Awww, Nuts

The title is tacky, but I couldn't resist. Let's talk about neutering.

If you have a prostate, and you have testicles, you WILL have a problem with the afore mentioned prostate. This happens routinely in human males and is why all men over the age of 40 should have PSAs run and digital prostate exams.


The SAME problem happens in dogs. Testosterone causes the prostate to continue developing and enlarging. At some point this may cause the urethra to become pinched off or may get so huge that you can't pass a stool either. Intact male dogs should have a prostate exam completed yearly. There is not a PSA test available for dogs yet.


Neutering removes testosterone and pretty much makes the prostate a non-issue.


Here's a news flash: Testosterone makes you do stupid stuff. Dogs with extra testosterone are more likely to show behaviors like urine marking, dominance, aggression, territorialism, and overactive libido. That's not to say that an intact dog is a "bad" dog and a neutered dog is a "good" dog. No, no. Neutered dogs can still be all of those things. But in so much as testosterone can make bad behaviors worse - it's not worth having it around if you don't need it.


It doesn't make you less of a man to have a dog without testicles. Honestly. Nobody cares if your dog is well-endowed. Nobody. However, if it's really that important to you that something hang down between the legs, then there are implants available called neuticals.



AMH

Poo's Clues

It's not pretty. We all make it. And it can be a goldmine of information.

To quote the TV show Scrubs: "If you wanna know what's wrong with you, it all comes down to number two!"

Not quite - but it highlights the wonders of stool. Poop. Doo doo. Feces. Stool is what's left over after your body has absorbed what it can from what you eat. The body also adds some fun stuff of its own on the way through.

You wanna know the major reason poo is brown? Stercobilin. It's a leftover metabolite of hemoglobin (the red color to your blood). The bacteria in the gut process it and it turns brown. Thus, COLOR of your poo is valuable. Orange, tan, white, gray, or black all mean something. (orange = jaundice? Black = digested blood or pepto-bismol? gray/greasy = undigested fats?)

In our companion pets, presence or absence of diarrhea is pretty important. Most dogs and cats eat a very regular diet. They should, therefore, produce normal, regular stool. Anything that speeds up the transit of stuff through the gut, the composition of the stuff in the gut, or interferes with the digestion of the stuff in the gut can create abnormal stools.

For instance: Giardia - this is a little single-celled parasite that infects the small intestines. It sits down on the lining of the gut and essentially clogs the works up. Food can't be digested. It makes it downstream to the colon where the colon bacteria throw a big kegger of a party and you get blow-out diarrhea. Similarly, Inflammatory Bowel Disease (IBS in people) or intestinal tumors may cause the gut to fail in absorption of nutrients with the same outcome I mention above.

On the other end of the spectrum, constipation can also be important to identify. Anytime the stool is not allowed to pass before too much water is reabsorbed by the colon, you get constipation. Severe cases of constipation result in an inability to pass stools known as obstipation. Fiber, most specifically insoluble fiber, stimulates the colon muscles to contract and helps keep the poo on the move. Fiber is fantastic stuff. It's as important to our geriatric pets as it is to us people. Most of us don't get enough fiber, our colons turn in to saggy bags and we have all kinds of problems with constipation when we get old. FEED YOUR COLON FIBER. Seriously.

Constipation is a problem we see more often in cats. Cats are known to have motility problems in their colons and they just don't move things through very well. In advanced cases, this lack of movement wears out the colon muscles and in severe cases, the colon stops contracting and becomes very, very large. Those guys sometimes need surgery to remove the colon. Less severe cases can be managed with diet and medications to convince the colon to contract better.

One VERY important thing that your veterinarian should be asking you for each year is a stool sample from your dog or cat. Just because you have an "indoor" cat or dog doesn't mean you shouldn't have the stool checked. I've found roundworms in the stools of "indoor" only cats on several occasions. Each time the owner was shocked to hear this. Roundworms are important because they are zoonotic - meaning WE can pick them up! Cat's can continue to self-amplify whatever they have since they always use the same bathroom (litterbox), so sometimes little infections become big infections.

A fresh stool sample can be processed and looked at under a microscope. The type and number of bacteria, parasite eggs, parasites, types of white cells, and presence of starch or fats can all give clues as to the overall health of your pet. Even more critically is the issue that some of these parasites are the type that WE CAN GET THEM. Roundworms, hookworms, and giardia to name a few.

Anytime you visit your veterinarian for diarrhea in your pet - MAKE SURE AND BRING A SAMPLE. It makes life so much easier.

See - you never knew poo could be so cool.

AMH

Gone Fishin'

I saw a patient tonight at the emergency room who had fallen off a cliff, drowned, and was spectacularly brought back to life by his teenage owner. That's the story, at least, and he's sticking to it.

Reynolds is a typical young, knucklehead black lab that went out fishing with her owner today at Denton Creek. The boys had hiked out a bit to get to a deeper part of the river to fish. Reynolds was, as usual, having a great time and was running around as they hiked down beside the creek to find the right spot.

Somehow Reynolds managed to loose her footing while she was walking along the bank and tumbled down to the creek below. She apparently hit her head on the way down and when she hit the water, she was stunned and immediately sunk. Her owner, Joe, jumped off the bank into the water and had to go under to get her back to the surface. He swam back to the bank and by then she was not breathing and her eyes had gone blank.

Joe somehow kept his cool, lay her out on the bank and began to squeeze her chest when he noticed she wasn't breathing. He kept with her for a minute or two and she suddenly started breathing again. She hacked up some water and was disoriented for a few minutes. They both had to find a way out of the mud and hump it back up the hill to get out. It was then a hike back out of the woods and to the car.

By the time they got to me at the emergency room, Reynolds was 100% herself. She seems absolutely fine on examination. I'm sending home a couple days antibiotic to protect her from any pneumonia from inhaling the creek water.

In the initial story, the fall was down a short hill into a creek. By the time I published this story the fall was twenty five feet and the water three feet deep. By tomorrow, I'm sure it will be a fifty foot fall from a rocky cliff into the deep, black, frigid waters below. It doesn't matter. It's a really cool story and deserves to be told. Way to go, Joe.

AMH

Vaccination Situation #1

Here's a subject that is likely to spark controversy. I'm only going to address vaccinations in adult animals in this post. Puppies and kittens require their own review. I'm going to split this one up into two parts. It's just too much information and it's too important to skip around.

Why does this matter? What's the hubub all about? Why do we care what vaccines are done every year, what vaccines are done every three years?


The answer isn't straight-forward. To put it simply, we want to use vaccines to prevent disease, not cause disease. The current concern regarding vaccines is that vaccines in general may not be as absolutely safe as we once thought. There is the autism debate in human children, the hypothyroid debate in people and in dogs. The autoimmune debate over things like lupus being related to vaccines. We don't know for certain that vaccines cause any of these things, but it sure looks suspicious.


So if we don't know for certain if vaccines cause problems, what are we to do about it? The answer is that we should re-evaluate how we choose and use vaccines so that we are limiting our exposure to only those things that are necessary to try and prevent disease. Our goal should be to use just enough, and not too little or too much. If there isn't a compelling reason to use a vaccine - WHY DO IT? The real fight becomes when you try to identify a "compelling reason" since different people feel strongly in one direction or another.


In other words - we have to be smart about our vaccine choices. We can no longer just blindly go in to get our "shots" whenever we're told we need them. We need to treat the right patient with the right product taylored for them.

Tune in tomorrow for the next post of specific types of vaccines and specific recommendations.

AMH

Surprise breeds

I had a kid ask me an interesting question one day while coming through the clinic on tour with her Girl Scout troop. The question was: "What breeds have surprised you most since you graduated?" I thought it was a pretty interesting question coming from an eight year old.

My answer surprised me: Golden Retrievers and Pit Bulls (American pit bull terriers, pit bulls, stafforshire terriers - purists would argue that these are distinctly different breeds, but most of us would paint them with the same brush).

I've had more Golden Retrievers try to eat my lunch in the past 10 years than any other breed aside from German Shepherd dogs. They're also NUTS.

The opposite is try for Pitties. They're AWESOME dogs. Really great. High energy, but amazingly good dogs. They also wear their emotions on their sleeves. If they don't like you - they tell you and are honest up front. Goldens look sweet and act sweet and then suddenly turn and try to eat you alive. Same with a lot of German Shepherds.

Pitties are also very powerful, so when you get a bad apple, it really spoils it for the bunch. We don't hear about cities trying to outlaw chihuahas, even though they are by far more evil than pitties. Land Sharks. They like to eat little children. They look sweet, but then they're like that rabbit in the Holy Grail movie. (Ok, that's not fair, but you just can't trust the little buggars.)

Now - it's not fair to generalize. And I shouldn't. I've seen sweet and mean of just about every breed imaginable. But the girl asked what breeds surprised me. My preconceived notions were that the goldens would be sweet and the pitties evil. Nope. What a surprise!

AMH

Over the counter pain medications

I am frequently asked if a pet can take anything over the counter for pain. Typically, the answer is NO. In cats, the more specific answer is not just no, but NO!


Dogs and cats are so very, very physiologically close to us in many ways and yet worlds apart in others. One of the big differences has to do with the way their livers process certain toxins (or drugs). Because of this, drugs in the Non-Steroidal Anti-Inflammatory Drugs (NSAID) designed for humans are exceptionally bad for dogs and cats. Instead, drugs had to be developed that they could tolerate. These drugs are all prescription and there are no over the counter equivalents.


Ibuprofen is horribly unpredictable in dogs and can easily be toxic at a single dose. Some dogs tolerate fairly high doses before they get sick. Since you can't predict this, it's not safe to give at any dose. Acetaminophen (Tylenol) is rarely used in dogs, and then only if required because it is in a combination with a narcotic (like Vicodin). Dog livers tolerate it OK, but not well enough to comfortably use it any more than you have to. Do NOT give tylenol to your dog.


But to all rules, there are exceptions. Dogs can tolerate aspirin. Small doses, at least. Before we had canine specific drugs, aspirin was commonly used. The problem with aspirin is that the side effects all happen at doses lower than those required to provide pain relief. Tummy upset and disruption of clotting are the two biggest side effects we are concerned about. Aspirin is a potent inhibitor of platelet function. It's why people take tiny doses daily to help prevent heart attack or stroke. Because aspirin is associated with such potential for problems, I'm not even going to mention a specific dose. There is the occasional dog that can tolerate aspirin quite well and does well on it as a pain medication. This is the exception and those patients are at higher risk of bleeding.


In cats, however, there are no exceptions. DO NOT give your cat anything over the counter. Period. A single Tylenol is fatal. Aspirin has to be given with extreme caution. Ibuprofen is likely to be fatal. I repeat - DO NOT give your cat anything over the counter. Nothing. Nada.


There are some great prescription drugs designed to work well with dog and cat livers. This class of drugs still requires care when using, but the veterinary drugs like Rimadyl (carprofen), Metacam (meloxicam), Deramaxx (deracoxib), and Previcox (firocoxib) are all fantastic in the right situations. Because they are SO safe relative to the over the counter options, it simply isn't worth the risk of giving anything else.


AMH

Allergy Season

This will be my first post on allergies. There's lots of information to be said and even more bunk out on the internet.

When people "get allergies" to thinks like pollen, grass, dust, etc, we typically think of the runny nose, eyes, and asthma. When dogs have inhalant allergies, they tend to have skin symptoms of itching, redness, and then secondary infection. There's plenty of crossover - some people get eczema, some dogs get runny eyes.

So the typical "allergy" dog is a foot licker, armpit scratcher, and face rubber. They also tend to have ear problems (itching, secondary infection). Some individuals only have ear problems or only lick their feet. Some have the whole list of symptoms and are miserable.

"Allergies" are caused when the body's immune system sees something like a pollen and reacts to it instead of ignoring it. The cells in the body that are responsible for reacting to antigen (antigen meaning anything, usually a protein, that the immune system reacts to with an antibody) are full of all kinds of fun chemicals designed to spread havoc. Histamine is the major player. Histamine causes blood vessels to dilate, causes itch, and swelling. Histamine is what makes that mosquito bite swell into a little bump.

Not everything is known about why this happens in certain individuals. Genetics is involved. Offspring of an allergic individual are more likely to have allergies, but it's not a guarantee. We now know that there are some really cool changes in the way the skin of an allergic individual is put together. As it turns out, the "cement" that holds all of the "bricks" of the skin cells together isn't quite right in these people and pets. As a result, the skin isn't as effective a barrier as it's supposed to be. This allows the body to absorb some antigens that you wouldn't normally absorb (like pollen) and the immune system gets all upset and you develop "allergies."

Allergies are also something that develop over time. The typical atopic dog shows signs during their 2nd or 3rd year of life. Sometimes earlier, but usually it's not their first summer. They also get worse over time, so the 8th summer is usually worse than the 2nd summer.

I'll post again with a discussion on treatments. There's TONS of stuff to talk about, so I'll break it up.

AMH

Animal Poison Control information - a MUST have for pet owners

This is the URL for the ASPCA Animal Poison Control Center:

http://www.aspca.org/pet-care/poison-control/

(888) 426-4435

There are many good articles and general information on this site. There are lists of toxic plants, foods, etc. I'll post again on toxic plants to give some more specifics.

Keep their phone number handy. If your pet ever ingests something and you're not sure if it's toxic, you can first call your veterinarian, but if there's any question - call APCC right away and they can save you a lot of time and money. They'll help you by 1) telling you if it's even a big deal and 2) if it is a big deal, they can tell your veterinarian how to effectively treat the issue and that will help save you lots of money in the long run.

There is a $60 fee charged to your credit card, but it's worth every penny!

They will give you a case number to take to your veterinarinan, so keep the number handy.

AMH

Melatonin for Thunderstorms

Dear Dr. Herndon

I read in a letter in the paper that said giving 1 1/2 Melatonin tablets per 24 hour time period might calm a dog that is afraid of thunder storms. The owner said they gave the dog, a lab, the Melatonin tablets when she "went into listening mode" (the dog could hear approaching storms before her owners could hear them). Melatonin would be safer and more readily available than, say, Xanax. Thought you might want to comment.



Melatonin is a hormone that the brain uses to help regulate circadian rhythms. These are things like when to sleep, when to wake, when the hair should grow, when a female should cycle into heat. Melatonin does have a sedative effect on the brain when taken in larger quantities. Many people have used it to help adjust to time changes when traveling, for instance. Melatonin may help your dog get through the storm if all they need is a little sedation.

In the case of thunderstorm anxiety the problem is one of intense fear and anxiety. The deep, booming sound, flashes of light, and all that extra energy in the air is too much for some pets to tolerate. It may only take a little sedation to make it through the event in mild cases. For others, they need something more.

I compare it to people who are afraid of flying. Some folks just have a vodka tonic before bording the plane and then drink another once they're in the air. The sedation effect is all it takes to get them through. True anxiety is typically worse. Sedation may not help that person and instead all you end up with is a drunk anxious that's so nervous they vomit in the seat next to them and end up finishing the flight in the toilet.

Thunderstorms are the same. If sedation is all that's requred, Benadryl might help (1mg/pound body weight diphenhydramine) or maybe your veterinarian will suggest a prescription sedative like acepromazine. These drugs make the dog drunk, but they really don't do much for anxiety. Acepromazine also drops blood pressure quite a bit and may not be safe for some dogs.

I tend to treat these guys with drugs designed to break anxiety (anxiolytics). These are typically drugs in the vallium family (vallium = diazepam; klonopin = clonazepam; Xanax = alprazolam). These work great at breaking anxiety in the vast majority of dogs. The difference between them has more to do with duration of action. I like clonazepam in thunderstorm dogs. Seems to last long enough and break the anxiety well enough. Alprazolam is fantastic, too, but very short-lived.

Dogs require fairly large doses of these drugs compared to people. They are also controlled, which means they are very closely watched by the federal government because of the potential of abuse. Your veterinarian has to be careful how much they prescribe. These drugs will also tend to sedate, so you get the double whammy.

Occasionally, there is a dog that acutally gets hyper-excitable on these medications. That's unfortunate. Always give a test dose before you need it. Finding out the medication freaks your dog out during a thunderstorm would not be enjoyable.


Don't forget about non-pharmaceutical options, too. Keeping a light on, the television on, or keeping the pet in a dark room where they can't see the lightening may all help. Cesar Millan has some good thoughts on this one.

AMH

Pet Food Choices

"Let food be thy medicine." - Hippocrates


"Feed the dog, Not the bag." - I can't remember who, but they were smart




There are lots and lots of foods on the market now. Most are good. Some are very good. Some are absolute crap. I'm going to mention a few by name. I guess that's an endorsement, but just because I don't mention it doesn't mean it's not good.


There is no food that is properly designed to be "good for all life stages."
Puppy food is designed for puppies. Senior food is designed for seniors. I encourage owners to feed an age appropriate food.


Here are a few general statements: Puppy foods are higher in fat and calcium. Adult foods are lower and fat, moderate in carbohydrates, and higher in protein. Senior foods are higher in fiber and carbohydrates, lower in fat, and moderate in protein.


Most puppies only need puppy food up until 6 or 9 months of age. Spaying and neutering doesn't make a pet fat. But their metabolism doesn't ramp up and so they just don't need the same calories as an intact dog or cat would. So from the time of their surgery, it's usually OK to go ahead and switch to an adult food.



Many adult foods are simply too many calories for the pet they are feeding. This is ESPECIALLY true in cats. Don't hesitate to switch to a lite or less active food. They don't have to be "fat" to switch. It's a preventative thing.


Senior pets must be careful what kind of proteins they eat. It's not that they need to be on a low protein diet. They need to be on a moderate protein diet. Older pet colons also benefit from a little extra fiber - just like you and I. Fiber is your friend!


Let's talk grain free.
This is a hot button issue. Many folks are ABSOLUTELY convinced that corn is the devil's fruit. Others see corn as an excellent carbohydrate source. I'm in-between those two extremes.


I disagree with the assertion that dogs and cats don't eat grains in the wild, therefore grains are bad. Dogs and cat's rarely eat a bowl of rice or some corn on the cob in the wild. What they do eat are the things that eat the rice and corn and have the corn in their bellies when they are killed and eaten. Therefore, the dog or cat do get the grains in an unprocessed/partially digested manner.


It's an effective argument to say that wild canids or felids don't eat processed grains and that processed grains are different from raw. Ok - I'll give you that one. But I have a hard time believing that grains are absolutely bad.


Rice and corn, for instance, can be outstandingly well digested by the body and are an excellent source of energy. Critics of grains in our pet foods argue that the processed grains used in pet foods are not an intended food for dogs and cats. Because of that, they are not appropriate for the overall health, energy, and immune state of the host system. Although these components don't cause direct damage, they still cause subtle disruptions in the body's energy and/or homeostasis. Therefore, your pets are "healthier" if you don't eat them.


There is big business in the specialty pet food market now. I find it immensely interesting that one company who markets a grain free diet uses potatoes as the carbohydrate source. Anybody ever seen a dingo eat a potato?

"We only use the part of the chicken you would eat." or "100% muscle."

Have you ever seen a wild dog or cat eat their kill? They leave tasty parts we would eat behind. Instead, a dog or cat eats from the butt hole forward. They need the guts, the liver, the heart, the lung, the kidneys, the blood. Sure, meat is tasty. But the good, balanced nutrition is in all the bits and pieces we won't touch with a 10 foot pole. Don't let this marketing trick fool you. "Animal digest" and "offal" are pretty disgusting to think about but they are really good for your pet.


Raw Diets:

I've seen some pretty amazing things happen when a pet with a poorly controlled, hopeless, chronic condition suddenly transforms when they are fed a raw diet. I've also seen some trainwrecks and death from people who don't know what they are doing. A proper raw diet is NOT JUST MEAT! It irks me when people think that some chicken meat constitutes a raw diet. If you feed your pet meat only, you will kill them. Just because it's not cooked, doesn't mean it's not balanced. If you are considering feeding raw - DO YOUR HOMEWORK! There's a right way and a wrong way. Some pets do fantastically on raw and it can be an excellent choice for someone dedicated enough to do it right.

Food safety is critical when feeding raw. Be aware of your source. Salmonella and E. coli can be just as lethal to your pets. Campylobacter and listeria as well. Quality sourcing of a quality product that is handled in a safe way is not easy to do. Nor is it cheap. If you aren't careful, you WILL make your pet sick. It is quite possible to kill your pet with raw food.

Therapeutic veterinary diets:
Each of the major food manufacturers has a line of therapeutic diets. Royal Canin, Purina, Iams Company, and Hills are the major players. Discussing therapeutic diets with veterinarians is sometimes like discussing politics or religion. People tend to have pretty strong feelings about it.

My opinion is that Royal Canin has far and away the best product line. I like them and encourage them to be fed. Your veterinary hospital may have two or three product lines that they carry. Some hospitals are exclusive to one company. I'm not a fan of Hills foods. Not at all, and that's all I'll say. They have one or two good diets, but they are the one that most folks recognize by name.

There is no such thing as a "prescription diet." Meaning no foods are considered legend drugs by the FDA and require a prescription. Prescription Diet is a trademarked marketing term used by Hills. If your veterinarian says they require a prescription to sell you a food - that's not technically correct.

Therapeutic diets are sold only through veterinarians because they are considered to be so specialized or restricted that they are not appropriate to sell over-the-counter to the public. Feeding a kitten or puppy a diet intended for a kidney failure patient could severely hurt the kitten's ability to develop and grow normally. Feeding a diet intended to prevent urinary crystals could be disastrous in certain dogs and cause them to become severely ill from pancreatitis. Although these foods are not technically a prescription product, your veterinarian may restrict to who and for what reasons they sell these foods in the interest of safety.

Specific foods:

When people ask me what foods I recommend I list the following:

Royal Canin
Wellness
Innova
Eukanuba
Iams
Purina Pro Plan


I have inconsistent results with Nutro. I have a strong dislike of Hills. Very strong dislike.

I'll add more to this later.

AMH

Welcome to my new blog! This is a new experience for me. For those that know me, though, it won't come as any surprise that I now have an online forum to keep talking and talking and talking...

My purpose here is to provide education. I want people to have a place they can come to and get reliable, current information regarding the health and healthcare of the small companion animals. I may also have a few words about goats, cows, birds, and reptiles. I'll try not to get too sidetracked :)

I've got a dozen or so topics ready to post, so check back often and see what I have. PLEASE ask questions - either by comment or e-mail. This lets me know what kind of information people want to hear!

I have a couple of rules, though:
1) No mean people. If you're mean - you're off. Pretty simple.
2) If you ask me a question about your pet - don't be surprised if I can't directly answer. Since I can't see your pet, I have to be very careful what I say or suggest. My hope is that this blog will be more topical and less specific, but we'll see what happens.
3) If it's an emergency - call your local veterinary ER.

And last, but not least, here's the legal disclaimer:
Above all else - the health of your pet is the most sacred. When in doubt - see your primary care veterinarian! I am not standing in front of your pet. I can't see, hear, smell, or interact with you and your pet. No advice, however well intentioned, from me can substitute for the face to face care of your primary care veterinarian!

This is going to be pretty fun. Keep in touch!

Dr. Herndon