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Pain Management for Pets

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imageDecades ago in veterinary medicine, pain was thought to be good for an injured or sick animal. This wasn’t because veterinarians were cruel or wanted pets to suffer; they believed that pain helped keep animals sufficiently quiet in order to heal. Plus, it was thought that there really wasn’t any way to know whether a pet was feeling pain or needed some relief. Today it’s just the opposite: veterinarians now believe they should treat for pain until there is proof that an animal isn’t hurting.

Why it’s important to manage your pet’s pain?

Pain management has become an important issue in veterinary medicine. AAHA along with the American Association of Feline Practitioners recently released the AAHA/AAFP Pain Management Guidelines for Dogs and Cats . These guidelines show that pain management will improve the recovery process, whether from illness, surgery or injury. Best of all, because it reduces stress and increases a sense of well being, pain management may even help your furry friend live longer.

Different kinds of pain

Acute pain comes on suddenly as a result of an injury, surgery, inflammation or infection. It can be extremely uncomfortable for your pet and it may limit her mobility. The good news is that it’s usually temporary. It generally goes away when the condition that causes it is treated.

Chronic pain is long lasting and usually slow to develop. Some of the more common sources of chronic pain are age-related disorders such as arthritis, but it can also result from illnesses such as cancer or bone disease. This pain may be the hardest to deal with, because it can go on for years, or for an animal’s entire lifetime. Also, because it develops slowly, some animals may gradually learn to tolerate the pain and live with it. This can make chronic pain difficult to detect.

How to know when your pet is hurting?

When we have pain, we complain. However, animals instinctually hide pain so we generally don’t hear a peep out of our pets until the pain is so bad they cannot hide it anymore. So how do you know when your pet’s in pain?

Because our furry friends aren’t able to tell us when something is wrong, it’s important for you, the owner, to take note of any change in their behavior. Look for any of the following signs they may be your pet’s way of saying “I hurt.”

  • Being unusually quiet, listless, restless, or unresponsive
  • Whining, whimpering, howling, or constantly meowing
  • Biting
  • Constantly licking or chewing at a particular part of the body
  • Acting funny and out of character, either aggressively or submissively
  • Flattening ears against the head Having trouble sleeping or eating
  • Seeking a lot more affection than usual
  • Unable to get comfortable (constantly changes positions to find the most comfortable position)

If you suspect your pet might be hurting, consult your veterinarian for help. Your veterinarian will help you figure out the problem and discuss the available options. Be prepared to answer questions about your pet’s behavior, activity level and tolerance for being handled. Your furry friend’s mobility is also a crucial topic. Does Rover now have a hard time getting up or walking up/down stairs (these were never a problem before)? Does Fluffy no longer jump up on to the furniture or have a hard time hopping back down?

Many animals, especially cats, naturally disguise signs of pain to protect themselves from predators. However, the lack of obvious signs does not mean they aren’t experiencing pain. If the injury, illness or experience is one that sounds painful to you, go with the assumption that it may also hurt your pet and get to your veterinarian.

Animal Health Week

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imageAnimal Health Week is a national public awareness campaign organized by the Canadian Veterinary Medical Association and hosted by veterinarians across Canada. Each year, during the first week of October, veterinarians and veterinary hospitals across Canada promote animal health and responsible animal ownership as part the of the Animal Health Week celebrations. The campaign slogan this year is ” Their health in your hands” and is centered  around the benefits of preventative health care for your pets and other animals.

What should you expect from an annual examination for your pet?

All dogs should have a veterinary examination at least annually. For many dogs, more frequent visits may be appropriate. Decisions regarding specific frequency of visits should be based on individual needs of the dog.

Health Evaluation

Subjective

History, including evaluation of life style and life stage, behavior, and diet

Objective

Comprehensive physical examination, including dental assessment, pain assessment, and body and muscle condition scoring

Assessment

On the basis of history and physical examination findings, assessments are made for:
  • Medical conditions
  • Infectious and zoonotic diseases
  • Parasite prevention and control
  • Dental care
  • Genetic, breed, and age considerations
  • Behavior
  • Nutrition

Plan

Client communication and education plan to include:

  • Diagnostic plan:
    • Every dog should have:
      • Annual heartworm testing
      • At least annual internal parasite testing
    • Customized plan based on assessment:
      • Other diagnostic tests (including dental radiography)
      • Early disease screening tests
      • Genetic screening tests
  • Therapeutic plan:
    • Every dog should receive:
      • Year-round broad-spectrum parasite control with efficacy against heartworms, intestinal parasites, and fleas
    • Customized plan based on assessment:
      • Tick control as indicated by risk assessment
      • Therapeutic recommendations
      • Dental recommendations
      • Behavioral recommendations
      • Dietary recommendations
  • Prevention plan:
    • Every dog should have or receive:
      • Immunizations with core vaccines in accordance with existing guidelines
        • Rabies virus
        • Canine distemper virus
        • Canine parvovirus
        • Canine adenovirus-2
      • Appropriate identification including microchipping
      • Reproductive and genetic counseling and spaying or neutering unless specifically intended for breeding purposes
    • Customized plan based on assessment:
      • Immunization with non-core vaccines in accordance with existing guidelines
      • Other preventive recommendations and counseling regarding zoonotic diseases
  • Follow-up plan:
    • Establish a plan for follow-up based on assessment and future care recommendations
    • Set expectations for next visit
  • Documentation:
    • Thorough documentation of the patient visit.
All cats should have a veterinary examination at least annually. For many cats, more frequent visits may be appropriate. Decisions regarding specific frequency of visits should be based on individual needs of the cat.

Health Evaluation

Subjective History, including evaluation of life style and life stage, behavior, and diet Objective Comprehensive physical examination, including dental assessment, pain assessment, and body and muscle condition scoring Assessment On the basis of history and physical examination findings, assessments are made for:

  • Medical conditions
  • Infectious and zoonotic diseases
  • Parasite prevention and control
  • Dental care
  • Genetic, breed, and age considerations
  • Behavior
  • Nutrition

Plan

Client communication and education plan to include:

  • Diagnostic plan:
    • Every cat should have
      • Retrovirus testing in accordance with existing guidelines
      • At least annual internal parasite testing
    • Customized plan based on assessment:
      • Other diagnostic tests (including dental radiography)
      • Early disease screening tests
      • Genetic screening tests
  • Therapeutic plan:
    • Every cat should receive:
      • Year-round broad-spectrum parasite control with efficacy against heartworms, intestinal parasites, and fleas
    • Customized plan based on assessment:
      • Tick control as indicated by risk assessment
      • Therapeutic recommendations
      • Dental recommendations
      • Behavioral recommendations
      • Environmental enrichment recommendations
      • Dietary and feeding recommendations
  • Prevention plan:
    • Every cat should have or receive:
      • Immunizations with core vaccines in accordance with existing guidelines
        • Rabies virus
        • Feline panleukopenia virus
        • Feline herpesvirus-1
        • Calicivirus
        • For kittens, feline leukemia virus*
      • Appropriate identification including microchipping
      • Reproductive and genetic counseling and spaying or neutering unless specifically intended for breeding purposes
    • Customized plan based on assessment:
      • Immunization with non-core vaccines in accordance with existing guidelines
      • Other preventive recommendations and counseling regarding zoonotic diseases
  • Follow-up plan:
    • Establish a plan for follow-up based on assessment and future care recommendations
    • Set expectations for next visit
  • Documentation:
    • Thorough documentation of the patient visit

 

 
 
 
 
 
 
 

Acetaminophen Poisoning of Cats

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This is a notice released by OVMA.

During the Labour Day weekend, the owner of three cats acquired a package of cat treats from a male individual handing out ‘samples’ while walking along the waterfront adjacent to the Burlington Ribfest. The treats were consumed on Sunday, September 8 starting at 1:30 p.m.

All three cats exhibited neurological signs that afternoon and evening. One cat died at 10:30 p.m. that evening. All three cats were presented to a Burlington veterinary clinic at 11:00 p.m. A short time later, the other cats were subsequently euthanized.

The manufacturer of the cat treats had no commercial association with the Burlington Ribfest, or any related sampling program. The three cats and a single kibble of the treat were submitted for testing on September 13 &14. The preliminary pathology report on the three cats is consistent with acetaminophen toxicity. The analysis of the treats indicated that acetaminophen was present on the surface of the kibble.

Veterinarians would like to remind pet owners not to accept pet food samples from anyone that is not clearly identifiable as a pet food distributor.  If you are a pet owner and believe your pet may be ill, please speak to your veterinarian immediately.

Kennel Cough Vaccine

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The following information regarding kennel cough came from a blog written by Dr. Nancy Kay for AAHA’s Healthy Pet newsletter.  Scholl Animal Hospital follows these recommendations and would be happy to discuss your options regarding the kennel cough vaccine.

With more than a dozen canine vaccines to choose from figuring out which ones your dog truly needs can be a challenge. The kennel cough vaccine is one you will need to consider. Unlike distemper and parvovirus vaccinations which are recommended for each and every dog (these diseases are ubiquitous, highly contagious, and life threatening), the kennel cough vaccine helps prevent a medical issue that is treatable and without universal risk of exposure.

In determining whether or not your dog should receive the kennel cough vaccination, the chicken soup philosophy of, “It couldn’t hurt!” doesn’t fly. All vaccines can cause negative side effects and a risk-benefit analysis should be performed for each and every one of them. The information below will help you determine if the kennel cough vaccine makes good sense for your dog.

What is kennel cough?

Kennel cough, also referred to as “canine contagious cough complex” (fabulous alliteration!) is an infectious, contagious form of tracheobronchitis (inflammation of the windpipe and bronchial passageways). More than ten different organisms can cause kennel cough. The two most commonly discussed are Bordetella brochiseptica (a bacteria) and parainfluenza (a virus).

Kennel cough spreads from dog to dog via respiratory tract secretions, so it makes sense that places where dogs congregate (boarding or grooming facilities, dog shows, dog parks) are potential hotbeds of infection. Kennel cough produces a hacking, incessant, keep-you-awake-all-night kind of cough. Recommended therapy most commonly consists of a cough suppressant and antibiotics to treat any possible causative bacterial agent or prevent a secondary bacterial infection. Complete recovery is anticipated within 10 to 14 days.

The vaccination

All kennel cough vaccinations protect against Bordetella. Some also include protection against parainfluenza. When considering whether or not the kennel cough vaccine makes good sense for your dog, consider the following:

  • Bordetella and parainfluenza are only two of the many microorganisms capable of causing kennel cough. Just as is the case with the human flu vaccine, vaccinated individuals can still develop the disease if exposed to one of the other causative infectious agents.
  • Immunization against parainfluenza is almost always a component of the distemper/parvovirus combination vaccination. Repeating the parainfluenza component within the kennel cough vaccine adds no extra protection. If you choose to vaccinate for kennel cough, ask your veterinarian if he or she administers Bordetella alone or in combination with parainfluenza. If the latter is used, question the rationale behind this practice.
  • Kennel cough vaccines come in three forms; those administered as an injection under the skin, those given intranasally (directly into the nostrils), and a recently released vaccine that is administered orally. Duration of immunity for all of them is one year. It is thought that the intranasal kennel cough vaccination provides better protection than the injectable form. This is a result of the “local immunity” conferred- protection right at the site where kennel cough organisms enter the body. The intranasal vaccination can be more difficult to administer to a wiggly dog and can produce mild, short-lived kennel cough-like symptoms (primarily nasal discharge and coughing). The oral vaccine is new enough that detailed comparisons to the other forms have not been completed.
  • If a dog has never received a kennel cough vaccination, two dosages of the injectable form of the vaccine must be administered three to four weeks apart before immune protection is achieved. Only one dosage is required for the oral and intranasal vaccines. Following vaccination, establishment of immune protection requires 7 to 10 days for the injectable vaccine and 3 to 5 days following the intranasal or oral forms. What all of this means is that administering a kennel cough vaccine to your dog the day before he enters a boarding or grooming facility may get him through the door (many establishments require this vaccination be on board), but may not provide significant disease protection during his stay.

When conflict arises

What should you do if your vaccine preferences and those of the grooming or boarding facility you wish to use are at odds? Discuss your rationale with the business proprietor. If there is no wiggle room, you will need to acquiesce or find an alternative facility with less stringent requirements. What should you do if your veterinarian insists on administering unnecessary vaccinations to your dog? I encourage you to step up to the plate as your dog’s medical advocate and find yourselves a more progressive practitioner!

What decision will you make about the kennel cough vaccine for your dog?

Best wishes,

Nancy Kay, DVM

 

Feline Environmental Needs Guidelines

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image  The American Association of Feline Practitioners (AAFP) and International Society of Feline Medicine (ISFM) have released the Environmental Needs Guidelines, which have been published in the March 2013 issue of the Journal of Feline Medicine and Surgery.  

These Guidelines, organized around five primary concepts that provide the framework for a healthy feline environment regardless of the cat’s lifestyle, were established to address the needs of pet cats in any environment, including home, veterinary hospital and shelter. 

Although cats often do not express overt signs of stress and anxiety, they do experience stress and this is frequently caused by their needs not being met, usually inadvertently, because of a lack of understanding of those needs. 

When cats’ needs are not met, there is an increase in abnormal behavior, or normal behavior considered undesirable by the owner. It is vitally important to meet cats’ needs and allow them to express their natural behaviors, to prevent stress, unfavorable behaviors and to improve feline health and welfare. 

By incorporating these Guidelines into the veterinary practice and home life, veterinarians and cat owners can help reduce unwanted behaviors, illness and feline stress, and improve their relationships with their cats. Incorporating these Guidelines into shelters can increase feline adoption rates by providing an environment where cats are more active and less fearful.

http://jfm.sagepub.com/content/15/3/219.full.pdf

Over the Counter Pain Medications

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4497284119_4f2b92b633Over the counter pain medications (OTC), such as Motrin, Advil, Aspirin or Tylenol, are familiar products found in most Canadian homes. People are comfortable following the instructions for these products relating to quantity, timing, and administration of the medication. Owners with a pet that is experiencing pain may be tempted to medicate the pet with one of these products. The following discussion explains the reasons to avoid OTC pain medications in pets and why you should consult with your veterinarian.

Non-steroidal anti-inflammatories (NSAIDs) are a class of drugs used to reduce fever & inflammation as well as provide pain relief. Some OTC medications included in this class are drugs containing ibuprofen and acetylsalicylic acid (ASA). Motrin and Advil contain ibuprofen and Aspirin contains ASA.

The primary mechanism of action of NSAIDs is through binding to and inhibiting a class of enzymes known as cyclooxygenases. These enzymes and their products are major players in the pathway of inflammation. Unfortunately, this mechanism also leads to the adverse effects of the drugs. Blood flow is decreased to the lining of the stomach and intestines as well as to the kidneys. This can result in ulceration of the stomach/intestine and damage to kidney tissue, which may contribute to kidney failure. It can also decrease the clotting ability of blood. A single ingestion of an NSAID can have severe effects including: vomiting, diarrhea, abdominal pain, anorexia, lethargy, muscular weakness, seizures, coma, and death. Toxicity is also often more severe and occurs at a lower dose in cats due to decreased amounts of liver enzymes required to metabolize the drug.

Veterinarians can prescribe NSAIDs that are more appropriate for treating pain in animals. They act more selectively on specific enzymes and reduce the risk of adverse effects. NSAIDs should be avoided in animals with compromised liver or kidney function, dehydrated animals, or animals with bleeding disorders or GI ulceration. Blood work prior to beginning a course of NSAIDs allows veterinarians to assess the suitability and safety of the drug for the animal.

Acetaminophen is the active compound found in Tylenol. It is largely regarded as a toxic substance in veterinary medicine and accidental administration constitutes an emergency. Once ingested by an animal the drug is absorbed and reaches the liver. In the liver it saturates the normal pathways of metabolism resulting in the production of a highly toxic compound. This compound primarily damages the liver and red blood cells. The damage to the red blood cells results in a decreased capacity to transport oxygen in the blood. Mucous membranes, such as the gums, will appear a muddy brown colour, the animal’s heart rate and respiration rate will increase, and the animal will exhibit signs of weakness and lethargy. Accompanying these signs there may also be vomiting, difficulty breathing, facial and paw swelling, and possibly death. The prognosis depends on the quantity ingested and length of time before treatment.

Call your veterinarian if you suspect your pet has ingested one of these drugs. It is important, if possible, to have the medication container on hand to provide accurate information. Depending on the quantity ingested and the signs the pet is exhibiting, clients are encouraged to bring the animal to a clinic for assessment, treatment, and monitoring, as necessary.

Introduction to Nutrition

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4431762153_3c8103eb39Choosing a pet food can seem like an overwhelming task when the market is saturated with companies and products. Pet food companies skillfully use marketing techniques to promote their brand. This is a brief introduction to understanding the information presented on commercial pet foods.

Pet food labels include the product identity as well as an information panel. The product identity consists of the manufacturer’s name, brand name
 & product name. The information panel is where key nutritional information is found: ingredient statement, guaranteed analysis, nutritional adequacy or nutritional purpose statement (product description), feeding guidelines, & statement of calorie content.

The ingredient statement is a list of the ingredients in descending order according to weight. This information cannot be used alone to assess nutritional adequacy of a diet, as it may be misleading, but is important information when performing food trials. The guaranteed analysis provides the consumer with the minimum percentages for crude protein & crude fat and the maximum percentages for crude fibre and moisture within the food.

A nutritional adequacy statement claims the completeness (or balance) of the diet for a particular life stage. These statements must be substantiated through standard testing protocols set by the Association of American Feed Control Officials (AAFCO). AAFCO has established minimum standards of food nutrient profiles for the formulation of cat and dog foods. The nutrient profiles differ for growth and reproduction and adult maintenance.

Recommendations on the amount of food to feed pets are found in the feeding guidelines. They are expressed as a volume or weight per day based on the weight of the animal. These recommendations are just guidelines and may not be appropriate for all pets depending on their breed, activity level and many other factors. Veterinarians assess the body condition of all pets they see and can make further suggestions on feeding quantities.

Nutrition plays an important part in the overall health and well being of animals. Clients should be encouraged to discuss any questions they have regarding nutrition with their veterinarian.

Blue-Green Algae

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5919496527_cd0ba659db     Many of our four-legged friends love a quick dip in the water on a warm day. However, pet owners should be aware of a potential danger – blue-green algae. Blue-green algae is comprised of a photosynthetic bacteria, that grows in the water, known as cyanobacteria

When cyanobacteria multiply to large numbers the result is a visible bloom. Blooms occur most often in the late summer or early fall, but can occur whenever conditions are favourable.  Slow moving, warm water that is rich in nutrients, from sources such as fertilizer or septic waste, promotes the formation of a bloom. Blooms appear on the surface of the water as thick floating scum or foam in bright paint-like colours of blue, green, brown or red.

Blue-green algae is dangerous to our pets because of the powerful toxins they can produce. These toxins when ingested can cause gastroenteritis (diarrhea and vomiting), liver and kidney toxicity, and neurotoxicity. It is possible for death to result quickly from the effects on the nervous system.

The best defence against blue-green algae is to avoid the water when a suspected bloom is present. If your pet has been in the water it is advisable to rinse them off immediately and prevent them from licking their fur. Seek veterinary care immediately if you suspect your pet has ingested any toxins. For more information about blue-green algae please see the following brochure.

Thunderstorm Phobias

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Living with a dog who has a fear of thunderstorms can be both an upsetting and frustrating experience. Many different factors associated with thunderstorms including noise, pressure changes and electricity in the air may contribute to the problem. This makes thunderstorm phobias a complicated problem to fully understand and treat. Below we have listed links to good articles on the basis of thunderstorm phobias and suggestions for easing a pet’s anxiety.

Thunderstorms – Veterinary Partner

Noise reactivities and phobias in dogs: Behavior modification strategies

Porcupines

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     Erethizon dorsatum, better known as the porcupine, is well known and respected by outdoor enthusiast. Porcupines have an unmistakable appearance. Hunched shoulders give the impression of an arched back and the tail is thick and muscular. Sharp, tapered quills cover the body of the animal excluding the muzzle legs and abdomen. When undisturbed the quills are concealed by guard hairs. However, when threatened or alarmed, muscles function to erect the quills.

Found throughout the majority of Canada the porcupine prefers to live in treed areas where rock formations serve as den sites. They feed on the inner bark of trees as well as the leaves of select plants. Generally a quiet animal, the best indicators of their presence are cut twigs, missing bark on trees and noisy chewing sounds.

Porcupines are slow moving and shortsighted. This allows them to be easily approached by a nosey dog.  When threatened the porcupine first attempts to flee and seek shelter either under ground cover or up a tree, if this tactic fails the porcupine resorts to a more offensive defense. Turning away from the threat the animal erects its quills and lashes its tail at the encroaching threat. If a dog comes in contact with these quills they penetrate and become embedded within the skin and deeper layers. Backwards facing barbs ensure that the quills are held firmly in place.

2811591696_e7594a4e93     Treatment of a porcupine encounter requires the removal of the quills ideally as soon after the incident as possible. Porcupine quills cause immediate trauma to the structures they penetrate resulting in pain and inflammation. Since dogs approach porcupines face first, often with open mouths, the majority of quills are found on the head, neck and inside the mouth. The quills can migrate within the body over time if not removed. In the region of the head and neck this may affect the eyes and brain of the animal. Quills located further from the head can also pose a threat to thoracic and abdominal organs. It is therefore important to seek veterinary care to locate and remove quills.

http://www.hww.ca/en/species/mammals/porcupine.html

Porcupine quill injuries in dogs: a retrospective of 296 cases (1998-2002)
Can Vet J. July 2006;47(7):677-82. Matthew D Johnson1; Kristenn D Magnusson; Cindy L Shmon; Cheryl Waldner