Pawcurious Vet Blog: With Pet Blogger and Veterinarian Dr. V

Pet pick of the week

I live in a pretty warm climate, and it’s a common occurrence for me to be in a hot parking lot calling the cops on a dog panting away in a boiling car. Conversely, it’s hard for me to forget the story of the dog abandoned in a van in a New Hampshire airport parking lot in the dead of winter, who miraculously survived. It amazes me how many people seem to think non-humans are somehow immune to the effects of temperature.

Granted, the types of people who make poor choices like that are not the types who would probably be interested in a climate controlled pet carrier, but for the rest of us who think about it on a regular basis, it’s a pretty cool idea (get it? ha ha!)

When I travel with my pets in the car we are obviously at a comfortable temperature for me, so I’m not entirely convinced this is a must-have for all people who travel with their pets. On the other hand, given the airlines’ increasing reluctance to take on the liability of putting pets in cargo, I can see this being a fantastic idea for people sending their pet by plane. I was in a rough situation the other day with a man who had to ship his dog from Los Angeles to Florida. The airline required that I sign a statement saying the pet could tolerate temperatures of 25 degrees. He couldn’t, really- the dog lived in Southern California. He wasn’t acclimated to that any more than the owner was.

Yes, the chances of the dog being in those temperatures for any significant length of time were pretty low. Yet on the off chance they were forced to make a stopover in Boise and the connection got delayed, and the dog sat on the tarmac freezing into a fur-sicle, guess who would get sued if he ended up dying of hypothermia? Good old Dr V, who never should have signed a statement saying it would be fine. The airlines have put us in a really bad position there- they won’t ship without that statement of acclimatization, and most vets are uncomfortable making a blanket statements that “this pet will be fine in both boiling and freezing scenarios, so if something goes wrong, don’t blame the airline, blame me.” Then the owner is stuck at the airport, usually yelling at me on their cell phone.

Next time a client tries to arm twist me like that, I’ll simply write, “This pet can tolerate temperatures between 25 and 80 degrees” (this is what they requested) “as long as they are in a revolutionary climate-controlled pet carrier.”

Gotta know when to hold ‘em, know when to fold ‘em….

Today, Pinkie arrived for a dental cleaning. Pinkie first came in a few weeks ago for an examination, and in the brief glimpse I got of her bared teeth before having to place a muzzle it was obvious that she had some pretty bad teeth. Unfortunately, when I placed my stethoscope on her chest, in between “grrRRRrrrrRRRRrrr” I heard the classic ‘whoosh-whoosh-whoosh’ of a heart murmur.

Heart murmurs are a common condition in older dogs. There are several causes, but the most common cause in older dogs is a leaky mitral valve. Instead of creating a nice seal between the atrium and ventricle of the heart, the valve leaks a little bit, and each time the heart beats a little bit of blood leaks back into the atrium, creating a distinctive sound that can be picked up on auscultation.

Many times, they are incidental findings. I don’t treat a murmur just because it’s there, unless there is some other identifiable form of cardiac disease that needs to be addressed. When we do find a murmur, though, the course of action directs that I recommend chest x-rays and an ultrasound of the heart. Without that reassurance that the heart is functioning well, I don’t anesthetize pets with a murmur.

“I don’t have the money for x-rays or an ultrasound,” Pinkie’s mother told me. “Can’t you do the cleaning awake?”

I didn’t think we had a chance in hell, but I felt badly for Pinkie and I wondered how much of her nasty view of the world was colored by the chronic pain of her rotting, green teeth. So I tried.

It was a horrible failure, by the way. I mean, I didn’t think it would work- the smallest pressure on her mouth caused her to growl, but I thought I owed it to her to at least try.

So I talked about it with Pinkie’s mom. We had two choices, as we saw it. Do the dental, or not. If we didn’t do the cleaning, she would be guaranteed to continue her life in pain. If we did attempt the cleaning, she might be OK, or she might not. With no x-rays or ultrasound, I had no way to gauge if that murmur was significant or not. So we talked about it in depth, with witnesses, and the owner said, Yes, I want you to try. Her reasoning was, and I quote, “chihuahuas live 12 years on average anyway, and she’s 11 1/2, so I figure it’s about her time soon.”

“I’ll be in and out all day,” she told me when she dropped Pinkie off. “If she dies, leave a message and I’ll pick her body up on the way home.” I replied, “Not if I can help it.”

It was a weird conversation.

We were very careful with the anesthesia, and I did the monitoring while my tech chipped layer upon layer of boglike slimy muck off Pinkie’s teeth. A couple of premolars fell out in her hand. Pinkie was, happily, completely stable under anesthesia and went home alive and well with a much more pleasant mouth.

It’s taken me a long time to be confident enough to take calculated risks. Earlier in my career I would probably have just said, nope, no dental, and left it at that. It takes the right owner, who understands the risk/benefit analysis and trusts you to take the gamble too. I’m glad we did. We are all the better for it.

There’s a reason the Marlboro Man doesn’t own dogs

There is a touchy question I have to work in whenever a client brings in a pet with a chronic cough. Somewhere in between the “how long has it been going on”s and the “what medications have you tried”s I have to find a way to tactfully phrase, “Are there any smokers in the house?”

Most of the time it isn’t really that hard a question to pose. I just ask it, and get either a yes or no. I don’t ask if it is them personally who smokes, so that leaves the door open to blame the roommate, which most people do.

But, when you open the exam room door and you are immediately assaulted with the stench of stale Menthols, and the poor dog is so steeped in secondhand smoke it stays on your hands long after the exam, and when the owner shakes your hand with tobacco stained fingers, it’s pretty obvious what the answer is. I’ve found through trial and error that a direct “Your habit is killing your dog” isn’t met with much enthusiasm, but simply skirting around the issue talking about air fresheners and the risk of other airborne irritants HINTHINT is usually met with a blank stare.

Strangely enough, although the risks of secondhand smoke are well known and documented, most people haven’t yet made the leap to the fact that dogs and cats, who also have lungs and breathe the same air that we do, would also be affected.

I just read an article from the journal Tobacco Control stating “one in three of the smokers said knowing smoking was bad for their pet’s health would make them quit and about one in ten said this would make them ask other smokers they lived with to quit.” They tried really hard to make this sound positive, but I guess I’m a pessimist. 100% of current smokers know smoking is bad for their own health and it hasn’t stopped them. And this study was conducted by survey- a theoretical situation- so I’m guessing of the 1/3 who would even make the attempt, how many would actually do it?

Smoking makes me sad. I’ve watched people I love suffer a great deal for it. It’s so frustrating to see a pet suffering terrible consequences for a choice they didn’t make and have no control over, and feel so helpless. I try to introduce the topic gently, just to clarify to people, yes, smoking can do this. And does do this. Then we look at the dog, wheezing and coughing on the table, and I put my stethoscope to his chest and hear the snap/crackle/pop of chronic bronchitis, knowing that nothing I can do will really help unless the owner makes a change.

Without a change, the story is always the same. The pet comes back, as bad as ever. I’m not sure what they want me to do. The meds help, somewhat. I address the owner who is somewhere in front of me in a cloud of smoke-stench. “This isn’t going to get better unless you get him out of the smoke,” I tell him or her. And they shrug, guilty as charged. Their kids look at me with red rimmed eyes. Good luck with that, lady.

I’m a real upper today, aren’t I? *sigh* Sometimes my job is like beating my head against a wall. While coughing.

For the gulper in your life

In my day, we didn’t have all these fancy schmancy dog bowls with their non-tip shapes and their fancy stalagmites sticking up out of them. We used plain, tippable, flimsy plastic bowls and we liked it! If your dog ate too fast, too bad!

Seriously though, modern ingenuity never ceases to astound me. What appears on first glance to be a large Duplo is in fact a very cleverly designed bowl designed to reduce the risk of bloat by slowing down a dog’s ingestion of food. Although bloat most commonly strikes large, deep chested dogs with a proclivity for inhaling food and kibble, it can strike any dog, any time. And it’s a killer.

Common sense precautions such as feeding smaller, more frequent meals and avoiding exercise around mealtimes abound, but lots of tricks have evolved over the years to try and slow down the dog who thinks the food is going to disappear into thin air if not eaten in its entirety in 5 seconds or less. I’ve heard of people putting tennis balls or rocks into the bowl to force the dog to eat around them, but for those with indiscriminate eaters the risk is pretty obvious there. This is a nice design that gets around that problem.

I considered getting one for Emmett to try out, but he’s actually a pretty deliberate eater so I never got around to it. I have been mentioning them to clients, though I haven’t gotten a lot of feedback. I’d love to hear from anyone who has used these, and what your experiences have been. What a simple, basic way to reduce a very risky behavior! I think they should make one for people too. I’d use it for pasta.

Say cheese!

Sometimes, in the wee hours of the morning, I lay curled in my bed and dream of Geroge Clooney -er, I mean my husband- whispering sweet nothings into my ear. I turn my head to him and smile. “Wow,” I say as I lean in, “Did you eat sardines last night?” He just stares at me, breathing heavily, until I open my eyes and realize it’s Emmett blowing dog-breath into my face.

There are myriad causes of icky breath, but the most common cause is icky teeth. Most of us know that the ideal standard of care is to brush our pet’s teeth every day. Do you? If you don’t, you’re not alone. The vast majority of pet owners, including (cough cough) even a few veterinarians, aren’t as consistent as they would like on a daily basis.

If the thought of wrangling your cat with one hand and liver flavored toothpaste in the other strikes terror in your heart, don’t fret. February is Pet Dental Health Month, so there is no better time to revisit some other options available to you.

Over the counter treats are a good way to help reduce tartar and plaque buildup. Greenies and CET chews are just two of many examples product choices out there. These help reduce buildup, but they aren’t going to eliminate the need for brushing or cleaning.

People often ask me, “How come I brush my dog’s teeth and you’re still telling me I need to get my dog a dental? I don’t see any tartar.” And I always respond the same way- “You brush your teeth every day, right? And you still need dental cleanings, and accumulate tartar, and get gingivitis, even though you don’t have big chunks of tartar on your teeth.” Unless they do actually have big chunks of tartar on their teeth too, then I just leave that last part out. All the tooth-brushing and Greenies and rinses out there help keep the teeth and gums healthy between dental cleanings, but these pets still do need and benefit from the full dental cleaning at the vet.

Some dogs and cats are more naturally prone to developing tartar than others. It depends on genetics, the shape of the mouth, and luck. For example, if you have a pug, don’t even think about- your dog needs a dental. Some dogs, like Emmett, get cleanings twice a year- and he has a normal bite. Dogs with malocclusions, overbites/underbites, and teeth turned in all different directions are little teeming petri dishes of bacteria-filled crevasses. It doesn’t stop me from letting the dogs kiss me and the kids, but it is motivation to keep the chompers in good health.

Dental cleanings at the vet are very similar to the cleaning you get at the human dentist- we assess the gums and teeth, scale the teeth, and polish them. Many practices also have the ability to take dental x-rays, which are an exceptional diagnostic tool. Because pets don’t hold still nicely, we have to do this under general anesthesia. I know a lot of people have reservations about this last part, but dental cleanings offer real medical benefits that usually far outweigh the risks of anesthesia in healthy pets. Talk to your vet about your concerns and the risks to your pet. It is tremendously sad to have to remove a mouthful of rotting, abscessed, decaying teeth and realize just how much pain the pet must be in. I can’t tell you how many times I see a pet a few weeks later and the owner says, “It’s like having a puppy again! I thought it was age slowing him down but it was pain.” In addition, these cleanings offer an opportunity to assess the mouth for things we wouldn’t necessarily be able to see in an awake dog- such as fractured teeth and oral masses- and deal with them early.

Many offices are offering special discounts or packages for the month of February. There’s no better time to get your pet’s mouth back in shape- and the kisses you get in return will be all the sweeter for it.