Degenerative Myelopathy in Dogs, by Dr. Dana Lewis

Degenerative Myelopathy (DM) is a slowly progressive disease that affects the spinal cord and a dog's ability to walk. DM results in lost coordination of the hind legs, which progresses to weakness and then to paralysis of the hindquarters. It may cause problems with elimination. It will ascend to the front limbs and also interfere with breathing eventually. Once the dog reaches the point where he can no longer walk, pressure sores, urine leaking and scalding, and loss of bowel control are likely to develop if the patient is not attended to.

The nerves in the mid to lower spinal cord are affected first, and the myelin sheaths that protect the nerves degenerate in this disease. The cause is a DNA mutation in a gene called superoxide dismutase 1 (SOD1). The neurologic disease is similar to some forms of human amyotrophic lateral sclerosis (ALS, often called Lou Gehrig's disease). The DNA test does not determine if a pet is suffering from DM but if he is at risk of developing signs. The test identifies dogs that are clear and have two normal copies of the gene, carriers who have one normal copy and one mutated copy, and those who are at much higher risk for developing DM because they have two mutated copies. But just because a dog has two mutated copies of the gene, it does not mean he will definitely develop the disease. Unfortunately, the only way to confirm the diagnosis is after the pet passes by examination of the spinal cord.

It affects older large breed dogs, particularly German Shepherds, but also Bernese Mountain Dogs, American Water Spaniel, Bloodhound, Borzoi, Canaan Dog, Chesapeake Bay Retriever, English Cocker Spaniel, Great Pyrenees, Kerry Blue Terrier, Sealyham Terrier, Whippet, Collies, Mastiffs, Setters, Old English Sheep Dogs, Huskies, Ridgebacks, and the only small dog that is more commonly affected is the Pembroke Welsh Corgi.

Dogs who are mixes of any of these breeds are also at risk. Other dog breeds can get it, but it’s less likely. Most small dogs and cats rarely are affected.

Typically, degenerative myelopathy isn't seen in dogs under the age of five, and more often it is between 8 and 14 years that it occurs. Because the disease is found in specific breeds, responsible breeding is the only way to prevent degenerative myelopathy. If you plan to get a purebred puppy of an affected breed, ask the breeder about history of DM in the kennel’s line. Understand that clinical signs don't develop until long after sexual maturity.

Symptoms

Often the first signs noticed are difficulty in the hind quarters when the dog is getting up particularly on a smooth surface. As the disease progresses, the dog becomes uncoordinated, will sway, the limbs may criss-cross each other and will scuff or drag the rear feet, knuckle over and not be aware of it, causing excessive wearing of the toenails. The muscles waste away and become weaker.

Sometimes one side is more uncoordinated than the other. The disease can wax and wane or progress steadily. It usually takes a few months to a year after onset for a dog to become unable to walk. Fortunately, dogs with DM do not appear to be in pain. However, if the pet falls she can hurt herself, or if she also has orthopedic problems complicating the situation, she could have concurrent worsening pain.

Diagnosis

Since the clinical signs of DM can appear the same as those for other diseases such as a herniated disk, cancer, infection, spinal stenosis, etc. the diagnosis in a live animal is based on excluding these diseases. Diagnostic testing is needed, including physical and neurological examinations, routine blood work, spinal radiographs, as well as possibly myelography, spinal fluid analysis, computed tomography (CT) or magnetic resonance imaging (MRI) scans. Orthopedic problems should also be evaluated.

Treatment

Unfortunately no treatment has been shown to reverse the signs. DM can be managed but not cured. Supportive treatment can help. A study evaluating combination therapy with aminocaproic acid, N-acetyl- cysteine with vitamins B, C, and E failed to detect a benefit. Minocycline, a tetracycline antibiotic with anti-inflammatory properties, is still being evaluated as part of therapy.

Exercise such as walking and swimming should be encouraged. Physical therapy helps to maintain muscle mass and quality of life. In one study of 50 dogs with DM, those that received intensive physiotherapy had longer survival time (mean of 255 days), compared with dogs that received moderate (mean of 130 days) or none (mean of 55 days). Dogs receiving therapy also maintained their ability to walk significantly longer than those that did not.

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Read more or contact Dr. Dana:
Dana Lewis, DVM
Lap of Love Veterinary Hospice
Raleigh, North Carolina
drdana@lapoflove.com  |  www.lapoflove.com

Dr. Dana assists families with Pet Hospice and Euthanasia in the Raleigh North Carolina area (Raleigh, Durham, Chapel Hill and the greater Triangle, as well as Wake, Durham, Orange, and Chatham counties. Special arrangements can be made for other surrounding counties and for the Triad area.  

Caring Beyond A Cure – A Look At Veterinary Hospice, by Dr. Mary Gardner

If you have ever cared for a geriatric or terminally ill pet, then you know what it’s like to hear those dreaded words, ‘There is nothing more we can do’ ; or even worse if your veterinarian simply says, ‘Call me when it’s time…

You will know when that is.’ However this does not mean that euthanasia is the only option available to you. Pet Hospice is an emerging field in veterinary medicine and is a unique approach to your pet’s end-of-life needs. It focuses on maintaining comfort and quality of life for of your pet, not at finding a cure for his or her disease.

As a veterinarian that solely practices in-home hospice and euthanasia, I have been given the unique privilege to help families during what I believe is the most important time they have with their pet. So often a pet owner who has just heard that their pet has a terminal illness needs time: Time to think, time to adjust, and time to make decisions. Veterinary hospice care supports both pet and family during this time.

The first and most important step in hospice care is educating yourself about your pet’s medical condition. You need to know what to expect in those last few months, weeks, days, and/or hours in order to make the best decision for you, your pet, and your family.

The second step is making sure your pet is treated palliatively. This means your pet is being medically treated for comfort or anxiety. Veterinary hospice is not about giving them such high doses of strong medication that they can’t function; it’s about making sure they feel good throughout the day and have a comfortable full night’s sleep.

The third step in hospice care is evaluating Quality of Life. This can be very subjective terminology and is highly dependent on the disease process your pet is experiencing, your pet’s personality, and your personal beliefs. Determining quality of life is made easy when you have a scale and diary to help guide you. There are many Quality of Life scales available online. After giving your pet a ‘grade’ you can determine where they are in terms of their condition and if medical intervention or even euthanasia is appropriate.

Hospice is not synonymous with euthanasia, although euthanasia should be discussed and can be a part of a hospice program. We all wish for a peaceful natural passing but it is not always that simple, fast or painless. As pet parents we are responsible for making sure our pets do not suffer – even if that means we have to suffer a little ourselves and make tough decisions.

Lap of Love Veterinary Hospice & In Home Euthanasia has been helping families for over 2 years. Our goal is to make the remaining time a family has with their little ones as comfortable and peaceful as possible.

Posted by Dr. Mary Gardner, DVM

Starting Off With Your New Kitten, by Dr. Robyn Baldwin

 Congratulations on your new family member! Kittens are a lot of fun, and there is a lot that you, as a new "parent," need to do to maintain your pet's well-being. As you go through the following information, please be sure to ask the veterinarian any questions that you may have.

• Vaccinate:
  Be sure that your kitten gets all the vaccinations that it needs. Kittens need to have a complete series of vaccines, usually beginning at approximately 6 weeks old and continuing approximately every 3-4 weeks until they are approximately 16 weeks old. The required vaccines are the distemper vaccine (that also protects against other viruses) and the rabies vaccine. The feline leukemia vaccine is recommended for all kittens in their first year of life. At next year’s visit, you and your veterinarian will determine if the leukemia vaccine series should continue. If the cat is ever going to go outside or will be in contact with other cats, he/she should also receive the leukemia vaccine booster as directed by your veterinarian. This vaccine works best when it is given to young cats.


• Important Testing:
  It is important to test your kitten for feline leukemia (FeLV) and feline AIDS. In most cases, the parental history of the kitten is unknown, and it is important to know the virus status of the kitten. If the cat ever goes outside or is ever in contact with other cats, this test should be repeated annually.


• Start Treatment for Worms:
  Make sure that your kitten receives an appropriate series of dewormers for roundworms and hookworms (that may cause infections in people as well) and that fecal samples are examined for other parasites. After the "kitten series," this is done every 6-12 months. You can bring in a fresh stool sample with you for your veterinarian to examine whenever you go in for an exam.


• Early Heartworm Prevention:
  Begin heartworm prevention medication for you cat when it is 8 weeks old. This is important for all cats, even those who never go outside. One study showed that more indoor-only cats had heartworms that did those who went outdoors. Consider a product such as Revolution which also control fleas, ear mites, and intestinal parasites.



"Ooh, can we hold her?"
Everyone wants to play
with a new kitten. Be careful not
to overwhelm your kitty with
new experiences -- let her feel safe
with you and her environment
but do socialize her.



• Spay or Neuter Your New Kitten:
  Make sure your kitten is spayed or neutered before it reaches sexual maturity. This should be done before he/she is 6 months old. It is best to wait until the vaccine series is completed before doing the surgery, but it can be done sooner if needed. In tact cats have a much higher chance of contracting life-threatening illness than do sterile cats. Spaying and neutering are the best means to help control the severe pet overpopulation problem. If you have any questions about the procedure or why it is important that it be done, please ask your veterinarian.


• Keep Kitten Indoors:
  Be sure that the kitten is kept strictly indoors and not allowed contact with other cats until he/she has completed the vaccine series and is spayed (females) or neutered (males.) Until this time, the kitten may not be fully protected against viruses, and may (if female), become pregnant, or (if male) impregnate females.


• Indoor Cats Are Healthier:
  Consider keeping your kitten an "indoor-only" cat. Indoor only cats generally live longer lives than do those that are allowed outside. This is because, when allowed outside, cats run the risks of encountering cars, dogs, and other cats. Being hit by cars, attacked by dogs, and bitten by other cats (possibly leading to feline leukemia or feline AIDS) are common reasons that cats are presented to the veterinarian. Any cat that has a white or light-colored face or ears should be indoors-only to decrease its chance of getting sun-induced cancer.


• Maintain Health With Checkups:
  Return to the veterinarian every 12 months for your cat's annual examination and any needed booster vaccines or laboratory tests. This is necessary for the life of your cat!


• Provide a Healthy Diet for Your Kitten:
  Feed your kitten a well-formulated diet. Science Diet Feline Growth, and Iams kitten are examples of excellent foods. They are strictly formulated to meet a growing kitten's needs, without any excesses that may be harmful. Unlike some grocery-store foods, the ingredients and formulations generally do not vary, so there won't be any sudden changes in your cat's food.


• How to Switch Your Kitten's Food:
  If you ever switch your cat's food, do it slowly over a course of at least 5 days: gradually increase the amount of the new food and decrease the amount of the old food until only the new food is being fed. This will help minimize the chance of diarrhea or stomach upset from a sudden change.


• Kittens are Ready to Change to Cat Food Around One Year Old:
  Once your kitten is fully grown (at around one year old,) switch him/her to an adult cat food, such as Science Diet Feline Maintenance, Hill's t/d or Oral Care (tartar-control formulas,) or Iams adult.


• Please, No Table Scraps:
  Never give your cat "people food." A lot of food that humans can digest without any problems can cause serious problems to pets. Giving food from the table only encourages begging, which will be a problem for you and your cat. As long as a well-balanced, high-quality cat food is being fed, there is no need for supplements.


• Dental Maintenance:
  Maintain a healthy mouth by performing dental home care. Now is the best time to begin training your kitten to accept tooth-brushing. Cats' gums are much more sensitive than people's, so it is important to use a very soft toothbrush, such as the CET Kitten or Cat toothbrushes, or the small end of the CET Dual-Ended toothbrush. Only use a toothpaste that is approved for cats; human toothpaste may be toxic to them. Most cats prefer the CET Poultry- flavored toothpaste; CET Forte (seafood) and malt flavors are also available. If you reward your cat after brushing, you should be able to develop a daily routine. Most cats like the Pounce treats (either regular or "tartar control") and these make great rewards.


• Identification for Your Kitty:
  Make sure your kitten can be returned to you in case he/she is ever lost. Get a safety-release collar now, and let your kitten get used to wearing it. Get a name tag with your address and phone number to put on the collar. Once the rabies vaccine is given, make sure that he/she wears the rabies tag at all times. Injecting a permanent microchip under the cat's skin provides a permanent, unchangeable means of identification. The injection is like a vaccine injection; no sedation is required and it can be done in minutes.


• Safe Toys for Play:
  Give your kitten safe toys to play with, and make sure that there are no possible dangerous objects around the house. Cats love string, but swallowing string can cause serious problems; make sure all sewing materials, tinsel, etc. are out of the kitten's reach. Make sure there are no small objects that the kitten may choke on. Antifreeze will kill pets; be sure that there is no access to it. Other possible toxins, such as old batteries, candies/gum with xylitol, etc. need to be kept away you’re your cat. Soft, catnip-filled toys (without any small parts) and fishing pole-type exercisers such as the Cat Dancer will keep your kitten entertained.


• Litterbox Training:
  Cats tend to be litter-box trained very readily. The general rule is to have one more litter box than the number of cats in the household. For example, if you have two cats at home, they should have access to three litter boxes.


• Scratching Posts Deter Scratching of Furniture:
  Be sure that your kitten has at least one scratching post. Kittens and cats need to scratch; it is done to keep their claws in condition and as a scent marking mechanism. If there is no scratching post available, they will scratch rugs, sofas, etc. Encourage the kitten to use the scratching post by rewarding him/her when they do so, and moving them to the post if they begin to scratch in an inappropriate area.


• Nail Grooming:
  Begin now to get your kitten used toenail trims.


• Car Training:
  Take your kitten for car rides other than to the veterinarian's office. If the only time he/she goes in the car is to get vaccinations, he/she may begin to fear the car. Go for short rides around the block, and reward the cat during the trip.


• Read More:
  Get a book on kittens! It can give you a lot of other suggestions on how to provide your cat with a long, happy life.


• Be Selective When Seeking Info:
  Be cautious when looking at information on the internet. Stick with reliable websites such as www.veterinarypartner.com.


• Maintain a Relationship With Your Vet:
  Call your veterinarian whenever you have any questions!

By Dr. Robyn Baldwin, Lap of Love Veterinary Hospice

Same kitty in these photos but here all grown up.
Her eyes were blue when she was tiny!
(Photo set donated by Lap of Love friends.)

Posted by:
Vet Robyn Baldwin
drrobyn@lapoflove.com
Lap of Love Veterinary Hospice and Euthanasia
www.lapoflove.com

Broward County, including: Pompano Beach, Lighthouse Point , Hillsboro Beach, Deerfield Beach, Coconut Creek, Oakland Park, Wilton Manors, Coral Springs, Tamarac, Plantation, Sunrise ~ Lauderhill, Oakland Park, Ft. Lauderdale, Aventura, Miramar , Hollywood, Davie, Pembroke Pines, Cooper City, and Weston.  

Starting Off With Your New Puppy, by Dr. Robyn Baldwin

Congratulations on your new family member! Puppies are a lot of fun, and there is a lot that you, as a new "parent," need to do to maintain your pet's well-being. As you go through the following information, be sure to ask the veterinarian any questions that you may have.

• Vaccinate:
  Be sure your puppy gets all the vaccinations that it needs. Puppies need to have a complete series of vaccines ("shots,") usually beginning at approximately 6-8 weeks old and continuing every 3-4 weeks until they are 16 weeks old. The required vaccines are the distemper-parvo combination vaccine (that also protects against other viruses) and the rabies vaccine. Your veterinarian can explain to you about other recommended vaccines. A bordetella vaccine is recommended for puppies who possibly will be in an area where other dogs are, such as the groomer/bather, dog park, boarding facility, or hospital (for example, at the time of spay/neuter surgery.)


• Socialize:
  Early socializing with healthy puppies who are up to date on their vaccines is a good idea to help promote appropriate social behavior. However, whenever possible, be sure that your puppy is kept away from other dogs who may be sick, and from places where sick dogs may have been, until about 3 weeks after its last set of vaccines. Until this time, the puppy may not be fully protected against viruses such as parvovirus, etc.


• Worm Medication:
  Make sure that your puppy has had an appropriate series of dewormers for roundworms and hookworms (that may cause infections in people as well) and that fecal samples are examined for other parasites. After the "puppy series," this is done every 6-12 months. You can bring a fresh stool sample into your veterinarian whenever you go in for an exam.


• Vet Checkups:
  Return to the veterinarian every six months for your dog's semi-annual examination and any booster vaccines or laboratory tests that may be due. This is necessary for the life of your dog!


• Heartworm Prevention:
  Begin heartworm prevention medication when your puppy is 6-8 weeks old. It is extremely important that your dog stay on this medication without interruption, for the rest of its life. Your veterinarian will test the dog every year to maintain the manufacturer’s guarantee, and to refill the prescription for the medication. In addition to being a heartworm preventive, most products also contain ingredients for intestinal parasite control. Certain products, such as Trifexis, also provide flea control. Ask your veterinarian which product is the most appropriate for your pet.


• Flea/Tick Control:
  If indicated, use prescription flea and/or tick control formulations. It’s easier to remember monthly products if they are used on the same day that the heartworm prevention tablet is given. Be sure to read the label completely on any product that you are using. Some topical products need to be applied only to the neck area, while some will be applied down the dog’s back (eg Vectra 3D, Advantage, Advantix, Advantage Multi, Frontline Plus, etc.) Ticks can transmit diseases, so be sure to use appropriate tick control products if your dog lives in or visits an area where there may be ticks. The Preventic tick collar can be used in dogs older than 12 weeks old, and lasts for 3 months. The Comfortis monthly flea adulticide is a convenient method of flea control that will not be washed off when the dog is bathed. It is combined with heartworm and intestinal parasite control in the product Trifexis.
  


• Pet Insurance:
  Consider subscribing to Pet Insurance. Different policies are available, and some even include routine examinations and vaccines as well as emergencies. These policies are often well worth the nominal investment!


• Healthy Diet:
  Feed your puppy a well-formulated diet. Science Diet Puppy and Iams Puppy are examples of excellent foods. They are strictly formulated to meet a growing puppy's needs, without any excesses that may be harmful. Unlike some grocery-store foods, the ingredients and formulations generally do not vary, so there won't be any sudden changes in your dog's food.
  


• Hypoglycemia Prevention:
  Tiny/ toy-breed puppies are very prone to hypoglycemia (low blood sugar.) They need to be fed very frequently (up to every 2 hours around the clock for some puppies) depending on age and size. Always keep Karo syrup or Nutrical on hand in case of a hypoglycemic episode. If signs of lethargy/ weakness, tremoring, seizuring occur, immediately put some on the puppy’s gums and call your veterinarian or the emergency hospital immediately.


• Switch Foods Carefully:
  If you ever switch your dog's food, do it slowly over a course of at least 5 days: gradually increase the amount of the new food and decrease the amount of the old food until only the new food is being fed. This will help minimize the chance of diarrhea or stomach upset from a sudden diet change.


• Adult Dog Food:
  Once your puppy is fully grown (about 1 year old for an average-sized dog), switch him/ her to an adult dog food, such as Science Diet Canine Adult, Hill’s t/d, or Science Diet Oral Care (a tartar-control diet.)


• No Table Scraps:
  Never give your puppy "table scraps." A lot of food that humans can digest without any problems can cause serious problems to pets. Giving food from the table only encourages begging, which will be a problem for you and your dog. As long as a well-balanced, high- quality dog food is being given, there is no need for supplements.


• Dental Care:
  Maintain a healthy mouth by performing dental home care. Now is the best time to begin training your dog to accept tooth-brushing. The size of the puppy and his/her predicted adult size will help determine which products are best suited to use. Tiny dogs, such as miniature poodles, Yorkshire terriers, chihuahuas, etc. should have a tiny toothbrush: the CET Mini- Toothbrush or the human Oral-B Sulcus toothbrush work well in these breeds. Small dogs can use the small end of the CET Dual-Ended toothbrush, or a small, soft human toothbrush. Large dogs do well with the large end of the Dual-Ended toothbrush, a medium-sized, soft human toothbrush, or the CET fingerbrushes. It is important to only use a dog toothpaste; human toothpastes may be toxic to dogs. The malt and poultry flavors seem to be palatable to dogs. If you give your puppy a reward after his/her dental care, it should not be too difficult to develop a daily routine that he/she may even enjoy!


• Identification Tags and Microchipping:
  Make sure your puppy can be returned to you in case he/she is ever lost. Put a name tag with your phone number and address on the dog's collar. After the puppy is old enough to receive it, make sure he/she wears the rabies tag at all times. Injecting a permanent microchip under the dog's skin provides a permanent, unchangeable means of identification. The injection is like a vaccine shot; no sedation is required and it can be done in minutes.
  
  
• Spaying/Neutering:
  Make sure your puppy is spayed (females) or neutered (males) before it reaches sexual maturity. This should be done before he/she is 6 months old. It is best to wait until the vaccine series is completed before doing the surgery, but it can be done sooner if needed.


• Females that are spayed before their first heat cycle (often around 6 months old) have almost no chance of ever getting breast cancer (the most common cancer that dogs get.) After a dog goes through heat cycles, she has about a one-in-four chance of developing breast cancer, that may be fatal. Spaying also helps prevent ovarian cancer, uterine infections (pyometra), and other problems. Neutering male dogs helps prevent testicular and prostate problems, as well as some behavioral problems. Spaying and neutering is the best method available to help control the severe pet overpopulation problem that exists. If you have any questions about the procedure or why it is important that it be done, please ask your veterinarian.
  
  


• Chew Toys:
  Dogs need things to chew on. Make sure that there is no access to any possible harmful objects. Keep all electric cords, small items/toys, etc. out of the puppy's reach to avoid electrocution/ choking/ etc. A good chew toy should not have the potential to harm the dog's teeth, gums, or digestive tract. CET Chews, Gummabone, and Kong toys meet these requirements. Hard toys may break teeth or scratch the gums. A good rule of thumb is the “knee test.” If you wouldn’t want the object thrown at your kneecap, then it is too hard for your dog! The felt on tennis balls and string on rope toys may rub away the enamel of the dog's teeth, and should be avoided. Toys that can be chewed up may cause stomach problems.


• Check for Possible Toxic Substances in the Environment:
  Make sure there are no toxic substances within reach of the puppy. Old batteries, antifreeze, gum/candies containing xylitol, drugs/medications, and pennies are common household items that may be fatal if ingested. Other potential toxins include chocolate, grapes, raisins, and onions. Bufo Toads, common to South Florida, may be very toxic and even fatal if licked or eaten. If you think that your dog may have come in contact with a Bufo Toad, first rinse the mouth copiously with tap water (rinsing through the mouth, so that the toxin is not swallowed), then call us immediately.
  


• Grooming:
  Begin now to get your puppy used to having baths, ear cleanings, and toenail trims. Playing with his/her feet frequently will make nail-trim time easier!


• Gland Maintenance:
  All dogs have anal glands (small scent glands that are located just inside the anus and are used in the wild for marking.) These are the same glands that skunks have to release their odor. Some dogs (especially the smaller breeds) are prone to getting a build-up of this material, which can lead to irritation, infection/ abscess, or even rupture. If you take your dog to a groomer, ask the groomer to express the anal gland material for you to help prevent it from building up. If you ever notice your dog scooting on its rear end or chewing at this area, bring him/her in so that we can check these glands for you.
  


• Car Training:
  Take your puppy for car rides to places other than the veterinarian's office. If the only time he/she goes in the car is to get shots, he/she may begin to fear the car. Go for short rides around the block, and give rewards during the drive.


• Learn More:
  Get a book on puppies, such as the Super Puppy Handbook, and do research on particular features on your puppy’s breed. You will find a lot of other suggestions on how to provide your dog a long, happy life.


• Be Selective When Choosing An Information Source:
  When looking for information to supplement what your veterinarian has told you, be careful when looking on the internet. Stick with a reputable website such as www.veterinarypartner.com.


• Call your veterinarian whenever you have any questions!

Enjoy your new friend!


By Dr. Robyn Baldwin, Lap of Love Veterinary Hospice

Posted by:
Vet Robyn Baldwin
drrobyn@lapoflove.com
Lap of Love Veterinary Hospice and Euthanasia
www.lapoflove.com

Broward County, including: Pompano Beach, Lighthouse Point , Hillsboro Beach, Deerfield Beach, Coconut Creek, Oakland Park, Wilton Manors, Coral Springs, Tamarac, Plantation, Sunrise ~ Lauderhill, Oakland Park, Ft. Lauderdale, Aventura, Miramar , Hollywood, Davie, Pembroke Pines, Cooper City, and Weston.  

Good Eats for Our Friends with Four Feets! by Dr. Mary Gardner

About two years ago, I was facing adrenal cancer with my Doberman Neo. I stopped being a veterinarian and instead turned into a frantic mom! One thing I wanted to make sure of, was that he was getting the proper nutrition to help him with his fight.

I turned to Jodi Ziskin, a Pet Nutrition Specialist who came to my home and we formulated a diet specific for his needs, disease and one that I could do easily. I really enjoyed preparing his meals as it gave me a ‘purpose’ when I felt so helpless.

I spoke with Jodi recently and asked her some common questions that I receive:


Do pet’s nutritional needs change as they age?

Nutritional needs do not really change for pets over the course of their lives, however senior pets require less calories, so smaller portions are recommended. In addition, just like humans, as pets age they produce less digestive acids that breakdown food. Adding digestive enzymes and a probiotic are wonderful for pets of all ages, but in my opinion, are a must for seniors.

Are there specific diets we should feed for certain diseases?

From a holistic perspective, the most important thing is to feed a diet made from whole food – real meat and vegetables. No by-products or rendered ingredients, no inflammatory foods like corn, wheat or soy. This is important for any pet, but especially ones suffering from disease. For example, for cats with kidney disease, it’s not about the amount of protein; it’s about the quality. Although cats cannot digest grains, adding some grain-like foods including quinoa (which is actually a seed, not a grain) or millet (which is a grass not a grain) can help slow the digestion of proteins so the kidneys do not get overwhelmed. For pets with diabetes, replacing high sugar vegetables like carrots and peas with vegetables that have a low glycemic load like kale and pumpkin is very important. Preparing homemade food is a great way to address specific dietary needs.

Is it difficult to make home cooked meals for pets?

Not at all. And it can take less time than driving to the pet food store and back! It is important to understand the species appropriate needs of your pet. Having the right balance of protein, vegetables, fats, minerals and vitamins is absolutely necessary. Many people are surprised how much money they actually save making homemade food. There are also a number of pre-mixes on the market. All you have to do is add meat and omega 3 oils and the work is done.

What species do you seem to help more?

There seems to be a 50/50 mix of dogs and cats. Every now and then a bird or rabbit gets thrown into the mix.

Jodi works with Lap of Love (via phone or in home consultation) to help families home cook (or find healthy alternative diets) for their geriatric or terminally ill pets. More information can be found at www.LapofLove.com under the ‘Nutrition’ tab.

Posted by:
Vet Mary Gardner
drmary@lapoflove.com
Lap of Love Veterinary Hospice and Euthanasia
www.lapoflove.com

Broward, Miami Dade, Palm Beach Counties including North Miami, Aventura, Hollywood, Davie, Cooper City, Coral Springs, Weston, Davie, Ft. Lauderdale, Plantation, Pembroke Pines, Tamarac, Wilton Manors, Lighthouse Point, Pompano Beach, Deerfield Beach, Boca Raton, Delray Beach, Boynton Beach, Palm Beach, and Jupiter. 

Pain Medication is Gold Standard for Vet. Hospice Care By Dr. Cheryl Maguire

Photo courtesy: Pet Plan

I recently received my annual membership card to the American Veterinary Medical Association and included with the card came a wallet-sized copy of The Veterinarian’s Oath. By taking this oath, I swore to use my knowledge and skills to “prevent and relieve animal suffering” and I strive for this every single day. Receiving this little wallet-sized reminder inspired me to do even more when it comes to preventing and relieving animal suffering. One way I would like to do that is to address the concerns many owners have when it comes to giving their pets pain medication.

Physical pain is something we have all endured at some point in our lives and, for most of us, an experience we would like to avoid at all costs. As a profession, veterinary medicine is recognizing and treating pain in animals more aggressively than at any other time in history. Most pet owners now consider their pets as members of their families. So, why then, are so few of my patients receiving the pain medication they need and deserve? Surprisingly, I find that many of my patients are not taking any pain medication at all despite most of them suffering from conditions that cause pain and discomfort. How can this be?

Although veterinarians are doing a better job than ever before at proactively recognizing and treating pain there are still some veterinarians out there who do not offer pain medication options to their clients. I would like to think that these cases are rare. For the most part, the patients I see have been prescribed pain medication but the owners are either not well-informed on how to administer the medication or the owners are reluctant to administer as prescribed. I have found that many owners are reluctant to give their pets pain medication out of fear and this is so unfortunate.

Many owners fear that pain medication will make their pet’s condition “worse” and this is just not the case when the pain medication has been appropriately prescribed by a veterinarian. Please trust that your veterinarian has carefully weighed the risk to benefit ratio when prescribing pain medication for your pet. Most pain medications are very safe especially on a short-term basis. If these medications must be given chronically over a long period of time your veterinarian should be monitoring your pet frequently. The need for regular rechecks with your veterinarian should not be a reason for withholding pain medication from a pet that would benefit from such.

For many conditions, more than one type of pain medication may be prescribed and pet owners may fear that their pet is being “over-dosed.” Giving more than one type of pain medication is called a multi- modal approach to pain relief and one of the most effective ways to tackle pain because it uses different classes of drugs together which may be more effective than using them singly. Please do not be afraid that your pet is being “over-dosed.” Using more than one type of pain medication is an accepted and effective method of treating pain.

If a particular pain medication does not seem to be working for your pet or is causing an unacceptable side-effect such as vomiting, please do not give up on pain medication all together. Discuss how the medication is affecting your pet with your veterinarian and in most cases an alternative pain medication can be prescribed.

Pain medication must be given consistently for it to work. This is especially important for chronic painful conditions such as arthritis. Also, it is much easier to manage pain that is at a tolerable level than to try to relieve pain that is severe and excruciating so, unless your pet has been prescribed a pain medication on an “as needed” basis please give the doses as prescribed. If your pet has been prescribed medication for arthritis it is important to give the medication as prescribed even if your pet seems better. Your pet is improving because the pain medication is relieving pain and inflammation and that is a good thing! We don’t want to slip back down that slippery slope of pain and immobility by rationing the pain medication.

This was not intended to be a discussion about the different pain medications available to treat pets but rather my attempt at addressing some of the concerns I hear frequently from my clients. For owners who would like to learn more about specific medications I recommend they ask their veterinarian for this information.

I hope I have alleviated some of the fears pet owners have regarding administering pain medications to their pets and opened the door for owners to discuss the topic of pain management with their veterinarians. Sadly, our beloved pets are not immune to physical pain, even though they may not show signs of pain in the same way that humans do, they do experience pain. Fortunately, we have some good options available to treat pain in pets but these medications will not help if they stay stashed away in a kitchen drawer or cupboard. I urge pet owners who are reluctant to give their pets pain medication to discuss their concerns with their veterinarians. Please do not withhold pain medication. Your pet will be grateful you didn’t.

The Pitfalls of Buying Pet Medication from Someone Other than Your Veterinarian, by Dr. Dana Lewis

Internet pharmacies and big box store commercials would have you believe that you're just throwing your money away if you buy your prescription medications, or heartworm and flea preventatives from your veterinarian. But these pharmacies have some drawbacks that you should be aware of: You still need a prescription from your veterinarian in order to get your medications, some pharmacies use questionable products, products might not be guaranteed by the manufacturer if complications arise, if you purchase non-prescription medications from an online pet pharmacy or any other pharmacy or pet store you need to make sure to talk with your veterinarian to avoid harmful medication interactions, and one more thing that is going to surprise a lot of people- these other pharmacies are making veterinary care more expensive , not less. Let’s start with that shocker first.

Pharmacies are making veterinary care more expensive – not less

Running a veterinary hospital is a business. Yes, we love animals, and yes we want to take care of them and make you happy but it costs money to pay the staff, the rent/mortgage, utilities, all the infrastructure (anesthesia machines, blood analyzers, microscope, computers, etc.) that makes a hospital run smoothly. We do nearly all the medicine and surgery stuff done in human hospitals but without the headaches and profits from having to deal with insurance companies.

Unfortunately, some things have changed in veterinary medicine that makes other costs go up, including losing a lot of the pharmacy revenue; changes in vaccine recommendations which eliminated some of the yearly vaccination revenue, and drug companies selling directly to pet owners rather than through veterinarians (this is why you see flea medications that you used to get only through your vet being sold in big box stores).

How veterinarians used to pay the bills: Get as many pet owners in the door as possible by charging a small fee for an office visit to keep the costs to access to veterinary care low. If an animal was ill and needed diagnostics or procedures to work-up a problem, procedures and diagnostics were performed and pet owners with sick animals were charged accordingly. If medications were needed, they were dispensed to the pet owner at a reasonable profit. The veterinarian had a lot of clients and patients coming in and bonding with the practice, ensuring the bills would be paid, and pet owners came to the vet for minor problems. The quicker a problem is dealt with, the less it often costs because it has not grown in significance to a much bigger issue.

But since people are filling more of their prescriptions outside our offices, the fees have to change. The office fee has gone up. Procedures, diagnostics, and preventative care are more expensive to help defray the costs previously recouped by selling medication. Or the vet feels they cannot afford to keep those diagnostic machines in office anymore and refer you to a specialty hospital, costing you time and more money.

What does a prescription mean?

Per the guidelines of the American Veterinary Medical Association, "Veterinary prescription drugs are to be used or prescribed only within the context of a veterinarian- client-patient relationship." This means that you and your pet must have a valid relationship with a veterinarian in order for them to prescribe medication for you. As a result, when veterinarians get faxes for pet pharmacies requesting medication for animals we have never examined, or haven't examined in over a year, these requests will be denied. Human medicine works the same way. Your doctor is not going to risk your health and their license and call in a prescription for you if they don’t see you first. Veterinarians need to know your pet and what we are treating before we prescribe.

Beware of foreign and counterfeit products

Some online pet pharmacies are more reliable than others. If the pharmacy is offering you a deal that seems to be too good to be true, it probably is. Some online pharmacies have sold medicines that are counterfeit, outdated, mislabeled, incorrectly formulated, or improperly made or stored. These medicines may not contain the actual drug, may contain contaminants, or the incorrect amount of drug, may not work as well due to age, or being stored in conditions that were too hot, cold, etc. Be aware of the pharmacy’s return or refund policies. The pharmacy should be easy to contact- an address, phone number and an e-mail address should be listed on the website. One way to check an internet pharmacy's reputation is to look for the VIPPS (Verified Internet Pharmacy Practice Sites) seal of approval. It is a service of the National Association of Boards of Pharmacy. The VIPPS web site (www.nabp.net) lists qualifying on-line pharmacies.

Some disreputable pharmacies may sell foreign or counterfeit products. Items like flea and heartworm preventatives are more common targets for this problem. Luckily this isn't too widespread at the moment but it does still happen. On more than one occasion I’ve had a client complain about a flea product that didn't work, and when they showed me the product, it was a counterfeit.

Another problem with on-line pharmacies is that they may not be selling drugs approved in the US. These products have different strengths and labeling than US products. Look closely at medicine ordered online. I had this happen when someone ordered heartworm prevention and they were confused because the weight limit on the medication was in kilograms instead of pounds. They brought it in for me to see and the pharmacy was dispensing product from Australia. This is illegal in the US.

Use caution combining prescription and over the counter medications.

Just like when you go to the doctor and then to your pharmacy, inform your veterinarian if you give your pet any natural, holistic, homeopathic, or other over-the-counter (OTC) medications or supplements. It is important to avoid any harmful medication interactions with prescriptions your pet is already taking, or that your veterinarian may prescribe in the future.

An example of what can go wrong: a client administered the prescription that we recommended for her dog’s arthritis. What she failed to tell us, was that she was giving her pet an OTC product containing a salicylate, which is related to and has side effects like aspirin. She didn’t think of that as a medication because it was not a prescription. Luckily for her dog, it didn’t cause a fatal gastrointestinal bleeding ulcer because we found out when the dog started vomiting that she was giving this other product. As your pet’s health care advocate, you lovingly assume responsibility for their welfare and provide them with the best care possible, so, medicate them wisely.

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Dana Lewis, DVM

Read more or contact Dr. Dana:
Dana Lewis, DVM
Lap of Love Veterinary Hospice
Raleigh, North Carolina
drdana@lapoflove.com  |  www.lapoflove.com

Dr. Dana assists families with Pet Hospice and Euthanasia in the Raleigh North Carolina area (Raleigh, Durham, Chapel Hill and the greater Triangle, as well as Wake, Durham, Orange, and Chatham counties.