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Hyperthyroidism in Cats: Introducing Hill’s y/d Diet

February 14, 2012 By Leave a Comment

    As devoted pet owners we know that as our pets’ age, they become more susceptible to illnesses and health conditions. One of the most common diagnoses in older cats is hyperthyroidism; hyperthyroidism is when the thyroid gland (located in the neck) makes too much thyroid hormone for the body.

   Often times the symptoms of hyperthyroidism are not visible, but over time and as the condition worsens, symptoms become noticeable. The most common symptoms are weight loss, frequent urination, increased thirst and appetite.

   When a cat is suspected of suffering from hyperthyroidism, the veterinarian will first feel the neck of the cat to see if he or she can feel if the thyroid gland is enlarged. Often times, the thyroid becomes inflamed when suffering from hyperthyroidism and swells a bit. Heart rate and blood pressure may also be checked because when a cat suffers from hyperthyroidism, it causes the heart to work faster and harder which can eventually lead to an enlarged heart. After the exam is complete, a blood sample is taken from the cat and sent to the laboratory to analyze the present thyroid hormone.

   Should your cat be diagnosed with hyperthyroidism, you should know right away that there are options. Encina Veterinary Hospital offers two key options for treatment: medication or a diet change. We know that many pet owners have a difficult time medicating their cat for multiple reasons; this is why we are big fans of feeding Hill’s Prescription diet y/d Feline Thyroid Health brand pet food. It carefully limits the levels of dietary iodine to reduce thyroid hormone production and help restore health without the need for any other therapy.

   Once your feline friend has been prescribed the new y/d diet, you will gradually introduce y/d over a 7 day period by mixing y/d with your cat’s current food, gradually increasing the amount of y/d until only y/d is fed. Once your cat has been eating y/d exclusively for 2 weeks, you will then remove all thyroid medication from his/her life. In the 4th week after starting y/d, your veterinarian at Encina will then perform a recheck to see how the thyroid is doing compared to before the diet change.

   One of our recent patients, Autumn Pumpkin, was diagnosed with hyperthyroidism and was given numerous medications to manage the condition. This was not only a stressful situation for both the owner and cat, but it was costly as well. 3 weeks after Autumn Pumpkin began the y/d diet, she was completely taken off of all medications and maintains healthy thyroid levels on the y/d diet alone! WAHOO!!!

   The most challenging part about feeding your cat the y/d diet is the fact that you can no longer offer the range of treats and snacks you once did. It’s important your cat eats the y/d diet exclusively to ensure it works. However, Hill’s has been working very hard to come up with ways that cat owners can still spoil their feline friends and developed several recipes for loving cat owners to make hyperthyroid safe snacks!

Click here to download the recipe for Snack Triangles from y/d Canned Food, Gravy from y/d Canned Food and Snack Cookies from y/d Dry Food

Filed Under: Blog, Cat Care, Interesting Cases Tagged With: , , , , , , ,

Pascal’s Thankful Thanksgiving

February 9, 2012 By 2 Comments

    Pascal is a very sweet Bedlington Terrier that has been a patient of mine since 2003. We diagnosed him with copper storage liver disease in 2003 and have treated him with medications and a prescription diet. Copper storage disease is when the liver begins to accumulate an abnormal amount of copper, which in the long run can cause liver cirrhosis and is actually common in Bedlington Terriers, Doberman Pinschers and Labrador Retrievers. Since his diagnosis, Pascal has done well and there has been no evidence that his copper storage liver disease has progressed.

    In late November, just before Thanksgiving, Pascal was rushed to us on an emergency. He was reported to have become acutely very sick and was vomiting, lethargic, and not wanting to eat. On physical examination, he appeared very depressed, dehydrated, had abdominal pain on palpation, and a fever. We hospitalized him and started intravenous fluids, pain medications, gastric protectants, and broad spectrum antibiotics, and of course took a blood sample to analyze to see what exactly was going on inside of Pascal.

    Once his blood work came back, it showed us an elevation of liver enzymes and an elevated white blood cell count. We then preformed an abdominal ultrasound on Pascal which showed one abnormal liver lobe and free fluid in the abdomen. A sample of fluid was taken from his abdomen and after looking at it under the microscope; we saw that it showed evidence of a bacterial infection. Based on these findings, our primary differential was a liver abscess.

    Liver abscesses are rare in dogs. Some potential causes are sepsis (bacterial infection in the blood), trauma to the liver, and diabetes mellitus. Pascal did not appear to have any of these underlying causes. It is possible that his copper storage liver disease predisposed him to a liver abscess but this has never been reported.

    I discussed with Pascal’s owner that this is a very serious condition and without surgical removal of the abscessed portion of his liver, Pascal might die. Pascal’s owners elected to pursue surgery and we were able to isolate the section of the liver that was abscessed (the left medial liver lobe) and remove it successfully. We flushed his abdomen cavity with warm saline (salt water) to remove residual infection that had spread throughout his abdomen.

    Pascal has recovered well from surgery and it is great to see him back to his normal activities. You would never know that just a few months ago Pascal was deathly ill and had major surgery!

                                      Written by Dr. Peter Nurre, DVM, Dipl. ACVIM

Pascal’s owner Judy had some beautiful words for Dr. Nurre that we would like to share with you:

Dear Dr. Nurre,

   I sat down to write you a “thank you” note and I’m finding it very difficult to say what I feel. I don’t have the words to express how much Pascal means to me and then I realized that it’s okay because I think you know.

   Thinking and thinking and thinking – how can I possibly convey the flood of gratitude I feel for your incredibly generous offer to save Pascal’s life. You are in every way extraordinary special; both as a person and as a doctor!

   I normally don’t consider myself to be a lucky person but whenever I think about November of 2011, that’s the word that comes to me – lucky! I’m the luckiest person in the world to have miraculously had the good fortune to have Pascal in your care. This was a thanksgiving I will always remember. We will forever be thankful to you!

   I very best thing I could ever wish for you is that should you ever find yourself in the worst of situations, as I was, one that seems hopeless – the best thing that could happen to you is for there to be someone just like yourself, right there for you, like you were for us!

   The words “thank you” don’t even begin to come close to how grateful we are, but please except them and know that they mean infinitely, so much more.

               Wishing you the very best!
                      Judy and Pascal

Filed Under: Blog, Dog Care, Inside EVH, Interesting Cases Tagged With: , , , , , , ,

Better Safe Than Sorry – Trupanion

February 6, 2012 By Leave a Comment


Similar to human health insurance, pet insurance provides peace of mind in case the unfortunate should happen with your pet. Its purpose is to help cover the costs of unexpected accidents and illnesses that may occur in the future.

When your insured pet becomes sick or injured, you bring him or her to Encina Veterinary Hospital. You then submit your invoice along with the pet insurance claim form to be reimbursed at a percentage, less your chosen deductible (you can choose your own deductible and even make it $0 if you wish!). Trupanion allows you to customize your own plan (your deductible amount and your monthly subscriber amount too).

Here is an actual testimonial from pet owner with an unlucky pooch …

Calypso the 2-year-old Boxer had some unfortunate luck recently. She had a run in with a porcupine and got to experience the frightening and painful quills. Sadly, one of the quills punctured her lung and caused pneumothorax which is a collapsed lung. Calypso spent time at the emergency veterinary clinic where she had surgery.

She is doing better since the attack and we are very glad that we could be there to help during such a scary time.
     Total claim amount: $7,852.67
     Deductible applied: -$0.00 ($100 deductible already met)
     Exam fees: -$165.00
     Unrelated charges: -$90.05
     10% co-insurance: -$759.76
     Trupanion repaid: $6,837.86

Trupanion Pet Insurance is now offering a FREE 30 Day Trial of Trupanion Pet Insurance with a complete physical exam! For dogs and cats between 8 weeks and 14 years old. Call us today to learn more (925) 937-5000

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Behaviorist Dr. Stepita Answers YOUR Questions!

January 27, 2012 By 2 Comments

This past week, we opened up our Facebook page for any questions you may have for our behaviorist, Dr. Meredith Stepita. You can read the questions below and Dr. Stepita’s answers too. We plan to do this again so be sure you like our Facebook page to stay in the loop and get your questions to Dr. Stepita in the future.

PLEASE NOTE: Although the veterinary medical information contained within this site is brought to you by a professional, qualified, practicing veterinarian of many years’ experience, the information is not intended to replace the advice of your own veterinarian or doctor. This website can not see your animal – your local vet can.

Q from Natalie Walker: My pit bull is white, and loves sun as she has gotten older she has black spots everywhere. why??
A: Hi Natalie. Thank you for the very first question! I would definitely recommend having your dog examined by your veterinarian as I am concerned that the black spots could actually be a medical problem.

Q from Kristine Larson: My Westie puppy (1 yr old) has a habit of licking and smacking his lips before he goes to sleep at night. Is this b/c he was pulled from his mother too soon (he’s a puppy mill rescue and was taken from his mother at 5 weeks!) or could it be something physiological, like acid reflux? I think he is self-soothing, but if I give him a bit of food before bed, he doesn’t do it as long or as badly. It’s borderline obsessive…

A: Thank you for the interesting question Kristine. Recently, we have been making the connection between licking and gastrointestinal disease. There was a study looking at this and all the dogs that licked excessively had a medical gastrointestinal problem (found on biopsy of their intestines), whether or not they had any other clinical signs of gastrointestinal disease. I would absolutely recommend following up with your veterinarian, especially since you notice that he is better if fed before bed. Other medical problems related to excessive licking include oral disease, metabolic disease (for example, liver or kidney disease), toxins, brain disease (for example, hydrocephalus or water on the brain), and electrolyte imbalances. It is more so in cats than in dogs that we have seen abnormal oral behaviors due to a behavioral cause in those that were weaned at an early age, but it could be possible in dogs as well.

Q from Megan Soriano: Why does my dog bark all the time? My other one is fine and only barks when people are coming up to the house, or when the mail man comes “normal” things. How can I get the other one to stop?

A: Thanks for the question Megan. Dogs do hear differently than us and there are many reasons your dog may be barking. For example, a territorial response, fear, alarm barking (when they bark a few times to let you know, for example, someone is at the door), stimulus response (barking in response to any sort of stimuli, for example, noises, people or other animals), or as an attention-seeking behavior. It’s important to figure out your dog’s motivation for barking in order to tailor a treatment plan to him. The first step is always to avoid the triggers that cause your dog to bark. For example, play white noise or music to drown out any noises. Then, a specific behavior modification plan is made based on his motivation for barking. Your veterinarian may be able to help you with this behavior modification plan or they may refer you to a veterinary behaviorist.

Q from Tootie Tatum: Why is my seven year old male both scared of and threatened by my 11 week old puppy? Along the lines of being an odd dog, why does he occasionally forget how to walk on smooth or tile floors? Some days he’s fine and others are apparently downright horrifying on the same surface.

A: Good to hear from you Tootie :) Can you describe what you mean by the older dog being threatened by the puppy? A fearful dog may become aggressive when cornered and there is no escape. Also, bringing a new dog into the house may come with some amount of stress and the hierarchy of the dogs in the house may become unstable – this can also lead to increased aggression.
Regarding smooth floors the first thing that comes to mind is to have him checked by your veterinarian for orthopedic problems. These floors can be slippery and conditions such as osteoarthritis can be more painful as they walk on smooth, slippery floors.

Q from Cheryllynne Bush: my 4 year old Doxie loves everyone she is very friendly, and she loves to give kisses almost obsessively, she will give kisses to the people in the car next to us or if she see’s someone walking down the street she will kiss the window, she will lick the air if she cant get to the person. we got her when she was 8 weeks old she is now 4 she has always done this. we have 2 others and they also love everyone but do not show this behavior. i just tell everyone she meets its better than biting.

A: Thank you for posting this comment Cheryllynne. I agree- much better than biting! In wolves and dogs licking can be an appeasement behavior where the subordinate dog licks the dominant dog in order to diffuse any aggression and puppies lick the mouth of adults in order for them to regurgitate food (although the latter does not happen in very many domestic dogs). It is thought that these juvenile behaviors as well as certain physical traits have been selected for in our dogs today.
What is the response of the person being licked? I am guessing that she may have been rewarded (even negative attention is rewarding for many dogs) for this behavior in the past. Dogs actually learn best when they are intermittently rewarded, similar to playing slot machines in Vegas. As in the above post keep in mind that excessive licking can be a sign of a medical problem which you can follow up about with your veterinarian.

Q from Nancy Hartford: “I have 5 cats, 4 adults and 1 kitten. We just brought in a stray maine coon cat who is just over a year old and she is licking the hair off of her back around her tail. She is also scratching jer neck raw. It is not contagious because none of the others are this way. I have been treating her neck with neosporin but not sure what else to do for her. She is getting along well with the other cats. Any suggestions?”

A: Thank you for your question Nancy. First, I would see your veterinarian to make sure there is not a medical cause. In a study performed by a dermatologist and a behaviorist, 76% of the cats that were licking themselves bald had a medical condition only with no behavioral component (http://avmajournals.avma.org/doi/abs/10.2460/javma.228.11.1705). As for behavior, we want to decrease stress by adding resting areas, litter boxes (at least 1+ the number of cats in the house), and feeding areas distributed throughout the house so that the cats do not have to interact if they do not wish to. I would also recommend using Feliway (a plug in that releases cat friendly pheromones which helps keep them cool, calm and collected). A good resource for cat behavior is on the website http://indoorpet.osu.edu/. Keep us updated!

Q from Jane Adams: I have a little pomashitz 6lbs everytime my lab comes near my chair she trys to eat her how can i stop this because my lab got mad once and almost ate her,but this really scares me my lab ignores her but i think momo bit her nose once is why she got mad

A: Hi Jane. Thanks for the question. This is a very serious situation. There may be a hierarchical issue between the dogs, your lab may have a possessive motivation, or there may be another motivation for your lab biting your pomashitz. It is important to get to the bottom of why your lab is biting your pomashitz in order to create a treatment plan and modify the behavior, especially before your pomashitz is hurt. Avoid the situation by not allowing the dogs near your chair and I strongly recommend that you find a veterinary behaviorist (see the website dacvb.org) or certified applied animal behaviorist (http://www.certifiedanimalbehaviorist.com/) immediately. There is also a veterinarian at Tuskegee, Dr. Carloine Schaffer, that may be able to help you.

Q from Prunelle Lolote: Here is a question for your behaviorist doctor, my brother’s old cat keep piing everywhere in our house since he went to his college. And she is not very nice to the other younger cat and the dog. But she used to get along with any pet we had.

A: Thank you for the question Prunelle. The first thing I would strongly recommend is to visit your veterinarian to rule out a medical problem. As for behavior, there are 2 types of urinating outside of the litterbox: marking (small amounts of urine usually on vertical surfaces) and normal elimination or “toileting” behavior (large amounts of urine usually on horizontal surfaces). There are different treatments, so it’s important that the correct diagnosis is made. In general there are some things that most cats like including a very large litterbox (I usually recommend an under the bed sweater box), fine and clumping non-scented clay litter (I usually recommend Fresh Step (r) ), an uncovered litterbox without a liner, scooping the box at least once daily, completely cleaning the litterbox every 1-2 weeks with mild dish soap and water, and multiple litterboxes easily acceptable and distributed throughout the house. It is important to clean up the urine outside of the litterbox with an enzymatic cleaner. I would also recommend using Feliway and if the cat is marking anti-anxiety medications may be recommended by your veterinarian as well as behavior modification for sources of anxiety. It is best to avoid any situations in which your cat will not be very nice to your other cat or dog so that she does not continue to practice the undesirable behavior and see a veterinary behaviorist (dacvb.org) or a certified applied animal behaviorist (http://www.certifiedanimalbehaviorist.com/) to help devise a behavior modification plan. For more information on conflict between cats and cats urinating in the house visit the problem solving section of the website indoorpet.osu.edu.


Thank you to everyone for submitting questions! If you would like to ask a question for yourself, please LIKE us on Facebook at facebook.com/encinavet to stay up to date on upcoming question submissions.
If you are in the Bay Area of California and would like to meet or schedule an appointment with board certified veterinary behaviorist, Dr. Meredith Stepita, please give us a call at (925) 937-5000 to schedule your appointment!

Filed Under: Blog, Cat Care, Dog Care, EVH Staff Tagged With: , ,

Peanut the Miracle Cat!

December 19, 2011 By 2 Comments

Peanut's Baby Picture

It is said by many that cats have nine lives, as it would appear in the case of Peanut Matthews. Peanut, a very sweet seal point Siamese, has proven herself to be a survivor not once, but twice. Found by her human dad at St. Mary’s College (my alma mater) in August of 2010, she is the only kitten out of her litter of six to survive. Peanut came to us on the brink of death earlier this year, after her brother found her curled up against the back door of their house, crying, barely conscious. Dr. Johnson brought her back using life-saving measures that night, and Dr. Christine Fabregas recalls her story below:

Dr. Fabregas, attempting to get Peanut's blood pressure

“Peanut” Matthews, a 1 year old female-spayed Siamese cat, who was found by her owner at the age of 4 weeks. Peanut’s new family bottle feed her and nursed her to a healthy kitten. She was an indoor/outdoor kitten that loved to adventure through the neighborhood. On October 13, 2011, Peanut was presented to Encina Veterinary Hospital comatose, very low body temperature and blood pressure; neither was able to be registered. At this time the thought was that there was a traumatic event that occurred such as a hit by car. Her skin was bruised on her limbs and abdomen. She did not have any fluid in her chest or abdomen when scanned with the ultrasound. An IV catheter was placed and blood work was ran revealing a very low red blood cell count (8%) and her clotting factor time was out of range. Her limbs became rigid and she began to arrest. Emergency medicine was instituted with epinephrine and atropine injections. Her cardiac electrical conduction revealed ventricular fibrillation on ECG. The doctors defibrillated her chest and brought her back to life. She was given a blood and plasma transfusion, and Vitamin K1 injection for the possibility of a toxicity. She was intubated for oxygen therapy and protection of her airway. Blood was noticed within her airway tube and suctioned out. She began to regain more energy and her airway tube was removed. She was maintained in an oxygen cage, on IV fluid and medications for the next 24 hours. Her pupils were dilated and fixed, unsure if she has vision.

Peanut getting a blood transfusion, with Dr. Johnson & Barb's help

Peanut’s owner called later that evening stating the high likelihood of rat-bait toxicity found in their neighbor’s yard. We continued treatment for D-con poisoning. D-con is an over the counter rat poison, an anticoagulant. The mechanism of action is to cause bleeding, most commonly into the abdomen, chest, or subcutaneous. This also occurs in cats and dogs if they ingest the poison itself or if they ingest a rat that has ingested the poison. If you notice that rat bait has been ingested by your pet, it is recommended to bring them in to the veterinary hospital for assessment. This rat bait ingestion can be fatal if not treated.

Peanut in the Oxygen Cage

Peanut required multiple plasma transfusions to increase the amount of clotting factors in her blood to stop the bleeding. She had a few seizures over her first night in the hospital and the following day, which were treated and subsided. Medication was given to decrease the pressure around her brain. An IV catheter was placed in her jugular vein(neck vein) for ease of blood sampling and fluid administration. Peanut did not seem to be neurologically appropriate, because she was just laying on her side, not responsive to her surroundings. She would vocalize when pet, but was not completely aware. She was not eating or drinking on her own. A feeding tube was placed to increase her nutrition and prevent any potential liver disease. She was fed a/d slurry and administered oral medications through her feeding tube. Chest X-rays were taken and showed an area of a bruised lung. She began to have episodes of agitation to stimuli outside of her cage.

Peanut following the placement of a feeding tube

With time and intensive care, Peanut continued to improve everyday. She was noticed grooming herself, walking around in the cage, vocalizing,and more alert to her surroundings. She was slowly transitioned out of the oxygen cage into a regular cage. Her vision was still questionable, but her touch and light reflexes were present. Her temperature, blood pressure, and blood work were reaching normal values. She began to eat small amounts of food on her own. Her tube feedings were reduced prior to discharge from the hospital. Her bruising on her abdomen and limbs were greatly improved. Peanut was discharged from the hospital with instructions on proper feedings and administration of medication via the tube. She was responsive to her owners.

Peanut eating on her own!

On recheck examination, Peanut was active and alert with partial visual improvement. Her feeding tube was removed since she was eating well on own. She was grooming herself in the examination room in the arms of herloving owner. We wish Peanut and her family the best of luck in the future.”

Peanut feeling much better following a few days of intensive treatment

I spoke with Peanut’s dad recently, and he said that she is up to her old trick of hiding in the hallway and grabbing the legs of unsuspecting passerby.  Her vision has returned completely, all the better to find her targets. Peanut’s  spunky personality is still very much intact, and she has even learned not to use her claws when playing with her human family. We at Encina are very happy have been able to witness Peanut’s miracle recovery, and wish the best of health for her for the rest of her life!

Peanut's Unbreakable Spirit is Evident in Her Beautiful Eyes

Also, as a fun bonus, please check out Peanut taking her medication right out of her owner’s hand! Dr. Johnson and I have never seen a cat take medication so easily!  Peanut Taking Pills

 

Filed Under: Blog, Cat Care, Interesting Cases, Uncategorized Tagged With: , , , ,

Persians are Purrfection!

December 6, 2011 By 1 Comment

Persians are one of the most recognizable and popular cat breeds on the planet. Known for their calm, laid back demeanor and beautiful (yet high maintenance) coat, this cat breed is said to date back to the 1500s. The gene for long hair is recessive in cats, and researchers believe that it “appeared spontaneously in the cold mountain areas of Persia”. Queen Victoria of England owned two blue Persians, which made them quite desirable in the early 1900s. In North America, the Persian is considered to be one breed, regardless of color, however, in Britain each color of Persian is considered a separate breed.

The fact that Persians are brachycephalic (flat-faced) means that the breed is prone to breathing difficulties, as well as skin and eye issues. Polycystic kidney disease is also prevalent, in which the kidneys become enlarged as a result of cysts that grow in and around the organ.

One of Dr. Johnson’s more famous Persian patients is named Gabriella, known around cat shows as KIT’Z PAWS GABRIELLA BLISS. Gabi is the beautiful kitty you see in these pictures. I asked her mom Felicia to share their story:


“Before I started showing Gabbi I had never shown any cat.  I had gone to a few cat shows, but just as a spectator.  I bought Gabbi as a kitten  with
the intention of showing her, and ran into all kinds of health issues within the first few days of owning her. These health issues went on for about a good year,  however with the excellent  care of Dr. Roger Johnson, Shannon, and everyone at Encina, she bounced out of all that and is a wonderful pet and show Persian.  Some people that show believe in caging their show cats to keep the cats coat in show condition,  I am not one of
those , Gabbi has the run of the house with my other 3 cats.  Nobody thought she would be in the place she is now, which is in the Ribbons at the Shows! Gabbi loves to go to the shows, and she is just looking better and better.
I started showing her in August of 2011,  her first show she received her “Premier”   title, and four shows later in October she received her
“Grand Premier”   title . I am currently competing for a Regional win, then she will have a “Regional Winner” title.

Encina would like to wish Gabi and Felicia the best of luck in all of their future endeavors, on and off the show circuit!

Filed Under: Blog, Cat Care Tagged With: , , ,

Procedure Day Play-By-Play

November 25, 2011 By Leave a Comment

I recently had the unique experience of bringing one of my furry babies in for a COHAT (Comprehensive Oral Health Assessment and Treatment…a.k.a. dental cleaning), and I gained perspective on what you encounter as clients on the day your pet undergoes a procedure. Please read on for what happens before, during, and after a procedure.

Meet Seal, my gregarious black lab. I rescued him from the pound two years ago, and let me tell you, he has come a long way since our first night together. We don’t know his age for certain, but we are guessing he is somewhere in the neighborhood of five to six years old. Prior to my adopting him, it would appear that he had no dental care. Though I brushed his teeth every night, fighting against the amount of tartar and plaque that had built up was impossible, he needed a thorough cleaning to get his mouth in order.

The night before the procedure: Seal was fed a normal-sized dinner and was given access to water until we left home in the morning. My parents wanted to feed him an extra-large feast since he was going to miss breakfast the next morning, but I reassured them that this was not necessary, as he would be anesthetized and given fluids early on in the day (large meals also = large bowel movements during the surgery).

Dropping off for the procedure: I brought Seal into Encina at 7:15a sharp on procedure day. When you drop your pet off, you can expect to sign an estimate, and leave the low end of the estimate as a deposit. The COHAT estimate has a very important portion for you to initial, regarding whether or not you authorize the veterinarian to extract teeth in the event that you cannot be reached, among other particulars. A client services representative will then take your pet to be weighed, and back into our surgical pre-op area.

Pre-procedure: Technicians will get vital signs, and place an intravenous catheter. If your pet has not had blood work processed within the last month or so, they will also draw blood and run an in-house blood panel to ensure your pet’s safety during anesthesia. The veterinarian performing the procedure will then perform a physical exam on your pet, again to make certain that your pet is healthy enough for the procedure to be performed. The patient is then administered intravenous fluids until anesthesia is given. Seal was very brave during the poking and prodding, and thankfully his lab results were all within normal range.

Going under: Pets are given a cocktail of what we refer to as “pre-medication,” which basically means that a technician administers a sedative prior to inducing anesthesia to reduce the stress level of our patients, and also to decrease the amount of anesthetic needed as well. Once the pre-medication has taken effect, an induction agent is administered, and technicians place an endotracheal tube when the jaw has relaxed completely. The tube allows doctors to use gas anesthesia, and gives them more control over the pet’s breathing during the procedure. After the endotracheal tube is placed, sevoflourane is used to keep the patient in a peaceful state of slumber.

Part one of the COHAT: One technician is posted at the side of the anesthetized patient at all times. Her sole purpose is to monitor and log vital signs (blood pressure, blood oxygen concentration, temperature, etc.) every five minutes, while keeping watch over the animal. A warming blanket is placed over your pet to combat the lowering of body temperature that can occur under anesthesia. A second technician then cleans and scales the teeth using the same type of sterile tools that your dental hygienist uses when you get your teeth cleaned. Gum pockets are measured and the teeth are deep-cleaned and polished in a process that can take up to an hour. As you can see below, Seal had a very dirty mouth!

Part two of the COHAT: After the teeth are shined up, the technicians then take radiographs of the entire mouth. These x-rays are used to measure the health of the roots and teeth, and help the veterinarian to determine whether or not extractions are necessary. This part of the procedure takes thirty to sixty minutes. The veterinarian reviews the radiographs and if needed, may ask the advice of one of our specialists. At this point, a doctor’s assistant will contact you if extractions are recommended, and provide you with an updated estimate of any additional cost. Seal only needed one extraction, the tooth pointed out in the picture below (the picture was taken post-cleaning/radiographs).

Extractions: If extractions are required, a technician will administer a “nerve block,” which is a local anesthetic that reduces the amount of pain your pet endures resultant of the procedure. The veterinarian will then surgically remove the teeth, and repair the area with dis-solvable suture material (stitches). Once this is complete, the mouth is rinsed, inspected, and fluoride foam is applied to the teeth. After the teeth are taken care of, the technicians trim the nails and express the anal glands, and administer both an antibiotic and anti-inflammatory injection, both of which last until the next day.

Post-Procedure: The sevofluorane is turned off, which enables the patient to wake. Technicians continue to monitor the pet, and once it is clear that the pet is awake enough to breath reliably on his own (indicated by an attempt to cough around the tube), the endotracheal tube is removed. Intravenous fluids are continued as the pet is placed in a cage to recover, and technicians carefully monitor the temperature and appearance of the patient until he is fully awake. We wait until this point to call you to set up a pick-up time. Your pet is administered fluids until the IV bag is empty. Technicians take your pet outside to use the bathroom as needed.

Pick-up: Several hours after the procedure (typically between 3-6 p.m.), we have you come in to meet with a doctor’s assistant and pick up your little friend. The assistant will have typed discharge instructions prepared for you, in addition to any medications that will be sent home. If no extractions were required, no medications are necessary unless the gums became overly inflamed during the cleaning. With extractions, patients are usually sent home with an antibiotic, an anti-inflammatory, and depending on the severity of the extraction(s), a pain medication. Seal was sent home with clindamycin (an antibiotic commonly used to fend off infections in the mouth), and Rimadyl (the veterinary version of Ibuprofen). The assistant will go over what to expect when you go home, as well as any questions you may have.

The night after the procedure: Seal went home a bit more tired than usual, but not overly drunk. At around 7pm I offered him water, and when he kept that down, I fed him half of his normal amount of kibble, which was soaked in warm water for ten minutes. He ate eagerly (he is a lab, after all), and then retired to his bed for the evening.

The next day: I fed Seal his normal amount of food, again soaked in warm water. I began his medications, which he took with a bit of cheese. He was as good as new, though I caught my parents feeding him scrambled eggs because they felt he looked extra hungry. Encina called to check on him in the afternoon, as they do with all patients. I nearly forgot to clear the house of any hard toys. The rule of thumb (pun intended) with post-extraction patients is that if your fingernail can leave an indent on a toy, it is soft enough for them to chew.

The following two weeks: Seal’s food had to be soaked in warm water for the two weeks following his procedure. He was given antibiotics for the first week, and the anti-inflammatory for the first five days. You would never know anything had happened to him, as he was back to doing his kibble ballet during meal times. No tug-of-war was played, and we were instructed not to brush his teeth.

The dental recheck: Two weeks after the procedure, if extractions were needed, we ask that you bring your pet in for a complimentary dental recheck with the veterinarian. The appointment takes roughly fifteen minutes, and during that time the doctor looks to see that everything is healing properly. After the recheck, you may commence brushing, feeding un-soaked kibble, and games of tug-of-war.

For a video of how to properly brush your pet’s teeth, please visit our YouTube channel at www.youtube.com/encinavet.

Filed Under: Blog, Dog Care, Inside EVH, Uncategorized Tagged With: , , ,

Thanksgiving Safety Tips for Pet Owners

November 23, 2011 By Leave a Comment

With Thanksgiving being tomorrow, we saw it fitting to have our own Dr. Jill Christofferson has put together some tips on what’s okay and what’s not okay for your pet this Thanksgiving.

Turkey: White turkey meat is okay for pets to eat; you want to avoid the dark meat and skin though because it is full of fat. Food full of fat is bad for your pet because it can cause pancreatis (pancreas becomes inflamed) which can be life threatening to your beloved pet.

Bones: Bones are a general no-no and cooked bones are an even bigger no-no; cooked bones can often splinter inside of your pet and puncture a vital organ. It’s very important you dispose of your turkey’s carcass securely in the trash. Should an emergency arise, please call us (we are open 365 days a year, 24 hours every day): 925 937 5000.

Green Beans: Green beans with no butter or onions are fine for your pets. The butter is very fatty and can cause damage to the pancreas and onions are toxic to pets.

Potatoes: Cooked potatoes are great for your pet! But as with green beans, be sure there is no butter or onions.

Garlic: If you’ll be seasoning your food this thanksgiving with garlic, a little bit of garlic is okay for your pet. Generally garlic is considered to be toxic but a small amount shouldn’t harm your pet.

Onions: Onions are considered to be toxic for pets and should never ever be fed.

Pumpkin: Pumpkin pie is much too high in fat for your pet and can cause pancreatis. A nice substitute for your pet would be unsweetened canned plain pumpkin (also good for helping firm up stool in pets with an upset stomach or diarrhea).

I want to prepare a safe thanksgiving dish for my pet, what can I or should I include?
White cooked turkey meat, plain cooked or raw green beans (or any green vegetable), baked potato and for desert, plain unsweetened canned pumpkin.

If you should experience any emergency, please do not hesitate to call us! The sooner, the better for your pet’s health: (925) 937-5000.

We will be open all day and night Thanksgiving, staffed with experienced emergency doctors and technicians.

Filed Under: Blog, Cat Care, Dog Care, Pet Tips Tagged With: , , , ,

Sophie’s Story, An Addisonian Crisis Averted

November 22, 2011 By 1 Comment

Dr. Dorothy Hoppe recently had a case that she found to be very interesting, and so we invited her to guest blog about it. Please read on for the story of Sophie, a dog that was close to death and had an amazing comeback!

Sophie, a 5 year old spayed female shepherd mix, came in one night at midnight. She was so weak she had to be carried in. Physical exam showed an extremely dehydrated dog, who was in profound shock. Her heart rate was unusually low and her blood pressure was so low it was difficult to detect. Sophie was literally on the verge of death. The history provided by the owners was not an unusual one for a dog coming in on emergency. Sophie had begun vomiting and having diarrhea that day. She vomited several times and become progressively more lethargic. She was known to chew on sticks and had access to a yard. However, her alarming state was not consistent with your run-of-the-mill vomiting and diarrhea. Something more serious was happening. The answer was quickly revealed by Sophie’s bloodwork. Not only did it show she was profoundly dehydrated, her electrolytes were extremely out of balance. This can happen with vomiting, but the pattern of her electrolytes was classic for a disease called Addison’s disease.

Addison’s disease is a disease of the adrenal glands. The adrenal glands are located above the kidneys and are very important! They produce adrenaline, the sex hormones testosterone and estrogen and the steroid hormones. The steroid hormones include glucocorticoids and mineralocorticoids. The glucocorticoids are important in the response to stress: they gear the metabolism towards the preparation of burning rather than storing fuels so as to be ready for a fight or flight situation. The mineralocorticoids are essential for electrolyte balance, which in turn regulates water balance. In short, steroid hormones are needed to adapt to stressful situations and without these hormones, even small stresses could lead to physiologic disaster.

In Addison’s disease, steroid hormone production is inadequate.  The body is thus unable to handle the stress of even a minor illness. Thus Sophie went from vomiting and diarrhea to severe shock in the space of twelve hours. She was in an Addisonian crisis.

Fortunately, an Addisonian crisis is very treatable if diagnosed and treated aggressively. Large amounts of intravenous fluids are critical, as is a dose of the missing steroids. These dogs often also require other supportive care such as anti-nausea medications and antibiotics, since their intestines are usually compromised and may be a source of bacteria. Within a couple of hours, Sophie was sitting up in her cage wagging her tail, and in the morning she was still a little weak but greatly improved.

Long term treatment consists of daily prednisone therapy to replace the missing glucocorticoids, and intermittent injections of Percorten, a drug that replaces the missing mineralocorticoids. Electrolytes are checked monthly to determine when more Percorten is needed. In times of stress, such as boarding, the prednisone dose is often increased to help the body cope. Dogs can live a long and healthy life with the appropriate treatment.

How is Sophie? She recently came in for an electrolyte check and was a happy, bouncy dog and was eating well; a very different dog from the one I first met.



Sophie (left) and Her Brother Lucas Enjoying a Day at the Beach

Filed Under: Blog, Interesting Cases Tagged With: , , , ,

No Dog Should Put Baby In A Corner

November 16, 2011 By Leave a Comment

Many couples begin their lives together by “practicing” with a canine baby prior to having the human version, but the adjustment period may not always transition smoothly when bringing a new addition into the home. We get many phone calls from worried new parents regarding the relationship between dog and baby, so I asked Lisa, one of our registered veterinary technicians, to write a post on how to prepare the family dog for the arrival of a baby. Lisa has worked in animal training for fifteen years, and has a pack of very sweet and well-mannered pups in her life. Please welcome Lisa, our guest blogger:

Expecting a baby? What about the family dog?

In this blog, I will detail what I feel is important for expectant parents to do before the baby arrives to ensure the first baby of the house (the dog) is not overwhelmed and lost in the hustle.

No matter how well behaved or trustworthy you think your dog is, do not leave your dog alone with a child. Accidents happen, and it’s unfair to dog and child to be hurt or reprimanded, when the responsibility lies on you, the adult, to keep all members of your family safe.

7 steps before you bring home a new baby

Step 1: Have your dog(s) fully evaluated by a veterinarian. A healthy dog is a happy dog. You will have peace of mind knowing your baby will not “catch” anything from your dog. An exam should include parasite testing and prevention and an oral exam. For older dogs include blood work and arthritis evaluation. Dogs get cranky just as we do with flare-ups of arthritis, they can also have limited patience when they have metabolic imbalances.

Step 2: Prepare your dog months in advance for your baby’s arrival. Puppies and adult dogs can be overwhelmed by the smells, sounds and overall hustle with the arrival of a new baby. Playing CDs of baby noises on a daily basis will help your dog get use to these strange sounds. Wear and use baby powder, lotions, creams, wipes, and other baby products to help your dog become familiar with the scents. Bring out the stroller, crib, diapers, baby bottles, and anything else that would be part of the baby’s routine. Let the dog get use to them sitting and moving around the house, so when the baby comes home, the dog is already use to seeing, smelling and hearing these objects.

Step 3: Teach your dog what toys are his/hers and what toys are not. This will help prevent the dog from taking a toy from the baby and grabbing the hand accidentally. You have already had practice doing this with other items in the house such as the remote control, shoes, slippers, sun glasses etc. This is just an extension of his/her previous training.

Step 4: Attention transition: Your dog(s) are use to being the “babies”. You have lavished them with attention, toys and treats. They are not going to understand that it’s all going to change when the new baby arrives. If you are the mother of the baby and your dog is closer to you than other members of your household, transition your dog’s attention to another member in the house. Have the other person feed, walk and play with him/her more and more. By spending less time each day with your dog you can minimize the “jealousy” behavior of him/her vying for your attention when the baby is home.

Step 5: Create “No Dog Zones”. You and the baby need to have a room or two that is dog free. Start teaching this to your dog months in advance. Having a safe place to let your baby crawl on the floor or even eat without the dog being around will relieve you of the task of shooing him/her away. The use of baby gates is highly recommended.

Step 6: Create a mock routine of having the baby home. That means getting up every 2 hours around the clock, carrying a doll wrapped up, and sleeping in odd locations. You will be able to identify the problem areas well in advance of your baby’s arrival and be able to help your dog adjust in a positive way, keeping him/her as a loving family member.

Step 7: Plan ahead and have your dog away from the entrance to your home when you arrive with the new baby. It is recommended that the primary caregiver to the dog enter the house ahead of the baby, greet the dog and then have the baby enter. Your dog is excited to see you return home, and can get overly excited when you and the baby come in at the same time. Causing you to be protective of the baby and scold the dog for being excited…this can put the caution flags up for the dog, baby = punishment. This can create a negative association with each other, defeating the goal before you begin.

With slow and progressive changes your dog will adjust by the time the baby arrives and you will not need to struggle with your dog’s new behaviors while caring for your newborn.

Filed Under: Blog, Dog Care, Pet Tips Tagged With: , , , ,
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