Early Detection of Disease
I have a friend who was diagnosed with an unusual, slow growing cancer that is usually only found once it has caused a problem. The journey we have gone through with the health care system has taught me that it pays to be informed and proactive. We’ve been told that he has probably had the cancer for years, even though we’ve only seen the effects for a few months. He told the doctor he didn’t feel good and was tired, but this was attributed to stress in his personal life. It wasn’t until he turned yellow that we knew it was not stress. My patients can’t talk. I rely on their owners to bring them in when they are ill. And my patients keep going even when they are ill because that is what animals do unless they are dying. At this point, treatment is often palliative only. Sometimes a thorough physical exam doesn’t tell me what is wrong. I need to run tests. I do not recommend a lot of work up if I don’t feel it is necessary. We have recently diagnosed three two year old dogs with serious life threatening illnesses. They came in for their yearly exam and they had lost weight. It was hard to convince those owners that there was a problem. But once we discovered it and they had time to reflect, they could see the disregarded symptoms. Early detection of any disease improves the prognosis. So here are my tips on what to look for. Weigh your pet monthly. A few pounds is a lot to lose for a pet. If your pet is “finicky”, something is wrong. Animals don’t just get tired of their food and stop eating it. If you notice increased thirst or your pet starts having accidents in the house, something is wrong. If your pet changes behavior, either becoming more or less affectionate, something is wrong. You know your pet better than anyone. If you are uncomfortable with something they are doing, bring it to your pets’ doctor’s attention. You may save their life.
Above all, do no harm
As a veterinarian, I have sworn the oath, "Above all, do no harm." It is rather a strange oath. You would think we would swear "Save lives" or "Be gentle with those who cannot understand the painful things you are doing to them in their own best interests."We humans do harm a lot. I went to the Galapagos Islands two years ago to see the animals Darwin did that helped him develop the theory of evolution. I saw amazing things. I learned that many species had been decimated because man introduced domestic animals, like dogs, cats and goats, that hunted these animals to extinction and ate the vegetation they lived on. I am reading about Australia, my next big trip. Again, I am going with a group of veterinarians and I will learn about the habitat and medicine of Koalas, wombats, dingos, and other species I have never seen nor heard of before.
Already I have learned that 24 rabbits released by Thomas Austin in the late 1800s have turned into millions that have destroyed the habitat of many indigenous species and led to the extinction of several. On a smaller scale, I am routinely asked to euthanize perfectly healthy animals, simply because they are no longer convenient or have been left untrained and have become unruly. I cannot do so if I deem that the animal can be placed in a new home. Even for sick animals with treatable diseases where the owner chooses not to treat or can't afford treatment, if I think I can find the pet a home, I try to do that. Most veterinarians do. We live in a tough, often frightening world, where small actions can have big consequences. Maybe the veterinary oath should be required of all of us.
Cats are not small dogs
Cats are not small dogs. That was one of our veterinary school mantras. The cat has caught up with the dog in popularity as a pet. Felines fit our frenetic American lifestyles. They are independent, yet affectionate. They adapt well to apartment life, as long as we don't try to crowd too many into a small space; they don't need to be walked and they aren't noisy to bother the neighbor in the condo next door. But we have to remember the mantra. Common difficulties arise when we try to treat them like dogs. First, we cannot use the same products and medications on cats that we do on our canine friends. The most common poisoning is the use of canine only flea control products. Over the counter products are either ineffective or deadly to the cat. Even if you only use the product on your dog, if your dog and cat are buddies, your cat can become ill from exposure to the product on the dog. Cats can't tolerate pain meds that we use on dogs. And because of their small size, it often takes only one dose to kill your cat. Cats have the reputation of being aloof, but they really are not social animals. They don't travel in packs like canines do, so they aren't so eager to please. But they love attention and affection, on their terms. The number one behavioral problem is not using the litter pan. I f your cat suddenly stops using the pan, do not assume that he or she is mad at you. Often, there is a medical problem. Talk to your veterinarian if this happens. It usually can be solved quite simply. Cats are fascinating little beasts that can bring great comfort and joy if you remember the mantra-cats are not small dogs.
Because of recent articles in the local newspapers, we have been getting a lot of calls about an old disease called Leptospirosis. It affects the liver and kidneys, and is caused by a bacterium that likes to live in water. Leptospira species are transmitted through urine via contact with mucous membranes and are transmissable to many mammalian species, including humans. It is speculated that our last few years of wet conditions coupled with an increase in the rat population in certain areas, as well as mutations in the organism and decreased vaccination have led to the recent increases in disease seen in certain areas of Western New York. Many of us do not routinely vaccinate for lepto for several reasons. First, there is a high incidence of severe vaccine reactions when leptospirosis bacterin is included in vaccines, including a life threatening shock reaction. I have almost lost several puppies so vaccinated.
Second, protection from the vaccine is limited, some estimates as short as 3-4 months duration. Third, the disease is highly treatable if treatment with fluids and antibiotics are started early and aggressively. Fourth, cold weather kills the bacteria in the environment. Given the recent trend to tailor vaccine protocol to each individual because of potential side effects from vaccines, I do not feel that every dog should receive Leptospirosis. My recommendations are to limit your pet's access to dirty water - ponds, puddles and the like. If your pet shows any signs of illness, lethargy, vomiting, diarrhea, don't wait three or four days before you have them seen. If they have Lepto, they could die. If you cannot limit their access, they need to be vaccinated in the spring, one month later and then 4-6 months after that to be protected. Panic is not indicated. Thought and planning for the warmer weather are.
Severe Bleeding Emergencies
Severe bleeding is one of the most common emergencies we see. The first rule in an emergency is don't panic. The calmer you are, the calmer your pet will be and you both will be better off for it. Wounds and bleeding are always scary for owners. It amazes me that people seldom think to try to stop bleeding on their own before they get the animal to me. If there is a severe wound on an extremity, wrap it tightly with anything you have available. Towels, tee shirts, whatever you can grab quickly. If the wound is on the body, place your cloth on the wound and apply manual pressure. If you have no one to help you, use a belt or scarf to hold your bandage in place.
Don't worry that it is not sterile. Most wounds are not sterile and profuse bleeding is more threatening than any infection you might introduce with a tee shirt. The only exception is if the pet won't allow you to touch the bleeding area without making you bleed. If possible, try to call your veterinarian before you arrive, so they can be better prepared to handle your crisis. Being prepared to administer fluids, oxygen, pain meds and antibiotics in a short period of time may save your pet's life. We practice to be prepared in an emergency. You should too. Have your own simple crash kit with bandage material, your veterinarian's phone number and the emergency after hours number. Think about how you would get your pet into the car if it can't move on it's own. Have a big blanket to handle a stressed cat safely and, at your next vet visit, have them teach you how to make an emergency muzzle in case your dog gets hurt and won't let you handle him. Practice a mock emergency with your pet. It will make the real thing easier.
Yes, Virginia, Pets Get Cancer Too
It always amazes me that people think their animals do not have the same medical problems that we do. Mammals all have similar anatomy and physiology. Yet people are surprised that their dog, cat or guinea pig, who is losing weight, drinking excessively and urinating all over the place, has diabetes mellitus, or sugar, as some call it. Cancer is another example. Breast cancer is fairly common in dogs. But unlike people, it is totally preventable. If a dog is spayed before she has her first heat, she has a 99.9% chance of never getting breast cancer. The other thing that amazes me is how often people bury their heads in the sand. They might notice a lump, but are afraid of what it might be, so they ignore it. In doing so, a cancer that may be entirely treatable has the chance to grow and spread to other places. It is like closing your eyes and plugging your ears at a scary movie.
The frightening stuff is still happening - you just are less aware of it. Your veterinarian can help your pet lead a healthy, long life. But only if she gets to see them. Don't ignore changes in behavior, appetite, drinking, elimination, lameness, lumps, weight loss or gain. These are often early indicators of diseases that may be very treatable. You and your veterinarian are the guardians of your pet's health. Don't wait for your pet's yearly physical if you notice something. Garfield can't drive a car. Garfield hates going to the vet. But Jon knows it's important, so when Garfield doesn't eat, he goes to the vet. You are the only one who can keep your pet healthy. You have the power. Use it.
Your Pet and Cancer
I just finished taking an online course entitled “Nutrition and Oncology”. The first thing I learned is that cancer is the largest cause of death in pets in the United States. Here is the second thing I learned. It is the most curable and preventable of all the diseases your pet can get. Early detection is the key to a cure. Once we see symptoms of most cancers, there has been spread to other sites. But increasing the number of times per year your pet has a complete physical as it ages, and doing routine screening tests like blood work and x rays, even when your pet seems perfectly healthy, increase the likelihood of early detection. Prevention is both the easy part and the hard part. It’s easy, because diet and exercise can prevent the majority of cancers. A pet that eats a good quality pet food, but a restricted amount of that food to keep a lean body mass, and that gets an omega 3 fatty acid supplement will be less likely to get cancer.
Most pets I see are obese. That is the hard part for most pet owners. They use food as the only reward for their pet, and I have a hard time convincing them that petting, play and attention are just as rewarding. Third, we need to spay and neuter at an early age. This markedly decreases the risk of certain cancers. Fourth, choose breeds that are not cancer prone or at least know what cancers are common in that breed, so you can be on the watch for them. Cancer is a scary word, but it doesn’t equal death unless we ignore it.
Blow Up Your TV, Walk Your Dog Instead
Almost everyone is worried right now - about the economy, about the war, about what the future holds for us personally and as a country. Many of us are looking for ways to save. As a devoted pet lover, I worry about where people decide to economize. In the last few months, I've seen people waiting until it is far too late for me to help their pets - then wanting me to perform miracles. They actually end up spending more money, and often, lose their pet in the "bargain". More emotional and financial loss is incurred than if they'd actually had that physical or did that routine bloodwork. I, too, worry about the future. But I know that an ounce of prevention is worth a pound of cure, in terms of health, longevity and money. Right now, we need as much love and stress reduction as we can find. Your pet is one of the best sources. Scientific studies have proved that pet owners have fewer illnesses, live longer and are happier than non-pet owners.
Families who have pets produce children that are more confident and responsible, and with fewer allergies than non-pet families. My suggestions are the following. Consider pet insurance - it now can cover prevention as well as catastrophe and it is not exorbitant. Talk to your veterinarian about a preventative health program. I'm offering discounted sick pet care if you enroll in a wellness program, and I'm sure others do the same, just as insurance companies waive co-pays for well visits. Establish a real relationship with your other family doctor. We love to share our knowledge and expertise. Don't give up your fuzz therapy in a move to economize. Cancel the cable instead. You'll be happier and healthier.
Knowledge and Health
It amazes me that people are amazed to hear that dogs, cats and other pets get all the same diseases that we do. When I tell a cat owner that their obese cat has developed diabetes, they usually say, "I didn't know cats could be diabetic." And when I tell them that we treat with diet and insulin, they are astounded. I shouldn't be amazed. The majority of people in this country are not aware of the things they should do for themselves to maintain good health. Obesity is the number one health problem in our country and it is a direct consequence of our eating habits and inactivity. Most people have no idea of what constitutes a balanced diet. After all, we had a president who thought that ketchup was a good vegetable. So when I tell people that good oral hygiene will extend the length of and improve the quality of their pets' lives, I shouldn't be amazed that people don’t believe me. I explain that the same is true for them. It is a fact that strokes, emboli and heart attacks are more prevalent in people with gingival disease and tartar.
When you chew, you send bacteria into your bloodstream through your gums. If you have a healthy mouth, the amount of bacteria is a lot less than if you don't. Constantly showering your body with bacteria constantly challenges your immune system. Systemic infection results. The same is true for animals. Bad breath is a minor consequence of dental disease. Heart disease is a major consequence. And yet, the way most people are persuaded to brush their pets' teeth or to have them cleaned is the promise of better breath. Again, I shouldn't be amazed. Toothpaste ads have gone from promises of fewer cavities to promises of whiter teeth and a sexier mouth. Another issue is second hand smoke. Just as you affect your children's health by smoking, so too, your pet is affected. Asthma and heart disease are exacerbated in your pet by smoking. No one has looked at cancer rates in the pets of smokers versus nonsmokers. It would be interesting. But what really amazes me is that we do manage to live longer than our ancestors, even through all our ignorance. It just goes to show that healthcare and education have made a huge difference in our lives and in our pets' lives. Just think how great the world could be for everyone if we truly made the effort to stay educated and informed.
Medications and your pet
As a medical professional, I see some very alarming trends in the way medication is treated in our country. The first is in our attitude toward medicines. The best ways to have a healthy pet and to stay healthy ourselves are threefold: exercise, eat healthy foods in moderate portions and have regular medical checkups. Those things take time and effort. We Americans want everything fast and we want it now. We want to take a pill to give us our nutrition, to help us lose weight and stay fit. That is simply not possible. It is no wonder that obesity is the number one health problem in our country for our pets and for ourselves. The second trend is in our propensity to self-medicate. People take supplements and so-called natural products in addition to or instead of the medications their physicians prescribe. They do the same for their pets. The problem is that these supplements are also drugs, many of them interacting or even counteracting the prescribed drugs. And, because they are not monitored by the FDA, often are inconsistent in what they contain.
Many of these products can interact with anesthetics as well or interfere with blood clotting. The third trend is in the cost of medications. In other countries, the same drugs are much cheaper than they are here. Many of them are manufactured in the same places, yet are sold in the U.S. at a much higher profit. I have seen the cost of most of the drugs I use quadruple in the last few months. Nothing has changed in the formulation or manufacturing of these products. In most other modern countries, pharmaceutical companies are not allowed to make the profits that they do here. This results in the American public bearing the cost. And that means that pets and people without insurance or the income to afford them, go without the medication that they need. We have the power and ability to change this, but again, it takes effort. If each of us picked up the phone or wrote a few short letters, we could improve healthcare and reduce drug costs for our pets and for ourselves.
There is no such thing as a free kitten
I never see free kittens or stray dogs. Once you bring them in to see me, they are your pet and it will cost you money to have me examine them, vaccinate them, neuter them or help them through an illness. "But I'm being a good Samaritan," you say. "I'm taking this animal off the street and giving it a home. Can't you give me a deal? I thought you loved animals because you’re are a vet." I do love animals. Why else would I get bitten and scratched and urinated on and defecated on willingly? People in animal medicine are not in it to get rich. But we do have to earn a living and pay our bills and staff. I went to school for eight years and incurred educational loans to do it.
When you go to a lawyer, do you expect a deal because you are in trouble and it's not your fault? What many people don't realize is that you are getting a deal. You now have someone in your life, who, if treated right, will give you unconditional love. You don't have to be gorgeous or a millionaire to get this. It really is quite remarkable. Unlike people, pets don't have an agenda past some affection and food-you are their world. The first year that you have a pet will cost you around $400.00 to vaccinate, deworm and neuter. After that, medical care is cheap unless they get hit by a car or some other catastrophic event occurs. Nothing worth having in this world is ever free. A pet that needs a home is about as close as you can get. But it still requires financial and emotional commitment. There are agencies like Save a Pet or the SPCA out there to take care of strays and find them homes. Let them do their job if you're not ready for the commitment. They do it well.
You're pet's eyes are a window to her health
When I perform a physical exam, the first thing I do is examine the eyes. First, just how upset is my patient? Dilated pupils in a visual animal are usually the result of fear. Constantly dilated pupils are an indication of blindness. Different sized pupils can indicate neurological problems. Are the eyes clear or cloudy? Cataracts, corneal problems and intraocular infection are possible. What color are the whites of the eyes? Red eyes can mean glaucoma, infection, allergies, ulcers, tumors. Yellow eyes mean liver disease or red blood cell problems (intravascular hemolysis). Are the eyes both open and are the openings the same size? Squinting in one eye indicates pain in that eye. Squinting both eyes can mean bright light hurts, caused by a neurological problem or severe headache. Does the patient blink normally in response to my finger moving toward the eye? If not, the patient may be blind or have a neurological problem. Are the third eyelids normal? (Yes, they have three lids - when I push on their eyeball I'm protruding the third lid to examine it.) Is there discharge? The character of the discharge can help me decide if there is infection, blocked nasolacrimal ducts or decreased tear production. Finally, I examine the back of the inside of the eye or fundus. Tumors, detached retinae, hypertension, degenerative diseases and certain types of infection can be detected here. All this happens in probably three minutes. Your pet's eyes may be the windows to her soul or not, but they certainly are a window to the rest of the body.