Thursday, January 26, 2017

Saying Goodbye to Your Fur-baby...

Co-written by Danielle B. and Dr. Gloria Ku

In April 2016, my 12 year-old dog, Vega, started showing swelling in her neck area that didn’t seem normal. She had been healthy most of her life, so of course my husband and I were concerned and brought her in to see Dr. Ku the following day. After a physical exam and lab work, test results were still inconclusive as to why she was swollen. As the days went on, we tried antibiotics but that didn’t seem to help with the swelling. We continued testing, radiographs and a biopsy until results gave us an answer…it was a form of aggressive cancer.

So now what? After discussing our options with Dr. Ku, we knew that we didn’t want her to put her through surgery at this stage in life, and financially we could not put ourselves in debt for the small chance that we’d have more limited time with her—it’s always hard to make that decision when you can say, "we did the best we could." And we did. She had a wonderful life with us and we soon made plans to continue our happy lives with her for as long as she was comfortable and content.

Vega was our first dog. This was our first time we were planning to say goodbye to a beloved fur-baby. Of course, sometimes other pet owners don’t have that luxury to plan their goodbyes, so we are grateful we had this opportunity. We knew for sure that when the day arrives, we would take her out for a burger, fries and vanilla cone (she’s always had dietary restrictions due to sensitive stomach issues, so this would be the ultimate treat for her!). But as we talked about remembering her in the future, we reached out to our friends and family for advice and support:

*Cherish the memories you shared. Pictures or small items that have meaning will help during this time of adjustment and something to look at fondly in the future.

*Use pictures to tell your pet's story.  Frame a photo to display. You can get creative with scrapbooking supplies or order a nice printed book from an online retailer.

dog tribute photo book
Photo Credit: http://www.mixbook.com/blog/pawprints-on-our-hearts-5-pet-photo-books-ideas/

Or make a collage or shadow box to display with love.
 
Photo credit: https://s-media-cache-ak0.pinimg.com/736x/78/eb/e3/78ebe3553f5bf96069fbc022e778496e.jpg
 
*Have a lack of space at home? Consider making a DVD or a using a thumb drive to store a collection of your pet's pictures and video.

Photo credit: https://aliexpress.com

*Have a friend or photographer do a photography session to capture special moments.

Image may contain: 2 people, outdoor
Some of our "family" pictures taken by a wonderful friend.
Photo credit: Photography by Tammy Nguyen Le

*Custom-made jewelry can be very special like charms with imprints of your pet’s paw.
Photo credit: https://img0.etsystatic.com/038/0/5304031/il_fullxfull.660390986_h12a.jpg
Remember, it’s ok to be sad…and it’s ok to cry. As you are going through this adjustment period, it will take time. Each person is different on how we handle grief. Talking with others that have gone through this can help too. If you are looking for a support group, Sacramento SPCA has information on a free support group (http://www.sspca.org/program-services/end-of-life-services/petloss):

Yolo Hospice Pet Loss Support Group
First Monday of every month from 6:30-7:30 p.m.
 
Yolo Hospice
1909 Galileo Court, Ste. A
Davis, CA
For questions, please call (800) 491-7711 or (530) 601-5756 or visit www.yolohospice.org.

This service is provided for free.

There are also books for children and adults about dealing with the loss of a pet. Here is a link to a list of books: http://petlossathome.com/pet-loss-books

Like most people, we had questions about what to expect towards the end of her life. We also asked Dr. Ku if she had any advice on the process we will be going through for the last of her days…

"As a veterinarian and pet owner, the question "when is it time?" is inevitable. For each pet and each situation that time may vary, but some of the things I ask pet owners to consider, and I ask myself are:
 
- Is the pet interacting with their surroundings and loved ones still?
- Are they still eating and enjoying meals as well as before they became ill?
- Do they still react positively when you come home? Have energy to greet or respond to you? Recognize you?
- Can they control their elimination behavior and if not is it manageable for all parties?
- Are you sleeping? Is you pet sleeping?

End of life issues are not only extremely variable by circumstance, but also very personal as to how we address them. Our own beliefs about life and suffering, and pain and comfort, are based on a lifetime of experiences that help us make the decisions we make. There is no right, and there is no wrong, way to do things. But we doubt ourselves because we do not want to be in charge of this decision. It is however, a responsibility as pet owners that we will all most likely face as our pets do not live as long as we do. Most often, once we accept that inevitability, and we consider life and health from the perspective of love for our pet, the decisions become more clear." -Dr. Gloria Ku

 
2 months later, my husband and I said our goodbyes to Vega as Dr. Ku was by our side.  And as we go through our daily life at home, there are wonderful reminders that she will always have a place in our heart and home.

Danielle (receptionist at HVH)
with Husband and Vega.

Thursday, November 05, 2015

Pet Insurance 2015



"Should I get pet insurance?" People often ask this question, and over the years my answer has gone from maybe, to YES!  This is why:

 
Today, we can diagnose and treat your pet for as many illnesses as we can for people.  This means we can do xrays, ultrasounds, CT scans, transfusions, experimental drugs and specialized surgeries, if needed.  As with most people, at some point in your pets life, he/she is likely to experience some sort of health related issue that will be costly.  For many of us, that is not going to be something we plan for, and will undoubtedly take us by surprise.  But with at least major medical insurance, the cost of an $8000 issue can be much more affordable if your insurance covers on average 80%.  $1600 is expensive, but not as formidable, and could mean the difference between treating your pet, or simply not being able to afford it. 

There are many more different pet insurance options on the market today than there were 15 years ago.  Some do major medical only (e.g. Trupanion) and others will do this plus routine coverage for annual exams and vaccines, dental cleanings, senior labwork, etc. (e.g. Pets Best).  Some are even offered by employers at a discount as an employee benefit.  Things to consider when choosing coverage may depend on how old your pet is, her/his likely health concerns due to their breeding, background, or conformation, and how active your pet is going to be outside the home (hiking, camping, etc.).  Insurance can be more expensive or can even exclude coverage if your pet has pre-existing conditions, so the best coverage begins before those conditions arise.  Some insurance policies can also include additional riders for cancer treatment, and many reset with regard to allowable expenses or maximums paid out with referrals to specialists, should that be necessary. 
Pet insurance is however not quite as easy to use as our own health insurance where the doctors offices bill insurance companies for us.  With most policies/practices now, the pet owner has to prepay the medical bills and file a claim for reimbursement with the insurance company.  Nevertheless, our clients who have insurance have not regretted or cancelled their policies, and many are able to provide the kind of healthcare they want to provide with significantly less economic worry as a result of carrying these policies. 

Its important to do your research and speak to your veterinarian about insurance companies they have had experience with before deciding which would be best for you.  In addition, some companies have comparison applications built in to their websites to help you decide the best fit for you and your pet.  Hopefully your pet will be lucky enough to never need insurance, but should he/she become ill, you will be more prepared financially to address the expenses associated with illness with it.
 
    

Here's a list of a couple Pet Insurance companies to review and compare:


http://animal-medical-clinic.com/wp-content/uploads/2014/06/Pet-Health-Insurance.png
Trupanion Pet Insurance: www.trupanion.com

https://www.petsbest.com/Images/PetsBestLogo.jpg?v=142
Pets Best Health Insurance: www.petsbest.com


http://www.petinsurance.com/images/VSSimages/consumer/header/vpilogonew.png
Veterinary Pet Insurance (A Nationwide Insurance Co.): www.petinsurance.com

Friday, July 24, 2015

Rattlers and the Wild West

Last year, the drought and warmer spring temperatures drove many rattlesnakes out of wintertime dormancy early in search of water and food.  The effect was that we had more human/rattlesnake encounters than typically noted.  In some cases, Californias fire fighters even had to delay entering fields to fight fires due to heavy rattlesnake encounters.  
Photo Source: photobucket.com/.../MojaveGreen2.jpg.html
California actually has several different types of rattlesnakes. You can find a good synopsis of snakes in California, what to do should your pet encounter one, what to do should your pet get bitten, and whether or not you should consider the rattlesnake vaccine for your dog at http://www.veterinarypartner.com/Content.plx?P=A&A=1717.

Photo Source: venturegalleries.com/...scott-linstead-jpg.jpg
Basically there are several things to remember.  The severity of the bite depends on the species of the snake and the size of the pet among other things. Some have more toxic venom than others, and how long it is been since the snake has last bitten, how mature it is, and if it is able to control the amount of venom ejected, can vary.  Statistically approximately 20-25% of bites have no venom, and on average 5% are fatal.  The venom is a toxin that spreads through the blood stream and circulates quickly.  It inhibits clotting and damages the blood vessels leading to swelling and loss of circulation.  Treatment is most effective the earlier it is given, and immediate medical or veterinary treatment should be sought.  One should not try to suck out the venom or cut open the wound in any way.  

Treatment usually involves immediate IV fluid support to prevent circulatory collapse, and usually antibiotics and antihistamines.  Approximately 1/3 of the bodys total blood volume can be lost to bleeding within a few hours.  Antivenin is a product made from horse or sheep antibodies to several common rattlesnake venoms.  It can cause an anaphylactic reaction if your pet has an immunologic reaction to horse or sheep serum and therefore a scratch test” is usually done before administering.  It helps to counteract the venom but needs to be administered intravenously within about 4 hours of a bite to be effective.  It is also quite expensive (over $800/vial not including supportive care here in Sacramento) and depending on the size of your pet, he/she may need several vials.  It is important to know that not all hospitals carry the antivenin as well.   
Photo Source: ww2.hdnux.com/.../622x350.jpg

There is a vaccine against the venom of several rattlesnakes that can provide protection similar to giving 2-3 vials of antivenin.  It is typically given as a series of 2-3 injections initially, and bolstered annually.  Even with vaccination, however, immediate care should still be sought.  A snake bite is always an emergency.  

Hopefully this will not be an issue for you and your dog(s), but with the increasing pressures of habitat, food resources and water in our state, we hope you will be aware of what they might encounter.  Happy trails!


Wednesday, April 08, 2015

Should I Spay My Dog And What Is A Pyometra Anyway?



Stinky Rose is one of our cutest little patients, but at age 8 she had not yet been spayed.  About two weeks after being in heat last year, she became severely ill.  She had a fever, stopped eating, and was drinking excessive amounts of water all of a sudden.  She also had a mild milky discharge from her vulva.  Stinky Rose had an infection in her uterus called a pyometra, and she underwent an emergency ovariohysterectomy, or spay procedure.  No longer a routine procedure, and with high risk of infection spreading, her surgical expenses were nearly 4 times higher than the discounted routine spay she would have undergone had she had this taken care of before this happened. And her chances of a smooth recovery were now much worse. Luckily, the uterus was able to be removed without rupturing, and the infection contained, before she became septic.   In a few days after hospitalization, she was able to go home and fully recover.  
 
Photo Credit: http://www.cannonvet.com/spay.htm
Dogs have a reproductive cycle that is unlike human cycles.  Female dogs will go into heat every 6 months and it is during the heat cycle that they are able to get pregnant.  The heat cycle is often distinguishable to breeders by a bloody vaginal discharge that lasts for about 2 weeks.  Unlike a human menses where bleeding is due to shedding of the uterine lining when a woman is not impregnated, the bloody discharge during the canine estrus cycle is caused by the effects of estrogen on the uterus.  There is no shedding per se and as such, no cramps, and no active turnover of the lining of the uterus.  The bleeding in this case indicates a fertile and receptive uterus.

Dog uterus with pyometra
Normal-sized dog uterus
When a dog fails to be impregnated after her estrus or heat cycle, she is prone to cystic endometrial hyperplasia. This is because the uterine wall has been stimulated and is responsive.  Because the lining of the uterus becomes thickened and vascular, bacteria, which can more easily enter when the female dog is susceptible and her cervix is open, can get trapped in this very fertile environment.  The cervix normally closes after the heat cycle and in some cases, this can trap unwanted bacteria and lead to a serious infection.  If the cervix is open enough to allow for drainage of the infection, one will see a purulent malodorous discharge.  If the cervix is only partially open or closed, the uterus will swell and become filled with pus and could eventually rupture.  The infected uterus is known as a pyometra.  A closed pyometra does not have a way to drain and is more dangerous because there are less outward signs and more risk of rupture.  Rupture can lead to an acute peritonitis, or abdominal cavity infection, similar to what happens with a ruptured appendix in people.  This can be life threatening.

If we spay a female dog before her first heat cycle, she will avoid the risk of pyometra, which could potentially happen after every heat cycle.  She is also more than 100 times less likely to have a malignant breast tumor if spayed before her first heat cycle, and 500 times less likely than she would be after her second heat cycle. 

It is safer and healthier for your female pet dog not to have these odds working against her.  Please spay your pet before her first heat cycle whenever possible, and avoid these unnecessary risks.

Friday, March 20, 2015

But The Squirrels Are So Cute!


Photo Credit: www.lyttleco.com
Last month, we came face to face with a previously thought to be uncommon infection in urban areas known as leptospirosis.  This is a bacterial infection carried by urban wildlife (squirrels, raccoons and other rodents), or grazing cattle, in their urine.  It doesnt harm these critters but can cause serious kidney and liver problems in dogs and people.  Apparently, the long dry summer followed by heavy concentrated rains in December allowed for a perfect storm so to speak, and this bacteria was able to follow the rainfall into standing pools and drainage areas.  When dogs drink or walk through these areas (in many cases our own yards after a heavy rainstorm), they can become exposed to the organism.  It causes acute kidney failure to start with, but what owners of dogs that are infected notice is their dog misses a meal, and then two and maybe three


How many times has your dog missed a meal or two and then felt better in 24 hours?  Mine have.  Sometimes it isnt that easy though.  One such Border Collie, a young 5 year old neutered male named Sammy, recently experienced just that.

Sammy was always a little picky about his food, but when he didnt eat for the second day, his owners became concerned.  He had vomited once, then just stopped. He seemed especially sluggish too, but had no fever.  He didnt act painful or sore, just seemed depressed.  A routine blood test alerted us that his kidney function tests were very elevated - more than one would expect with dehydration, although he was certainly dehydrated.  After receiving a liter of fluids and obtaining some urine, it became clear that his kidneys were not acting normally, and the diagnosis of leptospirosis was considered.  He did not have a yard that had standing water, but he had been to the dog park on occasion, and had killed a skunk a week earlier.  We ran the screening test and fortunately the diagnosis was made quickly. 
Photo Credit: www.petvet1.com
Leptospirosis usually responds well to antibiotics if they can be administered before permanent damage is done, and if aggressive diuresis is started to keep the kidneys from shutting down.  In Sammys case, that meant aggressive IV fluid therapy and hospitalization for three days.  Since he wasnt eating to begin with, we also had to give him medication to stimulate his appetite, prevent him from vomiting, treat the acid build up due to the kidney problems, and the antibiotics to treat the infection.  Despite all of this, his liver also started to become affected by the organism.  In some cases, these dogs do not recover despite our best efforts, and the recovery period can take weeks to months.  Luckily for Sammy, he started to turn the corner after about 1 week and now, 1 month later, he is gaining weight back and feeling like a normal active 5 year old Border Collie again!

To learn more about leptospirosis, visit this website:

Wednesday, December 03, 2014

When Dogs Take Their People’s Medicine...



Occasionally, we will get calls at the hospital when dogs (puppies in particular) accidentally take their owner’s medication.  This can be dangerous depending on the medication, and the size of the pet, compounded by the fact that certain medications are metabolized differently by dogs than by people.
While most animals are not particularly interested in pills or medication, some have an odor and/or size and shape that make them curious to our dogs.  Dogs are also often interested in trying things that we consume, as sometimes they aren’t half bad! ;) 

A recent episode involved a 10 month old puppy that presented seizuring, and the owner had recently had surgery and was on a fair amount of pain medication, and lived with an elderly person who was also on a fair amount of medication.  The potential for a toxic reaction with multiple medications is even greater.  Another incident involved an owner who had her medication and the dog’s heartworm medication on the counter for the morning doses, and when she looked down to take her own, she realized she almost took the dog’s and hers was missing. It happens.  Rule of thumb should be to separate all human and pet medications during administration, as well as where we keep these medications.

It is also important to remember that dogs metabolize medication differently than we do, so even when they are prescribed medication that people take, the dose is often different.   Recently with changing state laws on the use of both medical and recreational marijuana, cannabis related products are more available.  By far the most dangerous exposure for dogs is related to accidental ingestion of an owner’s supply, or food cooked with tetrahydrocannabinol (THC), the active ingredient in cannabis.  According to Dr. Lee, a consultant for the ASPCA Animal Poison Control Center, signs can include incontinence, low or high heart rate, respiratory depression, seizures, agitation, pneumonia and even unconsciousness.  The truth is that we do not know enough about how cannabis can affect dogs, and several dogs have died from ingesting baked goods containing THC.  According to Dr. Robert Silver, chief medical officer for a veterinary nutraceutical company, literature shows that dogs “have the same endocannabinoid receptors that let humans benefit from the therapeutic effects of cannabis,” but that “dogs have a higher concentration of these receptors in the hindbrain, which is why they develop more severe neurologic effects…”   At this time and until more research is done, we cannot safely recommend marijuana for pain relief or any other use in pets.

The point is we just don’t know enough about how many things, pharmaceutical or nutraceutical, will affect our four legged companions.  Even something that may seem very mild like green tea or green tea extracts are potentially harmful in dosages inappropriate for our pets.  So please, be careful not to share too much with your pet, even accidentally!

Tuesday, October 14, 2014

Pet Nails: How to Trim and What Can Happen If You Don't


Written by Danielle, Veterinary Assistant
Edited by Dr. Ku, DVM

Trimming your pet's nails can be a scary task to most people.  How much do you trim off?  How often should nails be trimmed?  What do I do if I trim my pet's nail and it starts to bleed?
Our hope is to help you understand how to trim nails,
and why it is important.


Photo Credit: www.examiner.com
First, nail trimmers come in many different shapes and sizes.  Some people are more comfortable with the scissor-like nail trimmers, while others prefer the guillotine-like trimmers.  Some nail trimmers will file down the nail instead of cutting it; however, not all pets are comfortable from the noise that comes from these tools.  Another product to have on hand is Quik Stop.  It's a yellow powder that will stop the bleeding if you accidentally trim too close to the blood supply in the nail.

Secondly, let's help you understand the anatomy of the nail.  Below is a helpful diagram that explains how the blood supply (quick) in a pet's nail grows and shortens over time when trimming the nails.
Photo Credit: www.chazlynboardinggrooming.com
And now it's time to begin!  Start with having your pet in a comfortable position--that could be sitting on your lap, or being held in the arms of another household individual.  Next, play gently with your pet's paws.  Having them get used to you touching their paws will help this process.  Lastly, trim the tip of one nail, and then give praise and a treat if needed!  We want to positively reinforce a good nail trimming experience.  Sometimes, no matter how much praise or treats are given, a pet is not a willing participant for having their nails trimmed.  Different restraint techniques, practice, and on occasion anxiety medication can help you succeed at trimming the nails.  Each pet is different--be patient and consult your veterinarian if you are having difficulties.

But what happens if you decide to not trim your pet's nails?

Photo Credit: www.examiner.com


Unfortunately, nails left untrimmed may eventually cause problems.  Longer nails make it easier for them to get caught and then torn or broken, causing the pet to bleed and feel pain.




When nails become too long, they start to curl and can become embedded in the pads.  This can cause infection and pain, making it uncomfortable for the pet to walk.
Photo Credit: http://mypetandvet.blogspot.com/2013/09/an-interesting-case-ingrown-nail-of.html
When this happens, a veterinarian will need to remove the nail from the pad, possibly prescribe medication for infection, and maybe wrap the paw to control bleeding if needed. Each case is different and should be assessed by your veterinarian.  If left untreated, the infection may get worse and the pet will continue to feel the pain as the nail grows further into the pad.
Photo Credit: http://mypetandvet.blogspot.com/2013/09/an-interesting-case-ingrown-nail-of.html



And if you're looking for a video on how to trim your pet's nails, please click on one of these great informational videos!


HOW TO TRIM YOUR DOG'S NAILS:
 

HOW TO TRIM YOUR CAT'S NAILS: