Posts Tagged ‘American Animal Hospital Association’

Goin’ to Carolina

November 5, 2011

While you are reading this, my husband and I are in the process of driving cross-country with our animals in tow. We’ve decided to follow our hearts on a new adventure and are leaving the warm slopes of northern California for the Blue Ridge Mountains of western North Carolina. The decision to move 3,000 miles certainly wasn’t made on the fly. My husband and I are big thinkers and planners, carefully weighing in on all the pros and cons over and over again. But, boy oh boy, this is a biggee and I vacillate between feeling super excited and scared to death!

Our friends, relatives, and colleagues (particularly those who have never been to western North Carolina) have all asked, “Why are you doing this?” The answer is really quite simple- our response is “Because we can.” Our three little chicks have left the nest and are doing their thing out in the world (Wyoming, Ohio and Germany). My hubby and I like to think of this major life change as our attempt to make our “third trimester” all that we want it to be. We are both avid horseback riders and we’ve longed to live on property abutting an extensive trail system. This means saddling and up and riding out with no horse trailering involved! Our new property abuts Dupont State Forest, a veritable mecca for horseback riding.

After figuring out where we wanted to live I checked out job prospects. The closest specialty hospital is Upstate Veterinary Specialists.  Now this part is too good to be true- not only did this hospital win the 2011 American Animal Hospital Association Specialty Hospital of the Year Award, the hospital owners want me to work with them! I will begin my new job in early December.

You won’t hear from me for another week or two. Not to worry, once settled I will resume my regular blogging habits, although you may begin to detect a bit of a southern accent!

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.

Advertisements

Pet Nutrition Follow-up

February 10, 2011

If you could see me now dear readers, you would know that I am giving you a standing ovation! I anticipated my recent blog post about what to feed our pets might generate some heated discussion and bullying behavior. I thought I might have to be a cyberspace referee! I needn’t have worried- your comments, which can be viewed at http://www.speakingforspot.com/blog/?p=2048 were all so darned civilized! You reported how you feed your pets and what you’ve learned through your own experiences. No one was even remotely pushy! Better yet everyone agreed, as do I, that there is no single type of diet that is suitable for every dog or every cat. Hats off to you! I’m deeply appreciative.

Now, as promised, I will fill you in on my current philosophy about feeding our pets. I emphasize current philosophy because I am absolutely willing to change what I recommend pending the results of future research. While there is plenty of data telling us which nutrients and how much of them dogs and cats need to grow and maintain good health, there is a paucity of legitimate research comparing how those nutrients are delivered, particularly pertaining to raw versus processed foods.

Keep in mind I am not a primary care doctor (aka, family veterinarian). As a board certified small animal internist, the clients and patients I see are referred to me to address internal medicine issues. Invariably, my clients have already made diet decisions based on discussion with their family vets. My job is to determine if and when I should “rock the boat.” After raising three children and working with gazillions of devoted dog and cat lovers, I’ve learned that it is wise to choose my battles wisely. If a client is clearly devoted to a particular diet for his or her dog or cat, and I am convinced that their choice is causing no harm, I don’t go there. Here are some situations that will prompt me to recommend a diet change.

1. My patient is eating a diet that is not nutritionally balanced. Although this can happen with prepared foods, it most commonly occurs with homemade diets and well-meaning clients who don’t know that diets balanced for human consumption are not balanced for canine or feline consumption. If these clients wish to stick with home preparation, I recommend consultation with a board certified veterinary nutritionist and/or reliable references that provide recipes for balanced homemade diets.
2. My patient is eating a raw or processed food diet of dubious origin. If I am unfamiliar with the brand of food I encourage my client to share the package label with the family vet or me so we can provide a better sense of whether or not the food is of good quality and nutritionally balanced. For example, I am not keen on pet foods produced by the neighborhood health food store. How can such a business possibly have the financial resources and knowhow needed to create a quality pet food product that is nutritionally balanced?
3. My patient is eating a raw diet while receiving medication or fighting a disease that causes immune system dysfunction (i.e., their immune system is on the fritz). In this situation I recommend discontinuation of the raw diet. While there is no data (yet) comparing the incidence of raw diet-induced infections in healthy versus immunocompromised patients, there is data that clearly documents increased numbers of disease-causing types of bacteria in the feces of animals fed raw animal protein. Until proven otherwise, I am concerned that my immunocompromised patients are at higher risk for developing raw protein-induced infections. And this simply isn’t a chance I want to take. Please know that some veterinarians feel differently about this, and in fact, believe ingestion of raw meat will help bolster the immune system.
4. My patient has a medical issue that would best be served by a change in diet. For example, I will encourage diet transition for the patient with kidney failure who is eating a high protein diet, the diabetic kitty who is eating dry food only, or the obese patient with arthritis who is eating a high fat diet.

I firmly believe that most of our dogs and cats can thrive on a variety of different foods/diets as long as they contain high quality ingredients and are nutritionally balanced based on life stage (puppies/kittens, adults, and seniors all have different requirements). Whether you choose to feed a homemade diet or prepared raw or processed food is a personal choice; just as shopping for yourself at Whole Foods versus Safeway (the main grocery store chain in northern California) is a personal choice. Whichever style of diet you choose for your pets, your goal is to ensure you are feeding a high quality, balanced product. Here are some suggestions to help you hone in on some good choices amongst the literally hundreds of products at the pet food grocery store!

• Shop at your local independent pet food store. Yes, the prices may be higher (quality pet food is expensive), but the sales people you encounter are far more likely to be knowledgeable than those working at the big box stores. Additionally, pet store shelf space is limited so the brands of food stocked there will be those the staff truly believes in.
• Learn what to be looking for when you read the food label. The best resource I’ve found for teaching this is The Whole Dog Journal. Your dog and I strongly encourage you to get a subscription as soon as possible (http://www.whole-dog-journal.com) ! Editor, Nancy Kerns provides her readers with plenty of practical wisdom about canine nutrition. In fact the February 2011 issue contains a fabulous article called, “Choices, Choices- On What Criteria Do you Base Your Dog’s Food Selection?” Be forewarned, there is some nepotism going on at WDJ- you will find at least one picture of Nancy’s dog Otto in every single issue! Now, if only Nancy would begin working on The Whole Cat Journal!
• The American Animal Hospital Association Nutritional Assessment Guidelines for Dogs and Cats can be found at http://www.aahanet.org/resources/NutritionalGuidelines.aspx. There is a lot of valuable information here. By the way, at the top of the page you will see that a major pet food manufacturer provided some funding for these guidelines to be made available in French, Japanese, and Spanish. Please don’t let this deter your learning.
• Talk to your veterinarian, let him or her know what you’ve learned, and discuss your pet food preferences.

As always, I welcome your comments!

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, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health 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.

Reasonable Expectations V: Discussion of All Options Regardless of Cost

October 24, 2010

This is the fifth part of an ongoing series describing how people are developing new expectations when it comes to veterinary care for their pets. Parts one through four can be found at http://www.speakingforspot.com/blog.

Veterinarians wear many different hats when they are in the exam room. It’s a given they provide medical care for their patients. But did you realize that, for their clients they often assume the role of social worker, calendar planner, grief counselor, and even mediator when there are conflicting opinions between family members (mostly spouses)? Why on earth some veterinarians wish to also become financial planners for their clients is beyond me! These are vets who pick and choose which medical and surgical options to discuss based on what they think their clients can afford.

I don’t work this way- I believe in presenting every option that is reasonable for my patient and then letting my client determine what they can and cannot afford. This means that my client will hear all the same options whether he or she arrives at my hospital driving a Mercedes Benz sports car or a jalopy. The American Animal Hospital Association agrees with my modus operandi- they conducted a study documenting that ninety percent of people want their vets to present every option regardless of cost. Please hear what this is saying: it is perfectly reasonable for you to expect discussion of all options for your precious family member regardless of cost!

Let’s consider the example of a torn cruciate ligament. The knee joint contains cruciate ligaments that are responsible for keeping the upper leg bone (femur) in alignment with the lower leg bone (tibia). Cruciate ligament tears commonly occur in large breed dogs and there are several options for treating this injury. The least expensive option is rest and anti-inflammatory medications, the cost of which might be a few hundred dollars over the course of a several months. This nonsurgical least expensive approach restores mobility and use of the leg, but predictably results in arthritis within the knee and chronic lameness. The most expensive option is one of two highly specialized surgical techniques (referred to as TPLO and TTA) performed by board certified veterinary surgical specialists. Such surgery is the very best bet for restoring complete lifelong soundness to the knee. Depending on where the dog lives (everything is more expensive in California!) the cost for this surgery is $3,000-$4,000. Tack on post-operative rehabilitation therapy (on an underwater treadmill) and add another $500-$1,000 to your bill. The “in between options” include various surgical procedures that many general practitioners perform. While they are less expensive ($1,000 to $2,000) such surgery is less likely to result in an arthritis-free knee. Treatment of cruciate ligament disease is a clear example of, “You get what you pay for.”

Now there are a number of factors to consider when determining the best treatment option for a torn cruciate ligament. Perhaps the dog is ancient and debilitated and the risk for general anesthesia and surgery is too great. Perhaps there are other medical issues that are likely to be life ending soon- in this situation it would be irresponsible to choose surgery. There are many factors to consider, and finances may be one of them. But how would you feel if discussion of medical therapy for your dog’s cruciate ligament tear was purposefully withheld because your vet assumed you could afford surgery? Likewise, what if there was no discussion of referral to a surgical specialist because your vet felt it would be too much of a financial stretch for you? Do you want your veterinarian to be your financial planner or would you prefer to hear about all the options, then decide for yourself? Let me know how you feel about this. By the way, it might be wise to let your own veterinarian know as well!

Now here’s wishing you and your four-legged family members abundant 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, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health 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. 

You can support your favorite rescue group.  The Speaking for Spot Gives Back Program shares a portion of the sales proceeds with approved non-profit organizations when you purchase a book via the Speaking for Spot website and designate the organization at the time of purchase.

Vaccinations for Your Dog: A Complex Issue

August 1, 2010

During my last year of veterinary school, I recall how scary it was when a new canine virus—parvovirus—seemed to appear out of nowhere.  Highly contagious, it spread like wildfire throughout the United States, causing severe illness and often death. It was a downright frightening time for veterinarians and the clients they served. Fortunately, an effective vaccine was rapidly developed, and this horrible new virus was downgraded from a rampant deadly infection to a preventable disease. Thank goodness for vaccines! They provide a remarkable means of preventive health care for dogs. 

As invaluable as vaccinations are for protecting canine health, determining which vaccines are appropriate and how frequently they should be administered are no longer simple decisions. In my book, vaccinations are no different than any other medical procedure.  They should not be administered without individualized discussion and consideration of the potential risks and benefits. Gone are the days of behaving like a “Stepford wife” when it comes to your dog’s vaccinations — it’s no longer necessarily in his best interest to vaccinate simply because a reminder postcard has arrived in the mailbox.

Consider the following: 

• There are currently 14 canine vaccinations to choose from! Back in the days when I was just a pup there were only five, and decision-making regarding vaccine selection for an individual dog was far less complicated.

• Over the past decade we’ve learned that, for some vaccines, the duration of protection is far longer than previously recognized.  In the past we vaccinated for the core diseases (distemper, parvovirus, and rabies) annually.  We now know that these vaccinations, when given to adult dogs, provide protection for a minimum of three years and, in some cases protection is life-long.

• The duration and degree of immune protection triggered by a vaccine is variable, not only based on manufacturer, but from dog to dog as well.

• Other than for rabies (state mandated), vaccination protocols are anything but standardized. There are no set rules veterinarians must follow when determining which vaccines to give and how often they are administered. Unfortunately, some vets continue to vaccinate for distemper and parvovirus annually even though we know that these adult vaccines provide protection for a minimum of three years.  Some vets give multiple inoculations at once, others administer just one at a time.

• Increasingly clear-cut documentation shows that vaccines have the potential to cause many side effects.  While vaccine reactions/complications are still considered to be infrequent, they can be life threatening. 

What you can do:

So, as your dog’s savvy and courageous medical advocate, what can you do to be sure that he is neither under or overvaccinated? Here are some guidelines for making wise vaccine choices for your best buddy: 

1.  Educate yourself about available canine vaccinations and the diseases they are capable of preventing (in some cases treating the disease, should it arise, might be preferable to the risks and expense associated with vaccination). Learn about duration of vaccine protection and potential side effects.  Talk with a trusted veterinarian and read the chapter called “The Vaccination Conundrum” in Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life. It provides detailed discussion about all aspects of canine vaccinations including the diseases they prevent, adverse vaccination reactions, and vaccine serology (blood testing that helps determine if your dog is truly in need of another vaccine). The American Animal Hospital Association’s “Canine Vaccine Guidelines” is also an excellent source of information.

2.  Figure out which diseases your dog has potential exposure to.  A miniature poodle who rarely leaves his Manhattan penthouse likely has no exposure to Lyme disease (spread by ticks); however a Lab that goes camping and duck hunting may have significant exposure.

3.  Alert your veterinarian to any symptoms or medical issues your dog is experiencing.  It is almost always best to avoid vaccinating a sick dog — better to let his immune system concentrate on getting rid of a current illness rather than creating a vaccine “distraction.” If your dog has a history of autoimmune (immune-mediated) disease, it may be advisable to alter his vaccine protocol or even forego ongoing vaccinations — be sure to discuss this with your vet.

4.  Let your vet know if your dog has had vaccine side effects in the past. If the reaction was quite serious, she may recommend that you forego future vaccinations, necessitating an official letter to your local government agency excusing your pup from rabies• related requirements.

5.  Consider vaccine serology for your dog.  This involves testing a blood sample from your dog to determine if adequate vaccine protection still exists (remember, vaccine protection for the core diseases lasts a minimum of three years).  While such testing isn’t perfect, in general if the blood test indicates active and adequate protection, there is no need to vaccinate. Serology may make more sense than simply vaccinating at set intervals.

6.  Ask your veterinarian about the potential side effects of proposed vaccinations, what you should be watching for, and whether or not there are any restrictions for your dog in the days immediately following vaccination. 

Vaccine Clinics

I will tell you right up front that I am not a fan of vaccine clinics –  a “factory line” approach to vaccinating dogs.  Their only redeeming quality seems to be their low cost that makes it possible for some dogs to be vaccinated that otherwise wouldn’t be.  Know that, if you choose to use a vaccination clinic you may be sacrificing quality of care for your dog in the following ways: 

• You may not receive adequate counseling about which vaccinations are appropriate for your dog based on his age and lifestyle.

• Serologic testing will not be an option.

• A thorough physical examination will not be performed prior to vaccination administration.  Abnormalities such as a fever, irregular heart rhythm, or abdominal mass will go unnoticed.  Not only might the vaccination do more harm than good in a dog that is sick, but a golden window of opportunity for early disease detection and treatment will be missed.

• Records pertaining to prior adverse vaccination reactions may not be available.

• The vaccination clinic veterinarian may not be available to tend to your dog should he experience an adverse reaction, especially one that occurs hours to days later.

Have you had difficulty figuring out which vaccines your dog really needs and how often they should be administered?  If so, please share your story with me.

Now, here’s wishing you and your four-legged best friend abundant good health!

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health Award
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life

Website: http://www.speakingforspot.com
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, or your favorite online book seller.