Q and A

One of my friends, Heidi, asked if I'd answer a few veterinary-related questions for her. She has a delightful, fluffy white dog named MC, the joy of her life. Some of Heidi's questions might be of interest to other readers, so thought I'd share them today.

Instead of automatically vaccinating MC every year, Heidi elects to have her veterinarian test MC's vaccine "titers." These are the antibodies that circulate in the blood of anyone who has ever been given a vaccine (or been exposed to the disease.) Antibodies develop in response to the stimulation of the immune system, and are what protect the individual from contracting the specific disease at hand. Immunologists calculate what level of these antibodies are considered protective, and anything less than this would require re-vaccination to further stimulate the immune system to develop a higher titer.

There are problems with running titers instead of just giving vaccines, as good as the medicine is behind running titers. You certainly don't want to give un-needed vaccines or drugs of any kind if there are safer alternatives. Titers are very expensive tests. You need to run a seperate test for each disease that we vaccinate against-just because a titer is deemed protective for one does not mean the patient is covered for all other diseases. Some tests are run so infrequently that local labs may have to send out the test, resulting in long waits to get results and furthur visits if we find the levels to be inadequate. If a dog happens to be going to a groomer or boarding facility in a few days and needs "proof" of vaccination, titers may not be readily available. Planning ahead is always the best course.

Heidi also asked about dewclaws in dogs. She wanted to know why some dogs had them and others were removed by breeders at very young ages. Dewclaws correspond to human "thumbs," the 1st digit on the legs of dogs, and can be found on the front and hind limbs. Some dogs are born without them and others have all four-or even more! The front dewclaws are often attached securely to the leg as our thumbs are, and many dogs really seem to use these digits, especially when manipulating a tasty bone or other chew toy. Dewclaws on the hind legs are often very loose or "dangly," and as a result, can become caught on things like heavy brush or sticks or woodsy vegetation, especially so in hunting dogs. This is why many breeders have them removed in puppies at approximately 3 to 5 days of age. Some breeds like a long, "clean" appearance to the front legs as well, especially in a show ring, so will also have the front dewclaws removed. There are breeds like Great Pyrenees dogs where there are multiple dewclaws, each with their own toe nails, and they are not to be removed in these dogs.

One other question had to do with senior diets. Heidi asked why older dogs should be changed to one. It's no surprise that our senior pets (senior humans, for that matter) start to slow down a bit. Less exercise can often lead to weight gain, and excessive weight is harder to carry for all of us, but particularly so on those older joints that might have a touch of arthritis. Senior foods address this problem by having less fat in their formulas and thus less calories per serving. They may have less sodium for blood pressure issues, and will often help those mobility issues by having a touch of glucosamine for joint support. The glucosamine won't likely be enough to be at a therapeutic level, so supplementation will likely be necessary if a pet does develop degenerative joint disease or osteoarthritis.

There are other benefits to senior diets including more antioxidants to help with the immune system and slow cell oxidation (degradation.) They have less quantity of protein but higher quality, as well as low phosphorus to help maintain good kidney function while maintaining strong bones and muscles. Fatty acids help in the proper function of nervous and immune systems as well as making a shiny coat and healthy skin. Diets for mature dogs will balance vitamins and minerals for dogs in this age range-feeding an older pet is not the same as feeding a youngster or even an adult pet. Those "one-size-fits-all diets that say they are "formulated to meet the requirements of all life stages" just aren't acceptable. They generally provide too much nutrition for our senior friends-and this is just as dangerous as feeding too little.

I hope that answered some of your questions, Heidi. Thank you for helping me educate my readers-they were good topics and I hope others learned a thing or two due to your curiosity. Give MC a sloppy kiss from Verbal and me.

Peace,
DrReneigh

Pablo's Aching Joints

When I was visiting my in-laws over the Thanksgiving holidays, I of course wanted to check over their way cool cat, Pablo. Both of Michael's parents are artists, so it has been a tradition in the family to have cats with artist names. One I fondly remember who resided at their art gallery and motel was a beautiful brown striped Norwegian Forest-type cat named Toulouse. She would often stay overnight with guests of the motel, and regulars would even call ahead to "reserve" her. She was a great cat.

Pablo is a sleek, black, very solid boy with some sprinkling of gray hairs and whiskers telling his age a bit. I noticed he was pointing his left front leg when standing still and was a bit hesitant to jump on and off the kitchen counter where he has access to a window that his mom props open for him. It looked like he had to take time to "plan" his jump; I thought he was reluctant because the action he had done multiple times a day for 10-plus years had taken its toll on his joints. Like I said, he is a very solid cat, and all that weight pounding on his joints over and over throughout his life now seemed to hurt him.

Pablo's mom had seen subtle signs of him "slowing down" recently; she had placed a stepping stool next to the counter so he didn't have as far to go in one leap. Now he could stage each jump into two smaller steps. She hadn't noticed the "pointing" of his front leg that I showed her-a symptom of some pain in his shoulder, and this was confirmed when I examined him. He was fine when I palpated his elbows and right shoulder, but REALLY objected to that left shoulder being flexed and extended. I didn't have my x-ray machine at hand, darn it, but I felt confident in my "rule-outs" for his condition. Pablo was likely suffering from osteoarthritis or degenerative joint disease.

We all know how "fun" it can be to medicate cats. It isn't just the physical action of getting a pill into a cat that makes medicating cats a challenge. The metabolism of a cat is different from other species and can be very sensitive to drugs we consider benign or safe. A single Tylenol, for example, can kill a cat. Their kidneys just can't handle many NSAIDs such as aspirin, at least when given at common intervals like we give humans or even dogs. Since I also didn't happen to bring my blood analyzing machine with me on vacation, Pablo's organ function was unknown to me. Fortunately, I had some experience with a product that might help him with out being harmful to his aging organs. It also comes in a formulation that actually tastes good to cats, too!
Cosequin is a nutritional supplement containing glucosamine, chondroitin and manganese-ingredients shown to support and maintain joint health. I love this particular formulation because it is a capsule that can be opened up-the powder inside is fish flavored. Our hospital cat, Noodles, actually chews up her capsule to get to the tasty powder inside!

I have quite a few of my older cat patients on nothing but Cosequin for their early "arthritis" symptoms, including Spencer, my sister Teresa's handsome companion. Some will eventually need more for pain management, and we will work on multi-modal analgesia (as we have discussed before) when that time comes. Weight loss and controlled exercise is just as important as it is in humans and dogs, but can be more difficult to implement (of course, we are talking about cats, after all!) Physical therapy and alternative treatments such as acupuncture have had varying success in cats, but it is often suprising how tolerant they can be of some of these things, even underwater treadmills and passive range-of-motion exercises.

When I got back to the hospital on Tuesday, I packed up a box of Cosequin and sent it off to Pablo. I hope he likes it and I hope it works to give him some relief from his apparent aching joints. If not, I'll make sure his mom gets him in to see their local veterinarian for some blood work and x-rays to see if it is safe (and appropriate) to get him started on an occasional "cat-friendly" NSAID such as Metacam (meloxicam.) Then again, maybe NOT jumping on kitchen counters is a good thing??? Nah.....

Peace,
DrReneigh