Milestone for the Nielsen’s

This month I am diverting from Veterinary advice and sharing a personal moment that our family experienced in July. Our daughter, Jaclyn, was married to Rich in Omaha. They met the summer after high school graduation. Their relationship survived the distance as Jaclyn attended UNI and Rich ISU. Rich is a medical sales rep and Jaclyn teaches in Omaha Public schools. This wedding was a first for our family of six. It was wonderful to have us all gathered for this event. A number of people had shared that a wedding is even more intense than a high school graduation. It is a whirlwind of emotions and activities. Those people knew what they were talking about.

Jaclyn spoiled us by handling the wedding plans with great efficiency and effectiveness. It was a magical few days celebrating with the family and friends that all gathered to wish this couple well as they began their life as husband and wife. A saying that I love is “The roots of a family tree begin with the love of two hearts.” I have been digging into my family tree in recent years and have discovered a new appreciation for my heritage. The challenges that my ancestors endured to come to America and the great losses they encountered are all a part of my legacy. I now see the continuation of that legacy with Rich and Jaclyn. Instead of a unity candle for their ceremony, Jaclyn asked me for a portion of the fern that was on the altar at our wedding 35 years ago. I repotted a portion of that plant and she then collected soil from Dan’s family Century farm, my family Heritage farm, Rich’s family farm, and our current farm in Madison County. During the ceremony, they added the soil to the fern and watered it, and now will watch it grow over the years. This representation of how we are all connected was very meaningful to me.

In 2017 my parents celebrated their 60th wedding anniversary. We honored them with a celebration at my country church that just celebrated its 150th anniversary this summer. We have had a family member sitting in the pews of that church for over 100 of those years. My grandmother was confirmed there and my mother and myself were baptized, confirmed, and married there. During this 60th wedding anniversary we had a program. My 3 daughters and my niece modeled wedding dresses from 4 generations. My great grandma was married in 1906, my grandmother in 1932, my mother in 1957, and myself in 1984. What is really exciting to me, is we now have a fifth generation wedding dress with my daughter’s dress. Love this quote, “The roots of our family tree run strong and deep, like our love they never end.”

If you have never dug into your family’s legacy, I would encourage you to find out whatever you can and write it down. The stories of the past connect us to one another in a way that enriches our lives. “Family is like branches on a tree, we all grow in different directions, but our roots keep us together.”

Was That a Seizure?

Pets can have seizures. They come in all varieties and it Is impossible to know how frequent or how long their duration may be. Years ago it was thought that all seizures were hereditary, poison related, or idiopathic. With the advancement of technology, machines that can measure brain activity and scan brain tissues have raised awareness to a large number of other causes. The challenges of diagnosing a cause are many. Difficult to determine when a seizure may occur so that brain activity can be monitored. The expense of brain scans are cost prohibitive for many clients. Most practices do not have the equipement to diagnose a cause. The results often indicate that surgery is not possible based on the location of the problem. The cost of surgery is not within a clients budget. These are only a few of the reasons seizures are a challenge.

Seizures are more likely to be seen in a dog than a cat. Seizures can begin at any age.  If seen early in life we assume it is congenital, poison, infection, or trauma related.  If beginning later in life, we consider recent trauma, poisons, or brain disease. If seizures develop after 6 months of age but before 5-6 years of age they may be classified as epilepsy. Epilepsy is a form of seizure activity where no underlying cause can be found.

When poisons are a factor we rely on owners to tell us what they were exposed to. Often a diagnosis will not be made in this category without an owners knowledge of the toxin. Simply put our patients cannot tell us what they ate or were exposed to. There are tests that can be done in a laboratory setting but we must tell them what to look for. If we did not see them consume the toxin it will be difficult to ask them to look for it. Occasionally the symptoms will give us a high suspicion of a toxic exposure and we will discover the offending product. If we do not have a clear idea of what the poison is we will treat the clinical symptoms and hope the body can clear the poison. Medications to control the seizures along with fluid therapy and activated charcoal are standard treatments for many suspected poisons that cause seizures. The need to start treatment immediately to reduce clinical symptoms is crucial. Yet if we did not see the pet consume the poison we do not know about its negative effects until the clinical symptoms begin to occur. Recently I discovered a common product used in humans called 5-fluorouracil is extremely toxic to dogs and cats if accidentally consumed. Within 30 minutes of chewing on the tube the dogs start to have seizures and die. If you know of anyone on this product please share this article with them to raise awareness of the risk this has to pets. Even licking this cream can cause toxicity in pets:

5-fluorouracil: Lifesaving for one species, deadly for othersveterinarymedicine.dvm360.com/5-fluorouracil-lifesaving-one-species-deadly-others

Congenital seizures can stem from Portosystemic shunts(PSS) in pets. These liver shunts direct the blood away from the liver. Surgeries are available to correct the shunt and stop the seizures caused by it. These seizures can be caused by hydrocephalus or more commonly called “water on the brain” in young pets. This condition has varying degrees of clinical symptoms but seizures can be seen in severe cases. Certain breeds are more prone to these conditions.

Traumatic injuries at anytime in a pets life can lead to seizure activity. Pets fall down stairs, then get hit in the head by large objects, they are hit by cars, they run into objects with their heads, etc. Any of these situations can potentially lead to seizures. Some will have their first seizure at the time of the injury. Others do not start them until later in life. I was hit in the forehead with a baseball and most likely had a concussion. That could lead to issues for me in the future. There is no way to know what may develop in the future when the brain has been injured.

Medical conditions of the of the brain and even some within the body can have seizures as possible side effects.  The list is endless but I feel as a whole the human and veterinary medical teams are learning more every day about the brain and how to treat some of these medical conditions.

After all of this information you may be asking yourself, “What can we do if a pet has a seizure?” First and most important, stay calm and move the pet carefully to a safe area. Do not stick your hand in the pets mouth or attempt to hold their tongue. They will not choke or swallow their tongue. The actual seizure is often short. The seizure can be mild and just be a pet staring off into the air and not responding to your voice. Maybe an ear will be twitching or an eyelid. They are still and unresponsive. The seizure could be a full blown grand mal like seizure where the animal is on its side rigid and paddling, having irregular breathing, drooling, unresponsive, it may pee or poop or both during the episode. After the seizure is over the pet has a stage called the postictal period where they are confused, uncoordinated in their movements, hungry, thirsty, exhausted, etc. This may last longer than the actual seizure but your pet will recover 100% if given time.

Please notify your veterinarian if you suspect your pet had a seizure. Treatment is not always begun at the first sign of a seizure. If the seizure was mild and they are infrequent then you may be encouraged to wait to start medications. It is important to let your veterinarian know if there are any concerns about poisons or infections that may have caused the seizure. If you have had a history of trauma with your pet you should share that information with your veterinarian. The recommendation on when to begin medication is varied between practices. It is best to speak with your veterinarian so you can discuss options available. Blood work is required to begin seizure medication and also annual exams.

Pets can live normal lives with seizures being controlled by medications for a number of years. Some activities seem to lead to seizures for some pets. Good record keeping can be helpful in determining the proper way to treat your pet. There are new diets and medications available to help maintain a good quality of life. If you have concerns about whether your pet is needing medication for seizures contact your veterinarian for more information.

Hype About CBD Oil Use in Pets

In recent months more questions are being asked about using Cannabidiol (CBD) oil in pets for different aliments. I want to start by defining these substances to avoid confusion for pet owners. The two plants that are being grown are called cannabis(marijuana) and hemp. Tetrahydrocannabinol (THC) is the hallucinogenic property that differentiates between these two plants. If the plant has more than 0.3% THC in it, that plant is considered cannabis(marijuana) and is illegal in Iowa. If that plant has less than 0.3% THC it is considered hemp. Hemp oil comes from the seeds of the hemp plant. The hemp oil has been called a superfood and has a nutty flavor. It has been used in cooking, soaps, and lotions. CBD oil comes from the flowers, leaves, and stem of the hemp plant. CBD oil is used for its medicinal properties. The current Iowa law allows for medical use of CBD oil for certain aliments in humans but not in animals.

These oils are considered supplements not prescriptions. CBD oils made from hemp and containing less than .3% THC will not have any mind altering effects. The source you get your supplement from must be researched since some products contain “whole hemp extract” not CBD oil. Those products may not contain any CBD oil at all and be completely legal to sell to consumers. We all have heard how unregulated the human supplement market is and these hemp products are no different. BUYER BE AWARE.

In 2018, President Trump signed the Farm Bill into law that legalized cultivating and producing industrial hemp containing less than 0.3% THC at institutions of higher learning and State Departments of Agriculture. Since it is legal at the federal level each state must now decide what its regulations will be and how and when to enforce those laws. With this bill in place more research can be done on the health and wellness benefits of these hemp plants. As veterinarians we look forward to the day when we are given clear details on our right and responsibility of prescribing and dispensing these products. Until that day we can discuss the potential benefits being seen within the pet industry, but in Iowa we are not allowed to sell or prescribe the CBD oils.

All mammals have an endocannabinoid system (ECS) with receptors built in to interact with cannabinoids naturally produced by the brain but also those derived from plants. When the CBD oils are supplemented to dogs and cats one can see benefits such as:

DOGS

  • Pain Killer
  • Anti-cancer Effects
  • Antiemetic

CATS

  • Appetite Stimulation
  • GI Tract Issues
  • Asthma

BOTH

  • Anti-inflammatory
  • Anticonvulsant
  • Anxiety/stress reliever

Looking at this list one would get the impression that this plant may fix all our pets health issues. This is far from the truth but it certainly indicates that once regulations are removed we may be seeing a steady increase in the use of CBD oil supplements by pet owners. Some veterinarians within the USA are already using these products in a large number of health conditions and I know CBD oils will eventually be encouraged in daily practice. Since there are still legal hurdles in all states around the use of these products you must stay tuned as we continue to learn more about these products in the human and animal markets.

I spoke with a representative at the Iowa Veterinary Medical Association (IVMA) about prescribing CBD oils. He indicated that the use of CBD oils in all 50 states is illegal in animals at this time. Whether a seller or prescriber of CBD oils is prosecuted is currently a gray zone. At Winterset Veterinary Center we have chosen to wait until more direction is given on the use of the CBD oils in private practice. For each of the above named benefits there are numerous other traditional treatments available to cure or relieve pain and suffering in our patients. We will continue to monitor developments on this hot topic and will keep you informed. Our main concern is the health of our patients and safety of all products that are recommended or prescribed. If you would like more information about this topic feel free to contact me for the information that I received from the IVMA. We welcome your thoughts and comments about this blog or any others that you may have an interest in.

Technology and Veterinary Medicine

In 1988 when I graduated from ISU College of Veterinary Medicine, I never knew how much change would occur in the area of technology. Computers were not a household item. We had just started to see VCR’s in most homes. Cell phones were nonexistent and not even a figment of our imagination. Most classes were taught with a projector and class notes printed out and placed in a binder to study. We still purchased text books and carried them with us to classes. Post offices and home rotary phones were the primary way to communicate with family and friends. It seems like this was only yesterday but also amazing what advances we have seen in the last 30 years.

When considering technology, I feel we are far better off with many of the modern advances but also feel we have lost some of the common courtesies of the past. I would hate to write out all of my notes on a typewriter or place them on hand written cards. Invoices that calculate sales tax are quick and easy with our software. Ordering products online to restock our shelves allows us to see immediately if a product is unavailable. Having clients receive text messages or emails has been a great addition to our reminder system for our patients and their preventative health needs. To even consider returning to the ways of the past gets my head spinning knowing how difficult tasks would be without computers.

In the past few years, our continuing education sessions have started including discussions on how to get the most out of social media sites for a veterinary practice. These sessions are insightful and offer lots of ideas on how to attract more clients to Winterset Veterinary Center. This monthly blog was one of the ideas that was shared about 3 years ago. Having a presence on the web was important and necessary to continue to attract new business and retain the current business. Phone books were no longer a good place to advertise since everyone seems to be looking up phone numbers on the web or they have the number stored in their phone. Whoever would have thought that phone books would no longer be needed.

Here is where I start to have a little concern when it comes to technology and information. The number of times I see or talk with people that have already sought out information from “DR GOOGLE” raises my eyebrows. It leaves me wondering at what point a practice like Winterset Veterinary Center will no longer be standing because we have already seen Doctors of human medicine and veterinary medicine diagnosing cases through computer portals. This seems like a great way to reduce cost and allow anyone and everyone access to affordable care. Yet removing the opportunity to place hands on a patient to assess the physical findings removes a large part of our diagnostics. The physical exam is the most important part of our evaluation. It gives us the direction needed to start our diagnostics and come to a diagnosis. Without that exam we are just guessing at what might be the cause.

We are seeing more and more clients choosing to order products online. The difficulty with this is that dogs and cats change weight classes and environments so what products are needed to prevent diseases constantly changes. Just because a product was used last year does not make it the best product to use this year. Lifestyles of the pets are constantly evolving and so without the help of your veterinarian you may be missing some key elements in prevention and thereby cause exposure to diseases and parasites that you were not even aware existed. The number of products that are available to chose from can be confusing and misunderstood for many clients. These are all important things to consider prior to ordering online. We as veterinarians are wanting to keep your pets safe and protected from internal and external parasites with the best products available to date. These products are changing constantly so do yourself a favor and ask your veterinarian what would be best for your fur baby. Buy local and keep your pets protected with the newest and most effective products.

Social media sites have shown to be helpful when finding business that offer services you are in need of. We have a website and a Facebook page currently. It is always nice to see when someone likes our page, a picture, or a blog that has been posted. We can track the activity and see the demographics of who is visiting our sites. The challenge with these sites is when an unhappy client wants to trash a business by telling only their side of the story. In the past if someone had a concern, they took their issues right to the source and together found a way to resolve the conflict. Now it seems people want to air their differences on these sites and it becomes a place where everyone shares their grievances as well. The negatives of social media on the lives of individuals and businesses can be detrimental. Numerous times lives are destroyed or worse ended because of words on social media.

Maybe we need to think carefully about what we write on these sites. If we would not be willing to say these words directly to the business or person, then maybe we should not write them online. Maybe we should consider speaking directly about the problem to the business or person and as in the “good old” days come to a conclusion together on how to resolve the issue. We need to remember to be kind when dealing with people. Everyone has a story and things happening in their lives unknown to us. We need to treat others as we want to be treated. If we all could use more gentleness and kindness in our daily lives what a better world this would be.

We love to see the positive reviews that are left on our Facebook page. We hope that our posts offer some important information. We appreciate all the times people share the found dogs or dogs up for adoption so we can help find their Forever Families. We are grateful we can now text or email clients with reminders and results. All in all, technology has been a positive addition to Veterinary Medicine. Let’s try to remember that relationships are important and we want to continue to serve our clients and their furry friends for years to come. We cannot do that without seeing you come through our doors. The relationships we make with our clients and their pets is what makes our days at Winterset Veterinary Center worthwhile.

Dog Bite Prevention

National Dog Bite Prevention Week is April 7-13, 2019. Over 4.5 million people are bitten each year and over 800,000 of those bitten require medical care. Over 50% of the victims are children and a higher percentage of the kids being bitten are under the age of 4. Over 50% of the biting dogs belong to family or friends, and greater than 77% of the bites occur on the dog owner’s property. These statistics show why it is important to always be aware of your dogs interactions with adults and children in and around your home.

Some general rules to teach your children to help avoid dog bites are:

  1. Never go near an unfamiliar dog. If an owner is present ask permission to pet before reaching out to touch them. If they say no, respect that and walk away.
  2. Never place hands inside fences or kennels to pet dogs.
  3. Never run from dogs as this encourages the dogs to chase.
  4. Never play with a dog’s food or toys
  5. Never approach a dog if growling or showing its teeth. A child not trained to be aware of this may think the dog is smiling. We show our teeth when happy.
  6. Never scream around dogs since this can be an instinct to attack.
  7. Never startle dogs from their sleep. They can come out confused and bite out of instinct.  Wake them first with touch or calling their name.
  8. Never leave small children unattended with dogs. Many homes trust their dogs and do not worry about their dog with their child, but what if the unthinkable happens.
  9. Never touch dogs that are sick or injured. They may bite because of pain.
  10. Never approach a dog that seems fearful and is hiding or avoiding you.

Over 30 different breeds have caused human fatalities in the last 30 years. There are certain breeds that appear to be listed more frequently than others, but the take away is that any dog can be vicious. Large dogs are more likely to cause serious damage but small dogs seem to have a higher possibility of biting out of fear and anxiety. Here at Winterset Veterinary Center we see dogs of all sizes, ages, colors, and breeds. We always are cautious, even when an owner indicates their pet would never bite. Often times when a pet does attempt to bite during an exam the owners are completely shocked by this behavior. We often times are not surprised since we can pick up on body language that dogs offer up indicating they are not comfortable with a situation. A few simple things to take notice of are dogs licking their lips, yawning, looking away from the person they are avoiding, tail tucking, and ears pinned back are all signs that this dog is not comfortable in this situation. Not every dog will bite after showing these signs but the potential is there and either the dog should be left alone or it should be approached with caution.

If you are fearful of a dog that is approaching you, DO NOT RUN! Even if you are the fastest person on the track team the dog will pursue you. Chasing moving targets is an instinct that dogs act on. Screaming is also important to avoid since dogs often hear high pitched sounds and consider it a sign of weakness. A reason to be silenced and attacked. Why else are they relentless with that squeaky toy to the point of silencing it? Children have been taught since early ages that if they are on fire — they should stop, drop, and roll. Please teach your children—ICE, TREE, ROCK for dog bite prevention. It may save their life someday. Ice indicates to freeze in the presence of a strange dog. Tree encourages them to stand tall and not look directly at the dog’s eyes since that can be seen as a challenge. Rock is used when knocked to the ground by a dog and you curl up into a ball and protect the face and belly with your arms and legs. As difficult as it would be, you should try to tell your children not to scream as this encourages the dog to continue to attack.

Dogs bite for a large number of reasons. I could not possibly list all the situations that could potentially lead to aggression or biting. A couple of important things to remember is early socialization, in the first 14 weeks of the puppy’s life, it is critical to making your puppy comfortable with new situations and all ages of people. Dogs that miss this window of opportunity can learn new social skills but the challenges are much greater. Avoid rough play with your puppy where you are encouraging barking, growling, or nipping at people. If allowed to play rough with one person, they will consider this okay with all people from babies up to the elderly. Start training your puppy to sit, stay, come, down, etc., immediately. These basic commands teach the puppy they need to listen and respect you.

A responsible pet owner will have their pet spayed or neutered to avoid unwanted puppies. It has been shown that neutered pets are 3 times less likely to bite. Being responsible also means keeping this pet for its entire lifetime which can be 15-20 years. Unfortunately, I have seen far too many owners give up their pets when they find them to be no longer desirable. Taking your pet to see the veterinarian for preventive care and seek out a training program that can help your dog live out its natural instincts. Exercise your pet daily so they can feel exhausted at the end of the day.

The late Dr. Sophia Yin has a poster about kids and pets. Follow this link How Kids and Pets Should Not Interact and get your free copy of this poster and share with your kids or students. Maybe if we spread this information, we will see the number of dog bites annually decline. Dogs are the most popular pet in households within the United States. Let’s work to make them the safest pet to have in our homes by being responsible pet owners and educating our friends and families about dog bite prevention.

Prevent Chronic Kidney Disease

Each February and September the IVMA (Iowa Veterinary Medical Association) invites veterinarians to attend their conferences. These conferences are held either at Iowa State University at the Scheman building or at Prairie Meadows Conference Center in Altoona. On Valentine’s Day, I attended the 2nd day of speakers and visited the booths of many of the companies that sell animal products from surgical to medical to dietary items. It is also a time we can share ideas and renew friendships with other veterinarians that attend the conference. New techniques and ideas are shared by speakers that come from all over the USA. Dialogue is encouraged during the sessions to enhance the learning opportunity for everyone.

I did not expect to attend a session that resonated with me so soundly. However, the sessions I attended were on the topic of Chronic Kidney disease (CKD) and how it is affected by other diseases. I have my own personal experience with CKD that I will detail to come. We learned about how important it is to screen for these different diseases early in our pets to allow a longer and better life. The take away is that kidney disease is something that cannot be detected on physical exam. Laboratory work is necessary to screen for this devastating disease. Dr Greg Grauer indicated that these tests are best performed annually so comparisons can be made from one year to the next. If elevations are noted this may be a cause for concerns even if we are still in the normal range.

The second session I attended by Dr. Grauer began by sharing some statistics of human kidney disease. I question if he was prompting veterinarians to “Go to the Doctor.” We should be more aware than the general population that these diseases cannot be found on physical exam. We should be keeping our diet and exercise in check to prevent obesity which is one of the leading causes of diabetes and high blood pressure. Diabetes and high blood pressure are common causes of CKD.

This topic of human CKD is very familiar to me. My younger brother was diagnosed suddenly with CKD in the spring of 2017. He was totally unaware of any issues before his diagnosis. The process he went through at Mayo in Rochester determined he was transplant eligible. They never gave him a definitive cause for his CKD. They recognized he did have high blood pressure. He had taken numerous allowable doses of Advil when in pain. He had a kidney stone a few years prior that may have caused a stricture in his ureter. He was born prematurely in 1965 and maybe had some damage early on. Whatever the cause he now was faced with changing his lifestyle while waiting for a possible donor. He was given strict dietary measures to reduce damage to the remaining kidney function. He was told to lose weight. He was placed on medications to lower his blood pressure. He made frequent trips to Mayo to monitor his blood levels while waiting to see if a donor could be found. They prefer to keep transplant recipients off dialysis, if possible, before transplant. This is a fragile time line.

Myself and my 2 sisters were willing to be tested to see if we could possibly be donors. The first step is an online questionnaire. Both of my sisters were not allowed to continue the questions related to health concerns of their own. I completed the survey and submitted it and later found out that I had passed the first step. They sent me a laboratory test kit to have blood drawn at a local facility to see if our blood types were compatible. Siblings can have very different blood types. It turned out that my brother and I were considered a “perfect match.” This indicates that we have the same blood type which is crucial. Yet to be a perfect match the other 6 subcategories need to match up as well. We were 6 for 6. They will do transplants with 3 or 4 subcategories of the 6 matching up. When these subcategories match up it may allow for less rejection medications and better opportunity for the kidney to live a long and natural life within my brother. The doctors at Mayo indicated that 52 years ago they had another sibling donor-recipient transplant that was a perfect match and both are still doing great.

In January of 2018, I spent 3 days in Rochester going through evaluations of my physical and mental health. I had my own transplant team that supported me through the process. If at any time I determined that this was something that I did not want to do, all I had to say was I have decided I do not want to do this and it would be over. They told me that even the day of surgery I could back out. They reminded me numerous times that I did not need to do this. They asked me numerous times, “Why are you doing this?” They gave me all the statistics from the successes to the potential failures. They presented the “What if’s?” What if my kidney is rejected? What if my brother does not take care of the kidney that I have given him? What if my family does not want me to do this? What if something unforeseen happens to you or your brother? It was almost as if they were trying to talk me out of doing this procedure. I guess in a way they were preparing me for anything and everything. It was only a few weeks and I received a call that I had passed and was able to be a donor for my brother. I waited to tell him so I could contact all my children and share the news with them first. I then made a trip north to let him know that I would love to be his donor.

November 21, 2018 was the date set to do the transplant. They would first operate on me and then soon after place the kidney into my brother. Both of my kidneys were healthy and so the left kidney would be removed. I would have two incisions for instruments on the left side about 1 inch in length and one lower horizontal incision about 3-4 inches to remove the kidney. There were 15 family members present in the waiting room supporting both my brother and I. We had prayers from more people than I can name during that entire procedure and recovery period. My kidney was placed within my brother and started working very quickly. The family would get updated text messages from the OR as things were happening. I am happy to report that my brother and myself are doing extremely well. I received a “Donor Diploma” from Mayo that I am proud to own. I am hoping that by sharing this experience it may encourage others to consider being a living donor. I did this for my “baby brother” because I could not bear to see him restricted from living the life he was meant to live. Mayo hospitals perform these procedures multiple times in a year and have high success rates for both donors and recipients post-operatively.

CDK issues occur in our fur babies as well. Transplants and dialysis are currently not an option. Obesity in pets is at an all-time high. We feel that if we love our pets, we should shower them with treats, chews, pet food, people food, etc. This is not the way to show love. Love needs to be shown through time spent with your pets by playing games and offering lots of tender loving care. Our pets will most definitely eat whatever is offered to them but I would encourage you to instead get out their leash or ball or both and go outside. The exercise will not only be great for them but also yourself. During our long cold winters, it is hard to spend time outdoors with our pets. I would challenge you to sign up for a class at the local dog training facility. Take a trip to a pet store to walk around and meet other pets and people. It is amazing how exhausted our fur babies can become when their mind is stimulated with new activities. Some hardware and home builder businesses allow dogs on leash to shop with their owners. Take them to doggy daycare for a day and see how tired they are when they come home. If the sun is shining and the wind is not blowing take a walk outdoors and be sure to wash off their feet when you come back inside. Some ice melt products can cause an irritation to the pads of our dogs. Strive to keep your pets body condition score at a 4 or 5. This will help them live a much longer and happier life.

If you know of anyone in need of a kidney and you have wondered if you could be a donor, do not hesitate to find out. I was told the oldest living donor Mayo has had was in his early 70‘s. My brothers insurance covered all medical costs associated with the transplant. There are grants and tax deductions available for out of pocket expenses not covered by insurance for living donors and recipients. My only restriction after surgery was no lifting of 10# or more for 4-6 weeks. I returned to work the day after Christmas and have been doing great. I expect to live a long and healthy life with my one kidney. I pray that my brother will be able to do the same. Either way I have no regrets. If being a living donor is not for you then at least consider being an organ donor after your death. The number of lives that you can impact after your death by organ donation is amazing as well. It is easy to have “organ donor” added to your driver’s license. Anyone can be a donor now or later.

If you are wondering if your pet should be screened for CKD or other health risks speak with your veterinarian. Most cats over 10 years of age and dogs over 8 years of age are considered senior pets. Starting laboratory testing at this time will offer a baseline for your pet’s future. Early intervention in the face of these diseases can offer added years with your fur baby.

February is Dental Health Month

February is the month that we focus on education about dental disease and the need for pets to have professional cleanings to remove tarter and decay that has built up on their teeth over the years.  Many pet owners do not know that this is an important part of care!  Most pets have some form of dental decay as early as 3 years of age since most owners chose not to brush their pets’ teeth daily. Brushing a pets teeth is the best way to keep them healthy. There are chews and special treats and diets that are helpful when attempting to freshen your pets’ breath or reduce tarter. Yet, nothing seems to work as good as regular brushing.  It is important to prevent your pets from chewing on items that are harder than the surface of their teeth. These items, such as bones, antlers, rocks, and hooves, will often cause fractures or flattening of the tooth surface. It is best to avoid these and keep your pets’ teeth healthier through the years.

Many studies have shown that poor oral health can have significant effects on other organs within the body. The biggest concern is with the heart, liver, and kidneys as bacteria becomes systemic and deposits within these organs. When pets have bad teeth, they often will not chew their food and that leads to more tooth decay. In recent years veterinary dentist have surfaced to help fix fractured teeth to prevent pain associated with the exposed pulp cavity. They have improved the bite of young dogs that were born with congenital defects of the jaw. Veterinary Dentists have repaired cavities to preserve the tooth that has been damaged. Advanced veterinary care has continued to improve the quality of our pets’ lives. These procedures are not for every pet but it is important that pet owners know their options. If you are interested in learning more about Veterinary Dentistry, we can refer you to the specialists.

If you have noticed odor from your pets’ mouth, I would encourage you to flip up their lips on each side and look at the teeth and gums. If you see more brown than white on the surface of the tooth or notice extremely red gums above the tooth surface, your pet is in need of a professional cleaning.  I wish we could clean a pets’ teeth without anesthesia, but pets could not remain still during the cleaning/polishing procedure. The biannual exams and cleanings humans receive are difficult for some of us so image how a cat or dog would react. I know anesthesia is a concern but ignoring a pets’ oral health is a huge risk as well. Once a professional cleaning has been done it would be wonderful if you began home care to reduce the build-up in the future. Brushing your pet’s teeth is the most effective way to prevent tarter build up. Other options include special prescription diets that will reduce tarter when the pets chew the kibble. A new product called “Oravet” can protect a dog’s teeth and offer fresher breath if offered once a day. Finding a healthy chew or toy that your pet will chew on at least 15 minutes a day can promote healthier teeth and gums. Avoiding soft foods and treats that stick to the teeth is helpful. There are any number of items that can help reduce tarter build up but nothing is more effective than brushing your pet’s teeth.

Teaching a pet to allow brushing of their teeth is much easier to do when they are a young puppy or kitten. At an early age we see more success in getting acceptance of handling their mouth and introducing the toothpaste/toothbrush. Starting this routine early, many pets will find it a fun daily event and look forward to it. The following video was created by a client of ours that has been brushing her pet’s teeth for a number of years. The teeth look amazing and she has yet to do a dental procedure on any of her pets. It really does make a difference if you are willing to take the time to brush daily. It is possible to teach an old pet to allow you to brush their teeth. It requires more patience and persistence but the rewards are worth the time and effort.

Click to view video of brushing pet’s teeth:

With the cold winter days, it makes getting outdoors with your pets next to impossible. Why not start working with them to allow you to brush their teeth? Why not schedule a professional dental scaling to improve your pets’ oral health and reduce risk to other internal organs? Your pet will thank you and those kisses will be more enjoyable.

Bring in a Stool Sample?

If your veterinarian staff request a stool sample…please do not bring them one of these! I got a good laugh when one of my clients presented me with this “stool” sample a few years ago. I keep it around as a reminder to be more specific when talking with clients about their pets. It is a great conversation piece as well. Why are stool samples, or more appropriately called fecal samples, important?

I have mentioned parasites such as fleas, ticks, and heartworms, but have yet to share important information about the “other parasites” that can be just as deadly if not treated. To start the new year off right for your furry friends I hope to enlighten my readers with some common knowledge about the “other parasites.”

Kittens and puppies are commonly infected with intestinal worms at the time of birth. The mother can infect her babies while still in the uterus and the parasites can be spread through nursing. The most common intestinal parasite is the roundworms that can be found in all pets but especially in kittens and puppies. These parasites can appear like a piece of spaghetti and can be seen in vomit or stools. When seen in stools or vomit you know that this pet is loaded with roundworms. The belly is usually more rounded and bloated. The scary part is that these roundworms can be present and no symptoms noted except microscopic eggs being found in a stool specimen. We encourage every owner of a puppy or kitten to have a stool sample check. These parasites are a stress to the immune system and need to be treated. Humans can contact this parasite and it will lead to infection within the liver, eyes, and or Central Nervous System. There must be direct stool to mouth contact with the parasite eggs. The most common place for this to occur is with sand boxes and children.  Cats love to use sand boxes as litter boxes and many children have been known to put sand into their mouths. We encourage people to cover sandboxes if possible and watch children when playing in them.

Hookworms are another intestinal parasite that can infect our pets. This parasite can cause anemia in any pet but especially the young. We also have seen skin lesions in heavily parasitized pets. Diarrhea is commonly associated with this parasite and can be difficult to find in a runny stool. The hookworm can be transmitted to people. It will cause a rash that can be itchy. Humans can be exposed through contact with the skin when walking barefoot or sitting in areas where hookworm larvae are present.

Whipworms are another parasite that can infect dogs more than cats. When present they shed microscopic eggs in small numbers making it difficult to find them in a stool specimen. They cause dogs to lose weight, have diarrhea, and sometimes cause anal itching. Anal gland impaction and allergies can cause anal itching also. Therefore it is important to consider all causes for anal itching. This parasite is less common than the roundworms or hookworms, but just as important to prevent.

Tapeworms are common in both dogs and cats. This parasite is the most common worm that owners are aware of.  When asking people if they have dewormed their furry friend, I often hear, “I do not see any worms in the stool.”  This is the only worm that 100% of the time will eventually be seen in the stool or even attached to the hair around the tail. This worm can be up to 6 inches in length and will break off in tiny white segments and eventually work its way out of the rectum and onto the stool or the area around the rectum. When it dries up on the hair or stool it almost appears to be like a sesame seed. If a pet licks or swallows one of these segments the infection will begin again. Fleas can transmit tapeworms and therefore infect pets when they swallow a flea. Rabbits and mice are common carriers of tapeworms. Guess who likes to eat mice? Our hunting cats are commonly infected by these parasites and therefore we recommend routine deworming. This parasite is more difficult to find in our fecal floatation, but owners usually do not miss this parasite when present.

What options are available to treat these “other parasites”? In the last many years our heartworm preventions have added intestinal parasite preventatives to their formula. At Winterset Veterinary Center we encourage owners to use Interceptor Plus monthly as a heartworm prevention and an intestinal parasite preventative for roundworms, hookworms, whipworms, and tapeworms. As of today this is the only heartworm prevention that prevents all 4 of the most common intestinal parasites for dogs. Over the counter intestinal dewormers may treat certain parasites but often not all of them.

For our cats we recommend Profender which is a topical intestinal dewormer that can be placed on the skin and done 3-4 times a year. It will treat roundworms, hookworms, and tapeworms. With both of these products the parasites are removed within a few days after the product is given. If the pet is exposed again soon after the treatment, they can get the infection right back. There is no product on the market that will continue to prevent or treat our furry friends after administration.

If your pet has been diagnosed with intestinal parasites, every stool that pet has deposited in your yard or litter box has those parasite eggs in it.  The stool disappears as it is being decomposed.  When the stool is gone the microscopic egg will remain in the environment. This is an opportunity for your pet to pick the infection back up. If your pet stays strictly indoors and is not a hunter and does not have fleas, then it would be unlikely they would become exposed. The one common cause that many people do not think about is bringing home that new puppy or kitten. Every new pet brought into the home is a potential source of infection for your current pets. Do yourself a favor and keep new pets away from your furry family members until they have been checked by your veterinarian. Definitely bring in the “stool” sample to make certain your pet is intestinal parasite free!

As we close out 2018, I want to take this opportunity to thank you for following my blog. If you have found a topic interesting or have a topic that you would like to suggest, please visit with me about it.  Winterset Veterinary Center hopes everyone has a happy and healthy 2019. See you next year!

Senior Feline Concerns

Often, I hear owners of elderly cats express during an exam that their cat is doing great since it eats and drinks all the time. When I ask why they believe their cat is losing weight, they want to blame that on age, they do not like the new food, they vomit hair a lot, or are surprised that they lost weight at all. Once a cat reaches 8-10 years of age, we consider them to be seniors. Cats can live 15-20 years so some believe they are still young at 8. Yet we often discover early symptoms of health conditions at this time. Senior Wellness exams are extremely important to help address issues hoping to avoid life threatening symptoms later.

Three key questionsto ask yourself about your furry feline friend are:

  1. Does my cat drink an excessive amount of water?
  2. Does my cat have larger clumps of litter in the box?
  3. Does my cat have changes to its eating habits?

If you answered yes to any of these questions, I would encourage you to speak to your veterinarian.

Cats that drink excessively usually will have a litter box that has larger clumps in it or the box is wetter than usual. The challenge is determining who is doing what when you have multiple cats in your household. Sometimes the issue is a cat not using the box and it is assumed a bladder infection when it could be a problem with needing the box cleaned more often because a cat is peeing more.

Changes in eating habits can come in many forms. Some cats will eat large amounts every day and continue to lose weight. Some cats will eat one day and then seem uninterested in food the next day, so people go out and buy a new food to try and low and behold the cat eats it, so they feel they got it figured out. Then a few days later the cat stops eating that food as well, so they do buy another diet and the cat eats again. We call this cyclic eating. It has nothing to do with you buying a new food and everything to do with the health issue lurking within the cat’s body. Some cats eat but seem to vomit often. This one causes most owners to clean up the vomit and relate the vomit to hairballs. Hairballs can be a cause of vomit in cats but in elderly cats you must also consider other health conditions. With all these scenarios, most of the cats will have gradual weight loss. Sometimes the weight will come off quickly in the case of an obese cat. Whenever a cat has weight loss and you are not actively trying to have your cat lose weight, this should be a red flag that something may be wrong.

The three most common age related conditions with these symptoms are:

  1. Diabetes
  2. Kidney Disease
  3. Hyperthyroidism

It is extremely difficult to diagnose any of these without doing blood work and checking a urinalysis. A cat can look completely fine on the outside but have one of these conditions if you are noting any of the above symptoms.  All 3 of these can be treated by diet and/or medications. The sooner we discover what is happening the better the outcome will be. Please schedule a Feline Senior Wellness Exam so we can monitor these different values as they age and make recommendations as needed for a long and healthy senior life.

Grain Free Diets and Heart Disease

Recently articles have surfaced indicating that dogs on grain free diets may have an increased risk of heart disease. The following article was written by a Lisa M. Freeman, DVM, PhD, DACVN who is a pet nutritionalist at Tufts University. She has dedicated her life to pet nutrition and has a Petfoodology blog. The article is extremely well written and shares the concerns we as veterinarians have had for a number of years when it comes to pet foods. The marketing companies for pet foods have caused people to make nutritional decisions based on fads not science. If you have been feeding a grain free diet or a “boutique diet” or a raw and/or home cooked diet, I would highly recommend you read this article. We as veterinarians want to see your pets live a long and healthy life and nutrition is the foundation.

A broken heart: Risk of heart disease in boutique or grain-free diets …vetnutrition.tufts.edu/…/a-broken-heart-risk-of-heart-disease-in-boutique-or-grain-fre…

I am not going to add anything to her amazing article. It is extremely well written and explains in detail the important facts verses fads that are ever present in our pet food industry. She talks about what you should do to make certain your pet is not going to be affected by these nutritional fads and marketing schemes. She even has a pet food quiz you can take to determine how knowledgeable you are about your pets nutrition. I got 10 of the 12 questions correct. Take the quiz and let me know your score! For the health of your furry friends please take this information seriously. Have a Happy Halloween and remember to keep your candy away from your pets. CHOCOLATE IS POISONOUS to pets.

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