Archives for March 2012

Aggression Behavior in Cats and Dogs: What to Look For & What to Do

This week, we asked our newest addition to the practice, Board Certified Veterinary Behaviorist Dr. Neredith Stepita, to write a piece on pet aggression. She explains to us what some signs of aggression are, how to avoid aggression developing in your pets, reasons for aggressions and treatment. It’s important to know that aggression can develop at any time in your pet’s life. If your pet is experiencing aggression and/or other behavior problems, give us a call to schedule an appointment with Dr. Meredith Stepita to help you and your pet lead a happier and healthier life together: (925) 937-5000

    The most common problem I see in my dog and cat behavior practice is aggression. Aggression can be directed at other animals, people or objects (I.E. vehicles). In dogs aggression can include lunging, barking, growling, snarling, lip lifting, snapping and biting. Cats can sometimes show more subtle signs of aggression such as staring as well as more overt signs including hissing, scratching and biting. Most of the time aggression is a normal behavior (your dog growling is equivalent to you as a human raising your voice), but not acceptable in our human society.

    The most common reason for underlying aggression is fear. Other reasons may include territoriality, possessiveness (over a particular type of item such as food or a toy), hierarchical/ social status aggression between two animals, dominance, play aggression, medical or pain-induced, maternal and re-directed aggression (when aggression is directed not at the primary target, but a closer target or a target that interacts with the animal when they are in an aggressive state). In cats another form of aggression is called petting-induced aggression. It is important to determine the reason for the pet’s aggression in order to determine the most appropriate treatment plan.

    Aggression is usually not cured, rather it is a problem we manage to decrease the chance of the behavior occurring. Prevention of behavior problems, including aggression, is the best medicine and this is why we recommend socialization for puppies 8-16 weeks of age (a week after an initial parvo/distemper vaccination and deworming). Puppies should meet new people and healthy, vaccinated dogs on a daily basis during this time. They should be exposed to anything else they could encounter later in life (I.E. vacuums, stairs, rain, people in uniform, men with beards, etc) to help minimize the chance of fear and aggression later in life. It is important to take precautions and not take puppies to places highly trafficked by dogs of unknown health or vaccination status (I.E. parks, streets, dog parks or pet stores).

    The first step in treating aggression is having your pet examined by your primary care veterinarian, since any underlying medical problem can lead to irritability and aggression. It is also recommended to avoid all situations in which the pet is aggressive so they do not continue to practice the behavior and learn that it works. For example, if your dog looks out the window and barks and growls at strangers passing the house, then close the blinds or put up wallpaper for windows.

    Other behavior modification techniques will be prescribed based on the type of aggression and situations in which the aggression occurs. These techniques may include creating more structure and predictability for the pet, learning new commands such eye contact or hand target, in dogs introducing a head collar for better control and using pheromones (AdaptilTM for dogs and Feliway ® for cats). Often these steps are in preparation to begin a desensitization and counter-conditioning program, the primary technique we use to change your pet’s emotional response to triggers of fear and aggression. In addition, sometimes anti-anxiety medications are recommended; however medications are generally not a first line treatment and should not be used without concurrent behavior modification.

– Meredith Stepita, DVM, DACVB

A Thousand Thanks from New Mexico

Back in July of 2011, we received a phone call from a gentleman named Kyle who was looking to schedule an appointment for a rhinoscopy for his pooch. Everything seemed fine until he explained to us he is currently in New Mexico and lives there as well. Kyle was doing some online research on what could have been causing his pooch, Oakum, to sneeze excessively, when he came across a previous blog entry of ours on a patient named Ice Bear who had a foxtail or two lodged in his lungs. This story prompted Kyle to give us a call and schedule an appointment with our Board Certified Veterinary Surgeon Specialist, Dr. Carl Koehler to help figure out what was going on with his beloved dog, Oakum.

Below you will find the detailed recount of events that Kyle went through as a pet owner with a pet in distress; the moment of panic, the numerous veterinarians and the lengths we as pet owners go to for our pets.

    As we all know, our lives change day-to-day, and often are not even remotely predictable. Events occur in an instant that can completely alter the course and thrust the most well meaning and responsible travelers on that familiar road into a fork, and an unmarked one at that. Life doesn’t come with an ‘‘instruction manual’’, and choices have to be made daily, hourly, minutely, and even second by second. Any one choice can be the wrong choice, and the devil of it is, you almost never find out until it’s too late to select ‘‘reverse’’.

    Living with an animal companion can be a very worthwhile and rewarding experience. Unfortunately, every reward carries it’s own distinct and definite risk. Illness is a very powerful force against those of us who have the fortune to be alive, and just because we love someone or something very much, doesn’t always protect the subject of our respect and our well-wishes. Love can help a great deal, but modern medicine is the only real foe for illness. The claws of medicine are instruments, it’s gaze is one of knowledge. The skill and strategy of medicine lies in the learned, and articulation and agility is empowered and enforced by scholars. To have all four in one place is certainly remarkable, and that is exactly what I found at Encina Veterinary Hospital. I traveled over a thousand miles to challenge my expectations, and when I arrived, I found them distinctly defined, and most certainly exceeded. Quantity is almost never an acceptable substitute for quality, whether it is in a book or a play, in a relationship, or even with veterinarians, quality pays for itself.

    My limits of attention were tested one evening, as I went into the backyard to work on one of my many projects. My dog followed me outside into the yard with which I share with a neighbor, and although I had asked her to keep the gate latched and shut, one way or the other it was left open by mistake, and my dog quickly exited to her delight, as to prowl and ponder the neighbors bushes and lawn. It couldn’t have been more then a minute from when I walked outside and from when I decided that it would be a good idea to check that the yard was secure and everything was OK before I set to continue construction on my home air purifier project. I let the dog out several times a day, and I try to always check that the yard is secure, but it is easier said then done, because the yard is long and the gate is around a blind corner. The dog has gotten out before, for this very same reason, so I was well aware of the danger of the risk of my neighbor leaving the gate unlatched. I had drawn up plans for a supplementary positive latch for the gate, but soon became conditioned after finding the gate closed several hundred times in a row.

    I found the dog right outside, about 20 feet from the gate, and I was quite relieved that I had found her quickly. As I got closer however, something was immediately apparent. My dog was sneezing quite violently, which is something I wasn’t accustomed to. My dog Oak was standing smack in the center of a Foxtail weed thicket, and as I looked closely, I could see that one of the crisp, lightly colored seeds had entered her little black nose. I told her to stop sneezing (a lot of good that did…) and attempted to prise the seed free with one of my fingernails. I have plenty of tools, and I even carry a select general few with me (knife, disposable lighter, ball point pen), but in the short seconds I had to attempt to fasten onto the seed and recover it, my attempts proved vain, and quite hampered by the fact that the animal was having a sneezing fit, and with each sneeze, the seed traveled further and further into the nose. A few sneezes later, it was too late, the seed had entirely disappeared into her nose, and I had to make a decision about what to do next. With my dog continuing to sneeze, I became on the verge of a panic. I figured that the seed could most certainly lodge in the throat of my dog and prevent breathing, (something that may have been entirely incorrect), and feeling totally helpless, I decided to seek assistance at the local emergency clinic. I called on the way to the clinic and was greeted coolly and not-quite-so cordially. Upon arrival, I found only that my helplessness was furthered, after waiting 8 hours for my dog to be sedated and examined with only the short stub of an otoscope, which I could have likely produced myself in that amount of time, and with a far lesser charge. The clinic was dirty, it smelled bad, and the nurses assistant acted like she had gotten in to the medicine cabinet and gave herself a little ‘‘treatment’’. I didn’t have a good feeling, but I couldn’t just change the plan now and give up! Not surprisingly, no seed was located or recovered, and I found myself wondering what to do with the rest of my weekend. Over the course of the weekend my dog continued to sneeze, and so I brought her to my usual general veterinary practitioner. This time, we held Oak to a metal table and again the vet used an otoscope to observe the immediate area local to the opening of the nostril. With the same result of no seed being observed, I again began to wonder about what to do next, as the vet had instructed me to ‘‘wait and see what happens’’. Several days passed, and my dog continued to sneeze and choke, and she became more and more out of character, as she layed around and seemed to be in somewhat of an agony. In my spare time, I researched foxtail seeds and the prognosis. I found that generally, acute foxtail inhalation usually was treated as an emergency, and that it wasn’t so unusual for the seed to enter one of the lungs and cause pneumonia, or pass through the lungs into a blood vessel and end up in the heart or brain and cause death that way. The seed could of course just remain local, and cause infection to the sinus cavity, or it could be expelled or swallowed.

    I’m not the kind of person who just sits by idly, likes to be told what to do, or even does what other people think I should be doing! I just feel better making proactive decisions that change the course of my life the way I feel it should be going. I decided that I again would seek professional assistance to fight illness, and this time I would take the most decidedly extreme approach I could afford or even design. I find that usually if you throw everything you’ve got at a problem and give it your full attention, it has a tendency to wither and disappear, and quickly. I called Denver, Phoenix, Ft Collins, and Santa Fe. In addition, I called every clinic that anybody that had a recommendation had, and still I found that I was either treated queerly and coldly, I was never given a return call, or most importantly, the equipment to look inside of the nasal cavity was not available. I must have called over ten DVMs in all. The stand-out was Dr. Köhler at Encina. I found the clinic while researching. Not only did he actually call me back and took the time out of his busy schedule to answer every question I had (I had plenty), he recommended that I see somebody closer to New Mexico. That was the silver bullet. I knew that someone who would recommend another’s services instead of himself had indeed the character of true responsibility. I again called around Denver and was told that ‘‘no information can be given without an examination of the animal.’’ That’s a nice rule to follow, but rules aren’t always the most practical items.

    My friend helped me drive to make the appointment at 9:15 am in California. We left Albuquerque. at around 2pm and drove through the night to arrive at Encina Veterinary Hospital at 9:10 am. Driving is not the safest of tasks, and my friend and I took quite the risk doing it. If you have one problem, you will be stuck on the side of the road with a sick animal, possibly in severe desert heat. We had no major problems getting to the clinic, but that could have certainly been different. I did have mechanical trouble (wheel alignment) that prevented me from leaving San Fransisco immediately. So take this medicine with a pinched nose, and be sure to explore all the information you have before making a decision.

    Using fiber-optics, there was a determination made that irritation was most certainly present in the side of the nostril that I saw the seed enter. No seed was found however, which indicates that it had become mobile and exited the body or located itself in another part of the body. It could most definitely have been swallowed, and since the chest radiograms were clear, and Oak is no longer sneezing or showing any symptoms, I may never find the seed, and I hope I never do 🙂

A thousand thanks from New Mexico,
Kyle C.

Kyle has sent us an updated picture of Oakum and has shared with us that he has trained her to now respond to a hand-bell so she comes inside to a pleasant sound!

Self Medicating Pets At Home: A Big “No-No!”

As pet owners, we hate seeing our pets in any distress and want to come to their aid right away. Often we have clients ask us if they can give their pet some over-the-counter human medications (such as Tylenol, Ibuprofen, Pepto Bismol, Pepcid etc.) in the event that they cannot come to the veterinarian at that very moment; you know, something to “hold them over” as they say.

First and foremost we’d like to state that we do not suggest you give your pet any medication unless under the direct treatment of a veterinarian. Many times you may believe the ailment in your pet is one thing, but the doctor finds it to be another, and the medication you were self medicating with prior to diagnosis ended up being more harmful than helpful.

Here’s what you need to know about human OTC (over the counter) medications and pets:

Acetaminophen (Tylenol®) Acetaminophen is a big-fat NO when it comes to pets. Acetaminophen can destroy red blood cells in pets and cause them to be anemic, as well as severe irreversible liver damage, and may lead to death if untreated. Acetaminophen is also more toxic to dogs and cats than people due to extensive recirculation of the drug within the blood.

Ibuprofen (Advil®, Motrin®) Ibuprofen has been used in dogs as an analgesic or to reduce a fever, only when directly under the care of a veterinarian. Dogs often can be allergic to ibuprofen, so it’s important that you don’t give this drug at home because you risk your dog developing an allergic reaction which may constrict his or her airway and eventually lead to a fatality. In addition, ibuprofen can be more toxic to dogs and cats than people due to extensive recirculation of the drug within the blood. It can also be linked with kidney failure and gastric ulcers. When it comes to dogs, ibuprofen is not used to treat pain or arthritis. When it comes to cats, there’s a big “no-no”; cats are never ever to receive ibuprofen under any conditions.

Bismuth Subsalicylate (Pepto-Bismol®, Kaopectate®) Bismuth Subsalicylate is used to treat mild diarrhea and stomach inflammation in dogs under the care of a veterinarian. It often leaves the stool a very dark color which should not be alarming. There are no serious complications caused by giving Pepto-Bismol to dogs, although there is not complete agreement that it is helpful either. It is important to know that Pepto-Bismol contains aspirin so it should not be used in dogs that are sensitive to aspirin, those with a history of GI ulcers or bleeding disorders; to do so could cause a fatal bleeding episode. When it comes to cats, it’s best to steer clear because they are more susceptible to suffering from a fatal toxicity.

Famotidine (Pepcid®) Famotidine is used in the treatment and prevention of stomach (gastric) and intestinal ulcers. Another use is management of acid reflux disease )a condition similar to “heartburn” in people) and caused by movement of stomach acid into the lower part of the esophagus. Dogs and cats with mast cell tumors may be treated with famotidine or a related drug because these tumors can produce large amounts of histamine. While generally safe and effective when prescribed by a veterinarian, famotidine can cause side effects in some animals, such as an allergic reaction. Medication should never be dispensed without the direct care of a treating veterinarian. This medication should not be used on patients suffering from kidney or liver disease.

Tums® In veterinary medicine, Tums can be used as a calcium supplement for dogs. A blood panel should be done on your pet before giving him or her Tums as it may not be good for them. An overdose on Tums can cause gastrointestinal upset, diarrhea and constipation.

Pseudoephedrine (Sudafed®) Pseudoephedrine causes increased heart rate and blood pressure, and should never be given to dogs.

Diphenhydramine (Benadryl®) Diphenhydramine is often used to treat allergic reactions in humans and pets. Diphenhydramine is a great emergency drug for allergic reactions related to insect bites and stings. Relatively safe, diphenhydramine is administered at the first sign of an allergic reaction in pets, children and adults, when bit by an insect or stung. Although it is relatively safe, diphenhydramine is not for every pet. Patients with glaucoma, prostatic disease, cardiovascular disease, and hyperthyroid, among other conditions, should generally avoid diphenhydramine.

Loperamide (Imodium®) Often used to treat diarrhea but can cause vomiting or abdominal cramping at lower doses, which can lead to dehydration. High doses can cause neurological signs like depression and ataxia in pets. Some dogs have a genetic sensitivity to the drug (same gene as Ivermectin sensitivity), and will show neurological signs even at low doses. It’s best you don’t give this one at home and contact your veterinarian when your pet has an upset stomach instead.

Give us a call at (925) 937-5000 immediately if you suspect that your pet has ate any medication, since some poisonings require antidotes or supportive treatment.

Always discuss with your veterinarian before “self-medicating” your pet for any condition.

Bernie: A Golden Story of Triumph

Below you will find a blog piece written by one of our former Doctor Assistants, Ashley. While with us, Ashley had the privilege of meeting and working with “Bernie,” a patient of ours who continues to amaze us each and every time we see him. Through out all of his ailments in 2011, Bernie continued to be a burst of positivity for us and we’re grateful he’s doing so much better, thanks to his doting father, Forrest.

    I originally met Bernie the golden retriever a few years ago during an annual exam. I was immediately taken by two things, 1) Bernie’s exuberant personality (he was all wags and barks) and 2) how much his parents cared for him. My coworkers and I became steadfast fans of Bernie’s infectious outgoing energy, so you can imagine our dismay when our lovable golden friend’s health began to fail two winters ago. It began with a diagnosis of diabetes in early December of 2010. Bernie mysteriously stopped eating, a sure sign in most retrievers that something has gone awry. Dr. Peter Nurre started Bernie on Humulin insulin. Soon after his change in medication, Bernie came in feeling crummy, and Dr. Roger Johnson performed an abdominal ultrasound on Bernie to find that he had an infection in his abdomen. Surgery was necessary to search for the source of infection, which is typically a perforation (hole) somewhere within the bowel, but in Bernie’s case the source of infection was not a perforated bowel, and remained a mystery. Dr. Johnson cleaned the infection out of the abdomen as best he could and stitched Bernie back up.

    After surgery Bernie’s troubles were not over, as he had several mysterious post-operative infections in spite of being treated with a battery of antibiotics. Soon after surgery Bernie went blind from cataracts, a common problem for diabetics, but had lost so much weight that the corrective surgery could not be performed as a result of the fact that his eyes were sunken into his skull so much. When I caught up with Bernie in February of 2011 I was shocked to see that he had dropped from a robust 80 pounds down to a paltry 55 pounds. His tail still wagged, but he was so thin he was nearly unrecognizable. It is hard to admit, but I was starting to lose hope for my furry friend. However, Bernie’s dad Forrest was vigilant during the whole process. Utilizing the latest in iPad applications and spreadsheets to track Bernie’s blood glucose and insulin doses, Forrest communicated regularly with Dr. Johnson via e-mail in hopes of controlling the diabetes.

    Bernie’s health seemed to decline even further when his jaw seemed to stop working in March of 2011, as he was diagnosed with a condition known as trigeminal neuritis by Dr. Filippo Adamo, our neurologist. This rare condition effects the nerves that wrap around the face, which control the ability of the jaw to open and close normally as well as the blinking reflex of the eyes. The symptom Bernie experienced was that of a “dropped jaw,” in which the jaw cannot close properly. Forrest had to hand feed and water Bernie for six weeks until the condition spontaneously resolved. During Bernie’s bout with trigeminal neuritis he would often bleed profusely from his mouth because when he would drink water, he would take in such large amounts that he would rupture blood vessels near the back of his tongue.

    After the trigeminal neuritis resolved Bernie began to gain weight again, and he was able to have cataract surgery in June of 2011. Bernie’s parents were thrilled when he regained his sight the same day as the surgery, and according to Forrest, the golden retriever’s happiness returned with his vision. Forrest noted the intense eye medication regimen that followed surgery, but Bernie’s renewed sense of self made the process worthwhile. Bernie’s eating stabilized, and in July of 2011 Dr. Johnson wrote the phrase, “getting fat! :)” in his chart.

    I caught Bernie and Forrest in the clinic a few months ago during a recheck visit to see Dr. Johnson, and I was thrilled when Bernie barked at me for attention as Forrest was showing me the latest blood glucose monitoring applications on his iPad. He looked like his normal Bernie self, and his wagging tail never stopped moving the whole time I was in the room. Dr. Johnson found some discrepancies within Bernie’s blood work recently (high tryglycerides and evidence of blood proteins), and he has since began a medication regimen to treat those conditions. Clinically, Bernie looked fabulous! I am happy to report that this past December the ten year old golden is once again at his fighting weight of 77.5 pounds. Dr. Johnson and the staff at Encina would like to commend Forrest for his vigilance in monitoring and caring for Bernie.

Please follow Bernie on Twitter @BernieLitke

A special thanks to Bernie’s dedicated father, Forrest Litke, for his contribution of information and pictures to this blog, and for allowing us to share Bernie’s story with everyone!