Archive for May, 2011

It’s foxtail season, again!

May 31, 2011

Photo © Margaret Birkhaeuser

 The emergency room docs I work with are  busy pulling foxtails out of eyes, ears, noses, and throats as well as from in between toes.  Such activity reminds me that it is once again time to blog about these pesky bristly plant awns that grow in abundance where I live in California.  In fact they are reported in most every state west of the Mississippi.  For more information about foxtails and the ways they wreak havoc, please read the blog I wrote right about this time last year.  

This year I’d like to tell you about a new way to prevent foxtails from finding their way into their favorite canine orifices (eyes, ears, nose, and mouth). Check out the OutFox Field Guard™ (www.outfoxfieldguard.com), the brainchild of a clever woman named Margaret Birkhaeuser. I suspect her invention was born as a result of multiple foxtail related trips to the veterinary hospital.  Have a look at Margaret’s site and you will see dogs modeling their mesh bonnets along with a video demonstrating the ease of attaching and detaching the device from a dog’s collar.  Believe it or not, dogs can drink and even carry toys in their mouths while wearing them!  A few of my clients who have purchased the product are completely sold on their investment.  

Photo © Margaret Birkhaeuser

If your dog has been a foxtail repeat offender I strongly encourage you to consider the OutFox Field Guard™.  Not only is it a great insurance policy to protect your dog’s health, think about the money you’ll save by eliminating trips to the vet clinic during foxtail season.  

Photo © Margaret Birkhaeuser

Has your dog been a repeat offender?  Please share your story.  

Best wishes for good health,   

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of  Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook   

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, and your favorite online book seller.

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It's foxtail season, again!

May 31, 2011

Photo © Margaret Birkhaeuser

 The emergency room docs I work with are  busy pulling foxtails out of eyes, ears, noses, and throats as well as from in between toes.  Such activity reminds me that it is once again time to blog about these pesky bristly plant awns that grow in abundance where I live in California.  In fact they are reported in most every state west of the Mississippi.  For more information about foxtails and the ways they wreak havoc, please read the blog I wrote right about this time last year.  

This year I’d like to tell you about a new way to prevent foxtails from finding their way into their favorite canine orifices (eyes, ears, nose, and mouth). Check out the OutFox Field Guard™ (www.outfoxfieldguard.com), the brainchild of a clever woman named Margaret Birkhaeuser. I suspect her invention was born as a result of multiple foxtail related trips to the veterinary hospital.  Have a look at Margaret’s site and you will see dogs modeling their mesh bonnets along with a video demonstrating the ease of attaching and detaching the device from a dog’s collar.  Believe it or not, dogs can drink and even carry toys in their mouths while wearing them!  A few of my clients who have purchased the product are completely sold on their investment.  

Photo © Margaret Birkhaeuser

If your dog has been a foxtail repeat offender I strongly encourage you to consider the OutFox Field Guard™.  Not only is it a great insurance policy to protect your dog’s health, think about the money you’ll save by eliminating trips to the vet clinic during foxtail season.  

Photo © Margaret Birkhaeuser

Has your dog been a repeat offender?  Please share your story.  

Best wishes for good health,   

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of  Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook   

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, and your favorite online book seller.

Normal Abnormalities

May 23, 2011

A “normal abnormality” is the term I use to describe something that is worthy of note within my patient’s medical record, yet is an anticipated abnormality (given the animal’s age, breed, or circumstances) that is highly unlikely to ever become a significant health issue.  I liken such abnormalities to the brown “liver spots” many people develop on their skin in response to sun exposure and aging.  Here are some examples of commonly encountered “normal abnormalities”:

Lenticular sclerosis:  This is an age-related change that occurs within the lenses of the eyes (dogs and cats). The pupil of the eye is normally black because the lens which is located just behind the pupil is crystal clear.  With age comes some rearrangement of lens fibers resulting in a grayish/whitish rather than normal black appearing pupil. This change is referred to as lenticular sclerosis.  People who notice this are usually concerned that their pet is developing cataracts. Whereas cataracts are opaque and interfere with light transmission to the retina, lenticular sclerosis causes no functional visual impairment. How can you know if your pet’s graying pupils represent cataracts or lenticular sclerosis?  Ask your veterinarian to have a look.

Sebaceous adenomas:  These small, warty appearing skin growths commonly develop in older dogs.  Sebaceous adenomas result from blockage of ducts that normally carry sebum to the skin surface. Smaller dogs are particularly prone- Miniature and Toy Poodles reign supreme when it comes to this age-related change.  Sebaceous adenomas are completely benign and rarely need to be removed unless they are growing or changing significantly (some dogs bite or scratch at these skin growth resulting in bleeding or infection). Removal of sebaceous adenomas may also be warranted if they manage to get in the way of grooming clippers.  Always point out any new lumps or bumps to your veterinarian including those you suspect are sebaceous adenomas.

Lipomas:  These benign fatty tumors develop under the skin in mature dogs (rare in kitties).  They can occur anywhere, but their favorite places to grow are the armpit, the inguinal region (the crease between the upper thigh and the belly wall), and along the body wall.  They are completely benign and need to be removed only if they are growing rapidly or, because of their location, have the potential to impede normal limb motion.  How can you know if a lump you’ve just discovered is a lipoma?  Schedule a visit with your veterinarian.  She will collect some cells using a small needle for evaluation under the microscope. If all that is present are fat cells, the diagnosis is a lipoma.  Every once in awhile these tumors become infiltrative sending tendrils of growth down into deeper tissues.  If your vet feels that your dog’s lipoma falls into this category, surgical removal will be recommended.

Stress induced changes:  No one likes going to the doctor, and our pets are no exception.  Squeezing your kitty into a cat carrier, the car ride, a lively waiting room scene, having a thermometer inserted you know where, the sights, the smells- all of these things can cause stress for your dog or cat!  And when the body is stressed, the body compensates by producing a number of normal physiologic changes such as increases in heart rate, blood pressure, body temperature, and blood sugar measurement.  Your veterinarian will have various tricks up her sleeve to determine whether such changes represent “normal abnormalities” or are indicators of underlying disease.

Should such “normal abnormalities” be ignored?  Not at all.  They should be noted in your pet’s medical record.  Additionally, “watchful waiting” will be recommended because every once in awhile, these abnormalities can morph into something that is deserving of more attention.  For example, a sebaceous adenoma can become infected, a dog with lenticular sclerosis can develop cataracts, and a growing armpit lipoma can begin to hinder normal motion of the front leg. While you are doing your “watchful waiting” count your blessings because, of all the abnormalities you or your veterinarian can find, a “normal abnormality” is the very best kind!

Does your dog or cat have a “normal abnormality”?  Do tell.

Best wishes for good health, 

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of  Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook 

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, and your favorite online book seller.

Advocacy Aids

May 16, 2011
 

Photo © Susannah Kay

I use the term Advocacy Aids to describe a set of health forms I’ve created to help you excel as your pet’s medical advocate. Where can you find them?  It’s easy.  Simply go to www.speakingforspot.com and look for “Resources” in the red horizontal main menu.  The first item in the Resources pull down menu is Advocacy Aids.  I invite you to download, print, copy, and use them to your heart’s content.  Feel free to share with others as well.  By the way, while you’re there  please check out my new website! 

The Advocacy Aids include: 

Health History Form:  This form provides an easy way to keep track of your pet’s vaccinations, test results, prior medical issues, surgical procedures, and adverse reactions to medications or vaccinations. 

Current Medications:  List all of your pet’s current medications (including supplements, flea and tick control products, and heartworm preventive).  Be sure to bring along a copy to every hospital visit. Your vet will be profoundly grateful and this paperwork will help you both catch any prescription errors. 

Current Health Issues:  This form helps keep track of all of your pet’s current medical issues.  It’s helpful to maintain a written list so none of the issues will be overlooked or forgotten. 

Medication and Treatment Schedule:  This template is wonderfully helpful if your pet requires medications/treatments multiple times daily and/or at different times of day.  I’ve provided you with the same template we use when treating animals in my hospital.  On my website you will find a sample template form that I’ve filled out (so you can see how it works) as well as a blank template for your use. 

Emergency Contact Information:  You will want to have ready access to this completed form in order to avoid spending time tracking down necessary information while in the midst of an emergency. Be sure to provide a copy to the person caring for your pets when you are away. 

Contingency Plan: Use this form when you are going out of town and may not be one hundred percent reachable.  The form lets your veterinarian know which trusted person you’ve designated to make medical decisions about your pet should you not be reachable.  Distribute a signed copy to your pet-sitter/boarding facility and your veterinarian. 

Veterinary Office Visit:  This form will help you keep track of the purpose of your visit as well as important questions to ask your veterinarian. 

For those of you with pets other than dogs, please forgive me as many of the forms contain the word, “dog”.  Feel free to cross this word out and substitute in any species you like!  After you’ve had a look at the Advocacy Aids, please let me know which ones you like and think you will use.  If you can think of other Advocacy Aids, please don’t be shy.  I would love to hear your ideas. 

Best wishes for good health, 

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of  Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook 

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, and your favorite online book seller.

Stem cells: A beneficial therapy or a waste of money?

May 8, 2011

 

Stem cell therapy (aka regenerative medicine) is becoming all the rage in veterinary medicine.  Initially used only to treat damaged horse parts (tendons, ligaments, and joints) the repertoire of stem cells has expanded to treating dogs, primarily for management of arthritis symptoms.  Even a few kitties are getting in on the act as regenerative medicine is investigated as a means of restoring health to their aged kidneys.

Here’s a rundown on the logistics of stem cell therapy. The process begins with the veterinarian harvesting fat or bone marrow samples from the affected individual.  These samples are then sent off to a specialized “stem cell company” for processing. Recently, one company, MediVet America, has provided the option for vets to propagate stem cells within their own hospital setting. Once harvested the stem cells are injected into the patient’s affected body part(s) and/or are administered intravenously.  Extra cells can also be “banked” for future use. And all of this for a price of $2,000 to $3,000, on average.

In theory, these stem cells have the potential to differentiate into bone, cartilage, and many soft tissue types.  Why do I emphasize, “in theory”? To date, there is no proof that the stem cells, once injected into the body, do actually become the cells we are hoping for.  Perhaps any observed benefit is a result of biochemical alterations of the cells already present rather than regeneration of new and improved cells. 

Not only is there a paucity of information about what actually happens to the cells after they are injected, there is a surprising lack of evidence-based data that supports any benefit of stem cell therapy.  In this regard, it appears that the stem cell therapy cart has pulled way ahead of the horse- unusual in the world of “western medicine” where veterinarians are typically reluctant to embrace a particular therapy without it having survived the scrutiny of evidence-based medicine.  Yet many western trained practitioners readily offer forth stem cell therapy to their clients based on anecdotal information (individual client impressions, vignettes told by other veterinarians, marketing materials from stem cell laboratories). 

According to a recent article in the Journal of the American Veterinary Medical Association (JAVMA), Dr. Robert Harman, CEO of Vet-Stem Inc reports that his company has processed stem cells from fat samples for approximately 8,000 patients.  Approximately half the patients are horses, the other half comprised of dogs and a few cats.  In the same article, Dr. Sean Owens, director of the Regenerative medicine Laboratory at the University of California- Davis School of Veterinary Medicine states, “We’ve moved forward so quickly that what we need to do now is put the science underneath.”

Dr. Brennan A. McKenzie is the president-elect of the Evidence-Based Veterinary Medicine Association. As stated in the same JAVMA article, “Dr. McKenzie thinks the use of stem cells is a promising avenue for therapy but that the evidence of efficacy and safety is inadequate to justify the expensive treatment in most cases.  He would prefer for clinics to offer stem cells as a truly experimental treatment in formal clinical trials.”

The North American Veterinary Regenerative Medicine Association has recently been organized with hopes of acting as a clearinghouse of information on the use of stem cells in veterinary medicine.  Their first official meeting will be in June with the intention of forming standing committees to address things such as clinical trials and regulatory affairs.

Given the paucity of research supporting stem cell therapy, is there any downside to opting for this form of therapy for your dog or horse?  While there is always risk associated with general anesthesia (usually required for harvesting fat or bone marrow samples as well as injecting the stem cells into the exactly appropriate spot), thusfar, there have been no reports of adverse effects caused by the stem cells themselves. If my own doggie had significant arthritis pain and nothing else in my medical arsenal (supplements, acupuncture, underwater treadmill therapy, nonsteroidal anti-inflammatory medications) made a difference, might I try stem cell therapy?  You betcha. Is there risk of expenditure of two to three grand without a return on investment?  You betcha.

Has one of your four-legged family members received stem cell therapy?  If so, I welcome your feedback.

Best wishes for good health,             

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of  Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook 

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, and your favorite online book seller.

When the Doctor Becomes the Patient: Not Always a Pretty Picture

May 2, 2011

While in the midst of my post-surgery “down time” I’ve been chuckling a bit about what my own physicians have endured as a result of my medical background.  How commonly is a surgeon interrogated about what type of suture pattern and material he intends to use? How often does an anesthesiologist need to provide a detailed pharmacologic rundown of the anti-emetic (anti-vomiting) drugs that will be used to keep the patient with a queasy stomach from puking post-operatively? 

© Steve Horton

I remember one particular appointment with my family physician a few years back.  When we discussed the reason for the visit I began with, “I think I have cancer!”  I explained that I’d been losing weight even though I’d been eating normally.  After all, a diagnostic workup on a middle-aged dog or cat losing weight in the “midst of plenty” often results in the diagnosis of cancer.   My physician worked hard to hide a grin as he explained that, given my age, sex, and overall vigor, other diagnoses were far more likely. Thankfully, he was right, and the next time I saw him he asked for permission to share this “amusing patient story” with some medical students he was training.  

Sometimes, the medical knowledge I have can be a detriment to my own peace of mind.  As the story above illustrates, I’m always keenly aware of the worst-case scenario (tough on a person who is a natural born worrier). Would I trade being a veterinarian for any other profession?  Not in a million years.  Not only do I love what I do, I love that my medical background (along with a bit of chutzpah) allows me to be a stellar medical advocate for myself.  And if you’ve read much of what I’ve written in the past, you know that I am all about medical advocacy! 

Do you work within the medical profession?  If so, how has this been helpful or detrimental when interacting with your health care professionals (including your veterinarian)? 

Best wishes for good health,             

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of  Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook 

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, and your favorite online book seller.