Anesthetic Safety in Pets

The naming of cats is a difficult matter.
It isn’t just one of your holiday games.
You may think at first I’m mad as a hatter.
When I tell you a cat must have three different names… – T.S. Eliot

My first cat had three first names but that probably had more to do with an attempt at avoiding sibling conflict. I don't remember very well since I was only 3 years old at the time. My brother was five.  I do remember that our cat's name was Terry Abigail Mopa Hallett and that my brother and I didn't always get along.  (The photo at the right shows my brother, me and our cat Terry.)

My parents were thrilled to teach us the facts of life when Terry Abigail Mopa had kittens. My preschool teacher was shocked when my mom told her that my brother and I would watch the birthing process. She remarked that she had never seen a cat have kittens so mom promptly invited her over to see it all.  I remember telling my teacher exactly what was going to happen since my nurse-mother had been getting me ready for days.

My first memory of a veterinarian was when Terry was spayed later that year, 1969. My parents brought her home to our rural Rhode Island home and we watched her slowly die that night after the surgery.  Maybe that is why I take  anesthesia and surgery so seriously now.

We do complete physical exams prior to surgery and require pre-anesthetic blood tests in older or high risk patients (and recommend it for all patients). We complete a pre-anesthesia checklist inspired by book 'The Checklist Manifesto' by Atul Gawande. We use IV catheters and fluids and monitor blood pressure, pulse ox, co2, ECG and body temperature. We have trained assistants and certified veterinary technicians that handle the monitoring so the surgeon can focus on the surgery. Our techs call owners at home at 8pm to check on the patients that we sent home earlier that day.

Some clients worry about anesthetic risk. I tell them that there is always risk with anesthesia but that we do all we can to minimize that risk, to identify problems early and to intervene before there is a crisis.  It's just the right thing to do. If you cut corners, sooner or later it will cost a patient their life and then some parents will have explain to their young son why their cat with three names died.

Click here to see behind the scenes anesthesia and monitoring at Hallett Veterinary Hospital.

Canine Influenza Returns? Should We Vaccinate?

Recent reports of a canine influenza outbreak in Texas got me thinking about our vaccine protocol.   Last week's outbreak was in a dog track Southeast of Houston and has sickened nearly 100 dogs with six deaths.  Most reports of other infected dogs over the last year seem to be in Texas, Florida, New York, Colorado and Southern California. The Canine Influenza virus is out there but is not "sweeping the country".

When initial reports of Canine Influenza surfaced in 2004 we were worried.  When a vaccine became available in 2009 we started vaccinating dogs that we felt were at risk. Because of the low incidence of Canine Influenza in Wisconsin, we no longer offer the vaccine. That could Change if new outbreaks occur locally.

Just to be clear, Canine Influenza is a dog virus and does not transmit to people. The reason we were so concerned is that very high mortality was reported in some of the initial outbreaks at dog racetracks.  Sick dogs were bleeding in their lungs (hemorrhagic pneumonia) and many died.  Now we know the bleeding was caused by a secondary bacterial infection with streptococcal bacteria, possibly related to the raw horse meat that many racing Greyhounds were fed.

Symptoms include coughing, vomiting, fever, not eating and lethargy.  These symptoms are the same as most of the other viruses that cause what some call  "contagious canine cough complex".  These viruses are transmitted by close contact with infected dogs. Day care, dog parks, boarding kennels, grooming facilities - anywhere there is nose to nose contact between dogs. If you want your dog to be a dog, these situations are unavoidable.

I do recommend vaccinating with the Bordetella/Parainfluenza (kennel cough) vaccine if your dog is at risk (dog park, day care, etc). Bordetella/Parainfluenza is much more common in Wisconsin than Canine Influenza.

So, what do I do when a coughing dog comes to see me? After a complete physical exam I will typically:

• Offer a PCR test that checks for several of the viral causes of "contagious canine cough complex". 
• If the heart or lungs sound abnormal, offer a chest radiograph (X-ray) to look for pneumonia or heart disease.
• Prescribe a cough suppressant (for comfort) if no pneumonia.
• Prescribe antibiotics if there are signs of secondary bacterial infection. 
• Keep the coughing dog away from other dogs!

Antibiotics are not always the answer since most of these cases are caused by viruses and antibiotics treat bacteria. Usually we need to make the dog comfortable by suppressing the cough and let the body's immune system deal with fighting the virus.

We will continue to monitor Canine Influenza outbreaks around the country and it is possible that we could start recommending Canine Influenza Vaccine at some point in the future, but right now it just doesn't seem to be necessary for the majority of our patients. Let us know if you will be taking your dog to visit a racetrack in Texas and we will discuss vaccination for Canine Influenza and Kennel Cough!

Here is a great link for more info about Canine Influenza Virus
http://www.avma.org/public_health/influenza/canine_bgnd.asp

Ticks, Ticks, and More Ticks This Year

Ticks, Ticks, and More Ticks This Year

The mild winter will set the stage for an abundant tick population this spring, summer and fall.  We saw ticks on dogs in January this year. I have not seen that in my 22 years of veterinary practice!  We usually see a few ticks on dogs in early March if there is a warm spell, then the ticks really come out in April. Unfortunately, this mild winter comes after a big year for ticks in 2011.

I ran on the trails near my house Sunday and came home with two ticks! Finding a tick walking on your arm is disgusting, but what is really scary is that they can transmit Lyme disease and other  bacterial diseases like Anaplasmosis and Babesiosis as well. I didn't find any ticks on my dog, Birkie, but he is a black lab with lots of hair so they would be easy to miss. Birkie is vaccinated for Lyme Disease but Lyme vaccine for dogs is not 100% effective and it has no effect in preventing other tick-borne diseases. Lyme vaccine should not be used as a substitute for tick prevention.

Tick-borne bacterial diseases can cause arthritis, joint inflammation, kidney failure, anemia and bleeding problems and even cardiac problems.  Many dogs respond well to treatment with antibiotics but some cases do not respond to antibiotics.  There is also a debate over whether or not antibiotics completely get rid of the bacteria from an infected dog.  Tick prevention is critical!

There are several tick repellents and tick killers for dogs on the market. They are not all the same and some are very toxic to cats, even if the product was placed on the dog that the cat cuddles with.  Ask your veterinarian which products are right for your pets. Never use a product labeled for "dogs only" on a cat. Sometimes the warning is in very small print on the package.

Some tick products repel ticks, others kill them. Some wash off the dog if they get wet and others do not. For high risk dogs (hunting and trail running dogs) I recommend a product that does not wash off (like Frontline monthly) in addition to a pyrethrin spray used at trailside before heading into the woods. 

For more information on ticks and tick-borne disease, check out this CDC website: http://www.cdc.gov/ticks/diseases/index.html