Dr Mc Blog

 

September 14, 2016
I am going to share with you the Veterinary Accreditation Program through the United States Department of Agriculture (USDA) and the Animal and Plant Health Inspection Service (APHIS). What? The USDA-APHIS educate and certify veterinarians to inspect animals for disease prior to writing a health certificate for animal travel.

The Center for Disease Control (CDC) in Georgia is a governmental body we should all get down on our knees and give thanks for! The CDC is our nation’s health protection agency. It monitors all kinds of diseases that crop up in the United States and abroad that might affect us, from food borne illnesses (think E coli in the spinach or listeriosis in raw cheese products) to contagious measles outbreaks that start at California resorts to zoonotic infections passed from animals to people. The CDC works hand in hand with the USDA-APHIS, and the system trickles down to yours truly, the local town veterinarian. Which means I am authorized to fill out and sign a health certificate for a pet planning to travel to another state or country. Not a big deal? Think again.

Why so much interest you might well ask, in where Fido goes on vacation? Is this just another way that Big Brother is invading your privacy? The short answer is no. According to the USDA-APHIS they are recognizing new emerging infectious diseases world-wide. Of ALL the bacteria, viruses and other disease-causing pathogens that affect humans, they estimate 61% to be zoonotic or spread from animals to humans. Of the new “emerging” diseases they believe at least 75% to be zoonotic. The USDA-APHIS bodies wish to protect YOU by verifying that all animals that travel are disease-free, to safeguard humans. As a veterinarian may I add that this also helps safeguard our pets and our food sources. Our way of life.

The National Veterinary Accreditation Program web site shares some fascinating information of how the local town veterinarian can be a link in this chain of protection.

In 2003 a shipment of over 700 small mammals and rodents were imported to the US from Africa. The wildlife importer brought in dormice, various unusual rats and some rope squirrels. There is always a market for unusual animals in the pet trade, sometimes zoological parks or animal preservation parks, even research. The animals arrived safely in Texas, where they were re-distributed to Illinois. Many of the rats were housed near Prairie dogs. The Prairie dog has been adopted as a pet by many people. They are native to many areas of the United States. They have not been bred in captivity for generations, but may be relatively docile, eat timothy hay and are awake in the daytime which is a real bonus for people who enjoy interactive time with small rodents as pets. Unbeknownst to all, the rats were carrying the monkeypox virus and transmitted it to the Prairie dogs. The Prairie dogs were distributed to pet shops in six Midwestern states. These Prairie dogs went into pet homes.

Monkeypox is a virus in the same family as Smallpox. Smallpox was a deadly viral disease that the European explorers and settlers first brought to the Americas in the 1600’s. Native American tribes had never encountered this virus and had no natural immunity; many Indian tribes were decimated by Smallpox. Smallpox was eradicated in the United States before 1980, so a vaccination program against Smallpox is no longer enforced. Monkeypox was first diagnosed in Africa over 40 years ago. The disease causes a fever, enlarged lymph nodes and small raised polka-dot like spots or rash that may cover the body. Both humans and animals can develop the rash. Monkeypox is known to be zoonotic, spreading from a sick pet to a human by body fluids, soiled bedding and close contact. Signs of Monkeypox can show up as little as one day after exposure. There is no specific treatment against this virus, though vaccination against Smallpox may provide protection against Monkeypox for 85% of the people who receive it. Again, no one has routinely received Smallpox vaccination since 1972. Children born after that time will have no immunity.

Monkeypox had NEVER been seen or diagnosed outside of continental Africa until this outbreak in 2003 in the United States. Over a period of four weeks, from May to June, at least 47 people were infected from their new Prairie dog pets. One of the first family cases started May 11th 2003 when two Prairie dogs arrived in their new home. One of the Prairie dogs was ill with a skin rash and runny nose on the 15th and taken to their veterinarian. By the 20th the family was ill and the Prairie dog died. The veterinarian sent tissue samples to various labs at the same time as biopsies of the skin were being performed on the family by a dermatologist. Joint diagnosis confirmed Monkeypox. Quick action taken by the CDC, USDA and APHIS contained the outbreak. No person died. Monkeypox has not been seen in the United States since.

As a small town veterinarian I have been involved with potential cases of Rabies, Salmonella, Campylobacter, Avian tuberculosis, Chlamydiosis and West Nile disease. All veterinarians are here to serve.

Christine B. McFadden, DVM
drmc@mcmenagerie.com

 

 

Dr Mc Blog

 

August 2, 2016
Ladies and gentlemen : the story you are about to hear is true. Only the names have been changed to protect the innocent….I take pride in offering good customer service. Which when it collapses, I have been known to say in a hushed voice “Wow. We don’t just drop the ball, we drop kick it into the closest wall.” What follows is a true story. Really.

The family was super nice, a throwback to Andy of Mayberry and Dona Reed. They presented as a mother and father with their sweet 4 year old daughter and brand new puppy. The Mom wore lipstick and a flowered dress. The daughter said cute things and blew kisses. The puppy was a miniature Dachshund and needed vaccinations. Simple enough, a service I provide daily and could do standing on my head. Or is that expression “in my sleep”? In the end, it wouldn’t matter a bit how experienced I was. I was doomed to fail from the moment they said “hello”.

The puppy was adorable and his examination went well. He was calm for his vaccination, which I appreciated because a shrieking puppy often sets off the children and then the mother joins in hysterically and suddenly everyone is snapping at each other and there aren’t enough princess stickers to calm everyone down. I have spent years developing a vaccination technique where I am rarely bitten by either the dog or the mother. These things are more important than you might think. I waved goodbye as I reminded them that the puppy was due back in a month for its next puppy shots and turned my attention to the next patient.

Within two hours they were back. The puppy was quiet, his tail dragging, running a fever, tiny body bumpy with hives. We re-name everything in medicine (not me personally, I just had to memorize it like a foreign language), so properly the allergic skin reaction was called urticaria. I expressed surprise (I was, it’s not that common to see a vaccine reaction) and concern (I was, though there was no indication of shortness of breath, difficulty breathing or vomiting, an indication of a severe allergic reaction called anaphylaxis which can lead to death). I treated the reaction with an antihistamine injection and advised them that we would modify the vaccine type for the next visit. In addition, they could start children’s Benadryl at home the day before to minimize any reactions. They toddled off and the puppy recovered beautifully overnight.

On his second visit the puppy underwent vaccinations without further surprises and we were all grateful. We also performed surgery that day, taking care of a small umbilical hernia that pouched open from his belly button area. The surgery went smoothly and his recovery was uneventful. The family picked him up that same afternoon and took him home, nestled safely in their arms. They were back the next day. He had chewed out his stitches. I re-anesthetized him and put them back in, adding an Elizabethan collar (the cone of shame) and placing him on antibiotics. I talked the Mom down off a ledge every day for the next week as the puppy fell over his cone, refused to eat with it on, threw up his medicine and in general did not cooperate with the program. We got through it.

In a parallel universe, back at work, we had a Clinic Cat. He went by the unimaginative name of “Barney”. This had nothing to do with purple dinosaurs or an Andy of Mayberry character, but originated as he did : he started life as a barn cat and eventually adopted us and moved inside. A big orange tomcat, we fixed him up, literally and figuratively. Barney knew the exact length of a dog’s leash and would calmly sit down and wash his face exactly 4 inches beyond its reach. Clients were always on their best behavior because other animal lovers were watching them and who could stand that pressure? Sometimes we had to spray water at Barney to get him to move before the dog stroked out. He was an unusually gentle cat and greeted many people and their pets. If you didn’t own a dog he could have a very calming effect.

Certainly the child with the miniature dachshund was entranced by Barney. The cat had withstood the affections of several Clinic Children many times over and we considered him the perfect clinic mascot. Until said child and her miniature dachshund puppy chased him under a bench, cornering Barney. Barney lashed out, inflicting a long scratch directly over the child’s eyebrow. All heck broke loose. The daughter’s trust in pets was broken. The child was hurt. She was a beautiful child and this could leave a scar on her face. It might become infected. These were all valid concerns and I sent the family to their pediatrician on my dime. Barney’s career ended and he went to a real home with a proper backyard and no dogs to torment. I vowed to never keep another Clinic Cat. And when the family moved away the following year I breathed a  sigh of relief that nothing could go wrong again!

Christine B. McFadden, DVM
drmc@mcmenagerie.com

 

Dr Mc Blog

 

August 16, 2016
Somewhere along the way your children catch on to you and become very suspicious when you are happy about something. Mine questioned the origin of names I kept pressing upon them for new pets. They obstinately refused to name the new cat “Tenesmus”. C’mon, I begged, it sounds great, doesn’t it? What does it mean? they questioned. Surly attitude! When I confessed tenesmus meant “straining to defecate” they did not laugh. I told them no one else would know. “No, Mom”, they said.

I have another favorite : Buphthalmia. Yes, it sounds like a long burp! Is there anyone else out there who only burps after drinking root beer? I digress. So what is “buphthalmia”? Pronounce it “bup” then add “thal-mee-ah”. It was an ophthalmologist, an eye doctor, who coined this word. Spelling that ph-th thing was the first question on our opth exam back in vet school.

Buphthalmia is different than exophthalmia. Exophthalmia is when the eyeball bulges out of the orbit, pushed behind by a space-occupying lesion like a blood clot or a mass. Buphthalmia is a little different : you will see an enlarged eyeball, bigger and wider than normal, because the cornea and surrounding tissues covering the eyeball have been stretched out by fluid build-up inside the eye.

The eyeball is nestled safely inside a protective ring of bones, often collectively referred to as the eye socket or orbit. The eye is an amazing organ and provides one of the five major senses, sight. The eyes of many animals have specialized features that allow them to see underwater, see in the dark, reflect light, and see in color. Most mammals and many birds and reptiles have a third eyelid which slides over their eyeball to both protect and lubricate the eye. Humans lack a third eyelid. It slides up from inside the inner lower corner of the eye, near the nose, and may be light pink in color. The inside of the eye is constantly bathed in a gentle fluid, the aqueous humor. This fluid circulates in front of the lens and helps to keep the eyeball round. The fluid pressure provided by the aqueous humor can be measured as intra-ocular pressure or IOP. If you, a human, has ever seen an eye doctor, they have probably measured your IOP with a tonometer – a little puff of air directed straight at the center of your cornea. We also use tonometry in veterinary medicine. Why do we care? Because the fluid in the front of the eyeball can build up, creating too much pressure. Too much pressure inside the eye is diagnosed as GLAUCOMA. This often happens because the aqueous humor doesn’t drain away properly. Once clogged, through a disease process or even an inherited problem of narrow drainage, the fluid builds up, creating pressure on the outer eyeball membranes and cornea which spread and bulge. The eye may look red or bluish and the pupils may dilate. Once the eyeball has enlarged, called buphthalmia, there is no going back. The eyeball will never return to its original size.

Your pet has an emergency. Without immediate medical treatment, in as little as a couple of hours the sustained high intraocular pressure can lead to blindness. If only one eye is affected by glaucoma the other may be at risk. Buphthalmia is a classic sign of glaucoma. Once diagnosed, the remaining Healthy eye should be treated with preventative eye drops for the rest of the pet’s life.

Certain breeds are predisposed to glaucoma, though the largest category is “mixed breed”, so no dog is safe. Cocker Spaniels, Bassets and Beagles, Boston Terriers and Norwegian Elkhounds all make the list. I’ve seen it in a family of Bouviers, an Akita and in Jack Russell Terriers. One day the owner notes their dog’s eye is a little cloudy and the next day as they come in for their appointment it is bulging and blood shot and ugly. It is too late to save the eye. A blind, painful eye requires enucleation or removal, for humane reasons. Thankfully, many eyes can be saved by prompt attention and treatment.

Christine B. McFadden, DVM
drmc@mcmenagerie.com
Valley Animal Hospital, Merced

 

 

Dr Mc Blog

 

July 19, 2016
“Tank” was adorable. An enormous Golden Retriever puppy, he had moved into the long-legged gawky teenage stage most pups go through and was ripe for the adjustments necessary to bond with his foster family, who had volunteered to train and socialize this puppy for Guide Dogs for the Blind. Guide Dogs for the Blind has been around since 1942. They place service dogs each year with blind and low-vision people who benefit from renewed activities and lifestyle once accompanied by their “Seeing Eyes” dog.

In order to prepare a puppy for his or her future responsibilities and to bond with people they benefit from leaving a kennel situation and moving into a home. A youngster needs to learn basic manners, basic obedience training, be properly housebroken and above all, be loved. Many future guide dog puppies are placed in homes through 4-H programs. They may live with their foster family for over 12 months, when they are returned to the Guide Dogs for the Blind school for temperament testing and suitability as a Companion Service Dog. A puppy that passes this test will be enrolled in further training, at the end of which they are matched with their Human. The foster family is invited to attend the Graduation Ceremony and meet the new Team (Guide Dogs may remain the property of the School). Dogs that do not pass an entry test will first be offered back to their foster family before being placed in a pet home.

Thus it was that Tank came home to roost. Large and ebullient, he was deemed a little too frisky to take his job seriously and flunked out of the program. Far from hanging his head in shame, Tank was overjoyed to be reunited with his first family and never looked back. He demolished hoses, lounged in the swimming pool and ate them out of house and home. On his visits to the Clinic we put on our “calm” faces – when pleased to see you (and Tank was pleased to meet everybody!) Tank could literally knock you over with his enthusiastic greetings. Subtlety was foreign to Tank, but his doggie charms were irresistible and he was so cheerful that we all loved him.

That was 11 years ago. Today Tank is nearly 12 years old. His owner has brought him in because he is very quiet, too quiet even for a dog that has calmed down with maturity. His weight has dropped, though not because of a diet. His gum color is a little pale, suggesting the possibility of anemia. Most horribly, I can feel a large mass in his abdomen. I keep my head down for a moment, bent over the dogs’ back as I consider what I shall say. Before I have to look his owner in the eyes. That first moment when unspoken fears are acknowledged.

We discuss tests, his age. Tanks’ owners agree to pursue a diagnosis.

The blood tests deliver both good and bad news. Tests confirm that Tank is anemic. But his liver and kidney function are good, other internal organs good. X-rays demonstrate a large undefined mass in his abdomen. We continue to an ultrasound examination of his abdomen, which helps to identify the spleen as the mass. We are breathless as the machine’s probe moves up to explore Tank’s liver. One of the most horrible cancers a dog can get typically involves both liver and spleen. Tank’s liver appears to be clean; we cannot identify evidence of cancer spreading there. We must now consider the option of other disorders of the spleen.

The spleen is an interesting organ. Looking like an elongated red-purple colored tongue, it sits near the stomach. The spleen is the largest filtration system of old blood cells in the body. In addition, it produces a portion of the new red blood cells the body needs and cells for the immune system. That said, a spleen can be removed and the animal can live a perfectly normal life, no special medications or supplements needed. Because it is filled with blood, the spleen can develop large blood clots called hematomas, which can burst open. The dog will bleed to death. It can twist upon itself or develop tumors. Any disease or trauma that causes a ruptured spleen may lead to death by rapid bleeding out into the abdomen. It is splenic cancer that is the most feared; because of its close connection to the bloodstream this cancer spreads rapidly.

We discussed the options. Tank might have hematomas of the spleen. Removed surgically, his prognosis would be excellent. But we might open him up and find evidence of a spreading cancer that had gone undetected by our other tests. Worse, in the early stages, cancer might have spread at the cellular level but not be evident until long after surgery. Often the trained eye of the surgeon cannot visually differentiate between a hematoma or cancer, so we could go to surgery, remove the spleen, performing a splenectomy, only to find out days later that the results of the biopsy test at the lab were cancerous. The family needed time to confer. Ultimately they agreed upon proceeding to an exploratory abdominal surgery, where we found a gigantic spleen. It was bulbous and lumpy, an angry dark purple color that spread from one side to the other and, once removed, was found to weigh over 3 pounds (when healthy it had probably weighed less than 6 ounces). Tank came through surgery fine. In less than 24 hours he ate a healthy breakfast. He went home the day after the surgery, wagging his tail at being relieved of that tremendous weight. Within 2 weeks Tank was rapidly putting on weight (sigh) and appeared restored to his old self. We all rejoiced when the pathology report could not detect any cancer, but pronounced the cause : splenic hematomas. Tank’s future appears bright and we all look forward to his cheerful greetings to come.

Christine B. McFadden, DVM
drmc@mcmenagerie.com
Valley Animal Hospital, Merced

Dr Mc Blog

 

May 24, 2016
Summer is coming. In Merced that can mean baking temperatures over 100 degrees. Even if the day doesn’t go over the 90’s, the black asphalt paths that line Bear Creek, Black Rascal Creek and many other favorite walking paths will heat up significantly, holding the heat well into the evening hours. People walking in rubber soled sneakers may not notice how hot the ground feels. I actually recommend that clients who take their pets out for an evening stroll bend down and place a flattened palm to the sidewalk or path – only then will they recognize what their dogs’ feet are feeling. Sometimes my hand has burned at 9 o’clock at night! If at all possible, consider early morning walks with your dog – they can be quite refreshing and you might take in an egret or hawk flying overhead.

Dogs are digitigrade (love words!), meaning they stand and bear their weight on their toes, not a sole or heel like a person. Each toe is covered by a protective pad of keratin, a horned callus that protects them from injury. Inside that is thick fatty tissue, a good shock absorber. This pad is soft in young puppies, thickening and hardening with the use they get from exercise and exposure to different terrain. A dog that has sat on the couch all summer will have tender feet if suddenly expected to go game hunting for miles in the fall. That bicycle ride you took, with your dog running gamely behind? Don’t be surprised if he or she comes up lame the next day, bare patches of pad rubbed away to expose bleeding sores. This goes way beyond blisters and will take weeks to heal, as the lost tissue can’t be sewn back on, but must slowly granulate in from the sides of the wound. Walking on soft grass is about all those dogs can bear to do for some time. Don’t take your dog’s feet or athleticism for granted – they need regular, planned exercise for peak performance and health. This is your chance to shine as a Personal Trainer! Don’t blow it!

I would like to believe everyone knows not to leave a dog in a car in a parking lot during our summers. Forget cracking the windows. A CRACKED WINDOW WILL NOT PREVENT HEAT BUILD UP IN THE CAR. It has been estimated that even on a day when the outdoors temperature is in the mid-70’s, that the interior of a car can rise to over 100 degrees or higher in less than 30 minutes. Seventy degrees? Can you imagine how quickly that temperature spikes in our area on a real summer day? One estimate I read stated that on a 90 degree day the inside of a car could reach 110 degrees in less than 10 minutes! The American Veterinary Medical Association (AVMA) posts some interesting and horrible facts from several studies on Pets in Vehicles.  The car acts like a greenhouse, with the air unable to circulate or get back out through the windows. The pet cannot breathe in the overheated air and dies from heatstroke. The dogs core (inside) body temperature may go over 104 degrees. The highest temperature I ever recorded in the stomach of a dog that had died from heatstroke was 110 degrees – our thermometer didn’t register any higher. It was too hot to keep my gloved hand inside to perform the necropsy. (The word “autopsy” is reserved for post-mortem examinations of humans or “self”. An autopsy is an examination done to determine the cause of death. In animals we most commonly use the word necropsy.). These are very sad moments, indeed. California does have laws restricting leaving pets confined inside a car under conditions that endanger the pet’s life. Please, leave your pet at home while you run errands. Here in the Valley make sure your outdoor kennels are not all concrete, baking in the sun. Shade cloth is not enough protection, either. Mature trees, watered and shaded grass, even outdoor misters should all be considered for your dog’s health and comfort during the summer days when they are outdoors. As we see each summer, it is a matter of life or death.

Christine B. McFadden, DVM
drmc@mcmenagerie.com

 

Dr Mc Blog

 

May 3, 2016
It was a very odd week. Monday started out with an African Grey parrot that was rushed in because of odd seizures observed by the owner. Popeye made the trip in a cat carrier since he couldn’t perch, and when I opened the grated door I had to laugh : a sizeable grey parrot with a dark maroon tail was fluttering convulsively but at the same time reaching out greedily to gobble down some peanuts just out of reach. He had figured out how to roll just right with each shake of his wings and was inching ever closer. Popeye wasn’t at all perturbed by his mild convulsions but was very upset that the peanuts kept evading him. After a brief discussion where I learned that he was fed almost exclusively on sunflower seeds I drew some blood tests and treated him for a calcium deficiency. Seeds may be high in protein and fat but are notoriously deficient in calcium and trace minerals. No single food item will ever provide complete nutrition to any animal. Popeye’s recovery was dramatic.

On Tuesday an owner presented his middle-aged Dachshund “Dracula” for a second opinion. The little dog just seemed to have muscle twitches all the time. He’d had some blood tests run, but nothing conclusive had turned up and regular anti-seizure medication had been of no help. Dracula lived a quiet life, mostly indoors and had never had any other medical issues. He trotted around the exam room, with a fine tremor marring his step. He wasn’t shaking from anxiety, nor did he act oddly in any other way. Looking over the chart shared by my colleague I noted that his blood calcium test was quite low. Since any single test may occasionally be off due to lab error I recommended we repeat these tests as a starting place. Again, his calcium levels came back very low. Diagnosis : A disorder of his parathyroid gland, which regulates calcium in the body. Treatment with calcium and Vitamin D supplements provided immediate relief while his case was fully worked up.

When the Green Iguana showed up on Wednesday I had a sneaking suspicion that I was having a “run” on calcium related issues. The lizards’ lower jaw was puffed out, looking mismatched to her upper face. She had an odd crook in her front leg from a “folding fracture”, indicating soft bones. Once again I investigated her diet and light exposure – never outdoors in natural sunlight (no creature was bred to live totally indoors!) and fed iceberg lettuce, no dark leafy greens, no vitamin supplements. Diagnosis : Metabolic Bone Disease or “Iguana Rickets”. Real sunshine and an improved diet did wonders for her.

By Thursday the staff had started to joke about it. Our 10 o’clock appointment was a young man with a muscular Pit Bull puppy, only 12 weeks old. The puppy had broken both his front legs. As I observed the heavy bodied male, named “Oscar”, I noted that he was unusually cheerful as he ran around the room, clumsily trying to chew on my assistant’s pants leg. He looked bow legged in front and indeed, both of his wrists (carpi) bulged and kind of knuckled over. He was walking on these legs, which a dog with a fracture usually cannot do, as it’s too painful and the bone actually can’t support weight as it slides apart. Questioning brought out the history of a puppy fed an exclusive diet of steak and hamburger. Oscar’s owner was proud of his beautiful dog and wanted to provide only the best for him. He had spared no expense by feeding an all-meat diet. What I was looking at was a very old-fashioned case of rickets or osteomalacia (soft bones). Without a balanced diet – and without bones meat alone is deficient in calcium – Oscar’s rapidly growing bones had softened and he couldn’t support the weight of his own body. The bones had started to fold down. Caught early, a corrected diet of simple commercial puppy food could reverse the process and over time the bones will straighten, though not always 100%. Happily, within two weeks Oscar was moving more normally.

The body is a marvel. Calcium is rich in many foods: dairy products like cheese, yogurt and milk, dark leafy greens, fish canned with their bones, bone meal by-products. Calcium is added to all pet foods formulated commercially, just as it is added to products like orange juice for people. But eating calcium rich food is not enough. The body requires Vitamin D3 to absorb and use the calcium taken in. Dogs, cats, birds and reptiles can all make their own Vitamin D when exposed to natural sunlight, through a complex interaction with UV light on their skin. Vitamin D is found naturally in egg yolk, fish oils and fatty fish like salmon or tuna, and cheese. Many animals, especially birds and reptiles, don’t naturally eat these foods and if kept deprived of sunlight (indoors/caged) will develop rickets, broken bones, and even seizures or death because they cannot make the Vitamin D they need. Even if their diet includes a calcium supplement they will suffer. For this reason special UV lights are recommended for indoor pets and at least weekly outings into real sunshine. All diets should include both fresh foods and commercial foods fortified with Vitamin D and Calcium, from turtle pellets to bird feed and other pet foods. Leave the balancing up to the professionals!

Christine B. McFadden, DVM
drmc@mcmenagerie.com

 

 

Dr Mc Blog

 

April 6, 2016
I thought we could talk about bladders today. Before you grit your teeth, let me say that it’s bound to be a lighter subject than body issues that lead to discussions of Milk of Magnesia or Preparation H. A far better organ system for public discussion. Bladders hold a deep fascination for my office staff. Instead of guessing how many jelly beans are in a jar, they often wait spell-bound to see how much urine that little dog can release on a waiting room plant. One client who frequents our hospital has a particularly clever little Yorkie who always manages to spray out a puddle despite our diligence and speed. Unfailingly, the good woman will say “My, he’s never done that before.”

Each day the kidneys filter the blood that flows through your veins, removing waste and impurities. Most of the blood continues to recycle to the rest of the body, but a small percentage of fluid and the filtered waste must be eliminated for continued good health. This fluid is called urine. In most mammals urine looks like a clear watery fluid, usually a shade of yellow, and is composed of excess body water, salts, and other waste. The yellow color is caused by the pigment urochrome, a breakdown product from hemoglobin. When dehydrated, the urine color may be darker yellow or orange as this pigment concentrates, indicating the need to drink more water. Each beat of the heart sends 20-25% of that blood flowing straight to the kidneys. Once urine is manufactured in the kidneys it travels from the kidneys via little tubes called ureters to the bladder, the holding tank in the body’s plumbing system. It is stored there until the pet voluntarily decides to empty their bladder, through another single tube called the urethra, to the outside. The act of emptying the bladder is called micturition or urination or voiding or peeing. Of course, all of these body parts can develop problems of their own, but the most common diseases revolve around the kidneys or the bladder. Kidney infections are not nearly as common as bladder infections, though often people confuse the two. Bladder infections may be caused by bacteria ascending up the urethra, because the bladder is the first stop from the “outside”. Today we will limit the discussion to dogs as the bladder problems seen in cats are often quite different in cause and treatment.

Prada’s Mom suspected a bladder infection when she observed blood in the urine. Female dogs are affected more often than males. Some affected pets may strain to urinate or may urinate very frequently or in unusual places. Although some dogs are depressed, Prada, a tiny snow-white Maltese, appeared bouncey and pain free. An examination was performed to determine if the bladder wall felt normal or was thickened. The bladder may have unusual “lumps” which could be cancerous growths or actual bladder “stones”, real rock-like growths that can fill the inside of the bladder. A urine sample was taken to analyze for bacteria, crystals, blood and other signs of disease. Sometimes the urine must be cultured to determine what kind of bacteria is affecting the dog and which antibiotic will best treat the infection. Because this was Prada’s second bladder infection in one year, a culture test was performed after obtaining her urine sample by cystocentesis, a sterile needle tap directly into the bladder. This method is preferred for a bacterial culture over a “catch” of urine because there will be no contamination from the pet’s hair or the environment as the sample is obtained. Chronic or repeat bladder infections may lead to the formation of bladder stones due to the chronic irritation of the bladder lining. These will require surgical removal in most cases. Bladder infections should never be minimalized as they can in turn ascend further up to the kidneys, which is potentially life threatening. Prada’s culture highlighted the best antibiotic choice for her and she responded quickly to her medication.

There is a small but significant obstacle to the pursuit and study of diseases of the bladder : obtaining the sample. Home catch, free catch, cystocentesis…. Apparently this has confounded veterinarians long before me! One very old veterinary text book neatly summed it up thusly : “Take about a dessert-spoonful of the dog’s urine(which you must use your own judgement how to obtain: place, for instance, a clean damp sponge at a spot where you think the animal will stale)…..”. Good to know you’re not alone!

Christine B. McFadden, DVM
drmc@mcmenagerie.com

 

Dr Mc Blog

 

March 29, 2016
It was near the end of four years of vet school and we were feeling pretty tough. With Board exams behind us, jobs or vacations all set, my classmates and I were just wrapping up the final pieces. Among other things this included looking into health insurance now that campus charity would not be there to cushion us.

The American Veterinary Medical Association, or AVMA, at that time offered a group insurance plan for veterinarians. Enticingly, full coverage was extended to everyone, no exclusions or waivers, as long as you signed up before actually graduating (this was in 1982). And they brought it right to our doorstep, holding a meeting in a classroom setting. Their plan was offered by one insurance company. We had the choice of one insurance agent, who handled the Sacramento area and probably made a bundle in June commissions before we scattered far and wide into others’ territories. If female and interested in maternity coverage you had the choice of one plan. The decision being out of my hands I was only mildly interested in what the man had to say. The charts and overlays flipped past. Plans A, B, and C. Daily hospital rates. Deductibles. Don’t die in San Francisco if you’re trying to save money.

Then came the part that was just for us, customized care for the lucky veterinarian. Rabies coverage. Disability coverage, strongly recommended for the solo practitioner. Hunh? Before I could take in the implications of “disability”, he threw out “dismemberment”. Enthusiastically the presenting agent gave a few examples, vividly sharing several gory stories. Hot stuff. I sat up straight. Dismemberment? DisMEMberment? What kind of profession was I going into? What would my mother say? I personally was going forth to save lives, perform miracle surgeries, educate the world about the wonders of modern veterinary medicine………….and someone was suggesting that an ungrateful little wretch of an animal might try to chew my face up and tear me limb from limb? Unheard of! Monstrous! I had been bitten, kicked and had my nose broken all in the line of duty but it had never crossed my mind that I might come way eyeless or armless. Too startled to absorb this information quickly I was still on “indignant” and barely registered when he got to “death”. Disability, dismemberment and death. Satisfied that he’d covered the fine print the insurance agent moved on. I never heard another word of his presentation.

I’m happy to report that the above never happened. Not that some pretty good efforts haven’t been made by some less-than-pleased patients. The danger of a pet attacking you is slight, but everyone should keep in mind a saying that a veterinarian once passed on to me, “ALL dogs bite”.  In March, 2015 the AVMA published a study, available to view on-line “Dog Bite Risk and Prevention : The Role of The Breed”. If you peruse the article and lists of breeds you will note that popular breeds are higher on the list, perhaps incorrectly black-listed simply because there are a LOT more of them. You are certainly more likely to be bitten by a Chihuahua in Merced than a Briard. Be cautious around stray dogs. Don’t tolerate mouthing by your own pet. Don’t give your dog bones when children are near. In short, never let your dog think that it’s alright to bite you or anyone that you have introduced to your dog. Including (smile!) your veterinarian.

Christine B. McFadden, DVM
drmc@mcmenagerie.com

 

Dr Mc Blog

 

March 1, 2016
Have you heard? There are new scrubs, mousses, lotions, creams, and wipes to improve your PETS’ appearance! For some reason these are not appearing in “Vogue” magazine or even “Dog Fancy”. Since I can’t skim a popular magazine in line at the grocery store without encountering pressure to rejuvenate my own skin, I don’t understand why all these products for pet appeal aren’t making big news. Perhaps skin care for animals just hasn’t caught on yet. Although I’m not entirely sure – I’ve heard there’s a blueberry facial mask out there, plus things like milk baths and rose water nail soaks for the (overly?) pampered pooch. Who knows? I heard of a doggie salon that gave the owners coupes of champagne while they waited. Perhaps that’s the force behind the trend.

For those of us in the less glitzy trenches, we refer to skin care as “dermatology” and the new mousses, wipes, etc have been formulated to address common health problems addressed daily in veterinary medicine.

Skin sores that bubble and break open on your pet may be the result of a bacterial staphylococcus infection. “Staph” is considered a normal inhabitant on the surface of the skin, until it goes rogue and breaks out as whiteheads or bubbling pus-filled lesions. In humans there is an increasing fear of an antibiotic resistant form of staph called “MRSA” (pronounce it “mersa”), which in simple terms means a staph bacteria that is resistant to the antibiotic methicillin, by extension the family of antibiotics headed up by penicillin. This bacteria takes advantage by invading the body through a wound, at a surgery site, or even a scraped elbow and is feared because it cannot be readily treated by the old tried-and-true antibiotics. The bacteria has simply found a way to survive, to overcome the tools fighting to destroy it. Because people in hospitals are at higher risk, due to their lowered immune resistance, stress, or fresh surgery sites, MRSA infections are feared. Pets can also develop a methicillin resistant staph infection, though it’s a slightly different bacterial strain called staph psuedointermedius, or MRSP (I say “mersip”. No one has corrected me yet). The veterinary community continues to monitor the prevalence of this infection and at this time it is not considered a risk to humans or other pets. When we find a skin infection not healing as expected we often recommend a culture swab be taken to diagnose both the type of bacteria and identify the best antibiotics to treat the problem. This is how we diagnose MRSP infections. One of the treatments is a mousse that cleans bacteria off the skin. It can also be used to bathe the pet, prior to an orthopedic or other major surgery, decreasing the risk of post-operative complications. There are anti-bacterial skin wipes, also.

Another new product is an eye wipe to assist dogs with epiphora, a condition where the pets’ tears spill down his or her face. A compound, porphyrin, in the tears causes a brown stain to form which is both unsightly and, staying wet, allows bacteria to breed which can lead to infection around the eye. The constantly wet skin may scald and create open sores under the eyes which is very painful. Dog and cat breeds with flat “pushed-in faces” like Pugs and Persians may be anatomically predisposed to problems of tears spilling out onto their faces. Once your veterinarian has determined that the tear ducts are open and draining properly and ruled out other medical causes, you may be directed to these wipes to keep the condition from escalating into painful sores.

Pets that are completely white haired, with no other color or pigment, are at higher risk of sun-related skin cancers as they sun bathe in our backyards here in the Central Valley. In cats red, scabby crusts may form on their ear tips or around the nose. In dogs it often begins on the thin skin of the nose or as deep purple blotches on the tummy near the back legs. Human sun screens may not be safe for your pets because they will eat it, literally, as they lick themselves! Zinc oxide (the white glob on the lifeguards’ nose) is toxic to dogs. Some dogs will tolerate hats or wear protective T-shirts, but the best idea in our hot summers is to simply keep these at-risk pets indoors during the day as much as possible.

In medicine there is always a new discovery around the corner. None of the skin care products I get to review will remove the laugh lines from Fido or Kitty but they do come with the promise of remedying a skin affliction. Please celebrate by raising your own glass of champagne.

Christine B. McFadden, DVM
drmc@mcmenagerie.com

 

 

 

Dr Mc Blog

 

February 17, 2016
They say variety is the spice of life. I am fortunate to have an extremely interesting career! In the past eight days I have seen one rabbit with an ear ache and spayed another. A lizard presented with scoliosis, curvature of the spine, caused by underlying malnutrition. I saw a cat with a very odd skin mite that may not have been diagnosed in Merced before! By the simple act of pressing scotch tape over the cat’s dander and looking at this under the microscope I found a mite I’d never seen before. My colleague, Dr. Klingborg, identified it from a derm (skin) meeting he’d attended in November and now we’ve held several discussions on the presence of this mite in Merced (it is considered to be contagious between cats). And always, the “usual” mix of cats, dogs, and birds. Today while performing spay surgeries (an ovariohysterectomy surgery) on cats I opened up one female cat only to find parts of a mummified fetus in her abdomen, causing no known distress to her before today. I completed the surgery and explained the situation to her owner, using digital photos taken during the surgery. Another veterinarian in the practice, Dr. Lauppe, was doing an orthopedic surgery on an injured knee while Dr. K removed a cancerous mass and attended to a dog that had been attacked by another dog (BBBD – Bit By Big Dog). A guinea pig with an eye ulcer came in and the Zoo needs a review on the Mountain Lion’s diet. A delightful Labrador had five enormous rotting teeth extracted and went home on antibiotics and painkillers. In two weeks he’ll be soooo much better! A lady called about a duck she thought might have eaten a tiny battery (the battery could corrode the stomach and cause heavy metal poisoning. All waterfowl are at risk of ingesting odd metal objects – they just like shiny objects). A woman (I never got her name) brought in a hummingbird that “fell from the sky”. We mixed up sugar water, revived the uninjured bird and sent it off with her to be released where she found it. An abuse case was brought in by Animal Control and a pregnant dog with three puppies stuck inside presented for a Caesarean section, performed beautifully by one of the other vets. I saw a Sulcata African tortoise with a mild upper respiratory disease and discussed the special dietary needs the new owner would want to address. Obtained from a Tortoise rescue group, the Sulcata’s shell mounded up on top, called pyramiding of the carapace. Much like the lizard with the deformed spine, it indicated an improper calcium and vitamin D ratio, the tip of the iceberg for signs indicating malnutrition.

February is National Dental Month for Dogs and Cats and most veterinarians who care for companion animals focus special attention on dental care this month. In veterinary medicine we are not focused on the whitest smile to impress someone! You are most fortunate if you have never experienced a tooth ache. Some dogs present with teeth so brown with mineralized plaque and calculus that it looks like moss has grown on them. That bad breath smell is from the bacteria growing along and under the gum line. The same bacteria that can dislodge and spread to the heart or kidneys. Cats demonstrate “jaw chatter” if you touch a tooth with a neck lesion cavity near the gum line – you can observe this incredibly painful response after you peel your cat off the ceiling. Most dogs and cats continue to eat despite foul teeth – please do not judge your pet’s dental pain by whether they haven’t starved to death! Over the years I have heard countless times of pets that “acted years younger” once their abscessed teeth were removed, their mouths healthy again. Call your vet today – there are some great deals out there this month!

Christine B. McFadden, DVM
drmc@mcmenagerie.com
Valley Animal Hospital, Merced