Archives for November 2012

Euthanizing a Beloved Family Pet

      Euthanasia is a topic that many pet owners face as their animals get sick, injured, or near old age. The decision of whether or not to have your pet euthanized is a very personal one that must involve you, your family, your pet, and your veterinarian.

       Knowing when it is time to have a pet put to sleep is one of the most difficult aspects of the decision. No one wants to end their pet’s life too early, but many struggle to find the “right” time. When guiding clients in the decision-making process, I often have them think about their pet’s quality of life. Some things to consider are: is your pet in pain? Can your pet move around comfortably? Can your pet eat and drink? Does your pet still enjoy some of his or her favorite things like a special toy? When owners break down their pet’s life into smaller pieces, the choice sometimes becomes clear.

      No matter how sure an owner may be that it is the right time, putting a pet to sleep is a very emotional experience. It is helpful to be well informed about what to expect as there are a few decisions that need to be made regarding the euthanasia. Your veterinarian can guide you through the process and choices, but here I will describe some things you and your pet may experience.

      The first decision you’ll need to make is whether or not you and your family want to be present for the euthanasia. If you are present, an intravenous catheter is typically placed in your pet’s leg to allow the doctor to have access to their vein. Your pet may be taken away from you for this process – do not fret! The technicians that put in catheters are very skilled and the process is usually much quicker when a pet is away from their owner and not distracted. After the catheter, you can spend as much time with your pet as you would like. When you are ready, the doctor will come into the room and perform the euthanasia. Sometimes, a pet may be sedated prior to the final injection and this is a case-dependent procedure. The final injection is an overdose of an anesthetic that causes your pet’s heart, lungs, and brain to stop. It is a very peaceful process, they will feel no pain, and they will just fall gently to sleep. Some things you may see during the injection include your pet looking around and possible vocalizations. These are side effects of the anesthetic and rest assured that your pet is not in pain, they may just feel a little strange from the drug. After the injection, you may see muscle movements and your pet may take a few breaths. These are the final nerve firings and muscle spasms and occur after your pet has already passed away. Finally, they may go to the bathroom because they are relaxed and often times their eyes will not close. If you decide not to be present for the euthanasia, there will be loving people surrounding your pet, talking to them and petting them while they pass away. You can visit with your pet for as long as you would like, before and after the euthanasia.

      Another decision you will need to make is what to do with your pet’s remains. Taking them home for burial may be an option if you have a yard. Another option that many veterinary hospitals offer is cremation – ask your veterinarian about specific details.
      Euthanasia is a difficult topic to think about, but the ability to end suffering for your beloved companion can be a priceless gift. If you have questions about your pet or euthanasia, please give us a call: (925) 937-5000

Kerry Thode, DVM

Does Your Dog or Cat Suffer From Allergies?

Allergies in dogs and cats can be one of the most aggravating and frustrating experiences possible, for the pet, the owner and even the veterinarian. Often times, it is difficult to find the exact reason as to why your pet is itchy or has allergies, and can be even more difficult to keep allergies under control.

Severe pruritus (itching) in pets can be broken down into a couple of basic categories as to their cause. Most of the time allergies, parasites that live on the skin, or a combination of both are the main contributing factors.

Allergies can include:
      1. Atopic dermatitis: development of an allergic reaction over time to something that is normally benign, such as pollen or dust. Certain breeds can be at higher risk for developing atopic dermatitis.
      2. Food allergies: development of an allergic reaction to certain ingredients in the diet. The most common food allergies developed are towards beef, poultry, corn, wheat and dairy products.

External factors on the skin include:
      1. Fleas: fleas can cause severe itching in dogs and especially in cats. As few as one or two bites in cats can cause a bad reaction.
      2. Bacteria / yeast infections: these are typically secondary infections that can add to underlying problems. Yeast infections, particularly those caused by Malassezia, can be terribly pruritic.

Flea dermatitis in a cat
Unlike in humans, where we typically see allergies manifested as itchy eyes, a runny nose or sneezing, our pets usually show their problems through their skin. This can include red / irritated skin, hair loss from scratching so much, ear infections, and of course, pruritus.
How do we determine why our pet is so pruritic? First, we make sure that they are on an appropriate flea control product. Proper flea control is important to help rule out one of the main factors listed above. Once we know that fleas are not a problem, but pruritus is still present, then we continue to look for the underlying problem.

Atopic dermatitis in dogs
For bacteria or yeast infections, medication is usually the first choice for control. Sometimes, if there is atopic dermatitis or a food allergy present, these external infections may occur over and over again, and will not be able to be easily controlled until the underlying problem is addressed first.
Determining if your pet has a food allergy, and to what food, can take a long time. Patients typically go on a food trial that lasts for 8-12 weeks minimum. A single, “novel” protein diet, such as duck, bison or venison based (a type of meat that your pet has never had before) is used. Once the pruritus is under control with the new diet, other ingredients are gradually added in. This way, we can determine exactly what food ingredient your pet is allergic to, and can then avoid it in the future.
For atopic dermatitis, the exact known cause can be difficult to determine. Ruling out all other causes for pruritus must be done first. Sometimes it is necessary to perform an intradermal skin test, where a very small amount of many different types of allergens, such as weeds, pollens, and grasses, are injected into the skin. We then look for a reaction to the allergen, and can determine what that allergen is and how to avoid it. Sometimes medication is required: in an oral form, topical, or a combination of both. The idea is to keep your pet as comfortable as possible and on as little medication as possible.

Controlling allergies and pruritus can take a lot of dedication on the owner’s part. In following an appropriate plan by your veterinarian, the lives of both you and your pet can be made much more comfortable. No one wants to be awakened every night to the sound of their poor pet constantly scratching. Taking control of allergies can take a long time, and sometimes there are relapses. Just remember to follow the advice of your veterinarian, and in the end, it will all be worth it, for you and your pet.

Byron Bowers, DVM

Lymphoma in Dogs and Cats

Lymphoma is a very common form of cancer seen in dogs and cats. It arises from the abnormal proliferation of lymphocytes (a type of white blood cell) within different tissues around the body. Lymphoma most commonly occurs in the lymph nodes, the spleen, and the liver, but the disease can involve almost any tissue in the body, which makes the presentation and course of the disease extremely variable.

Lymphoma is most commonly seen in middle-aged dogs and certain breeds are also predisposed to it, such as boxers and golden retrievers. Most dogs who develop lymphoma get a formed called “multicentric” in which several of the lymph nodes become enlarged. Lymphoma will also commonly affect the intestinal tract, liver, spleen, chest, and the skin.

Signs of lymphoma are extremely variable due to the disease’s ability to affect so many different locations around the body. The most common sign is lymph node enlargement, which may feel like lumps growing below the skin. This is often the only sign present, but some animals with lymphoma can also develop weight loss, lethargy, decreased appetite, vomiting, diarrhea, increased drinking/urination, skin lesions, difficulty breathing, facial swelling, or any combination of these signs.

The diagnosis of lymphoma depends on it’s location but it is most often diagnosed by aspirating cells from the affected organs (lymph nodes, spleen, liver) with a small needle and examining the cells under a microscope. In some cases a biopsy is required to make a diagnosis. Based on aspiration or biopsy results the “grade” of the cancer can also be determined, as well as the cell type present (T-cell versus B-cell lymphoma), both of which help us estimate a prognosis for the disease.

Lymphoma is very serious disease and will almost always claim an animal’s life eventually, however with treatment dogs and cats can life a relatively long period of time, with a high quality of life, doing all the normal things that they love. Without treatment the prognosis is only 1-2 months, with treatment the prognosis depends on the type of lymphoma present and the treatment protocol followed. Treatment for lymphoma is individually tailored to each animal, as well as the time and financial constraints of their owner. Chemotherapy in dogs and cats is usually far better tolerated than in people. We use lower doses, in order to maintain quality of life during treatment, and most animals will have minimal side effects.

In general, the treatment protocols for lymphoma that provide the best survival times and the best chance of putting an animal’s disease into remission are multi-drug protocols. With these protocols animals will generally be given a different chemotherapeutic drug every 1-2 weeks for 6 months or longer. Other treatment options include single drug chemotherapy protocols or treatment with steroids alone. These options are less costly than multi-drug protocols but generally the remission times and survival times are not as long.

We understand how scary it is to have a family pet diagnosed with a cancer such as lymphoma, however by working with your veterinarian and local veterinary oncologist lymphoma can be managed to allow you to spend the most quality time possible with your pet.

Trevor Miller, DVM

Beyond Separation Anxiety: Part 2, Confinement Anxiety and Barrier Frustration

One of the first natural thoughts that crosses the minds of most people with a dog may cause destruction around the house is to confine the dog to a crate. Unfortunately, most of my patients with separation anxiety DO NOT improve when placed in a crate and often have concurrent confinement anxiety. They pant, salivate, whine, howl, bark, urinate, defecate, and/or are destructive when confined. They sometimes even hurt themselves, breaking teeth and cutting their skin trying to escape. What constitutes confinement? You must ask each individual dog as confinement can mean a small crate or even a room.

The first step in differentiating confinement anxiety from separation anxiety is to video tape the dog home alone OUTSIDE of the crate, loose or confined to part of the house. Often confinement anxiety alone is an easy fix as they are calm when left outside of the crate. If the dog must be crated (ie at a dog show) the crate should slowly be re-introduced using a desensitization and counter-conditioning protocol prescribed by your veterinarian. This is the primary technique we use to change your pets’ emotional response to triggers of fear. Desensitization is exposing the dog to their trigger for fear (ie being in the crate) at so low of an intensity that they are calm and relaxed, and slowly increasing the gradient of the trigger, staying below their threshold for displaying fearful behaviors. For example, starting the exercise with the dog near the crate and gradually working up to them being inside the crate, first for a short period of time and then longer amounts of time. Counter-conditioning is the process of changing their emotional response to the fear-elicit trigger, usually using a high value food reward.

Barrier frustration can look very similar to anxiety (barking, whining, howling, and/or destruction) although the dog is not actually anxious. This occurs when the dog is separated from a person by a barrier (ie door, window) and calm when the owner is out of sight and hearing range. In this case we would use desensitization along with counter-commanding. Counter-conditioning is different from counter-commanding in that with the latter we are not changing the dogs’ emotional response, but rather rewarding them for a behavior that is incompatible with the negative behavior we are trying to eliminate.

Meredith Stepita, DVM, ACVB

If your dog is suffering from anxiety and you would like to get them the care they need, please contact the only specialty veterinary behaviorist in Contra Costa County Dr. Meredith Stepita to schedule an appointment at Encina Veterinary Hospital in Walnut Creek: (925) 937-5000