Mange Article

"You are getting under my skin is usually just an expression."  With the canine sarcoptic mange  mite,  it is actually literally true.  Canine sarcoptic mange is also called canine scabies. It can be a real nuisance for dogs and their owners, sometimes even causing a temporary severely itchy rash in people. It rarely affects cats and ferrets.

 

The mite is spread either through direct contact with an affected animal or through contact with fomites from an infected animal.  Fomites would include fur, skin cells, bedding. Foxes, coyotes, and dogs can transmit it to each other.  

 

The mite can eventually affect all of the skin on a dog's body, but often it is first noticed around the ears, armpits, abdomen, and legs.  The skin shows evidence of redness, scabs, hairloss, intense scratching, and sometimes blood. Affected dogs often eventually have trouble sleeping and keep their owners awake at night by scratching so much.  Just think how you would feel if you had mites literally burrowing under your skin and laying eggs in the tunnels they have created.

 

The first step to treating this problem is giving your veterinarian a very complete history of when the symptoms started, where your dog lives and plays and goes for walks, how intense the itching is, the flea/tick control you are using, and how many and which species of other pets are in your household.  Showing your vetwhere all of the skin lesions are located is also important.   Maybe skin scrapings will be done, but it is very difficult to even find the scabies mite on a skin scrape.  Sometimes, fur samples are taken to rule out other skin problems.  Many times veterinarians have to treat and monitor for response if they suspect scabies.  Even veterinary dermatologists only have about a 25% chance of finding the canine scabies mite.   First response will usually happen in 7 days, and will be noticeable by decreased scratching and scabs beginning to heal.

 

There are several prescription  products available for treating scabies and killing the mites. It usually takes about 6 weeks to clear the infection. Because it is contagious to other dogs and people, any other dogs with symptoms will have to be treated also, and affected humans will have to visit their physician for relief from the intense itch.  The sooner it is treated, the better for everyone involved.  We often see dogs who have been infested with the mite for months, and have extensive hairloss, scabs, skin infection, and intense itching. 

 

If the infestation has been present for awhile, then the veterinarian must also treat the skin infection with oral antibiotics, topical antibacterial and antifungal shampoo, and sometimes topical steroids for the intense itching.  

 

The other mange mite that dogs can have is the demodectic mange mite, and it is present in all dogs in minimal numbers. It lives in the hair follicles and oil glands of dogs.  It is not contagious to other dogs or people, but it can multiply and cause skin issues in certain breeds of dogs moreso than others.  Sometimes it multiplies due to environmental, immune, or nutritional stress.   These mites can also be treated by veterinarians with prescription products that are different than the ones used for scabies.  Dogs can get very serious cases of Demodex that require longterm treatment or even self-limiting, mild cases of Demodex that resolve on their own.  Dogs with demodectic mange are usually not itchy, but can be sometimes.  They often have to be treated with follicular flushing shampoos and oral antibiotics in addition to the products that kill the mites.  

 

The great news is that both types of mange are treatable today due to advances in veterinary medicine!

 

 

 

 

Dr Marisa Pepin-Slade and Dr Robert Slade are longtime Hampstead residents and operate a mobile veterinary housecall practice. They welcome your comments at DrsPepin.Slade@gmail.com.

Spring Pet Tips Article

Now that the daffodils (toxic) are blooming and the Easter Lilies (Very, Very Toxic) begin to adorn our homes, we know spring is in the air! Spring is a great time for pets and pet parents. Just watch your pets to make sure they don’t eat toxic plants, flowers, pesticides, antifreeze, etc.  Blow the winter dust off the Frisbee  and ball and head out into the yard  and let your dog stretch his or her legs. Perhaps head to one of our great local parks with leash in hand and go for an extended walk. Cats of course really do not like Frisbees or walks in the park but they do enjoy looking out a screened window at all the  wild critters outside and probably dream about being a tiger. However, they do get a little angry if they see another cat outside in THEIR yard.

            Now that our pets are getting out and about, we should  make sure all of their preventive health matters are up to date. All dogs and cats need to be up to date on their rabies vaccination. Not only is it the law, it is just good common sense! Rabies does exist in our area and an exposure can happen to one of our pets, and we may not know or see any signs of illness in them for weeks or months.  Exposure can be as simple as a bat bite. The current rabies vaccinations are very safe and effective. Rabies, when it occurs, is always—except in one rare case—always fatal for people and animals.  So if your pet is not vaccinated,  why take a chance  --- get them vaccinated.

            There are many other vaccinations that are recommended for your pet. Today we taylor the  vaccination protocol based on the pets lifestyle. All dogs should be vaccinated with the Canine Distemper Combination vaccination and cats with the Feline Distemper Combination vaccination. There is also a Feline Leukemia vaccination for cats. For dogs there are vaccinations for Lyme Disease, Leptospirosis, Bordetella(or kennel cough) and Canine Influenza. Each one of these warrants its own column. We do not have  the space to do them justice in today’s column.  We have written columns on Lyme disease and Leptosporsis in the past. Our past columns are archived on our website www.LoveYourPetVet.org. Talk to your vet about what vaccinations are recommended for your furry friend.

All pets that go outside need to be on effective flea and tick control. Today we have some very effective products. There are oral pills for dogs and topical spot ons and collars for dogs and cats. Be sure to purchase the products on the recommendation of your veterinarian. Some over- the -counter products are not very effective and some have safety issues, especially for cats. Flea and tick shampoos are not recommended much anymore as they have no residual effect once you rinse them off, and the fleas and ticks can hop back on your pet. Dips and powders are not recommended anymore because we have much more safe and effective products these days. Indoor only  pets, if not kept on continuous flea and tick control, need to be frequently monitored for infestations by brushing with a flea comb. Flea combs are cheap and available at most veterinarians and pet shops.

All dogs should be on a heartworm prevention. This was discussed in detail in last month’s column.

Most importantly, get outside, enjoy the beautiful spring weather with your dog. Open the windows and let in some fresh air and your cat will thank you. Maybe sit a cat tree next to the window. With a few simple precautions, our pets and their people parents will have a wonderful spring!

 

Dr Marisa Pepin- Slade and Dr Robert Slade are longtime Hampstead residents.They operate a mobile veterinary House Call Practice.

            

Rabies Article

This month we thought we would take a little deviation from the normal format of our column and discuss a personal event Dr. Slade had three weeks ago regarding rabies.  We all know that our pets should be vaccinated for rabies and  it is the law. Hopefully, we all keep our pets up to date.

            About a month ago one of my colleagues was presented with a  moderately fractious cat about six years old with a wound on its back leg. She x-rayed it and found a dislocated joint. She administered a rabies vaccination and gave a long-acting antibiotic injection. This kitty was presented by a couple who had been feeding this cat outside since it was a kitten, but until that day it was never presented for any veterinary care. The plan was that once the cat was stable enough from the infected wound, the injured leg would require surgery. The cat presented to me early the next week for a presurgical exam. At that point, though, the wound had not healed to the point that would have been expected. He also was now not eating, was wobbly in his other rear leg, and was very  calm. Actually, he was acting like a very nice kitty. I discussed further work up with the owner and had a long discussion with the owner about the possibility of rabies. The owner elected to hold off on any further workup and elected just to treat the dehydration that was present and start an appetite stimulant and think about things.

The next day they saw my colleague again and she explained to the owner that even if it was not rabies, the prognosis was poor. The following day the cat presented to me for euthanasia. The cat was presented to Animal Control for rabies testing. Several days later it was reported that the cat tested positive for rabies. The local health department contacted all who had contact with the cat. Since I had been previously vaccinated, I required two post-exposure vaccinations three days apart. The Carroll County Health Department is very knowledgeable as to the proper procedure in dealing with people who have had rabies exposure.  People who are  not vaccinated have a much more involved postexposure process. Since rabies is a fatal disease for pets and people,  it is nothing to fool around with. People in high risk professions should consider speaking to their local health department or health care provider to see if rabies pre-exposure vaccinations are recommended to them. High-risk people are often considered those in the veterinary profession, hunters, and avid outdoors people. All dogs, cats, ferrets and horses should be vaccinated. As for other animals, ask your vet.

             There were 335 cases of confirmed rabies across the state of Maryland in 2016, including 27 domestic cats.  Sometimes the only symptom is sudden death in a pet.   Since January 1st 2017, there have been an additional 10 cats who have tested positive for rabies in Maryland and 59 other animals.   Two of these cats resided in Carroll County.  Bats can enter people’s homes and bite indoor pets without owners even knowing about it.    Wild rabid animals can enter through dog and cat doors.   An elderly woman in Falls Church, Virginia, was recently  (March 2017) chased by a rabid fox who bit her all over her arms and legs, and then ran a mile away to attack and bite an owner’s pet cat. 

              If an animal or a person gets rabies, they die.  Post-exposure shots must be done right away after an exposure.   Everyone should thoroughly cleanse a bite wound from an animal right away with soap and water. It is your best first defense against rabies entering your body or your pet’s body.

            Please have all of your pets vaccinated against rabies even if they are completely indoor. You could save someone’s life  --- even your own.

Cushings Disease in Dogs Article

 We will discuss a  hormonal disease in dogs called Cushing’s Disease or hyperadrenocortism. This usually occurs in middle-aged to older small- to medium -sized dogs. It occurs when the body secretes too much cortisone. These dogs tend to drink and urinate more, develop  a pot belly, develop skin problems, and sometimes an increased appetite.   They are also more prone to diabetes.  The primary cause or presentation to the veterinarian is often  increased drinking and urinating.

            Upon presentation,  the veterinarian often checks  bloodwork and a urine sample. The bloodwork often shows an increase in a liver enzyme called Alkaline Phoshatase or ALP. The urine is often dilute. Once the history and screening labwork point in the direction of Cushing’s disease,  more needs to be done to confirm  Cushings.   If treated when not present,  Addison’s Disease or Hypoadrenocortisism  can develop, which can be life-threatening.

             A screening test  called a urine cortisol/ creatine ratio can be run on a free catch urine sample.   If this test is normal,  it rules out the diagnosis of Cushing’s. If it is elevated, more needs to be done to confirm the diagnosis of Cushings.  We often go right to a diagnostic test called a Low Dose Dexamethasone Suppression Test.  This test requires the collection of three blood samples. Once the first sample is taken,  a small injection of a corticosteroid called dexamethasone is administered. Then a blood sample is drawn four and eight hours after the injection. In a normal animal,  the body would recognize the cortisone and turn down its normal production of cortisone. In a cushinoid animal,  the down regulation does not occur or occurs less than would be expected. This test also often distinguishes between the two types of Cushings. About 85% of these dogs have a brain-based problem in the pituitary gland.   About 15% of these dogs have an adrenal gland tumor. If an adrenal tumor is suspected, then abdominal ultrasound is indicated to confirm the adrenal tumor. If an adrenal tumor is found—depending on how advanced it is--- it can be removed by a surgical intervention. The pituitary masses could be confirmed by an MRI,  but this is rarely done.

            Treatment of Cushing’ s is a longterm commitment that is  expensive with the required medication and monitoring lab tests. There is a drug called Lysodren  and a newer drug called Trilostane.  Lysodren works by physically destroying the adrenal gland where the cortisone is being produced. The trick is destroying enough of the gland to make the signs of Cushings go away while not causing life-threatening Addisons Disease. When this medication is started, the pet’s appetite and water consumption needs to be monitored very closely by the owner. Usually a high dose of Lysodren is given for five to ten days followed by a different test called an ACTH stimulation test. An ACTH test is kind of the opposite of a Low Dose Dexamethasone test. Here we are trying to see how much cortisone we can get the body to produce rather than  trying to see how much we  can turn it down. Depending on the ACTH results, a low maintenance dose of Lysodren is given along with periodic ACTH testing to monitor how the pet is doing. Pets can come out of remission and require reinduction.

            Trilostane is often seen as safer but it still requires frequent monitoring with ACTH stimulation tests. A small percent of dogs on Trilostane can develop a non -reversible Addisons disease. If Addison develops and is not identified early, it can be life-threatening. These dogs will require life-long treatment for Addisons Disease.

            Cushings is a complicated  and expensive,  but treatable condition. It requires mandatory periodic blood testing.   Ask your veterinarian.

 

Dr Marisa Pepin-Slade and Dr Robert Slade are longtime Hampstead residents. They operate a mobile Housecall practice. They welcome you coments at DrsPepin.Slade@gmail.com.

Feline Infectious Peritonitis Article

One of the most heart-breaking diseases in feline medicine is a viral disease called  FIP or feline infectious peritonitis. Fortunately it is not real common. However, for those who have owned a cat with this disease, it is a diagnosis that probably hit you like a brick.  That is, you did not see it coming until your kitten or cat was very ill.  The highest incidence is in felines between 3 months and 2 years old.  Occasionally, older cats or middle –aged cats have this disease, but not usually. 

 

Typically, a kitten or young cat develops a high fever not responsive to antibiotics, has a potbelly appearance with yellow fluid in its abdomen and/or granulomas in abdominal organs, and has decreasing energy and decreasing appetite and weight loss.

 

Diagnostic confirmation is very difficult and expensive, so many felines are diagnosed presumptively through history and physical exam. There are blood tests that can be done, but diagnosis is not definitive unless biopsies of affected organs are obtained and sent to a histopathologist that can do immunochemistry confirmation.

 

Prognosis is poor and almost 100% of felines die within a few days to several months. Some veterinarians treat cats with an immunostimulant called recombinant interferon, but it has limited success.  Corticosteroids are also used with limited success.  Certain genetic lines of cats have a higher incidence of FIP.

 

Felines must first be exposed to Feline Coronavirus to even develop FIP.  The chance for a Feline Coronavirus antibody positive cat of developing FIP is < than 10%.  Certain genetic lines of cats are more susceptible. It appears that it is the response of their immune systems to the Feline Coronavirus that causes the disease FIP. The prevalence of Feline Coronavirus positive cats is pretty high in most populations.

 

Prevention involves not exposing a Feline Coronavirus antibody positive cat to a negative CoronaVirus  antibody cat and   keeping cats indoors.  However, realize that most Feline Coronavirus  antibody positive cats  will not develop FIP.  FIP intranasal vaccine exists but is not very effective and makes cats Coronavirus antibody positive on testing.  Therefore, the vaccine is not recommended by the American Association of Feline Practitioners.

 

 In catteries, it appears that the main method of transmission is from asymptomatic queens (mother cats) to their offspring between 5 to 7 weeks of age.  Therefore, it is recommended to wean the kittens at 4 weeks of age and not allow these kittens to have contact with the mother or other cats until they are in a new home.   Routine disinfection easily inactivates the virus on cages/ premises/feeding bowls/ water bowls.  Use stainless steel or glass bowls that are easier to disinfect.  Plastic harbors organisms.

 

If you suspect your kitten or cat could have FIP, isolate it from your other cats and kittens and have it tested by your veterinarian for Feline Coronavirus Antibody.  If this test is negative, it is

very unlikely to have FIP and your vet can search for other reasons for your cat’s symptoms.

 

Since many cats are positive for Feline Coronavirus antibody, most veterinarians do not test for it unless a feline has symptoms of FIP.  The positive Feline Coronavirus antibody test just worries the owners and usually does not result in FIP.

 

Always remember to have new cats and kittens examined by a veterinarian before bringing them into your house with another feline.  Preventing transmission of any disease is much easier than trying to cure it.  Testing for FELV and FIV is  almost always performed at the first visit unless the feline is too young and ideally repeated at six months of age.  Feline Coronavirus antibody testing can be done if you wish, but is usually not done routinely.

 

Dr Marisa Pepin-Slade and Dr Robert Slade are longtime Hampstead residents and operate a mobile veterinary housecall practice. The welcome your comments at DrsPepin.Slade@gmail.com.

Be Prepared For Regional Emergencies Article

 

With all of the horrible suffering our country has endured during all of the recent hurricanes and the wildfires out west, we thought it was prudent to let folks know how to prepare for an unexpected event.  Whether it be a snowstorm that strands us in our home or an event that requires that we evacuate to a shelter (or elsewhere), we need to be prepared.

           First, what should we have for an event that strands us at home? 1. Enough food and bottled water to care for our pets for at least a week  --FEMA says three days, we recommend at least one week). 2. If our pets require prescriptions, be sure you also have enough medication to last at least  1 week.  Do not wait until the last minute to get those refills. 3. A list containing feeding and medication directions in case the pet’s primary care giver is unable to get home. 4. For cats, be sure to have enough cat litter! For dogs, you will need to clear a small spot for them to urinate and defecate outside if too much snow is on the ground.  5. Pets always need shelter from the elements; do not just leave them outside.  6. A pet first aid kit. You can make your own. Collect some non-stick Telfa pads, VetWrap (3M), sterile roll gauze, sterile saline to flush wounds, eye wash solution, Neosporin (DOGS  ONLY),  a bottle of pet ear cleaning solution, scissors, nitrile exam gloves, and hydrogen peroxide for wound care.  Boots to fit you pets’ paws would be a plus.  7. Be sure to have the number of your veterinarian and several local veterinary emergency hospitals to call for advice if needed. But remember,  they may also be stranded at home, so always have several backup people you can call.

            If you have to evacuate, it gets even more complicated and working out a plan ahead of time is important. Many  shelters for evacuees do not accept pets. Therefore,  it is important to know which options are available. It would be best to make a list of pet friendly hotels in your region and adjacent states. Make an extensive list because the hotels will book up fast.  Develop a list of family and friends who live outside your region who also could provide a place for you and your pets to stay. Of course, you can also provide the same for them if they have a regional emergency in their area. Also, contact local humane and animal control officials and see if they can house your pet. It is also recommended that your pet have an identification microchip in case you get separated, so your pet can be traced back to you. Talk to your veterinarian about getting your pet microchipped if he/she is not. It is not a very costly service. A photo of you and your pet is also a good idea. Everyone has one on their phone, but remember you may not be able to charge your device, so have a print photo too.  FEMA also provides information on how to prepare for these types of emergencies with your pet. Please see the following link: https://www.fema.gov/media-library-data/1390846777239-dc08e309debe561d866b05ac84daf1ee/pets_2014.pdf as  does the American Veterinary Medical Association: https://www.avma.org/public/EmergencyCare/Pages/Pets-and-Disasters.aspx. Plan ahead and if local authorities tell you to evacuate, listen to them! Not doing so may put you and your pets at risk!

            Lastly, in the wake of all the recent events, we wanted to give a few reputable organizations where one could donate to help pets who were affected. 1. Alley Cats 2. The Humane Society of the United States Distaster Relief Fund  3. ASPCA  4. AVMF.

 

 

 

Dr Marisa Pepin-Slade and Dr Robert Slade are longtime Hampstead residents. They operate a mobile Housecall practice. They welcome your comments at DrsPepin.Slade@gmail.com.

Cats! Article

Today we will discuss the many subtle signs that cats show when they are ill. They won’t fetch the keys to the car and hop into the car willingly to see the vet --- like some dogs.  Cats are so subtle that they will do everything they can to hide their illnesses, even from their veterinarians.  Cats learned this when they were in the wild, because showing signs of illness would make them an easy target for predators.

 

Cats who have urinary issues often start urinating outside their litterboxes. This is not out of spite but for one of multiple reasons.  This is where the services of a veterinarian and detective are needed. The veterinarian often has to do many diagnostics to find the cause of  the problem, and the detective has to use a black light to find all of the urine accidents in your house that happened before you realized your cat really had a problem.  These areas in the house need to be completely cleaned with a product that eliminates the odor with enzymes specific for cat urine. Otherwise, the cat will consider the area one of its new “litterboxes”.  Then the vet has to use the bloodwork, urinalysis, Xrays, etc. to determine the cause of the problem.  Many possible causes of this problem include urinary tract infection, bladder stones, kidney disease, diabetes, feline idiopathic cystitis, anxiety/stress, etc.  All of these conditions are treatable.  Some owners wait to tell the vet until their home is so smelly that they just want the vet to euthanize their cat. This is not appropriate and a very difficult situation for caring vets to handle. Owning a pet is a choice and a responsibility.

 

Cats who have hyperthyroidism will often develop a ravenous appetite but lose weight slowly, even when eating excessive amounts. They often become grumpy, start meowing excessively even at night, and show evidence of poor grooming habits---developing mats that were not a problem before. This condition is also treatable.

 

Cats with arthritis often have more difficulty when trying to jump on beds and couches and when climbing stairs.  They also can start urinating and defecating outside the box because they have trouble lifting their legs to climb into the litterbox. This is when litterboxes with a low side are useful for the cats.  Also, there are several effective joint supplements and prescription diets for cats with joint pain and stiffness. These can improve their quality of life tremendously.

Never use any over-the-counter pain relievers on cats. Many of them are deadly to cats.

 

Cats with diabetes will urinate and drink more than usual. They are often cats who started out being overweight and then started to lose weight. They can also have a diabetic neuropathy that makes them walk abnormally with their hindlimbs. These cats are treatable also once they are diagnosed with a blood sample and urine sample.

 

Cats with dental disease can have bad breath, salivation, decreased appetite, and may paw at their mouths if they have a tooth abscess or painful gingivitis.  This is treatable with pre- anesthetic bloodwork and dental cleaning.

 

In summary, any cat who is showing signs of increased urination and drinking, urinating or defecating outside of the litterbox, changes in appetite, poor grooming, or bad breath, should be seen by a veterinarian for a complete exam and diagnostic workup. Symptoms of disease are often very subtle in cats until the disease has progressed to a serious stage. Be on the lookout and try to practice preventive care for your feline friend.

 

 

 

Dr Marisa Pepin Slade and Dr Robert Slade are longtime Hampstead Residents and  operate a mobile veterinary House call practice.  They welcome your comments at DrsPepin.Slade@gmail.com.

 

 

 

Spay and Neuter Article

            This month we thought we would discuss the importance of spaying or neutering your pet. Many readers may remember former Price Is Right host Bob Barker’s show ending line about getting your pet spayed or neutered. Well, he was right. There are 670,000 shelter dogs and 860,000 shelter cats per year in the United States that are euthanized because they do not have homes.  This is unacceptable! Stop by the Carroll County Humane Society on any given day and see how many pets need homes right here in our county. Just as a  note, if you are looking for a feline or canine companion, check them out.  They always have someone looking for a loving home. They can also point you in the right direction if they don’t have the pet you are looking for.  Though there are many very responsible breeders, there are also many puppy mills and kitty mills.   Be careful getting your puppy off the internet and sites like Craigslist.  There are also breed rescues that adopt out specific purebred pets.  You can find many of these contact numbers online.         

            The statistics ---regarding how rapidly an intact cat or dog can reproduce-- are staggering! For example, in one year a single intact female cat and her offspring can produce 12 more cats.  In 5 years, this single female cat and her offspring  can be responsible for 11,801 cats.   And in 9 years this cat and her offspring can be responsible for the production of 11,606,077 cats! See https://goo.gl/images/q1YLoL.  For intact female dogs, one female and her offspring can be responsible for 16 dogs in one year, then 12,288 dogs in 5 years, then 67,000 dogs in 6 years. Letting intact dogs and cats roam can lead to a humongous overpopulation problem.  We see this all of the time, especially with neighborhoods who are overpopulated with outdoor cats.

            For more information on how to spay and neuter your own pets or neighborhood stray pets, contact your veterinarian or one of multiple local rescue groups: Humane Society of Carroll County  410-848-4810, The Baltimore Humane Society  410-833-8848, Maryland SPCA 410-235-8826, Spay Neuter All Pets (SNAP)  302-838-6996, Alley Cat Allies 240-482-1980.  These are also great organizations for donations to animal welfare causes.

            Rescuing pets at many of these organizations comes with financial and time-saving benefits.  Many of the pets are already spayed or neutered and have their first vaccinations, testing, and deworming completed.  Also, most of the pets are especially grateful for their new homes because they have been abandoned, hungry, and thirsty in the past.      

            Female cats that are not spayed are at risk of developing a pyometra ( a severe infection of the uterus requiring major surgery) that can occur usually in middle-aged to older female cats. Untreated, a pyometra can lead to death!  Female cats who are not spayed have obnoxious behavior (crying, mood swings) during their heat cycles which can occur multiple times per year and last 7 to 10 days. A male cat who is not neutered around 6 months old can excessively spray urine around  your house to mark his territory.                       

            For dogs, the age of recommended spaying and neutering can vary by breed. The likelihood of different cancers --like canine breast cancer-- and other health conditions can be increased or decreased, depending on the timing of the spaying/neutering.  Unspayed  dogs as they age are also at risk of developing a pyometa . The research is ongoing and it is best to ask your veterinarian for advice based on the current research as to when to spay or neuter your dog.

            In summary, spaying and neutering your cats and dogs is crucial to controlling our pet overpopulation problem and for preventing the euthanasia of over 1 million healthy, homeless dogs and cats each year. It also makes a happier and healthier doggie or kitty!

 

 

Dr Marisa Pepin-Slade and Dr Robert Slade are long-time Hampstead residents and operate a Mobile House Call practice. They welcome your comments at DrsPepin.Slade@gmail.com.

Feline Cardiac Disease Article

            This month we will discuss a silent but serious and often overlooked condition of cats: cardiac or heart disease. Some studies show that about 11% of all cats have heart disease. Sometimes murmurs are heard on physical exam but sometimes they are not audible or not present.

            In the old days many cats developed an enlargement of the heart called dilated cardiomyopathy from a deficiency of an amino acid ( a type of nutrient and a subunit of protein) called taurine. This condition has virtually been eliminated by the addition of taurine to commercial cat food. This is why the cat owner needs to be careful feeding a homemade diet without the consultation of their veterinarian. Be careful feeding diets found on the internet unless they are through a service like www.BalanceiT.com that is run by veterinary nutritionists.

            The most common type of heart disease found in cats today is thickening and enlargement of the heart called hypertrophic cardiomyopathy (HCM). Careful physical exam listening for murmurs and periodic blood screening for a compound called proBNP (IDEXX labs) can be done. ProBNP is secreted by the heart muscle when it is stretched more than normal. It is not foolproof but is easy and fairly inexpensive to run. X-rays often show a heart shaped like a valentine with this condition. The gold standard is an exam and an ultrasound of the heart (echocardiogram) by a board- certified veterinary cardiologist.  It can cost between $600 and $800 to have a complete exam and echo by them. The best source of recommendations for your kitty is at your regular veterinarian. He or she can examine your cat and  let you know what or if any additional work up is required.

            Cats that become ill from HCM often throw blood clots. They can create stroke- like signs, depending on where the clot lands. The clot can become lodged anywhere. In the brain or lungs, it often causes a sudden death. It can land in the aorta—a major blood vessel that comes from the heart-- as it divides to go to the hindlimbs, causing what is called a saddle thrombus. These cats often present not able to use their hindlimbs.   The legs are cold and painful. Often these cats end up being euthanized.    There has been some success using the “clot-busting” medications that are used in people who had a recent stroke, but they must be given soon after the clot forms before permanent damage is done. These drugs are very expensive and most veterinarians do not stock them.

            The best solution is early diagnosis and treatment. There is medication that can be given to help these cats. Though not a cure, medications can be given to control the heart rate and to prevent clot formation. Never give your cat any medication without consulting your veterinarian. Cats are very sensitive even to drugs like aspirin that people often take as a “blood thinner.”

            Conditions like hyperthyroidism –discussed in a previous column—can also cause heart disease. These cats need to have their underlying thyroid condition treated in addition to addressing the heart problem.

            Administration of long acting cortisone injections, as was in the past often used for feline allergies, can potentially complicate heart disease and are now not commonly recommended unless there are no other feasible options.

            Cats also can contract heartworm disease and there are quality heartworm preventives that cats should receive. Talk to your veterinarian. In dogs heartworm disease can cause major heart disease. In cats it is more of a respiratory condition. These cats often look like they have asthma. That is why it has been renamed as Heartworm Associated Feline Respiratory Disease.

            Make sure your feline friend gets a complete veterinary exam at least once or twice a year or as recommended by your veterinarian.

 

Dr. Marisa Pepin-Slade and Dr. Robert Slade are long time Hampstead residents and operate a mobile veterinary House Call practice. They welcome your comments at DrsPepin.Slade@gmail.com.

 

            

Pumpkin Article

 

 

We thought it would be a good idea to have an inspirational article in the middle of our winter season.  Many times, we sadly have to give poor prognoses on our animal patients. However, every once in a while, those well-intentioned and well-researched poor prognoses turn out differently than expected. We will now tell you a true story about one of our own pets who –- thus far --- has beaten the odds of her illness.  We adopted our 7-year-old orange tabby cat Pumpkin when she was 3 months old. Originally, she rescued from a garage attic by a colleague in Pennsylvania when just a few weeks old.

 

In early May of 2017, she became ever so slightly subdued in her behaviors. While doing an exam on her, we felt a lump in the middle of her belly.  Starting with abdominal X-rays and bloodwork, we saw an irregular mass about 1.5 inches in diameter in the middle of the belly. We sent these digital X-rays for evaluation by a board-certified veterinary radiologist.  She reported that Pumpkin’s left kidney was irregular and had a mass-like appearance. Next step was taking her to a board-certified veterinary internist to have an ultrasound-guided needle biopsy of Pumpkin’s left kidney.

Unfortunately, even with several attempts, the specialist could not get cells from the irregular kidney for evaluation. Some tumors won’t shed cells for diagnostic evaluation. The next step would be surgical removal and biopsy of the left kidney. We set up a surgical consult with a board-certified veterinary surgeon. We discussed the pros and cons of the procedure.  We also thought about the significant expenses involved.  We would get the answer about the kidney tumor, but we may cause other kidney to fail if it could not make up for the loss of the left kidney.  If 75% of the total kidney function still remained, we would be okay. We decided that the only way to know if we could do anything to help Pumpkin was to have her left kidney removed and sent for biopsy. 

 

When we picked Pumpkin up from the specialty hospital after surgery and several days of intensive fluid therapy and care, she was a very unhappy camper. Had we made the right decision?  Or should we have just let her live out her life until her quality of life became poor?  We got the biopsy report about a week later from a prominent board-certified veterinary pathologist.  The report confirmed that the kidney contained a rare, highly malignant undifferentiated sarcoma with potential for spread to other parts of the body.  We knew that chemotherapy could be done, but her estimated lifespan even with chemo would be about 3 months. The type of chemo needed would most likely cause some unwanted side effects and also add significant expense to her treatment.  We decided not to have chemotherapy for her, and explored alternative options. The alternative options offered no guarantees of effectiveness for such a rare tumor and also would lead to significant expense.  Her kidney function was compromised and she developed kidney disease. We started offering her a smorgasbord of prescription kidney diets, started an appetite stimulant and fluids under the skin several times weekly, and started a good quality feline omega 3 fatty acid supplement.  After 3.5 months of this therapy, we notice her gaining her weight back and were able to stop the appetite stimulant and decrease the fluid frequency.  She is 9 months past her diagnosis and appears to be thriving on prescription kidney diet and occasional fluids given under the skin. She is back to being an avid mouse hunter whenever a mouse manages to enter our house. She also has become a constant bedtime companion and purrs loudly with contentment. We realize that her prognosis could change again, but for now we are enjoying the extra 6 months that we have been given!

 

Dr Marisa Pepin-Slade and Dr Robert Slade are longtime Hampstead residents and operate a mobile veterinary House call practice. They welcome your comments at DrsPepin.Slade@gmail.com.

Common Pet Toxins Article

It could take many articles to discuss all of the common household and yard toxins to pets, but we will try to highlight some of the most common ones. Referring to www.aspca.org/apccor 1-888-426-4911 will give a more complete overview of toxins for pets.  The number is helpful for toxic emergencies in pets that occur any time of day or night. It is a nonprofit organization, but you will be charged a fee with your credit card to cover the expenses of a 24hr organization. Pet Poison Helpline is also a 24/7 Animal Poison Control Center (1-855-764-7661) with website @petpoisonhelpline.com.

 

The top 10 toxin calls for cats received by Pet Poison Helpline include lilies, canine flea topicals containing pyrethroids / pyrethrins, household cleaners, antidepressant meds, rodent poison, ibuprofen/acetaminophen, glow sticks/jewelry, amphetamines (ADD/ADHD drugs), decongestant meds, and essential oils. The top 10 toxin calls for dogs include chocolate, rodent poison, ibuprofen/acetaminophen, xylitol (found in sugar-free gums and candies), Vitamin D (in large amounts), antidepressant meds, fertilizers, grapes and raisins, decongestant meds, caffeine in pills and drinks.

 

Especially important for cats this time of year is the toxic nature of the Easter Lily. Never

allow a cat to access an Easter Lily.  Other very toxic lilies include tiger, day, Asiatic hybrid, etc. Very tiny ingestions of petals, leaves, pollen and vase water can result in sudden kidney failure.

 

With the onset of spring, more flea and tick products will be used on cats and dogs.  Many dog flea products can be deadly to cats.  For example, K9 Advantix (Bayer) is fine for dogs but very toxic to cats. Make sure cats only have contact with cat flea and tick products.  Discuss the safest, most effective products with your veterinarian. 

 

Household cleaners should be dry before pets can contact them with their tongues, paws, or bodies. Always be aware of the ingredients in household cleaners and whether they are toxic.

 

 Rodent poisons of all types are toxic to cats and dogs. Even small ingestions can result in death. We prefer ultrasonic devices for rodent control. Cats themselves can be good mousers too!

 

All medications and vitamins need to be kept out of reach of all pets. Many of our over-the-counter and prescription human medications are toxic or deadly to cats and dogs.

 

Be careful with essential oils for cats and dogs, even in diffusers.  Respiratory irritation can occur from inhalation of essential oils thru diffusers.  Consult petpoisonhelpline.com for a detailed list.  Rapid absorption occurs orally and thru the skin also.  Symptoms can include salivation, tremors, ataxia, respiratory distress, low heart rate, low body temp., and liver failure. Tea tree oil in .1 to 1% concentration in pet shampoos labeled for dogs and cats is not a concern, but higher concentrations can be dangerous!

 

 

 

Chocolate can cause vomiting, diarrhea, seizures, and death in dogs. The darker the chocolate —the more severe the response. Cats don’t seem to like chocolate, but keep chocolate out of reach of all pets because the toxic dose of chocolate for cats is even lower than for dogs. Coffee and tea have similar effects on dogs and cats and need to also be kept out of reach. 

 

Xylitol is highly toxic to dogs and even small amounts can cause a life-threatening drop in blood sugar. Keep away from cats also since there have been some reports of cat sensitivity also. Xylitol is contained in gums, candies, beverages, low sugar peanut butter, oral rinses and toothpaste, some human meds, protein bars, weight-loss products, lotions, facial products, deodorants, nasal sprays, etc.

 

Keep dogs and cats away from fertilizers and chemically treated mulch and cocoa mulch.

These are all toxic to dogs and cats and best not to use if you cannot keep your dogs and cats away from them.

 

Grapes and raisins can lead to kidney failure in dogs even with small amounts of ingestion. Cats don’t usually like grapes and raisins so it is unknown if they are toxic to cats. 

 

Dr. Marisa Pepin Slade and Dr. Robert Slade are longtime Hampstead residents and operate a mobile veterinary house call practice. They welcome your comments at DrsPepin.Slade@gmail.com.

 

 

Tick Borne Disease Article

Philosopher Friedrich Nietzsche said, “What doesn’t kill you makes you stronger.” This is usually true, but not with many tick-borne diseases that our dogs and cats encounter through tick bites.  These diseases also affect people in large numbers.  Just on the news this past week, the CDC is warning people to beware of ticks, mosquitoes, and fleas! Vector-borne illnesses from ticks, mosquitoes, and fleas have more than tripled between 2004 and 2016 and nine new vector-borne disease organisms have been discovered since 2004. Dr. Lyle Petersen, director of CDC’S Division of Vector-Borne Diseases, wants everyone to know that severe diseases can result from tick bites, mosquito bites, and flea bites.  Because of the vast number of vector-borne diseases, we will concentrate on tick-borne diseases affecting our dogs, cats, and ourselves.

 

The main ticks in our Maryland/Pennsylvania environment include the deer tick, brown dog tick, American dog tick, and lone star tick.  Each of these ticks can transmit more than one debilitating (or even deadly) disease to our dogs, cats, and even ourselves.  Lyme is the most common disease here transmitted to dogs and people. Other diseases include Ehrlichiosis, Anaplasmosis, Babesiosis, Bartonella, and Rocky Mountain Spotted Fever in both dogs and people. Cats are mostly resistant to Lyme, but can develop Ehrlichiosis, Anaplasmosis, and rarely the deadly Cytauxzoonosis.  Symptoms of tick-borne diseases are vague and include lethargy, fever, lameness, lack of appetite.  Early recognition and treatment can often lessen the impact of the disease tremendously. However, prevention with year-around quality flea and tick control will give your pet a very good chance of avoiding these diseases completely. We have several safe and effective flea and tick control products for dogs and cats. There are some products in the over-the-counter market that are not as effective and not as safe.  Ask your veterinarian for recommendations.  NEVER USE A DOG PRODUCT ON A CAT OR A CAT PRODUCT ON A DOG!  It could result in deadly consequences, especially for the cats. A very effective Lyme vaccine is available for dogs.

 

For people, Sawyer 20% Picaridin lotion seems to be one of the safer, more effective products.  You can research this on CDC websites if you wish and ask your doctor. It lasts for 14 hrs. after one application per the label. Dogs and cats are like “canaries in the coal mine”.  If your pets are getting exposed to tick-borne disease, you probably are also in the same situation.

 

Tick-borne diseases can also be difficult to diagnose with the current tests available.  Many tick-borne diseases are treatable with antibiotics if diagnosed early, but some are not. PREVENTION is the best way to avoid tick-borne diseases and being vigilant for ticks crawling or attached. The lone star larval stage ticks can crawl right in between the threads of your socks and bite you.

 

The best way to remove a tick is with the original Ticked Off instrument or a hemostat or

tweezers. The goal is to pull the tick at the mouthparts end, slowly from the skin.  DO NOT USE

a lit match, fingernail polish, or petroleum jelly. This will cause a tick to spew its saliva, possibly containing disease organisms, into the host’s body and make it more likely for disease to occur.

Then it is best to put the tick in dry form in a Ziploc bag and label the date it was found, on whom it was found, and where on the body it was found. If the patient develops disease later on, the tick can be sent to lab to see if it contains any disease organisms.  

 

The amount of time a tick must be attached to transmit disease varies with the type of disease. The deer tick typically has to be attached at least 24 hrs. to transmit Lyme but only for 15 minutes to transmit Powassan Virus in people.  Powassan has no treatment except supportive care and is sometimes deadly.

 

In conclusion, PREVENTION is the best way to avoid all tick-borne diseases. BE PREPARED WITH PREVENTIVES AND STAY VIGILANT!!!! Remember ticks are out year round and tick-borne disease is a year round threat!

 

Dr. Marisa Pepin Slade and Dr. Robert Slade are longtime Hampstead residents and operate a mobile veterinary House call practice. They welcome your comments at DrsPepin.Slade@gmail.com.