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Monthly Archives: April 2013

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There are many causes of vomiting. To help us narrow it down we divide them into three categories: inflammation, foreign body/obstruction and systemic.

Inflammation

A common cause of acute inflammation is dietary. Make sure to tell your vet about anything out of the ordinary that your pet has eaten, any changes in diet or any new treats that may have been introduced. Most cats and dogs are used to eating the same thing every day and if anything new is eaten the digestive system can be overwhelmed and vomiting can result. Unfortunately, our patients cannot tell us everything they may have gotten into so often we have to make the assumption that they ate something that stressed their system out. Dietary sensitivity or intolerance can be a cause of chronic vomiting. This occurs when an animal looses the ability to digest certain nutrients that are in the diet. When this is suspected a dietary trial with a highly digestible diet will be conducted. If the vomiting stops or significantly reduces then the diagnosis is confirmed. Other GI disease such as inflammatory bowel disease and cancer can cause vomiting. Additional diagnostics such as gastroscopy (inserting a fiber optic tube into the stomach via the mouth) and biopsy are necessary to diagnose inflammatory bowel disease and cancer.

Foreign Body/ Obstruction

Let’s face it; some of our pets will eat anything. And, if large enough these objects can cause a mechanical obstruction. Sometimes the diagnosis is easy. The owner saw the pet eat the object and it shows up on an x ray. Sometimes the diagnosis is not so easy. Certain objects that cause obstruction do now show up on x rays. Some examples are plastic bags, dental floss and thread. If nothing is showing up on x ray your veterinarian may recommend doing a barium series. This involves giving the patient a thick white liquid by mouth and taking several x rays over a 6-12 hour period. The liquid shows up on the x ray. If a complete blockage is present then the barium will not pass. This is a great test but it is not 100% sensitive. Sometimes the barium can go around an object. Sometimes the only way to diagnose an obstruction is to do exploratory surgery. When doing exploratory surgery for a suspected obstruction there is always a chance that nothing will be found. It is always better to do an exploratory and find nothing then not do one and miss something. If fact a very wise veterinary surgeon once told me “If you’re not doing negative exploratories then you are not doing enough surgery.” Even if an obstruction is not found, an exploratory is a good opportunity to take biopsies of the liver, stomach and intestines. These biopsies are usually very helpful.

Systemic

These are causes of vomiting that are not in the GI tract. Some examples are kidney disease and some neurologic disorders.

The above is by no means a complete list of the causes of vomiting. If your pet is having a problem with vomiting contact your vet to discuss diagnostic and treatment options.

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Spring is here and so are the thunder storms. Unfortunately many of our pets do not react well to thunderstorms. While some pets could sleep through anything, other pets hear the thunder and just plain panic. The reaction can be anything from being a little clingy to frantically pacing around the house for hours at a time or shaking violently for hours. So what do we do about it? For the most part the problem mainly affects dogs so that is what we will focus on today.

1)      Medication.  This can be a short term and a long term answer.  Some dogs have such extreme anxiety that they truly need to be sedated. The 2 main drugs we use for this are acepromazine and valium. They provide sedation and anti-anxiety effects for about 4-6 hours. The determination about which drug to use is based on the pets age, health status and history. Sometimes a little trial and error needs to be done to find what medication and dosage works best.  The disadvantage to the above treatments is that you have to try to guess when a bad storm is coming and often by the time the medication is given it is too late. A solution to this for dogs that consistently and frequently have storm anxiety is to put them on a daily medication such as an anti-depressant. This way therapeutic blood levels are already present when the storm hits. These medications are usually reserved for severe cases.

2)      Thundershirt. This is an interesting product. The most important thing is that it can do no harm. I’d say that of all the pet owners that have told me about trying it about half had desirable results. It’s worth a shot, especially if it can help you avoid having to put your pet on medication. To read more about the thundershirt check out: http://www.thundershirt.com/?utm_expid=16997785-5&utm_referrer=http%3A%2F%2Ftrainingcenter.thundershirt.com%2F

3)      Behavior Modification. This is another long term solution. Behavior modification can be done with or without medication. The goal is to desensitize the dog to the sounds that trigger the reaction. One technique is to obtain a “sounds of the storm” type cd. Desensitization consists of playing the disc very quietly (so quiet that the dog doesn’t notice it). While playing the disc you engage the dog in a fun activity such as fetch. Over an arbitrary period of time (about 2-4 months) you gradually increase the volume while playing with dog. A good resource for this is Sound Therapy for Pets: http://www.soundtherapy4pets.co.uk/index.html

These are just a few suggestions for managing this problem. Just like any other behavior issue the longer it goes on for the worse it can get. So, early intervention is the key to success. If you think your dog may have storm anxiety contact your veterinarian to discuss treatment options.

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With advances in nutrition and medical care many of our pets are living longer than ever. But with age comes age related diseases such as arthritis. For years we have been using NSAIDS to control pain in our arthritic pets. NSAID stands for non steroidal anti inflammatory drugs. These are drugs that help alleviate pain and inflammation without steroids. In general NSAIDS are safer for long term use than steroids. NSAIDS are not completely safe and need to be used with caution. Some side effects associated with NSAIDS are vomiting, diarrhea and decreased appetite. They can cause bleeding in the GI tract and can be hard on the kidneys and liver. The good news that if used judiciously the side effects can usually be avoided and they can greatly improve the quality of life in our older pets. The following are some guidelines to follow to minimize the side effects and maximize the benefits of non-steroidal anti-inflammatory drugs:

1)      Periodic Blood Testing. Before going on an NSAID for long term use a pet should have bloodwork done to identify any contraindications to giving NSAIDS, such as kidney disease. Also if a pet is going to be taking NSAIDS on a regular basis they should have their blood rechecked 1 month after starting to make sure they are tolerating the medication. After that the blood should be rechecked every 6 months or as directed by their veterinarian. With periodic blood testing abnormalities can be detected and addressed before they become a problem.

2)      Do not give NSAID to your pet if they are not eating or may be dehydrated. When pets are dehydrated they are more susceptible to side effects of these medications. This is especially important in cats.

3)      Use the lowest effective dose. Many arthritic pets are able to take a fraction of the dose of their arthritis meds. This is important because side effects are dose dependant. This means that the less of an NSAID that is given the less of a chance of side effects. Oh yeah, and giving less medication also saves money to. If your pet is taking arthritis medication on a regular basis then talk to your veterinarian about determining the lowest effective dose.

4)      Not all NSAIDS are created equal. While over the counter NSAIDS like Tylenol and Ibuprofen seem innocuous they are not always appropriate for cats and dogs. Tylenol can be deadly for cats and Ibuprofen can cause ulceration and bleeding of the stomach of dogs.

5)      Compliment traditional medical treatments with supplements and other alternative treatments. This is a broad topic that I will expand on at a later date.

When dealing with arthritis in pets it is important to bring your pet in for regular checkups and keep your vet updated on your pet’s progress.  If you feel that the current treatment is not working, then consider trying something else. Because of the high prevalence of arthritis there are many treatment options available and there is always something else to try. If you think your pet has arthritis contact your vet and set up an exam.

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When traveling with your pet it is important to be prepared. If flying contact the airline to see what is required. Airlines often need current health certificates and will have specific requirements for the dimensions of carriers that fit under the seat. It is also important to determine if your pet needs to be sedated for the flight. If you have not given your pet a sedative before, it is a good idea to do a trial at home a few days before traveling to make sure your pet doesn’t have any adverse effects. It is also good to have the contact information of a day practice and an emergency practice at your destination. If you travel to the same location with your pet on a regular basis it is a good idea to bring you pet in for an exam to get established with the veterinary practice. For more information on traveling with your pet check out: https://www.avma.org/public/PetCare/Pages/Traveling-with-Your-Pet-FAQs.aspx