Holiday Hazards

 

Season’s Greetings from our Doctors and Staff! The Holidays are a time of giving and sharing.  However sometimes pets will help themselves to unhealthy fun!  Certain types of food are particularly dangerous (especially for smaller animals who don’t have to ingest too much) and include chocolate, raisins, grapes, macadamia nuts, onion, fatty gravy.  Don’t give in to begging or those sad eyes!   Bones can splinter and even some commercial chewies can break off in hunks and cause intestinal blockage.  Also be aware that the sight of shiny ornaments, decorations, and new plants can be playground heaven for our pets.  Watch for access to electrical cords, tinsel, ribbon, artificial snow, and ornaments with small parts.  Poinsettias, Holly Berry plants, Easter Lily, and Mistletoe are all potentially toxic if ingested in large enough quantities.  Enjoy the Holidays!  But make it safe for your pets.

A Special Case

 

Tobi came to us with a vague complaint:  gradual changes in behavior over the last several months, especially the last 2 or 3 weeks, to the current point of spending much of her time laying on the floor against a certain spot along the wall.  She wasn’t spending hardly any time in her favorite chair, and to top it off her appetite was beginning to be off.  Tobi was a 15 year old Himalayan, and 3 years ago she had experienced a severe “fatty liver” condition that nearly took her life.  She had done very well since, but with these recent changes in Tobi’s attitude and behavior, her owner feared the worst, a recurrence of the liver disease, and just wasn’t sure that she wanted Tobi to go through another extended hospitalization that she might or might not survive.  It wasn’t said overtly, but humane euthanasia was on the owner’s mind when she brought Tobi in.

 

We talked at length and gave Tobi a thorough medical exam.  Other pieces of history fell into place:  when she would get down from a table (food would motivate her to get up there until recently), she would first step down on a chair before hopping to the floor.  She was grooming herself excessively at the rump, but there were no fleas or evidence of other allergic skin disease.    She was not “jaundiced”, or yellow, a hallmark of fatty liver disease.  In fact Tobi looked pretty good…except when mild pressure was applied to the veterbrae near her pelvis, she objected.  And she especially didn’t like it when the tail was raised up.

 

Lab tests were run to make sure there were no serious metabolic issues – and there weren’t.  X-rays, however, revealed the problem:  she had advanced arthritis in the “lumbo-sacral” part of her spine – kitty version of severe lower back pain – and in her elbows (the #1 place for arthritis in cats).  Her diagnosis – chronic, progressive pain associated with osteoarthritis and lumbo-sacral intervertebral arthritis.

 

The treatment was very straight forward:  pain medications.  She received a tapering course of meloxicam, a non-steroidal anti-inflammatory drug.  She also received gabapentin, a novel, user-friendly medication (first on the market as an anti-convulsant) that has shown great utility in “dampening” pain impulses in the spinal cord.  And the owner has been giving twice-weekly injections of Adequan, a drug that improves joint fluid character and helps to heal damaged cartilage.

 

It is a great joy to report that Tobi showed an almost immediate and dramatic improvement just after initiating the treatment regime.  Her appetite returned, and she once again was up in her favorite chair rather than staying on the floor.  She continued to improve even as the meloxicam was reduced in frequency.  Generally her abilities and mobilities were like they had been 1-2 years earlier.  And we expect the trend to continue and have Tobi to be maintain comfort and a high quality of life for many years to come. 

 

The recognition of pain, especially chronic pain, in cats remains a challenge.  But with an observant owner’s diligence, and a veterinarian’s thorough history and exam and confirmatory tests, we have great tools that can be brought to bear on behalf of these patients.  

 

Meet the Staff

 

Dr. Mark E. Epstein, senior veterinarian at Forestbrook TotalBond Veterinary Hospital, has recently become Credential-Eligible in the American Academy of Pain Management.  The AAPM is the only nationally-recognized organization dedicated to advancing the practice of pain management in humans, many principles of which are being applied to animals.  AAPM is an interdisciplinary organization, but Dr. Epstein is only the 4th veterinarian to achieve the designation of Credential-Eligible, on the path to become a board-certified specialist in pain management.  This status is achieved by the demonstration of a commitment to the enhancement of pain control and relief in his patients, and the implementation of the most modern, integrative pain management strategies within his practice.  The final step for becoming AAPM Board-certified is a 1-2 year process of study, cumulating with a rigorous examination.  Dr. Epstein has practiced at Forestbrook for 21 years, and is Medical Director of TotalBond Veterinary Hospitals, with 6 hospitals in the Gastonia-Charlotte-Lake Wylie vicinity.

 

Senior Pets Questions Answered

 

MY PET IS 9 YEARS OLD TODAY. HOW OLD IS THAT IN HUMAN YEARS?

 

You’ve heard I’m sure of the old adage about multiplying your pet's age by seven to get the equivalent age for us?  Well it works, kind of, but you have to know when and where to apply it.  For example, in the early years a 1 year-old pet is basically a mature (physically if not emotionally) individual, much like a 17 or 18 year-old teenager, except that a 1 year-old cat doesn’t scream at you “LEAVE ME ALONE! YOU DON’T UNDERSTAND! By the way, can you take me and Jamie to the mall?”  On the other hand, a 19 year-old cat is not the equivalent of a 136 year-old person but is more like someone who is 100 or 105 years old (not all that uncommon!), except that a cat will not repeat the same stories over and over.  So we multiply by more in the younger years, less in the older years, and roughly by seven in the middle years.

 

WHAT DO YOU MEAN BY THE "MIDDLE YEARS" AND "OLDER YEARS?"

 

That depends on the breed.  Large dogs mature and age faster than smaller ones, and cats a little slower than either.  Because of this variability, the American Animal Hospital Association Senior Care Guidelines defines “Senior” as being “the last 25% of the predicted life span for their species and breed.”  So giant breeds such as Great Dane, Saint Bernard, and the like can be considered senior at six years of age.  For large breeds such as Retrievers and other dogs in the 60-80 lb range, senior status is usually considered achieved by eight years of age, and for mid-sized dogs (21-50 lbs), about 9 years old.  Small dogs and cats can stay fairly spry up to 10 years of age and beyond.  Oldest dog I've seen was a dachshund 19 1/2 years old.  The oldest cat I've ever met was 25 years old and had seen his owners have both kids and grandkids.

 

HOW DO SOME PETS MANAGE TO LIVE SO LONG?

 

Genetics are an important aging determinant, of course, but external factors play an extremely critical role.  For example, indoor animals will live longer than outdoor ones since they will be exposed to less disease and fewer accidents.  Similarly, routine health maintenance by your veterinarian is vital.  Later in life, "routine" health maintenance is quite different for the older pet than when they were younger.  There is a diminishing role for vaccinations, for example, while there will be growing importance for screening laboratory tests, dental care, and more frequent examinations.  The AAHA Senior Care Guidelines recommend that wellness tests and twice-yearly physical exams by the veterinarian begin no later than as the animal enters the “third quarter”, that is the last half, of its life expectancy.  Your pet visiting the veterinarian every 6 months is akin to you seeing a doctor every 3-4 years, and there is really no substitute for that type of preventive health care.  At home, regular exercise, a premium diet, keeping the pet challenged and stimulated, and early recognition of potential problems are all important.

 

WHAT ARE SOME SIGNS THAT MY PET IS BECOMING SENIOR?

 

·         Diminished mobility or exercise intolerance

·         Diminished (or seemingly discretionary) vision or hearing

·         Bad breath

·         Excessive thirst

·         Changes in bowel, urinary, or sleeping habits.

·         Unexplained weight loss, with or without a change in appetite

·         Sudden affinity for Frank Sinatra

 

WHAT DO I DO WHEN I SEE THESE CHANGES?

 

Understand that ”old age is not a disease.”  40% of us have a senior pet. With proper care and attention between you and your veterinarian, life expectancy can be prolonged and quality of life maintained or even improved.  There are many, many things we can do with simple tests, inexpensive medications, and sometimes just diet changes to help your pet in its later years.  You may visit www.healthypet.org for a more comprehensive look at the aging pet, and the AAHA Senior Care Guidelines in particular.  As always be sure to seek out your veterinarian with any questions.