Archives for November 2011

Procedure Day Play-By-Play

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.

Thanksgiving Safety Tips for Pet Owners

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.

Sophie’s Story, An Addisonian Crisis Averted

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

No Dog Should Put Baby In A Corner

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.

EVH’s 2011 Halloween Costume Contest Winners!!!

Announcing the Winners of our Staff Pet Halloween Costume Contest, 2011!!!

The competition was fierce for this year’s annual Encina Staff Pet Costume Contest, and though it was hard to choose, both employees and clients voted and winners have been chosen!

FACEBOOK FAN FAVORITE “Stupid” of Barbie (Doctor’s Assistant), Jedi

CLIENT FAVORITE “Loki” of Sarah S. (Patient Care), Cowboy

FUNNIEST (and MOST TORTURED PET)“Chloe” of Shannon P. (Client Services), Mermaid

MOST CREATIVE “Larry” of Ashley (Doctor’s Assistant, Blogger), as Prince Larry

CUTEST “Willow” of Meg and Lisa (both Patient Care), Butterfly

OVERALL FAVORITE “Banana” of Giselle (Client Services), as a Banana

HONORABLE MENTION “Leila” of Rebecca S. (Patient Care), Boxer

MOST VOTES OVERALL
“Toby” of Angela (Administrator), Pirate

Congratulations to this year’s winners! I know that Larry will enjoy his gourmet canned crickets! To see all of our contestants, please visit our Facebook page at facebook.com/encinavet!

October Food Drive


As you may remember, we had a food drive here at Encina Veterinary Hospital for the month of October where everyone (staff and clients!) brought in dry goods to donate to families in our county who may not be able to afford food this holiday season.

Together we raised a total of 104 POUNDS of food for the Food Bank of Contra Costa County!!

THANK YOU!!!!

If you missed out on donating and would like to, please visit their website to see how YOU can make a difference in a family’s life this holiday season.

Food Bank of Contra Costa County’s Website

Introducing … Hospice & In-Home Care!

Today being National Pet Hospice Day, we felt it would be appropriate to announce Encina’s newest service: Hospice and In Home Care!

The focus of our pet hospice program is to make a pet’s last stage of life more pleasant with the proper use of pain medications, dietary strategies and veterinary care provided by our registered veterinary technician, Barbara. The goal of pet hospice is not to cure your pet’s illness but rather to ensure a peaceful end-of-life experience. Alongside your veterinarian here at Encina, Barbara will work closely with you and your pet to decide what is best for your beloved pet in the comfort of your own home.

Our in-home care is geared towards pets who aren’t terminal, but need some assistance at home. Your pet may be recuperating from surgery, recently paralyzed or need at home fluids/injections; these are a few of the reasons why one might elect in-home care.

You can read more about our hospice program by clicking here.