Sunday, November 20, 2011

When to put your dog down

When is the right time to put your dog to sleep?

One of the most difficult decisions people have to make when they own a pet is when to have that pet put to sleep.  Many phone calls I receive start off with, "Dr Gardner, my family says I should put my dog down but I just don't know if it is the right time."

To help people evaluate when the 'right time' is - I start off with learning what disease the pet has. Every disease will produce different symptoms, effect quality of life differently, carries a different life expectancy, etc.  For example, Congestive Heart Failure may shorten the life span of a pet faster than arthritis. 

Next I find out what is currently being done for the pet in terms of treatment and home environment. All too often pet owners are reluctant to bring their pets to their regular veterinarian when they are old because they are concerned about the expense and also that their doctor will suggest euthanasia before they are ready.   That is where hospice comes into the picture.  Pet Hospice is a philosophy that aims to allow the pet to spend as much quality time at home as possible before euthanasia or natural death occurs. It typically does not include a lot of tests, bloodwork, xrays, etc. But rather focuses on treating symptoms short-term to give families more time with their loved ones. 

Arthritis/mobility is the most common reason people call me. After a hospice visit, many pets do well on the medications I prescribe (ex: pain medication and anti-inflammatories) and also with some simple modifications to the house to help the pet feel better. (Click here for some ideas)  Another mis-conception  many people I hear from have is that they don't want their dog or cat all 'drugged up'.   The medications we use are very similar to what humans use.   If I were to have a headache or my knee what hurting me - I'd reach to my medicine cabinet... and I wouldn't be all 'drugged up' the rest of the day. :)  (NOTE: DO NOT give your pet human medication without first speaking to a veterinarian. Many of our medications can be fatal in other speices)


Another common disease is Kidney (Renal) Failure. Patients with Kidney Failure can greatly benefit from administering fluids under the skin every day. This is a daunting task for some owners but once they do it two or three times, it becomes second nature.  



Click Here to go to enter our Common Disease page which has information sheets on many of the diseases our pets suffer from.

Quality of Life Scale


Last, I go over the Quality of Life scale (click here for scale) that we have created. Or use our free online Pet Hospice Journal This helps owners evaluate their pet objectively and will help guide them in determining when the right time is for the pet and the whole family.




It is never an easy decision and it does carry guilt at times. Remember that euthanasia means, 'A good death', it is very peaceful and it is a gift that you can give your pet when they are suffering. 

Please explore our website www.lapoflove.com or contact your local Lap of Love veterinarian to ask any questions you may have about hospice and euthanasia.



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


About Lap of Love:
Lap of Love is a group of compassionate veterinarians that provide peaceful veterinary hospice and euthanasia in the home. We empower owners to help care for their geriatric or terminally ill pets in an environment most comfortable for them.  




Dr. Mary Gardner with Hospice Patient Koleman

Friday, November 18, 2011

Pet Euthanasia At Home New Port Richey

Dr. LeighAnn with Bindy
Lap of Love Veterinary Hospice and In Home Euthanasia is proud to announce that Dr. Leigh Ann Littlejohn has joined the organization to bring our services to the New Port Richey, Florida region. 

Dr. Leigh Ann is a native Floridian and grew up in Palm Harbor. She attended the University of Florida for both her undergraduate degree and her Doctorate of Veterinary Medicine (Go Gators). Immediately after graduating from vet school, Dr. Leigh Ann attended the Chi Institute in Ocala Florida where is became a a Certified Veterinary Acupuncturist.

"As far back as elementary school, I can remember wanting to become a veterinarian even though my other options included pizza maker or hair stylist." Littlejohn says, "Growing up, we had many great dogs but I would say the one most special to my heart was my Australian Shepard, Tucker. He provided me with many excellent “hands-on” educational opportunities throughout his life such as treating skin diseases and seizures to unfortunately cancer. I also credit Tucker for exposing me to a branch of veterinary medicine that was not too common, TCVM (Traditional Chinese Veterinary Medicine). This discipline used herbals and acupuncture to completely cure him of epilepsy (seizures). I did not understand how TCVM worked, but knew that it had saved my dog’s life and that I needed to learn more about it."

Dr. Mary Gardner and Dr. Leigh Ann Littlejohn
Dr. Littlejohn also happens to be one of Dr. Mary Gardner 's vet school classmates and best friends .... and is a wonderful addition to the team! To learn more about Dr. Leigh Ann- click here for her whole biography.

If you know anyone in the area - please let them know about this option for their pets.



Leigh Ann Littlejohn, DVM, CVA
(727) 478-4107


About Lap of Love:
Lap of Love is a group of compassionate veterinarians that provide peaceful veterinary hospice and euthanasia in the home. We empower owners to help care for their geriatric or terminally ill pets in an environment most comfortable for them. 

To learn more about Pet Hospice - click here.  
To learn more about In Home Euthanasia - click here


Wednesday, November 16, 2011

Pet Hospice for Feline Lymphoma


Owner turns to Pet Hospice
when his cat is diagnosed with cancer

 
Young Healthy Romeo
It was the middle of May 2011 when I was fighting South Florida traffic and my cell phone rang. It was a gentleman from my town of Lighthouse Point asking me about Hospice Care for a cat that had been recently diagnosed with cancer.  I remember clearly his tone. I could tell that he cared so deeply for his kitty and that he was not one to give up so soon on his buddy.  He told me that his sweet cat Romeo was doing okay for now but between a decreased appetite and increased vomiting,  he was losing weight at a fast pace. But Romeo still slept on his chest every night and was enjoying getting loved by everyone in the house.  Clearly it was not his time to say goodbye; they just wanted to know his options.

So, I headed to Romeo’s house to meet his dad, Anthony, and see if there is anything I can do to help him.  Little did I realize that that visit would turn into a great friendship and a good story!

I was greeted at the door by three dogs – all characters!  Indy and Sadi were little yorkies that would not let me pass without being pet and alongside was a gentle beagle named Kobi.  Later I learned that Kobie, recently adopted, was completely blind.  Even I, as a veterinarian, couldn’t tell that Kobie was blind at all – he didn’t miss a beat!

Then a tangerine cat, Juliet, jumped to the back of the couch to give me some crazy love right about the same time that I heard squawking from a bird cage. CLEARLY this family loves pets.  Finally I saw a skinny little grey tiger cat meander in our direction. Romeo was not looking so great. Obviously he didn’t care about cleaning himself too much and I could see his facial bones really well.  He didn’t mind me petting him but this was not the 'lovey' Romeo I was expecting… he was tired.  And then to my surprise, I noticed that he was missing a back leg.   This cat has really had a few major medical issues in his life but he also lucked out by landing this family!

Romeo after first surgery
Romeo was adopted as a kitten in December 1997 and when he was 9, he was diagnosed with fibrosarcoma of his left-rear foot.  The first surgery only removed a portion of his outer foot to remove as much tumor as possible while leaving the foot fully functional. However, the pathology reports came back that the tumor had not been fully removed and so it resurfaced a few months later. So Romeo had a second surgery to amputate the full limb at the hip on January 16th 2007.

Romeo stayed at the hospital for 3 days and then returned home where he recovered FAST! Anthony said he was functioning normally his first day home and fully recovered within a few weeks. (Note to the public: 3 legged animals do GREAT!)

In March 2011 Romeo started to experience chronic vomiting with sudden bouts of diarrhea. After two months of testing to rule out diabetes, thyroid and other possible causes, an ultrasound was performed on May 2nd, which showed thickening of his intestinal walls, swollen lymph nodes and other visible signs that led to a diagnosis of intestinal lymphoma.  His prognosis was 3 months and the family was told there wasn't much that could be done for treatment.  After consulting with 2 other veterinarians, each confirming the findings and giving little hope, Romeo was prescribed medications to treat the vomiting, diarrhea and loss of appetite

Romeo at time of first Hospice visit
“We then started looking for someone to help us with at-home hospice care.  In the middle of May we contacted Dr. Mary Gardner, who came to our home to look at Romeo's current state and help us understand the process.  Immediately we were greeted with a compassionate presence and felt a great sense of relief knowing that we now had a partner to help guide us through what we thought were the final stages of Romeo's life,” Anthony stated.  “Dr. Gardner prescribed a regimen of fluid therapy and B12 shots to help maintain quality and comfort and would also stop by to monitor his health.”

As a veterinarian, we keep in mind when treating pets with diseases that there are a variety of opinions, treatment options, and most important emotional and financial budgets.  Having recently gone through chemotherapy with my dog Neo just 6 months before, I really wanted Romeo to see an Oncologist.  Lymphoma in cats responds well to chemotherapy and I wanted him to have that chance.  I always tell my clients about all options so that they can make the best decision for their family. I knew from the bottom of my heart that Romeo’s dad was not ready to give up without a fight and I also knew sending him to an oncologist was the best thing for him.  However, Anthony and his wife were not easy to convince!

  “Dr. Gardner had advised that we seek a cancer specialist to see if there were any treatment options.  She had to push us twice to do so since the advice of the three other veterinarians was that there was little that could be done based on the broad coverage of the lymphoma across all of his organs.  Finally in June we were seen by a cancer specialist clinic (http://www.animalcancercareclinic.com/), who told us the condition was treatable in cats and we immediately started a chemotherapy treatment schedule.” Anthony said.

Romeo NOW! On Chemo

 YAY!  Romeo was getting treatment -- and there was hope!  Even if it only gave the family 6-12 months more, there was more time! And GOOD time with Romeo!   To date, Romeo has returned to his normal weight of 11.7 pounds -- all the way from his low point of 7 pounds.  After an operation to gather tissue samples from all affected areas, it has been determined that no lymphoma is present.  The vomiting, diarrhea and all other previous symptoms have disappeared.


Romeo Now - doing great!
Romeo is currently on maintenance medications to hopefully prevent any recurrences.  He is taking prednisolone and Leukeran, a low-dose chemo drug, and is doing GREAT!  Romeo and Anthony still enjoy their night time snuggling and are completely out of Hospice care!  Now I just visit Romeo to say hi and Anthony texts me monthly to keep me posted.  He looks like a new cat from when I first met him!  Very handsome, perfect weight and well-groomed.  It is now exactly 6 months from getting that phone call on the road.   




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

Lap of Love - www.lapoflove.com - was founded by Drs. Dani McVety and Mary Gardner to provide at-home veterinary hospice and euthanasia care and services. Veterinary hospice is an adjunct service provided to clients, and is not designed to replace the care of a general veterinary practitioner. Lap of Love currently operates in Florida, North Carolina, and Tennessee with planned expansion to additional states in the coming months.

Drs Gardner, Simons and Sabo help families in 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. 

Monday, November 14, 2011

Canine Cognitive Dysfunction Jennifer Hawthorne

Canine Cognitive Dysfunction
by Jennifer Hawthorne, DVM

Photo Credit: http://www.carolinamountaindog.com/
Canine Cognitive Dysfunction (also known as cognitive dysfunction syndrome or doggie Alszhiemer’s) is a progressive decline of mental function in dogs.  Typically it presents as behavioral changes in the pet including disorientation, changes in social interaction with family, changes in sleep patterns, loss of house training and decreased activity levels.  While some mental changes may take place in many older dogs, CCD does not occur in every aging pet.  Studies have shown there may be “susceptibility genes” associated with the disorder and similarities occur between humans with cognitive impairment and dogs with CCD in the brain.  Oxidative damage can lead to increased ventrical size and accumulation of amyloid plaques in the brain.


There are numerous possible clinical signs associated with CCD.  These include:

Photo credit: http://tiptopdogschool.com
  • House-soiling
  • Depression or increased anxiety
  • Vocalizing at night
  • Altered sleep/wake cycles
  • Wanting more or less attention from owners
  • No interest in play
  • Pacing/ restlessness
  • Compulsive behaviors (increased licking)
  • Confusion, not responding to previously learned commands

Other possible differentials for this disorder include anxiety disorders, hepatic encephalopathy, brain tumors, etc.   
 
So what can be done to help and cope with this disorder in your pet?  While there is no “cure” for CCD there are many things that may be helpful in improving your pet’s brain function.  Rewarding good behavior is important and it is imperative that the pet is not punished for the undesirable behavior.  Protecting the pet from potentially hurting itself may be necessary.  Emphasizing daily routines and cycles and providing mental and physical stimulation (to the pet’s ability) is important.  Other pets in the household can sometimes keep the pet with CCD mentally and physically stimulated as well. Encouraging relaxation for the anxious pet is also a good idea.  


There are some newer supplements and medication on the market that have shown to have some positive effects.  Supplement such as Neutricks and Senilife contain antioxidants and other ingredients that may help support brain health.   





 
Hill’s Science Diet makes a prescription diet, b/d, that also contains important antioxidants and such for important brain health.  Antioxidants include vitamins E and C,  Lipoic acid and l-carnitine, and  carotenoids and flavonoids (found in fruits and vegetables).  Also fatty acids such as DHA and EPA are helpful.  One prescription medication has been shown to help in some dogs.  Selegiline (Anipryl- Pfizer) given at 0.5mg/kg per day may help, though it may take weeks to see results.  


Older animals often slow down but if you feel your older pet is exhibiting some of these symptoms, talk to your veterinarian.  Many pet owners think, “oh, my dog is just getting older, this is normal,“  while it often is not. These changes can be very frustrating to deal with and not every aging pet exhibits these symptoms so it is important to monitor changes in your pet’s behaviors, talk to your vet, and have a physical exam performed on your aging pet routinely.  


Blog by:
Jennifer Hawthorne, DVM
Lap of Love Veterinary Hospice and In-Home Euthanasia

Dr. Jennifer helps families in the Mecklenburg, Cabarrus and Iredell counties including Charlotte, Concord, Kannapolis, Huntersville, Mooresville and more. Click here to read Dr. Jennifer's biography.

Sunday, November 13, 2011

In Home Pet Euthanasia Gainesville Florida

Lap of Love welcomes Dr. Jeni Bansel to the organization to help families in Alachua county Florida with in home hospice and euthanasia for dogs and cats.

"While attending veterinary college I found my passion was working with animal rescue and behavior. The two are very closely linked and many times behavior is the main reason animals are abandoned at shelters." Dr. Bansel says. "Upon graduating, I began working in private practice and truly enjoyed the close connections I made with many of the pet owners and their beloved family companions. I found that one of the most important and difficult tasks was assisting owners with the decision to euthanize their pet as well as performing the Euthanasia." 

Lap of Love is a group of compassionate veterinarians that provide peaceful veterinary hospice and euthanasia in the home. We empower owners to help care for their geriatric or terminally ill pets in an environment most comfortable for them.

"I am very pleased to be able to provide in-home hospice and euthanasia. My goal is to make this difficult time as stress-free as possible, so that you can always remember your pet’s last moments surrounded by peace and love." Dr. Bansel says.

To learn more about Dr.Bansel- click here to see her whole biography
(352) 505-2258

Dr. Bansel services towns in and around Alachua county including Gainesville, Hawthorne, Alachua, Newberry, Micanopy, Hawthorne, Ocala, Starke, Archer and High Springs.

To learn more about Pet Hospice - click here.   To learn more about In Home Euthanasia - click here

Lap of Love has veterinarians in North Carolina, Tennessee and Florida.


Saturday, November 12, 2011

Mary Gardner Nicole Sabo at the Happy Paws Pet Expo

Today Veterinarians Dr. Mary Gardner and Dr. Nicole Sabo were at the Lap of Love booth at the Happy Paws Pet Expo in Davie, FL.  There was a great turnout and we were able to educate a lot of people on how to care for their geriatric or terminally ill pet.

Dr.  Mary Gardner manning the booth

Dr. Nicole and her dog wearing purple!

 



We had some cute visitors stop by - here is Olivia sporting some hair/fur feathers!








 And you know what a sucker Dr. Mary is for red dobermans! 


 A HUGE thank you to Pet Meds (www.1800petmeds.com) for supplying us with some great treats to hand out including Joint Enhancers, Oatmeal Shampoo, Flea and Tick products and Max/Molly toys! 
Max and Molly Toys - Pet Meds' Mascots
                

                               
Plus Dr. Mary was visited by some clients and she met "Paris" a 'new love' - never a replacement but a new brightness in the family's life.      

PLEASE STOP BY TOMORROW AND SAY HI! Dr. Nicole will be there from 10am - 2pm and Dr. Mary will be there from 2pm - 6pm.  www.happypawspetexpo.com

Rescue Groups & Non- Profit Organizations That Are There:


Beyond Nine Cat Rescue ~ Big Dog Ranch Rescue ~ Boxer Friends ~ Broward County Animal Care ~ Cat Crusaders ~ Cat’s Exclusive ~ Cocker Spaniel Rescue Of Florida ~ Dachsund Rescue of South Florida ~ Dogs 4 Disabled Veterans ~ Florida Humane Society ~ Friends of Greyhounds ~ Grateful Paws Dog & Cat Rescue ~ Grey2KUSA ~ Luv -A -Bull All Breed Rescue ~ No Kill Nation ~ Old English Sheepdog Rescue ~ Warm Hearts Rescue

 

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.

Wednesday, November 9, 2011

Hospice for Dogs and Cats - Congestive Heart Failure Story

 Hospice for Pets

Lady, a 16 year old spayed female Bichon Frise, was first diagnosed with congestive heart failure (CHF) 10 months prior to our first meeting.  The 4-legged child of 2 nurses, she was in good hands from the start!  As with most early-diagnosed CHF pets, proper medication and instructions from her regular veterinarian ensured her a good quality of life.  Her parents, Kim and Jim Griffin, were well educated on the “Rest plus 3-D’s” of heart disease treatment – Rest ensures lower demand on the heart, Diruetics (like Lasix) help reduce fluid accumulation, Dilators (usually Enalapril) help dilate vessels, and Dietary restriction of sodium reduces total retained fluids.  

Lady’s owners were consistent with the medication and were very happy with her quality of life.  Although she was considered a geriatric pet by this time, they maintain she still had energy to play fetch and even tussle with your younger sibling.  It wasn’t until 10 months after her diagnosis that she started to show signs of slowing down.  She began to tire quickly and cough, especially after any type of exercise.  As nurses, the Griffins knew this was a sign that her heart and lungs were overloaded with fluid.  Lady was becoming increasingly hard to pill, however, and they were very worried about her getting the proper medication to allow her heart to function.  She still had a good quality of life and they were not ready to take that from her.  That’s when I stepped in.

During the first home hospice visit, we discussed Lady’s average daily routine and addressed any issues that might be contributing to her dislike of the pills (bad teeth, neck pain, etc).  We determined it would be best to switch Lady to injectable medications to decrease the anxiety associated with the oral pills.  As nurses, Mr. and Mrs. Griffin were very comfortable with this option and readily agreed.  Luckily, Lady tolerated the injections quite well!  She received daily doses of Lasix and vitamin B-12 while discontinuing the other medications in order to focus on quality of life.  Her parents we well versed on the end-stage of congestive heart failure and even rented an oxygen tank in the event Lady began to have difficulty breathing.  They also kept injectable pain medication on hand in case Lady showed any signs of discomfort.  The sole purpose of this period of time was to ensure Lady did not suffer while they awaited my arrival for an in-home euthanasia, whenever that may be.

Two months later I received the call we all knew was coming, Lady was ready.  She had some difficulty breathing but the biggest sign for the owners was her disinterest in her favorite treat, her mom’s meatballs.  They knew it was time.  I arrived a few hours later and Lady passed peacefully in her parents’ arms.   

This case illustrates the importance of in-home hospice care, when appropriate.  Lady’s owners were willing, able, and educated enough to feel confident in their ability to treat and evaluate their little one’s condition.  Although not right for every family, the ability to think outside the box and to search for new alternatives to care is incredibly important in this rapidly evolving area of geriatric medicine.  This is best summed up in the words of the owners, “We wouldn’t change a thing.  Having Lady in her home until the very end was the best gift we ever gave her.” 

For more information on Hospice Care for your pet - click here.
For information on certain common diseases our pets suffer from - click here.
To join our e-mailing list - click here.

Blog written by:
Dr. Dani McVety
Lap of Love Veterinary Hospice and In Home Euthanasia

Dr. McVety services all towns in and around Hillsborough and Pasco counties including Tampa, Seminole Heights, Carrollwood, New Port Richey, Wesley Chapel, Brandon, and surrounding areas.

Lap of Love - www.lapoflove.com - was founded by Drs. Dani McVety and Mary Gardner to provide at-home veterinary hospice and euthanasia care and services. Veterinary hospice is an adjunct service provided to clients, and is not designed to replace the care of a general veterinary practitioner. Lap of Love currently operates in Florida, North Carolina, and Tennessee with planned expansion to additional states in the coming months.