Pawcurious Vet Blog: Pet help, stories, and information with Dr. V

In news that is not exactly news because it’s not saying anything we didn’t already know, the EPA is investigating whether it needs to more closely scrutinize spot-on products for flea and tick control.

Unlike most veterinary drugs, which fall under the jurisdiction of the Food and Drug Administration, spot on flea and tick preventives are overseen by the Environmental Protection Agency due to their classification as pesticides (the exception being those products that also function as a heartworm preventive.) I’ll be honest with you, the inner workings of the EPA are as much a mystery to me as they are to you, and I have no idea how prepared they are to deal with adverse event reports, since they do not primarily function in that capacity. But last year alone they fielded 44,000 reports about suspected adverse reactions.

Adverse events both mild and major can and do occur with any product. There are many flea and tick spot on treatments available these days, and not all are created the same. The ingredients, and their likelihood to cause adverse reactions in pets, vary widely. Some are considered so safe you can douse a pregnant dog in a 4x overdose and not expect a problem for mom or babies. Others are so scary that a single application of the dog product to a cat can cause seizures and death.

Veterinarians, and owners whose pets have suffered the consequences of a poorly chosen product, have been clamoring for years for better oversight of these products. There is no one right product that I would recommend, since it depends on your pet, your risk factors, and what bugs you are trying to prevent. If you do have a question about flea and tick control, ask your vet- there are many wonderful products out there that are safe and effective. And sadly, some that are not.

At least once a week, someone comes to me with a flea infested dog or cat and proclaims they are treating their pet for fleas and it’s not working. Rule of thumb: If you bought it in the grocery store, toss it. This is one of the times where you get what you pay for- and it’s not worth saving a couple of bucks for a product that at best, doesn’t work that well, and at worst, results in a bad, bad outcome.

Not that you asked, but I, personally, not-meant-to-endorse-solely-or-discredit-anything-else-that-isn’t-this….I use Advantage.

I could go on and on about this and probably come up with a lot more than 5, but there’s plenty of time to do some sequels. So in no particular order, here are 5 of some of the most common myths people ask about on a daily basis. (I use the word dog in this, but they all apply to cats as well.)

1. My dog must be sick because his nose is warm.

There are several places to take an accurate temperature on the dog, but the nose is not one of them. Note the multiple corollaries to this one: My dog’s nose is cold/dry/wet therefore he must be sick. I would love to be able to predict a dog’s state of health based on how his nose feels- it would make my job a lot easier!- but sadly, a warm nose means only that his nose is, well, warm.

2. My dog isn’t hurting that badly, because he’s not yelping.

This is usually said in relation to a limping dog. If you’ve ever known a person who was injured, or maybe even just someone who was arthritic, I imagine they probably don’t moan and groan every single time they take a step. That just takes too much energy, unless you are of course looking for attention and/or sympathy. Considering dogs are in general even more stoic that most humans, it stands to reason that they have a good ability to remain quiet even when they are experiencing discomfort or pain. Oftentimes people have no idea how much their dog is hurting until they treat the problem, and are then amazed at how much more spry their dog has become.

This also applies to pets with dental disease, when owners assume they are OK and not in need of treatment because they are able to eat despite a mouth full of rotting teeth.

3. My dog doesn’t need heartworm preventive because he’s not around other dogs.

Heartworms are spread by a bite from an infected mosquito. A dog can be infected with heartworms even if they have never met another dog in their life. Although there are some areas of the country where heartworms are endemic, even in areas with a low heartworm prevalence, like my own, we have been seeing it more and more. It’s so easy to prevent and so difficult to treat, there really is no reason to skimp on this medication.

4. I don’t need to neuter or spay my dogs because they are brother and sister. They know better.

Dogs, sadly, are not blessed with the societal norms that we are. Should they heed their biological imperative and procreate with a relative, there is no jail time, no fear of being ostracized from the community, no neighbors making rude comments about Deliverance, etc. So when it happens, the only one who looks bad is you.

5. My dog doesn’t need a dental cleaning. I brush his teeth once a week.

You brush your teeth twice a day (hopefully) or more, and you still need to get your teeth cleaned. Although we have suspected it for years, a recent paper in the Journal of the American Veterinary Medical Association confirmed the link between dental disease and heart disease in dogs. It’s not just about the breath!

P.S. I don’t believe you about the tooth brushing.

Emmett the good sport is currently taking antibiotics and pain meds to combat the swelling and bacteria from Easter Smackdown 09. He usually takes his Rimadyl with no complaint- it’s a chewable beef flavored tab- but he’s less than enthused about his Clavamox.

Normally I just stick the pills in peanut butter and he’s happy to take them that way, but my husband is mightily protesting my use of his Jiff stash for such purposes. I’ve also been known to hide them in aesthetically pleasing swirls of pressurized Kong stuffing cheese flavored product, but I ran out of that last week. I suppose I could just manually put the pills in his mouth, but I hate doing that when I have a pet who is perfectly happy to take them in a food product.

I remembered at this point that we have a box of Greenies Pill Pocket samples, which I have been sending home with clients and getting good feedback on, so what better time to give them an official test run than now?

They are pretty great.

Emmett took them with no problem- of course, he’s a Golden and he has been known to eat trash and diapers, so I don’t know how discriminating his palate is. But what I really like is how easy they are to use.

It’s like a little squishy can with no lid. You put the pills inside the pocket, and seal the top off with your fingers. It’s much neater than peanut butter or making a meatball out of canned food. I admit it. I am lazy. I like to do these things with maximum efficiency, and anything that leaves me with no sticky fingers or utensils is aces in my book.

Per the website, you can also put liquid medications in the pill pockets. Clever little product! Emmett and I both give it two paws up.

I just finished reading “Still Alice,” a book about a fictitious Harvard neurology professor who is diagnosed with early onset Alzheimer’s disease. It’s a good read, albeit a depressing one, and it brings up a lot of issues about terminal disease.

In the earlier part of the book, she goes to her doctor and asks for a bottle of sleeping pills- with plans to take them all once her disease had progressed to a certain point. In real life this situation plays itself out over and over, the desperation of people with incurable disease trying to find a dignified end when there is no longer reprieve from their suffering.

We humans, and perhaps us Americans in particular, are so weird about accepting death. We fight it tooth and nail, which is admirable, sometimes, except when it’s unwanted. There is only so much one can do. There is living well, and there is dying well.

In this, I think veterinary medicine has the advantage over human medicine. We have some amazing medical care available, renal dialysis and chemotherapy and advanced neurosurgery. And when that isn’t an option, for one of many myriad reasons, we have some amazing ways to die.

When a pet comes in to me for euthanasia, we first place a catheter in the leg. That is the most discomfort a pet will experience, that one poke. That gives me an open access to a vein for whatever I choose to administer.

With rare exception, it goes as follows: I administer an anesthetic agent, the same one we use to induce general anesthesia. The pet falls asleep in their owner’s lap. Pets who have been suffering for a long time carry a great deal of tension and stress in their body, and the owners often take a deep breath when they see this tension melt as the pet relaxes, realizing how much of a burden it was for their pet.

I flush the catheter.

Then I administer an overdose of pentobarbital. Usually, by the time I am done giving the injection, the heart has stopped. The whole process takes a minute or two. While I am doing this, the owner is whispering to their pet, giving them rubs, letting them leave this earth in the arms of their loved one with their voice filling their ears.

It is a peaceful, gentle event.

People who haven’t been through it are often shocked- they expected something more dramatic and stressful. It’s almost anticlimactic after the invariable stress of the days leading up to it. I’ve found, both as a vet and a person who has had to do this to my own pets, that the days before are much worse than the euthanasia itself. Having such a kind and peaceful passage is, in my opinion, the last and kindest gift we give to our pets in return for all they have given us, and I don’t regret that part of my job for one moment. So much so that I often think about starting a home hospice practice.

Our pets often have a better end than we do. That makes me sad and proud, both at once.

Here he is, ladies and gentlemen. The new First Dog- Bo. A Portugese water dog. Bred for herding fish, working long hours out in the field, about to come into a tightly regulated fishbowl and become the unwitting symbol of rescue dogs everywhere.

Backyard Portugese water dog breeders everywhere are rubbing their hands with glee. Shelters and Portugese water spaniel employees are rubbing their temples resignedly in anticipation of the unusual breed now catapaulted into the spotlight, courtesy of one allergic First Daughter, sure to experience a huge boom before flooding the shelters and rescues in question when reality sets in.

Cesar Milan has already weighed in, of course, saying very diplomatically that “Portuguese water dogs are an active breed and will need long walks and will need to understand quickly who is the ‘pack leader.’ ” Translation: You need to run them silly and train the heck out of them. Hope the Secret Service is up for some loooooong walks.

I have a Portugese water dog, Beulah, as a client. Her owners are big time Obama supporters. Even they think he is mildly nuts for choosing this dog.

Fare thee well, Bo. And Barack, may I suggest a Gentle Leader? Looks like your hands are full already.

I was very pleased to see how many people are interested in the cat food discussion and are thinking about making a change! In the spirit of that, I spent a good hour at the local boutique pet food store collecting some different cat diets. I’m going to try giving them to my cats and tell you what sort of reaction they have to them, as well as what kind of reaction I had (being someone who is, ironically, easily grossed out). I’ll also give you the lowdown about how much work went into preparing each one, and tell you how much I paid for a general cost-comparison.

Fortunately for me, I have two very unselective cats, which is not that common in cat-world. There are some cats who show a marked preference for one kind of food over another (ie will only eat dry or only eat canned); if you decide to try changing foods, just be aware of this and do it gradually if needed. Sometimes *very* gradually. Where it’s not a big deal to make your average dog wait it out for a day or two to decide they are hungry enough to try a new food, letting a cat go without eating for a few days can have some nasty consequences, so proceed with caution.

I picked up four different kinds of foods for comparison. All of them are grain-free, which I think should be a minimum requirement for anyone trying to improve their cat’s health with diet. The four types of representative foods I selected are a bag of dry food, a stack of canned food, one bag of freeze dried food, and one bag of pre-made raw diet nuggets. I’m starting off with the freeze dried food this weekend, since I found the idea of cat astronaut food strangely appealing- stay tuned for the results!

This brand is the first contender.

As a side note, it’s always fun to go into those kinds of boutique pet food stores as a veterinarian. “I’m so happy you are doing this,” said the owner. “I’d give you some cards to hand out to clients, but I know you’re contractually obligated to recommend XXXX brand so I won’t.” When I assured her that wasn’t the case, she seemed shocked. I know I sound like a broken record, but although vets may have preferences just like everyone else, there’s no one holding a gun to my head to make me recommend a brand, even the ones whose prescription diets we might stock. No one could make me recommend a medication or a food I didn’t want to- I shudder to think about what that would mean for medical professionals if that were required. She also told me how horrified she was at the number of vaccinated dogs she’s seen who are coming down with parvo, and is telling customers to just not vaccinate and the problem would be solved because obviously the parvo vaccine is causing parvo. That’s when I smiled, took my bags of food, and left.

My point is: Go there and get the good food but ignore the rest of the blather, OK? Listen to me.