Here’s an article from the Freep that talks about how much pet owners are spending on their pets. There’s a neat breakdown on the different areas of spending. I’m happy to see that the two most important things are food and veterinary care — right where it should be! 🙂 Owners are making healthier choices in foods and care, which is great.
Two weeks ago I was in Boston for some family business. I took part of a day to visit the New England Aquarium. It was pretty impressive! The center of the facility was a multiple-story coral reef. There was a spiral ramp around it that let you walk from bottom to top. The reef was teeming with life. Very cool. Around the spiral ramp the rest of the building housed regional tanks with salt and freshwater species from around the world.
Of course, I took a ton of photos. Here are a few:
Today’s link is a short article that talks about the importance of an annual vet visit for cats. While just about all vets will acknowledge that cats can be very difficult for everyone involved, we all feel that the benefits outweigh the trouble. There’s some good advice on making the trip better in the article, too.
Science is a funny thing sometimes. We get excited about being wrong just as much as being right. The way we study things allows us to gather good, helpful data from something that doesn’t work or isn’t how we thought it was.
Rather than repeat the entire article I want to share this week, I’ll start by saying that it’s about a recent discovery in the canine eye. It has implications for human health, and it causes doubt in our belief that dogs don’t have very sharp vision. It caught my attention because we’d talked about and given examples of how dogs and cats see the world. Turns out that it may not be entirely correct!
Here’s a labeled diagram of an eye to help you with some of the anatomy mentioned in the article.
This week’s news article comes from the Detroit Zoo. The head veterinarian, Ann Duncan, cares for the zoo’s residents. One of the biggest jobs she has is to keep an eye on the heart health of the gorillas. Heart disease is a major concern for captive gorillas, so the zoo has worked on training the animals to have their hearts looked at via ultrasound. All of this is done without anesthesia — no darts, no drugs, just training!
Great article here:
LOS ANGELES (AP) — The next time you start shaking your finger and shouting “Shame on you!” because your dog chewed up your favorite fuzzy slippers, just remember that no matter how guilty your dog looks, it doesn’t know what your rant is about. Behaviorists insist dogs lack shame. The guilty look — head cowered, ears back, eyes droopy — is a reaction to the tantrum you are throwing now over the damage they did hours earlier. “Just get over it and remind yourself not to put temptation in the way next time,” said Dr. Bonnie Beaver, a professor at Texas A&M University’s College of Veterinary Medicine and executive director of the American College of Veterinary Behaviorists.
Also, no post on Sunday. I’ll be out of town for a few days. Stay warm!
Most of us would happily win a contest, lottery, or competition. I’ve never heard anyone regret a big win at a casino. Enjoying the benefits of a bit of fickle luck gives us a rush, too. That feeling you get when your chair -almost- but doesn’t quite tip over? That’s a win. The human mind loves to play the odds. Some of us are downright addicted to the gamble because of the potential payoff. Adrenaline junkies, don’t think you’re above the game. There’s a chance that parachute won’t open, isn’t there?
There are times that the odds are exactly what you want to put you on the losing end, though. When we’re talking about your chances of illness and injury, you’re hoping that you’re not that one in a thousand, ten thousand, or million. Winning a bout of the flu is one thing. Winning cancer is a whole separate kind of problem.
It’s not all that fair for me to bring up “The Big C” as an example. Yes, it does give us a clear statement of our chances. It also helps us identify risk factors so we can avoid the “win.” Cancer is so scary and close to home, though, that I think we’ll get bogged down in just the numbers instead of the big picture.
Better examples comes up when we talk about the generalities faced by pet owners every day. Should you vaccinate for a given disease? Should you use heartworm and flea/tick prevention? Should you allow your pet to go under anesthesia?
The art of practicing medicine teaches us to avoid promises and to keep to conservative estimates whenever possible. We hate to promise and under-deliver. I do, at least. It’s important to me to lay out the pros, cons, and possible consequences of our decisions. Owners need to participate in this risk assessment, but they’re at a disadvantage. More than one, really. You’ve not had the training we’ve had. You’ve not had the benefit of years of experience and thousands of cases to draw upon. We’re at a disadvantage because we simply don’t know your pet as well as you do. (Granted, I’m generalizing here against my own better judgement. Clearly we can sometimes see things that owners don’t. The reverse can also be true.)
Vets and owners usually develop rapport and can work together to help pets. We’ve got the same goals in mind, after all. There will occasionally be differences of opinion. Ultimately, all I really need is for owners to make an informed decision. I’m far more adamant when I have to advocate for a pet’s quality of life, but I can acknowledge the fact that some owners simply can’t do everything on the “Should Do” list. That’s when we optimize the “Can Do” list and move forward. Guilt, yelling, browbeating, hard sales… just not my style.
There’s a group that I need to bring into the discussion at this point: breeders. It’s a dangerous thing for me to do. I’m going to admit that I’m biased. Consider it a disclosure rather than a conflict of interest. I’ve never been a breeder. I’ve worked with many by way of my profession. Many breeders have not been vets, nor any type of veterinary professionals. What I can speak of is my own perception of the situations as I’ve encountered them.
Breeders have the benefit of having worked with their chosen breeds for a long while. They have lots of contacts in their interest group, too, which is a good thing. On the other hand, they don’t have the benefit of large, well-organized research studies to back up some of their claims.
Vets have the benefit of a lot of hard science and training. We also have the experience of working with LOTS of dogs and cats. Balancing that is the fact that we may not know a particular breed as deeply or well.
This sets the stage for a few really obnoxious contentions. Anecdotal evidence isn’t the same as data. Yes, sometimes anecdotal events are true, and research proves this. Some are not, also proven by research. The burden of proof is on the individual or group making the hypothetical statement.
For example: Breed X is more sensitive to anesthesia! Breed X will die if you give a Lepto vaccine! Breed X puppies have to be on adult dog food! Breed X can’t have pork as a food ingredient!
Often, these statements are what we are faced with in the exam room. The owner is stuck in the middle. Breeders know their own stock well. I know my products well. I don’t think that breeders are all being vindictive, here. These folks care about the animals, too. I get testy when it’s implied that I would do anything I knew was harmful, but that’s a whole other rant for another post.
Is it possible for an individual to have physiology and/or genetics that could make it more sensitive to side effects or dangers associated with vaccines, medications, anesthesia, etc.? Yes, absolutely. Could those problems run in a family line? Yes. So, if a particular breed has a fairly narrow genetic pool, then it’s technically possible for Breed X to have much higher odds of a given problem. Can that be said about ALL of the individuals in that breed? Probably not.
I’ll use one of those earlier statements to illustrate the issue. You’ve purchased a puppy of Breed X. As part of that purchase, you’ve signed a contract that says that you will not have the puppy vaccinated for distemper/hepatitis/parvo/parainfluenza (which is the “distemper vaccine”) before 14 weeks of age. You bring your happy new 9 week old puppy to me. Your kids, aged 5 and 9, have had their new puppy for 2 weeks already and are totally attached. I take a look at the vaccine records from the breeder. No vaccines given at all, but the pup has been dewormed several times. For the sake of the example, we’ll say that this puppy is normal and healthy.
I recommend starting a puppy vaccine series. You knew it was coming. The breeder warned you that I’d want to do this. Your breeder has explained to you all about how Breed X is too sensitive to vaccines when they’re young and must wait until later. My first instinct is to call BS, but for the sake of the discussion here, let’s assume that it may be true. As the owner, you now have two choices to make, each backed by an expert.
If you choose to NOT vaccinate your puppy, what are the consequences? Your pup may be unprotected. It could catch distemper, which is often fatal. It could catch parvo, which is fatal 30% of the time even if treated aggressively.
If you choose to vaccinate, some of the possible side effects include: allergic reaction that requires immediate treatment for anaphylactic shock, anemia caused by the immune system attacking the red blood cells, lethargy and mild pain at injection sites. Some of these side effects could be lethal.
As an owner, you’re stuck playing the odds. What’s more likely to happen? What are the chances of your puppy getting sick? I honestly have no idea how to advise you when you’re staring this kind of thing in the face. All I can do is give you the best information I have and hope we land on the same side of the decision.
Personally, I think that the risks for vaccines are lower than the risks of contracting one of these diseases. The benefits of protecting a dog outweigh the risks. I recommend vaccination. I’ve seen more unvaccinated dogs get sick than I have vaccinated dogs get sick due to the vaccines.
In the end, my perception is that I can do more good by ignoring most of the Breed X declarations and treating my patients as individuals. I don’t know what causes the experiences that most breeders use as support for such statements. Did they receive poor quality veterinary care? Are bad genetics being passed down in a line unknowingly? Or knowingly? Whatever the cause, it lands owners smack dab in the middle of a dispute they rarely have the information needed to sort through. That can lead to bad decisions all around, and the animals suffer for it.
My best advice is for new and prospective owners is to ask questions. When a breeder or a vet makes a statement, ask for support. What makes you say that? What specific things went wrong with your puppies/kittens that makes you say they can’t have vaccines? What kind of anesthetic complications were seen that makes you want to avoid drug Z? What will happen if my puppy or kitten does NOT get vaccines until that age and gets sick from one of those diseases? How many of your puppies/kittens have had these problems? Is my puppy/kitten from the same mother or father as that litter that had problems? What can I do to minimize risk? What happens if a complication arises?
At the very least, you’ll know the rules and have a feel for the odds.
There is growing evidence to support the fact that ongoing vomiting in cats is NOT a normal thing. “Hairballs” aren’t normal if they’re being thrown up frequently. There’s a high probability that those cats have gastrointestinal disease.
Here’s a link to a good, quick explanation. If your cat fits the pattern, ask your vet what you can do to figure out what’s really happening!
In the midst of the major changes happening in the human medical industry, I’ve been very interested in a new business model for human physicians. It’s being called “concierge medicine” or “direct care medicine.”
Concierge medicine is set up so that patients pay a fee directly to the doctor on an annual (or monthly) basis. This fee gives the patient direct access to the doctor and medical staff. In some cases, this means that your physician is available to speak directly to you. In others, it means that you get a certain number of visits per year for preventative care. There are a ton of variations, but the primary difference between this and the common model we experience is that you get more direct and frequent access to the doctor.
Fees for concierge medicine vary from $600 to $5000 according to the figures I found with some basic searching online. Keep in mind that for some human practices, this is IN ADDITION to what you pay for insurance. In others, that fee is paid to the doctor and includes a certain amount of care, with insurance never entering the arrangement.
I have a customary arrangement with my physicians. I’ve never had the doctor call me back personally about lab results. When I call, I don’t get to speak to the doctor. If I have an emergency, they route me to the urgent care facility or the ER. If I’m feeling sick and need an appointment right away, I’m almost always routed to the urgent care facility. They also don’t ever send me reminders for when I’m due for regular services.
The advantages of the concierge plan are touted mainly because humans have more ways and opportunities to interact with their physician. Communication tools like Skype, email, and traditional phone calls can all get you in touch with your doctor. As I was reading through a couple of articles about concierge medicine, I couldn’t help but think, “Wow, they’re starting to catch up.” Veterinarians have been doing this all along!
At our hospital, I think we do a pretty good job of bucking the ‘normal’ of human practice. Doctors call clients back with blood results or other lab results. Those results are usually available the next day instead of a weeks later. We’re almost always available to speak directly to clients. We do our best to work in any sick pets the same day. (Now and then we do have to refer to the ER for extremely serious problems or major surgeries.) We also send reminders (maybe too many? 🙂 ) to let owners know when pets are due for care. The only drawback to our model is that we don’t have a doctor available outside normal business hours. It’s something I’d like to address in the future.
The best part about how most veterinary hospitals operate is that you get all of these benefits at no extra cost. It’s part of why I’m proud of our profession. We’re a great example of a lot of things that are good and right about medical practices.
What are your thoughts on how human and veterinary medicine can better serve clients and patients?
Today’s news story is about the difference anesthesia makes when cleaning a pet’s teeth. Don’t forget that February is Pet Dental Health Month. This is a quick, easy read that shows the clear benefits of a professional anesthetized evaluation and treatment of a pet’s mouth and dental disease.
Keeping a cool head in the event of a life-threatening injury may be the only thing that gives your pet a chance higher than zero to survive. The statistics are sadly pretty dismal. About 6% of pets that undergo cardiac arrest survive to leave the hospital. The aftercare of a successful resuscitation is incredibly important, which means that a pet MUST go to a critical care facility for intensive care after a resuscitation.
Six percent. Why bother? The blunt truth is that the reason for the arrest informs the likelihood of success. A patient that’s very sick with cancer or organ failure or heart disease isn’t likely to make it. A younger animal in a trauma case or some other accident has a better chance of surviving. I think it’s worth it if your pet is otherwise young and healthy. Even if it’s not, it’s important for you as an owner to feel that you’ve done everything you can. Trying CPR is one of the things that you can do wherever you are, including on your way to the hospital.
CPR (cardiopulmonary resuscitation) in pets is very similar to what is done in people. Recently, the human CPR guidelines/instructions were changed. Veterinarians have adopted the same recommendations for pets. I’ll briefly go through the steps here.
First, you need to determine if your pet is breathing and has a pulse.
Breathing can be assessed by the rise and fall of the chest, or the motion of air through the nose, which you can feel with your hand on most dogs. There is a breathing pattern called an “agonal breath” that is NOT actual breathing. This happens when an animal has undergone arrest. A pet may open its mouth wide and the chest may heave, but it’s not a normal breath. I promise that if you see this, you will not mistake it for a normal breath.
The pulse is best felt on the inside of the thigh. The videos below shows you where to feel for a pulse. It will take a bit of pressure to feel the femoral artery. My best tip for this is to find the thigh bone and move your fingers into the sort of groove formed by the muscles in front of and behind the bone. The pulse may be weak and just barely there, but that still counts. You can also put your ear against your pet’s chest, but there’s a caution with this strategy. Hearing a heart noise does NOT necessarily mean that the heart is generating a pulse and circulating blood.
If you don’t have breathing, but you do have a pulse, you can start rescue breathing. First, open the mouth and make sure there isn’t anything blocking the airway. If there is, get it out before you start rescue breathing. The next step is to close your pet’s mouth. Seal your mouth around the nose of the pet and gently breathe out. You only breathe out until you see your pet’s chest rise a little bit. It is entirely possible for you to overpressurize the lungs and cause severe damage. So, just enough breath to raise the chest a bit. You should repeat two breaths every 4-6 seconds. You can stop if your pet starts to breathe on its own.
If there is no breathing and no pulse, or just no pulse, you will need to start chest compressions. This is where the guidelines have changed. It was decided that chest compressions are more important than the breathing, so instead of airway-breathing-circulation, we have circulation-airway-breathing.
Compressions for most pets are accomplished with the pet on its side. For dogs, you’ll want to place your hands on the chest right where the elbow would touch the ribcage if you pulled the elbow up and back. It’s at the 4th-6th rib spaces. Compressions should be done with you on your knees and bent over your pet. Your elbows should be locked and you should have your hands placed one atop the other. You’ll push the chest down about 1/3 of its total thickness.
(Images credited to the Journal of Veterinary Emergency and Critical Care.)
The pace of the compressions should match the beat for one of these songs: Stayin’ Alive (Bee Gees), Another One Bites The Dust (Queen), or Cecilia (Paul Simon). Compressions continue for a total of 30 compressions before you then breathe for your pet. For very small dogs or cats, you can use one hand to perform compressions by slipping your fingers under the chest and “pinching” the chest between your thumb and fingers. You will need to brace your pet’s back so that you can keep your pet in place for effective compressions. For big round-chested dogs like bulldogs, you should position your pet on its back and compress the chest in that position, right over the breastbone, just like for people.
Compressions and breathing should continue for 2 minutes, after which you can reassess breathing and pulse. If there is another person with you that can continue compressions after the quick check, you should trade off. CPR is more exhausting than it seems, and it’s important that you don’t get too tired to perform effective compressions.
If, after 20 minutes, your pet has not had a heartbeat or breathing resume, it’s time to stop resuscitation. If you become too exhausted to continue, then you’ve done all you can, and stopping is OK.
If you’re one of the lucky 6% and your pet’s heartbeat and breathing come back, get to the emergency hospital as quickly as you can. Emergency-critical care is required because these pets need 24 hour monitoring and often fairly complex treatments.
Here are a few links to help review and show the CPR procedure. Keep in mind that the recommendations have changed to be C-A-B instead of A-B-C.
The video below is a live dog that they’re demonstrating on, so she was absolutely incredible through the procedure. The timing of the breaths and compressions here is NOT too accurate compared to current recommendations.
The next video is a practice dummy. This is an older video as well, but there are good examples of how to locate the heart and how to breathe for your pet.
Today’s news link will take you to an article that discusses the positive personal and social impacts of owning a pet. There’s a link to another article in this one that leads to an interesting read, too.
I’ve had water in my big tank since October 13th. My family and friends are always shocked that I don’t have any fish in it yet. There’s a reason! (Well, several reasons, but one main reason.) I thought I’d elaborate for the tank update this week. For those of you that have any experience in the hobby, this is going to be old news. For those not familiar, this is the keystone to basic, happy fish keeping.
Aquariums are mostly closed systems. The flow of fresh water into the tank is periodic — i.e., happening only when we humans take out old water and put in fresh clean water. In between, waste products from living organisms, decay, and changes in water chemistry due to things like driftwood all accumulate in the tank. It won’t be a surprise to anyone that swimming around in their own waste is bad for fish. This is one of the central problems after creating an acceptable habitat in the first place.
Fish excrete ammonia as waste. Their stool and other decaying things in tanks also release ammonia. Ammonia is very toxic to fish. It burns their skin and gills. If the ammonia gets too high, fish can be killed. Other organisms, like my freshwater shrimp, can’t tolerate ammonia at all and will die if it’s present. If the ammonia went untouched, every fish tank would poison itself and kill the non-plant inhabitants.
Thankfully, bacteria come to the rescue! There are naturally occurring bacteria that will convert the ammonia into a less toxic form called Nitrite. Then, different bacteria will convert the nitrite to nitrate, which is the least toxic form. Then, when we perform a water change, the nitrates are removed from the tank. Fresh, nitrate- and ammonia-free water is put into the tank. We wait for the bacterial cycle to raise the nitrate level to a point that we once again need to change the water. This beneficial process is called “Cycling.” It can take a few weeks to a few months to happen.
Let me restate that. Growing the right kind of bacteria requires ammonia to be present in the tank. Even then, it can take a few weeks to a few months for this to happen. The way we know that the cycle has occurred is to test for nitrates in the water. When nitrates are present, there is a population of bacteria converting ammonia to nitrite and then to nitrate. That’s when we know it’s a safe tank for fish or other organisms. There are two ways to go about getting your tank to cycle. They’re called “Fish In” or “Fishless” cycling.
Fish-in cycling requires the aquarium to be stocked with fish that are very hardy and can withstand some ammonia and nitrite in the water. Some of these fish favor water with a little bit of salt in it (brackish), which helps decrease the ammonia/nitrite/nitrate toxicity. Fish-in cycling is most commonly what people do because they’re interested in having fish right away.
The other method is one in which the human acts as the source of ammonia for the tank. Fishless cycling requires that ammonia (pure, with no other chemicals) is added to the tank to encourage the bacterial populations to grow. The amount of ammonia is calculated to maintain a certain level in the water, which feeds the bacteria.
When the cycle is running well, we can test for nitrates. When nitrates are present, the cycle is complete, and living things can be added safely to the tank.
Testing is best done with a liquid chemical test kit. There’s one that’s sort of the gold standard, which is what I have. It’s fairly easy to perform these tests. A specific amount of tank water is put in a test tube. Chemicals are added to that water sample in a specific amount and order. The readings are made by comparing the color of the water in the test tubes to a chart.
In the photos below, you can see the test kit’s chemicals and my two water samples. I’m testing for ammonia and nitrates. This ‘first and last’ testing lets me know that the cycle is complete, but also that I’m feeding the bacteria well enough. Remember, ammonia is needed to create the cycle!
When it’s time to read the test, I compare colors in the tubes to the reference chart. For me, the ammonia is at or less than 0.25 parts per million (ppm). The nitrates are about 30 or so, which is higher than I like to have them. I’m planning to do a big water change tomorrow to get rid of some of the nitrates.
With the knowledge that my tank is producing nitrates, I can comfortably add plants and gradually add fish to stock the tank. The only catch is that I need to order the big, bright LED lights that will help my plants grow. The wimpy fluorescent bulbs I have now just don’t have the strength to grow plants well.
There are a couple of good tricks to cycle a tank faster. You can take things from an already established tank and use them to ‘seed’ a new filter or tank. It’s sort of like transplanting a healthy ecosystem into a brand new one. The other way is to buy the beneficial bacteria in a bottle. Several companies sell these tank ‘probiotics.’ I’ve used them in the big tank to help with a jump-start. There is debate about whether the specific species of bacteria in these quick start liquids will stay alive in a big enough population in the tank for long periods of time. Most of the quick start manufacturers advise “boostering” the tank monthly with their product. I find that fairly off-putting given that they advertise as being a ‘natural bacteria source.’
I personally selected a fishless cycle for my tank. I’ve been adding ammonia to get the bacteria to product nitrate. I’ve also poured in a bunch of duckweed, which is usually a “pest’ plant that people run away from as if it’s the herpes of the aquarium hobby world. The plants, however, will use nitrates to grow. This helps reduce the nitrates in the tank water and lets me change the water less often. It’s also better for the fish. Plants provide hiding places and beneficial chemistry.
In the test above, the ammonia is under the 4ppm that I prefer to have, so I’ll be adding some ammonia tomorrow after I change the water to lower the nitrates. Once I have the lights, I’ll be buying plants and then fish to stock up the tank.
So, the short answer is that it takes a long time to get a tank ready to house fish in a healthy, non-toxic environment. It’s all about the bacteria!
Pet supply stores make me cringe. There are innumerable choices with little to no information that helps owners decide on which product is best. Whether it’s food, toys, leashes, houses, etc., it’s hard to know what’s really safe for pets. The AVMA has put together a short video about picking safe and appropriate toys for pets. Have a look! It’s sound information.