Friday, July 30, 2010

Performing a brief monthly at-home exam on your pet

Just as physicians recommend monthly self-examinations for men and women (whether we do perform them or not is another story), I recommend a brief at-home monthly check-up of your pets. This of course DOES NOT replace the more thorough 6-12 month check-ups recommended by your veterinarian (more frequently if your pet has a health problem). The purpose of these brief at home exams is to identify changes in your pet that may require you to see your veterinarian sooner than the previously scheduled check-up.

A great time to do this is before you apply the monthly flea/tick/heartworm preventative medication and it should only takes a few minutes. The more routinely you perform this the easier it will be for you to note when changes do occur.

Just as I start my exams in the office, step back for a moment and just watch your pet. Do they seem to breathing comfortably? Do they appear too thin or overweight? Do they have trouble laying down and getting up? This is a good time to go over and answer the important questions your veterinarian will ask (see previous blog post “10 important questions your veterinarian will ask that you should be prepared to answer”).

I then recommend starting at the face and working your way to the tail. Observe for any discharge or redness of the nose, eyes or ears. If discharge is seen, note which side is affected and the amount and color of the discharge.

Next, if your pet allows, gently lift the lip on each side and note any tartar on the teeth, broken or discolored teeth or changes to the gum color. Healthy gums should be a nice pink color. Bright red gums along the border of tartar covered teeth may signify gingivitis. Some pets have pigmented gums and these changes may be difficult to assess. If you notice pale, blue/purple or yellow gums it is best to call your veterinarian and have your pet assessed further as they may have a serious medical condition.

Next, move your hands along the neck to the shoulders, down each front leg and back up and down the rest of the chest and abdomen finally reaching the back legs. As you do this you should be feeling for any lumps, bumps or painful areas. Three areas to check as you move from head to tail are at the end of the jaw just below the ears, in front of the shoulders, and behind the knees. Major lymph nodes are located in these areas and any changes to their size may indicate inflammation, infection or cancer. You can ask your veterinarian to demonstrate where you should be feeling during your next visit.

If lumps are encountered they are most likely lipomas or "fatty growths" that don’t cause a problem unless they get too large and infiltrate adjacent areas BUT lumps that look and feel like "fatty growths" can also be dangerous cancerous lumps. The only way to tell the difference is to have your veterinarian sample them. This is easily done as we poke the lumps with a needle and apply the cells on a slide (fine needle aspirate). Your veterinarian may look at it under the microscope in their office or send it to the lab so a pathologist can analyze the cells. Obtaining this aspirate is not 100% as only very few cells are sampled, but is a good start in helping decide if this lump should be removed immediately or if it is ok to monitor it for changes in size and appearance. Your veterinarian will note the size and location of the lump in the record to keep track of it during future visits. Sometimes depending on the location, feel and look of the lump it may be recommended to remove a piece of the lump and send it to the pathologist instead of performing an aspirate or after an aspirate.

Once you reach the tail, again if your pet allows it, lift the tail and examine for any discharge, nodules or uneven, bumpy areas around the anus. Tumors involving the anal glands can occur and go unnoticed until it is so large that your pet has trouble defecating and by that time it has most likely spread. In female dogs you can monitor for any discharge from the vulva.

Finally, if your pet is good about laying on its side or back, examine the hairless areas of the belly for any rashes, redness, fleas or mammary growths. Run your hands along their bellies and note any lumps and bumps. In male dogs this is a good time to notice any discharge from the penis.

This simple and quick exam will help you identify any possible changes to your pet’s health earlier, instead of waiting months for the next scheduled exam. Recognizing these changes early may save your pets life, allow for a possible cure or at least be able to start important medications before the disease becomes too advanced. It also helps your pets get used to a part of the more thorough examination that your veterinarian will perform. As always, if you have any concerns about your pet, please call your veterinarian first for further advice before ignoring a problem, misdiagnosing a problem or self-medicating your pet as you may be causing more harm than good!

Wednesday, July 14, 2010

10 Important questions your veterinarian will ask that you should be prepared to answer

A visit to your veterinarian doesn’t just involve your pet and the clinic staff; it includes YOU, the most important part of your pet’s health care team. The veterinarian relies on you to identify concerns about your pet’s health just as a pediatrician relies on a child’s parents.

Although you may wonder what the questions we ask have to do with your current concerns, answering them honestly and completely is essential. In fact this process (known as acquiring the history) is one of the most important parts of the visit and may help us identify your pet’s health problem.

If the person taking your pet to the veterinarian will not be able to answer these questions I recommend that you write down the answers to these questions and send them with your pet or provide a phone number where you can be reached so that we may ask these questions.

1. Any coughing, sneezing, vomiting or diarrhea?

You will be asked when does it occur (day or night or at any time), how often, the color of material produced, whether it is improving, worsening or the same.

2. Changes to appetite, water consumption or urination?

Many diseases will cause your pet to eat more or less, drink more and urinate more often. If your pet has not been finishing meals, continuously begs for food, you have been filling the water bowl more often, have noticed urinary accidents in the house (especially at night when you can not take your pet out) or have been scooping more clumps of litter these may be an indication that your pet has a medical condition. Your veterinarian will want to take a urine and blood sample as a start.

3. Are you giving any medications?

It is very important to identify ANY AND ALL medications your pet is currently receiving including preventatives, vitamins and over-the-counter products. Know the name, milligrams, how much and how often you are administering the medication. Sometimes bringing the medication with you is easiest. DO NOT withhold any information as medications your veterinarian prescribes may react with a current one potentially causing serious health problems.

4. Travel History?

Many diseases occur more commonly in specific areas of the country. If you travel to certain areas your pet may be exposed to different diseases. Also, if you are planning on traveling, your veterinarian may suggest certain preventative medications that target not only fleas but also ticks and heartworms.

5. Are there other pets in the house and do they have any medical conditions?

This is important in situations where diseases that are potentially contagious are of concern. Your veterinarian will provide tips on how to monitor your other pets for signs that they are also affected or provide treatment for your other pets.

6. Indoors only? If outdoors are they always supervised or sometimes unsupervised?

We all know that there are certain dangers that come with being outdoors. If your pet is indoors only it may help your veterinarian narrow down why your pet is sick.

7. Previous medical history?

This is a very important question as your pet may be affected by a recurrence of a previous disease or the treatments for one disease may make another disease worse.

8. Are vaccines up to date? Which have been given and when were they last given?

This question is important for many reasons. If your pet has not been properly vaccinated for a specific disease your veterinarian may be more suspicious of what is making your pet sick. Also, certain vaccinations can cause tests for that specific disease to be positive even though your pet does not have that disease.

9. What do you feed your pet and how much? Include treats and table scraps.

What you feed your pet is very important to their health. Certain diets may not be ideal for your pet’s life stage or for certain medical conditions. Also, on occasion, food recalls occur and at certain times these foods may have serious effects on your pet’s health. You or a guest may unknowingly have fed your pet a food item that is toxic to them.

10. Any other changes you have noticed or concerns you may have?

Things you bring up during this period may provide additional insight into what has been going on. Even if you think what you are about to say is unimportant or may make your veterinarian think you are crazy bring it up, you will be surprised how many times this piece of information may be the biggest clue in figuring out what’s wrong with your pet.

Wednesday, July 7, 2010

Do Microchips Cause Tumors?

There have been various stories warning pet owners of the dangers of implanting a microchip in their dogs or cats. One such concern is the development of a tumor.

Do microchips really cause tumor formation in dogs and cats? Probably yes.

Does this stop me from recommending to my clients that their cats and dogs (and other pets) have microchips implanted for their proper identification? No.

Why not? Well, to date the best data we have is from The British Small Animal Veterinary Association which has been tracking adverse reactions to microchips since 1996. They identified a link between microchips and cancer in two dogs of more than 4 million that have received a microchip. To me, this makes it a very rare event.

How would a microchip cause a tumor to form? It is known that irritation, inflammation, and/or wounds are promoters of tumor development. Therefore, virtually anything that causes a local inflammatory reaction may potentially be responsible for initiation of tumor formation.

What about the reports of tumors developing in lab mice that have microchips placed? It is important to remember that mice and rats in those studies were either inbred strains or strains that have been genetically modified to predispose individual animals to cancer formation, making them very prone to developing tumors. Therefore a direct link between what occurs in mice should not be made with what occurs in our pets.

I have not witnessed a case of a tumor at the site of microchip implantation but I have witnessed many cases of pets being brought to our hospital after being found and MOST have no form of identification. There have been a lucky few that had a microchip which our scanner identified. The owner was called and they were shortly reunited with their pet! It is therefore VERY important to remember to make sure your contact information is current, if you have changed your phone number or address since your pets microchip was placed please call the microchip company to update your information.

Other possible risks of microchip implantation include but are not limited to infection, severe bleeding, migration of the microchip and injury to the spine or other organs from the injection. I have not witnessed these events occur at our hospital.

Having a microchip placed in your pet is not a risk- free procedure, but like any medical procedure one must weigh the possible risks of the procedure with the possible benefits. In this case, the occurrence of lost pets is significantly higher than the reported reactions to microchip implantation and therefore in my opinion the benefits outweigh the risks.

Before having a microchip implanted in your pet (or any other procedure) make sure you have a discussion with your veterinarian about the risks and benefits so that you may make an informed decision. If you do feel any bump, lump or growth on your pet, it is important to make an appointment with your veterinarian to have it evaluated.