Nancy Kay, DVM, Dipl., American College of Veterinary Internal Medicine, is a 2009 recipient of AAHA's Animal Welfare and Humane Ethics Award and author of Speaking for Spot.
Wellness: Healthy Living
June 5 2012
Heartworms and hookworms and fleas, oh my!! Get ready- the forecast is that this year’s combination of unseasonably warm winter temperatures and plenty of springtime precipitation is going to produce a deluge of parasite problems for our pets including: heartworm disease, fleas, ticks, and intestinal parasites (roundworms, hookworms, whipworms, tapeworms).
The Companion Animal Parasite Council (CAPC) predicts a substantial nationwide rise in parasites above normal levels. Hardest hit will be the southern portion of the United States (West Virginia, Virginia, North Carolina, South Carolina, Georgia, Florida, Alabama, Tennessee, Mississippi, Arkansas, Oklahoma, Texas, and Louisiana). The CAPC anticipates that 2012 will be a “banner year” for heartworm disease, and that even the slightest deviations from administering heartworm preventive as recommended could pose significant health threats for pets.
The CAPC is also predicting a jump in parasite populations within the Northeast (Maine, Vermont, New Hampshire, Massachusetts, New York, Rhode Island, Connecticut, New Jersey, Pennsylvania, Delaware, Maryland, the District of Columbia) and the Midwest (Kansas, Missouri, Illinois, Indiana, Ohio, Michigan, Wisconsin, Iowa, Minnesota, North Dakota, South Dakota, Nebraska), particularly in areas with above-average temperatures and rainfall. During the past five to ten years, the incidence of heartworm disease has been on the rise in both the Northeast and the Midwest.
Washington, Oregon, and Northern California are expected to experience moderate increases in companion animal parasite populations this year. The parasite forecast for Southern California, Arizona, New Mexico, Nevada, Utah, Colorado, Wyoming, Montana, and Idaho is moderate compared to other regions in the country.
Sounds like there will be no hiding from parasites this year! In order to protect your dogs and cats from these pesky varmints I suggest the following:
1. Talk with your veterinarian about the products best suited for protecting your dogs and cats against heartworm disease, intestinal parasites, fleas, and ticks. There are a variety of products to choose from and their effectiveness can change from year to year. Your veterinarian will be “in the know” about which preventive medications have the current best track record. Be reminded, animals with thick hair coats or those who are housed mostly indoors remain susceptible to heartworm disease.
2. Be downright religious in adhering to a schedule for administration of your pet’s heartworm prevention medication. This year in particular, missing the mark by even a week or two could have dire consequences.
3. Set up a schedule for routine testing for parasites. Your veterinarian can advise you on how frequently your pets should be screened for intestinal parasites and heartworm disease.
4. Check out the CAPC website to have a look at parasite prevalence maps (updated monthly) and get information about your specific geographic area.
5. Visit the American Heartworm Society website to catch up on the most current information pertaining to heartworm prevention for dogs and cats.
Are you “good to go” with a parasite prevention plan for your dogs and cats? What will your strategy be?
Wellness: Health Care
Become an advocate for your dog
April 9 2012
How much easier it would be if vets had Dr. Dolittle’s ability to talk to the animals—when we took our pups in for a check-up, they could speak for themselves. Since that’s not the case, our dogs rely on us to act as their advocates in the exam room. In Dr. Nancy Kay’s ground-breaking book, Speaking for Spot, she provides us with the tools we need to do just that, relayed clearly and with gentle humor. We’re pleased to offer our readers a sample.
Here are 10 tried-and-true secrets to making every visit to your dog’s veterinarian exceptional for you and the entire office staff. They also directly benefit your dog’s health—and nothing is more important than that.
I: Thou shalt push thy veterinarian off her pedestal.
In most cases, the pedestal on which a veterinarian resides is a figment of the client’s imagination. I’m delighted that the profession is viewed favorably, but vets truly don’t deserve any extra helpings of adulation. So, before you arrive at the veterinary clinic, prepare yourself to “push” the vet off her pedestal. Remember, this is a simple mind-over-matter endeavor. And if your vet clings fast to her pedestal, consider choosing a different teammate!
II: Thou shalt be present.
When a dog is experiencing significant symptoms or is sick, it helps to have all the decision-makers present at the time of the office visit. If this is difficult to arrange, the person present should take notes, and even consider tape-recording the conversation with the vet. This is useful, since details inevitably get lost in translation—especially when traveling from spouse to spouse! Consider bringing the kids along (unless they will create a significant distraction), as they can be wonderfully uninhibited sources of information and keen observers of their dog’s habits.
Lastly, turn your cell phone off before entering the exam room. A client who answers a call while I am discussing her dog’s health isn’t truly “there” with me.
III: Thou shalt let the staff know if thy dog is aggressive.
I clearly recall a nasty bite to my hand with no warning glare or growl to clue me in. As I stood by the sink washing my wound and muttering under my breath, the client had the audacity to inform me that the same thing had happened to the last veterinarian they had seen! I momentarily fantasized about biting her, but showed tremendous restraint.
If your pup has previously growled or attempted to bite in a clinic setting, it is vital that you divulge this information. Trust me, withholding such important information is the quickest, most effective way to alienate yourself from an entire staff, and you will not be welcomed back. The flip side of this coin is that veterinarians have nothing but respect for the client who brings along a muzzle that’s just the right fit.
A dog acts out of character in a hospital setting for a number of reasons. Pain, fear, a bad experience or the need to protect their human can all provoke aggression. Fortunately, there are many humane ways to work effectively with an aggressive dog: chemical sedation or muzzling is a reasonable option. Sometimes, simply separating a dog from his human subdues this aggressive tendency. Restraining with brute force (a.k.a. “brutacaine”) is never warranted.
IV: Thou shalt provide information.
Medication and Diet
And, know the brand name of the food your pup eats. The color of the bag and name of the store where it was purchased simply won’t give your veterinarian adequate information.
Prior Medical Conditions
V: Thou shalt confess everything.
I once had to confess to a large-animal vet that I’d fed rhododendron trimmings to my goats. Rhododendrons are toxic to goats, causing terrible abdominal distress—something every veterinarian learns in school, but I’d somehow managed to forget. Ingestion requires immediate and specific therapy, so my confession facilitated my goats’ complete recovery, thank goodness. I still feel a wee bit embarrassed when I cross paths with the vet who saved them. Ah, the things that keep us humble!
VI: Thou shalt pause for confusion.
Most veterinarians, myself included, lapse into “medical speak” because we are so used to these terms running around in our heads. We might say to a client, “Ruffy is in renal failure and needs aggressive diuresis,” instead of, “Ruffy’s kidneys aren’t functioning properly, and we can help him by giving him intravenous fluids.” We need you to stop us in our tracks when we confuse you. If you are a “visual learner,” ask your vet to draw a picture or show you what she is talking about on your dog’s X-rays, lab report or ultrasound images. Remember, always “pause for confusion”—when you don’t understand, stop and get clarification.
VII: Thou shalt share thy concerns.
• Are you feeling scared or angry? (Anger is a normal stage of the grief process—many people experience it in response to a dog’s illness.)
• Are financial limitations creating a roadblock?
• Are you convinced your dog has a terminal disease?
• Are you terrified by the thought of anesthetizing your dog because a beloved pet once died unexpectedly while under anesthesia?
• Are you receiving pressure from family or a co-worker to put your dog to sleep, but you don’t think it’s time yet?
Your vet will be better able to understand your reasoning if she knows how you are feeling, and you will receive a much-needed dose of empathy.
VIII: Thou shalt ask questions.
IX: Thou shall treat the entire staff well.
X: Thou shalt always come away with a plan.
• Your six-year-old Norwegian Elkhound has just had his annual checkup, and, much to your delight, everything is completely normal. The “plan” is to bring him back in one year for his next “annual.”
• Your three-year-old Chihuahua-Jack Russell Terrier mix has just been evaluated for coughing, and prescribed an antibiotic and cough suppressant. The “plan” is to call the hospital in one week to report whether or not the cough has fully resolved. If not, chest X-rays and a blood test will be scheduled.
• Your Golden Retriever puppy has a heart murmur. Ultrasound reveals a problem with the mitral valve in his heart. Future prognosis is uncertain. The “plan” is to repeat the ultrasound in six months, or sooner if coughing or decreased stamina is observed.
• Your Terrier mutt just had surgery to remove bladder stones. At the time he is discharged from the hospital, the “plan” is to feed him a special diet to prevent stone reformation, return in two weeks for removal of the stitches, and schedule a two-month follow-up to recheck a urine sample.
Vets often fail to provide clear follow-up recommendations and well-intentioned clients often fail to comply with them. Do your best to solidify the “plan” and put it in writing. You’ll be glad you did.
News: Guest Posts
First, outrage. Then, education.
March 2 2012
Part I: The Gorham Town Meeting
I read the article in the Canandaigua Messenger with disbelief. It appears that the town of Gorham, New York is rolling out the red carpet for a large-scale puppy mill expected to house 500 breeding dogs (yes, you read this correctly, there will be 500). The proprietors, Curtis and Jolene Martin are not new to puppy milling. In fact, they have been previously cited for their work—busted by the USDA for violations such as rodent droppings in whelping boxes, sick and injured dogs on the premises and inadequate staffing.
Mr. Martin maintains that he is not into mass breeding just for the money. He states:
We don’t just produce as many puppies as we can, that’s not our goal. Yes, we do have to do that but it’s not the main reason we’re in it. We’re in it for the animals.
Have a look at the minutes from the December 19, 2012 Town of Gorham Planning Board Meeting. Be forewarned, reading these minutes made me feel sick inside. There was plenty of discussion about numbers of dogs (not to worry, puppies don’t take up much room), noise prevention (not to worry, the dogs will be housed completely indoors with plenty of sound-proofing), and composting and burying of dead dogs (not to worry, there will be enough containment so as to prevent water contamination in the neighborhood). Never once during the lengthy discussion did a single board member question how the dogs would be exercised, how they would be fed, what size cages would be provided or how the emotional needs of the dogs would be met. Was there not a single dog lover in that boardroom?
I’m not naïve enough to believe that what’s happening in Gorham, N.Y. isn’t happening in many other towns throughout the United States. Perhaps this situation strikes a particularly sensitive nerve because it is happening in the state where I attended veterinary school and received an extraordinary education. On the one hand, New York trains veterinarians to care adeptly and compassionately for dogs. With the other hand, they welcome the abuse of dogs. I suspect that the Gorham town board members have their eyes focused on the prize. Can you imagine the tax revenue stream from the sale of thousands and thousands of purebred puppies?
What can you do to help stop such madness? If you happen to live in the vicinity of Gorham, New York please contact city and county officials there to find out what would be needed to change their minds about welcoming the Martins or any other puppy millers into your community.
If you don’t live in or near Gorham, but feel fired up about what is going on there please put that energy to good use. Puppy mills exist throughout the United States. Learn more about what is happening in your neck of the woods and begin a letter writing campaign, organize a peaceful protest, educate a classroom of children about puppy mills, counsel a friend or relative who is ready to purchase a purebred pup on how to find a reputable breeder or rescue organization. Never ever purchase a pup from a pet store or online site and sight unseen. Feel free to share this blog post. Every little bit helps. One less purchase from a puppy mill brings us one step closer to their eradication.
Part II: A Response from Gorham, New York
Mr. Doug Negley, a councilman for the Town of Gorham read my blog post and reached out to me for some candid conversation. During our talk it became clear to me that Mr. Negley is a true dog lover and that he was surprised by the rapid action taken by his town’s planning commission. Mr. Negley told me that he remains unclear whether or not the decision to approve the puppy mill can be reversed.
Prior to this Gorham chaos (town leaders have been inundated with phone calls and emails), Mr. Negley admits that he was unfamiliar with the horrors of puppy mills. You can trust that I provided him with a solid education during the course of our telephone call. I asked Mr. Negley to provide me with his point of view in writing, something I could share with you, my readers. Here are his thoughts:
Dr. Nancy Kay,
Thank you for the opportunity to comment on your blog of February 9, 2012 “Shame on you Gorham NY.”
Your perception of “commercial kennels/puppy mills” is right on—this is a national if not international problem. In the last paragraph you mentioned learn what’s going on where you live. Educate others on “commercial kennels/puppy mills.” I would like to add instead of buying a new pup consider rescuing a dog.
On your comment “I suspect that the Gorham town board members have their eyes focused on the prize. Can you imagine the tax revenue stream from the sale of thousands and thousands of purebred puppies?” New York State law currently exempts USDA Class A “commercial kennels/puppy mills” from local dog licensing. Yes, that’s right Gorham receives nothing for this type of operation. And these breeders do not contribute to the state spay and neuter program to help low income people spay and neuter their pets, even though, each year they are contributing to the numbers of unwanted dogs.
As for this town board member’s eyes, they are focused on:
1) The best for residents of the town of Gorham.
2) Using education because it is the best weapon against puppy mills.
3) Build a case supported by facts against puppy mills.
4) Then take action at both state & federal level.
There is no reason why, over time as a society, we can’t get rid of such operations. I would like to help in their eradication. Like many topics the public is ignorant of this practice, me included.
I have thought about and continue to research the concept of “commercial kennels/puppy mills.” I do not like the idea of having a facility in our town. However, if Gorham is going to be saddled with this business I want a golden pig with lipstick, not just another pig. Thanks again, to be continued.
Doug Negley, Councilman for the Town of Gorham
Mr. Negley told me that he would be happy to respond to your comments. Let’s keep it civilized!
News: Guest Posts
Veterinarians issue new guidelines for responsible pet ownership
January 17 2012
The executive board of the American Veterinary Medical Association (AVMA) recently approved the content of the following brand new, hot-off-the-press pet ownership guidelines. Have a look and see what you think.
Guidelines for Responsible Pet Ownership
Owning a pet is a privilege and should result in a mutually beneficial relationship. However, the benefits of pet ownership come with obligations. Responsible pet ownership includes:
“AMEN!” is my response to these guidelines and kudos to the AVMA for issuing them forth to the public. Now, if only they were rules rather than mere guidelines! With all due respect to the AVMA, I would add one more item to their guidelines as a means of working towards the extinction of puppy mills. That item would be, “Never, ever purchase a puppy from a pet store or online site and sight unseen.”
What do you think of these AVMA guidelines for responsible pet ownership? Do you have any suggested additions for the AVMA to consider?
Wellness: Healthy Living
October 14 2011
The internet, which has become a remarkable healthcare tool, is also changing the way veterinarians and their clients communicate with one another. These days, many folks want email access to their vets, and why shouldn’t they? Email communication between patients and their physicians is increasingly the norm, and many human health-care operations are fishing for new customers by marketing “email my doctor” programs. Kaiser Permanente leads the charge in this regard, and a recent study of thousands of their patients documented that those who communicated via email with their physicians enjoyed better health outcomes.
Do I think being able to email your vet is a reasonable expectation? You betcha! People who are comfortable communicating with their veterinarians become better medical advocates for their pets.
However, while the expectation of electronic interaction with your vet is reasonable, not all vets are on board quite yet. A recent unpublished survey of 120 northern California veterinarians revealed the following:
Vets responding to the survey commented on the convenience of email communication. Not only can it be less time-consuming than telephone tag, they like having the option of responding to email at any time of the night or day. I can certainly relate to this. I sometimes don’t finish up with my patients until well into the evening, at which point I’m concerned that it may be too late to return client phone calls.
Vets unanimously reported that email is great for simple, non-urgent communications, emphasis on nonurgent. Just imagine every vet’s worst nightmare: an email sent by a client early in the day — but not read until evening — describing a dog who is struggling to breathe. Oh, and by the way, the dog’s gums are blue. Here are some of the ground rules vets using email want their clients to abide by:
Survey responders who aren’t using email reported a variety of reasons for not doing so, including poor word-processing skills, too much time needed to carefully edit their “written words,” inconvenience of transcribing the email communication into the medical record and a concern about clients abusing the system.
I happen to be a speed demon when it comes to word-processing, and I would love the flexibility of communicating with my clients at any time. That being said, why haven’t I fully jumped on the email bandwagon? So much of what is perceived during communication has to do with body language and voice inflection, neither of which can be transmitted in an email (though, God forbid, I suppose I could begin Skyping with my clients!). Using email, I worry that I will miss out on what’s going on with them emotionally. When I invite clients to email me, I’m clear that the questions should be really simple, such as: “When am I supposed to bring Lizzie back in to see you?” or “Is it okay to give Radar his heartworm preventive along with the other medications you prescribed?” Anything more complex and I’ll be on the phone in the blink of an eye.
If emailing your dog’s doctor appeals to you, I encourage you to ask about it the next time you visit your vet clinic. Anything that enhances communication between you and your vet is bound to be a good thing for your dog, and nothing’s more important than that!
News: Guest Posts
Madonna of the Mills premieres August 24
August 22 2011
Mark your calendar for Wednesday, August 24th so you can watch the HBO documentary, Madonna of the Mills. I was able to preview the film and liked what I saw. The movie documents the passion of Laura Amato (the Madonna) on her forays into Lancaster, Pennsylvania. Her sole purpose for traveling into the heart of Amish country is the rescue of puppy mill dogs, specifically those who are “used up” (no longer capable of breeding) and slated to be destroyed.
Laura is an intriguing main character. Her composure remains completely passive as she interacts with puppy mill breeders. She is therefore allowed access into the kennels and, on occasion the camera is allowed to follow. When this happens, what we see is predictably gruesome. One wonders how Laura can remain so emotionally detached while in the midst of such inhumanity. Clearly, she understands that such passivity is required if she is to accomplish the task at hand, namely the rescue of innocent victims, one at a time. The movie credits state that Laura has rescued more than two thousand dogs.
For those who are familiar with puppy mills, there’s really nothing new revealed here. The kennel conditions are beyond horrific, the dogs are physically and psychologically traumatized beings, it is clear that legislation is needed to make things better, and there are some happy endings thanks to generous, kind-hearted, patient people.
One could argue that, through her actions, the Madonna is enabling puppy mills to thrive. It wasn’t clear to me if Laura actually purchases the dogs she rescues. What was clear was that that none of her actions would deter the puppy mill trade. Laura is clearly a prisoner of her passion. One senses she would give up anything and everything in her life before surrendering her rescue missions. In a brief moment of emotional vulnerability she talks about the enormity of the puppy mill situation while seemingly trying to convince herself that by rescuing one dog at a time, she is making a difference.
Whether or not you agree with what Laura is doing, the beauty of this documentary is that it will educate the public about puppy mills. Someone contemplating purchasing a pup from a pet store just might be dissuaded from doing so after watching this movie. By the way, I wish the movie had more strongly emphasized that pups purchased online (site and sight unseen) are also likely to be puppy mill progeny. Nonetheless, kudos to those responsible for making this documentary. Have a look and tell me what you think. Have you already heard more than enough about puppy mills or do you think there's room for more? By the way, you may want to have a box of Kleenex close at hand, and perhaps something to soothe your nerves while viewing the graphic scenes.
Here's the trailer:
Madonna of the Mills Trailer from Umbrella Girl Media on Vimeo.
News: Guest Posts
Poisonous species are more common than you might think.
April 11 2011
I remember the sad sinking feeling I experienced last August as I read an email from my friend Diana Gerba. Seeing her email in my inbox initially prompted excitement—oh goodie, more photos and stories about Donato, Diana’s adorable Bernese Mountain Dog. My excitement quickly morphed into utter disbelief as Diana described the death of her barely six-month-old pup caused by ingestion of a poisonous mushroom.Diana’s heart was broken. As she wrote in her email: “A special boy, Donato was a silver tipped puppy, a rarity in our breed. With his tail always wagging, he had boundless enthusiasm for life. He was a happy little chap and was my joy. He loved me and I him. We were a team ordained by the stars.” Every region of the country is different in terms of mushroom flora. Where I live in northern California, Amanita phalloides (aka Death Cap) is the most common poisonous species and grows year round particularly in soil surrounding oak trees. Ingestion of a Death Cap mushroom causes liver failure (in people and in dogs)—makes sense given the liver’s function as the “garbage disposal” of the body. Symptoms typically include vomiting, diarrhea, lethargy, loss of appetite, delayed blood clotting, and neurological abnormalities. Every year at my busy hospital, we see at least a handful of dogs with liver failure clearly caused by mushroom ingestion. In spite our very best efforts, the individuals who survive mushroom poisoning are few and far between. Affected people can receive a liver transplant; no such technology available (yet) for dogs. To learn more about poisonous mushrooms, visit the North American Mycological Association and Bay Area Mycological Society websites. If you suspect your dog has ingested a mushroom get to your veterinary clinic or the closest emergency care facility immediately (choose whichever is most quickly accessible). If possible, take along a sample of the mushroom so it can be professionally identified if need be.
Fortunately, my friend Diana has managed to put a positive spin on the loss of her beloved Donato. Not only does she have Tesoro, a new little Berner boy in her life, she has made it her personal mission to warn people about the potential hazards of mushroom toxicity in dogs. She created an educational flyer (feel free to download and post it wherever dog-loving people congregate.) Diana sent a blast email out just a few days ago after finding a Death Cap mushroom in her yard. Coincidentally, today I discovered several mushrooms on my property while beginning the task of weeding my garden. They’re gone now, but given our current weather pattern, I’m quite sure there will be more tomorrow. What can you do to prevent your dog from ingesting a poisonous mushroom? Clear any mushrooms from your dog’s immediate surroundings, and be super vigilant on your walks, particularly if you have a pup (youngsters love to put anything and everything in their mouths) or an adult dog who is a known indiscriminate eater. Learn more about which poisonous mushrooms grow in your area and what they look like. And, please remember, if you see your dog ingest a mushroom—get yourselves to a veterinary hospital as quickly as possible (even if it is after hours). Ingestion of even a nibble of a toxic mushroom is life threatening, and the sooner treatment is started the greater the likelihood of saving your best buddy. Are you aware of poisonous mushrooms in your neck of the woods? If so, please share where you live (city and state) and the name of the mushroom if you happen to know it. Best wishes for good health.
News: Guest Posts
Could I still support my home team?
August 18 2009
Michael Vick’s reentry into professional football, the latest update in his life story, has me wondering how I would feel if I happened to be an ardent Philadelphia Eagle fan. Honestly, I’m not altogether sure. Would I believe that everyone is deserving of a second chance? Would I boycott the games, or choose to watch but cheer every time Michael Vick fumbled the ball or threw an interception? Would I hate Michael Vick for his heinous actions, or could I muster up compassion for a guy whose upbringing allowed him to think that treating living creatures in such a horrifying fashion was perfectly okay?
Wellness: Health Care
People want the very best for their dogs and, when it comes to veterinary care, they are expecting more than ever before. What’s responsible for this change? No doubt, the popularity of the Internet has fueled what I call “The Age of the Empowered Client.” Gone are the days of simply following doc’s orders. “Dr. Google” is teaching people how to become informed, savvy consumers of veterinary medicine. Do I believe such changing expectations are a good thing? You betcha! The changes I’ve witnessed all make wonderful sense—in fact, I wonder why some of them have taken so darned long to catch on. Most importantly, these transformations clearly enhance the quality of care provided to the patient—and nothing is more important than that.
This is the first in a series of articles describing veterinary care–related expectations that are on their way to becoming mainstream. What happens if your vet doesn’t readily embrace such changes? Employ some respectful discussion, patience and persistence, but if your vet simply won’t budge, it might be time to find a new teammate for you and your best friend.
This expectation is my personal favorite because, once it is fulfilled, satisfaction of other expectations will naturally follow. It is perfectly reasonable for you to expect “relationship-centered care” from your veterinarian. This is a style of communication in which your vet holds your opinions and feelings in high regard and allows enough time during the office visit to hear them. She recognizes the unique role your dog plays in your life and is a willing source of empathy and support. Rather than telling you what to do, vets who practice relationship- centered care discuss the pros and cons of all options before making a recommendation. They believe in collaborative decision-making. Compare this to “paternalistic care” in which the vet maintains an emotional distance and recommends only what she believes is best without consideration of her patient’s or client’s unique situation. She provides no significant opportunities for discussion or collaboration.
Relationship-centered care is not for everyone—some people truly prefer to be told what to do—certainly the way I feel when my car is in need of repair! However, if you desire relationship- centered care from your vet (or, for that matter, your own physician), know that this is a perfectly reasonable expectation. How do you find a veterinarian who employs this style of communication? Schmooze with neighbors, dog park friends, trainers and people who work at your local pet/ feed stores, grooming parlors, boarding facilities and animal shelters. Ask the staff of your local emergency hospital for their recommendations. They will have a clear sense of the communication styles employed by the family vets who refer their after-hour emergencies to their facility. Once you’ve created a list of possible good choices, arrange some interview visits to determine who deserves the honor of becoming your dog’s doctor.
Access to Round-the-Clock Care
If your dog is sick enough to require hospitalization or has just undergone a major surgical procedure, how will he or she be cared for overnight? As much as the mere thought of this makes me cringe, I must advise you that even though your dog is “hospitalized,” in some veterinary clinics this will involve no supervision whatsoever from closing time at night (perhaps 6:00 pm) until early morning when the first employees arrive. What if your dog manages to slip out of his Elizabethan collar and chews open his surgical incision? What if he is experiencing pain? What if he vomits and aspirates the material into his lungs? Please think about a ll of these “what ifs” whenever hospitalization is recommended, and ask how your best friend will be cared for overnight. Many don’t think to ask, likely because they cannot fathom the possibility that adequate supervision would not be provided.
It is perfectly reasonable to expect round-the-clock care, and there are a few options for making this happen. While a 24-hour hospital staffed with a veterinarian is ideal, this simply does not exist in all communities. If it does exist in your neck of the woods, by all means take advantage. Here are some other viable options:
Vet Observation A veterinarian comes into the clinic multiple times during the night to check on the hospitalized patients (some vets prefer to take their patients home with them overnight to make monitoring and supervision more convenient).
Tech Observation A skilled veterinary nurse (technician) comes into the clinic multiple times during the night to check on the hospitalized patients and can contact the vet should the need arise.
Home Observation Your dog or cat spends the night at home with you, but only after you receive thorough monitoring instructions along with a way to reach your vet should questions or concerns arise. As scary as this might sound, this remains a better option than leaving your best little buddy completely unsupervised overnight— imagine how you would feel lying in a hospital bed, hooked up to intravenous fluids and no one entering your room to check on you for twelve long hours!
Does your vet practice relationship-centered care? If hospitalized, how will your dog receive round-the-clock care? Please share your answers with us in the comments.
Wellness: Health Care
When rich food appears, pancreatitis lurks
’Tis the season for family gatherings, gift giving and food galore. Veterinarians know that this is also the season for canine pancreatitis (inflammation of the pancreas), a painful, potentially life-threatening condition most commonly caused by overindulgence in foods that are particularly rich or fatty. And what kitchen isn’t overflowing with such foods this time of year?
The pancreas is a thin, delicate-appearing, boomerang-shaped organ that lives in the abdominal cavity, tucked up against the stomach and small intestine.While the pancreas may be diminutive in appearance, its actions are mighty! It is the body’s source of insulin and enzymes necessary for food digestion.When pancreatitis is chronic or particularly severe, this little factory sometimes permanently closes down, resulting in diabetes mellitus and the need for insulin shots and/or exocrine pancreatic insufficiency requiring digestive enzyme replacement therapy.
When a dog eats, enzymes are released from the pancreas into the small intestine, where they are activated for food digestion. Sometimes, for reasons we do not understand, these enzymes are activated within the pancreas itself, resulting in the inflammation of pancreatitis. In addition to rich or fatty foods, certain drugs, hormonal imbalances and inherited defects in fat metabolism can also cause pancreatitis. For some dogs, an underlying cause is never found.
Classic pancreatitis symptoms include vomiting, abdominal pain, and decreased appetite and activity levels. Short of performing a pancreatic biopsy (an invasive and risky procedure), diagnosing pancreatitis can be challenging, because noninvasive tests are fraught with falsenegative and false-positive results. Veterinarians must rely on a combination of the following:
• A history of dietary indiscretion, vomiting and lethargy.
There is no cure for pancreatitis—much like a bruise, the inflammation must resolve on its own. This is best accomplished by allowing the pancreas to rest, which means giving nothing orally (not even water) to prevent digestive enzyme secretion. Treatment consists of hospitalization for the administration of intravenous fluids; injectable medication to control vomiting, pain and stomachacid secretion; and antibiotics to prevent secondary infection or abscess formation. Dogs should be monitored around the clock for the life-threatening complications that sometimes accompany pancreatitis, such as kidney failure, heart rhythm abnormalities, respiratory distress and bleeding disorders.
Small amounts of water and a fat-free diet are typically offered once vomiting has stopped, abdominal pain has subsided, and there is blood test and/or ultrasound confirmation that the inflammation has calmed down. If your dog has pancreatitis, count on a minimum of two to three days of hospitalization, and be sure to ask who will be caring for your dog during the night. Long-term treatment for pancreatitis typically involves feeding a low-fat or fat-free diet. This may be a life-long recommendation, especially if your dog has been a “repeat offender.”Most dogs fully recover with appropriate therapy; however, some succumb to the complications associated with this disease.
How can you prevent pancreatitis during this food-oriented time of year? You can avoid feeding holiday leftovers altogether (this would cause canine mutiny in my household) or you can heed the following recommendations.
New foods should be fed sparingly and only if well tolerated by your dog’s gastrointestinal tract and waistline.Keep in mind that whether offered a teaspoon or a tablespoon of something delicious, most dogs will gulp it down in the same amount of time and reap the same psychological benefit.
Don’t offer tidbits from the table while you are eating. This is a set up for bad behavior. Offer the treat only after you’ve left the table. If you shouldn’t be eating the food yourself (emphasis on shouldn’t), please don’t feed it to your dog! By all means, give your precious poopsie a bit of turkey breast, but without the turkey skin or fat-laden mashed potatoes and creamy gravy. Go ahead and offer your sweet snookums a bite of brisket, but please —no potato latkes or sour cream! Bear in mind that most dogs are so darned excited about getting a treat, they don’t care what it is, only that they’re getting it!
Some people dream of sugar plum fairies, a white Christmas or a stress-free family gathering. I’m dreaming of a holiday season in which not a single dog develops pancreatitis! I wish you and your four-legged family a happy and healthy holiday season.
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