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.