Month: March 2010

Each year thousands of hopeful students apply to veterinary college with the dream of becoming a veterinarian.  With hard work, persistence and careful planning, you can be one of them.  The following is a list of tips to help you achieve your dream. 

Grades:  Work hard to get the best grades you can in high school.  You do not have to get straight A’s to be a veterinarian.  However, you want to establish good study habits that will sustain you through undergrad and into veterinary college.  Take all the college prep courses you can especially in chemistry, biology, physics and mathematics.  Having a strong base in these areas will help you with the required courses in college. 

College:  When it comes time to select a college for your undergraduate degree, do your homework on each school.  Besides touring the campus and learning about the student activities, ask to speak to the pre-professional adviser.  Find out the success rate of their students getting into veterinary school.   Please note that smaller colleges and universities often have one pre-professional adviser for medicine, dentistry and veterinary medicine.  Others will have an adviser for each.  Either system will work depending upon the adviser.  After you speak with the adviser, ask to speak with some pre-vet students to verify what you were told.    
 
Important note:  Since the acceptance rate into professional schools has become a marketing tool, some schools will cut students out of their professional programs if you do not meet their standards.  I take issue with this since the people making these decisions are not veterinarians or veterinary educators.  I believe every student  should have the opportunity to pursue their dreams.  The advisers in these programs tend to focus primarily on GPA, without taking into account the importance of the GRE test scores and experience.  Make sure you understand the college’s policy before you apply.  Ask, ask, ask and then verify with others in the program.

Experience:  Your experience with animals is vital to becoming a veterinarian.  It is broken down into two categories:  veterinary-related and animal-related.  Working under the direct supervision of a veterinarian is optimal.  Try to get experience in a variety of veterinary settings.  For example, spend one summer with an equine veterinarian, another with a small animal veterinarian and another with a food animal veterinarian.  While school is in session, work as a research technician with laboratory animals.  During breaks volunteer with an animal charity.  

Not every candidate can get this kind of experience, but try.  Great experience will counter
act average grades or test scores.  If you have excellent grades or scores, experience will distinguish you all the more.  It will also provide a more thoughtful perspective on the profession.  Start gaining experience and building your resume now.  You are never too young.       

More information on application to veterinary college is available at: http://www.vetschoolapp.com/ 

This is a fabulous profession.  I wish you all the best and look forward to calling you a colleague someday!

In inflammatory bowel disease (IBD), an allergic reaction in the walls of the intestines causes inflammation that interferes with the normal function of the gastro-intestinal system.  Treatment centers around removing the cause of the allergic reaction and suppressing the immune system.  In addition, some veterinarians like to add a broad spectrum antibiotic to the treatment plan.  This protects against a bacterial infection when the cat is receiving steroids to suppress the immune system.  Since bacterial overgrowth is not commonly associated with inflammatory bowel disease, other veterinarians disagree with this approach because indiscriminate use of antibiotics may lead to bacterial resistance. 

When I treat a patient for inflammatory bowel disease, I let the blood work and the patient’s temperature tell me if they need antibiotics.  If the patient has a high white blood cell count primarily from neutrophils and/or is febrile, I know the intestinal mucosa has suffered severe damage allowing bacteria to enter the blood stream.  I treat these cats with a broad spectrum antibiotic but warn the owners that some antibiotics can cause gastrointestinal upset.  After two weeks of therapy, I stop the antibiotics and then consider probiotics to restore the normal gut flora. 

Lastly, I would like to clear-up confusion about metronidazole use in IBD.  This drug is an antiprotozoal which means it kills protozoal organisms such as giardia.  It also is a great antibiotic for anaerobic bacteria.  But it is used in inflammatory bowel disease for its ability to inhibit cell-mediated immunity which decreases the inflammation in the mucosa. 

Inflammatory bowel disease is cats is a frustrating problem characterized by vomiting, diarrhea, weight loss and anorexia.  Since other problems such as parasites, pancreatitis or cancer may cause the same clinical signs, a biopsy of the intestinal wall provides the definitive diagnosis.  Patients with inflammatory bowel disease are reacting to something in their intestinal tract.  This could be the protein in their food or parasites.  In addition, some of the common bacteria living in the intestines may release inflammatory products.  In response, the walls of the intestines fill with lymphocytes and plasma cells disrupting normal function.

Treatment of this disease is twofold, remove the offending allergens and dampen down the immune response.  Cats with inflammatory bowel disease are dewormed and placed on a hypoallergenic diet.  (For more details see prior post.)  A combination of drugs are used to address the immune system, steroids to suppress the humoral immunity (B lymphocytes and plasma cells) and metronidazole for the cell-mediated immunity (T lymphocytes).  

There is a debate in the veterinary community regarding steroids in cats, specifically whether prednisolone is better than prednisone.  Both are glucocorticoids that function well to suppress the immune system.  The difference lies in their metabolism.  Prednisone is converted into prednisolone by the liver.  Because cats are lacking glycuronyl transferase, some believe only prednisolone should be used in cats.  Other veterinarians disagree and use the two drugs interchangeably.   

Because of the side effects, some owners taper their cats off of the steroids too quickly before all the inflammation is gone.  Please don’t do that!  Tapering too quickly is very dangerous.  Give the entire dosage schedule prescribed by your veterinarian and speak with them before making any changes.  When it is time to taper the dosage of steroids, do so in a slow deliberate manner.  The goal is to get the steroid down to the least possible amount while still controlling the symptoms.  

In my experience, cats suffer far more reactions to the metronidazole than the steroids.  These include weakness, lethargy, gastrointestinal upset, liver toxicity and neurologic disease.  My own cat acted as though he was drunk after just one dose of this medicine.  So be sure to watch closely for any changes in behavior while your pet is on this or any medication.  

If the standard therapy is not controlling your pet’s symptoms, talk to your veterinarian.  There are other medications such as leukeran and cyclosporine that can be used to control the disease.       

Inflammatory bowel disease can make the cat miserable and challenge their veterinarian to find a treatment protocol that works.  Cats with this disease suffer an inflammatory reaction in the walls of their intestines that causes vomiting, diarrhea and weight loss.  These cats seem painful when I palpate their abdomens.  The inflammation occurs when the cat develops antibodies -an allergic reaction – to their food.  Specifically, the protein source is usually what gets them.

Here are my suggestions for feeding a cat with inflammatory bowel disease:

I start with Hill’s zd ULTRA Allergen-Free diet combined with steroid therapy.  According to the company’s website, “Hill’s Hydrolyzed Protein Systems is a process that eliminates animal intact proteins and significantly reduces the possibility of an adverse reaction to food.”   This means the protein is broken down into a low molecular weight so the cat’s immune system cannot detect it.  Most of the cats I put on this diet do well – they eat it (that’s a key point) and their symptoms resolve.  Once the cat is stable, I add in the zd Low allergen which comes in a dry form.

Unfortunately, there is a small subset of my patients who still experience problems, even on zd Ultra without any other foods or treats.  It seems to happen in cats allergic to poultry products.  Since zd ULTRA is made from chicken livers, I don’t think that hydrolyzing the protein is hypoallergenic enough for these cats.  I switch to IVD rabbit, duck or venison diets knowing that over time, the cat will probably become allergic to the protein in these products as well.  In my experience, the cat gets 6 to 12 months on a new protein before the clinical signs return and I switch to a new protein source.   

One other caveat for zd, it is not recommended for growing kittens or cats on urinary acidifiers. 

One of the most overlooked aspects of allergy treatment for dogs is removing allergens from the animal’s environment.  We spend so much time treating the dog that we sometimes forget to treat the environment in a way that will minimize allergens.  The following is a list of recommendations I make to my clients who live with allergic dogs and cats. 

1)  Get an air purifier.  I used to scoff at the effectiveness of air purifiers until my husband bought a Holmes unit for our bedroom.  It made a huge difference for me, our dog and our cat. 
2)  Use hypoallergenic products to wash all of your dog’s bedding.  Double rinse after cleaning.
3)  Avoid sprinkle in carpet cleaners.  I think it is the powder that sets-off allergic animals.
4)  Prevent exposure to aerosols of any kind.  Place them in another room while using the products and wait at least two hours before allowing them back in.  Besides cleaning products, this category includes air fresheners, perfume and hairspray.      
5)  Do not use flea collars.  I have seen dogs with allergies suffer horrible reactions to the chemicals in flea collars.  They develop an ulcerative dermatitis that is difficult to treat because the chemical remains in the skin for a long time. 
6)  Avoid wool blankets or real fleece beds.  Cotton seems to work better although I had one patient who developed an allergy to cotton.
7)  Keep your dog off golf courses.  The chemicals used to keep the grass growing often cause severe reactions.  If you absolutely must take your dog on the course, i.e. the dog is used to keep waterfowl off the course, then rinse their feet off well at the end of the day.
8) Avoid recently salted roads and sidewalks.  The salt burns if trapped between their toes.
9) Vacuum regularly to decrease the amount of dust in your house.  
10) Use high-quality filters in your HVAC system.  At my home we use 3M brand Ultrete filters (in the purple wrapper).
11) If you smoke, go outside and leave the dog inside until you are finished.  

 

This post concludes the series on dog allergies.  I hope you gained a better understanding of the problem, available tests and treatments to help manage your pet’s allergies!  -Dr. Nelson