Category

Uncategorized

Common Household Toxins

By Uncategorized No Comments

 

 

I tend to date myself by recalling the old days when I first started practicing. When I was a young veterinarian we encountered a lot more toxic reactions to common household items than we do today.

I saw cases of lead poison, mostly in puppies who licked paint chips off the floor. The symptoms were frequently neurologic; seizures and definite decreases in mentation. They were difficult to treat because by the time the symptoms showed up the lead had become ingrained in the body and had done a lot of damage. Trying to rid the body of a heavy metal like lead was next to impossible. We were left with just trying to manage the chronic side effects, often with little success. Fortunately, lead has pretty much been expunged from most every day household items and it’s been at least 30 years since I’ve seen a case.

I treated several episodes of mercury poisoning as well. Most of these cases were the result of broken thermometers. Again, small dogs and puppies were the most likely to be affected as it took very little mercury to cause problems. Mercury poisoning is insidious and creeps up long after the exposure. As I recall these incidents usually ended heartbreakingly. I don’t miss seeing them.

Even some of the common items that are still around…like automobile antifreeze….cause very little damage these days.

Most people don’t change their own antifreeze anymore and pet owners have become much more aware of the dangers of antifreeze and keep their pets away from it. Antifreeze contains a solvent called ethylene glycol that when ingested crystalizes in the blood stream and clogs up the kidneys almost immediately. Severe and often times irreversible kidney damage ensues. Treatment for antifreeze toxicity must be administered within minutes to hours. Recovery is never guaranteed.

We used to see insecticide toxicities a lot more than we do now. Lindane and Chlordane were popular flea and tick products 30 years ago. They were in flea shampoos, collars, dips and sprays. They were meant for dogs only….never cats and are outlawed now by the EPA.. Every summer I would see several cats presented emergently suffering from seizures….often still wet from the bath the owners had just given them to kill fleas. They used a dog shampoo or dip. Yikes! Fortunately, many of these cats could be saved by using atropine as an antidote. It needed to be given intravenously and the patients needed to be closely supervised….but most recovered. In those days there were no 24/7 emergency clinics and I remember staying up late into the night monitoring these patients. I recall bringing some home with me and placing them in a clothes basket next to my bed so I could monitor them throughout the night. Oh man, I don’t miss those days.

Today, there is one common flea and tick product that cat owners need to be careful about. Permethrin. It is found in many current products for DOGS. Permethrin is a synthetic version of pyrethrin which is derived from chrysanthemums (thank you spell check), probably the oldest flea product on the market. It’s been around as long as I have.

The source of pyrethrin

The source of pyrethrin

Eating a chrysanthemum is also dangerous, but it takes a lot. I don’t think I’ve ever seen anything other than an upset stomach from eating one. Nevertheless, if your pet noshes on one you should call us. As for the flea products, DON’T USE DOG PRODUCTS ON CATS. Permethrin containing products like Advantix is for dogs only. Advantage contains pyrethrin and is safe for both dogs and cats. Clinical signs of toxicity, again, will look neurologic; seizure like activity. They can be treated successfully but quick attention is required.

Be careful of mouse and rat poisons.

Can cause fatal bleeding

Can cause fatal bleeding

Everyone should be aware of mouse and rat poisons. Frankly, if you own pets you should not have this in your house. D-Con contains a product that interferes with the ability of blood to clot. It leads to fatal bleeding. Vitamin K injections and frequently blood transfusions are necessary to treat it. Too often, we don’t know if the pet, in fact, ingested it. Sometimes the owner isn’t even aware the pet got into it. I have seen cases where a cat has caught a mouse who ingested Di-Con and got the toxin by eating the mouse. Again, this is a case where early detection and treatment are critical. Better yet, avoid D-Con or any of the “baits” and use glue traps if you must.

Sticky traps that don't poison the mouse...or your pet.

Sticky traps that don’t poison the mouse…or your pet.

Recently, we are seeing household food items. Chocolate chocolateAnd the sugar substitute sweetener Xylitol and Grapes.    Grapes                                                                                                                                                                                                                                                                                   We worry about 3 kinds of chocolate; milk chocolate, semi-sweet and dark or baker’s chocolate. Milk chocolate is found in most processed candies. The semi-sweet kind is most often found in baked goods like cookies and cakes, either ready made or baked at home. The dark or bakers chocolate is very bitter and if consumed in its raw form is the most dangerous. The severity of toxicity (if any) is dependent on the age and size of the pet…usually dogs…and the type and amount of chocolate consumed. Remember in baked goods the chocolate is diluted with a lot of other things like flour and sugar, etc. So 5 ounces of Oreos is not 5 ounces of semi-sweet chocolate. It’s probably no more than 10% of that. Even in Hershey Bars or M&M’s (Dr Beebe’s favorites are the peanut kind in case anyone wants to get on his good side) the amount of milk chocolate is less than the total volume consumed. Older and smaller pets are more susceptible to showing signs which can range from simple upset stomach and some diarrhea the next day all the way up to severe restlessness, panting, excessive urination, tremors, rapid heart rate, seizures and in the most sever cases collapse and death.

A rule of thumb is it takes roughly 1 oz. per lb. of body weight for milk chocolate to cause signs. It takes about 1 oz. for every 3 lbs. of body weight of semi-sweet chocolate and 1 oz. per 9 lbs. of bakers chocolate to make a dog good and sick. So for your 40 lb. beagle it would take 40 oz. of milk chocolate, 13 oz. of semi-sweet and only 4 oz. of bakers chocolate. If your dog consumes anywhere in that vicinity of chocolate you might have a problem. Please call us anytime you think your dog has consumed chocolate. Don’t assume it’s going to be OK. Just call us. Usually it’s not serious, but don’t ignore the possibility.

Grapes. In general it takes a lot of grapes to make a dog sick. It takes 1/5th to 1/2 of an ounce PER POUND OF BODY WEIGHT to cause problems. Dark grapes are more dangerous than green grapes and it’s the skin that causes the problems. I don’t think I’ve ever seen (that’s 40 yrs. of practice) a serious grape toxicity case. If your dog snarfs up the occasional grape fallen on the floor, don’t despair. He’s gotta eat a big clump to have a problem. If he does get a bunch, inducing vomiting usually solves it. It can take days for signs to develop and they usually revolve around kidney issues. Just be careful. Don’t leave the big bag of grapes out for your sneaky guy to get into.

Which brings us to a new one. One that many pet owners are unaware of. Xylitol.

Chewing gum and breath mints are the culprits

Chewing gum and breath mints are the culprits

This one is relatively new. Xylitol is a sugarless gum additive which is harmless to most people. However, in pets, especially dogs, as they are the guys most likely to chew this stuff up, wrapper and all and eat it, it can cause severe hypoglycemia…i.e. low blood sugar. Basically what happens is when this Xylitol hits the dog’s blood stream the body releases a ton of insulin from the pancreas which drives the blood sugar down very rapidly. It does nothing to Xylitol. The body thinks the dog just has had a flood of sugar enter the bloodstream and wants to lower it with insulin. It’s the same effect as getting an overdose of insulin if you are a diabetic. It can happen within an hour of ingestion. Severe hypoglycemia can lead to comas and seizures. This toxicity requires immediate attention. The toxic amount is roughly 50mg per pound of body weight. Most sugarless gums contain 100-300 mg. per stick of gum. There are some that can contain as much as 1000 mg. per piece. A small dog might not need to consume but 1 or 2 pieces. A 50 lb. dog might need to eat the whole package. The issues we have run into is the wrappers are usually destroyed along with the eating of the gum and we aren’t able to determine the amount. Often, even if we have the package, it doesn’t state how much Xylitol is there. We have had some success with poison control and consumer websites that can give us an idea of how much was in each piece, but really, we end up treating these dogs as if they have consumed a toxic amount and monitor them closely for days before we feel we are in the clear.

There are some others. Using common sense is usually all that’s necessary. I have innumerable cases of human drugs accidently consumed by pets. Aspirin, any one of the NSAIDs like acetaminophen or ibuprofen, name any tranquilizer or anti-anxiety drug….heart drugs…any number of creams and ointments. Ummm…even marijuana. Trust me, I can tell you some interesting…and in hindsight….pretty funny stories.

 

 

It’s A Wonderful Life

By Uncategorized No Comments

All of us at the Goodfriends Veterinary Clinic would like to take this opportunity to extend to all of our wonderful clients and gentle furry friends our warmest wishes for a joyous holiday and a prosperous and happy new year.

Yes it is a wonderful life.

Every year at this time I get a kick out of my two college age daughters. They always make time to sit with their Dad and watch “It’s A Wonderful Life”. I introduced them to it when they were little. They used to role their eyes and whine, “Ahh, Dad…do we have to? Again?” But now…after endlessly watching scene after scene, many that we know by heart, they’ve come to share my love of this timeless story.

Growing up, I would often remind them of how the simplest event…or the most innocent encounter with another person might end up having a profound impact on their lives. The life of George Bailey could be a metaphor for all of us. Whether it was the seemingly accidental notice of the prescription wrongfully filled by the druggist Mr. Gower or the jumping into the pond to help his little brother who fell through the ice….who would have known what those few seconds of one’s life would end up meaning to countless others many years later.

If you watch it again, I recommend paying close attention to Jimmy Stewart’s character, George Bailey, as his friends and neighbors pour into his living room on Christmas Eve. Specifically, the look on his face when his little brother, Harry, who was awarded a war hero’s medal, enters the room. The definition of great acting is being able to convey an emotion and give meaning to a scene without saying a word. To me, that wordless few seconds; the look on Jimmy Stewart’s face, defines the greatness of that movie.

"To my big brother, George. The richest man in town"

“To my big brother, George. The richest man in town”

 

Another holiday favorite is actually an animated Christmas film. “The Polar Express”.

Polar Express street scene

I love it for several reasons but mainly because it reminds me so much of my childhood growing up in Grand Rapids, Michigan. Chris Van Allsburg, the author of the children’s book upon which the movie is based was also born and raised in Grand Rapids. His book and the movie are riddled with quaint references to our shared hometown. Many street scenes are accurate depictions of neighborhoods where I grew up.

There’s a brief moment when the train passes a store front all decorated with Christmas scenes and the kids flock to the window to see. The store was called Herpolscheimers. It was a real store in Grand Rapids and it was the go to place for families to take in the holiday season and for kids to visit Santa Claus. I went there countless times.

Herpelsheimers

The most poignant moment of the film is at the very end when the little boy shakes the sleigh bell and he is the only member of his family that still hears it jingle; signifying that he is the one who still believes in the true meaning of Christmas.

JingleBell

Every Christmas morning with my family I ring our sleigh bell to remind us all what the season really means.

Happy Holidays to all.

 

 

What’s all the FUS?

By Uncategorized No Comments

FUS stands for “Feline Urological Syndrome”

We see this problem a lot. Cats, males and females, straining to urinate in their litter box. Sometimes….not in the litter box. One of the most common reasons clients give up on cat ownership is because their kitty isn’t properly using the litter box.

Sometimes it’s behavioral. Here are several tips for getting your feline friend to use the litter box regularly.

1. Have at least one box per cat per household. Some even recommend 1 1/2 boxes per cat, i.e. 3 boxes for 2 cats…maybe 5 boxes if you have 3. I know, I know. That seems like a lot. At least one per cat is a good idea.

2. The box needs to be roomy. Don’t be afraid to have a big one. I recommend a sweater box. The plastic kind you can buy at Target to store sweaters under the bed. Throw away the top.

sweater bx

The one on the bottom is best

3. Clumping litter is usually preferred to the old fashioned clay litter. It’s also easier to clean up and dispose of. Avoid heavily scented litter. Some cats loathe the floral odors they emit.

4. Place the box(es) in quiet, out of the way places, but are also readily accessible. Kitties like privacy too. And avoid placing them near mechanical devices like washers or dryers, sump pumps or furnaces. The sudden noises they can make while your kitty is in the nearby box can be startling and make them wary of returning.

5. Some cats prefer covered litter boxes but I have found more cats prefer uncovered. I recommend “uncovered” whenever possible.

6. Keep them clean. Scoop ’em out at least once/day. Your furry friend will appreciate it.

However………………..

There are the medical issues that can cause litter box issues. This is where we get called in. It can be a serious problem.

97% of the cat population…whether they are strict housecats or go in and out….rarely have lower urinary tract issues. For those 3% who do, however, it can not only be frustrating for both you and your kitty, but very dangerous as well.

As you can imagine, bloody urine is never, ever OK. Cats will feel the same things as people who have bladder issues. Urgency, a sense of needing to go, a burning sensation when they do urinate and frequent attempts to go. However, cats do not understand the problem and may attempt to go in other places thinking the litter box is the cause of their discomfort…not their bladders.

Most of the time bloody urine is due to the formation of struvite in the urine. Basically, struvite is very fine, gritty crystals that form in the bladder and cause friction and irritation when the cat urinates. In the male cat, struvite can cause a plug that will block the outflow of urine from the bladder and cause a painful emergency. Females rarely plug as their outflow tract (the urethra for you anatomical purists) is shorter and straighter than a male’s. A male cat straining in the litter box should not be ignored. A “blocked” tomcat is serious.

If we are treating a female cat with struvite we will use antibiotics. Many of these cats will not have actual infections causing the problem but will develop one due to the straining and blood. Next, we try to dilute the urine as much as we can. It would be nice if we could “ask” our patients to drink a lot of water….but they often don’t listen. Adding water to their food helps. We also encourage the use of drinking fountains. A lot of cats are attracted to the burbling sound and fresh, filtered water a fountain like this can provide.

kitty cat drinking fountain

Try it, you’ll like it.

We also will frequently try to reduce the straining and discomfort your cat may be feeling. We have several options; anti-spasmodics, anti-inflammatories and specific pain relievers can all be used.

Ultimately, a change in diet may be required. These diets are the equivalent of drinking cranberry juice in humans. We’re trying to alter the “chemistry” of your cat’s urine. Some are low in magnesium which is a critical component of struvite. Others specifically change the pH of the urine so the struvite is less likely to form. There are some over the counter diets that can be effective, but for the male cats…..that’s next, coming up…..we really recommend the prescription diets. They are a little more expensive, but can save you a ton of money in veterinary bills if they can alleviate this problem.

The Boys

If you’ve ever had a male cat “block” you’ll know what I’m about to describe. This is a big deal. A blocked, male cat can’t urinate. The kidneys make urine at a constant rate and it travels to the bladder to be stored until passed in the litter box. If your cat can’t pass the urine the bladder becomes large, full, hard and very painful. When I palpate these guys their bladder will feel like a baseball in their belly. Yeah, it’s that big and that hard.There is no place for more urine from the kidneys to go. It backs up into the kidneys and they stop working. Acute kidney failure. Very, very sick cat. It’s an emergency. Call us or go to the emergency clinic.

  • Cat stands in box for ages straining to urinate
  • Cat appears to be constipated
  • cat stands in corner trying to wee pee
  • Small drops of bloody urine on penis tip or in sand
  • Sand is dry, despite cat spending a lot of time in its box
  • Cat makes weird vocal noises – low pitched and crying
  • Cat tries to wee in pot-plants, on the couch, in the basin and the bath and on the bathmat or owner’s clothes.
  • Cat is comatose or not moving
  • Cat cries when picked up due to the pressure on the full bladder
  • Cat’s tummy seems to be bloated or full
  • Rock hard mass in abdomen
  • Male cats, usually 3 years plus, slightly tubby
  • It is the change of season.
  • Cats are usually castrated males

These cats need to be sedated and have a catheter placed in their bladders to relieve the plug and re-establish the flow of urine. This can be difficult as the struvite/stones in the urethra can be lodged and difficult to flush back into the bladder. I have had to do emergency surgery on these cats a few times and go through the abdomen first and unblock the cat from the bladder (inside) side of the abdomen. Difficult and dangerous. We then suture the urinary catheter in place to maintain a means of egress for the urine blocked up in the bladder.

Once we have the him unblocked we need to re-establish normal kidney function. We place an intravenous catheter in the foreleg and administer a high rate of IV fluids. This forces the kidneys to make more urine than they would normally. The kidneys will pump out the extra urine through the earlier placed catheter in the bladder. Essentially increasing the flow from the north end and flushing it out the south end.

unblocking tomcat

 Depending on the severity of the kidney damage hospitalization can last several days.

cat on IV fluids

Usually, after 1-2 days of cathertization we can remove the catheters and see how well our patient can urinate on his own. They will still strain and it may take days for the blood to finally abate, but most will return to normal within 3-5 days.

If special diets are not adhered to (and sometimes even if they are) a male cat can reblock. In these cases a surgical procedure to open the urethra and make it easier to urinate can be done. A urethrostomy used to be a common procedure that old geezer veterinarians like me used to do all the time. I won’t get into the details but it can be life saving. Fortunately, with the new foods that are now available and the medications we have today, this surgery is rarely needed anymore.

What’s up, app?

By Uncategorized No Comments

Technology: If you look at some of my previous posts you’ll notice I have a bit of a love/hate relationship with it.

Digital radiography? Love it

Twitter? What? Never done it.

And I’m always a sucker for online gadgetry that will help my golf game.

Here’s a device and website we are starting to like a lot. It’s called Voyce and you can read about it here: Voyce: It’s a collar that monitors your dog’s vital functions; like heart rate, respirations, activity levels and calorie burn. It’s a bit like a Fitbit for dogs that helps us to monitor patients that are suffering from chronic problems.

voyce collar image

The collars only come in sizes for dogs larger than 15-20 lbs. and the company is marketing them to pet owners along the same lines an exercise wearable like the Apple iWatch or FitBit.

We have a couple patients wearing them right now. Once you sign up and get the collar we will receive an e-mail every morning from the company with your dog’s daily activity level. You will too. You can see it on your desktop, smart phone or tablet. In addition, we will get “alerts” if something odd shows up. We can set the parameters we want to measure and customize the values for your dog’s unique lifestyle and activity level.

Recently I came in on a Monday morning and noted one of our patients vitals had spiked over the weekend. I immediately contacted the owners and found out they had boarded their dog over the weekend. Obviously that was more stressful and caused the values to spike. She was fine, but it was a great example of our seeing something that might have suggested our patient was taking a turn for the worse.

We think the Voyce collar is a terrific monitoring system for older dogs and especially for those that have chronic, debilitating conditions. The collar helps us fine tune our treatments and alerts us to when we may have to make adjustments.

You can buy the collars outright or lease them on a monthly basis. You can get them directly from the company or through our office. We have them in stock. The cost is pretty reasonable and it’s the same whether you get it directly from them or us.

See what you think.

 

Fleas!

By Uncategorized No Comments

It’s September. Beware! This is the peak month for fleas in Connecticut. Not too hot, not too cold. Just right. It can go on right up to the first hard frost and the start of the home heating season.

Get that flea!

Get that flea!

Read more about the following products by clicking on their highlighted names.

Hopefully you haven’t suffered any issues with your dog or cat. Dogs who go outside every day (most do, right?) need to be on a flea and tick preventative. We are particularly fond of NexGard as it is chewable and works great against both fleas and ticks. There are still a number of topical, spot on products on the market, but honestly they are losing their appeal. They’re definitely messier to use, not nearly as effective and the cost differential from the oral products is small.

For cats, even if they don’t go outside, beware. If you have a dog too, they can bring fleas into your house and transmit them to your cats. It’s possible for fleas to hitch a ride on you or a family member if you visit someone else who has a flea problem in their house. They can latch onto your clothing and just go home for the ride. So don’t be so sure that your cat is immune just because he or she is an isolated house pet. Frontline is our preferred product for cats because it also is effective against ticks. Revolution works well against fleas as well as preventing heartworm disease in cats, which is rare. A product called Cheristin is probably the best at killing fleas on cats. We use all of them.

I also recommend pet owners be aware of the flea life cycle. It’s like a butterfly or moth life cycle; egg, larva. pupa (cocoon) and adult flea. If you have a flea problem over 95% of your fleas will be eggs, larva and pupa. They don’t bite. You don’t see them….and…mostly they are NOT on your pet. They are in the pet’s bedding, your carpeting or upholstery. Oh yes…yes they are.

Life Cycle of a Flea

Life Cycle of a Flea

To get rid of them you will not only need to get them off your pet, but out of the house as well. Some people use foggers that can be picked up wherever pet supplies are sold. If you do get several small ones…not the big cans. One small fogger per room. We highly recommend using a spray. They’re safer, can be put directly where your pet spends the most time and you do not have to vacate the premises when you use it. The important thing about the sprays and foggers is that they need to contain Methoprene. This is not an insecticide, but rather a synthetic growth regulator that stops the flea reproductive life cycle in it’s tracks. It’s harmless to people and pets, but devastating to fleas. It keeps the eggs and larvae from becoming a pupa. Siphotrol Premise Spray is our recommended product.

Often, particularly dogs, will develop hot spots and severe pyoderma from fleas. Medicated shampoos and antibiotics are often needed. We are increasingly using a new anti-allergy product from Zoetis (formerly part of Pfizer) called Apoquel that controls the severe itchiness of flea bite dermatitis without the nuisance side effects that steroids can cause; like excessive thirst and urinating. It’s really effective. We like it a lot.

In the end fleas like an environment when the temperature is around 70 degrees and the humidity is 70% and above. Sounds like Connecticut in September.

 

 

 

Technology….Gah!

By Uncategorized No Comments

Where would we be without all the great technology advances we’ve achieved over the past 10-20 years. Our practice could not function anywhere near the way it does without the internet, cell phones, iPads and all the digital equipment from X-rays and ultrasounds to tonopens (for glaucoma) and glucose monitors (for diabetes).

But sometimes….when it goes haywire…..GAH!

Recently we had a patient chew up a computer recharging cord (more technology!) and when we went to X-ray his stomach the computer monitor decided to go on the fritz. Yikes! We couldn’t see the image. A quick run to Best Buy and an hour later….voila! However, it wasn’t without a lot of anxiety for the owner.

Recharging cord in dog's stomach

Recharging cord in dog’s stomach

Fortunately, everything came out fine (if you know what I mean).

With all this heat we’ve been experiencing our air conditioning system has also decided to be temperamental. Two extended visits by our HVAC guys (4-5 hrs. of troubleshooting) finally…we hope…solved the problem. A 2×4″ switch on the unit, which is on the roof of our building, needed to be replaced. The switch was not expensive. The labor to replace it was. GAH!

A recent thunder storm caused a brief power outage at our office. All of our computers have surge protectors and power, backup batteries attached. Out of site, out of mind, right? Two didn’t work right. Not a huge problem as our server backup did work properly. But, checking all of them and making sure they all will work next time took time and effort.

And here’s the best one. It wasn’t at the office, but when I was on vacation a couple weeks ago with my family in Canada. I went to park our rental car. We were suppose to leave at 7am the next morning for the airport. The key fob that locks the doors when you exit the car didn’t work. This was one of those push button to start cars. I have one at home. I’ve never had a problem with it. I jump back in the car and think if I just restart the car and turn it off everything would be fine. No!

Now the car won’t start. It’s 6pm and everything is closed. I call the rental car company’s 800 number and after 15 minutes of holds and switches I still can’t get help. I go to the concierge in the hotel. He says the local car rental office is closed. I call the airport office where I picked up the car. Maybe they can bring me another car tonight….or maybe we have to take a cab to the airport the next morning 120 miles away!!! GAH!

While I’m on hold the valet parking attendant asks me if I’ve tried to start the car by using the key fob to push the start button. “Don’t use your finger. Push it with the fob”, he says. Apparently, he’s the only guy who knows this….and IT WORKED! The valet got an extra tip. He told me he’s had this happen a bunch of times.

Press the fob to the start button

Press the fob to the start button

 

As Roseanne Roseannadanna used to say back on Saturday Night Live, “Well, Jane, it just goes to show you, it’s always something — if it ain’t one thing, it’s another.”

Gilda Radner as Roseanne Roseannadanna

Gilda Radner as Roseanne Roseannadanna

 

 

Horrors!

By Uncategorized No Comments

I said when I started blogging that I wouldn’t be political. But this story I couldn’t resist.

Brexit. Great Britain is going through a bit of turmoil over their recent vote to exit the European Union. It seems the kitty cats that reside at the Prime Minister’s residence; 10 Downing Street and the Foreign Office right around the corner do not agree as well.

Here’s the full story from the NY Times.

This is the PM’s cat, Larry. Named after someone named Larry I assume. Larry

Below, is Palmerston. Named after the Viscount Palmerston (1784-1865) who was a two time Prime Minister and three time Foreign Minister who was known for his aggressive manner and “gunboat diplomacy”. Hmmm…appropriately named methinks.

Palmerston 2

Palmerston won.

Larry bad paw

Colonel Mustard in the kitchen with…..

By Uncategorized No Comments

How do we do it? It’s really not a secret, but many people have been intrigued by how veterinarians go about figuring out what’s wrong with your pet. It’s hard…but after a while, once you’ve done it, it’s not so much if you follow a system.

There are 3 parts to coming to a diagnosis. Then there’s a lot of things that go into coming up with a treatment plan. But to start, let’s talk about the 3 parts of making a diagnosis.

1. History.

This is where you, the pet owner, are the most important. I’m fond of saying your pet isn’t going to tell me where it hurts…or what he ate….or what he was doing last night. That comes from you. Clearly, we wouldn’t be seeing your pet if you didn’t think something was up. If you’ve been through this with us before you know we will ask a lot of questions.

When did the problem start and how long has this been going on? Is he eating? Drinking? More? Less? Any vomiting? Diarrhea? What did it look like? Accidents in the house? How’s his attitude? Active? Still happy? Droopy? Lethargic? Coughing? Sneezing?

I’ve found that many dogs will eat no matter how sick they are (think Labrador Retriever or Beagle) and many cats won’t eat at all even if there’s hardly anything wrong. In general, the first thing a cat stops doing when he gets sick is eat. The last thing he starts to do upon recovery is eat. I like to say to cat owners that if your cat is still eating, whatever it is that’s bothering him can’t be imminently bad. They’re eating.

Is your pet limping? All four? Which leg? Holding it up? Skipping? Dipping? How long? Can you associate it with any particular event or activity?

Itching? Scratching? Head shaking? Where is he fussing? All over? Just the feet? Are you using flea and tick products? Which one? How much time does he spend outside? Has he visited someplace other than your own yard? Has been around other pets or animals?

Does he have a head tilt? Circling? What’s his posture? Where does he place his paws? Does he know where his feet are ? Paw pinch? Can he feel it? Dragging a paw? Painful? numb? We have ways to figure it out.

We like people to be precise. We like to hear “2 days” as opposed to “awhile”. We’ll ask more questions. We’ll get it out of you. Nothing personal. It’s OK to say, “I’m not sure” or “I don’t know”. To me, if you did not notice something it usually means it wasn’t very significant. If you don’t think he’s drinking a lot of water, he probably isn’t.

….then we get to the stuff we need to do.

2. Physical Exam

Interestingly, this can be the easiest and sometimes the least useful of the 3 parts of a diagnosis.

We take the vitals; age, weight, temperature, heart rate, respirations…sometimes blood pressure and compare it to information we may have collected at previous visits. We check the gums for changes in color; pink? red? pale? blue? How is the pulse? Strong and regular? Thready? The eyes? Clear? Inflamed? Are the pupils equal? Do they respond properly to light? How are the lymph nodes…all over the body. Are they enlarged? How does his heart sound? Regular? Irregular? Do we hear a murmur? Are the lungs clear? Raspy sounds? Can we elicit a cough?

dog stethoscope                                                         I'm not enjoying this...                  thermometer

Let’s see him walk? Limping? Can we illicit any pain? You should know some dogs/breeds are better at showing pain than others. Some are pretty stoic (like Greyhounds) and don’t express their pain much at all. Some toy breeds, like Chihuahuas, will act painful if you look at them cross eyed. Cats are all over the map. Some will just sit there and sit there and sit there acting like nothing is wrong than lash out like a Tasmanian Devil. Then others, will freak out and act like the world is coming to an end the moment they enter the front door. You know who you are.

The art in these cases is to know the difference and appreciate what’s meaningful and what’s an act. It’s why we call it practice.

And finally, the 3rd leg of the stool….

3. Tests

This is where expenses can come into play. Dr.Dinwoodie and I are very sensitive to this and try assiduously to run only the tests we think are going to be the most practical and cost effective. Veterinarians do not have the virtue of insurance companies footing the bill for every test under the sun. Mostly, you’re paying for all of this so we want to be as transparent as possible. On the other hand, we also don’t have the Sword of Damocles hanging over our heads if we do not run every test and exhaust every diagnostic avenue in an effort to avoid the charge of “negligence”. We try very hard to give our clients as many options as we can to keep the fees under control while we get to a resolution of your pet’s problem.

Blood work is the core of our testing protocol. We can do a lot of testing “in house” now and frequently get results within 15 minutes. When I first started in practice, blood results frequently didn’t come back for 2 or 3 days….and they were not nearly as accurate or comprehensive as they are now. I’d say the most significant advancement in modern veterinary medicine is the advancement of quick, reliable lab results for our patients.

IDEXX Lab Equipment

IDEXX In House Lab Station

X-rays. We still use the same X-ray machine that was purchased when the Goodfriends Veterinary Clinic was started back in the early 90’s. What’s changed is we now use digital screens to record the images and read them on a computer. No more film. No more developing. No more chemicals. Fast, clear and reliable. With the internet we can now e-mail images to specialists and get second opinions within hours…at a fraction of the cost of a referral. Super duper.

digital x-ray image

Digital Radiology

Ultrasound. This was invented after I graduated from veterinary school. We started using this technology in the 90’s and now it’s a cornerstone of veterinary testing. We have our own ultrasound machine, but we also frequently have Dr. Patty Hogan, a board certified radiologist, come to our office and use her expertise and more sophisticated equipment to get an answer.

ultrasound image

Ultrasound

Frequently we send blood out to an over night lab; IDEXX. They’re terrific. Most of the time the results are back when we come in the next morning. They also do some pretty unique tests that were never around back in my youth. Hormones can be measured. Very specific enzymes and proteins that can be keys to very rare…but often treatable diseases are now commonly available. We can even measure drug levels for chronic management of certain diseases, like phenobarbitol for seizures.

There’s more…but in the end we have to put it all together and come up with some diagnostic ideas. It’s like playing the game of “Clue”. I love this part. Problem solving. When I talk to kids who think they want to be veterinarians I ask them how much they like to play games. Puzzles ( I’m addicted to Sudoku)? Do they like to solve problems? Do they like math? Most don’t…but those skills that help a student solve math problems come in pretty handy for us veterinarians. Algorithms.

FIP algorithm                                                                      Calcium Algorithm

Statistics. Knowns and unknowns. Make a list. Can you rule certain things in or out based on your history, exam or tests? What are the odds of…..? A little bit like Clue. A little bit of algebra. A little bit of experience…….

handle with care

 

 

 

 

 

 

What’s in a name?

By Uncategorized No Comments

Over the years I’ve had clients name their pets all sorts different things. Frequently they’re named after current public figures like sports stars, singers or actors.

We have a “Tebow”. One of our technicians has a dog named “Johnny Cash”. We’ve had lots of “Elvis’s” and “Ringos” over the years as well. A “Mick’ and a “Jagger” I’m sure.

rock and roll                                   .

“Jeter” has been popular in the past but Derek recently retired from the Yankees. His name could fade, but he did just marry a super model named “Hannah”, so maybe she will garner some name support. We have a Doberman named “Zdeno” after the Boston Bruin and a Boston Terrier, “Papi”, presumably named after the Red Sox star. I know of at least 3 “Fenways” we currently see.

fenway park

There have been lots of “Bo’s” and “Mickeys”….some “Ali’s” and lots of “Busters”. But fortunately, no “O.J.s”. Whew.

Sometimes we get names from popular culture like “Harry Potter” or like one of our clients who called her two cats “Harry” and “Sally” after the Billy Crystal/Meg Ryan characters from the movie of the same name.

The movie “Roots” was recently remade, but way back in the 70’s when the first one was originally broadcast I took care of a wonderful little cat named “Kunta Kitty”, a play off the name of the LaVar Burton character.

I’ve always tried to come with clever names for my own pets or a name that means something to me. The first dog I ever had all for myself I named “Schaeffer” after the last name of one of my best friends when I was 8 years old. There were some little kids who lived in my condo complex way back who used to love to play with “Shavers”. I gave up trying to correct them.

I had a wonderful Siamese cat I named “Sweet William” after the flower. One of my best cats was named “Pete”. He was 19 lbs. and lived to be 19 yrs. old. He was born in late 1979 and he passed in early 1999. If he had lived another 8 months he would have lived in 4 decades. He was a good guy; the best purrer of all time. My current cat is “Mr. Whoopie” named after a cartoon character who was called “Professor Whoopie”. Trust me, my Whoopie is no professor. Think of him more like the minister’s kid.

Beware!

Beware!

People names are always popular and I’ve had my share. “Clyde”, “Boris” and “Sam”  come to mind. Our hospital cat is named “Carl”. I had a black lab named “Mabel” and after her I named my chocolate lab, “Bogie” because I love to play golf (not because of Humphrey). Currently, we’re living with “Lily” our French Bulldog.

We sometimes call her "Chubs"

We sometimes call her “Chubs”

Finally, two of the more memorable names I had for patients were with the same client, Ernest Tidyman. He passed away years ago. He was a Hollywood screenwriter with many credits to his name. He won an Academy Award for writing the French Connection starring Gene Hackman and Roy Scheider. He was also known for writing screenplays for gritty, urban crime thrillers like the “Shaft” movies starring Richard Roundtree.  He had two delightful Jack Russell Terriers. They had regular names (that I forget) on their official records, but in the margin they had their real names that Mr. Tidyman usually called them. I cautioned my receptionist to check the waiting room before she announced the next appointment, “We’re ready for…..”Sex” and “Violence”.

the-french-connection1

 

 

 

 

Veterinarians in Cinema

By Uncategorized No Comments

This blog post is for fun.

I love the movies. One of these days I’ll pass along more of my favorites, but for now I’ll cover the ones I like that have veterinarians in them or relate to the profession. There haven’t been that many and most of the time veterinarians are only bit players. I’ll stick to the ones where we star. To start, I don’t think the animal specific ones like Dr. Doolittle count.

Groucho Marx played Dr. Hackenbush (his first name was never mentioned), a veterinarian who impersonates an MD to help save a sanatorium that has fallen on hard times; 1937’s A Day at the Races. Interestingly, it is the only Marx Brothers film to ever to garner an Academy Award nomination; for best dance direction…back when they gave awards in that category.

A day at the Races                   Groucho Marx

QUOTES:

“Emily, I have a confession to make. I really am a horse doctor. But marry me, and I’ll never look at another horse.”

Dr. Hackenbush (taking pulse) ” Either he’s dead or my watch has stopped.”

Baby Boom starred Diane Keaton (Alert #1: She was in two of my all time favorite movies; Annie Hall and The Godfather) and her love interest in the movie was a veterinarian played by Sam Shepard. ( Alert #2: who was in another all-time favorite: The Right Stuff). Interestingly, Sam Shepard grew up on a ranch in California and originally wanted to become a veterinarian before he ended up in Hollywood. I figure, he and I are like…..connected. He wanted to be a veterinarian and I am one. I wanted to be in the movies and he is. Whew. I know, weird.

Babay boom        Sam Shepard

This is getting interesting.

Another movie with a veterinarian in it was a Steve McQueen/Allie McGraw drama, The Getaway. The guy who played Howard Sprague on the old Andy Griffith Show on tv, Jack Dodson, played a veterinarian kidnapped by McQueen. Here’s Dodson.

Jack Dodson

Incidentally, the little boy, Opie, in the Andy Griffith Show was played by Ron Howard who grew up to direct The Right Stuff with veterinarian wannabe, Sam Shepard. Here he is again.

Sam Shepard

Sally Struthers, from the old All in the Family television series played Jack Dodson’s wife in the Getaway. After All in the Family, she went on to star in a spinoff of that series called Gloria which featured a veterinarian played by Burgess Meredith. Here he is.

bmeredith

Meredith played the trainer of Rocky Balboa in all the Rocky films. (Alert #3, I loved Rocky I and II, but not III, IV or V or VI…..) So even though Rocky didn’t have a veterinarian in it, it did have an actor who played one on television. That counts.

And here’s the 6 degrees of Dr. Beebe. We have a wonderful client, Mrs. P, who is a retired actress who had a role in Rocky II with Sylvester Stallone and Talia Shire. Talia Shire was also in….ta da….The Godfather with Diane Keaton before she starred in Baby Boom with veterinarian wannabe and Dr. Beebe alter ego, Sam Shepard. Amazing, right? Again…just in case you forgot what my “wanted to be a veterinarian but became an actor instead” alter ego looks like.

Sam Shepard

Finally, actor James Caan was also in The Godfather and another of my guilty pleasure films, Rollerball (the original one from 1975, not the crummy remake of 2002). Before he went to Hollywood, Caan attended Michigan State University. A few years later that’s where I went to veterinary school. Who knew? Here’s a picture of Caan, another MSU Spartan who became an actor…like…well…..you know….

James Caan       Michigan