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Thursday, August 25, 2011

Arthritis - a partial overview

The hills of ones youth are all mountains.  Mari Sandoz American writere

     With arthritis, the opposite is also true, it's really hard to physically do the simple things that one enjoys when everything hurts.  A great resource for the basics of arthritis can be found on the AAHA Healthy pet.com website.  They even have printable brochures.  Their article on cats and arthritis shows just how far we've come in the recognition of our companions needs. 
     So what can we do for the arthritic pet, and how can we slow down the degradation of the joints so they can continue for many years to enjoy their time with us?  First off, start now.  If you're feeding too much and they are tending to overweight, cut back and maintain them at a healthy weight.  The wear and tear of extra weight on any joints is bad, but it also effects the heart and body in other ways, so it's a serious issue to address.  What to feed?  A good quality, name brand, well-known food like Science diet, Royal canin, ProPlan, Nutro, etc.  Don't go for bulk, store brands, or local fad brands, if the track record is unknown, your pet is the guinea pig.  For pets with clinical symptoms of arthritis, clinical trials have shown Science Diet J/D (joint diet) to ease the pain.  The food has more than some supplements can do, so if it's an option I recommend it.
     As for supplements that actually help, I swear by chondroitin/glucosamine and omega fatty acids (like fish oil).  Some of these supplements also contain MSM or antioxidants, which have been proven to not hurt, and possibly help.  As with any new addition to the diet, watch for a response (usually >3 weeks to see), and allergic reactions (vomition, hives, itchy).  These are all things that are safe in younger dogs, all the way through their golden years.   Recently I've seen a few people advocating vegetables as anti-inflammatories.  I don't see anything wrong with eating vegies, and they can make a dog feel full without eating a lot of calorie-dense food, but be sure to avoid toxins (grapes comes to mind immediately) and only feed well washed samples.  I prefer the frozen kind just because they're easier for me.
     Mild gentle exercise is best all the way around, something like walks or swimming, but if your dog is a sporter, make sure to have him on good surfaces that encourage strong landings without damage.  Wet surfaces that are slick, hills, hard uneven surfaces, and other hazards play havoc on their joints just as they do on ours.
      A good egg-crate bed decreases the pressure points when your pet is sleeping.  There are several models available, though my dog just uses my old ones, and sometimes the new one on my bed as well.
     Medications are a last resort before unconventional methods of pain control associated with arthritis.  I use the weaker NSAIDs (non-steroidal anti-inflammatory drugs) at low doses until a stronger dose is required or the pet proves the drug is incompatible with them.  for a run-down on the NSAIDs available, teh fda.gov site has an animalveterinary/resourcesfor you section that outlines them all.  NSAIDs are strongly discouraged in cats, as they develop life-threatening diseases from them, so we usually still use steroids.  Ketoprofen does work but tastes awful, and robenacoxib is still in the research stage as far as I can see.  Some sources are using tramadol, and that does seem to provide effective and safe pain control in some cats.  I use the tramadol more for it's synergystic effect with the NSAIDs in dogs.  This allows me to use a lower dose of both to achieve longer use of lower doses, resulting in less side effects from the medications (vomition, kidney and liver disease, GI upset). 
     Acupuncture (veterinary certified), laser, massage, ultrasound, stem cell treatments (from fat no less), surgery, and braces are all out there.   Each of these is used in specific spaces and places, and should be on the recommendation of your veterinarian.  They are important in some cases, but not in all, so should be approached with a discerning eye.  I've worked with a few really great acupuncturists over the years, and the dogs (and cats) being treated really seemed to enjoy it.
     This isn't a comprehensive overview of everything available, but hits the most common and most promising available modalities for pain control and arthritis control.  Keeping dental disease, and for that matter any whole body diseases that lead to inflammation, can also help decrease the pain from arthritis.  If you have questions, or wish for an evaluation, give me a call.  303-279-2322

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Thursday, August 18, 2011

A start on puppy and kitten basics.

Vaccines - every 3-4 weeks from the age of 2 months to 4 months, we use this to see your new pet and look for issues before they develop.  They require at least 2 boosters, so that the vaccine actually results in protection from the disease being vaccinated against.  The first rabies is given on or after the 4 month visit.  These important vaccines will them be boostered again a year later and as recommended after that (usually yearly for DALPP and bordetella and 3 year for current rabies nowadays).  No animal is ever "done" with vaccines except in extremely rare cases.
Deworming - every 2 weeks for 2 doses in low count areas (CO and other dry states), these liquid dewormers are often pre-empted into Heartworm preventives each 4 weeks.  Make sure something is being given, as these parasites can cross species and cause some serious illness.
Heartworm - "more important" to canines (puppies and adults), this vector-borne disease (from musquitoes) can infect cats as well.  The preventives are usually pretty easy to give and very effective.  Ask your vet about them, as some breeds and areas have different preferences and needs.  After 6 months of age all pets are tested to prove a negative status before starting a preventive.  The most recent guidelines recommend year-round administration even in seasonal areas to decrease parasite resistance and spreading of the disease by sub-clinical carriers.
Socialization - This is in it's simplest form touching and introduction of people, pets, and others that the pet will not always be around but needs to get used to.  Obviously, some of this is within the family, but much is outside of it.  Puppy classes are a great way to start and interact with many animals and people.  An unsocialized pet is often fearful, noisy, and aggressive to strangers.  Working through certain pet issues will often require a trainer or behaviorist so that the inappropriate behaviors aren't reinforced.  Catching it early and correctly is the best strategy.  Any behavior that you wouldn't want in the adult, should be trained out from teh pup.  Positive reinforcement is the best in all species, since the young want to please and get good feedback from interactions.  Everyone in the family and around must be on the same wavelength when training.
Grooming - start early, start slow, and repeat often.  Under 3 months do only sections of less than 1/3 of the pet.  Whether brushing, trimming or bathing this keeps them from being overdone and stressed.  Mutiple short sessions will allow the youngster to develop good habits and a life-long ability to be properly handled.  Touch everywhere, even though you may never trim the nails, clean the ears, etc.  It is much better to touch everything and have them allow it, then to have a disease or need and have them fight you all the way. 
This isn't a complete list by any means, so stay tuned for more.

Dental care 101: Yes pet teeth brushing works.

     Your dentist has you brush your teeth, floss your gums, and hopefully even rinse with flouride to keep your pearly whites beautiful; so what's a pet owner to do?  Brush, BUT NO FLOURIDE, supply good dental toys & food, and keep an eye out for when the next surgical dental will need to be done. 
     Your veterinarian will check your pets mouth each time you go in.   Visits are recommended each 6 months since your pets age 5-7 years for our 1.  We are looking for red and inflammed gums, bad breath, nasty tartar buildup, and other proof of dental disease.  All pet mouths have some disease once the adult teeth have erupted, but when it starts to damage the structures then we recommend a deep cleaning and polishing.  Often, this will also require tooth removal to keep the rest of the body healthy.  Bacteria from the dental caries are absorbed into the blood stream and cause myriad issues to the lungs, liver, and kidneys. 
     Going back to brushing, even an old pet can learn to allow it, but it's easiest to start when they are very young.  Pets have deciduous teeth until 6 months of age, by then the adult teeth have erupted and each set of baby teeth has fallen out (if all goes as planned).  Starting with gentle stimulation of the gums, using gauze/finger toothbrushes/large soft toothbrushes, the pet is introduced to the concept of something foreign in their mouth.  You want your pet to get used to this different touch and "invasion" of their space, without making them nervous or hurting them.  I am not brushing the "bite" between the teeth or on the inside surfaces where the tongue motion helps keep them clean.  Using a flavor of NON-FLOURIDE toothpaste that they appreciate (poultry, apple, biscuit, vanilla, etc) can help with this transition.  There are also gels, liquids, and powders available, use whatever is easiest for you.  You start by "wiping" the canines, these big pointy prominent teeth stay in till 6 months, are easy to reach, and are pretty easy for a beginner to get used to.  Over time the gentle wiping motion is extended back into the corners of the lips, I don't lift the lips, but slide my finger or the brush up under to the molars, premolars, and incisors.  During the eruption phase of the youngster I usually avoid the spaces left by missing deciduous teeth until the new tooth shows, however my kitten enjoyed the stimulation of these areas and wanted me to touch them.  Older pets start the same way, but may require more time before moving into all the teeth getting brushed.  Everytime I finish they get a treat, either a crunchy dental treat or a rawhide.
     For best results, do short sessions at first and extend the time as your pet gets used to it.  Puppies and kittens are usually just wiggly, whereas adults may be protective of their mouths.  Work within the constraints of your pet, not putting yourself in danger if they truly will NOT allow this.  Once daily brushing is the best, but any is better than none, and if once a week is doable, do it.
     Dental toys are great if you have a pet who uses them safely and willingly.  These toys vary in their uses, and different pets will use or abuse different types of toys.  Introduce any toy when you will be there to watch, play with your pet to see how it works, and dispose of any worn or dangerous ones immediately.  The incisors are for picking up and nipping, not for grinding, so most toys don't help keep these teeth and gums clean.  The canines are for grasping and puncturing, so soft toys and striated toys or treats work well.  Premolars and molars are for grinding, so chew toys and striated toys and treats work well for them as well.  Make sure stuffing, soft strips, small pieces, rawhide pieces, etc are not being removed and ingested.  Tatters on toys usually mean it's time to get a new toy, or consider one that doesn't split apart so easily.  Striated type toys and treats are those that have oriented strips to clean the teeth and get between and down to the gums.  Ropes, dental treats, and dental foods like Science Diet T/D all can have this oriented strand that cleans as they penetrate the kibble.  The ropes, as long as not being ingested, also act like floss in the right patient.  Real bones are no longer recommended for chewing, as too many of our pets were breaking their large (carnassial) premolars, resulting in a need for surgical removal of this important tooth.   The best toys and chews are hard, but not so hard as to damage the enamel (protective layer).
     Once periodontal disease (gum reddening and swelling, smell, bleeding), cavities (feline resorptive lesions, canine wear or cracks), and infection (tartar, plaque, bleeding, smell) set in it is time for a dental.  Even with good, daily burshing, this tartar will build up over time; that's why we get cleanings each 6 months at the dentist.  Dentals clean, polish and remove painful teeth and foreign material, allowing the gums and teeth to recuperate and heal.  They also decrease the bacterial load, ease your future cleaning of the shiny surfaces, and make eating and drinking more enjoyable again.  Most dental patients will require antibiotics and pain medications after the procedure.  Depending on their genetics and temperament they will also need dentals each year or so after the first one.  Talk to your veterinarian today about this important health care option.