Archive for November, 2009

Avoiding Pancreatitis During the Holidays

November 30, 2009

I wrote the following last year for one of my favorite magazines, BARK (the inventors of “Dog is my co-pilot”).  With the holidays once again upon us, I thought I’d toss this information out into cyberspace as a timely reminder to avoid overindulging our dogs!

‘Tis the season for family gatherings, gift giving, and food galore.  Veterinarians know that this is also the season for canine pancreatitis (inflammation of the pancreas), a painful, potentially life-threatening condition most commonly caused by overindulgence in foods that are particularly rich or fatty. And what kitchen isn’t overflowing with such foods this time of year?

The pancreas is a thin, delicate-appearing, boomerang-shaped organ that resides in the abdominal cavity, tucked up against the stomach and small intestine. While the pancreas may be diminutive in appearance, its actions are mighty! It is the body’s source of insulin and enzymes necessary for food digestion. When pancreatitis is chronic or particularly severe, this little factory sometimes permanently closes down, resulting in diabetes mellitus (requires insulin shots) and/or exocrine pancreatic insufficiency (requires digestive enzyme replacement therapy). 

When a dog eats, enzymes are released from the pancreas into the small intestine, where they are activated for food digestion. Sometimes, for reasons we do not understand, these enzymes are activated within the pancreas itself, resulting in the inflammation of pancreatitis. In addition to rich or fatty foods, certain drugs, hormonal imbalances and inherited defects in fat metabolism can also cause pancreatitis. For some dogs, an underlying cause is never found. Classic pancreatitis symptoms include vomiting, abdominal pain, and decreased appetite and activity levels. 

Short of performing a pancreatic biopsy (an invasive and risky procedure), diagnosing pancreatitis can be challenging, because noninvasive tests are fraught with false-negative and false-positive results. Veterinarians must rely on a combination of the following: 

• A history of dietary indiscretion, vomiting and lethargy.

• Physical examination findings (particularly abdominal pain).

• Characteristic complete blood cell count (CBC) and blood chemistry abnormalities.

• A positive or elevated Spec cPL (canine pancreas-specific lipase) blood test.

• Characteristic abdominal ultrasound abnormalities. 

There is no cure for pancreatitis—much like a bruise, the inflammation must resolve on its own. This is best accomplished by allowing the pancreas to rest, which means giving nothing orally (not even water) to prevent digestive enzyme secretion. Treatment consists of hospitalization for the administration of intravenous fluids; injectable medication to control vomiting, pain and stomach acid secretion; and antibiotics to prevent secondary infection or abscess formation. Dogs should be monitored around the clock for the life-threatening complications that sometimes accompany pancreatitis, such as kidney failure, heart rhythm abnormalities, respiratory distress and bleeding disorders. Small amounts of water and a fat-free diet are typically offered once vomiting has stopped, abdominal pain has subsided, and there is blood test and/or ultrasound confirmation that the inflammation has calmed down. If your dog has pancreatitis, count on a minimum of two to three days of hospitalization, and be sure to ask who will be caring for your dog during the night. 

Long-term treatment for pancreatitis typically involves feeding a low-fat or fat-free diet. This may be a life-long recommendation, especially if your dog has been a “repeat offender.”  Most dogs fully recover with appropriate therapy; however, some succumb to the complications associated with this disease.

Nicky 

How can you prevent pancreatitis during this food-oriented time of year? You can avoid feeding holiday leftovers altogether (this would cause canine mutiny in my household) or you can heed the following recommendations. New foods should be fed sparingly and only if well tolerated by your dog’s gastrointestinal tract and waistline.  Keep in mind that whether offered a teaspoon or a tablespoon of something delicious, most dogs will gulp it down in the same amount of time and reap the same psychological benefit. Don’t offer tidbits from the table while you are eating. This is a set up for bad behavior. Offer the treat only after you’ve left the table. If you shouldn’t be eating the food yourself (emphasis on shouldn’t), please don’t feed it to your dog! By all means, give your precious poopsie a bit of turkey breast, but without the turkey skin or fat-laden mashed potatoes and creamy gravy. Go ahead and offer your sweet snookums a bite of brisket, but please —no potato latkes or sour cream! Bear in mind that most dogs are so darned excited about getting a treat, they don’t care what it is, only that they’re getting it!

Some people dream of sugar plum fairies, a white Christmas or a stress-free family gathering. I’m dreaming of a holiday season in which not a single dog develops pancreatitis!

Wishing you and your four-legged family members a joyful and healthy holidays season.

Dr. Nancy Kay
Specialist, American College of Veterinary Internal Medicine 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller.  

Speaking for Spot, signed by Dr. Kay, a great gift idea for holiday 2009 shoppingOrder  a copy of Speaking for Spot personally signed by Dr. Kay – http://www.speakingforspot.com/purchase.html

Join our email list – http://speakingforspot.com/joinemaillist.html

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Listen to Dr. Kay’s interview – A Veterinarian Advises “How to Speak for Spot” on NPR’s Fresh Air with Terry Gross

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Get Out Your Reading Glasses!

November 25, 2009

When was the last time you took a close look at your pet’s prescription medication label?  Would you be surprised to know that, by law, the label is required to include twelve different informational items? Have a look at this mandatory dozen and see if every single one of them appears on your pet’s prescription label.

Speaking for Spot's advice on reading your pet's medication labels

1.   Date the medication was prescribed

2.   Your pet’s name

3.   Your name

4.   The prescribing veterinarian’s name

5.   Address and telephone number of the facility filling the prescription

6.   Amount of medication dispensed (milliliters, ounces, number of tablets or capsules)

7.   Strength of the medication (milligrams, micrograms)

8.   Dosage and duration of treatment

9.   Route of administration (orally, applied to the skin, in the ear)

10.  Number of refills

11.  Cautionary instructions (“shake well,” “keep refrigerated,” “don’t let your dog drive”)

12.  Expiration date 

After performing this exercise, please let me know what you learned, other than, that’s one heck of a lot of information for such a tiny label?  It’s no wonder I need my reading glasses! 

Wishing you and your four-legged family members abundant good health,

Dr. Nancy Kay
Specialist, American College of Veterinary Internal Medicine 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller. 

Speaking for Spot, signed by Dr. Kay, a great gift idea for holiday 2009 shoppingOrder  a copy of Speaking for Spot personally signed by Dr. Kay – http://www.speakingforspot.com/purchase.html

Join our email list – http://speakingforspot.com/joinemaillist.html

Look for us on Twitter – http://twitter.com/speakingforspot

Become a Fan of Speaking for Spot on Facebook

Listen to Dr. Kay’s interview – A Veterinarian Advises “How to Speak for Spot” on NPR’s Fresh Air with Terry Gross

A Gift of Spot

November 21, 2009

Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life by Dr. Nancy KayWho doesn’t have a dog lover or two on their holiday gift list?  If you are brainstorming the “perfect present” for your friends, relatives, veterinarian, groomer, and Dog Park buddies, here is an idea to consider.   How about a personally signed copy of Speaking for Spot!  I would be pleased, in fact, honored to personally inscribe as many gift books as you like. Heck, I’ll even provide the wrapping paper (dog motif, of course). Additionally, now through the end of December, 10% of the sales proceeds will be donated to Morris Animal Foundation’s Canine Cancer Campaign (www.curecaninecancer.org/).

Here’s what a few people who love dogs have said about Speaking for Spot: 

“From vaccinations and pet insurance to second opinions and end of life decisions, dog lovers often feel overwhelmed trying to make the best choice for their pup, pocket book, and peace–of–mind. Thanks to Speaking for Spot, we finally have a book that makes sense of it all! With experience, warmth, wit, and candor, Dr. Nancy Kay provides an authentic, user–friendly guide for making all types of health care choices for your dog.”

– Dr. Marty Becker, resident veterinarian on Good Morning America, nationally syndicated newspaper columnist, and cofounder of petconnection.com 

“Speaking for Spot is an engaging, compelling and truly indispensable book. Dr Nancy Kay enables her readers to become well-informed advocates for their pets’ health care decisions. She has provided the perfect guide that will make a tremendous difference for dogs and for the people who love them.”

-Claudia Kawczynska, Editor-in-Chief, The BARK magazine 

If a dog owner could have only one book for health information, this is it. This is an excellent book at a reasonable price.  I highly recommend it.”

-Dr. Susan M. Cotter, Diplomate, American College of Veterinary Internal Medicine, in the Journal of the American Veterinary Medical Association, Sept. 15, 2009 

There are two ways to obtain personalized copies of Speaking for Spot.  You can mail your own books to me or you can purchase the book via my website.  For either option, simply follow the steps found at http://speakingforspot.com/purchase.html

Not only will this “gift of Spot “ be personalized and easy on the pocketbook, it will provide the people you care for with an invaluable resource that will last a lifetime. Don’t forget to “gift yourself” while you are at it! 

Wishing you and your four-legged family members abundant good health,

Dr. Nancy Kay
Specialist, American College of Veterinary Internal Medicine 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller. 

Join our email list – http://speakingforspot.com/joinemaillist.html

Look for us on Twitter – http://twitter.com/speakingforspot

Become a Fan of Speaking for Spot on Facebook

Listen to Dr. Kay’s interview – A Veterinarian Advises “How to Speak for Spot” on NPR’s Fresh Air with Terry Gross

The Grapes of Wrath

November 15, 2009

What a gorgeous time of year it is where I live, in the heart of northern California’s wine country. The leaves of the grapevines are luminescent shades of orange, yellow, and magenta. The vintners are smiling because the weather has provided them with a bumper crop.  Their grapes have been harvested and the “crush” is on.

As much as I enjoy this season, the grapes always create some anxiety for me.  What most people don’t realize is that grapes (and raisins) can be terribly toxic for dogs.  Fortunately, not all dogs become sick after eating grapes or raisins, but nothing clearly predicts which ones are susceptible.  For those who are, ingestion of even a small amount (as little as 0.35 ounces of grapes per pound of the dog’s body weight and 0.05 ounces of raisins per pound of the dog’s body weight) has the potential to cause kidney failure that may be irreversible. The toxic component within grapes and raisins hasn’t been identified, but it is thought to be contained within the flesh of the grape (not within the seeds). 

In susceptible dogs, symptoms of kidney failure develop within 24 hours following ingestion of the grapes or raisins.  They include: lethargy, loss of appetite, vomiting, and diarrhea. Partially digested grapes or raisins might be seen in the bowel movement or vomited material. What should you do if you discover that your dog has eaten grapes or raisins?  Seek out veterinary care as soon as possible- the earlier treatment is started, the better the prognosis.  If it has been less than a few hours, your veterinarian will induce vomiting to try to remove the toxin before it is absorbed into your dog’s bloodstream. If several hours have lapsed, hospitalization for treatment to prevent kidney failure will be recommended.  Once kidney failure develops, the prognosis is guarded. One study documented only a 53 percent survival rate even with aggressive treatment.  

So, here is the lesson of the season- dogs and grapes (or raisins) are a potentially lethal combination. Cats are thought to be susceptible to this toxicity as well.  Fortunately, cats who fancy fruit are few and far between! Please share this information with all of your dog-loving friends and relatives and ask them to do the same.  You just might save a life in the process! 

Wishing you and your four-legged family members good health,

Dr. Nancy Kay
Specialist, American College of Veterinary Internal Medicine 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller. 

Join our email list – http://speakingforspot.com/joinemaillist.html

Look for us on Twitter – http://twitter.com/speakingforspot

Become a Fan of Speaking for Spot on Facebook

Listen to Dr. Kay’s interview – A Veterinarian Advises “How to Speak for Spot” on NPR’s Fresh Air with Terry Gross

Medical Alert for Those Caring for a Diabetic Dog or Cat

November 7, 2009

If your four-legged family member is diabetic and the insulin product you are administering is Vetsulin®, please pay close attention.  The FDA’s Center for Veterinary Medicine is alerting veterinarians that problems with this product are being reported. Apparently, as Vetsulin® sits in storage, the crystalline zinc crystal component (which is supposed to comprise 70% of the solution; the remaining 30% is the insulin) can increase above 70%.  This leads to a slower onset of action of the insulin and, potentially a longer duration of action both of which can result in unpredictable fluctuations in blood glucose values (values that are too high or too low). 

The manufacturer of Vetsulin®, Intervet/Schering-Plough Animal Health is unable to assure the FDA that each batch of their product is stable.  This company, along with the FDA have requested that veterinarians closely monitor their patients receiving Vetsulin®.  

There is absolutely no need to panic.  However, if your dog or cat is receiving this product, I strongly encourage you to discuss the following with your veterinarian: 

  1. Symptoms to be watching for that might indicate your pet’s blood glucose value is too high or too low
  2. Monitoring of blood glucose values
  3. Whether or not your pet should be transitioned to a different brand of insulin 

At the time of this writing, this problem has not been addressed on the Internet/Schering-Plough Web site (www.vetsulin.com) but I expect information will soon be forthcoming.  

For more information about Vetsulin® concerns visit www.fda.gov/AnimalVeterinary/NewsEvents/CVMUpdates/ucm188752.htm.

Wishing you and your four-legged family members good health,

Dr. Nancy Kay
Specialist, American College of Veterinary Internal Medicine 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller. 

Join our email list – http://speakingforspot.com/joinemaillist.html

Look for us on Twitter – http://twitter.com/speakingforspot

Become a Fan of Speaking for Spot on Facebook

Listen to Dr. Kay’s interview – A Veterinarian Advises “How to Speak for Spot” on NPR’s Fresh Air with Terry Gross

Will Your Pet’s Microchip Bring Him Home?

November 3, 2009

Other than hanging identification tags on collars, I’ve always thought (and advised my clients) that microchipping our dogs and cats is the best way to ensure that we will be reunited should circumstances separate us. As it turns out, microchipping is not nearly so foolproof as I’ve believed- not because the chips are defective, but rather, because of human error.  Have a look at what I just read in the November 1st edition of the Journal of the American Veterinary Medical Association (JAVMA)

“A limitation of the microchip registry system is than many pet owners do not register microchips in their names according to ‘Characterization of animals with microchips entering animal shelters’ (see JAVMA, July 15, 2009).  In that study, shelters contacted microchip registries regarding 1,943 animals but found registrations for only 58.1 percent.  The registries were unable to find any information on the owner or on the person who implanted the microchip for 9.8 percent of the animals. Among other recommendations, the study’s authors suggested that veterinarians and shelter personnel should not only register pet microchips at the time of implantation, but also remind the pets’ owners to update information in the registry. 

Jason Merrihew, American Animal Hospital Association spokesman said, educating pet owners is a key step to improve microchipping as a form of pet identification. ‘Every time that they change their address or change phone numbers, then they need to update that microchip information,’ Merrihew said.” 

So what does all this mean? Here’s the bottom line in terms of achieving the intended purpose of your pet’s identification microchip: At the time your dog or cat is microchipped, be sure to complete the registration materials and have them processed with the appropriate microchip registry.  Be sure your veterinarian (or whoever it is that implants the microchip) does the same.  Additionally, update that registry whenever your contact data (telephone number, address) changes.  I haven’t moved or changed my phone number (or my name!) in well over a decade, so my pets and I are in good shape.  How about you and yours? Will your lost dog or cat be able to find you again?  If you know your contact information is not current, or you are unsure, pick up the phone or go online today.  It could make all the difference. 

Wishing you and your four-legged family members good health,

Dr. Nancy Kay
Specialist, American College of Veterinary Internal Medicine 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller. 

Join our email list – http://speakingforspot.com/joinemaillist.html

Look for us on Twitter – http://twitter.com/speakingforspot

Become a Fan of Speaking for Spot on Facebook

Listen to Dr. Kay’s interview – A Veterinarian Advises “How to Speak for Spot” on NPR’s Fresh Air with Terry Gross