Making Veterinary Visits Less Stressful For Cats, Part 3 Returning Home

In Part 1 of the series, “Making Veterinary Visits Less Stressful For Cats”, we discussed how to acclimate cats to a carrier. Part 2 covered what to do and not to do during the visit to the veterinary hospital. The final blog on this topic will discuss what to do once the cat is home. In my experience, few people think about this until it is too late. Here are my suggestions for home care after a veterinary visit.

1) Leave the cat in the carrier for 20 minutes. In my experience, the biggest mistake people make after veterinary visits, is to immediately release the cat from the carrier. The freaked out cat streaks from the carrier and hides for several hours. Worse yet, it may associate one of its family members with the visit and avoid or attack them. To prevent this, place the carrier on a table, chair or bed in a quiet room. Turn off the lights and close the blinds to make the room as dark as possible. Leave them alone for 20 to 30 minutes. After they have calmed down, return with a treat or toy. Open the door and then immediately reward them with the treat. If the cat is in the mood for affection, rub their face and let them sit on your lap. If they have pent up energy, get out a toy and play until they burn it off.
2) Confine the cat to a room with a litter box and water. While at the veterinary hospital, the cat picked up scents that other animals can smell. This can lead to fights when the cat mingles with other household cats. To prevent this, I recommend keeping the cat who visited the hospital separate from the others until the scent has worn off. If that is not possible, you may bathe the cat to remove the scent or apply perfume to all the cats in the household so that everyone smells the same.   
3) Re-acclimate the cat to the carrier. After a veterinary visit, it is important to re-acclimate the cat to the carrier to erase the bad memories. Leave the carrier out for the cat to observe. After a few days, follow the steps outlined in Part 1. In my experience, most cats will only need a few refresher lessons before they willingly enter the carrier again.

Making Veterinary Visits Less Stressful For Cats, Part 2 The Veterinary Visit

Many cats hate going to the veterinary hospital. Some express their angst by urinating or defecating.  Others hyperventilate due to stress. Still others, turn into attack cats who draw blood from the veterinary staff. Here are my suggestions for making the veterinary visit less stressful for the cat and more pleasant for their human families.
   
    Prepare the carrier: Place a thick towel or bed that is used by the cat inside. The cat will smell their scent and feel more at home. Spray Feliway inside the carrier.  These feline pheromones are calming to the cat.
    Transporting the cat: Secure the carrier in the backseat of the vehicle. Do not place them in the front seat. If the airbags deploy, they might seriously injure or kill your cat.  I wedge the carrier between the front and back seat and then place the seatbelt through the handle.

 

Alternatively, the seatbelt may be wrapped around the front of the carrier.
 
 

    Checking in and the lobby: Place the carrier on the counter while checking in. Cats like high places. Placing them on the ground makes them feel anxious and vulnerable.  Look for a quiet corner in the lobby to wait. Place the carrier on a chair or table to keep them high. 
     The exam room: Place the carrier on the examination table, not the floor. Give them a few minutes to survey the room, then open the door. Bold cats will come out immediately to explore the room. Leave the carrier on the table so they know they can go back to it at any time. Most cats remain inside the carrier. For these cats I recommend unfastening the top of the carrier but leaving it in place. When the technician or veterinarian enters, they will remove the top but allow the cat to stay inside for the examination. Staying in the bottom of the carrier where their scent is present provides comfort to the cat.  After the visit is over, replace the top and remember to keep the cat up off the clinic floor when checking out.

Making Veterinary Visits Less Stressful For Cats. Part 1 The Carrier

Bringing cats in for veterinary care is stressful for the cats as well as the humans. Some cats freak out when they see the carrier. Others get sick in the car. Still others do well until they see the vet. I am starting a series on how to make veterinary visits less stressful for cats and their human family members. In part 1, we will discuss carriers and acclimating your cat to them. Part 2 will deal with the visit itself.  Part 3 will discuss what to do when the cat gets home.
   
Part 1: The Carrier
    Selecting the proper carrier: The proper sized cat carrier should allow the cat to stand and turn around. In my experience, cats feel more secure with a solid top and back.  Although the soft carriers are easier to carry, I prefer the hard plastic carriers over canvas because they provide more protection for the cat. The big drawback is the slippery bottom.  I recommend placing a bed or large, folded towel inside to prevent sliding. 
    Inspect the carrier prior to use to make sure it is safe. Check soft carriers for holes along the seams. I see them develop where the handle attaches to the carrier as well as the ends. Also check the zippers for rips, to make sure they glide easily and stay closed. One of my patients nosed the zipper open and took a tour of the parking lot. For hard plastic carriers, check all the nuts and screws along the sides of the carrier. Tighten loose ones and replace missing ones. I have seen tragedies when an animal sticks its head through the side of a carrier missing some fasteners and then chokes. Also check the door lock to make sure it closes tightly. Overtime, the spring softens and needs to be replaced. Some cats learn how to stick their paws through the mesh and pull the latch open.
    Acclimating to the carrier: The biggest mistake people make with carriers is with acclimation. If the cat only sees the carrier when it is going somewhere bad, like coming to see me or going to a boarding kennel, it won’t take long for them to hate the carrier. The experienced cat sees the carrier and goes into hiding. If the family can eventually find it, getting the cat inside the carrier then becomes a major battle. Here are my recommendations for acclimating cats to carriers:
    Step 1: Place the carrier in the cat’s environment. At first, experienced cats will go into hiding. But over time, they will realize the carrier is not a threat and ignore it. Remember, cats like high places. Put the carrier on a chair, bed or table to entice them to explore. Make sure the carrier is level and secure. When the cat is no longer afraid of the carrier, it is time to move to step 2.
    Step 2: Secure the door in an open position. Place a towel or bed that the cat regularly uses inside. The scent will reassure the cat. Allow the cat to see the open door for a day or two before proceeding to step 3.

    Step 3: Use food to entice the cat into the carrier.  When the cat is hungry, give them one of their favorite treats in the vicinity of the carrier. Get closer and closer as the cat becomes more comfortable.  When the cat’s confidence is high, place the treat just inside the door. Move the treat further and further inside, until the treat is as the back of the carrier. Before the cat can exit, reach inside and give it another treat or pet it before allowing it to leave. Keep doing this until the cat waits inside the carrier. Now you are ready for step 4.
    Step 4: Leave the cat inside the carrier for brief periods of time. Now that the cat will voluntarily go inside, it is time to close the door. I recommend feeding the cat inside the carrier and closing the door while they are eating because most cats go into a grooming mode after a meal. They lie down, groom and go to sleep. Start with short periods of time and gradually extend until they are comfortable for an hour. If the cat appears anxious, open the door immediately. Signs of anxiety include meowing, flicking the tail, dilated pupils and pawing at the door. 
    Step 5: Pick the carrier up. Start by sliding the carrier along the ground a few inches. Give the cat a treat for being calm. Gradually work up to picking the carrier up and walking around the house. 
    Maintaining the cat’s acceptance of the carrier: Once the cat is acclimated to the carrier, the process needs to be repeated occasionally. Once a month bring the carrier out for a practice session. In addition to food, you may place cat nip or a toy inside.     

Hummingbird Family

My neighbors have the good fortune of having a hummingbird nest in their courtyard. The hen picked a great spot as the courtyard has a gate to keep wildlife out and it is also surrounded by the home. After she picked the inner branch of a tree, she got right to work constructing a nest. She built it in about 24 hours then laid two eggs.  They remind me of jelly beans. Here are two pictures courtesy of Bernie Hay. Look closely at the second image to find the chicks. Their dark coloring is great camouflage but the orange beaks are a give away. Enjoy!


More Dogs Sickened From Jerky Treats

For years now, I have been warning people about problems with jerky treats. Chicken, sweet potato and duck jerky treats have sickened over 5,600 dogs and 24 cats. Over 1,000 dog deaths have been linked to these jerky treats. Now, 3 humans have been sickened as well. Since most of the toxic jerky treats came from China, many people are under the impression that jerky made in the United States is safe. Unfortunately, this is not the case.

Products marked, “Made in the USA,” mean the product was assembled within our borders. It does not necessarily mean all of the ingredients came from the United States. Companies create grocery lists for their products then shop them around to see who has the lowest price. They could buy chicken from China, manufacture the jerky in the U.S. and still label it, “Made in the USA.” 

The Federal Drug Administration and Centers For Disease Control are working to identify the cause of the toxic jerky. Until the cause is identified and removed, I do not recommend feeding any jerky to your pet. Why take the chance when there are so many other treats available? 

Source:
– Aleccia, Jonel. “Pet Treat Mystery: More Dogs Dead, 3 People Sick, FDA Says“, NBCNews, May 19, 2014, http://www.nbcnews.com/health/health-news/pet-treat-mystery-more-dogs-dead-3-people-sick-fda-n107286.

 

Chagas Disease Spreads Into Texas

Chagas disease has spread from Mexico to Texas. This disease is caused by that parasite, Trypanosoma cruzi, that is transmitted by kissing bugs. The parasite causes severe heart problems that can be fatal in humans and animals. The typical history is that an animal is behaving normally, then suddenly drops dead. 

Here’s how the disease is spread. Kissing bugs emerge at night looking for an animal. These sophisticated little vampires can detect carbon dioxide produced during exhalation. They follow the CO2 trail to the mouth of the sleeping animal then bite often by the mouth leading to their name. After they ingest a full meal of blood, they defecate on the host and leave. Unlike mosquitos transmitting heart worms through their bites, kissing bus transmit T. cruzi through their feces. When the animal scratches the bite, the parasite left in the excrement gains access to the victim’s blood stream. Once inside, this protozoan parasite circulates around looking for a home in smooth muscle. They often choose the heart. Over time, the muscle of the heart is damage so badly, that death occurs.

Since there are no vaccines to prevent this disease and treatment is minimally effective, prevention is of paramount importance. All pets should be placed in a protected environment at night when the kissing bugs are active. Keep dogs and cats indoors if possible. Outdoor dogs should be confined to screened in kennel or barn. If a night activity is planned, apply an insect repellant to the animal. Remember to reapply frequently, especially if the dog’s coat becomes wet. 

Source:
-Tompkins, Shannon. “Bugs’ ‘kiss’ a major threat to dogs.” Houston Chronicle, May 8, 2014.

Helping Humans and Dogs with Breast Cancer

The University of Pennsylvania, College of Veterinary Medicine has joined the fight against breast cancer in women as well as dogs. Lead by Dr. Karin Sorenmo, a veterinary oncologist and Dr. Olga Troyanskaya, a bioinformatics professor at Pinceton, the team studies how breast cancer develops at the molecular level. The program accepts shelter dogs with breast cancer that would otherwise be euthanized.

Here’s how it works: Shelter dogs are enrolled in the Penn Vet Shelter Canine Mammary Tumor Program. The first step is surgical removal of the tumors. Next, the samples are divided in half. One half go to pathology for diagnosis and analysis of the margins. The other goes to Dr. Troyanskaya who analyzes the genes. She looks at changes in how a gene or several genes transform a tumor from benign to malignant.

Dogs are a good model for human breast cancer for two reasons. First, just like humans they develop breast cancer in response to exposure to estrogen. The practice of spaying dogs and cats at a young age protects them from mammary gland cancer.  This is one reason among many to spay your pets.  Second, dogs have ten glands. In dogs who develop breast cancer, it is common for them to have it in multiple glands. The tumors are in various stages giving the researchers a rare chance to study the progression of cancer.

The Penn Vet Shelter Canine Mammary Tumor Program has treated over 100 dogs. Many of these dogs would have been euthanized because of the cancer. Instead, they received medical care and a chance to find a new home. Some have even been adopted by women who are breast cancer survivors. I hope they wear pink collars to celebrate their status as survivors!

Sources:
-Penn Vet Shelter Canine Mammary Tumor Program, http://www.vet.upenn.edu/veterinary-hospitals/ryan-veterinary-hospital/services/comprehensive-cancer-care/cancer-research/canine-mammary-tumor-program
-Rabin, Roni Caryn. From Dogs, Answers About Breast Cancer. The New York Times, www/well.blogs.nytimes.com, March 31, 2014.

You Make The Diganosis: Thickened Skin Over Dog’s Elbow

Pictured below is a close up of an abnormal patch of skin on a dog’s elbow. As you can see, the skin is rough, thickened and pigmented which means dark in color. The lesion started small and slowly developed into what is pictured below.  This dog has these lesions on both elbows.  What is it?

Diagnosis: Elbow Callus

Although the skin in this picture looks bad, it is a non-cancerous elbow callus. Calluses develop over pressure points such as elbows, hips and hocks. They are usually bilateral as in this dog. People often confuse this with a melanoma because of the black color. Calluses may be pink or black depending upon the absence or presence of pigment in the dermal cells. Since this dog is a German shepherd mix, it has dark skin with lots of pigment.

On occasion, I have seen calluses crack and bleed. To prevent this, I recommend applying a moisturizing lotion to the callus and then taking the dog for a walk before they can lick it off. I am not a big fan of using creams to dissolve calluses in dogs as it seems painful. One of my patients tried to chew the entire callus off after the second dose of a dissolving cream. Instead, I place a moist, warm towel over the area to soften the callus then rub off the excess keratin with a towel.

Be Careful with Birch and Other Essential Oils in Dogs and Cats

With more and more people using essential oils to enhance their own well being, it is also spreading into veterinary medicine. Unfortunately, most essential oils are toxic to dogs and cats. People who use them for treating or training their pets may, in fact, be unintentionally harming them instead.  

Birch Oil: Birch oil is often used for scent training dogs. Researchers at Michigan State University, College of Veterinary Medicine found that birch oil contains toxic amounts of methyl salicylate. If a dog comes into contact with undiluted birch oil, it can cause severe gastrointestinal ulcers, kidney failure, seizures and death. In addition to this direct poisoning, the smell of birch oil, anise or clove may lead to secondary poisoning from xylitol. Dr. Cheryl Swenson and colleagues found scent trained dogs may confuse the birch oil, anise or clove scent with the wintergreen scent used in many sugar-free products. Most of these products contain xylitol which is safe in people but harmful to dogs and cats.    

Tea Tree (Melaleuca) Oil:  In the last five years, I am seeing an increase in the number of animals poisoned with tea tree oil.  According to the Pet Poison Helpline, “as little as 7 drops of the 100% oil has resulted in severe poisoning.”  The owner brings their dog or cat in for lethargy and problems walking. During the physical examination, I find an oily substance on their skin or in their ears. The animals also have a low body temperature.  They look like a drunk human! In mild cases, the animals will perk up within 24 hours of removing the oil from their skin. Unfortunately, even with supportive care some animals will slip into a coma and die.  
 
Other Essential Oils: In practice, I have seen dogs and cats with severe skin damage from essential oils. In mild cases, the oil burns the skin causing inflammation. In severe cases, layers of skin slough off causing deep ulcers. The poor animal licks it off causing a secondary burn to their mouth. I saw a cat who sloughed the entire top of her tongue from essential oils. Her owner used undiluted oil as a treatment for ear mites. The insides of her ears were a bloody mess. With intensive care, the cat survived but was deaf for the rest of her life.

Sources:
-Veterinary toxicology alert: Oils used in ‘scent training’ can harm dogs., DVM360, March 17, 2014.
-Petpoisonhelpline.com

Common Causes of Recurring Urinary Tract Infections in Dogs

Recurrent urinary tract infections (UTI’s) are no fun. The frustrated dog licks and urinates frequently in a vain attempt to ease the pain. They often keep their family members awake all night, begging to go outside. Worse yet, the dog has accidents in the house. The family comes into my exam room frustrated because the infection came back. Here are some common and uncommon causes of recurring urinary tract infections: (please note that UTI’s are more common in females due to the increased diameter and shorter length of the urethra as compared to males.)

1) Using the wrong antibiotic the first time. To save money, some people choose to skip performing a culture and sensitivity of the dog’s urine. Without this vital information, the veterinarian is left guessing which antibiotic to use.
2) Treating for too short a time. Unfortunately, some bacteria such as E. coli are difficult to get rid of and may require several weeks of therapy.
3) Failure to follow instructions. Once the dog feels better, some people stop giving the antibiotics. This may lead to antibiotic resistance.
4) Urinary stones that irritate the protective lining of the urinary system, making it less effective at repelling bacteria. The stones also offer bacteria a place to hide from contact with the antibiotic.
5) Diverticulum of the bladder wall. A diverticulum is an out pocketing in the bladder. Urine tends to stagnate in these pockets.
6) Abnormal anatomy including ectopic ureters (the ureters empty into the urethra instead of the bladder leading to incontinence), pelvic bladder (bladder is in the wrong location leading to urine pooling) and deep set or hooded vulva.
7) Uncontrolled diabetes. The sugar released into the urine provides energy for the bacteria.
8) Dilute urine. Common causes include kidney disease, diuretic therapy for heart disease, hyperadrenalcorticism (Cushings Disease) and excessive salt in the diet.
9) Immunosuppressive therapy
10) Vaginitis.
11) Incontinence