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

Tied Up in Knots

We saw Bunny yesterday-she had been vomiting and not eating very well for about 2 weeks. No, bunny isn't a rabbit-she is a darling little wisp of a kitty, about 10 months old and ordinarily rambunctious and in to EVERYTHING as all good kittens are. She was sleeping a lot and wouldn't play with her beloved toys. Ordinarily a tiny cat, she was losing weight (and doesn't have it to lose.) In getting her history, we found out she was particularly fond of the Christmas tree and all the pretty packages with the shiny ribbons and all. More than once her owner had to take chewed up ribbons and strings away from her, but was very concerned she didn't catch her at some time and that she might have a piece of string, or maybe a toy or who knows what stuck inside her. Looking at how sick this cute kitten was, it sure was possible.

We took radiographs of her abdomen and ran some blood work. While there wasn't an obvious toy or piece of "something" present on the x-ray film, there was a distinctive "bunching" of the small intestinal loops that often happens when animals eat strings or ribbons or fishing line. Some gas was building up on either side of these bunched up gut loops, but there was, thankfully, no evidence of free fluid in her abdomen as there would be if she had large perforations or tears in her gastrointestinal organs. We sent the films to our radiologist for review, just like they would if they took x-rays of us.

Bunny's blood work came back this morning and it showed that she was low in her total protein, no surprise since she hadn't eaten in so long. Most concerning, however, was the elevation of her white blood cell count. Normal values are about 6 to 14,000-Bunny's were over 43,000! WBCs come about in times of infection or inflammation-perforation of the gut walls was looking more likely. The radiologist called this morning (he usually just sends a faxed report in the afternoon but knew there was a need for a "STAT" report in Bunny's case) and he concurred that she had evidence of a linear foreign body. He suggested giving her some contrast medium, barium, and follow it with multiple x-rays through out the day to see if it was obstructed in the region where we saw the bunching of intestines. When I told him about the elevated WBCs, he said doing an exploratory enterotomy (doing abdominal surgery to find out what was going on in there) was a smart choice, especially since it was a Friday and we are closed for the weekend. Why do animals always who have been sick for WEEKS get ready to die hours before we close for a holiday or weekend?

Linear foreign bodies (strings, fishing line, ribbons, etc.) are very attractive to cats-anyone who has tried to knit or crochet with cats in the house knows how "helpful" they can be, batting at your yarn, chewing on the end and making your project all spitt-y. My Stella has been incredibly lucky so far because she is obsessed about these things and I really have to string-proof the house. I have had to pull ribbon away from her on numerous occasions. What a brat.

The reason they are so dangerous is they often snag or get hung up at one end, the other end continues to travel through the GI tract, and this is what literally causes the bunching up of the intestinal loops. It can cut through the mesenteric border or the top edge where the connective tissue is located, making small perforations difficult to see, but causing leakage of intestinal contents into the abdominal cavity. This sets the cat up for peritonitis, a potentially deadly infection. We treated Bunny with two broad spectrum antibiotics, pain medications and placed an IV catheter for fluid support. Then we took her to surgery.

The first thing we did when we got her in surgery was to look under her tongue. Yes, her tongue. What in the world was I thinking? Well, cats who swallow string foreign bodies often hook the string under their tongue-that is why it catches and won't pass through the intestines in the first place. It cuts into the delicate tissue there and becomes buried, very difficult to see in an awake cat. Bunny wouldn't let me see under her tongue during her exam, either because she didn't like being messed with or because it hurt-and sure enough, there was a necrotic ring around the base of her tongue! We had our diagnosis, darn it. We dissected into this tissue and pulled out the thinnest, see-through thread you have ever seen. I have used thread like this, I think they actually call it "invisible thread" on sewing projects in the past. If we hadn't seen what the string foreign body looked like there, I don't know how we would have found it buried in those intestines.

I made an incision into her stomach and after a lot of searching, found the micro-thin thread, and put gentle traction on it. The mouth ends of the string came right out, but the end leading into the small intestine had too much tension and I was afraid that by pulling on it, I could pull it through the fragile tissues and cause a perforation. I sewed up this incision and made another one a few inches along the small intestine. I was able to get the stomach end out, but again, there was more tension where there was obviously more string in the bunched up intestines. I made a third cut into the small intestine and was finally able to remove what I hope is all of the offending string. I followed all of the intestinal tract a final time, looking for tears and any remaining bunching and none remained. There were many areas of small hemorrhages or bleeds where the mesentary or connective tissues join with the intestinal walls, but no overt leaking. We went ahead and spayed Bunny since she hadn't yet had this done, flushed out her abdomen and closed her up.

Bunny's recovery was surprisingly quick and uneventful-that is a good thing. Her body temperature never fell very low as it certainly could have due to the length of the surgery and the fact that her abdomen was wide open to the elements for a while. She had good pain medication before and after her procedure, so she didn't thrash around or act painful or scared. We will send her to a 24 hour hospital for monitoring over night and they will discharge her if there are no complications and she is eating OK. She is a young, healthy kitten and should do well, but this was a major procedure and you can't be too careful.

Bunny's owner will have to Bunny-proof her home all over again. All her sewing things will have to go up or into cabinets. It was a good thing there was no needle attached to the thread this time-I have seen that happen in other cats. Not good. Her owner has a toddler in the home and thought baby-proofing equaled kitten-proofing. Bunny has proven this isn't necessarily the case. We hope she has learned her lesson about strings, and tieing her intestines up in knots.

Peace,
DrReneigh

A Very Wet Patient

I had to scoop out a dead goldfish from the aquarium in my bedroom this morning. Bummer. It always happens after I "splurge" and buy a dozen or so feeder fish (you know, the 9 or 10 cent ones sold as food for bigger fish.) Who knows what diseases they carry, how old they are, how they have been handled, etc. They weren't meant to live long. Still, I hate finding them floating in the corner of my tank-I feel like I failed them in some way. I guess I was thinking of them as rescue fish, like getting last chance critters from the pound or something.

Keeping fish as pets goes back thousands of years, raised to a fine art by the ancient Chinese and later Japanese people. They were the ones who developed the goldfish in all its forms and colors by selectively breeding from close relatives of the common Crucian carp. The Paradise fish (Macropodus opercularis) was probably the first tropical fish to be kept in home aquariums in Europe in the 1600's, being able to survive in unheated normal room temperature waters. The first heated aquaria were done so with candles below slate bottoms. It wasn't until the early part of the 1900's that fish keeping became really popular, due to the construction of public aquaria. Most species kept are freshwater fish since they do not require the use of a great deal of specialized equipment or investment in the more expensive fish than do the more spectacular saltwater varieties. The fish can provide emotional, educational, and recreational outlets that can range from simple enjoyment to dedicated breeding and competition in highly organized shows. Properly cared for, many species are long-lived and can provide years of enjoyment. I just happen to like the back ground "white noise" of the bubbles in my bedroom when I sleep!

Fish medicine is often practiced as a "herd health" issue. If an individual sick in a tank is sick, it may be sacrificed to do testing or even an autopsy for the sake of the rest of the fish in the group. This is particularly true in the case of the huge fish "farms," where preventive medicine is an economic situation. But some people pay incredible amounts of money for individual fish and can develop bonds with them as any pet lover can. In these cases, sick fish need to be handled as any ill pet would. We don't see many pet fish as patients-there are far more experienced fish doctors than me. It isn't a simple thing to take a sick fish to the veterinarian. The stress of being netted, transported, examined and then returned to the aquarium may well exacerbate the problem and even result in the death of the fish. Few fish owners want to pay for a home vist from their veterinarian. Most fish are just cheaper to replace. Therefore, most people try over-the-counter remedies from the pet store, only calling their veterinarian if two or three of these OTC treatments have not worked for them or if surgery may be needed.

That was the situation with a gorgeous silver and gold Koi that I saw the first year our hospital opened. I don't remember if she had a name, but I remember that the owner had spent over $1500 for her as a younger fish, and estimated she was worth double that at the time he called me to see her. The fish had a large mass or growth on the side of her neck close to her gills. Even though the problem was pretty obvious, I took a thorough history, tested the water of the pond and briefly looked over the other fish in the pond for similar symptoms. She was the only fish with an offending mass, and it didn't appear to be affecting her in any adverse way. Her weight seemed fine, (I palpated over her ribs to assess muscle mass) she ate readily, and her gills moved normally.

Her owner was most concerned that this mass was impinging on internal structures, or soon would with as fast as it had come up on this fish. The only way to really know for sure would be to "look" inside her. I thought a radiograph would be helpful-but putting a fish on an x-ray table didn't sound like a good idea. I decided to experiment by herding her to the shallow end of the pond, placing a ziplock baggie over a small x-ray cassette and sliding the cassette under the fish-right in the water. I was worried how the water would affect the films-so took some with the fish balanced on top of the covered cassettes (very quickly and gently). I took several exposures at different settings since I was away from the hospital and thus wouldn't be able to develop them and see any problems until I got back. We got several very nice quality films-our radiologist was very impressed when I told him how they were exposed!

The radiographs told us that the mass was encapsulated and localized to the area we could see. There was very little mass tissue below the skin. The owner asked me if I could remove it. I told him I had never done fish surgery but had coincidentally just read an article about general anesthesia in fish (it is funny how things like that happen, isn't it?) He asked me to give it a go, and since I love surgery, readily agreed. We used an injectable anesthetic, but instead of trying to find a vein under that thick, scaley skin (I didn't even know where you would find one-so much for my fish anatomy!) we dripped the drug onto her gills throughout the procedure. We also ensured that her body stayed wet by wrapping her in a very thin, water-soaked towel. I dissected out the mass fairly easily-closing the wound left behind was another story. It was large and required some dissection of surrounding tissues and some fancy sutures that didn't pull through the skin, relieved the tension and closed the "dead space." It looked OK when all was done and the fish recovered in that shallow end of her pond with no problems. We took the sutures out about 2 weeks later and it looked great! Not to brag or anything, but I sure was impressed how well the incision had healed with very minimal scarring. You know, we often use fish oils on skin to minimize scars on human skin-this fish had a constant supply of her own oils. That sure did the trick!

That very cool owner moved out of state a few months later. He had a company that specializes in relocating pond fish ship his collection and all of them, my patient included, made it to their new home just fine. It was my pleasure to spend a little time talking to a veterinarian in their new town to introduce my patients and ensure continued care. I haven't heard from them since, but I won't soon forget my experience with that very wet patient.

Peace,
DrReneigh

Jaws

By now I suppose you have a feel for how much I love animals, and some of the extremes my staff and I will go to save sick or injured pets. But if there is an appointment on the books for a euthanasia of a dog because he has bitten somebody, there is no hesitation on my part. Of course I don't "like" it-I die a little along with every pet I say good-bye to. However, there are way too many safe, non-aggressive dogs out there that need homes to even consider risking the serious injuries (even death-approximately 12 people die each year from dog bite wounds) that can occur from these dangerous animals. By the time an owner and I have reached the stage of scheduling a euthanasia appointment, we have undoubtedly tried everything we could for that aggressive dog. It isn't likely to be practical to re-home a dog that is a known biter. There is no medication that works predictably for aggression in dogs. Many trainers just aren't qualified to work through these situations. There is tremendous liability involved. You can imagine the feelings of guilt and failure that go through all of us involved in these cases. Some dogs just aren't safe.

On average, there are 4.5 million dog bites, ranging from nips to full blown maulings, annually in the United States alone. Most of these are never reported. Victims of bites that require medical attention number about 800,000 per year. Most people are bitten by their own dogs or dogs they know, and many owners unwittingly promote the aggression or allow the aggression to go unchecked in their dogs. Dog bites are a serious problem.

Even the sweetest, youngest puppy can bite if it provoked-in fact, purse-sized dogs like Chihuahuas are one of the highest ranking breeds most likely to bite. Because of their size, these bites are less likely to cause significant damage; that is why so many people tend to dismiss their small dogs' bad behavior.

Children are much more likely to be seriously bitten than are adults, likely because kids get dogs all worked up, excited and nervous and many bite in response to the adrenaline rush. Male dogs are twice as likely to bite as are females, intact (not spayed or neutered) animals are 3 times more likely than sterilized ones, dogs younger than 5 more likely than older ones, and mixed breed dogs more commonly than "pure" breed dogs.

So, what can you do to decrease the risk to you and your family? Carefully consider your choice of which dog to add to your family. Your veterinarian is an excellent resource BEFORE your selection, offering information on suitability, adaptability, temperament testing as well as over all health of the dog or puppy. A well socialized puppy is less anxious and more at ease around other pets and people. Don't put your dog in situations where it feels threatened, teased or scared. Be sure to neuter your dog as soon as possible-your veterinarian will advise you at what age this is recommended for your particular puppy. Be sure he/she is healthy and up to date on all vaccines, particularly rabies. If a dog bites a human and proof of rabies vaccine cannot be produced, the dog will need to be quarantined or even euthanized for testing and the bitten person may be subjected to painful and expensive rabies treatments. Be sure to train your pet well-even basic obedience commands like "sit," "stay" and "come" builds trust between the dog and people. Avoid highly excitable games like tug-o-war or "sic em;"a dog will become confused about when it is play and when it is "for real." Be a responsible pet owner-obey leash laws, give your pets plenty of exercise and companionship-dogs left alone are more likely to develop behavior problems.

Children should be taught at a young age how to be careful around pets. Never leave babies or small children alone with even the seemingly best trained, friendliest dog or puppy. Teach them to ask other owners before they approach new dogs, only petting them if given permission. They should learn to stand still if a strange dog approaches them-let it sniff them; most dogs will go away when they realize there is no threat. If threatened by a dog, have the child remain calm-more excitement in a situation is a bad idea. They shouldn't scream or run. They should avoid eye contact. If knocked down, they should curl into a ball and protect their face.

If the worst happens and a bite occurs, even if it is "understandable," such as when the dog's tail is stepped on or he is hurt in some way, seek medical treatment right away. Even minor bites can become infected very rapidly-punctures from teeth are like injections of bacteria directly under the skin. Your doctor may recommend rabies and/or tetanus prophylaxis. Contact animal control or the police and report the situation. If it is your own dog, remove him from the situation if you can do so safely. Don't ever try to break up a dog fight between 2 or more dogs. Comply with local laws about reporting dog bites and provide the necessary rabies vaccine information. Contact your veterinarian right away to discuss the behavioral aspect and take steps to help this from happening again.

OK, Want to play a game? Answer true or false to these questions:

1)Dogs always make their intentions known by growling or barking before they attack.

2)Talking softly to a dog while petting it will reassure it that you mean no harm and will reduce your chances of being bitten.

3)Dogs only attack if you threaten or challenge them.

4)Many bites occur because the dog is protective of its home territory.

5)Turning away and retreating quickly from an aggressive dog will prevent you from being bitten.

6)Carrying dog biscuits with you will help you make friends with dogs.

7)Keep a dog repellent in your car so you will have it at hand.

8)Sneak around a sleeping dog if you need to go to the door where one is in the yard so you don't disturb it.

9)One way to protect yourself is to spray repellent on a dog at least once so he will be afraid to challenge you.

10)A storm or screen door will keep the dog inside from attacking you at the door.


All of these are False except for #4. Dogs DO instinctively know their owners premises as territorial boundaries.


Of course, dogs can be wonderful companions. It is so important to me to cover all bases in enhancing the relationship you and your family have with them. Send me an email or give me a call if you have any other questions about this important subject.

Peace,
DrReneigh

Ewwww, Gross!

Even though I loved my professor, ( Dr. Hendrix, who interviewed me and called at 6 am one morning to inform me I had FINALLY been accepted after applying to that particular school, Auburn, 3 years in a row) parasitology was one of my worst subjects in school. The internal and external "hitchhikers" on animals (and humans-ewww, gross!) are just nasty. Even though a veterinarian is supposed to love all creatures great and small, worms and fleas and mites are just out of luck as far as I am concerned.

We often get calls from worried owners when they find a worm in their pet's feces or in their bedding. I don't know why, but we tend to describe the way worms look in food terms. I suppose they are just familiar references. "Does the worm look like a spaghetti noodle, round and long, or like rice segments, short and flat?" "Does the thing in the bedding or on his hind end look like a little dried up sesame seed?" We generally recommend that the owner bring in a sample of the pet's feces if there is any doubt so we can test it and see for ourselves. Fecal testing involves centrifuging (spinning) and floating a sample in a solution to allow eggs of worms and other microscopic organisms such as coccidia and giardia, to rise to the top. We then draw a bit of this top fluid off the sample and examine it under the microscope. We also take a smear of the fecal matter and look at that directly, often finding things not evident on the spun sample. Eggs of tapeworms, for example, are often shed in "packets," too heavy to float in most standard solutions. We rely on visual identification of the wiggling "rice-like" segments or the dried up "sesame seeds." in the bedding to make a diagnosis.

Tapeworms (Dipylidium caninum) are an interesting (though still gross-I'm not going back on my original claim!) creature due to the stages of their life cycle. The adult worms live in the small intestine of the cat or dog. Theoretically, they can also infest humans, but they aren't zoonotic or contagious from the pet. They hook into the intestinal wall, but do not "suck" nutrition as do hookworms. Instead, they absorb nutrition through their "skin" as the food passes by the worm on its travels through the digestive tract of the infested animal. All the segments are hooked together, end-on-end, sometimes reaching over 6 inches. There is another species of tapeworms, (Taenia Hydatigena) that can grow up to 5 YARDS long! That is just not right.

As the worm matures, the end segments, which are really just the egg packets we described at this point, detach from the rest of the worm. These are passed in the feces and observant owners see them, bright white, glistening, wiggly "rice." These packets break down and release tiny eggs into the environment or on the animal, usually in the same vicinity where there are fleas going through their life cycles. Larval fleas will eat the flea "dirt" or dried blood passed by adult fleas, along with the tapeworm eggs. When a pet grooms itself or chews its fur because it is itchy, it will often ingest one or more of these infested fleas. Once inside the host animal, the young tapeworm is released, ready to attach to the small intestine and start the cycle all over again. There is no other way a pet (or human) can get the Diplidium tapeworm-it had to eat a flea. The less common Taenia tapeworm is contracted through eating prey animals or rotting carcasses.

Fortunately, the treatment for tapeworms is easy and safe. Praziquantel is the drug of choice, given as a single dose. It can be expensive, but what isn't these days? It is also essential that good flea control is implemented or the pet will immediately become reinfested. The drug rarely "fails." Much more likely is the pet clearing the current adult parasites, ingesting another flea, and starting the life cycle again. It takes 3 weeks for a tapeworm to go from being swallowed by the pet inside the flea to shedding segments in the feces (and thus being seen by the owner.) It is not necessary to deworm all of the pets in one household just because one has the segments-that is, unless you see the segments on each pet or on all of their bedding. We only give medication like dewormers to the animals that need it.

We like to save some of the really "good" parasites that people have brought to us over the years for identification-we have a "chamber of horrors" on an upper shelf that is really popular with the school tours when they come through. All together now, "Ewwwww, gross!"

Peace,
DrReneigh

What Could it Hurt?

Geoffrey has an upset tummy, vomiting (oh no, not THAT subject again!) a bloody fluid and turning down all the food he is offered-even his favorite treats. But that wasn't the problem a week ago when he was playing hard in the snow with his buddy. His owners said he slipped on a patch of ice, yelped, and came up lame on a front leg. They were tired and sore from over-doing it themselves, so thought they knew how he felt. They went to their medicine chest and got out some aspirin-some for themselves and some for Geoffrey. They didn't wrap their own dose in a piece of cheese, however. Geoffrey took his "treat" eagerly and after awhile did start to feel better. He got the aspirin on and off during the week; he was noticeably better with his limping after getting a dose than if they missed giving it for a day. But yesterday he started acting like a sick dog-Geoffrey usually LOVES his food, so turning down treats was a big red flag. When he vomited what looked like blood, they knew they better call us.

Aspirin is a very common medication, found in many homes and used by most humans at one time or another for headaches, joint pain, or fevers. It even comes orange candy flavored in some children's formulations, making this important drug seem very benign-what harm could it cause?

Cyclooxygenase is an enzyme involved in the inflammatory process-aspirin inhibits this and the subsequent production of of an inflammatory chemical called prostaglandin. Arachidonic acid, a fatty acid that is essential in the diet of cats and dogs, makes up cell membranes. When inflammation is present, cells begin to make prostaglandins from their arachadonic acid. Aspirin is a true anti-inflammatory drug as it stops this process.

The problem is that there turns out to be more than one form of cyclooxygenase, and they do not all generate inflammatory prostaglandins. Some prostaglandins have important functions and we prefer not to interfere with these. Aspirin, unfortunately, does not distinguish between different forms of cyclooxygenase and inhibits them all. Because of this, aspirin has largely been replaced in our at-home pharmacies or medicine cabinets by safer medications like ibuprofen (Advil) or acetominophin (Tylenol.) They primarily inhibit the form of cyclooxygenase that is associated with inflammatory prostaglandins. Aspirin is inexpensive and readily available but no longer a leading choice for pain/inflammation relief.

Thromboxane is a prostaglandin that deserves a mention here. It is involved in blood clotting. When a blood vessel is injured, a type of blood cell called platelets accumulate in the area and pile on top of each other, creating a plug or clot. Thromboxane is important for keeping these platelets adhered together, constricting the blood vessel to minimize bleeding and several other more complicated operations that enhance clotting. By inhibiting cyclooxygenase, thromboxane cannot be produced and the platelets present at the time aspirin is given are permanently inactivated. This is how aspirin works to prevent abnormal clots, an important part of treatment for many human heart disease patients as well as the rare pet with abnormal clotting tendencies.

The most common side effect of aspirin is stomach upset. It has been discovered that most dogs get some degree of stomach ulceration, ranging from microscopic to full perforations. Hematemisis (bloody vomit) can result. In humans, nausea has been so common that the numerous alternative pain relievers (Tylenol, Aleve, etc.) are becoming more common. It is important to resist the temptation of using any of these non-aspirin products in pets as most have a far greater potential to ulcerate the stomach than does aspirin. As human pain relieving drugs go, aspirin is probably one of the safer ones; however, as veterinary pain relieving drugs go, aspirin is generally the last choice. Even "Dog Aspirin" commonly found for sale at pet stores is not without its potential for serious side effects.

Dogs and cats are NOT small humans and we have to remember that some medications are metabolized (broken down or utilized by the body) differently in these species than in us.

CATS METABOLIZE ASPIRIN SLOWLY AND IT IS EASY TO OVERDOSE THEM.

Aspirin will reduce blood flow through the kidney, which is likely to make pre-existing kidney disease much worse.

Enteric coating of aspirin may alter the way aspirin is absorbed in an animal's stomach. The pills tend to stick to the stomach lining instead of dissolving properly. If enough tablets accumulate, overdose and death can occur.

We took Geoffrey off the aspirin, of course, and started him on some gut-protectant medications. If he does not improve rapidly, he may need radiographs of his abdomen and/or an endoscopic evaluation of the gastric mucosa (stomach lining) to look for any serious ulcerations (which he undoubtedly has-thus the blood in his vomit) or perforations. Dogs have died from peritonitis or infections in the abdomen as a result of this, and it is a very painful condition. Geoffrey will be fasted for a time, then started on bland food so his gut won't have to work as hard to digest it. If he later needs pain medication for the gastric ulcers, (or for the original lameness problem) we will probably try a narcotic or other drug that won't have the same risk of side effects.

Most of the time you could probably get away with using aspirin on your dog with out any problems, but how awful would you feel if he or she had a reaction (not at all uncommon) like Geoffrey did? So, the moral of the story is:

Do not use human medications on pets without specific instructions on how to safely do so from your veterinarian.

Peace,

DrReneigh

"Nosey" Greetings

A dog's nose "knows" a lot. It is their way of exploring the world, checking out their surroundings and saying hello to friends. They will tentatively sniff out new dogs and humans alike, getting to know them through all those yummy smells. An older client once told me that since dogs sniff each other to get to know one another, the stinkiest dogs are the most popular-they have been places and done exciting things and have good stories to tell. That was his explanation for why dogs like to roll in stinky things; Verbal loves the bright green chicken poo, diving neck first onto the lawn to rub it behind her ears. It makes sense-that is where her pulse points are, just where you would put your finest perfumes. She must be a popular dog indeed.

It is no surprise that dogs like to sniff the hind ends of other dogs right off. Tails are up and noses are right there-it is probably the stinkiest part of the body if they haven't put on their "perfume" as Verbal does. The source of the very strong odor and thus the attraction for other dogs is the anal sacs, two small, grape-like structures just inside the anus, similar to a skunk's scent glands. They fill up with material from the anal glands that line the sacs, material with a foul, fishy odor that once you smell, you will be able to identify from a mile away. Normally, these sacs are emptied when a dog or cat defecates, secreting the material to lubricate the feces. Some animals aren't able to do this naturally, either because of an anatomical problem or because the sacs have become blocked or impacted. When this happens, the material may build up inside the sacs, causing pressure and discomfort. The most common sign of anal sac or anal gland impaction is scooting on the hind end, dragging the bum along the carpet or grass in an effort to release the blockage. Pets may lick obsessively or chase their tails; they may leak a bit of the material when the sacs over-fill and you will be treated to the offensive smell on your dogs fur or bedding (or on the seat of my car when Verbal jumps into it-bummer!)

If your pet shows any of these signs, a trip to the veterinarian is a good idea. Groomers often perform the anal sac expression procedure, but tend to do so via an external method-pressure being applied to the sacs outside of the anus and removing some of the contents. Most often this does not completely empty the sacs and they tend to fill up again pretty quickly. Groomers also aren't trained to recognize the signs of abnormal contents or feel of the sacs to determine if there may be an infection or other problem causing the impaction. Veterinarians or veterinary technicians are trained to express the sacs internally-inserting a (gloved) finger into the rectum and completely emptying the sacs, as well as palpating or feeling for abnormal growths or contents of the sacs. Occasionally antibiotics and/or pain medications may need to be prescribed for abscesses in the region. If pets get repeated infections, or just get impacted very frequently, a diet change may be recommended. I have seen animals with food allergies manifest themselves with chronic anal sac issues, only to resolve with hypoallergenic diets. Adding fiber to the diet may be enough to help some pets since this can bulk up the size of the stool and the larger feces may empty the sacs as it passes them by.

Very serious repeated infections or impactions that are very uncomfortable for the pet may warrant surgical removal of the sacs. The anal sacculectomy is not without its possible complications, however, due to the intricate nerves and blood vessels in the area, and the possibility of leaving gland material behind causing persistent draining tracts, so it must be carefully considered.

Is that more than enough information for you about anal sacs? If you would like to read some more or see some funny little graphics, check out the VeterinaryPartner.com page: Anal Sacs. I told you veterinarians need an iron stomach when we were talking about vomiting the other day. Anal glands produce one of the foulest known odors ever invented. We are always trying to find good odor neutralizers or deodorants to cover up the smell when we have finished the anal sac expression procedure on a pet-sending a pet home with a stinky bum isn't very good PR. But it does make for some "popular" dogs with good stories to tell.

Peace,
DrReneigh