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.  

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.

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.

Pet-pocalypse

If you're reading this, that means that December 21st, 2012 has come and gone and we are all still here.  Which is good.  But I would like to chat a bit about actual emergency contingency plans and your pets.

Most human evacuation sites will not take pets, although I'm hopeful that will not always be the case (props to NJ with the recent Sandy landing, where many shelters were announced as pet-friendly).  So in the case of evacuation it is important to have some idea of what you might do with your pets.  I don't have all the answers for this, as every situation is different, but I encourage you to have a sketched out plan in mind.  Animal shelters have been overrun after each natural disaster, either by pets who were lost or abandoned, and then flooded with calls looking for those lost pets as well.  While there are sometimes happy endings to these sad stories, a plan to keep your pets with you or in a situation where they can be returned to you safely is a better bet.

Not all emergencies are to the extreme of Katrina or Sandy.  What about in case of fire?  Do you have a sticker on your window letting fire fighters know that they should be looking for your pets?  You can purchase these stickers from online venues such as Amazon.com, and some rescue organizations and pet stores will have them available for free.

Many people live alone with their pets, and need to consider what will happen with them if they were to become injured or unable to care for them.  I realize that this is a bit depressing, but talking to friends and family about who would be able to help in these situations ahead of time can alleviate a lot of stress and confusion.  I find that clients who have willingly accepted and prepared for bringing a new pet into their homes are much happier than those who have 'inherited' a pet that they didn't want.  Along those same preventative, yet somewhat morbid, lines, specific requests or directions regarding pets should be included in a Last Will and Testament as well.

Contingency plans are important, for yourselves as well as your pets.  But since we've made it past the Mayans' prediction, let's take a minute to squeeze our fuzzy friends.  And tomorrow, we plan.

Runs with Dogs

Like Dances with Wolves.  Get it? sigh.

So I'm a runner.  Not a fast-moving racing fiend, but a runner nonetheless.  And I see a lot of runners while I'm out there plodding along, some of which are running with their dogs.  Which is awesome for the dogs, who need their exercise in order to sleep rather than destroy the couch, and for the humans, who have bonding time as well as fitness time.  But there are things to consider when running with a dog...

Leashes.  In the city, dogs should always been on leash.  When you're running with a dog, you should have a good hold on the leash, and keep it short.  Dogs like to clothesline people, telephone poles, parking meters, etc when you're least expecting it.  And NEVER EVER EVER use a retractable leash when running.  There's a previous blog post about those wretched creations, but just don't.

Running path.  In an ideal world, you would only run with your dog on blissful tree-lined paths with clearly marked lanes for each direction...these do not exist in most of the world, so you'll need to think about the real life path-of-least-resistance instead.  If you're bringing your dog with you, avoid sidewalks with heavy foot traffic, tons of traffic lights and cars making right turns on red.  These obstacles are frustrating for a lone runner, but can be terrifying or deadly for a dog, even if they're only a foot away from you.  It sounds like common sense, and it is, but many of us don't think about it until we're tangled up in a tour group, have a cigarette flicked at us or a Starbucks spilled onto our dog. (Ask me about the woman who just dumped her full coffee, cup and all, 2 feet in front of me.  Didn't even look around first.  AND there was a trash can 100 feet ahead of her!)

Age of dog.  This may be unexpected, but it is actually very important to keep your young dogs off the streets and running paths.  They can chase a ball in the park until the cows come home, but the constant pounding from concrete running does a number on open growth plates.  Wait until your dog is about a year and a half before you do much more than a mile of straight running, and even then you need to work them up to longer distances gradually to avoid injury.  Older dogs are also a consideration - osteoarthritis is one of the most common diseases we see in dogs as they age.  If you notice lameness after a run that used to be 'no problem', you may need to reduce your mileage, or even slow down to walks only.

Breed of dog.  If you want a running partner, be aware of what you can expect from your dog.  An English Bulldog or a Pug are not likely to match you mile for mile.  Any brachycephalic (short-nosed) breed is high risk for exercise, as they don't exchange oxygen as easily and can overheat quickly.  If you are not a runner and you have a high energy breed like a Weimaraner or a Pit Bull, you might want to get yourself fitted for some running shoes!  Keeping a high energy breed on a low energy schedule can lead to destructive behaviors, and is one of the reasons our shelters and rescues are always so full.

Awareness.  You are running with another being who does not share your mind.  They may be the best and most attentive dog in the world, but they can make the untimely decision to go left when you need to go right.  Being aware of what your dog is doing, what fellow pedestrians are doing, and what cars/bikes are doing is a major undertaking, and it is important for everyone's safety.  Just remember, running with a dog ain't no walk in the park!

Tie A Yellow Ribbon...

...around your dog's leash?

That is what a movement out of Sweden is encouraging people to do, for their dogs who need space.  I just learned about this, and I think it is a ridiculously AWESOME idea!

There are many reasons why a dog who is out for a walk should not be approached.  The first to come to mind are that the dog is reactive, fearful, or aggressive.  Wouldn't you be happy to know that you should give those pups a wide berth?  There are other reasons as well - what about a contagious disease?  Those dogs need to get their exercise too, but don't you want to skip that greeting?  Often people are working on training their dogs, and having another dog or person come up to them can be very distracting - a yellow ribbon would allow for training to continue uninterrupted, so that we can soon have another model dog citizen in the world.

I am constantly telling clients that it is much easier to train your dog than to train the people your dog will meet.  Yellow means caution, and if we can train the general public to use caution when we put a yellow ribbon or bandana on a dogs leash?  Just. Freaking. Brilliant.

The (limited) website is: http://www.gulahund.se/default_en.asp and they have a facebook page as well: http://www.facebook.com/pages/Yellowdog-Some-dogs-need-space/401739849882648 .  Friend them, tell a friend, tell all 400+ of your facebook friends, tweet about it, retweet it...you get the idea!

Cat Litter Conundrum

I want to start out by saying something very unfortunate, but in my opinion, very true: there is no perfect cat litter on the market.  There are various types of litter out there, which is one thing I want to cover in this post, but the reality is you need to pick and choose your battles.  It won't be too hard to see which battle I'm fighting...

The most common type of litters out there are clay-based.  They're cheap, they clump, and cats tend to like them.  They are also VERY environmentally unfriendly, as the main ingredient that causes clumping, sodium bentonite, is STRIP-MINED from as deep as 50+ feet into the ground.  This material does not compost and it does not break down - this stuff is in our landfills for the long haul. There is also concern that sodium bentonite can be harmful for the cats - they inhale it, and it is on their paws and fur after use, which is then ingested via grooming.  There are no proven studies that show it is harmful, but it has also only been on the market for ~20 years - a relatively short time.  My guess is that we will start to see studies come out against the use of this material in the future.

Alternative options are not perfect, as I mentioned, but they are better for the environment, which means they are better for me.  There are many, but I will just touch on the most common and readily available.

World's Best Cat Litter is made from corn husks.  As far as usability and availability, it is very similar to clay.  It clumps in a very similar manner, without using sodium bentonite.  It's price point is higher than clay litters, but it tends to last for a decent amount of time with regular scooping.  The negatives: the corn is likely genetically modified corn, and has been exposed to pesticides and herbicides.  It is clearly not organic, and there is no research regarding what kind of remnants of that kind of treatment is still present in the litter.  Again, no research does not mean no harm.  This is the most similar litter to clay, and cats tend to like it, but it may pose a health risk.  Odor control is reasonable, not outstanding.

Feline Pine is made from, shockingly, pine trees.  The wood is a natural source, clearly better than clay, but there are concerns regarding pine resin and oils that could remain in the litter and potentially be harmful for cats.  Again, no research on this, so no definitive answers. It is pelleted, which does not always please the cats, and is probably my biggest issue with it.  When the pellets become wet, they turn into sawdust which can be difficult to scoop out.  Odor control is quite good, as long as you like pine trees.

Yesterday's News is made from recycled newspaper.  I like the idea, and I would love to support this whole heartedly, but unfortunately it is pelleted as well.  The pellets become damp mush when wet, and often you end up dumping the whole box rather than successfully scooping out the waste material.  If you are a diligent daily scooper it is possible to use this with success, as long as your cat approves of pellets.  As a multi-cat household I found it to be very difficult to stay on top of cleaning without wasting.  Odor control is minimal, but if you're scooping often it's less of an issue.

SWheat Scoop is a wheat based litter.  It clumps pretty well using wheat's natural properties when wet, and does not have any added chemicals or fragrances.  I could not find information on whether then wheat has been chemically treated with pesticides, so that concern still exists.  There are reports of insect larvae being an issue with this type of litter (so maybe pesticides aren't an issue), and assumably this would be a problem with World's Best as well, given the crop nature of the litter base.  Odor control is decent.

There are other varieties of litter out there, as I've mentioned.  There is more information regarding various litters here: http://www.thelighthouseonline.com/articles/natural.html, and an article discussing clay litter here: http://cats.about.com/cs/litterbox/a/clumpingclay.htm.  There is also the whole internet, which has opinions too :).

Before signing off on litter speak, I want to briefly touch on flushing and composting.  Cat feces should NOT be flushed into the water supply.  Many cats are carriers for Toxoplasma gondii, a parasite that can cause disease in mammals, and has been linked to the decline of sea otters on the west coast.  While we don't have a complete understanding of what damage this parasite can cause, it's better to play things safe.  Please keep your cat poop out of the toilets!  As for composting, animal feces can be composted, but NOT into compost used on any edible plants.  Composted animal feces can be beneficial for your decorative flower beds and your shrubs, but keep it away from your vegetable gardens and fruit-bearing trees!

I hope that at the very least this post encourages you to think about your litter.  And if anyone has ideas for a truly perfect, eco-friendly, cat-friendly, affordable litter that we can produce and retire on, let me know!