Holiday Pet Survival Guide

Give up the toys! 

I'm pretty sure pets love the holiday season just as much as I do. Think about it - for a month or two shiny new toys get hung up all over the house, the whole house smells like food, and lots of gullible friends and relatives wander in and out who are much more likely to fall prey to puppy-dog eyes and give you some of whatever they've got handy. And, if you're lucky, you get into enough trouble for a visit to your favorite person - the veterinarian!

Okay, so maybe we aren't your pet's favorite person (second favorite? third?). Unfortunately, that is an all-too-common holiday scenario. So, if you'd like to give Muffy the gift of staying away from me this season, read on for simple tips to keep pets safe and healthy during the holidays.

They Call It "People-Food" For A Reason
Human foods may agree quite well with pet's mouths, but they often disagree quite strongly with their stomachs. While eating random table scraps and treats usually just causes a day or two's discomfort, there are very, very, very  (!) serious problems that may result:

• Many common foods - and holiday treats in particular - can be deadly toxins for pets.
• Pancreatitis is a life-threatening condition that may be triggered by fatty foods.
• Bones - all bones - commonly result in fractured teeth, intestinal obstruction, and even stomach perforation.

Last but not least, holiday treats are a leading cause of Food-Amplified Tissue (FAT) syndrome, which can take a year or two off your pet's life (and lead to a lecture from me about putting Muffy on a diet).

Curiosity Can Kill The Cat - Decorate Carefully!
The holidays bring lots of exciting things for pets - shiny tinsel, ribbons galore, electrical cords running everywhere, and a big green scratching/climbing post right in the living room!

• Strings and ribbons can be deadly if ingested - aside from causing blockages, they can saw right through intestines - and the only thing more interesting to most cats than string is a shiny string. Keep tinsel and ribbon well out of reach or avoid them entirely.
• Anchor your tree to the ceiling or wall to keep anyone from tipping it over. Fake trees are best, too, since pine needles can also poke through intestines if ingested.
• Missletoe, Holly, and Ivy can all make your pets ill. Check out this link from the ASPCA for a laundry list of other problem plants.
• Try to keep all those extra electrical wires neat and hidden.
• Don't leave candles unattended, and make sure pets can't reach them or otherwise knock them over.

Curiosity Can Kill The Cat (Again) - Keep Things Tidy! 

These bars will not hold me. I will eat
your toys, and garbage, and shoelaces.
I will eat them all.

My wife is going to laugh when she reads this - me, telling people to keep things neat and clean. But, a big part of keeping pets from getting into things they shouldn't is preventing access, so:

• Clean the kitchen as you go, and don't leave bowls of candy and the like out where pets can reach them.
• Pick up all the wrapping paper and ribbons immediately after opening gifts. December 26th is usually paper/ribbon/string foreign body day at the ER.
• Don't let the kids (or your husband) leave new toys laying around, else they get confused for chew toys, food, or both.
• If you have a ferret, lock it in the bathroom with food and water until late January. Okay - that's a little extreme, but those buggers get into everything!

Respect Pet's Personality and Space 
Some pets are social butterflies, but many just get stressed by the all the people and commotion that come with holiday parties. It's never wrong to put the furry kids in a room of their own for the evening and let them have some peace and quiet. And even if they do enjoy a good party and are given roam of the house, you should provide a room or crate for them that's off-limits to guests in case they do need some alone time. New Year's Eve is a particular problem for many pets, with the potential for lots of noise and even fireworks - this article offers some tips for pets with noise fears.

Also make sure any random children the in-laws drag along only get to interact with pets while supervised, as kids who aren't used to pets usually don't understand "boundaries" at all. Or, suggest putting the kid in the spare room with food and water while the pets roam free. That usually goes over poorly with their parents, though.

Choosing Pet Gifts

Best. Christmas. EVER!

I'm all for a new toy or special treat for the holidays. Seriously, send me something. Oh, and get the pets something too - just be thoughtful in your selection.

• Toys should be resistant to shredding into small, ingest-able bits. 
• Also avoid super-hard chewables like Nylabones. These are a big cause of fractured teeth. My rule of thumb: bit down hard on it yourself - if there's no give or the pressure hurts you, Muffy shouldn't have it either. Plus, it's really amusing for anyone walking by in the pet isle.
• Avoid treats made in China, or anywhere else with questionable regulatory oversight.

Educate Your Guests

You, dear reader, are smart enough to take all this advice and avoid any unexpected visits to me and my ilk this holiday season. But it's all for naught if you set a couple dozen folks loose in your home who really think Muffy needs that turkey bone, chocolate candy, ball of yarn to play with/eat...or that despite her pulled back ears and snarl, she really just needs a belly rub right now. Make sure your guests know what is and isn't okay. If educational enlightenment doesn't seem to work, consider threatening them with fruitcake. Works for me.

Two final tidbits: make sure all pets have up-to-date ID (tags, microchips, or both) in case someone leaves a door open, and check out this article if you plan to travel with Muffy this season. Happy holidays!

Pet Vaccines 103 - How Vaccines Do (And Don't) Work

So, we've talked about the diseases we commonly vaccinate for in the first (canine) and second (feline) articles. Now we'll offer up some answers for the questions we commonly field about vaccines.

How do vaccines protect my pet from disease?

That's a deceptively simple question, considering how complicated Muffy's immune system is. The basic idea is easy enough to grasp, however. In order for your immune system to fight off an invading disease, it first needs to identify it. In the cellular soup that is the living body, when something new and harmful comes along it can take some time to identify it - time you often don't have when under attack by disease. Remember how much of the town got wiped out in Invasion of the Body Snatchers before folks figured out how to tell who's who? So, vaccines contain bits of the offending virus or bacteria that have been rendered harmless, giving your immune system a "heads up" on what to look for if infected in the future. That means they can take care of the enemy before it becomes a problem, instead of wasting time trying to figure out who the enemy is.

What's actually in those vaccines?

There are three basic types of vaccines. 

• Killed vaccines are basically busted-up bits of a virus or bacteria. They contain important proteins your immune system can recognize and learn to differentiate in the future, but everything's dead so the virus or bacteria can't spread or cause disease. 
• Modified live vaccines actually can multiply in the body, but they've been altered by the kids in the lab so they no longer cause disease. These generally produce much better immunity since your immune system gets exposed to a lot more virus. 
• Recombinant vaccines take the best of both worlds - generally, a harmless virus (yup, probably the majority of viruses out there cause no real harm) is injected with a few genes that allow it to produce a few proteins that are specific to the disease we want to vaccinate against. It's sort of like a good samaritan going door-to-door with photos of annoying door-to-door salesmen so you know when not to open the door.

Are vaccines 100% effective?

Realistically, nothing is 100%, but most manufactures claim efficacy of 100% or at least the upper 90's for the "core" vaccines. Non-core vaccines like leptospirosis, FeLV, and FIV sport lower numbers but are generally still pretty good - in the case of lepto, sometimes even if disease isn't prevented, a reduction in severity could be life saving. 

It's also worth noting that a very small percentage of animals will be "non-responders" to a particular vaccine - for whatever reason, there immune system won't recognize and mount a response. Another potential reason for failure is mishandling of the vaccines, which generally are sensitive to temperature - this is the main reason buying and giving vaccines yourself is a bad idea. I threw out $800 worth of vaccines a few months back when a refrigerator died over the weekend - I frankly don't trust the kid at the feed store or the businessman running a mail-order outfit to do that.

What's "herd immunity?"

Okay, so no one's ever actually asked me about the concept of herd immunity. But it's worth bringing up here. Basically, the idea is that if you create immunity to a disease in a majority of a population through vaccination, the individuals who don't develop immunity (from failure or lack of vaccination) get a sort of second-hand protection, since you've drastically decreased the odds of them being exposed to the disease. Imagine 100 people in an office. If 90 of them get flu shots, you've just reduced the risk of exposure to the flu at the office by 90% for the other 10 folks. So, even if a vaccine isn't 100% effective for everyone, if everyone gets it they'll be well protected regardless (and that's how you end smallpox, kids). 

As an aside, this is why I tend to think of vaccination (both animal and human) as a social responsibility - those 10 folks who didn't get the flu shot are not only freeloading on everyone else's vaccines, but they're serving as a potential reservoir for the disease, too.

So, two big questions remain - how frequently should pets be vaccinated, and what are the risks of vaccinating (hint: they're a lot less than not vaccinating). We'll get to them next, but for now I'll let "herd" immunity serve as an excuse to leave you with the following video.

Pet Vaccines 102 - Common Feline Vaccines

For the the first article on canine vaccines, and a discussion of rabies, click here.

Cats are not just small dogs that will agree to relieve themselves on ground-up clay. They have their own medical (among other) quirks, their own diseases, and with the exception of rabies, their own unique vaccination needs. This article discusses those vaccines and the disease they prevent. Rabies vaccination is recommended (and legally required) for cats as well; we discussed that in the prior article on canine vaccines so I won't repeat myself here.

Feline Distemper Complex (FVRCP)
This is the standard combination vaccine for cats, along the lines of the canine "parvo combo." I'll be the first to admit all the different names and acronyms make talking about it confusing. Most vets, and their medical records, use the acronym FVRCP; I've underlined the letters that acronym comes from below in an attempt to clarify.

• Feline Viral Rhinotracheitis (Herpes) and Calicivirus: These are two separate diseases, but they are so similar in how they affect cats that we tend to lump them together. Both primarily cause transient upper respiratory symptoms - sneezing, nasal discharge, lethargy and the like (rhinotracheitis = inflammation of the nose & windpipe). Infection is permanent, and both viruses may flare up temporarily any time the animal is stressed - just like cold sores in people. Herpes commonly causes ulcers on the eyes, while calicivirus more often causes oral ulcers. Both are highly contagious between cats, so it's no surprise that many cats are infected as kittens. So why vaccinate everyone then? Well, if you don't have it you don't want it - and equally important, vaccinating everyone reduces viral spread through the population in the long run.

• Panleukopenia (Feline Parvovirus or Feline Distemper): Yeah, this one has too many names. Here's the scoop - this is very closely related to canine parvovirus, and typically produces the same sort of disease - vomiting, diarrhea, etc. In kittens it also is very effective at damaging white blood cells, hence "panleukopenia," which translates to "all white cells decreased." That's important because that means their immune system is suppressed and thus they become very likely to get secondary diseases. And, in neonates, the disease may damage the nervous system, resulting in problems similar to canine distemper. So that's where all the names and confusion come from. Fortunately, a very effective vaccine comes from your veterinarian so your cats hopefully never need to worry about those details.

Non-Core Vaccines

• Feline Leukemia Virus (FeLV): This disease primarily affects white blood cells, potentially turning them cancerous (leukemia). However, the most common effect is a depression of the immune system, leading other illnesses to be more severe and predisposing to secondary infections when sick. It is transmitted via saliva, and cats are most susceptible when young. Thus, an initial series is recommended for all kittens, and adult boosters are recommended for cats that spend time outdoors - potentially exposed to other cats. Since cats may be infected for years before showing signs, testing is also recommended for all cats when young.

• Feline Immunodeficiency Virus (FIV): In many ways similar to FeLV, FIV is basically the feline equivalent of AIDS. It is capable of dramatically depressing the immune system, leading to potentially fatal opportunistic infections. The virus must enter the bloodstream directly, making bite wounds the most common manner of transmission. Vaccinated animals will test positive, meaning there's no way to differentiate vaccination from a sick animal in the future. Considering the efficacy of FIV vaccines is somewhat questionable, vaccination is recommended only on a case-by-case basis, primarily for outdoor male cats - since guys, as always, are more likely to fight. 

So there are your kitty shots in a nutshell. The next article in the series will cover questions about vaccine types, frequency, and risks. Stay tuned!

Pet Vaccines 101 - Common Canine Vaccines

Almost everyone has their pets vaccinated against a variety of diseases. I'm always surprised how few questions I get about what all those needle-pokes are for. Well, if you've ever wondered about the whole story on all those tiny little vials - this series is for you. The first two articles will cover what diseases we vaccinate in dogs, then cats. Then, we'll cover the questions I do get asked on a regular basis - like how often to vaccinate, how vaccines differ, and potential reactions to vaccines.

2009 animal rabies cases (CDC).

Rabies Virus
It's the big one that everyone is familiar with, thanks to the fact that rabies is pretty much 100% fatal once it becomes symptomatic - and therefore your pet is legally required to be vaccinated against it. Transmitted by saliva into open wounds, it travels to the brain where it causes neurological effects ranging from stupor and loss of coordination (the "dumb" form) to violent outbursts (the "vicious" form). The time from infection to symptoms can vary from weeks to several months; after symptoms develop it progresses to death fairly quickly, though.

Pretty much any mammal can get it and give it - to your dog, cat, ferret, or you. Fortunately, human and pet infections are rare in the US nowadays - thanks largely to vaccination. It is very present in the US, however; every state except Hawaii reports anywhere from a handful to hundreds of cases in wild animals annually. The most common carriers are bats, raccoons, skunks and the like.

"Parvo" Vaccine Complex
Pretty much all veterinarians use a combination vaccine that includes parvo, distemper, and hepatitis. These are discussed individually below. Some combo vaccines also include parainfluenza, which is discussed below under "kennel cough."

There are tons of variations on specific
vaccines and combinations.

• Parvovirus: Most folks have heard of this one too, as it is the only disease we routinely vaccinate against that's still relatively common. The virus very efficiently destroys the cells lining the intestines; this leaves the dog unable to digest food, retain water, or keep intestinal bacteria from entering the bloodstream. A malnourished, dehydrated, septic puppy is generally a dead puppy without treatment. On the bright side, if caught early and treated aggressively dogs generally respond well - if they live long enough, they'll generally clear the virus on their own. However, several days in the hospital on intravenous fluids and antibiotics gets costly fast, and is by no means a guarantee.


• Distemper Virus: About 50% of dogs who catch distemper will experience mild general malaise and/or respiratory disease. Unfortunately, the others will develop a potentially fatal infection of the brain and spine; those that survive often have serious long-term neurological problems. All affected dogs will experience severe suppression of the immune system - the virus first attacks white blood cells - and potentially life-threatening secondary infections often occur in any affected dog. You may not hear a lot about it, but it's out there - and it's not a disease to be trifled with.


• Infectious Canine Hepatitis (Canine Adenovirus Type-1): This is a disease that primarily damages the liver, potentially fatally, but it may also affect the eyes, kidneys and other organs, or turn into a chronic, low-grade infection. Fortunately, it's very rare nowadays because of routine vaccination. Interestingly, the vaccine is actually CAV-2, a related virus that causes transient respiratory disease and is part of the "kennel cough" complex discussed below. CAV-2 vaccine provides good cross-protection against the more serious CAV-1, and the old CAV-1 vaccines had more frequent side effects.

Other, Non-Core Vaccines

• "Kennel Cough" - Bordetella bronchiseptica & Parainfluenza Virus: "Kennel cough" is the common term for a group of upper respiratory infections that are generally self-limiting. They generally don't hang around in the environment long, and instead are passed between dogs in close quarters - most commonly, in kennels, at dog parks, or at events like shows or agility contests. Bordetella & parainfluenza are two of the more common culprits, and the primary ones we vaccinate against. They aren't consider "core" vaccines, since many dogs never board at a kennel and have minimal contact with other pets - but they are highly recommend for those who do, and required to stay at kennels.


• Leptospirosis: Lepto is a bacterial disease that can shut down the kidneys and may damage other organs like the liver. That's bad. It's also something you can get, though good oral hygiene minimizes risks (making it mostly a concern for children). The majority of mammals can carry it, sometimes without major symptoms, and transmit it via urine. We all know what dogs do when they find urine, hence why they're prone to it. Risk levels vary from area to area, so talk to your veterinarian. However, if you travel with your pets it is a good idea regardless.


• Lyme Disease: This bacterial disease is most commonly associated with severe arthritis, though it can also seriously damage organs such as the kidneys. It's transmitted by ticks, and is also known as borreliosis after the bacteria that causes it. This is another fairly region-specific disease, with the east coast and Great Lakes regions being at greatest risk, so talk to your vet.

Continue to the next article, Pet Vaccines 102 - Common Feline Vaccines

Leaving On A Jet Plane - International Travel & Pets

Traveling across town to with your pet in the car can be an adventure; traveling outside the country with your pet can be like navigating between the Scylla and Charybdis. I should know. I currently run an Air Force clinic, and we help people get their furry family members overseas on a daily basis. Every single country in the world gets to make its own decisions about what hoops you need to jump through to import your pet. They also get to change them whenever they want.

This article is geared toward travel outside North America (including Hawaii). Mexico and Canada are fortunately pretty easy to travel between. For travel outside North America with your pet the best advice I can give you is this - start early (like yesterday), research thoroughly, and double-check everything. You will need at least a month's lead time, and for countries like Japan you may need six months or more.

This is also one situation where I'll tell you your veterinarian is not the expert; few vets ever send pets to Japan, let alone Moldova. They'll do everything they can to help, but ultimately it's your responsibility to become the expert and make sure everything Muffy needs to get where you're going is taken care of. This article should give you the tools to turn yourself into that expert. If you're serious about this, you might also start by make yourself a nice, calming cup of chamomile.

Before You Do Anything Else:

1. Contact the consulate of the country you are traveling to; this is the horse's mouth, so to speak, when it comes to what is required to get into that country. You must do what they require or they can detain your pet. You must know what the current and specific requirements are. 


2. APHIS is another good resource for export regulations. The country in question has the final word, but the Animal and Plant Health Inspection Service maintains information on most countries at the website above, which may (or may not) help to clarify instructions from the consulate.


3. Research airlines. They all get to make their own rules about what can fly, how it flies, and how much it costs. Pets with significant health issues may be okay to fly in the cabin, but they should not fly in cargo - often that is the only option for international travel. Your flight plan is an additional consideration; if you have a layover in a country other than the destination you might need to make import arrangements for that country too.


4. Check out this article for tips on making travel less stressful for you and your pet.

Things You WILL Need:

1. Current rabies vaccination and certificate: Usually this must be done at least a month prior to travel, and for some countries can be six months or longer. This is currently all you need for Canada. Vaccination must also occur after microchip implantation.


2. Veterinary health certificate: Your vet will need to examine your pet and sign a form attesting that they are in good health and free of disease. APHIS Form 7001 is good for general travel; however, many countries require special certificates (especially if English is not the national language). Contact the country's consulate or check with APHIS to be sure. 


3. ISO Compliant microchip: Unfortunately, some US microchips may not work for international travel. ISO-compliant 134.2kHz chips are the current international standard. Check your pet's number, if it's 15 digits you're OK. If not, you'll need to get a new chip or bring a scanner with you. Excepting a few unique situations, I wouldn't recommend the later. A scanner costs $150-$200, and more importantly, if your pet were lost while traveling no one could read the chip to get them back to you.


4. USDA endorsement: Generally, you will be required to visit your local USDA office after getting a health certificate from your regular vet. You do not need to bring your pet with you, just all the documentation. They will make sure everything is in order, which is great since small mistakes - which can lead to big problems at foreign airports - are easy to make in this process.

Things You MAY Need:

1. Anti-Parasite Treatment: Many countries require treatment for parasites shortly before travel. This generally needs to be given by your veterinarian and attested to on the health certificate, so make the appointment with that in mind. As a side note, it may be worth considering a broad-spectrum deworming when you get home as a precaution against any unwanted stowaways in Muffy's gut. Talk to your vet.


2. Other Vaccines: Since they all get to make their own rules, countries may require all sorts of vaccines or treatments. Guam, for instance, requires Coronavirus vaccination...which is pretty silly if you ask me, since the vaccine is junk and the disease isn't very serious. But no one asks me, and if you want to take your pet overseas you have to play by that country's rules, period. It's also a good idea to ask your vet if there's anything Muffy hasn't had that might be recommended - Bordetella (kennel cough) and leptospirosis in particular.


3. FAVN (rabies) testing: This is a special blood test that verifies your pet has enough antibodies against rabies to prevent infection - in other words, that the pet was effectively vaccinated. It is required for import into most rabies-free countries and quite a few others as well. This often requires a lot of planning and time, since:

• Your pet generally needs at least two prior rabies vaccinations, at least two weeks prior to testing.
• At least one vaccination must happen after microchip implantation.
• Getting results often takes 2-4 weeks.
• After the test, there is usually a minimum waiting period before importation of anywhere from 3 weeks to 6 months.
• There's always the possibility your pet fails the test - though this is unlikely if they have a good vaccination history.

Your veterinarian likely runs few, if any, FAVN tests; look like a genius and tell them they can send the blood to Kansas State University for testing. Likewise, if there are any unusual vaccines, treatments, or forms required your veterinarian may need a significant heads-up period to get what you need, or may need to send you to another vet. Hardly anyone stocks coronavirus vaccine, for instance.

If you've read all this and you still want to travel internationally with your pet...I admire your fortitude. You either really love Muffy, or you're crazy. Probably a little of both. But with preparation and planning, it is manageable. 

Quick Tips for Pet Travel

Maybe you're headed on a big cross-country road trip. Maybe it's just a weekend with the in-laws a few hours away. Whatever the occasion, traveling with pets can be fun, exciting....and stressful. Poorly planned, it might even be dangerous. Today's article covers several easy tips to lower the stress level and keep things safe, so you can focus on relaxing and having a good time together.

Bear in mind this just refers to domestic travel by car; airlines and international travel are different beasts that will be covered in future articles.

1. Bring plenty of extra food / medications: This is an obvious one...so it should be no surprise it's the most common one folks forget. Imagine running out of food, having to substitute something else, and triggering a nice bout of diarrhea. While driving. In your car.


2. Seatbelts / carriers:  I'm not going to lie - my dog usually rides shotgun, unrestrained. He's also been dumped forcefully into the floor when I've had to slam the brakes. That wouldn't happen if I was smart enough to practice what I preach and get a pet seatbelt. Excited pets bouncing around the cabin isn't conducive to safe driving, either.


3. Windows up: I once witnessed a Yorkie jump out of the car window as it drove by the vet clinic I was working at. Good timing, I guess - but it nearly killed him.


4. LEASHES!: Never let your dog (or cat, or iguana) off leash in an unfamiliar place. I don't care how much you know/trust them - the unfamiliar sights, sounds, and smells could provide the unexpected surprise that leaves you spending the day searching for them, or worse.


5. Dealing with anxiety and car-sickness: Pheremone collars (DAP or Feliway) can help many pets with mild travel anxiety. For motion sickness or more significant anxiety, talk to your vet about Benadryl and other options.


6. Current flea & tick prevention: Make sure your pet's flea prevention will cover the duration of the trip; no one wants to finish off a vacation with a bunch of nasty new house guests. Do this even if you don't normally use a flea preventative - trust me. 


7. Microchips: Make sure your pet's microchip is registered to your current address. If they don't have a microchip consider getting one

Here are a few more things you may want to ring your veterinarian's office for:

1. Get a record or certificate of all vaccinations (and make sure they are up-to-date): Most hotels require up-to-date rabies vaccination at a minimum. Tell them where you are going, and ask if there are any other vaccines they'd recommend. These may include Bordetella, Leptospirosis, lyme disease, or others.


2. If your pet has any major medical history - chronic diseases under treatment or past major surgeries - ask for a copy of the medical record to take with you. Hopefully your pet won't need veterinary care during the trip, but if they do that record may be invaluable.


3. Ask your veterinarian about an official health certificate: may be required to enter certain states or to stay at some hotels, and all airlines require them. Your veterinarian can provide one after a thorough physical exam - which is itself valuable, since more than once I've picked up problems owners weren't aware of that might make travel a bad idea. Health certificates may only be good for a limited time (10 days for airlines), so set your appointment appropriately.

First Aid - How & When To Make Your Pet Puke

A bandage eaten by a dog. The ironic part?
It was from his tail amputation, which
resulted from his attempts to eat said tail.
He was not to be deterred.

Pets eat stuff. Sometimes things you, I, or even your average indiscriminate 3 year-old would never dream of eating. This first-aid article is about how to make your pet vomit that stuff back up again; but that's pretty simple (I know what you cat owners out there are thinking: all I need to make Muffy puke is a nice pair of shoes). The tough part is knowing when it's okay to do so - because in many situations inducing vomiting can make things WORSE. On the other hand, quickly getting certain toxins out of your pet could also save their life. So, this article is mostly about knowing the difference between those situations. Then we'll wrap up with quick instructions on inducing vomiting, without ruining your favorite shoes.

First thing's first - if your pet has eaten something you think may be harmful, call your vet or Animal Poison Control before attempting anything on your own. That's the guaranteed way to make sure you don't wind up doing more harm than good. It's also very possible your pet will need to go in for further treatment or monitoring. Oh, and one other thing - don't panic. That never helps, eh?

When You Should NEVER Induce Vomiting

• Your pet is in any way sedated, confused, weakened, or mentally altered: If their consciousness is altered, they may not be able to keep the vomit from getting into their windpipe - making a bad situation far worse.
• Household chemicals (detergents, cleaners, pesticides, etc): many of these are inherently caustic and can do much more damage coming back up again. Pesticides usually aren't harmful coming back up, but many can cause neurological effects (see #1) that predispose to aspirating stuff back into the lungs.
• Petroleum products: if they get into the airways on the way back up, they'll wreak all kinds of havoc.
• Anything sharp, or potentially sharp: It could puncture the esophagus or stomach in the process. Vomiting can be a good way to deal with ingestion of small foreign bodies, but it's best to leave that call to your vet - I generally recommend x-rays first (who knows what else is in there) and in-hospital monitoring (in case of choking) if we're going to try this.
• Your pet recently had surgery. 

Looking around the web for other's thoughts on the subject, I noticed many warnings against inducing vomiting if...they're already vomiting. Kinda seems that would go without saying - I guess my readers are smarter than theirs. Many also recommend against inducing vomiting if it's been over two hours; that's a textbook number for how long it should take to digest something. I haven't caught a dog reading a textbook yet, but I have seen more than a few toss stuff up long after it "should" have been digested. Often folks don't know when it happened, for that matter, and I wouldn't obsess over that 2 hour mark - though it's a good rule of thumb.

When TO Induce Vomiting

If you've ruled out all the above contraindications, and talked to your vet or APC, it's likely a good idea to induce vomiting if your pet has recently eaten the following:

• Potentially harmful foods.
• Prescription medications (yours, or overdoses of theirs)
• Antifreeze (caveat - this needs to happen fast, as it is absorbed very fast)
• Rodent poisons

What To Do AFTER Inducing Vomiting

Yes, we'll get to inducing vomiting in a minute. What you do next is extremely important, and I don't want you to stop reading after the punchline (like I would). 

• Obtain some of the vomit for potential ID by your vet.
• Gather the packages or product inserts for whatever you think they got into. We need to see the ingredient lists - I've got no idea what's in "Super Cleaner X."
• Closely monitor your pet.
• Unless you've talked to them and they told you not to, head to your vet's office or the nearest pet ER. Your pet's life could depend on further treatment; this isn't the time to "wait and see."

How To Induce Vomiting

Okay, here's the moment you've all been waiting for! 

• If your pet is a cat, stop reading: Don't try this unless specifically instructed by your vet. Peroxide makes kitty guts very unhappy.
• If your pet hasn't eaten much recently, offer a small meal: Bread is good, since it sponges stuff up. It's tough to vomit thoroughly when there isn't much in the stomach.
• Grab some 3% hydrogen peroxide - DO NOT use anything other than 3%: Stronger peroxide formulas like the stuff beauticians use can kill your pet.
• Get 1 milliliter per 2 lb into your pet: There's about 5ml in a teaspoon, so that's 1/2tsp for a 5lb chihuahuah or 4tsp for a 40lb border collie. Don't exceed 45ml per dose. You can use a syringe or turkey baster, but often if you just mix it in some ice cream or milk they'll do the work for you. You can repeat that dose once if it hasn't worked in 15 minutes.
• Get a towel: Put it in the back seat of your car. It's probably going to take 5-15 minutes to work, and you should be on your way to the vet. Yet another reason you should only do this if your vet tells you it's necessary, eh?
• Do all those things listed above in "AFTER Inducing Vomiting": Seriously.

Lastly, NEVER, NEVER, NEVER (!) induce vomiting on your own if your pet ingests large denominations of money. Leave that to the professionals - call me at home, I'll take care of it. I'll need to keep the evidence, of course - you don't want a bunch of nasty vomit-covered hundred dollar bills anyway, right?

Is Pet Insurance For Me?

By Dr. Courtney Smock

I have recently been asked my opinion about pet insurance several times by friends and family, and it seems to be a question on the rise among clients as well. While a quick comparison between the costs of identical services at human vs. veterinary hospitals makes clear that vet care is one heck of a value, that still doesn't mean it is cheap. Particularly when the bill is coming out of your pocket, not Humana's or Blue Cross'. We want the best care for out pets, and it's no surprise an increasing number of people are looking toward insurance plans to afford that care. But are they a good deal for everyone?

As with any free-market product, there are almost as many choices for pet health insurance as there are pets.  However, with little exception, they all share an operational feature: YOU pay the bill at the veterinary clinic, submit your claim, and get reimbursed (or not!) at a later date.  This is an extremely important point to consider before anything else - even though pet insurance may help offset your costs in the future, you are still responsible for the entire bill in the present.  So, if you cannot temporarily access a few thousand dollars for an emergency situation (think tapping into savings, a high interest rate credit card you wouldn't normally use, or borrowing from friends and family), then pet insurance is not going to do squat for you, because there will probably be very little veterinary care happening.

Well then, what is pet insurance for?  Like any insurance, it is a tool to mitigate your expenses should something unfortunate happen.  But pet insurance is unique in the respect that it may help you make a difficult medical care decision should something unfortunate happen to your pet.  Let me give you two examples:

• At your dog’s yearly wellness visit, the veterinarian tells you that she feels a mass in Muffy’s belly.  X-rays suggest that it is a tumor in the spleen.  Your vet explains that there is a decent chance the tumor is benign, meaning that surgical removal of the spleen could be 100% curative.  If you do nothing, Muffy’s spleen could rupture, leading to fatal blood loss.  The estimate for surgery is $1500.  You have a credit card you could use, but every dollar is already spoken for in your budget and you don’t know how you will be able to make payments.  Pet insurance might allow you to authorize the surgery, knowing that most of the cost will be reimbursed in your insurance payout.  
• Your happy-go-lucky lab puppy gets loose at the dog park and is hit by a car (Dog forbid).  Fortunately there are no mortal wounds, but one of her legs is broken in the incident.  The vet says the fracture is too complicated and will need to go to a specialist for repair - but all those plates, screws, rechecks and the expertise of the surgical specialist are going to run $3000-$4000.  Otherwise, the fracture won't heal and the only humane thing to do is to remove the leg.  Pet insurance could save the leg without amputating your savings in turn.  

I used to tell clients that I didn’t think pet insurance was a good value; that they should take the money they would pay in premiums each month and put it in a dedicated pet savings account.  The problem with this recommendation is that if aforementioned puppy goes on the lam and you’ve only had time to save $60, that’s not really much help.  Now I amend that statement to say that if you have $2-5,000 to put in a dedicated savings account for your pet, or some other way to access that kind of money in an emergency, you definitely don’t NEED pet insurance.  However, if the idea of dropping five grand on Muffy’s prolonged hospital stay when she breaks her elbow jumping out of your handbag makes your stomach turn, you may still WANT pet insurance.

In the interest of full disclosure, I will freely admit that my pets are not insured, nor do I have $5,000 socked away in a pet savings account.  If, dear reader, you are still with me, and still thinking about getting pet insurance, then consider these KEY POINTS:

1. Remember that insurance providers are businesses, and they wouldn’t offer this service if they didn’t make a profit – you may break even or come out ahead financially, but the odds are not in your favor, so that should not be the main factor in your decision.
2. Wellness care (annual exam, vaccines, spay/neuter surgery, heartworm testing and preventative) is an expense that can be anticipated and for which you can save – I do not recommend insuring for wellness care.
3.  For the love of Dog, READ and be sure you understand any policy in full before committing (See point #1 above)!  Particularly be on the lookout for pre-existing condition exclusions and waiting periods, breed-related exclusions, and maximum payout details. If you have questions, talk to your veterinarian.
4. Go to Dr. Frances Wilkerson's site, Pet Insurance University.  Aside from an excellent article series on how pet insurance works and why you would consider it, she provides detailed reviews on all the major plans for easy comparison.

Quick Tips For Low-Stress Vet Visits

Imagine your mother dropped by this morning with a very large box; without words or explanation she unceremoniously forced you into it, then tossed you in the car and took off. Eventually the car stops and she lugs you into the doctor's office (she's stronger than she looks, that mother of yours). She doesn't seem to understand your repeated questions, so you still have no idea what's going on or why you're here. However, several others seem to be in similar situations. Some are in boxes like you, others are tied to ropes - there's one person who won't stop shouting nonsense, another urinating on a chair leg, and one guy who won't stop trying to lick everyone in the face. Eventually you're taken into another room, dumped out of the box and onto your keister, then poked and prodded for no apparent reason by some strange woman in a white coat. They finish off with a couple of unexpected shots in the rump, then good ol' mom shoves you back in the box and drives you home.

Yeah, I guess that might be a little stressful. 

A little food cajoles most cats...

For some pets there may be no such thing as a "stress-free" vet visit, but we can reduce that stress to manageable levels. It's also important to note that animals deal with stress differently, just like people - some may growl or cower, but acting overly submissive or affectionate can be less-obvious signs too. Today's article covers several simple things you can do to make veterinary visits easier on your furry housemate's nerves (and in turn, your own).

Setting Expectations
Animals are bright, fast learners. If that cat carrier, leash, or car ride always culminates in getting poked in the butt by a stranger, it won't take them long to start freaking out at the first sign trouble is on it's way. I have one diabetic patient whose owner tells me Tiny's fine in the car if they turn left out of the driveway - but turning right always means the vet, and blood draws, and one instantly ticked-off Tiny. Fortunately, pets make positive associations just as easily, so you can undo most of this stress with a little effort.

....and the odd dog. This one
is more odd than most.

• Get in the habit of setting the cat carrier out once or twice a week with a treat or toy in it. They'll be eager to get in the next time you need to use it for travel.
• Likewise, take your dog on fun leash walks around the neighborhood regularly if you don't already.
• Once they are good with the paraphernalia, start taking your dog or cat on short car trips. Bring a food reward or two to make it fun - some fast food places like Sonic keep dog treats at the drive-thru so you can both get a little positive reinforcement.
• Placing a familiar-smelling item like a blanket in the car or carrier also helps pets relax.
• Drop by the vet clinic occasionally with Muffy, just to say hello or check their weight. Bring a favorite reward and ask a staff member to offer it.

On a related note, I highly recommend the pet carriers with snap-on tops. It's so much less stressful on everyone to just pop the top off, instead of prying Muffy out only to force her back in afterwards.

There's Stress In Numbers
Stress is additive and contagious. It's tempting to try getting all the pets in at once, and make it a family-fun event, but....Take two hyperactive kids, one mother shouting for them to calm down, then add in your incessantly barking Beagle-buddy to boot, and even the calmest Shih Tzu in the world is going to be on edge.

• Making veterinary visits an adults-only, single pet endeavor can really go a long way toward lowering the stress levels for everyone - you included. Plus, you get a lot more for your money when you can focus on asking questions and listening to the staff's recommendations without extra kids, furry or otherwise, vying for your attention. 
• If your significant other likes to argue or won't let you get a word in edgewise, get them a sitter too (my wife says her spouse is like that...). 
• On the other hand, if you are stressed out - which is okay, and often understandable - your pet will sense that and follow suit. It's always okay to ask to wait outside during the exam, and sometimes it really is less stressful for everyone.

The same strategies can be applied when choosing a vet or setting an appointment:

• Some clinics have started providing separate waiting areas for cats and exotics, since a room full of barking dogs is pretty much guaranteed to stress them out. 
• If you're flexible, asking for an appointment at a slower time of day is a good move too.
• Lastly, the discount walk-in shot clinic is almost guaranteed to have a waiting room full of chaos; that's one of many arguments for paying a little more to see the doctor down the street.

Better Living Through Chemistry
Of course, there are a few pets out there who just aren't going to adapt well to the clinic, car, or carrier no matter what you try. For those guys, there are varying levels of "chemical intervention" we can try to help them out.

What, you don't recognize Benadryl?

• Mild Anxiety: Pheromone sprays or collars like Feliway and D.A.P. may be helpful. They're also useful initially in conjunction with the above techniques to take the edge off.
• Moderate Anxiety: Ask your vet about trying Benadryl. It often provides some sedation and is quite safe for most animals at the proper dose - again, ask your vet.
• Severe Anxiety: There are several sedatives and anxiolytics that can be life-savers for dogs that truly need them; all have the potential for significant side-effects and require a prescription, however, so a good chat with your vet is in order. Furthermore, pets who need this level of intervention for a trip to the vet likely have other behavior issues that need addressed.

Lastly, but probably most important - if the stress of veterinary visits is truly tough on you and your pet, consider making an appointment solely to discuss this issue and come up with a plan of attack. You can even consider a consultation without your pet, if need be. Fortunately, though, most dogs and cats can learn to manage a trip to the vet with a just a bit of work and forethought on your part. I'm really not that bad. Plus, I have treats.

Beware the Chinese Chicken

True story.

No, a drumstick will not make your brain stop tickin'. However, over the last year the FDA has reported a rather dramatic increase in reports of pet illness that may be related to chicken jerky treats made in China. Concerns are now extending to duck and sweet potato products. Problems have ranged from vomiting and diarrhea to kidney failure and death; however, I should emphasize that no direct link or cause has been identified yet, and nothing has been recalled as of yet. In other words - don't panic.

On the other hand, there have been more than enough reports to warrant avoiding Chinese-made jerky treats and tossing any you may have bought, just to be on the safe side. Frankly, China has jack for safety regulations, a fact underscored by several recalls of very dangerous products produced there in recent years.  I try to avoid anything with "Made in China" on the back, period. Sorry, Beijing.

This is also a good opportunity to point out two great resources for information about pet food and product recalls. The American Veterinary Medical Association maintains two recall lists, one for foods and another for pet products:

• Pet Food Safety Recalls and Alerts (AVMA) 
• Pet Product Safety Recalls and Alerts (AVMA)

Of note, several brands of thyroid medication were also recently recalled. Manufacturing issues may have led to non-uniform pills (that is, varying drug strengths); this probably won't cause serious side effects, but if your dog is on thyroid meds you should ring your vet's office to see if you've received any of the problem lots. Also, some Petco food bowls were recalled due to radioactivity. I couldn't make this stuff up.

Out Of The Kitchen And Into The ER: Four Dangerous Foods For Pets

Folks often ask me if this-or-that food is okay for pets. I like to tell them all people foods are "toxic" to animals, since even moderate quantities can lead to a chronic condition proven to shorten lifespans and known colloquially as FAT, or Food-Amplified Tissue syndrome. You can read more about that in this article. Furthermore, anyone whose Lab has ever raided the trash can can tell you that enough of anything a pet isn't used to eating can result in a few days of sickness (and maybe a visit from the carpet cleaners). Of course, some things in the kitchen can harm your pet much more quickly and severely, and today's article covers the four biggest culprits.

Lets start with a few general notes. First off, if you are concerned about something Muffy indiscriminately scarfed down the first thing to do is call your vet. If they aren't open, try the nearest pet emergency hospital or Animal Poison Control. They can tell you if you should freak out, how much you should freak out, and what you should do next (after they get you to stop freaking out). The risk is usually going to depend on how much toxin went into how much dog; that is, a nibble of onion or milk chocolate probably won't faze a Great Dane, but it could be enough to kill your 2-pound chihuahua. Cats also tend to be more sensitive to most toxins, food or otherwise.

Anyone else suddenly craving Italian?

Onions and Garlic
Plants in these families contain sulfur compounds that can damage red blood cells, causing them to rupture. Since red blood cells are responsible for carrying oxygen to the body's cells, and those cells need oxygen, this is kind of bad. Common signs logically include weakness and pale gums; however, these problems occur hours to days after exposure. Note that garlic and onion powders are just as dangerous, and may be used in processed human foods in significant portions - just one more reason to keep pets out of the people food!

Grapes and Raisins
These can trash your pet's kidneys. Kidneys are rather important. Raisins are more potent in this regard, which shouldn't be surprising since they are basically grapes minus the water - and water, at least, is good for kidneys.

Before anyone asks -yes, some dogs and cats seem to tolerate grapes and raisins just fine, and we aren't sure exactly what the mechanism for the toxicity is in the first place. On the other hand, some pets die from eating these. Just keep them out of them, okay?


Chocolate

Fortunately, there is nothing wrong with
eating chocolate in front of your pet.
Which I think I shall now do.

Cocoa contains stimulants that are very dangerous for pets. Early signs include vomiting and diarrhea, leading to extreme excitement and agitation (imagine your chihuahua on three cups of espresso), and even death.

But wait - a culinary lesson! Chocolate is a blend of sugar, fats, and cocoa; the amount of these determines the type, flavor, and quality of the chocolate. Milk chocolate has little actual cocoa, dark has a good bit, and semi-sweet or baker's chocolate is mostly cocoa. This is important because the more cocoa, the more danger for your pet. White chocolate is made with cocoa butter rather than actual cocoa powder, and so is fairly harmless unless they try to eat their weight. How much is too much? Check out this excellent interactive chart from National Geographic. But remember, each dog is different - contact your vet if you are worried!


Xylitol (that's a sweetener, not a Russian side dish)
This is present in many sugar-free gums, mints, vitamins and even toothpaste. Within 30 minutes of ingestion it may cause a dog's blood sugar to drop to dangerous levels, resulting in seizures, coma, or death. Worse yet, even if they don't show these signs some dogs may develop liver failure hours to days later. Because of this overnight hospitalization and monitoring is advisable in most cases.

Lastly, this list is not exhaustive. These are the most common and dangerous food items; other things like macadamia nuts, avocados, and fruit seeds may be harmful as well. APC has a nice question-and-answer list covering the good, bad, and mostly-harmless foods folks often ask about. But definately keep Muffy out of  your stash of sugar-free, chocolate covered raisins dusted in onion powder! You can send me some, though. That sounds tasty.

Anesthesia - Keeping The Big Sleep Safe

Few things make owners as nervous as anesthesia. Heck, when I was first unleashed upon the world as "Dr. Rowland" anesthesia wracked my nerves way more than surgery. I distinctly remember the first time I knocked a patient out - I calculated the dose, double-checked it, then looked it up and checked it again, then read the drug monogram for the Nth time and checked the dose several more times. I've gotten over that, of course. Wouldn't see many patients at that rate!

Here's the thing - with the right drugs, good monitoring, and a relatively healthy patient anesthesia is quite safe. But anesthesia is never without risk, and should never be taken lightly. Today's article is geared toward relieving the anxiety most of us feel when our pets need to be anesthetized - by giving you knowledge about what the risks really are, and what we (vets and owners) can do to minimize them.

Monitoring
Guess what the best way to miss a problem is? Not looking for it.

A fully-functional veterinary monitor.

Anesthetic drugs don't just cause loss of consciousness - they may affect heart rate, blood pressure, respiration and more. In case you don't know, these things are kind of important. The body has needs - nutrients, oxygen, and removal of waste products produced by using those things. Respiration and circulation are how the body gets it done. So it only makes sense to closely monitor how all that's working, right? And since a living body is a pretty complicated bugger, there are many things that can go wrong and many things we can watch to recognize problems and address them before they get out of hand. Here's what I consider minimum monitoring for most procedures:

• Heart rate and blood pressure - These are the main determinants of blood flow, but they can also clue us in on "depth" of anesthesia and even other problems like blood loss.
• Electrocardiogram (ECG) - That's the green wave with the reassuring beep on the TV hospital shows. The heart is a complicated pump running on electricity; an ECG looks at that electricity to identify problems with rate, rhythm, or coordination of the heart.
• Respiratory rate and blood oxygenation - Blood flow to your pet's tissues does little good if it doesn't have oxygen. And, even if you are breathing, lung or circulation problems can keep the body from getting the oxygen it needs.

Except for pulse and respiration, all those require special equipment to monitor. But this belies an important question - who monitors the monitors? Indeed, the most important monitor of all is the human being keeping track of, interpreting, and responding to all this information. Since the veterinarian is usually kind of busy -cutting this, stitching up that, and keeping sterile all the while - the best monitor is a living, breathing, highly-trained veterinary technician. They keep an eye on all that data for problems, address the minor stuff, and let me know when I need to stop playing with this or that organ and focus on what the rest of the patient is doing. Plus they monitor important stuff no machine can, like reflexes and gum color, and administer whatever treatment the vet deems necessary if problems do arise. 

How Do I Know You're Healthy?

A 2008 British study showed that anesthetic risk increased almost 7 times for patients with significant systemic disease. That's not exactly surprising, but I'd go farther and say the most common reason for anesthetic problems in patients we think are healthy is that they aren't healthy. Pets with early or mild disease often compensate well and show no outward problems - until we knock them out with a bunch of drugs that reduce their ability to compensate. Here's what I recommend before any anesthetic procedure, to feel reasonably comfortable your pet is healthy:

Occasionally, bloodwork is really surprising.
This pet appears to be possessed by demons.
(okay, not really...)

• A Good History & Physical Exam - The importance of these can't be overstated. Changes in appetite, activity level, urination or other behaviors are major clues to systemic problems. Likewise, many problems with the heart and lungs can be heard with a stethoscope. Some diseases leave early signs that can be seen with a good look at the eyes, skin, or mouth. And more than once I've felt something that shouldn't be there in the abdomen of an outwardly normal patient.
• Basic Bloodwork - Simple blood tests can identify problems with the liver or kidneys that may not cause clinical problems in your pet - until we challenge them with a bunch of anesthetic drugs. A blood count can also catch problems like anemia or inflammation, which in turn may be clues to undiagnosed infections or immune diseases.

Realistically, even if we ran thousands of dollars worth of MRI's and fancy bloodwork we couldn't be 100% sure your pet didn't have some strange, subtle disease. But those simple things will rule out the majority of problems without breaking the bank - a simple blood panel runs about $40-$60 most places. 

Anesthetic Drugs

The drugs used for anesthesia are really your vet's prerogative, and far beyond the scope of this article. However, it's worth briefly mentioning two things about drug choices. First off, when we do find a health issue with a pet that requires anesthesia we use that knowledge to select the safest anesthetic drugs for the condition. Each drug has it's own profile of side-effects that may impact the heart, liver, kidneys, etc; none are without side effects, but we can choose those least likely to aggravate the patient's individual problems.

Secondly, pain and stress also impact many of the things we worry about during anesthesia - heart rate, blood pressure, and even the heart's electrical rhythm. While I haven't came across any studies establishing that good pain control leads to safer anesthesia, it stands to reason that a less stressed, pain-free patient should handle anesthesia better. Most of us nowadays provide sedation prior to inducing anesthesia and various kinds of pain relief (analgesia) during procedures for just this reason.

What Should You Do With This Knowledge?

Here's the point - understanding all this means you can make informed choices when your pet needs anesthesia. Here are some questions you should now be able to ask when choosing a vet for a procedure:

• What kind of things do you monitor when Muffy's asleep?
• Is there a person watching Muffy while he's out? What kind of training do they have?
• What kind of bloodwork do you recommend? 
• Based on your exam, do you think Muffy's okay for anesthesia? Is there anything else we should check?
• If the procedure may be painful, what kind of pain control do you provide?
• Do you have any other questions about Muffy, Doc? (That is a smart owner question.)

So, why tell you all this? Thing is, many great, smart veterinarians don't do all the things they'd like to or feel they should because of financial reasons - that is, you won't pay for it. Not every clinic provides all these services, and many clinics that do offer everything mentioned above make them "optional" for an additional fee. Those monitors I talked about run $3,000-$10,000, with a life expectancy of a few years. The technician monitoring the monitors is $13-25 per hour. If you won't pay for it, we can't pay for it - or we have to cut costs somewhere else, which isn't good for your pet either. Honestly, I don't put the blame for that on pet owners, but squarely on we vets - we can't expect you to pay more if you don't understand why the extra money is worthwhile. Hopefully now you do, and can make informed decisions about who treats your pet and how. The most expensive place in town may not necessarily be the best, but I can pretty much guarantee if you price-shop around for the cheapest place your pet is missing out on some or all of these safety measures. 

Likewise, some vets make good arguments that some of the things discussed here aren't necessary. And maybe they aren't strictly necessary - the vast majority of outwardly health animals are indeed healthy, and would probably be fine if knocked out with a 20-year old drug protocol and ignored. Bear that in mind if you truly can't afford the extra money for all the "best" care. But most of us can handle an extra $100-150 for good monitoring, pain control, and some basic bloodwork; the peace of mind it buys is worth a lot more, if you ask me. 

Dope on a Rope? Quick Tips for Leash Training

It's almost comical how often I see dogs dragging their owners in and out of my door. I have this theory that twenty-something men concocted a formula where "manliness" is computed via a dog-to-wife weight ratio. Best of all, the macho husband is usually worse at controlling that monster Great Dane than his tiny, exasperated wife. The humor dies out, though, when you can't keep the dog from darting into traffic, attacking another animal, or you wind up at your own doc getting rotator cuff surgery. Today's article will provide tips on keeping Fido under control so everyone stays out of trouble.

Properly fitted Gentle Leader.

The Right Tools for the Job

Controlling your dog on a leash really boils down to training, but the right equipment can make the difference between success and giving up in frustration. Any pet can be trained to behave on any leash or collar. But you can also train to run a 5k on stilts - it's just a heck of a lot harder. Here are my suggestions for what equipment works, and what you should shy away from.

Gentle Leader (TM) head harness: These are awesome. One loop goes behind the head, one over the nose, and the leash attaches under the chin. This takes the dog's mechanical advantage away - it's no longer using the full force of it's legs to push that leash snapped on it's back forward, but instead it's trying to awkwardly push it's own head around. Unlike choke/pinch collars, this doesn't rely on making the dog uncomfortable, though some do think the slight pressure applied across the bridge of the nose may stimulate pressure points that help them focus, much like mom nipping their nose to get their attention. 

Note that the biggest problem folks have with these is not fitting them properly. Most leave them too loose, which is actually more uncomfortable than a tight fit because it allows the loops to slide and rub across the nose, while also reducing your control over the dog. Make sure and buy the one that includes the DVD - watch it, fit it right, and you can literally train your dog to heel in an afternoon.

Second handle = manual retraction = control

Retractable Leashes: Throw these away. There is no firm, certain boundary with a retractable leash - meaning they train dogs to constantly test their boundaries. Likewise, they train owners not to control their dogs. Buy a short, fixed-length leash. I particularly like the ones with a second handle near the collar to give you firm control when needed - like when passing a pack of yippy, tasty Corgi's on the sidewalk.

Choke/Pinch Collars: Many obedience schools will base their programs around them - my advice is find another school. It's an old method that can work, and does if you learn it thoroughly (like many folks who run those schools, to be fair). But hardly anyone becomes expert enough after a few classes, and used improperly they have the ability to do harm - unlike a standard collar or harness. Too often I hear dogs gagging in the lobby as they stubbornly forego oxygen to continue dragging their owner around. 

If you use these, ONLY leave them on the dog when you are attached to the other end and paying attention! They CAN catch them on things and asphyxiate themselves.

Harnesses: These don't really provide any advantages or disadvantages for controlling you pet, but they do have the benefit of not encouraging the dog to tug on his own windpipe. They're a good option for small dogs, where physical control isn't so much an issue. 

Ok. Sometimes
Scott Baio is in charge.

Training

Who's in charge? I'm in charge. 

The key to training your dog (or child, or spouse) to do anything is rewarding the behavior you want while not rewarding behavior you don't. In this case we don't need treats - the reward is being able to keep going forward toward that next wonderfully disgusting odor Rover just has to sniff. At the first tug on the leash, we stop. I'm in charge. No reprimand, no attention, just no movement until they relax, stop pulling, and focus on me. Then we go forward again until they start tugging - and repeat. It's simple, but it takes a lot of patience and a bit of time. It should also be clear why retractable leashes are so counter-productive; how do you learn what they boundaries are when they keep changing?

Just like your kids (or your husband), as soon as you start thinking you've almost got them trained and let your guard down a bit they'll be testing those boundaries hard-core. You must be vigilant. Tugging shall not result in moving forward! Keep at it. You're in charge. It's also worth emphasizing the importance of getting them to focus on you before they get rewarded- you are the one providing guidance, instructions, and rewards. Focus doesn't have to be visual, though - many dogs benefit from staying right up against your leg, quickly learning to read subtle signals in your movements. 

As with all training, the right equipment makes things easier - but at the end of the day it boils down to patience, consistency, and work. But you can do it - and for any dog over thirty or forty pounds, you really need to do it for everyone's sake. 

Heartworm 103 - Those Pesky Cats

Cats are not just small dogs, and feline heartworm disease is a prime example. The first two articles of this series dealt with how heartworms cause disease and preventative/diagnostic strategies primarily in relation to dogs. Today's article will outline specifically how heartworms effect cats; in many ways they are a more frustrating and elusive problem in cats, made all the more dangerous because many owners don't realize feline heartworm is a serious concern.

Accidental Guests: Heartworm Disease in Cats

Cats are not the natural host for heartworms. Unfortunately, no one seems to have explained this to the mosquitoes that spread infection or the heartworm larvae that cause it. Consequently, these uninvited and unadapted parasites really, really tick off the cats immune system. The first consequence of this is positive - cats seem much better than dogs at killing off larvae before they develop into adults. Studies suggest only about one-third to one-half of naturally infected cats develop adult worms, though it's tough to nail down accurate percentages due to the difficulties in testing that we'll go into later. 

Hey, human. Indoor cats get
heartworms too.

The second consequence of cats' super-miffed immune system is a negative one, however. Killing off the larvae within the lungs results in significant inflammation. Vessels and lung tissue gets thickened, making blood flow and air exchange less efficient and resulting in the classic signs of respiratory disease - coughing, rapid or labored breathing, and general malaise. This is now referred to as heartworm-associated respiratory disease (HARD), and it is a major reason why I've started recommending all cats receive monthly preventatives. Depending on the studies you look at, perhaps as many as 15% of cats in some areas are exposed to heartworms and thus at risk for HARD - even if they never develop adult worms. And if you think your kitty is free and clear because it's indoor only, think again - in one published series of cases, 27% were indoor-only cats.

What about the ones who do develop adult worms, though? Whereas dogs may have dozens of adults, cats rarely have more than two or three - again, their immune system is pretty good at whacking those larvae. This means many cats with adults have such a low burden they may show none of the cardiovascular problems typical in dogs. The caveat to this is that when those adults die off after a year or three, the dead worms are big enough to block off major lung vessels - and between that and the cat's once-again huge inflammatory response it can be enough to quickly kill them. Indeed, most veterinary texts list "sudden death" as a major "sign" of feline heartworm infection. That's not the way I like to diagnose things.

Diagnosing Heartworms in Cats...

...is really, really frustrating.

In the second article we talked about how the main test used to diagnose heartworm in dogs looks for a protein produced by adult female worms. This test works equally well in cats, if there is an adult female worm. In one study on naturally infected shelter cats over 50% had only a single worm, and none had more than four. This means cats are fairly likely to have male-only infections, and thus come up negative on this test - even though a single male could potentially kill them. 

Cats aren't good at tests.

Even more importantly, a lot more cats will develop the serious respiratory disease discussed above (HARD) without ever developing adult worms. On the bright side, there are antibody tests available that check for exposure to heartworm larvae. These would be great for diagnosing HARD or even male-only adult infections...except studies suggest they aren't that sensitive and miss many exposed cats, maybe more than 50% of them. 

Not surprisingly, I don't spend much time screening outwardly-healthy cats for heartworm. I'll run both tests when I suspect a cat has HARD or adult worms...but if they're negative, I don't cross heartworm off the list. Chest x-rays or ultrasound of the heart can be useful, but diagnosing feline heartworm can be elusive even when you're sure that's the problem.

Treating Feline Heartworm

Here's a quick topic. Remember how one dead adult may be enough to gunk up the lungs and cause sudden death? We can kill the worms easily enough, but we're just as likely to kill the cat. Yeah...we don't treat feline heartworm. "Treatment" is pretty much relegated to using anti-inflammatory drugs to control the signs and hoping for the best when the worms do die off. It's pretty frustrating when you find yourself crossing your fingers and wishing a freeloading parasite a long, healthy life.

Heartworm Preventatives for Cats

Most veterinarians used to be wishy-washy at best about recommending monthly preventatives for cats because adult infections were relatively uncommon, and serious complications (like death) even moreso. But the respiratory complications - which can potentially be life-threatening themselves - are looking more and more common. Complicate this by the fact we don't have a great diagnostic method  (meaning we likely are underestimating prevalence) and hopefully you're starting to understand why I've started recommending all cats stay on a monthly preventative. 

As of this writing, there are two topical products and two oral products on the market, and all are effective for heartworm prevention. Both topicals are great products, covering fleas and some common intestinal parasites while sparing you the adventure of trying to get a pill into a cat. Neither oral product covers fleas, but Interceptor covers several of the more common intestinal parasites. It's a good alternative in areas where fleas aren't a concern as it's a fair bit cheaper than the topicals.

I've covered a lot of ground in these three articles, and in a good bit of depth. If you're not 100% convinced that heartworm is a serious risk that warrants monthly preventatives, I'm happy to address any lingering questions or concerns in the comments section below!