Friday, June 14, 2013

Collars....Choose Wisely

Last week there was a very sad occurrence at a popular Philly dog park - two dogs were playing when one dog's mouth got caught on the other's collar.  The dogs panicked and the end result was that the collar suffocated it's wearer until he died.  This is such a terrible story, and so sadly preventable.  But the reality is that many people don't realize that their collar can make such a huge difference.

Those in the dog biz (especially doggy day cares, where off-leash play is a big part of their day) see jaws caught on collars as a somewhat regular occurrence, and they have rules that only allow easily removed collars such as velcro play-safe collar or break-away collars for life-saving purposes.  Some dog folk prefer that dogs 'play naked' to completely prevent the risk of being caught up, but that should be decided based on the dog in question.

Martingale collars have become a very popular collar, although they originated for long-necked greyhounds and other sighthounds; they are a kinder variety of 'choke' collar and they need to be slid over the head to be removed.  If a dog's jaw is caught under it there is no way to remove the collar aside from cutting it, and sharp implements are not always at hand.

Metal choke collars would also be very difficult to remove in this situation, as they are slipped off and on over the dog's head.  These collars are often used incorrectly anyway, where they are always in 'choke' mode instead of loose when not engaged.  I feel that these collars should only be used in a training setting, and by someone who knows how to use them.

Prong or Pinch collars are a training collar that will pinch the skin around the neck when pulled tightly. They are also typically used as slip over the head types, and although you can theoretically separate the collar at any of the joints it would be close to impossible with another dog's jaw pulling it taught.  Many people have issues with these collars in general, as they can be considered cruel.  I will not get into that discussion today, as any tool that is used properly may have it's uses; proper use is just not as common as I would like.

Buckle collars may not be removable in time to prevent this type of incident, and even snap collars might not be that helpful if the release is in the dog's mouth or unreachable during an incident.

There are so many nice collars out there - fun designs, fancy bling, tooled leather, personalized and what have you.  And there is no reason that your dog can't have all of these in their wardrobe, to be used on walks (a sturdy, well-fitting collar is most appropriate for walks anyway).  But when your dog is engaged in off-leash play, or in a crate, or even in your back yard, go with the safer option of a quick-release collar or none at all.

Friday, May 24, 2013

Cat's Who Need Crate Rest - Really?!?

I am a vet.  I make recommendations alllll the time that I realize are being ignored.  Either completely ignored or partially ignored, but I continue to make these recommendations.  Why? Because it's the right thing to do.  And because a lot of the time my recommendations can make the difference between a positive outcome or a lot of frustration.

One example is crate rest.  The concept of the crate with dog people is pretty easy to get across.  Many dogs had crates when they were puppies or first adopted, and often they are a continued presence in the home into adulthood.  Dogs often *like* their crates, and seek them as a safe haven or stress-free zone. So if I recommend that you crate rest your dog, both you and your dog kind of understand the concept. You may not like it, but you get it.

Cats who need crate rest...that is a much more difficult concept.  Cats don't appreciate being confined, or being told what to do in any capacity, really.  Plus they go to the bathroom in a box, on their own schedule, so that box needs to live with them in the crate and get cleaned A LOT.  And while cats typically sleep 22 out of 24 hours in the day, for some reason it tugs on our heartstrings to see them sleeping in a crate all day.  Finally, people just don't understand putting a cat in a crate - it's a foreign and weird idea.  Because of these reasons, and others, I will sometimes suggest a bathroom or laundry room - somewhere small and confined but not a true crate.  And sometimes it works!  The problem with this is that it's not strict rest.  If a cat can jump onto an object (toilet, sink, washer/dryer, etc) they will; and if they can't jump onto said item because of an injury, they may still make the attempt, often with disastrous results.  And when the cat is not getting better and I have to insist on the crate we've already delayed the healing process and frustrated everyone.  The short of it?  If your vet tells you to crate your cat, listen.


The owner of a cat who needs to live in a crate for the at least 8 weeks, and the wife of a man who asks daily if she can come out yet... (At least Bina has sympathetic Trouble to keep her company!)

Regenerative Stem Cell Therapy

Let's start at the beginning - we are not talking about embryonic stem cells.  No cord blood is involved in this process.  We get these stem cells from FAT, and the patient's own fat at that (see, you knew that muffin top had a purpose).  So now that *that* is out of the way...

Stem cells are starter cells - they can differentiate into the cells that are needed, such as bone, tendon or ligament; they also act as a beacon for other healing cells to hone in on, bringing them to the areas of the body that need to be repaired.  

Stem cell therapy is an up and coming modality in veterinary medicine, and it is showing some pretty impressive results.  The gist of it is we harvest fat from your pet, process it until all we have left are the stem cells from the fat, and then reintroduce those cells into the areas that need it most.  It is most commonly used for osteoarthritis patients (creaky old joints) and other orthopaedic injuries (cruciate tears, elbow dysplasia, hip dysplasia), although there is progress in other areas of  regenerative medicine as well.

Why would you choose stem cell therapy over traditional management?  Well, traditional management for osteoarthritis includes many things, but those that tend to be the most problematic are NSAIDs (non-steroidal anti-inflammatories like Rimadyl, Deramaxx, Metacam, etc).  Many pets use these medications safely and long term, but they can cause GI upset, can affect the liver, and require blood work to monitor their use.  While stem cell therapy doesn't always allow a pet to completely discontinue these medications, it can help to reduce their dependency on them.  

Why would you choose stem cell therapy instead of surgical correction?  Depending on the surgery you're talking about, stem cell therapy is more affordable (total hip replacements can get up to $10k or more), is generally less invasive, and tends to have a quicker turn around time.  Also, if your pet has multiple joints that are affected (both hips, both hips and a knee, a knee and an elbow) recovering from a surgery that incapacitates an entire limb may cause worse damage to the other limbs.

This sounds a bit like a commercial for stem cell therapy, doesn't it?  Sorry about that, it's not my intention.  Stem cell isn't for everyone, and it doesn't have a 100% guarantee (neither does surgery, or NSAIDs, or physical therapy - there are no 100% guarantees), but it is SO exciting to have another option to treat these pets and relieve their discomfort.  And the research and medicine behind it is so freaking COOL - turning fat into ligament??? Awesome.  

Saturday, April 6, 2013

Lentil the Inspirational Frenchie Puppy

If you don't already know who Lentil is, go look for him now.  Here you go - he has a Facebook page called 'My Name is Lentil' and he is a ridiculously cute and personable French Bulldog puppy.

Now that you're acquainted with his cuteness, let's talk about his reality.  Lentil is the only surviving puppy from a litter that were all born with cleft palates and subsequently turned over to the French Bulldog Rescue Network.  A cleft palate is a birth defect of the oral cavity, an opening in the roof of the mouth which prevents the ability to suckle and predisposes them to aspiration pneumonia.  The severity of Lentil's deformity is intense - his palate is completely separated, and the cleft extends to his nose (that's what gives him such a distinctive face).  His prognosis was guarded when Foster Mom Lindsay accepted responsibility for him at a few days old; he was not expected to live past his first week.

That was over 2 months ago, and Lindsay's life has been turned upside down to defeat the odds for little Lentil.  He requires tube feeding every 3 hours around the clock (stop and think about this - EVERY THREE HOURS), and is never left alone.  And let's not even talk about all the press he's been getting lately - he's internationally famous!  She does all of this for him, in between operating her own business (Chic Petique, in Northern Liberties), her own dog rescue (Street Tails Animal Rescue/STAR), and being on the board for the Animal Care and Control Team of Philadelphia (ACCT).  Any one of these activities is a large time commitment, and she manages to do them all, and do them well.  I personally can't fathom it, and give her major kudos for maintaining sanity through it all.

Lentil is more than just a cute and fuzzy cuddle bug - he is also an inspiration.  Cleft palates and cleft lips are among the most common birth defect that we see in human babies.  Since Lentil has become an internet sensation he has been able to reach into the lives of thousands, and is a friend to children that are in the same boat.  He is beating the odds, he is adorable and easy to love, and he shows these kids that it's okay to be a little different.  This means so much to the children, as well as to the families who love them.

Babies with orofacial clefts go through surgery to have them corrected, and, as they grow, they often need additional surgeries, dental work, and speech therapy.  In a few short weeks we will all be able to follow Lentil through this process, as he gets started with the first of likely many surgeries by Dr. John Lewis at the Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania.  Lentil brings these surgeries into the public eye, and will show these kids that they are not alone in what they are going through.  He is Lentil, the inspirational Frenchie puppy...and he eats through a tube.

Friday, January 18, 2013

A spay is a spay is a spay, right? Wrong.

Spaying and neutering your pets has been recommended for years...just ask Bob Barker.  But where and how you go about having this procedure performed *does* make a difference.  

Shelter and low cost spay/neuter clinics exist for a reason - we have overpopulation of stray animals, and preventing reproduction goes a long way to reducing those numbers.  Most shelters will not even adopt out their animals without first having these surgeries.  And shelter and low cost surgery is a bit how you would imagine it - the pets are anesthetized (often with only injectable medications), surgery is performed and they're sent on their way.  Often 50 or more patients are having surgery done that day, so things move along at a good clip.   What these vets and organizations are doing cannot be undersold - they are providing a great service for those who need them, and I really don't want to disparage them at all.  But they are working with some serious volume, limited resources and limited staff.  So let's look at the other side of the coin for a minute.

At a high quality veterinary practice there are a few more steps.  Your pet receives their examination and has pre-operative blood work run to look for any reason that anesthesia would be inadvisable.  Then an intravenous catheter is placed to provide immediate venous access in case of emergency, as well as to provide intravenous fluids for the losses sustained during surgery.   Pre-medications that include pain management are given, as well as a separate induction agent to make your pet sleepy enough to be intubated.  Intubation allows for use of inhalent gas anesthesia without risk to the veterinary staff, and allows for better control of how much inhalent is actually being delivered to your pet.  During surgery your pet is monitored by a trained individual whose job is dedicated to monitoring your pet's ECG and blood pressure, their level of anesthesia and comfort.  After surgery, that same individual stays with your pet until they are awake enough to have the endotracheal tube removed safely.  Heat support is provided during and after surgery.  Your pet receives additional pain medication while in the hospital, as well as some to go home.  An elizabethan collar (cone) is also sent home to prevent self-trauma to the surgery site.

There are veterinary hospitals that are somewhere in between these two.  They may not place a catheter in every patient, or they may not intubate.  ECG and blood pressure monitoring might be optional, pre-operative blood work may not be done.  There are levels and levels of what is going to happen when you drop your pet off for their procedure.  And the cost differences that are out there will reflect those levels.  I don't want to tell anyone that can't afford to spay or neuter their pet at the high end of this spectrum that they shouldn't do it - that is why low cost options exist, and I'd much rather have the surgery done, period, as it significantly decreases certain health risks later in life.  But I do want people to understand the fundamental differences in what these surgeries entail, to ask the right questions to compare them, and to be aware that a spay is NOT just a spay.