Why Does My Pet Need a Rectal Exam?

We’ve all been there before. Bella comes to the vet for a regular checkup or maybe she has another pesky ear infection. Bella is very excited to come and get treats and attention. She is then disappointed to find that she must tolerate a full physical exam. As the friendly veterinarian is performing the part of the exam we usually save for last, you and Bella both wonder if it is really necessary to perform a rectal exam. After all, you are just there for an ear infection! I am here to tell you that it is absolutely necessary and you are not getting your money’s worth out of the physical exam if a rectal is not performed.

– The first thing a veterinarian evaluates on a rectal exam
is the quality of the stool. An owner may describe that there is blood in the stool but a veterinarian will be able to determine if it is actual blood or maybe just red dye from something the pet ingested.
For better or for worse, veterinarians have a lot of experience looking at poop and can learn a lot about your pet’s health by examining it.

– Another thing we evaluate is the anal glands. We can detect
and relieve an anal gland obstruction or treat an abscess. We can also find a tumor of the anal glands or colon early, before your pet shows any signs, which allows for the best outcome in treating these tumors.

– A rectal exam allows us to feel lymph nodes inside the
abdomen (the sublumbar lymph nodes) and helps us diagnose cancers and inflammation or infection that can cause these lymph nodes to enlarge.

– A rectal exam is a must for a pet that has sustained a
trauma such as getting hit by a car because it allows us to feel for pelvic fractures. We can also feel certain bony tumors.

– In male dogs, a rectal exam involves feeling the prostate
for enlargement or pain which may be signs of infection or cancer.

– We can feel the urethra in female dogs via a rectal exam.
This allows us to detect any abnormal thickening or stones lodged in the urethra. Sometimes stones are lodged in a position that overlaps with the pelvis on x-rays and a rectal exam is the easiest way to find them.

– Part of assessing a dog’s neurologic status is checking the anal tone of the dog. Decreased anal tone can be a sign of disease in the spinal cord.

As you can see, while rectal exams aren’t a veterinarian or a pet’s favorite past time, they are vital for assessing the health of your dog and diagnosing disease early in its course.

Alina Kelman, DVM

What’s Up With My Dog’s Breath?

“You have dog breath.” — “Why, thank you!”

The term ‘dog breath’ conjures up a rank sour aroma in our minds, powerfully repelling. This is one of the great injustices in animal health care today. The term ‘dog breath’ unfairly creates the idea that bad breath is an unavoidable truth for our four legged companions, but this is far from the truth!

An overwhelming majority of pet owners do not employ any type of home oral hygiene routine for their cats or dogs. What would happen to your teeth or your breath if you didn’t brush your teeth for a month? Now, what would happen to your mouth if you didn’t brush your teeth for 2 years? 7 years?
10 years? This is what we are subjecting our pets to. ‘Dog breath’ should more appropriately be called ‘lack of appropriate hygiene breath’ or ‘medieval breath.’ Animal dental care has lagged heavily behind animal health care for far too long.

Fresh smelling breath is not the only reason that we should turn our attention toward animal dental hygiene. Research in humans and animals alike is linking dental disease to systemic diseases. Current research provides us with evidence for associations between periodontal disease and systemic diseases (heart disease, kidney disease, respiratory disease,
etc) and some research has shown improvement in systemic disease following treatment for periodontal disease. Further research is needed to determine the full extent of the relationship.

Hmm, maybe I should start doing something for my pet’s teeth, but does it have to be brushing? What about all of the dental foods, treats, chew toys, water additives, wipes and sprays? As a veterinarian, I get asked this question often. My response is this, if there were a treat, a spray, a water additive, or something that was easier than brushing but just as effective, would we still be brushing our own teeth? Some of these things help, just like carrots and apples are good for our teeth, but there is no replacement for brushing.

How often should I brush my pet’s teeth? Is once or twice a week enough?

Every little bit helps and the more you brush your pet’s teeth the better but consider this, plaque hardens into tartar in 24-36 hours. Daily brushing is the best way to help prevent dental disease from developing and to prolong the interval between regular dental cleanings.

Okay, but who has the time to brush their pet’s teeth everyday? Brushing your pet’s teeth doesn’t need to be as time consuming as brushing your own teeth. You only need to focus on brushing the outside of your pet’s teeth.
The insides of their teeth accumulate tartar at a much slower rate than the outside of their teeth as a result of the action of the upper teeth moving against the outside of the lower teeth and the action of the tongue moving against the insides of the teeth. To brush your pet’s teeth effectively, you need only hold their mouth closed and lift their lip on one side, put the brush against the molars at the back of the mouth and brush in circles to the front of the mouth. Then switch and do the same thing on the other side. The whole process should take about 15 seconds.
That’s 90 minutes a year to give your pet a happier, healthier, longer life!

If you’re still on the fence about this whole brushing thing, consider
this: the cost of a dental procedure can range between a few hundred dollars and several thousand dollars, depending on the rates of the veterinary clinics in your area and the amount of oral surgery (extractions, etc) that your pet requires. Let’s pretend, for the sake of argument, that every time your pet has a dental procedure, it costs $500 and your pet has a dental procedure yearly (some pets, just like people, need to see the dentist more frequently, some less frequently). Now, let’s estimate that brushing your pet’s teeth daily will extend the interval between dental procedures to a year and a half. That reduces the cost of dental procedures from $500/year to $333.33/year… a savings of $166.67/year. That’s $166.67 for approximately 90 minutes of work. These numbers are very rough estimates and are on the low end of the spectrum, but you get the idea. Some people need to see the dentist every 6 months despite daily brushing and some people do fine for years. The same goes for our pets. My own dog goes about 3 years after a dental cleaning before I notice any ‘dog breath.’ In fact, people that meet my dog often comment, “Wow, her breath doesn’t smell at all.”

One more benefit that can’t be ignored – less frequent anesthesia.
Although anesthesia is far less risky than it once was and the risk of complications is low, reducing the number of times a pet has to go under anesthesia is a nice benefit. This is of particular value for pets with diseases that put them at higher risk for anesthesia, such as heart conditions, kidney disease and liver disease.

What about anesthesia-free dentistry? This is a topic that deserves its own focus, but the bottom line is this: more than 50% of a tooth is below the gum line and anesthesia-free dentistry can only address part of what is above the gum line, leaving significant dental disease unaddressed.
Anesthesia-free dentistry is cosmetic only, with no real health benefit.
For more information on anesthesia-free dentistry (also called non-professional dental scaling) refer to the following website:
http://www.avdc.org/dentalscaling.html

What can I do today to start taking care of my pet’s oral health?
Call your veterinarian and schedule a consult for a dental procedure. If your pet already has significant dental disease, brushing now will cause pain and may make your pet averse to brushing. Have a dental procedure performed by your veterinarian before you start brushing your pet’s teeth so that you are starting with a clean slate.

Renee Hartshorn, DVM

EMPLOYEE OF THE MONTH: November 2014

JT (Patient Care Team)
Nearly 3 years ago, Jen “JT” Tsutsui joined the patient Care team here at Encina Veterinary Hospital. At the time she was looking to expand her horizons and saw Encina as a fit for her.

As a veterinary technician on the patient care team, JT spends most of her time assisting and caring for our patients. Blood draws, sedations, radiographs, chemotherapy, assisting with managing the lab equipment and outpatient services are just a few of the things you can catch her doing day-to-day.

JT says she loves working here because “every day I get to do different things”. She attributes her success to liking the people she works with: “I enjoy working with the doctors and staff”.
She admits her greatest challenge here is also one of things she loves the most – “Keeping up with the busy days can be crazy”.

When she heard she had won this month’s EOM, she says she was “very ecstatic, I was surprised”.

Outside of Encina, you can catch her spending time with her family, especially her two little ones or on the softball fields.
“Let it Go” from the Frozen soundtrack is her go-to song to sing-a-long to.

Should she have the luxury of inviting whomever she wants to a dinner party she says, “All my grandparents who have passed away – a grandparent reunion!”

Why Does My Pet Scoot?

A pet “scooting” or dragging its hind end on the floor, grass, or nice carpet is a common sight, especially in smaller overweight pets (but larger dogs can be affected too!). Both dogs and cats can show signs of scooting their behind on the floor. Most of the time it means there is an issue with their anal sacs. Anal sacs that get impacted or infected can cause itching, bad odor, pain or discharge. Other signs of an anal sac issue may include chewing or licking the area, swelling around the anus or difficulty defecating. There are other possible causes of scooting such as peri-anal tumors, irritation from diarrhea, worms or matted hair. It is important if you see signs of scooting to see a veterinarian to rule out these other possible causes.

What are anal sacs?
The anal sacs collect oily secretions from the glandular tissue that lines the sacs. If the anus was a clock viewed from behind the anal sacs sit at 8 pm and 4 pm between the muscles of the anus. The oily secretions are used for “marking” or communication between other cats or dogs. Usually a normal bowel movement is sufficient enough to express the anal sacs. If a pet is having loose stool or diarrhea they may not be adequately expressed.

What should I do if I see my pet scooting?
The first thing you should do is schedule an appointment with your veterinarian to rule out the various causes. If left untreated minor inflammation of the anal sacs could turn into infection, abscessation or rupture. This can be an extremely painful condition for your pet.

What are some treatment options?
Treatment options for anal sac issues depend on the cause (impaction, infection, abscess, tumor). Treatment can range from simply expressing the anal sacs to lancing or flushing under general anesthesia. Other options include antibiotics to treat infection, pain medications, warm compressing or diet change (increasing fiber). Please speak to your veterinarian about specific treatment for your pet’s condition.

How are the anal sacs emptied?
Anal sacs are emptied by applying compression to the anal sacs and extruding the oily material. Normal anal sacs do NOT need to be expressed manually and it is not recommended unless indicated by your vet. If anal sac expression does need to be performed there are a couple ways. This can be done outside the anus by gently pushing up on the anal sacs towards the anus. It can also be done by wearing a latex glove and inserting your finger into the anus using your thumb and forefinger to express the contents. It is important to have safe proper restraint while performing either of these techniques. For pets with recurring problems they may need their anal glands expressed frequently. It is best to have your veterinarian evaluate your pet and show you proper safe restraint and technique before trying this at home.

My pet keeps scooting!
If your pet is having recurrent problems please see your veterinarian! They will want to rule out all the possible causes including anal sac tumors. If frequent anal sac expression is not doing the trick surgery to remove the anal sacs can be performed. Your veterinarian will have other options for long term management.

Any questions, concerns or if your pet is ill please see your veterinarian! This blog post is meant for informational purposes only.

Lisa Shapiro, DVM

Why Wont My Cat Use the Litterbox?

      Cats can urinate outside the litterbox for many reasons… a frustratingly large number of reasons. Some cats will posture to urinate in a normal way then will typically “bury” the urine spot afterwards. If this is on your floor, then they are probably just making the burying motion with their paws around the spot, but are not actually burying anything. The alternative to this would be marking or spraying, and they are doing just that, “marking” what belongs to them. When cats do this they typically have backed themselves up against a wall and spray urine on it while they are standing and their tail is straight up. This is most common in intact male cats, but neutered males and females will do it also. The very basic reason that cats will do each of these (with the exception of the intact male) is the same: the cat is displeased about something and is feeling stressed out. Remember dogs have owners, but cats have staff. And cats generally let you know when something is not to their liking.

      The first step is to make sure that there is not a medical reason for your cat to be urinating outside of the litterbox. Some medical conditions cause cats to urinate large amounts which can cause them to occasionally not make it back to the litterbox in time before they have to go. Alternatively, they can develop bladder inflammation or stones that cause them to have difficulty urinating or have painful urination. If this is the case, then a cat may have had a painful experience in the litterbox and then choose to avoid it in the future. The veterinarian will likely want to test your cat’s urine +/- blood and do some imaging of the bladder.

      If it is determined that your cat has no medical concerns, the next step is to make sure that the cat is happy with her litterbox. Litterboxes are not fun for pet owners to clean, but cleaning urine out of your carpet is much much worse. First of all there should be at least one litterbox in your house for every cat, and every litterbox should be scooped at least daily. Cats are very clean creatures, and a dirty litterbox can be off putting. Some cats prefer for the litterbox to be cleaned multiple times a day. Cats often also prefer litterboxes that aren’t covered and clumping litter. The box should be large enough for the cat to get in all the way, head to tail, comfortably. The litterbox should be in a place where there is some privacy and no loud noises that might startle the cat while they are using it, such as a washing machine or furnace. Inter-cat aggression can also be a reason that a cat may not be using a litterbox. Sometimes one cat will keep another cat from being able to get near the litterbox, another reason that it is important to have multiple boxes in your home. Remember that if anything negative happens within the box, that your cat will be more wary about using it in the future.

      But cats need more than a beautiful litterbox to be happy and mentally healthy. First of all, cats need somewhere to scratch. This is a natural behavior for a cat and they should be provided with an assortment of horizontal and vertical scratching opportunities. They need a place to rest where they feel safe. They need a cozy place in a back bedroom or den that they can relax and not be startled. Being high up makes cats feel safer as well, so having a perch for your cat can decrease stress, and some perches or resting places need to have a view outside. A view of the birds outside in the tree can be great entertainment, but your cat needs toys so they can play inside the house too. Playing with your cat is important to provide a chance for them to practice normal hunting behaviors, to provide your cat with exercise, and as a bonding opportunity between you and your cat. Some cats are very particular in the types of toys that they like to play with. Take the time to find out what they like.

      Next we need to make sure that your cat is not stressed by anything else in the home. Cats do not like changes in their lives, and any change such as a new animal, new baby, moving, or change in your work schedule can be extremely stressful. Try your best to make any of these changes slowly and try to keep the routine as normal as possible for your cat. For more ideas on any of these specific situations or anything about cat or dog emotional needs, please reference the website at the bottom of the page.
Finally some cats need a little extra help. Feliway is a product that is a synthetic version of the feline facial pheromone. This is what cats are spreading on the furniture when they rub their chins on it. It says to the cat that they are in a safe and familiar place. Feliway comes in sprays in diffusers. They can be located near litterboxes or in locations where a cat is marking. And some cats need oral anti-anxiety medication. Some anti-anxiety medications are very effective in decreasing marking behavior.

Please reference the website indoorpet.osu.edu for more information on making a happy and healthy home for your cat (or dog!)

Erin Clark, DVM

Emergency Preparedness for Pets

Medical emergencies can be terrifying, especially when the emergency involves your pet. Being prepared for an emergency ahead of time can not only make the situation less scary but can even improve your pet’s chances for making a full recovery. In some cases, being prepared can save precious time and mean the difference between life and death for your pet.

Every pet is different and you, as the owner, are in the best position to notice when something abnormal is going on with your pet. Signs that something is serious and your pet should be evaluated ASAP can range from vague signs (lethargy, inappetence, panting excessively) to more obvious signs (vomiting, diarrhea, seizures, collapse, trouble breathing, lameness, inability to stand, etc). If your pet is obviously sick, it should be evaluated by a veterinarian as soon as possible. There are some things that you can do to help make the process more efficient and to help your veterinarian provide the best care for your pet as quickly as possible.

When is an emergency really an emergency? When in doubt, call your primary care veterinarian or an emergency clinic if it is after hours. Veterinary clinics receive calls frequently from clients asking about whether the current clinical signs are enough to warrant an emergency trip to the veterinarian. The staff are usually very good at asking the right questions to determine whether your pet should be seen right away.

What can I do to be prepared?

Phone numbers! Keep the number and address for your pet’s primary care veterinarian and the emergency veterinary clinic in your area in an easily accessible place. If you do not know which emergency clinic to take your pet to, ask your veterinarian for a recommendation or go to the Veterinary Emergency and Critical Care Society website (www.veccs.org) and click on the directory link for emergency clinics. If you think your pet is sick, don’t wait to call! Waiting can lead to bigger problems, a more challenging disease or problem to treat and more expensive treatment. You should also keep the number for poison control with your list of emergency numbers. If your pet has ingested a potential toxin, call poison control before or when you arrive at your veterinarian’s office. It is usually less expensive for you to call poison control than if your veterinarian calls. When you call poison control, you will receive a case number. Give this number to the veterinarian seeing your pet. Your veterinarian will then be able to call poison control and discuss the case with a toxicologist without being charged another fee.

Medical record and current medications: Keep a copy of your pet’s medical record (including all bloodwork, test results, CDs with xrays, etc) on hand to bring with you. If your pet is seeing a veterinarian other than your regular veterinarian, it will be very helpful for the veterinarian evaluating your pet and preparing a treatment plan to have access to your pet’s previous medical records. You should also keep a list of all current medications, doses and frequency. This is very important information for your veterinarian to know so that they can make appropriate treatment decisions (some medications can cause serious side effects if used together!).

For further information on being prepared for pet emergencies, visit the following websites:
• American Animal Hospital Association (AAHA)/Healthy Pet: https://www.aaha.org/pet_owner/pet_health_library/general_health_care/default.aspx
• The University of Illinois College of Veterinary Medicine: http://vetmed.illinois.edu/petcolumns/petcols_article_page.php?OLDPETCOLID=530
• American Red Cross: http://www.redcross.org/prepare/disaster/pet-safety
• VeterinaryPartner.com: http://www.veterinarypartner.com/Content.plx?P=SRC&S=1&SourceID=20
• AVMA First Aid Tips for Pet Owners: https://www.avma.org/public/EmergencyCare/Pages/First-Aid-Tips-for-Pet-Owners.aspx

Renee Hartshorn, DVM

Why Does My Cat Scratch My Couch?

Most people know that cats will scratch objects with their front paws to sharpen their claws, but there are secondary reasons as well. Believe it or not, cats often use scratching for communication. They have scent glands on their paws, which leave their specific scent onto objects telling other cats they have claimed those objects as their own.

As a consequence, cats will scratch very obvious objects, such as couches, trees, doors, fence posts, etc. Both male and female cats will do this so it is not related to gender specific hormones. Therefore, spaying and neutering will not change the scratching behavior. Declawing will also not change the scratching behavior since the scent glands are still left behind on the feet so the drive to scent mark is still there.

Cats will also scratch as part of their play behavior, to stretch, to greet people, and occasionally to relieve frustration.
Overall, it is much easier trying to prevent problematic scratching behavior rather than trying to change a cat’s preference for a scratching surface. This means that owners should work hard to provide appropriate scratching surfaces as soon as they acquire a cat as a pet before problems arise to establish appropriate behavior. This will lead to a greater human-animal bond and reduce the likelihood of cats being relinquished to shelters.

General Recommendations
– Provide several scratching posts in multiple areas of the house where your cats like to spend their time (focus on areas where they sleep or play).
– Encourage cats to use the scratching surfaces by scenting them with catnip or placing dangly toys for them to play with easier.
– Try covering the inappropriate scratched surface with something cats do not like to scratch to try to deter them from further destroying that object (plastic, aluminum foil, mesh).
– Praise cats when they use the correct scratching substrates.
– Trim your cat’s nails regularly to minimize damage to your furniture.
– Declawing cats should be the last option.

Alex Philippine, DVM

Why does my vet have to do all that bloodwork

Bloodwork that we run here at Encina Veterinary Hospital falls into a few basic categories.

1) The CBC, or Complete Blood Count, measures the number, size, shape, and types of cells that are in the blood. The two main varieties of blood cells are the red blood cells and the white blood cells. The red blood cells are responsible for carrying oxygen to all of the body’s tissues. Assessing the red blood cells can tell us about diseases which cause acute or chronic blood loss, dehydration, destruction of red blood cells, or a decrease in production of red blood cells. Assessing the white blood cells tells us about infection, inflammation, clotting, and some cancers.
The veterinarian may also make a blood smear to get a closer look at the shape of cells which can be affected by various diseases or to confirm abnormal findings picked up by the CBC machine. The findings of the CBC are not always specific and must be interpreted in light of other diagnostics but it is a great place to start in order to be able to rule out broad categories of disease.

2) The blood chemistry and electrolytes are another component of basic bloodwork. This tells us about kidney and liver function, metabolic diseases, some cancers, endocrine diseases, gastrointestinal function, toxicities, and more.

“That’s all fine,” you say, “but why does Sadie need her blood checked when she just broke a nail?” Whenever we prescribe certain medications, such as an anti-inflammatory and pain medication in case of a broken nail, we have to keep in mind potential side effects and risks to the patient. Anti-inflammatories used in pets, such as Rimadyl, are generally very safe but can have rare and serious side effects involving the kidneys, liver, and gastrointestinal tract. When we prescribe Rimadyl we want to be sure that your pet does not have a condition that makes him or her more susceptible to these side effects so that a broken nail does not turn into kidney failure!

“Ok, but Rover just had bloodwork done a month ago, why are we repeating it?” Great question! Blood cell counts and chemistry can change day to day. If Rover is coming in to us with clinical signs which did not exist at the last visit, he may have significant changes in his bloodwork which will help us to diagnose his new illness.

“But Fluffy has never been sick in her life, why does my wellness appointment include bloodwork?” Our pets can’t tell us how they feel and often put on their bravest face for us, concealing chronic illness.

Annual bloodwork for them is like bloodwork every 7 or so years for us.

Early detection of certain chronic diseases such as kidney disease can help us take measures to slow their progression such as changing the diet of the pet.

Remember, if you have a question about why the veterinarian wants to perform a certain blood test, just ask! We would be happy to explain the reasoning and the risks we would be taking by not performing the bloodwork.

Dr. Alina Kelman

How to Administer Subcutaneous Fluids to Pet Cats or Dogs

Many medical conditions may require treatment with subcutaneous fluids. If your veterinarian has prescribed fluids to be administered to your pet under its skin (subcutaneously), this video will help you to set up your fluid bag and line, as well as how to administer the correct amount of fluids.

Keeping your Cat Healthy: Getting your Cat Comfortable with a Carrier

One challenge to providing adequate veterinary care for pet cats is the struggle to get cats to the veterinary office. Many times, a trip to the vet includes locating the pet cat under a bed, dragging them out, and stuffing them into a carrier for transport to the vet. Below is a video produced by the feline practitioners of the CATalyst Council. They suggest some useful techniques for making pet carriers more interesting to your pet cat. If your cat is interested in going into her carrier, your trip to the veterinarian will be much easier!

Click here to learn more about making your cat’s trip to the veterinarian easier.