is more affordable to buy it in bulk instead of in those little packets, so I’ve been buying the 16 oz instant yeast, “Saf Red instant”  from King Arthur Flour—it is only $5.95 and that makes a lot of bread. This yeast is the one most recommended by bakers and it has never failed me.

I just bought my second one-pound purchase, the first one lasted almost a year. Make sure to store yeast in the refrigerator. I place a smaller amount into a little glass jar and then store the rest of the yeast in a larger container.

Flours:

Bread flour: I use King Arthur’s but there are many other good ones—you must use bread flour, all-purpose does not have the protein content for bread.

Whole wheat flour: There are a few great brands, some of them from local millers. The hard red winter wheat flour (In California) from Community Grains is great, so too is the organic whole wheat high protein flour (made from Northern spring wheat) from Giusto’s Vita Grain. King Arthur Flour  also has a good whole wheat flour but I urge you to see what your local milling companies have to offer. It really is quite the discovery to learn about how vibrant that sector has become.

Rye and Spelt flours: Arrowhead Mills, Bob’s Red Mill, Hodgson Mill also have good ones.

Other Sources:

Even though “no-knead” was invented by Jim Lahey there are many others who have interpreted this method very successfully.  I have also used the recipes from Jeff Hertzberg and Zoe Francois’ Healthy Bread in Five Minutes a Day—I especially like their brioche. There are oh so many videos showing methods and recipes, including Breadtopia.com.

Just go to YouTube and search for “no knead bread,” you’ll be amazed at how many others have been baking bread, so hopefully this will inspire you to start baking your own. Send us photos when you do, would love to see your “loaves.”

Uses for leftover bread:

For croutons, I use whatever is left over as I bake the next loaf (I bake about 3 times a week), slice the bread into small cubes (or whatever size you prefer), place in a bowl and add olive oil mixing the oil well on all the cubes, then place on a cookie sheet and cook at around 350 for 15 to 30 mins.—the baking time depends on how crunchy you like them. I give them to the dogs for extra special treats, sometimes spreading a little homemade peanut butter on them. (I also just started to make peanut butter, another extremely simple thing to whip up.) For the bread crumbs, I heat up some day old (or older) bread, cut it into larger cubes, place in a blender or food processor, and pulse a few times until is the consistency you desire. Some people then bake the crumbs in the oven for a few minutes, but if you heat the bread first you don’t need to do that. You can freeze the bread crumbs if you aren’t going to use them soon.

Bread knife:

If you don’t have a good bread knife you will soon be wanting to get one, I found that the Victorinox model 47547 works really great. You should be able to find one for less than $40 (considering that I was looking at knives arranging from $200 to $300, this great find, recommended by Chow, was a bargain).

 

 

Wellness: Healthy Living
Making Pet Meds More Affordable
Greater choice made available to pet owners
More Affordable Pet Meds

As politicians and voters squared off this fall, a little bill sat in committee on Capitol Hill, awaiting action that in all likelihood won’t happen. If it expires, it will probably be reintroduced at the next Congressional go-around in 2013. But even if it dies on the vine, the bill has opened debate on an issue that affects virtually every pet owner — the cost and availability of veterinary medications — and promises to keep the discussion going for years to come.

If passed, the legislation (officially known as HR 1406: Fairness to Pet Owners Act of 2011-IH) will require vets to give clients a written copy of all prescriptions. It also will require them to notify clients, in writing, of the client’s option to have the prescription filled elsewhere, and to confirm (via fax or other means) any prescriptions sent to outside pharmacies. This is not a novel concept; a majority of veterinarians already do this for those who request it. The act would, however, make it mandatory for vets to provide the prescriptions without being asked.

The bill is modeled on the Fairness to Contact Lens Consumers Act of 2003, which required eye doctors to give their patients a copy of their prescriptions, thus breaking the medical monopoly on those lucrative little bits of polymer. This “prescription portability” was credited with changing the entire contact-lens market, giving consumers freedom to comparison shop (making prices more competitive) and also improving the quality and safety of the products themselves by streamlining the supply chain and distribution system. In the world of veterinary medicine, prescription portability would, at least in theory, reassure bargainhunting consumers that they’re shopping around in a truly open (and safe) marketplace.

HR 1406 was introduced April 2011 under the sponsorship of Representatives Jim Matheson (D-UT) and Lee Terry (R-NE) and was immediately sent to the Health subcommittee of the House Committee on Energy and Commerce, which must approve the bill before it can be voted upon by Congress. But because 2012 is an election year — one that most certainly hasn’t been dominated by debates over pet prescriptions — few observers predict any action. The legislative monitoring service GovTrack gives the bill a 1 percent chance of passing before the end of the 2012 session; not great odds, obviously, but not particularly bad, either, given that only about 4 percent of the bills introduced in 2009–2010 were enacted.

“Most often, bills like this take five to seven years to get passed,” says Andrew Binovi, federal legislative manager of government relations for the ASPCA, which is supporting the bill. Alyson Heyrend, communications director for Rep. Jim Matheson, adds, “There is no action expected on the bill before the end of the session — it’s an election year. But we’ll most likely be reintroducing the bill next time. It’s a good bill, good for pet owners, good for consumers. In this economy, every little bit helps, and lots of people aren’t even aware that they have options when it comes to pet medications.”

A Pocketbook Issue
The subject of pet medications has been getting attention in other parts of the government as well. The Federal Trade Commission held a public workshop on the topic in October, and is expected to issue a report on its findings sometime in 2013. In its official statement, the FTC calls the price of pet meds “an important pocketbook issue for many consumers,” noting that the 62 percent of American households with pets spend roughly $7 billion annually for prescription and over-the-counter drugs for their companion animals.

Like everything else in Washington, the Pet Owners Act has both fans and foes. According to the Center for Responsive Politics, eight organizations are registered to lobby on HR 1406, including Walmart and the National Association of Chain Drug Stores. “This bill allows consumers a choice when it comes to prescription medications for their pets, and Walmart supports efforts that give our customers a say where they purchase medicines and enable them to save money,” says Molly Philhours, a media relations rep. This support is hardly surprising, as the act would be a boon for Walmart and other big retailers, drug and grocery stores, says David Sprinkle, research director for Packaged Facts, a market research firm. “What we’re seeing is a natural progression, as the pet-health market moves toward greater parallelism with human healthcare.”

However, the number of pets covered by health insurance is miniscule, arguably making the out-of-pocket cost of a pet’s prescription drugs an even bigger concern for consumers than their own meds. “Less than 1 percent of the cats and dogs in America are insured, so this is a huge issue for owners,” says Laura Bennett, CEO of Embrace Pet Insurance. “Even if this bill doesn’t go through, it’s already had a big impact.”

Bones of Contention
The bill’s biggest opponent is the American Veterinary Medicine Association, which has registered to lobby on it and is urging its members to voice their opposition. “We’re not opposed to our clients having their pets’ prescriptions, or filling them at accredited pharmacies, but we’re against the legislation because it’s redundant,” explains Ashley S. Morgan, DVM, AVMA’s assistant director of governmental relations. “We don’t need a federal law to mandate something that most vets have been doing on their own for some time.” She notes that 26 states already have laws that require essentially the same thing as the new bill stipulates, and that most consumers are well aware of the wide availability of pet prescription fulfillment options.

The proposed legislation has another downside for vets: loss of revenue. While the impact will vary among individual practices, Morgan says, most veterinarians today make between 14 and 28 percent of their income from in-house drug sales. In addition, vets typically charge fairly high mark-ups, an average of 129 percent over wholesale, according to the American Animal Hospital Association. Many also charge a “dispensing fee,” typically an average of $9 per script. Morgan adds that the proposed law would drown vets in paperwork, and require clinic staff to spend an inordinate amount of time communicating with outside pharmacies. Most veterinarians will be forced to pass those extra expenses on to their clients.

Until fairly recently, veterinarians were the sole source for prescription pet medications. But with the advent of online pet pharmacies, such as Drs. Foster and Smith (which began selling medications and other pet care products through its catalog in 1983 and online in 1998), price-conscious owners started taking their drug business elsewhere. And in 1994, with the passage of the Animal Medicinal Drug Use Clarification Act (AMDUCA), veterinarians could prescribe certain approved human drugs for animals. In many cases, this gave veterinary clients an option to choose between the animal and the human drug, and to buy those drugs from outside pharmacies.

But this just means that vets are behind the times when it comes to setting their prices, says Bennett. She notes that many veterinarians deliberately undercharge for some services to keep clients happy; like restaurateurs who exponentially mark up the wine they sell to make up for value-priced entrees, these vets count on the sale of medications to make the balance sheet work. “If you’ve been relying on drug sales all this time, this is a wake-up call,” she says.

Competition — and Choices
According to Bruce Rosenbloom, chief financial officer of PetMed Express Inc., parent company of the online retailer 1800-PetMeds, pet owners today spend about $3.8 billion annually on prescription drugs for their companion animals, and vets make about 67 percent of those sales. (Packaged Facts’ estimate of vets’ share of drug sales is roughly the same.) PetMed Express’s research shows that big retailers like Target, Walmart and Walgreens sell about 22 percent of pet medications through their retail and online stores, while web and mailorder retailers like 1800-PetMeds and Amazon account for the remaining 11 percent.

All of these outlets offer incentives to pet owners. Kroger, for example, sells a long list of generic pet drugs, including some of the most-prescribed for dogs — pain-relievers like tramadol and meloxicam and antibiotics like amoxicillin and cephalexin — at $4 per 30-day supply. Target’s PetRx program, available in more than 1,200 of its instore pharmacies, can fill veterinary prescriptions for animal-specific medications, and all Target pharmacies will fill pet scripts for human drugs (they offer many $4 generics, as well). At Walgreens, you can add your dog to your $35-a-year family membership in the discount pharmacy program. With that, you get reduced prices on pet prescriptions and access to over 400 generic medications priced at $12 for a 90-day supply. Stop ‘n Shop and Winn-Dixie stores fill human-equivalent scripts, and have arrangements with online pet pharmacies to get your dog’s meds to you in one to two days.

For those who’d rather shop online, there are currently 18 web-based pet pharmacies accredited with the National Association of Boards of Pharmacy through its Veterinary-Verified Internet Pharmacy Practice Sites (Vet-VIPPS) program, each of which has its own offers and incentives. (There are also countless websites that aren’t accredited — or properly licensed — which the Food and Drug Administration and other groups strongly suggest you avoid.)

All this competition is good news for consumers, says ASPCA’s Binovi, because it guarantees that pet owners will be able to fill prescriptions as cheaply as possible. “There are big benefits here for both pets and their guardians,” he says. “It’s not that the veterinarians were a problem, just that this bill would harmonize all the different state laws to guarantee that everyone has better access to these medications.”

Keeping the cost of pet ownership down is especially important in this economy, he adds. “We know that economics weighs into the decision to adopt an animal and even, in some cases, to surrender an animal to a shelter.” There are no statistics on the number of owners citing the high cost of prescription drugs — or any other expense associated with keeping a pet — as the reason for surrender, but it’s not a great leap to suggest that someone who’s facing serious financial problems might see the family dog as an expense that could be eliminated. And even for an owner who’s not in dire straights, every little bit helps. “It’s always good to have more choices and better access, no matter what you’re buying,” he says.

You can verify an online vendor’s Vet-VIPPS standing on the NABP website: nabp.net.

Wellness: Recipes
From Scratch: Yogurt Making
Probiotic for you and your dog

Making yogurt is easy, economical and it helps both you and your dog to stay up on your probiotic regimes. With only two ingredients and a few tools, it couldn't be simpler. (While a commercial yogurt maker is convenient, it is not necessary.)

Tools:

Heavy pot
Kitchen thermometer (with a clip to hold unto to the pot)
Whisk
Glass jars or yogurt maker or warming pad or insulated cooler.

Ingredients:

1 qt. milk (low fat or non-fat; cow’s or goat’s milk)

2 or 3 tbsp. of fresh plain yogurt (from the previous batch or store-bought—but be sure it contains a live-culture!)

Step One: Heat the milk

Pour milk into a pot, heat slowly until the temperature reaches 185 degrees, stirring frequently (this can take up to 20 minutes). The longer you maintain this temperature, the thicker the final product. Be sure not to scald or burn the milk.

Step Two: Cool the milk

Pour the hot milk into a bowl or keep it in the pot—it will need to cool down to 110 degrees. You can place the bowl/pot into a larger bowl (or in the sink) with cold water or ice cubes around it to help the cooling. This takes around 15 minutes. It is important that it cools down before adding the culture. High temperatures can destroy the culture.

Step Three: Add the culture

Pour about a cup of the cooled milk into a small bowl or into a two-cup measurer and add 2 to 3 tbsp of yogurt. Whisk. Add it back to the rest of the milk, whisking again to make sure the milk and culture is thoroughly mixed.

Step Four: Incubate

Pour this mixture into yogurt-maker jars or into 2 large glass jars. If using glass jars, cover them and wrap in towels. Place them on a heating pad (set on medium, or a setting that assures 110 degrees) for 8 to 12 hours or until thickened. Or wrap the jars in towels, and place them with other jars filled with hot water into a cooler, close the cooler and let set for 8 to 12 hours. (There are many other methods to provide this low-warmth level, but the key is to hold the mixture undisturbed for 8 hours or more at 110 to 115 degrees.) After the yogurt has set, put in the refrigerator where it will set more. It can keep up to 1 week chilled. 

Remember to make your next batch, use 2 tbsp. from the present batch.

There is also an easy crockpot method you might like to check out, we have heard that it works well.

Extras for Dogs:

Frozen Yogurt Treats:

Your pups will love e a frozen yogurt treat. Pour into silicone ice cube trays, with a few blueberries or other fruit or juice. Dogs eagerly lick up these tasty, healthy treats! Or share your smoothies with them.

Extras for You:

Eat yogurt plain (a French meal favorite) or add honey or an easy-to-make fruit compote like this blueberry one adapted from Anson Mills.

For the blueberry compote:
1 pint fresh (or frozen) blueberries
Pinch salt
¼ cup granulated sugar
½ small cinnamon stick
Juice of one lemon

Place berries into pot with the sugar, salt, lemon juice, and cinnamon stick, and set over medium-low heat. Stir frequently as the berries begin to sizzle softly and melt. They will quickly begin to release their juices and cease sticking. Bring them to a simmer until soft and saucy, about 5 minutes. Transfer to a bowl, remove cinnamon, cover, and refrigerate until ready to use.  Stir into a portion into individual yogurt servings.

Additional uses:

To use yogurt as a sour cream substitute, thicken it by straining through a coffee filter. Or to make yogurt cheese (dog’s favorite), wrap the yogurt in fine, unbleached cheesecloth and hang it up for a day, for a quick cheese.

 

Dog's Life: Lifestyle
Setting the Table
Healthy Eating

Whether you’re feeding your dog kibble, canned food, a raw diet or home-cooked meals, how you feed him can also make a difference. In his new cookbook/nutrition guide Feed Your Best Friend Better, Rick Woodford has some basic tips for setting the table at floor level that can be applied to all dogs.

  • Let your dog know that patience is a virtue. “We ask our to dogs sit and stay in place while we’re dishing up their food. This helps prevent accidents as well as dogs getting into one another’s food bowl.” If the dog moves while you’re filling his bowl, let him know it’s time to sit back down by freezing in place and waiting for him to go back into position. With practice, your dog will catch on, and mealtime will be just a little calmer.
  • A bowl licked clean is not a clean bowl. Dog bowls should be washed after every meal to prevent a build-up of bacteria, dust or pet hair. “We have a collection of bowls that we rotate through the dishwasher, so every dog gets a clean bowl at each meal. You can add to your dog-bowl collection by keeping an eye out at thrift stores or garage sales,” suggests Woodford. Make sure they’re ceramic, glass or stainless steel, all of which are preferred over plastic, which can leach toxins.
  • When serving, always put down two bowls: one with water and one with food. Your pet may not empty the water bowl, but throughout the day, it accumulates bacteria, dust and even pollen that can aggravate environmental allergies. There’s nothing like a fresh bowl of water to wash down a meal.
  • A scoop is not a very well defined measurement. A month of feeding your dog just 10 percent more than he needs can easily pack a pound or two on him. Measure the appropriate amount of food for your dog into a glass container and mark with a permanent marker to create a more precise measuring tool.
  • Feed twice a day, which will help keep your dog from being either frantically hungry or overfull. Smaller meals also put less pressure on dogs’ digestive systems.
Wellness: Healthy Living
Trimming Nails
To trim or not to trim — that is the question
Dog Nails

Attentive as we may be, trimming our dog’s toenails is one of those vexing tasks that many of us studiously avoid. Should they be trimmed, and if so, how often? What if they bleed? What if the pedicure becomes a wrestling match, and the dog always wins? Here are some general guidelines and recommendations to help you tend your dog’s toenails.

Every dog wears down his or her nails differently. For example, take my two. Nellie, Quinn and I walk together daily on a variety of surfaces, from grass to cement. Nellie’s nails naturally remain at an ideal length, but Quinn needs a nail trim approximately once every two months (and he’s the one who runs two miles for every mile I walk).

One way to determine if your dog needs a pedicure is to manually extend the toes and assess the length of the nails in relation to the bottom of the foot. To do this, place your thumb on top of your dog’s foot and your other fingers on the large pad on the underside of the foot. Gently squeeze your fingers together, which will cause the toes to extend. With the toes in this position, check to see if the tips of the toenails are level with or go beyond the underside of the foot. The former can be left alone, while the latter need to be trimmed.

Some dogs have clear nails, which allows you to easily tell how far the tip of the nail extends beyond the “quick,” that pink- to red-colored, blood-filled cavity that runs down the center of the toenail. If the nail extends well beyond the quick, it’s time for a pedicure. (Be aware that dogs with chronically overgrown nails may also develop lengthy quicks.) And then there are dogs with black toenails, which makes it impossible to see the quick at all. To be certain about whether or not your dog’s nails are too long, consult with your veterinarian, vet tech or groomer.

If you have never before trimmed a dog’s toenails, my advice is this: ask a pro — veterinary technician, groomer, breeder — to teach you how. Pedicures can be tricky business! If your dog has clear nails (quicks readily visible) and happens to be an angel about having his or her feet handled, you’re good to go. Black nails or dogs who are moving targets make the job far more difficult. It’s easy to hit the quick, and that can be painful for your dog. Also, a nicked quick bleeds, not enough to be harmful to your dog, but enough to sure as heck be harmful to your carpeting! If bleeding occurs, your best bet is to drag the tip of the toenail through a soft bar of soap; the soap will sometimes form a plug that stops the bleeding. A safer bet is to have silver-nitrate sticks or powder on hand.

Some dogs — even the most wellbehaved dogs — absolutely, positively hate having their nails trimmed and will fight tooth and nail (pun intended) before allowing a pedicure. If this description fits your dog, know that you are not alone. In this case, trimming just one or two nails at a time may be the ticket. For others, the use of a Dremel tool rather than clippers restores sanity to the situation. Of course, routine handling of your dog’s feet and lots of praise can pave the way for less hectic pedicures as well.

Still, there are dogs who, no matter what, struggle so much that four people are needed to accomplish the nail trims — three to restrain the wriggling beast and one to trim the nails (and these are dogs who are often perfectly mannered in every other situation). In such cases, one has to question whether or not it’s really worth it. If that’s the case with your dog, I encourage you to talk with your vet about how to make the nail trim less stressful and more successful. She might be able to recommend a more effective restraint technique, behavior modification strategies and/or the use of Rescue Remedy or chemical sedation.

Remember: performing pedicures on black toenails and/or wiggly dogs is not for the faint of heart. Don’t hesitate to enlist the services of a seasoned veteran. It will be a relief for you and your dog!

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