Should a Pet With Cancer Get Chemotherapy?

by Michael Fagan, DVM

“Cancer” is a word that can induce fear and other emotions.  Many people have personal experiences with cancer and chemotherapy that they don’t wish to impose on their pets.  To be sure, cancer and the many treatment options we can offer are not to be taken lightly.  However, we do have many patients that have received treatments for cancer with favorable outcomes, from cures or long term remission to improved quality of life for many months to years.

The most important factor in determining treatment options and recommendations is what type of cancer the pet has developed.  “Cancer” is a very broad term, with many different types and variable response to different kinds of treatment.  Each patient with cancer is unique.  We offer options based on the type of cancer, symptoms or lack thereof, the pet’s overall health, and owner preferences.  Some cancers are best treated by surgical removal.  Others respond best with radiation, chemotherapy, or immunotherapy.  Some have a poor prognosis regardless of treatment, and control of pain or other symptoms takes priority before opting for euthanasia. We will often consult with a veterinary oncologist as we explore the options available.

The goals of treatment are also unique to each patient, but as a general rule, we aim for a cure only if we can preserve good quality of life throughout the process.  More often, we are trying for a long term remission or control of tumor growth for many months to a few years.  The most common treatment for cancers that are not curable with surgery is chemotherapy of one form or another.

Herein lies a vital difference between veterinary and human medicine:  in human medicine, the treatment goal is often to eliminate the cancer and then recover the patient; in veterinary medicine, we want to preserve good quality of life while limiting the cancer.  In other words, we use drugs, doses, and treatment schedules that minimize side effects while still providing the benefit of remission or delayed growth of the cancer cells. 

With chemotherapy, we have had lymphoma patients live longer than two years; bladder cancer patients, one to two years; dogs with nasal tumors, over a year; most with minimal side effects from the chemotherapy and reduction or elimination of symptoms caused by their cancer.  Unfortunately, not all patients respond, and not all tolerate the chemotherapy equally.  Each patient needs to have its treatment protocol customized. 

One relatively new approach to chemotherapy is using small daily doses instead of higher intermittent doses.  This tends to reduce toxicity and has a different effect on tumor growth.  Rather than actively killing tumor cells directly, low-dose daily therapy (called metronomic therapy) may work by reducing the blood supply to the tumor and by allowing the immune system to respond more aggressively. 

The bottom line is that we have many options for treating the many kinds of cancer that we diagnose in pets, including surgery, radiation (by referral to a veterinary oncologist), traditional or metronomic chemotherapy, immunotherapy (there is a vaccine for melanoma!), and/or palliative care (control of pain and other symptoms caused by the cancer). In animals we also have the option of euthanasia when appropriate but that is a subject for another blog. 

"Is Your Veterinarian Being Honest With You?"

Dr. John Hallett

Sometimes, my dad would lecture me and my brother about something my brother did wrong, and I would interrupt to say, "But dad, I didn't do it." Dad didn't like interruptions, especially when he was on a roll sharing his life lessons with his captive audience. Dad would scowl at me and say, "Son, if the shoe fits, wear it!" I was insulted that I had to sit through a lecture when my brother was the one who left the dirty dishes in the sink or tracked mud in the house. Dad was trying to say, "if this doesn't apply to you, then just listen anyway."

Last week, there was a 20/20 episode on ABC asking "Is Your Veterinarian Being Honest With You?" Many veterinarians are insulted by the episode and are angry that our profession is being accused of cheating pet owners.  I, however, have decided to take my dad's advice because "the shoe doesn't fit."

I realize that a small number of veterinarians do things that are dishonest or unethical or just outdated. I agree with 20/20 that pet owners should be educated and involved in their pet's care, and they should ask questions.  The veterinary community is not highly regulated, and there is wide variation in the level of care offered in different facilities. 

Let's look at some of the points made in the 20/20 piece.

Recommending services to boost the clinic's income:

I believe that a veterinarian can and should make a profit by practicing good medicine, educating pet owners, involving owners in the decision making process, and by charging appropriately for what is done. Veterinarians do not have to resort to selling unnecessary vaccines or procedures just to make money.  Not every client is going to follow every recommendation, but when they leave my office, they will be educated and involved.

Two areas cited by 20/20 are dentistry and lumps:

Dentistry:

I do my best to do a complete oral exam on awake dogs and cats. It is hard. They move, they lick me, some try to bite, and none will tell me that a particular tooth aches. I try to predict when a pet needs a dental cleaning under anesthesia based on what I see in the exam room. The problem is that I often miss problems that only become apparent once the pet is anesthetized because that allows me to probe the gum line and look closely at all the teeth. We are constantly reminded that 60% of the tooth is hidden below the gum line and only becomes visible when dental radiographs (X-rays) are done. Dental radiographs can't be done without general anesthesia in pets. We also have to balance the cost of labwork, monitoring, and safe anesthesia with the need for dental work. I wouldn't cut corners to save a few dollars with my own pet, and I won't with my patients either.  I do my best to recommend dental cleaning and evaluation under anesthesia before teeth need to be extracted, but I can't always do that based on my oral exam in an awake patient. I rarely recommend annual dental cleaning and never based on age alone, but if I see gingivitis, a crevice between calculus buildup and the gum, a gingival mass, or if I smell bad breath, then I will recommend a procedure. For more information on veterinary dentistry, watch this 3 minute video from our practice.

It is interesting to note that one of the dogs that 20/20 argued did not need dental cleaning did have an oral mass clearly visible next to the upper left premolar. That mass should be removed under general anesthesia and submitted for biopsy. Hopefully, it is benign, but some oral masses can destroy bone in the jaw (or worse).

That brings me to lumps and tumors: 

My oncology professor taught us that you can't tell what a mass is just by feeling it. Masses on the skin and under the skin are easily assessed with a fine needle aspirate using the same size needle we use for vaccines.  If I see fat cells under the microscope, then it is most likely a benign lipoma. Without the needle aspirate, I'm just guessing. Anybody can guess. People pay me for my educated opinion and expect me to make recommendations based on my 23 years of practice experience and the most current information available in the veterinary literature. They pay me to look in the microscope, not to guess.

If an owner tells me that a mass has been there for years and hasn't grown or changed, then I am less likely to suggest an aspirate. I educate the owner, tell them the cost, and let them decide. If the owner chooses to wait and monitor the mass, then that is their educated decision, and I tell them to return if the mass grows rapidly, bleeds, or becomes painful. Sometimes, I see things in the microscope that are clearly cancer or are worrisome, and I recommend removing the mass and sending the tissue in to a pathologist for review. Of course, we discuss cost, risks, and potential benefits with the owners.

I love helping animals, but I do not work for free. I do have staff to pay, expensive equipment, overhead, and personal bills, but those bills do not drive my decisions. Providing excellent care for my patients is always my goal.  I treat all my patients the same way I treat my own pets. Yes, keeping pets healthy can be expensive, but consider that veterinary care is far less expensive than human medical care, even with the Affordable Care Act on the way. I believe the majority of veterinarians are honest, but there are unethical or lazy people in all professions including veterinary medicine.

My advice to pet owners: 

• Ask your veterinarian questions
• Discuss options and potential outcomes
• Ask for articles from reputable sources if you want to learn more
• Get a second opinion from a board certified specialist if needed
• Ask your veterinarian what continuing education they attend or how they stay current

My advice to veterinarians: 

• If the shoe fits, wear it! Otherwise, stop complaining about a TV show and use it to educate your clients.

If you would like to watch the 20/20 episode, click here.

Grain-Free Diets for Dogs???

News flash!  Dogs are descendants of the Grey Wolf.

by Dr. John Hallett

photo by Thomas Calvy

Everyone knows that dogs and wolves are related but recent research shows that a dog's dietary needs are very different from wolves. A few months ago I heard a fascinating story on NPR about this research and how it applies to my canine patients. 

Apparently dogs have genes that allow them to digest carbohydrates, wolves don't have those genes so they eat almost exclusively meat. It seems that this was important in the domestication process because the dogs that survived best around people were those that could digest carbs in human food scraps.

I get daily questions from dog owners about what to feed their dogs. Many of them proudly tell me that they feed "grain-free" dog food. They read on the internet that this was important because wolves don't eat grain and dogs are like wolves. This implies that a lack of grain in the dog's diet will make them healthier so it is worth the extra money to buy the expensive "grain-free" diet.   

So, what do animal nutritionists tell us about dog nutrition? First, dogs are omnivores, meaning that they need a variety including both meat and grains and fiber. Second, corn (one of the most common grains in dog food) rarely causes food allergy or skin problems in dogs. A grain-free diet is not the answer to all your dog's health problems.

What should you feed your dog? Before you pay extra for a grain-free diet, ask your veterinarian for suggestions. Our hospital staff are very knowledgeable on nutrition topics. Kelly Neu, one of our certified veterinary technicians, has a special interest in nutrition and has put together a notebook with nutritional information on many brands of pet food. Dr. Heidi Hallett has also done a tremendous amount of reading on nutrition topics and is available to answer questions. 

The big news today is that dogs are different from wolves. Thank goodness!
Here are links to the NPR story  to the original research article in Nature. 

Cats are an entirely different topic that we will cover later. Cats are obligate carnivores, meaning they must have meat.

So You Want to be a Veterinary Technician?

by Kelly Lemke, CVT

Kelly Lemke, CVT

It took me awhile to figure out what I wanted to "be" when I grew up.  I was never one of those kids who knew what they wanted to do by the time they were 10 years old.  After I graduated from high school, I went to UW-Milwaukee for a few years taking pre-vet classes with the plan of going on to veterinary school.  Then life got in the way.  I got married, bought a house, and realized that I didn't want to be in school for 4-5 more years, or spend a few hundred thousand dollars more on my education.  The only thing I still knew was that I still wanted to work in veterinary medicine.  Becoming a veterinary technician was the perfect option, and looking back, I'm so happy I never made it to veterinary school. 

To become a veterinary technician, a person must graduate from an AVMA accredited school and pass the Veterinary Technician National Exam.  Thirteen years ago when I started school, the only AVMA accredited school in Wisconsin was Madison Area Technical College.  The Veterinary Technician program is two years, plus a summer internship.  I spent hours taking notes in lectures (with an actual pen and notebook), staring into microscopes in clinical pathology labs, prepping and monitoring surgery patients in surgical nursing classes, and learning how to examine, draw blood, and give injections to mice, cows, goats, horses, dogs, and cats.  I carried on average 16 credits a semester, which cost me roughly $2000/semester.  On top of that, I had to buy books, a stethoscope, scrubs, coveralls, and boots to wear in the barn.  These additional supplies were about $500 a semester.  The summer internship was considered “summer school” so I had to pay to do that as well.  I spent 320 hours working here in a small animal hospital and at Jefferson Veterinary Clinic working with large animals.  I was fortunate to be paid minimum wage during my internship, but many of my classmates were not paid at all, which isn’t unusual for an internship.  All told, my education cost me around $11000, plus the money I spent on gas driving to Madison five days a week for two years.  In 2011, the average starting salary for a Certified Veterinary Technician was $20000-$23000, which in the “real world” isn’t a lot of money.  In fact, low salary was the number-one cited reason for veterinary technicians leaving the field in a 2007 survey by the National Association of Veterinary Technicians.

Veterinary Technicians don’t spend as much on their educations as veterinarians do and oftentimes don’t have huge amounts of debt coming out of school.  Yes, we don’t earn a lot of money, but there are other rewards.  If a person is unable to afford veterinary school, becoming a veterinary technician is an affordable option.  If you are trying to decide what you want to “be” when you grow up, give us a call and arrange a day to job-shadow a technician.  We’d be happy to show you what we do!

 

So You Want to be a Vet?

by Dr. Michael Fagan

Michael Fagan, DVM

This post is geared toward high school or college students who might be considering veterinary medicine.  I don’t want to discourage anyone who is certain that they want to become a veterinarian, but I do want to help set up realistic expectations. 

I love my job as a veterinarian.  I get to work with other like-minded people.  I get to play with puppies and kittens.  I very often make patients’ lives better, and every now and then literally save a life.  Biology and medicine are interesting and challenging.  Surgery can be exciting and rewarding.  There’s no other job I would prefer to do. 

But, like any other good thing, there are not-so-good things that tag along.  Sometimes we can’t save a patient’s life, or even make it feel much better.  Euthanasia is always sad, even when it is the best and right option.  People sometimes get angry with us.  Sometimes they cannot afford a treatment we know would help.  Surprisingly, some dogs and cats don’t like us!  Bites are rare but can happen at any time.

Then there are the financial issues facing new or prospective veterinarians.  A recent article in the NY Times revealed the median cost of veterinary school (including living expenses) to be nearly $250,000 in 2011.  This does not include the cost of three to five years of undergraduate study.  Meanwhile, the median salary of new veterinarians that year was only $45,500. 

It is nearly impossible to repay a $250,000 loan on such a salary.  It would require over $2500 a month, on a salary less than $4,000 a month.  And not all graduates are finding jobs lately.  Last year, about one third of veterinary graduates were without an offer for a full time job.

There are some loan forgiveness programs, such as 501(c)3 charitable or military service, or Income Based Repayment or Pay As You Earn programs which keep payments lower but come with a potentially hefty tax burden at the end. 

So!  If science and math and problem solving and communication and a love of living things are your strong suits, by all means consider becoming a veterinarian.  But do so with eyes wide open to the cost of getting there and the challenge of repaying loans after graduation.  It is possible, but requires planning, discipline, commitment and endurance, and sometimes help from families or spouses. 

And finally, if you are still interested, contact us to arrange a day of job-shadowing so you can see what a small animal veterinarian does in real life!

Kelly's Cat "Sixxy"

by Kelly Lemke, CVT

Sixxy

I’ve been a Certified Veterinary Technician for 11 years.  I understand and believe in the importance of annual physical exams for all cats.  I’m also the owner of a big, black cat named Sixxy.    He’s a good cat, he goes in his crate willingly, and is cooperative during his physical exam.  Just like many cat owners, I hate bringing him to the hospital.  It’s stressful for me; listening to him cry all the way to the hospital in the car, holding him for his exam, and watching him get his vaccines.  The visit is also stressful for Sixxy; having his mouth examined, getting on the scale, and, of course, getting his vaccines.  Sixx is lucky (I’m sure he’d argue otherwise) because I still bring him in at least once a year for a doctor to do a physical exam and make sure he is still doing well.  We can catch problems early and begin treatment if something is found.  Many other cats are not so lucky and we see them only when something is very wrong.    Because we know how stressful it is to bring cats to the doctor, we decided to do something about it.  Hallett Veterinary Hospital was recently recognized as a Cat Friendly Practice by the American Association of Feline Practitioners.  We have voluntarily evaluated our practice to meet the standards set by the AAFP to become cat friendly.

So how will this help cats? As a Cat Friendly Practice, we are committed to learning ways to make visits more pleasant for cats and to help owners learn ways they can also contribute.  Our cat only exam room is an environment that is less threatening for cats.  We have a Feliway (pheromone) diffuser plugged in all the time.  The exam room is situated away from the busy area of the hospital.  We even have a windowsill where cats can look outside.  Our staff has been trained on how to interact with and handle cats to make their experience more pleasant and less stressful. 

            As the Cat Advocate for Hallett Veterinary Hospital, I am dedicated to making sure the cat friendly standards are adhered to.  I am happy to answer any questions on what we are doing to remain Cat Friendly and how to make your cat’s visit easier on you and your cat. 

            As for Sixxy, he’ll be here in July for his annual exam and vaccines, hopefully leaving with a clean bill of health and a lot less stress!

"I found a baby wild animal! Now what?"

by Dr. Heidi Hallett

Spring is a time when young wildlife species are more commonly encountered.  Sometimes, a young animal may appear injured, abandoned, or in need of help.  The following discussion may help determine the best course of action to follow.  Most of the young animals found in the wild are not abandoned, but if a wild animal is injured, sick, or orphaned, steps should be taken to contact the DNR (WI Dept. of Natural Resources) or a licensed wildlife rehabilitator.  Contact information appears at the end of this article.  Wildlife rehabilitators are licensed individuals trained and equipped to provide temporary care and treatment to injured, sick, and orphaned wild animals for the purpose of release back into the wild. Rehabilitating wildlife without a license is against the law in Wisconsin.  If it’s necessary to help an injured or orphaned wild animal, a non-licensed person may have the animal in their possession for up to 24 hours in order to transport the animal to a licensed wildlife rehabilitator.  In Wisconsin, skunks cannot be rehabilitated nor can deer in any county within a 10 mile radius of a known CWD (Chronic Wasting Disease) positive deer, either captive or wild.  Deer rehabilitation has been banned in Waukesha County for 2013.
 
General Instructions: ​If transporting orphaned or injured wildlife to a licensed rehabilitator, place the animal inside a ventilated container in a dark, warm and quiet place away from human disturbances.  A cardboard box punched with small ventilation holes and lined with a ravel-free material works well.   Due to the risk of being bitten or scratched and possible disease exposure, try to avoid handling the animal directly, even with gloves. It is recommended to scoop the animal into its travelling container if possible. Wash hands thoroughly with soap and water after coming into close contact with wildlife. Try to minimize stress to the wild animal as much as possible.  Avoid direct eye contact with wildlife, since most animals see eye contact as a threatening or challenging gesture. It is also recommended not to provide food or water to the wild animal.  The wildlife rehabilitator will provide the correct nutrition needed.

​
To help determine if a young, wild animal is orphaned, the following normal development guidelines and behaviors can be used as reference.

Grey Squirrels:  Squirrels nest in trees by using a tree cavity or building a nest out of leaves.  Mothers will retrieve their young if they fall out of the nest.  Newborn grey squirrels are about the size of a human thumb.  Their eyes open at about 4 weeks of age, and they begin to explore outside the nest area.  They are weaned at 8 weeks old, but cannot survive on their own until at least 12 weeks old.  Squirrels with bushy tails that are approximately half the size of an adult are old enough to be on their own.  Grey squirrels can have multiple litters each year, so baby animals can be seen any time from spring through fall.

​If a young squirrel is found with its eyes still sealed shut, it has probably fallen from its nest.  If it’s uninjured but can’t be safely placed back in its nest, put the squirrel on a soft, ravel-free cloth at the base of the tree with the nest.  There is a good chance the mother will return it to the nest herself.  Observe from indoors or from a distance, and if the mother hasn’t retrieved the baby after an hour or so, call a local wildlife rehabilitator.

Bunnies in HVH yard

Cotton-tail Rabbits:  Rabbits commonly make shallow fur or grass-lined nests in the ground.  Mothers only feed their young at dawn and dusk and won’t stay at the nest during the day.  The babies’ eyes open at 1 week and they leave the nest at 2-3 weeks of age.  A cotton-tail rabbit approximately the size of a softball (4-5 inches long) with upward pointed ears is capable of being on its own and should be left alone.  Rabbits can have multiple litters each year, so baby animals may be seen anytime from spring through fall.

​
If a nest is disturbed by a pet, child, or because of lawn work, the nest can be rebuilt and the babies replaced, and the mother will most likely return.  To determine if the nest is abandoned, place leaves or grasses in a crisscross pattern over the nest and check it the following morning.  If the pattern has been disturbed, then the mother has been there to feed the babies.

Raccoons:  A raccoon will nest in tree cavities, caves, brush piles, rock crevices, and buildings.  Mothers will retrieve their young if they fall out or wander away from the nest.  Litters consist of 2-6 babies, and their eyes begin to open at ~3 weeks of age, and teeth begin to erupt at 4 weeks of age.  At 4-6 weeks, raccoon kits are capable of walking, climbing, and running, and may begin to explore alternate den sites with their mother.  Weaning occurs at 8-12 weeks, but the kits remain with their mother until the following spring.

​If young kits are wandering alone outside of the den before the age of 4-6 weeks, it is usually an indication that the mother has been gone for several days, (ie, trapped or dead), and a wildlife rehabilitator should be contacted.  If healthy raccoon kits are found outside of their den, they can be placed in a ventilated box at the den entrance overnight for the mother to retrieve.  If the babies are still there the next morning, contact a wildlife rehabilitator.

White-tailed Deer:  Newborn deer can be as small as 3 pounds.  Very young fawns are weak, can’t walk well, and lack the strength to follow their mother as she feeds.  Fawns are protected from predators by their coloration and lack of body odor.  The mother only comes to feed the fawn every few hours, and nursing is accomplished quickly.

​Do not touch the fawn or bring children, pets, or friends to look at it because that endangers the fawn. Human scent can lead a predator right to the well-hidden fawn.  If a fawn is in obvious danger, such as in the middle of the road, use gloves to pick up the fawn and move it about 50 feet off the road.  The mother deer will find the fawn.  Due to Chronic Wasting Disease concerns, wildlife rehabilitators currently are not allowed to provide care for orphaned fawns in most of southern Wisconsin, so it is very important that people protect the babies by leaving them alone to be raised by their mothers.

Songbirds:  Songbirds lay a clutch of eggs in a nest, and young birds are usually tended by both parents. Once the eggs have hatched, the featherless “nestlings” remain in the nest for some time completely dependent on the parents for warmth and food.  Baby songbirds leave the nest just prior to the full development of their feathers and so cannot fly for several days to a week.  During this time, they are called “fledglings” and hop around on the ground building their strength and coordination under the watch of their parents.

​If a fledgling is found, keep predators such as dogs and cats away and watch from a distance to see if the parents are still tending to it.  If the parents do not return within an hour, contact a wildlife rehabilitator.  If an uninjured bird is found in the grass, and it is featherless or unable to hop from one spot, it needs to be replaced in its nest if possible.  It is a common misconception that parents won’t return to care for a baby bird if humans have touched it.  Birds actually have a poorly developed sense of smell.  If the nest can’t be reached, call a wildlife rehabilitator for advice.

Mallard Ducks:  Mallards lay approximately 6-14 cream to greenish-buff colored eggs in a nest typically concealed in wetland grasses or by bodies of water.  The hen will not sit on her nest until all of the eggs have been laid.  Once she starts to incubate the nest, the babies will hatch in approximately 23-29 days.  Mallard ducklings are born with their eyes open and a covering of downy feathers, but depend on the mother for warmth and protection from predators.  The mother will lead them from their nest to water when they are about 24 hours old.

​If the nest is in a dangerous place or if there is concern about the hen getting the ducklings safely to water, call a wildlife rehabilitator for advice.  It is not uncommon for a duckling to get separated temporarily from its family.  If a duckling is found alone, look and listen for any signs that the mother and siblings are in the area. If the family is not nearby or won’t accept the duckling within an hour, do not try to place the orphaned duckling with another family in the wild.  The orphan will need to be placed in the care of a wildlife rehabilitator.

​ 
Contact information for licensed area wildlife rehabilitators (WI DNR website): Waukesha County:

Name	Address	Contact	Species
Wildlife in Need Center	W349 S1480 S Waterville Rd. Suite B, Oconomowoc	262-965-3090  website	All, except deer, skunks, and bats.
Susan Verden	Oconomowoc	262-965-4335 arakun@earthlink.net	Opossum, rodent/rabbit, small carnivore, raccoon, reptile, amphibian
Susan Saliga		website	Squirrel
Humane Animal Welfare Society	701 Northview Rd., Waukesha	262-542-8851 ext. 108  mark@hawspets.org	All, except deer, skunks, seabirds, and eagles
Nancy Meier	S41 W33855 Hidden Valley Dr., Dousman	262-392-9309 possums@live.com bunniesrus@hotmail.com	Opossum, rodent/rabbit

Sources:  WI DNR website: dnr.wi.gov/topic/wildlifehabitat/wildlifehealth.html

​    Wildlife in Need Center, 262-965-3090

What is a Cat Friendly Practice?

Hallett Veterinary Hospital Recognized as Cat Friendly Practice

Cats are quickly becoming the most popular pet in America, with more than 86 million cats loved as pets, compared to 78 million dogs.  With the number of people choosing cats steadily increasing, the American Association of Feline Practitioners (AAFP) has initiated a program to improve the health care and overall well-being of the growing feline population.  

A Cat Friendly Practice (CFP) is committed to learning ways to make the visit more pleasant for your cats and to help you learn ways that you can contribute also. 

A Cat Friendly Practice has adapted an environment that is less stressful to cats and meets the cat’s unique needs.  The staff at the practice is aware of ways they can interact and handle your cat so that examinations and procedures will be less stressful.  A Cat Friendly Practice also values your contribution to your cat’s healthcare plan and will make every effort to help you understand your cat’s needs and help you learn what you can do at home to ensure that they get the care they need.  Hallett Veterinary Hospital is proud to announce that it is recognized by the AAFP as a Cat Friendly Practice.

Why Cat Friendly?

​“There is a tremendous recognition that while cats are the largest percentage of companion animals in homes, their wellness visits and other types of veterinary care are much lower than for dogs,” said Dr. Elizabeth J Colleran, AAFP Past-president.  The association pioneered the Cat Friendly Practice program to provide a framework for creating a positive practice environment for cats, including medical care that supports the cat’s unique needs, and knowledgeable staff members who understand feline friendly handling.  The Cat Friendly Practice program was created to improve the treatment, handling, and overall healthcare of cats.  Its purpose is to equip veterinary practices with the tools, resources, and information to elevate the standard of care for cats.

​“We are committed to providing quality care to our patients.  When we heard about AAFP’s Cat Friendly Practice Program, we knew it was time to take a fresh look at our practice to determine what could be done to make the veterinary visit more positive for cats and cat owners,” said Kelly Lemke, CVT and Cat Advocate at Hallett Veterinary Hospital.  “We evaluated every aspect of the practice and its environment from the perspective of the cat.  We can proudly say that from the minute they walk through the door, our patients and clients will be part of a welcoming, comfortable experience that will ultimately lead to the improved health of our feline patients.  

​

Top 10 Reasons To Keep Your Cat Indoors

by Dr. Michael Fagan

10.  Cars.  Self explanatory.  I see a road-killed cat between home and work at least monthly.

9.    Coyotes.  They like to eat cats. (We have a patient who was rescued from a coyote's mouth!)

8.    Owls.  Seriously, you wouldn’t believe the damage an owl or other raptor can do even if it misses. (We treated a dog with wounds from an owl attack!)

7.    Worms.  Your cat can bring home parasites that can infect your kids.

6.    Birds and other small wildlife.  Cats in the US kill 1.4–3.7 billion birds a year, 7-20 billion mammals, as well as snakes, lizards, frogs, etc.

5.    Other large wildlife.  Raccoons and foxes can transmit rabies and raccoon poop can carry dangerous parasite eggs.  Oh, and they have sharp teeth, too.

4.    Other cats.  Cat fights can cause abscesses and eye injuries, and can transmit Feline Leukemia or Feline Immunodeficiency Virus, for which there is no cure.

3.    Toxoplasma.  Cat poop in the garden is the largest source of human exposure to this microscopic parasite.  Bonus item if you live near the ocean:  toxoplasma from cats washes into the ocean and infects sea lions with catastrophic effects.

2.    Tiny little bugs.  Indoor cats almost never get fleas or ticks.  Almost.

1.    Life!  Outdoor cats have an average life expectancy of about 4 years.  Indoor cats average well into their teen years.