Thinking about getting a dog?

With the new year, I see a lot of families with new dogs.  I think it is great to add a pet to the household, but I do find that a lot of people don't prepare themselves for what is involved with a new dog.  Most people decide on getting a dog, but may not think about all the work that goes into a dog.  So, I am going to go over a few questions you might want to ask yourself before going to the humane society, breeder, or store to purchase a pet.

1.) What breed of dog do I want?  It seems a simple question, but it is a good one to ask.  Are you a single person who is looking for a pet to keep you company.  Do you have a family where there are a lot of people available to help with the dog's care.  I wouldn't typically recommend to an owner to get an energetic, young, Labrador if he/she doesn't have the time to walk the dog twice daily for an extended period of time.  We will just run into problems with that dog destroying furniture or "misbehaving" because they have so much energy they need to get out.  Same thing for a person looking to have a pet to play with, or run with, etc; don't look into getting a Shih Tzu as the pet might not be able to keep up with you.  So, ask yourself what breed you might be interested in before getting a pet.

2.) Do I want a puppy versus an adult dog?  There are advantages and disadvantages to both young and old dogs.  Advantages to young dogs are the ability to help shape their personality, high energy level, and of course overall cuteness; however, you typically have to devote more time, lose sleep, and deal with potty training for these pets.  With older dogs you typically get a pet that is already potty trained or may not require as much supervision, but you might not be able to change behavioral issues, might run into medial issues sooner, and the pets life span won't be as long.

3.) Am I going to be able to take care of this pet?  The bill for purchasing the pet isn't the end of spending on this pet.  Once home, you are going to have expenditures for food, toys, veterinary care, damaged furniture  etc.  Remember that veterinarians will recommend being on heartworm and flea preventatives and they will need their shots, etc.  Also, if your pet gets sick, you may have to bring them in for unexpected charges.  It is always a good idea to set aside some money for the care of your pet and also consider pet insurance as this can help if they become really sick.

4.) Am I mature enough for a pet?  Most dogs require constant care and some people may not be ready for a pet.  Although they are cute, pets can be a lot of work and you have to be around to care for them.  If you are used to going away for weekends or overnight, you need to consider where you might keep your pet if they can't come with you.  Some people just don't have time for pets, which is fine, but make sure you realize this before you get your pet.

There are many other questions to ask yourself before looking for a pet.  If you don't think you are ready or have other questions, don't hesitate to call your local veterinarian to ask other questions that you may have about pet ownership.

Urinary Problems

Now that I have talked about behavioral issues and the litter box, let's talk a little more about some medical issues that can lead to problems urinating outside the box.  When trying to determine what the medical issue may be when cats are having problems with the litter box, we first want to determine whether this is a lower urinary tract (bladder) issue or more a problem in the kidneys or elsewhere.

We can usually narrow down the problem just by getting a thorough history.  There will be a few questions asked about how the accidents are occurring:

1. Have you noticed any increased amount of urination or drinking?
2. Is there an increase in frequency of urination?
3. Does there seem to be any discomfort when going to the bathroom?
4. Have you seen any discoloration in the urine or change in smell of the urine?
5. Is it a small amount or large amount of urine when your pet is having accidents?
6. Have you noticed anything else like weight loss, increased or decreased appetite, etc?

When you notice that your pet is drinking more or urinating more and is leaving large puddles outside the box and may or may not be losing weight or having other problems (inappetence or large appetite, etc), then we typically look at either the kidney or other metabolic or endocrine problems.  Your cat is probably having accidents because they are urinating more and might not be able to make it to the box or the box is dirty because they are using it more and then they have an aversion.  Some common medical issues that we see that can lead to this are diabetes mellitus, chronic kidney disease, hyperthyroidism, liver disease, electrolyte imbalances, etc.  We can evaluate for a lot of these problems with some simple testing, which usually includes a complete blood count, serum chemistry profile, urinalysis (+/- urine culture), and thyroid profile.  Occasionally, imaging of the kidney with radiographs or an ultrasound may be recommended.  Once a diagnosis is made, then that particular condition can be treated (insulin for diabetes; change of diet for kidney disease, etc).

If the history includes problems like discomfort when urinating, small, frequent accidents, and blood in the urine, then we are more likely to pursue a problem with the lower urinary system (in particular, the bladder).  When we have histories like this we like to get similar blood work as described above, but the urinalysis, urine culture, and bladder imaging becomes much more useful in diagnosing the underlying problem. The breakdown of common medical problems in the lower urinary tract varies greatly depending on the age of your pet.

When approaching cats younger than ten years old, we typically think that more than half will have a condition called idiopathic cystitis (inflammation of the bladder of unknown cause), a quarter will have bladder stones, and the remainder will have conditions like urinary tract infections, bladder masses, or trauma.  The classic cat with idiopathic cystitis is a young (4-5 year old), male cat who is on an exclusively dry diet.  We usually treat these cats by re-hydrating them (intravenous fluids or subcutaneous fluids), treating their pain, and then giving them time to recover on their own (2-4 days).  In the long term, we try to increase hydration by switching them to an exclusively wet or mostly wet diet along with promoting drinking with a continuous water fountain.  There are also many medications that are used; however, many of these medications don't have definitive evidence that they work.  I find that increasing these cats hydration level works the most to help prevent future problems.  For more more information, visit this site.

When cats are older than ten years, then the distribution of problems shifts and a majority of these patients will have a urinary tract infection, with fewer having bladder stones, and a minority having a bladder mass or other issue.  The treatment will again depend on the underlying problem, but with older pets we also want to look for primary issues that can lead to the infection (chronic kidney disease, diabetes, etc) and treat these underlying conditions.

As you can see, the simple act of urinating outside the box opens up a lot of questions about your cat.  Although it can be difficult to determine the cause, a majority of cases can be solved and it is just a matter of being patient while we are trying to figure out the cause and best treatment for your cat.

Trouble with the Litter Box

It is fairly common for owners to bring their cat in because of problems with their cat urinating outside the litter box.  When this happens, it is the veterinarians job to try and determine whether this is a medical or behavioral problem.  Then, after figuring out what the problem is, trying to come up with a treatment plan.

The first step is getting a good history of when, where, how, etc that these accidents are occurring.  An indication that the problem may be medical would be a history where the cat is straining to urinate, producing frequent, small urine spots, licking a large amount at the back area, drinking more or urinating more than usual, or in general not feeling well.  When this is the case we can worry about infections, inflammation, bladder stones, etc.  I will discuss these problems in more detail in a later blog.

Even if the history doesn't quite fit with a medical problem, it may be suggested to perform a medical work-up to make sure that no problems are seen.  This could include basic bloodwork (complete blood count, blood chemistry, thyroid hormone) and then a more detailed analysis of the urogenital system (urinalysis, urine culture, imaging of the urogenital tract with either radiographs or an ultrasound).

If a medical issue is ruled out, then the problem may be more of a behavioral issue.  Behavioral issues can be broken down further into issues involving marking versus litter box training or aversion issues.  An indication that problems with the litter box may be a marking issue would be if the history includes:

1.) Urine spraying on a vertical surface
2.) Problem started after a change in the household (new roommate, new furniture, recent visit from friends/relatives, new pet)
3.) Accidents occur around a window or door
4.) Accidents occur on owner's bed or clothes
5.) Accidents tend to occur in a similar spot
6.) The pet is defecating in the box, but not urinating in the box.
7.) The pet sometimes urinates in the box, but sometimes urinates outside the box

These histories tend to indicate more of a territorial or anxiety issue and the cat trying to assert it's claim on that particular environment.  This is different than a problem with litter box aversion or training issue.  In these situations, the histories tend to include things like:

1.) There was a recent change to the litter box, litter location, or litter type
2.) There was a traumatic experience when our pet was using the litter box before (loud noise, attacked by another pet, etc)
3.) The litter box is dirty or perceived dirty by the pet (there are not enough litter boxes for the number of cats in the house.  We typically recommend one more box than the number of cats that you have)
4.) The cat isn't using the litter box for both urination and defecation
5.) The litter box is covered or in a high traffic area of the house
6.) There is a new pet or another pet or person (small child) bothering the pet when they are trying to go

Depending on which problem is determined most likely, we can then determine a treatment plan.  For territorial issues there are a number of medications that can be tried to help with the problem.  Most of the medications tend to run in the anti-anxiety family and can include amitriptyline, fluoxetine, or buspar.  There are also pheromone treatment options that can sometimes work (Feliway).

In cases where there is a litter box aversion, then the solution is more along fixing the perceived problem with the litter box.  This could include adding a litter box, changing locations, cleaning the box more frequently, or switching back to the previous litter.  In some cases, people have confined their pet to a small kennel with the litter box and once their cat is using the box on a regular basis, they will give them more freedom by allowing in a small bathroom, then small room, then the house.

Urinating outside the box can be a very frustrating issue for both clients and veterinarians.  The important thing to remember is that many times the answer is not straight forward and trying different treatments/solutions may be needed.  Give it time and hopefully the problem will be solved.

My Cat or Dog is What?

Cryptorchidism is a condition where one or both of the testicles are not in their correct position.  Instead of being in the scrotum, they are either in the inguinal canal (where the leg meets the belly) or inside the abdomen.  It is much more common to happen in dogs, but as I recently was exposed to (2 cats in 2 months) it can also occur in cats as well.  I should first explain how this happens and then will discuss what should be done about it and why.

The testicles develop in the abdomen near the kidneys.  In the late stages of the fetus and then after a puppy or kitten is born the testicles make a slow descent from the abdomen, through the inguinal canal (small opening between muscle layers of the abdomen and leg), and eventually into the scrotum where they will live.  The testicle is essentially attached to the scrotum by a ligamentous structure called the gubernaculum.  This structure responds to certian hormones during the developmental life cycle and pulls the testicle to its normal position.  Typically the testes should be out of the inguinal canal at birth and then by six months should have made their way to the scrotum.

In cases where this process doesn't happen, the pet is consider to be cryptorchid.  Why is this important?   The testes are outside the abdomen because they require a lower temperature for proper sperm development.  When you have a pet that is cryptorchid, the sperm development may not occur correctly and you might have a sterile pet.  This typically isn't a problem except with breeding pets.  The other major issue is that testes not in the scrotum are at a higher risk for cancer development.  The condition is also hereditary.  Because of this the recommendation for cryptorchid pets is to have them neutered. 

In the case of the neuter, the testicle may be located any place along the descent of the testicle.  In many cases the testicle can be palpated in the inguinal canal and a small incision over that area is all that is need to perform the neuter.  In other cases where the testicle is not easily found in the inguinal canal, the veterinarian may need to perform an abdominal exploratory to locate the testicle, as it could be any place from near the kidney to right by the inguinal ring. 

If your pet only has one or no descended testicles, don't panic.  We typically give them until 6 months of age to drop and then if they haven't we can perform a specialized neuter to remove them.

Is my pet getting old?

A common question that I get when seeing patients is how old would my pet be if it were a human.  There are a lot of formulas out there that claim to change your pets age into human years.  Many of these do work fairly well, but as far as figuring out an exact human age I wouldn't put huge faith in them.  What I can tell you is that I see many older dogs and cats and have a general rule of thumb when seeing them:

1. For smaller breed dogs (less than 10-15 lbs) I can routinely see 14-15 year old dogs.  I usually start to classify them as senior around 8-9 years of age.

2. Larger breed dogs (>60-70 lbs) tend not to have as long of a life span and I typically start to call them senior around 6-7 years of age

3. Cats can differ, especially between indoor or outdoor cats.  Indoor cat can live a very long time and I see many 16+ year old cats.  I usually classify them as middle age around 7 years and senior after 10 years.  Outdoor cats tend not to live as long, but I usually classify them the same way.

So, why does it matter when your pet gets older?  Well, just like with people, pets tend to develop medical problems as they age.  They might not show outward signs of problems, but bloodwork can sometimes pick up early signs of problems.  This is why we recommend a senior screening examination for pets determined to be elderly.

What does a seniors screening exam involve?

1.  With dogs, after the exam we run bloodwork that includes a complete blood count, a six panel chemistry (looking at liver, kidney, blood sugar, and protein values), urinalysis, heartworm test, fecal floatation test, and eye pressures.

2. Cats are slightly different and along with an exam we perform a complete blood count, six panel chemistry panel, urinalysis, thryoid values, and fecal floatation test

The reason that we run these tests are to screen for medical problems where we might be able to intervene and prevent further damage or manage the diseases successfully.  For dogs, we worry about liver disease, Cushing's disease, kidney disease and these tests help determine whether a problem is present.  With cats, we are looking for signs of kidney disease, hyperthryoidism, diabetes, or liver disease.

If changes are seen on bloodwork, then your veterinarian can recommend further diagnostic tests that should be pursued to better evaluate for what may be going on.  They can then recommend treatment options to help manage problems that are found.

Make sure to ask your veterinarian about your pet's senior health at your next visit.

Trouble Breathing

With selective and successful (or unsuccessful depending on how you view it) breeding in dogs, veterinarians see a lot of congenital problems in pets.  One of the more common problems we see is in short nosed breed dogs (Boston Terriers, Bulldogs, etc) called brachycephalic airway syndrome.  This isn't just one problem, but a combination of problems that can lead to difficulty breathing.

If you talk to the owner of one of these dogs, you likely will hear them describe noisy breathing, snoring, and sometimes gagging; but problems can also become more serious with faining episodes, turning blue, or even death in severe cases.  So what causes these problems?  It all stems from the selective breeding of the shorter or no-nose at all trait.  This has lead to collateral problems; in particular an elongated soft palate, stenotic nares (narrow nasal passage), and hypoplastic trachea (narrow windpipe).  Over time this can lead to negative pressure in the back of the throat, which can cause further damage including everted laryngeal saccules (these interfere with the opening of the airway) and in worst case scenarios laryngeal collapse (complete blockage of the airway).

 

So why is it such a big deal to have these traits?  If the traits are mild, then it may not be a huge deal; however, with extreme cases the traits can interfere with breathing.  As you can see from the above image, the larynx is the area in the back of the throat where two functions connect (breathing and eating).  There is a small structure called the epiglottis that covers the opening of the airway (windpipe) when a pet is eating and drinking to prevent food or water from entering the windpipe.  This should only cover the windpipe during swallowing and otherwise the larynx and windpipe should be open and free to allow air to pass into the lungs.  Dogs with long soft palates have problems because the back of the soft palpate can interfere with the windpipe opening and prevent air from passing into the windpipe and lungs.  The noisy breathing or snoring is from the air being blocked by the soft palate.  The narrow nasal passages also interfere with the movement of air.  Like I said before, in mild cases this is not terrible, but as dogs age or in extreme cases the soft palate can get worse (swollen) and completely obstruct the airway.  This can become life threatening if the pet cannot get this unblocked as they essential suffocate from lack of oxygen.

If the soft palate dose not completely block the airway, over time the back of the throat (larynx) can get worse as the negative pressure placed on the larynx from the narrowed passageway can cause it to weaken and essentially collapse leading to blockage of the airway as well.  In these cases, the only real way we can help is to perform a permanent tracheostomy (make a hole in the neck of the dog that connects to the windpipe) for them to breath through.

Obviously, making a hole in the neck of a pet is not the most ideal.  Fortunately, there are some things we can do prior to this point to help out dogs with serious breathing problems.  We essentially correct the problems surgically.  This typically involves widening the openings of the nostrils to allow more air to move through the nasal passage along with shortening the soft palate to a more normal length.  These procedures are most effective when performed on younger dogs as it prevents pressures from working on the larynx and weakening it.  Many times these can be performed during a spay or neuter procedure, so a second anesthetic event is not needed.

Soft palate after resection. Courtesy of Vet Specialists of South Florida

Although the procedures may not completely rid a pet of noisy breathing, in most cases dogs show considerable improvement in breathing, as well as exercise tolerance.  For more information on this condition, you can visit this link.

Feeding Your Cat

Giving advice on feeding your pet can be quite difficult with so many options available in pet foods these days.  For the most part, many of the diets out there are well balanced and your cat will likely receive the proper nutrition with a majority of the diets that they eat.  I would like to give a few suggestions though when choosing a diet for your cat.

First, a little background on cat's nutritional needs.  Unlike dogs that are omnivores, cats are strict carnivores.  In the wild, they would typically eat small mammals like rabbits and mice, so their protein and fat requirements are high while their need for carbohydrates is low.  When you break down a typical mouse they are around 55% protein, 38% fat, 2% carbohydrates, and the remainder a mixture of minerals and vitamins (with a moisture level of around 65%).  Looking at many commercial diets you may see that they can have carbohydrate loads upwards of 20-30% (which is typically very high for cats) and the dry diets have moisture levels of around 10% (which is very low for cats).

So then, what do I suggest that a cat eat.  First, feeding an all wet food diet or mostly wet food diet is helpful.  This helps a lot with hydration, which is important (especially in male cats).  Many cats can get urinary issues when they are chronically dehydrated and keeping them on a wet diet helps prevent this.  Also, a diet low in carbohydrates (hopefully less than 15%) with a protein level higher than 30% would be ideal.  You can check out this table to see where your pet food stands.  Making sure that the protein sources are from a meat source and not plant source is important as well.  

The other issue is feeding the correct amount of food for your cat.  Most cats only need between 150-250 calories per day of food, which typically comes to around one 6 oz can of food or 1/3-1/2 cup dry food per day.  More active cats will need more food while less active ones need less.  A typical cat is ideally around 12 pounds.

Another good resource for feeding your cat can be found here.