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:

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 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

Importance of Annual Exams for Dogs and Cats

Annual exams are important part of veterinary medicine, in part due to the fact that they provide a veterinarian with incite into how your pet has been doing since its last visit, they address and treat certain problems or conditions that may be going on with your pet presently, and they can provide your animal with preventative measures such as vaccinations and medications that are important factors at preventing the spread of diseases not only to your animal, but also to prevent the spread of disease to other animals that your animal may come in contact with — including yourself.

During the annual exam, a veterinarian will ask certain questions about your pet’s history in order to see how your pet has been doing since its last visit. Some questions may be geared toward problems that have been going on, while some other questions may be directed toward finding out the answer to a specific problem(s) that may have been occurring recently or in the past. By asking these questions, it allows a veterinarian to gain knowledge about an animal’s overall health and about the management of certain diseases or problems that an animal may have. It also allows the owner to ask questions to a veterinarian about concerns or problems that they may with their pets at home over the past year.

After the history of a pet has been taken and the owner’s questions have been answered, a veterinarian will perform a physical examination in order to help determine the current health of an animal. A good physical examination will take a look at different parts of your animal’s body to determine if any disease is present. For example, a veterinarian may listen to the heart to determine if there is evidence of any heart disease and he or she may palpate the animal’s belly in order to determine if any abnormalities are present within the internal organs. There are many organ systems that can have disease present and that the owner may not be aware of these problems being present until a complete and through all physical examination is performed by a veterinarian. This is one of the reasons why annual exams are extremely important to have performed consistently, so that problems associated with certain organ system can be caught early and be addressed through diagnostics and/or treatment.

In addition to the physical examination, a veterinarian may ask an owner to have annual blood work and urinalysis performed in order to screen for certain diseases. Blood work and urine screening allow the veterinarian to look at how certain organ systems are functioning on a physiological manner and to see if any changes in the blood work or urine could indicate disease. Animals can appear overtly healthy on the outside, but physiologically they can have disease present. This is why it is important and recommended by veterinarians to have these tests performed on a yearly basis.

After the physical exam and diagnostic tests have been performed, preventative measures such as flea/tick control, teeth brushing/cleaning, hair coat maintenance, and/or vaccinations can be discussed by a veterinarian. These preventative measures are extremely important in veterinary medicine because they help to prevent the spread of disease not only in the animal they are examining, but also help to prevent the spread of diseases to the community of animals or humans that the animal lives in. Without these preventative measures in place, more diseases would be prevalent than they are today. This is why it is important to vaccinate pets yearly and to use preventative medications monthly in order to help control the spread of infectious diseases within a community.

Therefore, in order to ensure the health of our pets and of the community with which they live in, annual exams should be performed to not only to prevent the spread of diseases through vaccinations and medications, but also to evaluate, address, and treat certain diseases that could be present within our pets. Early screening for any disease can help to monitor an animal’s overall health and if a disease is caught early, it can decrease the impact that it may have on animal’s future lifespan.
If you have not gotten your pet’s annual exam performed this year, please schedule an appointment to have them looked at to ensure that they are feeling at their best, to screen them for any diseases, and to ensure that they can be protected against diseases that they may come in contact with in the future.

Jonathan MacStay, DVM

Annually Awesome

Going to the vet doesn't have to be a hair-raising experience!

Summer is fast approaching, and with a little more daylight, and much better weather, this is a perfect time of the year to bring your dog or cat in to see us for an annual exam (especially if it has been awhile since your pet has seen a vet). Even if your pet’s health is stellar, annual exams are recommended for a myriad of reasons, including:

1) Prevention and early detection are the most cost effective ways to maintain your pet’s health (“An ounce of prevention is worth a pound of cure”)

2) Some vaccines must be administered annually, such as bordetella (kennel cough), and lepto, among others. Also, dogs and cats need boosters one year after their last set of puppy or kitten vaccines, and rescued animals need boosters one year after their initial vaccines (usually around one year after adoption, your adoption paperwork should state when they are next due for all vaccines).

3) Pets age much more rapidly than humans, and may experience dramatic shifts in health between exams that should be monitored by a veterinarian.

4) In order for us to legally refill prescriptions, your pet must have been seen by a veterinarian within the last year. This helps us ensure that your pet is on the proper medication at the appropriate dose for their current state of health. Some medications such as antibiotics and steroids may require more frequent check-ups.

5) Yearly screenings (heartworm tests, fecal exams, and other bloodwork) can help diagnose conditions of varied magnitude before your pet has any symptoms. Recently, Dr. Johnson recommended an abdominal ultrasound for a senior boxer during a routine physical. The ultrasound revealed a cancerous mass on the dog’s spleen, and she was able to undergo a life-saving splenectomy the following week.

The above handful of reasons to never become a stranger to Encina are only scratching surface as to why annual exams have become de rigueur in veterinary medicine. Why do we really want you to come in? Because it is our job to enhance the lives of your pets by being guardians of their health. We also enjoy cultivating the relationships that we have with you, our clients. I cannot tell you how many times a conversation with a pet parent about their “baby” has buoyed the spirits of my coworkers or myself. We enjoy bringing you the best veterinary care possible, and the environment at Encina definitely lends itself to providing you just that. Every doctor that gives your pet a once over has the ability to confer immediately with our specialists should they feel they need input on a case. For example, if Dr. Jurewicz (one of our general practice doctors) hears a murmur while listening to your puppy’s heart, she can have Dr. Wang (our Internal Medicine resident) take a listen in the treatment room to confirm her finding, for no additional fee. Conversely, if Dr. Christofferson (another of our general practice doctors) notices that your cat has balance issues, she can easily consult with Dr. Adamo (our neurologist) to see if he notices the same deficits in coordination. In addition to our unique collectivist approach to medicine, our doctors are backed by the latest and greatest surgical and diagnostic tools, such as a digital x-ray machine, ultrasound machines, endoscopy/laparoscopy equipment, and a CT scanner.

We hope to see you around these parts soon! We have appointments available from 8a to 8p Monday-Friday, and from 8a to 12n on Saturdays. Please call (925)937-5000 to set up an annual exam for your pet today. You can e-mail encina@encinavet.com with questions 24 hours a day.