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

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

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 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.

My Dog was Skunked! What to do…

Skunks produce an oily liquid that is yellow in color and produced by glands in the anal region. The skunks glands produce the liquid, which is stored in 2 sacs that each have a duct that exits at the 4 and 8 o’clock position around the anal opening. Dogs and cats have similar structures. Dogs and cats produce less pungent material that is thought to be used for marking territory, while skunks use their’s for defensive purposes. Each sac can hold about 1 teaspoon of liquid, which is enough for multiple sprays. The oily liquid is made up of multiple ingredients, most of which are sulfur-containing thiols that give the liquid its potent smell. It is thought that people can smell the liquid at concentrations as low as 10 parts per billion. As a result, it can be very difficult to completely remove skunk odor from a pet that has been sprayed by a skunk. If the animal is harmed in anyway during the encounter with a skunk, you should seek veterinary care.

Paul Krebaum’s home remedy for removal of skunk odor.
Tomato juice (with or without vinegar) used to be commonly advised to remove skunk odor, but it is relatively ineffective. The most common home remedy recommended for removal of skunk odor was developed by a chemist, Paul Krebaum. It involves a mixture of the following:

– 1 quart of 3% hydrogen peroxide (usually sold in pints, so 2 bottles needed)
– ¼ cup baking soda (Arm and Hammer is the most common brand)
– 1-2 tsp liquid hand soap (preferred brands are “Softsoap” and “Ivory Liquid”)

The ingredients should be mixed in an open plastic container with plastic utensils and then used immediately. An open container is important due to the amount of gas produced; while plastic is preferred as metal will encourage decomposition of the hydrogen peroxide. The solution can be diluted with 1 quart of lukewarm water for larger pets to help cover a wider area. The solution is placed on the animal while avoiding any exposure to the eyes, ears and mouth. A small strip of eye lubricant or few drops of mineral oil can be placed in the eye for protection. The solution should remain for at least five minutes prior to washing it off and can be repeated as necessary. Use of latex or rubber gloves and old clothing is recommended.

Paul Krebaum’s recipe works by focusing on the chemical nature of the thiols that create the skunk smell. Thiols are not water soluble even with soap. The soap serves to keep the coat wet and get the oily skunk spray into solution where it can react with the other ingredients. The baking soda facilitates the ability of hydrogen peroxide to alter the thiol through oxidation into a water-soluble form as a sulfonate for easy removal.

Commercial remedies for removal of skunk odor
If you are not inclined to try a home remedy for the skunk smell, numerous commercial products exist on the market that have had variable results. Nature’s Miracle skunk remover is one option. This product is thought to work by enzymatic breakdown of the thiols and works best when massaged into a dry coat and left for hours while it dries. Odor-Mute and Earth Friendly Products skunk odor remover are other products that are designed to work by enzymatic breakdown of the thiols. Skunk Off is another product for skunk odor remover that uses various non-enzymatic methods for odor control as described on the website.

There are a number of professional products that are available, that are better applied for environmental control in difficult situations. Products include Neutroleum Alpha, Freshwave, Epoleon and Nisus Bac-Azap. Information regarding these products and additional information regarding removal of skunk odor can be found through the University of Nebraska – Lincoln Extension, Institute of Agriculture and Natural Resources.

By Dr Stephen Atwater

The Impact of Stress on Indoor Pets

It has been well established that there is an important link between mental health and overall health and well-being of people. Avoiding stress plays a critical role in the general welfare of people. It should not be surprising that the same can be said for dogs and cats. Poor mental health in dogs and cats often lead to behavioral problems such as house soiling or aggression that may lead to animals being relinquished, abandoned, or euthanized. Although it may not be easily apparent, poor mental health can result in the development of disease conditions and a poor quality of life for the pet. Owners can best avoid problems by understanding the normal behavior and general needs of their dog and cat. In doing so, owners can provide the best preventative and therapeutic care for their pet.

General guidelines for the well being of indoor pets
An important need for the well being of children is a predictable daily routine, predictable consequences and environmental enrichment. When parents provide these things to their children, children are less likely to develop behavioral problems as they feel they have more control of their lives and circumstances. It should not come as a surprise that the same holds true for indoor pets. Daily routine for indoor pets include feeding, elimination, social play and environmental exploration, and sleep or periods of rest. These needs vary depending on the breed and age of the animal, as well as the household itself. By making these basic needs regular and predictable events, the indoor pet gains some sense of control and therefore less stress in knowing how these basic needs will be met.

The Indoor Pet Initiative
An excellent website on environmental issues for dogs and cats is available for veterinarians and pet owners, called the Indoor Pet Initiative . It was created by The Ohio State University’s College of Veterinary Medicine with the purpose of providing information that describes the basic physical and behavioral needs of dogs and cats. It also provides basic recommendations for dealing with common behavioral problems and resources for help in addressing more severe or dangerous behavioral issues. Being aware of and understanding normal companion animal behavior and needs will help improve the quality of life of your pet dog or cat. One of the main goals of the Indoor Pet Initiative is to improve the quality of life of indoor pets by increasing knowledge and awareness of normal companion animal behavior and needs.

Dr Stephen Atwater

Dr. Stepita’s Behavior Tip

Adding a New Pet to the Family
    When considering adding a new pet to your family I highly recommend researching which species and/or breed best match your lifestyle and family situation. Your veterinarian is a great resource! Drs. Lynette and Ben Hart have studied breed and gender differences among cats and the information can be found in their new book, Your Ideal Cat. Interested in the dog version? The original study which was performed in the 1980’s is called The Perfect Puppy: How to Choose Your Dog by Its Behavior….. Look out for the updated version of this book which should be published soon (FYI- the Hart’s found similar information in the new dog study as they did when they performed the original study, but the new book will include more breeds).

Here are a few pieces of information found in these studies:
1. Female dogs are easier to housetrain than males
2. Terriers rank high in snapping at children
3. Bengal cats rank high in aggression and urinating outside of the litterbox

Meredith Stepita, DVM, Dipl. ACVB

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Izzy is currently up for adoption through Community Concern for Cats in Walnut Creek. Izzy is a sweet kitty, great with other cats and dogs, and settles in very quickly. She also is fine with loud noises like a hair dryer, the vacuum, etc. And she likes to lick! She can be silly and loves to play with other kitties. (click image for larger size)

PET HOLIDAY SAFETY TIPS

While the holidays are a great time to decorate and celebrate with loved ones, our furry family members seem to be up to mischief. Here are a few things to be aware of this holiday season:

EMERGENCY VET We’re open 24 hours a day, 7 days a week – including all major holidays. Don’t hesitate to call us with your pet concerns at any hour of any day because we are always here for you: 925-937-5000

PLANTS Did you know holly, mistletoe, and poinsettia plants are poisonous to dogs or cats? If you normally use these plants to decorate your home, they should be kept in an area your pet cannot reach.

DECORATIONS Whether your decorations may be ornaments, or cranberry or popcorn strings — they are like time bombs waiting to happen. These goodies are just too enticing and your pet will surely tug at them, knocking down your wonderfully decorated spruce.

CANDLES Burning candles should be placed on high shelves or mantels, out of your pet’s way — there’s no telling where a wagging tail may end up. Homes with fireplaces should use screens to avoid accidental burns.

WIRES To prevent any accidental electrocutions, any exposed indoor or outdoor wires should be taped to the wall or the sides of the house.

GIFT WRAPPING When gift wrapping, be sure to keep your pet away. Wrapping paper, string, plastic, or cloth could cause intestinal blockages. Scissors are another hazard, and they should be kept off floors or low tables.