Tuesday, August 30, 2011

Ask the Vet: Senior Pets by Kristel Weaver, DVM

With good preventative medicine, pets are living much longer than they did in the past.  An annual physical exam, annual blood work, good nutrition and better dental care are just some of the factors involved in extending the golden years of your pet’s life.

When is my dog considered a senior?
Dogs age at different rates based on their size.  Small breed dogs tend to live a lot longer and are not considered a senior until nine years old, whereas giant breed dogs are considered a senior at six years old.   Cats are also considered senior when nine years old.  These numbers are just a guideline; some ten-year-old dogs still act like puppies.

Why does it take my dog so long to get up in the mornings?
Arthritis is very common in both dogs and cats as they age.  The hips and elbows are most commonly affected but arthritis can plague any joint.   Dogs with arthritis usually take a long time to get up after a nap but seem to loosen up after a bit of activity.  We use X-rays to diagnose arthritis and rule out other problems such as a bone tumor or infection.   Treatment typically consists of pain medications, supplements, weight control and a modified exercise routine.

My dog’s eyes are cloudy, can he still see?
When most people ask this question they are referring to a common aging change called nuclear sclerosis, or cloudiness of the lens.  Yes, dogs can still see when they have nuclear sclerosis; their vision is not affected.  The lens is like an onion that constantly grows new layers of cells.  As more layers accumulate over time, the density changes and the lens reflects light differently, appearing cloudy.  There are other causes for eyes to appear cloudy so it is always good to have your veterinarian check them out.

What causes the lumps and bumps all over my senior dog?
Several different types of growths show up in older dogs, some benign and some malignant.  One of the most common growths is a lipoma, a benign fatty tumor.  These are typically soft, movable and under the skin.  Although lipomas are not that attractive, we usually recommend leaving them alone.  Another common benign growth in older dogs is sebaceous hyperplasia.  These are pink, wart-like growths that are usually less than 1cm in diameter.  In order to tell a benign growth from a malignant one, your veterinarian needs to take a sample of it.  Treatment depends on the type of growth and can range from doing nothing to aggressive surgery, radiation and chemotherapy.

My dog has horrible breath, what can I do about it?
Bad breath in dogs and cats is most often caused by periodontal disease.  Just like us, dogs get gingivitis, plaque and tartar as well as other dental diseases.  Bacteria flourishes in an unhealthy mouth and can spread to the rest of the body causing an infection in distant organs like the kidneys or heart.  Some senior pets really benefit from having their teeth cleaned and examined under anesthesia.  Extractions may be necessary to maintain a mouth free of pain and infection.  Brushing your pet’s teeth and providing safe chews can also help improve bad breath and keep your pet healthy.

What food should I be feeding my senior dog?
If your senior dog is overall healthy but slowing down, he should be on a senior diet.  Senior dog foods are usually lower in calories and higher in fiber.  Some senior diets contain supplements such as glucosamine and chondroitin, omega 3 fatty acids and/or vitamin E.  If your dog has a medical problem like kidney disease, diabetes or food allergies your veterinarian will probably recommend a specific diet.  If your senior dog is underweight or extremely active he should stay on an adult or performance diet.

How can I keep my senior cat happy and healthy as long as possible?
Once your cat is a senior, we recommend an annual physical exam and annual blood work.  During the physical exam your veterinarian may find treatable problems such as periodontal disease or an enlarged thyroid.  Blood work is useful to evaluate for kidney or liver disease, diabetes, hyperthyroidism, anemia and more.  For some of these problems, early diagnosis leads to early treatment and can slow the progression of disease keeping your pet happy and healthy as long as possible.

How do I know when it is time to let my pet go?
It is really difficult to watch your pet endure a painful disability or terminal illness.  You know your pet better than anyone and will know when he or she is suffering.  But to help you make that decision about euthanasia, consider your pet’s quality of life.  Does your pet still want to eat?  Does your pet want to be scratched and enjoy getting attention?  Does your dog still bark when the mailman comes to the door or chase squirrels in the yard?  Does your cat still sleep on your bed at night?  When your pet no longer cares about the things that are typically important to him, then it is time to make that difficult decision to say goodbye.

Dr. Kristel Weaver is a graduate of the Veterinary School at the University of California, Davis where she received both a DVM and a Master’s of Preventative Veterinary Medicine (MPVM).  She has been at Bishop Ranch Veterinary Center & Urgent Care in San Ramon since 2007.  She currently lives in Oakland with her husband and their daughter, Hayley. If you have questions you would like Dr. Weaver to answer for future articles, please email info@webvets.com

Monday, August 29, 2011

Monday Pet Tip: Chin Acne in Cats


What is chin acne?
Feline chin acne is a poorly understood disorder of follicular keratinization, which means the overproduction of keratin, a protein found in the outer layer of skin. When this excess keratin is trapped in the hair follicle, comedones or “blackheads” form. These comedones may become infected with bacteria and form pustules or “pimples”. Feline chin acne is similar to the acne that humans get.

What causes chin acne?
While the exact mechanism is not understood, the abnormal follicular keratinization is thought to be related to a primary genetic predisposition to forming keratin plugs in the pores, to poor grooming or cleaning, or to excessive sebum production (the natural oily “moisturizer” produced by the skin). The end result is that the hair follicle becomes “plugged” and an infection with its accompanying clinical signs (swelling, bleeding, pain, etc) often results.

What are the clinical signs of chin acne?
The most common clinical sign associated with chin acne is the “dirty” appearance of the chin, and the typical pustules and comedones may appear on the chin, lower lip and/or  the upper lip. The chin often appears dark and flaky. Careful observation will reveal the “blackheads” and infected follicles. Chronic cases may have hard, crusty lesions that are sore when touched. Both male and female cats can develop chin acne.

How is chin acne diagnosed?
Diagnosis is based on medical history and clinical signs. Occasionally, blood and urine tests and skin culture and sensitivity tests will be performed. In cases that are suspected of having a neoplastic (tumor) origin, biopsies or skin scrapings may be recommended. 

How is feline chin acne treated?
Treatment often involves improved hygiene, and in many cases we will shave a cat's chin to allow better cleaning and treatment at home. Cleaning with benzoyl peroxide facial preparations is often advised. Antiseborrheic shampoos and clipping of the hair are often recommended. Antibiotics and, paradoxically, fatty acid supplements may be used in more severe or chronic cases.

In a significant number of cats, there is an association between using colored plastic food dishes and chin acne.  In these cats, if the food dishes are changed to ceramic, glass, or stainless steel, the condition resolves. 

What is the prognosis for a cat diagnosed with chin acne?
Most cases respond well to improved hygiene. Owners should closely follow their veterinarian’s instructions to ensure success. Refractory cases will often benefit from medications and more aggressive treatments. 

Friday, August 19, 2011

In Memory of Gena Austin by Shann Ikezawa, DVM

Whenever Gena answered the phone, so did five to eight Pugs and sometimes a French Bulldog and Shiba Inu. You could always hear her family of dogs barking along in the background happily talking with her as she tried to have a conversation. There are many animal advocates in this world, but few were as dedicated and caring as Gena Austin. We all suffered a great loss when Gena Austin passed away on July 19th of this year. Every dog she ever encountered had their life made better because of her and all of us who knew her recognized it was a privilege to have spent time with her. She was always positive, always thinking of others, and always working to make the world a better place, one snort and tail wag at a time. I felt the need to write this story because on a more personal note, I feel she was pivotal in my career and now, my lifelong love of pugs and all things canine and short nosed. 

Gena Austin was the president of PROS Pug Rescue and a member of French Bulldog Rescue. She worked tirelessly to rescue as many dogs as possible. Those with birth defects, dumped at shelters by thoughtless puppy mills or backyard breeders were given medical care, surgery, or even fitted with specially designed wheelchairs, then placed in loving forever homes. One famous Pug can be seen in her special wheelchair on Youtube if you look up Princess Daisy Pug. Abused, scared dogs with behavioral problems were slowly won over and patiently worked with. The old and ill, deemed too sick to be adoptable, were not euthanized or turned away, but were given humane care to make them comfortable and placed in long term hospice homes until they no longer had a good quality of life. Gena and her team of dedicated volunteers made sure that these dogs had a wonderful end to a life that may have been filled with fear and trauma. When fosters were overloaded, she always found a spot for another Pug in her home. I'm probably just describing the tip of the iceberg as far as what Gena did for Pug Rescue, but from my perspective, she was wonderful to work with, always had the dogs' best interest in heart, and there was nothing she wouldn't do to make their lives better. It sounds so cliched, but she was an inspiration to me. On days when it would be difficult to do my job because I couldn't save them all, Gena would come in with someone new in need of help and a desire and will to do whatever it would take. My part was easy... diagnosis, medication, surgery, maybe a day or two in the hospital. Gena and Pug Rescue had the hard work. They had to take the little guys home and nurse them back to health, train them to be adoptable, and get their spirits back into shape. It was always so rewarding to see them come back, completely new, under the care of someone who really cared and loved them.

I considered Gena a friend and a colleague. In our own ways, we both dedicated our lives to the welfare of animals. I always knew Pugs were cute with their wrinkles and corkscrew tail, but she was the one who allowed me to work with them daily and see that their quirky personalities, unique medical problems, and unbreakable spirits make them very special. I've even grown to love their loud snorts and snores. I feel very lucky to have known her and know that all of us at Bishop Ranch Veterinary Center feel the same and we will all miss her dearly. She wanted to make sure that her good work would continue and I promised her that I would do all I could to ensure that it would. Pug Rescue is part of our family here just as Gena was.  

You can read Gena's newspaper obituary here and from Pug Rescue here. If you would like to make a donation in Gena's honor to PROS (Pug Rescue of Scaramento) you can visit their website at www.pugpros.org or mail a check or money order to PROS P.O. Box 5094, Concord, CA 94524.

Monday, August 15, 2011

Cats and Diabetes by Frank Utchen, DVM

 One of the less common problems we see in cats, yet perhaps the condition requiring the most patience and cooperation between a veterinarian and cat owner, is diabetes.

Yes, diabetes can happen to cats and dogs just as it does in people. One distinct difference is that in cats diabetes can be reversible, and with early treatment and proper diet approximately 1/3 of cats will revert back to an un-diabetic state.

So how do you know your cat may be diabetic? The outward indicators are typically excessive drinking and urinating, with a normal or increased appetite, yet with progressive weight loss. Without adequate insulin the body is unable to properly store fat and weight loss ensues despite normal or increased food intake.

A veterinarian can measure a cat’s blood glucose (sugar) or urine glucose level to confirm the presence of diabetes. Blood or urine tests like these are important to distinguish diabetes from other conditions that can cause a similar increase in water intake and urination, and weight loss, such as kidney disease or hyperthyroidism.

The treatment for diabetes involves once or twice daily injections of insulin, and feeding an appropriate low-carbohydrate, higher protein diet. There are several different kinds of insulin available for use, and the type generally recommended for cats is called “Lantus” insulin (also called “Glargine”). These injections are given using insulin syringes with tiny needles, injected in the skin over the back of the neck. The needles are incredibly small and I have yet to encounter a cat who objected to being given insulin injections. Even though many cat owners are intimidated by the prospect of having to give their cat insulin injections, I have never found a cat owner who felt it was difficult after they got started doing it. It really is easy to do. 

We start with a low dose of insulin and work our way up to whatever dose a cat requires. If we start with a dose that is too high, we can lower the blood sugar too much, and that is dangerous—a cat can have a seizure if the blood sugar goes too low. Of course, having high blood sugar is not good either, but at least with high blood sugar there is not an immediate risk of a serious problem like a seizure that can happen if the blood sugar drops too low.

Perhaps surprising to most people, it is a simple procedure to measure a cat’s blood sugar using the same type of monitor that people use to check their own blood sugar level. A tiny pin prick of the ear is generally ignored by a cat, and allows a small drop of blood to be obtained for home testing. For most people and cats this is much easier (and cheaper) than bringing a cat into the hospital to do it. Most cats require twice a day insulin, but a few cats can be managed by just giving it once a day. By measuring a cat’s blood sugar every week and adjusting the insulin dose gradually upward until her blood sugar has dropped to normal, we can manage most cases of feline diabetes without complication. 

That whole process of determining the correct dose of insulin for a particular cat can take a month or two, so just be prepared for it to seem like a long time before your veterinarian gets the insulin dose figured out exactly. Even then, it's likely that your cat’s blood sugar level will not be within the normal range 24/7--diabetes is just too erratic of a disease to get it right every minute of the day. The goals in managing diabetes in cats are these, in this order:

1. Keep their body weight stable or increasing. If this is the case, the dose of insulin is virtually always adequate.
2. Keep their water intake and urine output normal.
3. Keep their blood sugar levels normal.

The blood sugar level jumps around so much, even in human diabetics, that there will be plenty of times during a day when a cat’s blood sugar level will be too high. It can be discouraging if you get obsessed with keeping the "numbers" right, because blood sugar levels fluctuate a lot, even in well-managed diabetics.

The diets usually recommended for diabetic cats are low carbohydrate, high protein foods such as "Purina DM" or "Prescription Diet m/d". Amazingly, about 1/3 of the diabetic cats will revert back to normal (i.e., become "un-diabetic" and no longer require insulin shots) if they are given insulin for a few months and eat one of these foods.

Because cats are adapted to eating high protein, low carbohydrate diets in the first place, it is not recommended that diabetic cats continue eating dry foods (with the exception of those specially formulated foods mentioned above). Dry cat foods are often 35% or more carbohydrate, and carbohydrates are metabolized to sugar, which makes diabetes management more difficult. In fact, sugar and carbohydrates in general are so foreign to a cat’s system that it was recently discovered that the gene for the presence of the “sweet” taste bud has evolved away in cats and they can no longer detect that flavor in foods.

Diabetes can be a challenging condition to manage in cats. But with patience and dedication it can be one of the most rewarding diseases to treat, and a cat who would otherwise have their life severely foreshortened by diabetes can continue to live a normal and fulfilling feline life.

Tuesday, August 9, 2011

Pet Hotels: Traveling with Your Pets by Franklin Utchen, DVM

Just as vacations with children are different from adult-only trips, vacationing with your dog works out better if you plan the journey with an eye to finding places where your pets are truly welcome and traveling when fewer people will be around.

Finding these places can be a challenge, but not as much as it used to be. The travel industry used to grudgingly accept the fact that many people traveled with pets. Now, many hotels, motels and resorts actively court pet lovers, and a few are marketed almost exclusively to this once-neglected group of vacationers. Well-mannered pets and well-heeled pet lovers are appealing to an industry that isn't booking as many vacation travelers as it would like. And that's good news for people looking for the perfect pet-friendly vacation.

The best way to plan your trip? Check out web sites dedicated to traveling with pets, and look for vacation ads in pet-related magazines and newsletters.

As for books, you'll find plenty that provide simple listings of places where pets are allowed, such as the AAA travel guides. But there's one series that really gets the inside information on where pets are genuinely welcome: the Dog Lover's Companion books (www.dogloverscompanion.com). The series has books on California and Florida, on all of New England, and on Seattle, Boston, New York, Chicago and Washington, D.C.

Even though more people than ever are traveling with their dogs, there are plenty of people who don't like sharing space with the four-legged tourists. There are also plenty of resort properties that are one pet mess away from changing to a no-dog policy. That means you and your dog must be above reproach, to keep a great place open for future pet travel.

Here are a few things to do when staying at a hotel with your dog:
  • Keep them clean. Your dog should be well-groomed and clean-smelling. Always dry off wet dogs and wipe off muddy feet -- using your towels, not the motel's -- before allowing your dog inside. Cover furniture, carpets and bedspreads with your old sheets and towels, and if you need to bathe your dog, be sure, again, to use your towels and clean up afterward.
  • Keep them under control. Your dog should be obedient, friendly but not annoying, and never aggressive -- not to people, not to pets and not to wildlife. Do not allow your dog to bark uncontrollably. Use your best judgment when to let a dog off the leash in areas where doing so is allowed, and be sure that your dog isn't annoying other people or pets.
  • Pick up after them. Take your dog to out-of-the-way places on resort property to do his business -- the corner of the far parking lot, not the grassy inner courtyard. No leg-lifting allowed near rooms and eating areas. Make it so the pickiest dog hater on earth wouldn't notice your dog has been around.
And finally, don't forget to show your appreciation. Those of us who travel with our pets realize it's a privilege, not a right, to have a nice place to stay. So along with keeping your pet from being a nuisance, don't forget to say thank-you to resort staff, and tip generously when appropriate. Pets mean extra work for the people who work at these places, so let's try to keep them on our side.