Cats News

Hairballs – More than just fur


Every so often, your otherwise fastidious cat will do an alarming and somewhat disgusting thing. She’ll awake from a peaceful nap, rise up on her paws, retch convulsively for a moment or two, and spit up what may appear at first glance to be a damp clump. What the animal has disgorged — in the middle of your kitchen floor or, worse yet, in the middle of your prized Persian rug — is a trichobezoar, a wad of undigested hair that is commonly referred to as a hairball.
Despite the term, disgorged hairballs are not usually round. They are often slender and cylindrical, shaped more like a cigar or sausage than a ball. According to Richard Goldstein, DVM, an associate professor of small animal medicine at Cornell University’s College of Veterinary Medicine, a spit-up hairball’s elongated shape is imparted by the narrow food tube (esophagus) in which it develops or through which it passes on its journey from the cat’s stomach to the outside world. However, he notes, a hairball that is not disgorged and remains in the stomach will indeed be round — “like a sponge or a rolled-up sock,” he says.
Regurgitated hairballs are variable in size; though usually about an inch long, they can be as long as five inches and an inch thick. The color is mainly that of the cat’s coat, darkened by the color of the animal’s food and various gastric secretions, such as green bile. The ejected matter will typically have an unpleasant but tolerable odor.

Hazardous Potential
Hairballs are the unsavory by-product of a normal habit. As your cat grooms herself, she swallows a lot of loose hair. This happens because the tiny backward-slanted projections (papillae) that roughen the surface of her tongue propel the hair down her throat and into her stomach. Unfortunately, Dr. Goldstein explains, the main structural component of the hair — a tough, insoluble protein substance called keratin — is indigestible. While most of the swallowed hair eventually passes through the animal’s digestive tract and gets excreted intact in the feces, some of it remains in the stomach and gradually accumulates into a damp clump — the hairball.
It’s not uncommon, says Dr. Goldstein, for a cat to regurgitate a hairball once every week or two. Aside from inconvenience to the owner, this is nothing to worry about. However, the wad of matted hair can pose a serious health threat it if grows too large to pass through the narrow sphincters leading either from the esophagus to the stomach or from the stomach to the intestinal tract. Also threatening, he notes, is a hairball that manages to pass into the small intestine and become tightly lodged there. “This is uncommon,” he notes, “but it is very serious when it does occur. Without surgical intervention, it can be fatal.”

Relieving the Obstruction
A cat that is lethargic, refuses to eat for more than a day or two or has had repeated episodes of unproductive retching or true vomiting should be examined by a veterinarian without delay, he advises. It’s possible that the frequent hacking has nothing at all to do with hairballs. It may instead be a sign of another gastrointestinal problem or of a respiratory ailment, such as asthma, in which case emergency treatment may be necessary.
Diagnosis of intestinal blockage is based on physical examination, bloodwork, X-rays, perhaps ultrasound, and a history of the animal’s pattern of hairball regurgitation. If a blockage is detected, surgery may be required in order to remove the hairball. More often, however, therapy will center on protecting the intestines through several days of clinical care that includes the use of a laxative to move the hairball through the digestive tract.
Although laxatives may be effective in enabling passage of a stubborn hairball, Dr. Goldstein strongly advises owners never to give their cats a laxative without the approval and supervision of a veterinarian. The same advice applies to the use of commercial diets that claim to be effective in preventing or relieving such an obstruction.

(c) District Vet – 2017

Cats Dogs News

Why we ask for poop!

“And please remember to bring a fecal sample.” Whenever a client schedules a wellness or sick pet visit, our front staff requests they bring a fresh stool sample. We are not fascinated by your pets’ poop, per se, but are concerned about your pets’ well-being and the potential for transmission of parasites to people. That being said, we are routinely amused by the containers in which people bring us their pets’ sample.

So what do we look for in a fecal sample? Mainly parasites, but we also want to see that the color is appropriate, assess if obvious blood is present, and evaluate consistency. What goes in must come out, they saying goes, but lots can happen in-between. Parasites can affect a whole host of organs, blood may indicate tumors or ulcers, color changes may indicate pancreatic or digestion issues, and consistency may be an indicator of allergies or inflammatory bowel disease. Poop is a valuable diagnostic tool.

Many parasites are passed through fecal material. Numerous parasites live within the intestines and colon and lay their eggs within the lumen of the intestines. When the pet defecates, the eggs of the parasites are shed into the environment, waiting for a new host to infect. Most parasites obtain entry into their new host via the fecal-oral route – aka the host eats the eggs in a small quantity of fecal matter. As for dogs this is very common, whether they eat feces off the sidewalk or simply clean their feet after a nice stroll through the park. Roundworms, one of the most common parasites in dogs, can even infect a host by penetrating through the skin of the their feet. Commonly transmitted parasites via the fecal-oral route include round and hookworms and giardia. Less common, but more concerning is toxoplasmosis (a conversation for another day).

Some other parasites take a bit of a more circuitous route, but still need to pass through the intestines of the pet. This includes tapeworms, flukes, and several other parasites. Tapeworm eggs are shed into the stool and ingested by fleas. When the dog or cat eats the flea, the tapeworm is released into the pet, starting the lifecycle over again. Other tapeworms and some flukes require a snail eat the feces, then the pet eats the snail and here we go again.

When you bring a fecal sample and we send it out to the lab, the technicians analyze the sample for the eggs of these parasites. This is performed either by the floatation method where they scan the feces for actual eggs, or via the ELISA method, where the sample is tested for chemical markers to the parasites. It is important to remember that parasites are like chickens: they do not lay eggs every day. Frequently we will ask for several samples from different times – this is especially true for puppies and kittens. We want to maximize our chances of catching any parasitic infections. If an infection is found, appropriate treatment is initiated.

Before the sample is sent out to the lab, it is inspected. Is the color correct? Is there blood present? Is the stool too soft? Is there a large amount of mucus present? If abnormalities are found, we then assess if further testing is needed or if there is a problem with the pet. A particular pancreatic dysfunction results in the stool being a very light cream color. Early in the disease, this is the only clinical sign. If treated dogs usually fully recover. Blood may also be the only sign of a tumor or a parasite. Extremely hard stool may indicate constipation, dehydration, kidney disease, or a lack of fiber. And loose stool may be a sign of a food allergy, parasitism, or an inflammatory process within the intestines.

Simply put, poop can tell us quite a bit about overall health. No one loves playing with a stool sample, so here are a few suggestions to make collection easier. We have stool collection vials that you can take home and then return to us – they have a small spoon and once sealed, contain all the odors. If you collect it in a plastic bag, please double bag the sample. You may also use a jar or other suitable container. We don’t need a large sample, either: about several pennies weight of sample is sufficient. Don’t bring a Great Dane’s worth, please. It is important that the stool be as fresh as possible. If there may be a lag between collection and bringing it to us, you may refrigerate (not freeze) the sample for a day. Don’t neglect bringing samples for cats, either, but do take care to not bring a sample that is old and dried out.

And most important, bring a sample to every annual exam, even if it is in a Tiffany’s box.

Dan Teich, DVM

Cats News

Hyperthyroidism in Cats

Our feline friends are living longer than ever, and as they age, we see the emergence of certain conditions, including an over active thyroid gland. Hyperthyroidism stems from the thyroid gland over-producing thyroid hormone, leading to a host of problems, ranging from weight loss, heart disease, kidney disease and other issues. The good news is that this common problem can be managed and even cured in many cats.

A cat’s body needs a normal amount of thyroid hormone: it regulates metabolism, heart rate, body temperature, overall body condition, and more. It is important for normal functioning, but too much of a good thing can be bad. Excessive thyroid hormone leads to increased metabolism – the body burns too many calories, resulting in weight loss. The elevated metabolism also increases blood pressure, leading to possible long-term kidney and heart damage. Problems may also be noted in the eyes and brain.

The thyroid is a small organ, located in the neck on top of the trachea (windpipe). Usually it cannot be felt, but in some cases, especially when there is hyperthyroidism, it can palpate the size of a pea. Each cat has two thyroid glands.

Clinical signs associated with an overactive thyroid may vary between cats, but may include weight loss, increased appetite without weight gain, vomiting, diarrhea, hyperactivity, increased heart rate, behavior changes, poor haircoat, increased drinking and urination, occasionally depression or weakness, and difficulty breathing. Many of these observations are also present in other disorders, so one cannot diagnose thyroid disease purely upon clinical signs.

Diagnosis of thyroid disease is performed by your veterinarian through a physical examination, thorough history, and evaluation of blood values, specifically thyroid hormone. Most cats with the disease will have very high levels of thyroid hormone, but some may be marginally elevated or high normal. Thyroid hormone levels can fluctuate some, so if it comes back normal, your veterinarian may want to check the level again shortly after the initial examination.

The cause of hyperthyroidism is not definitively known, but the incidence of the disease has increased over the past decades. Researchers are looking into whether a fish-based diet may increase the incidence if the disease. PBDEs, a chemical used in fire retardants is commonly found in dust mites and sometimes in cat foods with a high fish content. There is thought that this chemical may contribute to hyperthyroidism.

There are several methods for treating hyperthyroidism. The goal is to bring down the level of thyroid hormone to a normal value. A medication called methimazole reduces the amount of hormone released by the thyroid gland. It is usually used first, with the veterinarian carefully monitoring the thyroid level, kidney values and blood cell counts several times to be certain an appropriate dose of the medication is administered. Many cats are kept on this medication for prolonged periods of time.

If the cat cannot tolerate methimazole, if giving the medication is difficult, or if a long-term solution is the goal, an injection of radioactive iodine may cure the disease. Iodine is taken up by the thyroid gland from the bloodstream and is used to make thyroid hormone. The iodine is very dilute in the body, but concentrates in the thyroid, essentially irradiating it, reducing the amount of thyroid tissue present. Many cats will quickly have a normal thyroid level or slightly low level. If the treatment is not effective, it may be repeated. The downside is that cats must remain in the hospital for 3-4 days while all the radioactivity dissipates and is urinated out.

A new veterinary diet called y/d is available for the treatment of hyperthyroidism. It contains only trace amounts of iodine, a mineral essential to the formation of thyroid hormone. Without sufficient quantities of iodine, the thyroid can only produce small amounts of thyroid hormone. This diet may be good for cats that are difficult to medicate or have other medical problems. It is essential that the cat have filtered water and eat no other foods, not even treats, as even trace amounts of iodine can negate the purpose of the food.

In some cases surgery is performed to remove the affected thyroid gland. The surgery must be performed carefully to preserve the parathyroid – a small gland adjacent to the thyroid that regulates blood calcium. There can be small areas of thyroid tissue not connected to the thyroid and unless these areas are identified in advance, surgery may not be successful.

Hyperthyroidism is a treatable disease. If there are no other significant complications, cats may go on to live long lives with treatment and supportive care as needed. If your middle-aged to older cat is losing weight, thyroid disease should certainly be a differential.

Cats Dogs News

Diabetes Affects Dogs and Cats

Diabetes Mellitus

Diabetes ranks high amongst chronic diseases in humans and pets. While most people know that diabetes concerns the amount of sugar within the blood, they are unaware of why it occurs and how it is treated. The disease in pets closely parallels that of humans and is treated in much the same manner.

So what is diabetes? Here’s the technical answer: Diabetes mellitus is a disorder of carbohydrate, protein and fat metabolism caused by either an absence of insulin or an inability of the body to use insulin, leading to elevated blood sugar levels and a cascade of significant metabolic derangements.

Now let’s break that down a bit. When one eats they take in carbohydrates, fats, proteins, minerals, and other nutrients. The stomach breaks down many of these substances into smaller components and the intestines selectively absorb nutrients, including sugars. These nutrients then cycle into the liver for further processing and then circulate in the blood to the body. Now that we have this down, let’s talk about sugar.

Sugar, known as glucose, is an essential fuel for many cells, especially those of the brain. But you see, glucose needs to get into the body’s cells order to be used. To do that the body produces a hormone called insulin. This chemical attaches to body cells and signals them to take in glucose. A simple analogy is to think of it as a key, allowing the glucose to flow into the cell.

When you eat and absorb sugars, the elevated levels of glucose trigger the beta cells within pancreas to produce and release insulin into the bloodstream. If there is a problem making insulin or for some reason the body does not adequately recognize or use insulin, the blood sugar levels can be elevated for prolonged periods. This is diabetes.

So what? Blood glucose levels are elevated. What happens? The body turns to other sources of energy, namely breaking down fats and proteins. Fat travels to the liver where it is turned into ketones, another energy source, but ketones themselves are toxic at high levels and the liver can only handle so much fat processing before it gives out. The excess fat leads to fatty liver disease and liver failure. Breaking down muscle proteins isn’t sustainable for long as there is not an unlimited source of muscle. Without energy the body fails to function, the brain and nerves start to shut down, other organs experience deleterious effects from using other energy sources and eventually death results.

What are the signs of diabetes? Can it be felt? Diabetes in itself is not painful and it is possible for a human or pet to have the disease and initially be unaware of its presence. The typical first signs involve increased drinking and urinating. High blood sugar levels lead to the kidneys relating large amounts of water and sugar into the urine. If you observe your pet, especially cats, drinking and urinating very frequently, diabetes may be a concern. Weight loss is seen in most pet diabetes cases. Usually the person notes that their overweight pet is suddenly losing weight and that the diet they placed the pet on is ‘working.” Be certain that diabetes is not a factor. Some pets will experience problems walking – this is caused by nerves not working properly secondary to not receiving enough glucose. Cataracts in the eyes may for. They are caused by excess water to flowing into the lens, potentially leading to blindness. Other pets may simply have a poor hair coat and not be thriving as in the past.

We know what diabetes is now, so what causes it? The answer depends as there are several pathways that lead to diabetes. First is the destruction of the beta cells. This can occur from certain infections, genetic traits, infections, and immune diseases. Simply, there aren’t enough beta cells to pull off the job. The second way involves the body not efficiently using the insulin produced by the pancreas – this is known as insulin resistance.

Ok, so how is it treated? In pets we use several different modalities to get the blood sugar level under control. The hallmark treatment is administering insulin via an injection once or twice per day. This depends upon the type of insulin being used and several other factors. Next we modify the pet’s diet to a higher fiber diet that releases sugars into the intestines at a slower, more sustained rate. Several prescription veterinary diets exist and in some cases, can control the disease by themselves. They prevent spikes in blood sugar levels. The last major component is weight loss in obese pets. Carrying many extra pounds can lead to diabetes and research as shown that it can be greatly improved with controlled weight loss.

What’s the prognosis? Generally pretty good. Diabetes tends to affect older cats and middle-aged dogs. Treatment is not complicated in most cases, but does require dedication. With proper care, may pets with diabetes will go on to lead happy lives.

The above is a simple overview of a complicated disease. When caught early, diabetes is very treatable. Should you have any questions about pet diabetes or any cat or dog health issue, please reach out.

Dogs News

Lyme Disease – An Annual Invasion

Lyme disease

Be prepared for an invasion. Not from across the ocean, but from little critters hitching a ride on mice: ticks. Each year the territory of ticks carrying Lyme disease appears to be spreading, and urban and suburban environments are ripe for the reason they spread: mice. While traditionally people have blamed Lyme disease on deer, mice appear to play an even larger role in spreading Lyme infected ticks.

Research by ecologists has shown that the numbers of mice the previous year is correlates with the number of Lyme cases the following summer. Due to mild winters the past decade, the population of mice has increased and the range and severity of Lyme disease has increased as well.

The CDC tracks Lyme cases and the spread of Lyme has been startling. Lyme was originally confined to New England and some areas of Wisconsin. It now can be found from Maine down through Virginia, across Wisconsin and Minnesota and in smaller pockets throughout the country. The ecologists suspect this is due to larger populations of deer, increased fragmented forests (mice thrive in small patches of woodlands), decreased predators feeding upon mice and deer, and increased travel by people. DC has plenty of mice and great moue habitat: small gardens and small patches of woodlands.

Lyme is spread via an infected tick biting either you or your dog (it is possible in cats, too, but less frequent). Infected ticks carry the organism that transmits lyme, Borellia burdorferi, in their saliva and inject it into the animal while feeding. In general it takes over 24 hours for the tick to transfer Lyme to its host once it attaches. The disease is treatable in both humans and dogs, but prevention is key. For people routinely checking for ticks post any outdoor activity is key. Look in great places for a tick to hide: behind the ears, in the groin area, under the arms.

Therefore, if you note a tick on yourself or your pup, it is important to remove it as soon as possible. When removing a tick, grasp it with tweezers as close to the skin as possible and pull it off. Do not squeeze its body. Always check yourself and your dog after playing outside – simple walks in the neighborhood are sufficient to have ticks jump onto you and the pup.

For dogs, we have a three-fold method of prevention: removal of ticks, oral and topical tick preventives, and a vaccination against Lyme. The most effective preventives focus on killing ticks as soon as possible. Simparica, NexGard, and Bravecto work via causing uncontrolled neurologic issues in ticks and the ticks rapidly die. The medications have a very high affinity for the specific chemical in ticks (fleas, too), and usually cause no ill effects in dogs. When giving any of these three preventives, monitor your pup for any adverse reactions, such as vomiting, tremors, or simply not feeling well. Side effects are quite rare and pass with time. The risk from Lyme and other tick-borne disease is much greater than the risks from the preventives.

There are several Lyme vaccinations available as well. They prime the immune system to recognize the Borellia organism and mount a immune response its presence, thus decreasing the likelihood of clinical disease. Here in DC, the vaccine is recommended for most dogs.

Even with preventives and vaccination, Lyme can still be transmitted – these methods are not fool-proof. We recommend that your dog be tested for Lyme once per year as part of annual parasite testing. If positive for Lyme, treatment can help prevent problems from arising.
Tick and parasite control is complicated and requires several different paradigms. We veterinarians are here to help keep your pup (and to a degree you) safe from ticks and tick-borne diseases. As always, please let us know how we can help.

Dan Teich, DVM
District Veterinary Hospital

Dogs News

Senior Dogs in the Winter – Keep Them Active!

Winter may be harder on senior dogs than the balmy warmer months of summer. Sure, it is cooler and we do not have to worry about heat stroke, but arthritis is worsened by the cold, their level of exercise decreases, boredom sets in, and there are routine winter hazards. The importance of mental and physical exercise in the winter cannot be overstated – for senior and younger dogs.

Similar to humans, and as discussed a few months ago, dogs develop arthritis as they age. Sure, we give them medications and supplements to aid in comfort, but don’t forget that exercise is equally, if not more important. Walking keeps joints more nimble. When it is warm, be certain to go for routine walks and adjust your schedule some on cooler days so as to walk longer when it is warmest outside. All dogs need to be walked a minimum of three times daily to eliminate. If the walks are short due to the weather, you will need to increase exercise inside. Consider interactive tugging toys, mild games of fetch, training involving sitting and laying down, and other physically tiring activities.

Walks outside are mentally stimulating, so when indoors, find other ways to tire your dog’s brain. Consider playing a treasure hunt game where the dog is tasked with finding hidden treats or toys. Start simply by having your dog sit and stay and watch you hide a treat. When you are ready, release him to find the treat and once found, reward with a high-value treat. Once mastered you can up the difficulty by hiding things in different rooms, under different objects, around corners, in open boxes, etc. Be creative! This activity can last for hours. You can even play hide and seek with your dog, but the requires two people. Begin with both of you standing next to the dog, make him sit, and then one of you goes off and hides. Once hidden, have the other person release the pup to find you. What a wonderful prize – you!

A variation of the hunt game can involve cups with a treat placed under one cup. The challenge is for the dog to knock over the cup with the treat. This task is challenging for dogs, requires little space, and can act as a great bonding activity for both of you. Begin with two upside-down plastic cups. While the dog is watching, place a treat under one cup, wait a few seconds and then give a cue to get the treat. Perform this task 10-20 times until the dog becomes proficient. Then start alternating which cup hides the treat. If the dog chooses the incorrect cup, elevate the cup, show him the treat but do not let him have it. Replace the treat under the cup while he is watching and repeat. If mastered, place under a cup and then slide the cups to switch places. See if your dog can use all of his senses to find the treat. Remember, this is a difficult task – not all dogs can master the cup game.

Tired of picking up your dog’s toys? Teach them to place them back in the bin themselves. This game requires much patience and many sessions, but is worth the effort. Begin by teaching your dog to drop a toy, aka, “drop it.” Use traditional treats, praise, or clicker training techniques. This alone is a valuable task and is worth the investment of time. Once mastered bring out a bin and give the dog a toy, when he walks near the bin with the toy, give the command to drop-it. The closer to the bin, the better the reward. Reinforce the behavior with one toy once mastered. Eventually you can change “drop-it” to “put it away” and slowly add the number of toys to be placed in the bin. In time you can train the dog to run around the house to gather toys, awaiting a treat once they are all in the bin.

Well, it’s time to walk the dog again. You’ve been playing in the house for a few hours, but she needs to pee again. Be mindful of icy conditions – for both you and the dog. Avoid walking on heavily salted areas, if possible. Salt can become wedged between paw pads, causing discomfort. Simply clean between the paws with a paper towel, if needed. Any discomfort should resolve once the salt is removed. Don’t let your dog drink from puddles, especially when surfaces have been salted. The salt can irritate their stomachs. If your dog is happy to be outside in the cold, consider a snug-fitting dog jacket. Many varieties exist and they can help keep pup comfortable on those cold days.

May your winter be full of warm times with your dog. And as always, we are here for you.

Dan Teich, DVM
District Veterinary Hospital
(c) District Vet 2017


Thanksgiving Week Hours and Info

thanksgiving catHappy Thanksgiving to everyone. In celebration of November, Thanksgiving, and especially Family, District Vet will be closed Wednesday, Thursday, and Friday. Dr. Hassell and crew will be seeing appointments on the following Saturday and Dr. Walker will be back on Monday, with dt,dvm returning to appointments on Tuesday. In case of an emergency, please see this page.

Warmest wishes to you, your human family and your furry family (and spiny family, in the case of Pickles).

And see here for holiday treats and tips for your pets.

dt,dvm, Dani Walker, DVM, Brant Hassell, DVM, Beth, Laura, Amanda, Asiatu, I’Quita, Naomi, Kelly, Ellen, Nala, and Brian, The Dog.

Dogs News

Canine Arthritis Management

The most common source of chronic pain in dogs is arthritis, also known as degenerative joint disease. Arthritis develops with age in many dogs, but can also begin earlier in life in dogs with hip or elbow dysplasia or as the consequence of an injury. In a select few cases, surgery may be of benefit, but in most dogs, treatment involves attempts at preventing further joint damage, increasing mobility and decreasing pain. The best way to treat arthritis is via a multi-modal approach, combining several different therapies / medications to achieve a better result than one treatment alone. Your dog does not have to be in pain – we will discuss some of the options available below. As always prior to starting any therapies and treatments, have a good discussion with your veterinarian about the condition at hand.

Joint Supplements / Nutraceuticals

Omega three fatty acids, as found in cold water fish oils, are known to have anti-inflammatory properties and may reduce some joint inflammation. Regular fish oils may work well, but there are veterinary specific brands, which may have an even better effect. Many people use flax seed oil, but it is not as effective in dogs as the oil in flax seeds needs to be converted in the body to an omega 3 fatty acid – and humans are much more efficient at this process than dogs. Stick with fish oil.

Glucosamine and chondroitin sulfate

Cartilage is composed of a number of elements, including chondroitin sulfate and glucosamine metabolites. These compounds are the building blocks of cartilage and by supplementing the diet with them, you are assuring that your dog has these components available to repair damaged cartilage. Glucosamine and chondroitin sulfate are available in a number of oral chewable supplements, making administration very easy. Dogs have been found to absorb glucosamine better than humans, making it potentially more effective than in people. There may even be a subtle anti-inflammatory effect from them. We have seen some remarkable results with glucosamine supplementation, but there a few caveats: it takes several weeks to months to show an effect and quality of the product is essential. Most glucosamines on the market (especially human brands / generics) are of poor quality and are not absorbed well. The branded veterinary products are tested and found to be far superior. We are happy to chat with you about these brands and have Dasuquin Advanced in stock at all times.

Anti-oxidants and free radical scavengers

Free radicals are compounds that can damage cells and are thought to contribute to aging. They are formed in the body via natural processes and from external sources, such as pollution, sunlight, food contaminants, etc. In human medicine free radical scavenging molecules are being used to help slow aging and possibly aid in slowing arthritis. This is still a new field and we expect more research developments in free radical scavengers in the near future. Anti-oxidants include Vitamins C and E, S-adenyl Methionine (sAMe), and Superoxide Dismutase.


MSM, or methyl sulfonyl methane, is frequently combined with glucosamine chondroitin sulfate. It, too has anti-inflammatory properties. The compound contains a large amount of sulfur, an essential element in glycosaminoglycans, a main component of cartilage that enables cartilage to absorb water and stay soft. MSM provides another building block to help repair cartilage.

Adequan(R) – polysulfated glycosaminoglycans

All of the above supplements / nutritional additives are taken by mouth, but there is one that has proven very effective and is approved by the FDA for use in dogs, which is given via injection. Adequan(R), composed of glycosaminoglycans, has been shown to stimulate cartilage repair, inhibit destructive enzymes, and increase joint fluid. Giving Adequan(R) is not as scary as it sounds: many dogs tolerate injections very well and we can even show you how to give them at home. The biggest fear is conquering your own fear of injections – the dogs don’t care! Adequan(R) is highly recommended for most dogs with arthritis as its benefits can be tremendous and the side effects minimal.


With any medication it is important to follow your veterinarian’s directions carefully. Many medications are safe to administer, but have specific dosing amounts and are not safe to be combined with other medications. You should also never increase the dose or frequency of administration of medications without consultation with your veterinarian. In addition many of the arthritis medications are flavored and should be kept in a cabinet, far out of the reach of dogs and children. This is especially true of NSAIDs (discussed below).

Non-Steroidal Anti-Inflammatory Drugs (NSAIDS)

The most common medications used to treat chronic arthritis are non-steroidal anti-inflammatory drug (NSAIDs). These medications work by inhibiting the production of cyclooxygenase, an enzyme which stimulates cells to produce prostaglandins, a group of chemicals that cause inflammation. Prostaglandins contribute to pain, inflammation, further joint damage, and fever. The inflammation produced further damages the dog’s joints, leading to more discomfort. Prostaglandins are important for other bodily functions, including supporting platelets and blood clotting, stomach lining protection, blood flow to the kidneys, etc., therefore NSAIDs must be used carefully.

When used under the direction of a veterinarian, with routine monitoring, NSAIDs provide the most reliable and effective pain management for arthritis. Many dogs with severe pain will have remarkable responses to NSAIDs. The most common veterinary approved NSAIDs include Rimadyl (carprofen), Deramaxx (deracoxib), Previcox (firocoxib), and Metacam (meloxicam).

NSAIDs should be used with caution in any dog with kidney, liver, heart, endocrine, and intestinal disorders. Never give your dog another NSAID or corticosteroid unless specifically directed by your veterinarian. District Vet doctors most commonly use Rimadyl and have it in stock at all times.


While NSAIDs control inflammation and to a lesser degree pain, there are several medications commonly used to control pain itself. Remember, arthritis is painful and this is why dogs are lame when walking. Tramadol works directly upon pain pathways, making dogs more comfortable quickly. It may be used alone or in combination with NSAIDs as they have very different mechanisms of action. Tramadol works similar to morphine: it blocks opiod receptors in the brain, leading to less sensation of pain. The effects of the medication can last from 6-12 hours, depending upon the dog, but the medication is generally given twice daily. Use with caution in dogs with seizures and those on anti-depressants or other medications. The main side-effect we have seen with tramadol is mild sedation, but it can also cause constipation or insomnia.


Gabapentin has recently gained favor in the treatment of chronic arthritis in dogs. It works via mimicking the activity of GABA, a chemical in the brain which helps calm nerve activity. Traditionally gabapentin has been used to treat seizures, but at a different dose, it helps address chronic pain, too. The medication is considered quite safe to use, with the most common problems including sedation and wobbling when walking. Usually adjusting the dose takes care of these issues. Gabapentin may be used in combination with several other arthritis medications.
Other therapies aside from nutritional support and medications may also be employed to control arthritis pain and discomfort. Cold laser therapy (CLT) has been gaining in popularity and use over the past few years. CLT works via shining a beam of light at a certain frequency, which gently warms tissues, many times resulting in pain relief, decreased inflammation, increased blood flow, enhancement of immune cells to combat pathogens, and tissue regeneration. The therapy is given over a number of sessions, generally twice per week for a month, and does not require sedation or have any side effects. It is particularly useful post injury and may be combined with any other form of arthritis treatment. We have several strengths of gabapentin here in the office.


Although last in the article, rehabilitation therapy is integrative to many arthritis and post-injury protocols. As in humans rehab helps increase mobility, decrease pain, and helps strengthen muscles and bones. There are many modalities in rehab, from using an underwater treadmill (allows dogs to more freely use their legs with less pressure), to manual flexion / extension / massage of joints, to chiropractics and acupuncture. Rehabilitation therapies will require their own article in the near future.

Please remember that the above content is only for informational purposes. Never treat your pet without being under the direct supervision of your veterinarian. And as always you may feel free to contact one of us at District Vet if you have questions or concerns about your dog.

Cats News

Common Cat Myths

Common Cat Myths

Cats always land on their feet.
Not quite true. When cats fall or jump, they try to right themselves and land feet first, but sometimes the fall is from too low a height, limiting the time that a cat can right itself. Many cats that fall break bones in their legs and / or their jaw and can also injure their lungs. Be sure windows have good screens and are as cat-proof as possible. And then there are cats that are klutzes.

You should give your cat milk.

Please don’t do this. Cats cannot digest lactose, the main sugar in milk, which causes diarrhea in many felines. A lick or two every so often is generally not harmful, but larger or more frequent amounts can lead to problems.

Indoor cats cannot get rabies.
Almost any mammal is susceptible to the rabies virus. It is also uniformly fatal. An indoor cat should always be vaccinated against rabies as cats may escape (I once treated a cat that fell out of a 13th floor window), may come into contact with the number one carrier of rabies – bats (happens much more than you want to believe), and is mandated by law in most jurisdictions.

Cats are untrainable.
Definitely not true. The problem is that most people do not take the time to train a cat. I have seen cats be trained to use the human toilet, trained to sit, roll over, fetch and myriad other things. Training a cat can increase the bond between you and your cat. And it’s good for their mental well-being.

Most tapeworms can be caught from cat food.
The most common tapeworm in cats is not obtained from food, but from fleas. The common cat flea carries immature tapeworms. Cats, through regular grooming, eat the infected fleas, which then grow into adults in the cat. Cats can also get certain tapeworms from eating infected mice and other rodents. If your cat has fleas or goes outside, he or she should be treated for tapeworms at least once per year.

Indoor cats do not need to see the doctor.
The biggest myth of them all – and completely false. Indoor cats age like any other creature. They can develop many problems – from dental disease, to kidney problems, heart disease, obesity, diabetes, you name it. And many viruses are airborne, allowing indoor cats to get common cat illnesses. By having regular veterinary exams and vaccinations, your cat will have the best chance of living a long, healthy life. Cat hasn’t been to the vet in the past year? Schedule an appointment!

Pregnant women should not own a cat.
The concern is toxoplasmosis, a parasite of some cats. It is transmitted via stool and the easiest way to avoid any problems between pregnant women and cats is to avoid touching cat feces. The parasite also needs to sit in the stool for at least 24 hours before it becomes infective, so if the box is cleaned at least daily, the risk to anyone is minimal.

Cats can heal wounds by licking them.
In most cases cats licking a wound make things worse. Any cat with a wound that is more than a simple scratch should be seen by your veterinarian. Licking of wounds can lead to infections, which can be life-threatening.

You can save your drowned iPhone with cat litter.
True! Not a myth. Here’s the skinny: if your phone is dropped in water, there’s a good chance it is dead, but try shaking out as much water as possible, let it air dry for an hour or two and then place it in a bag of silica-based cat litter – aka crystal cat litter. Give it 48 hours – you may get lucky.

Dan Teich, DVM
(c) 2016

Cats Dogs News

Pet Insurance – There Are Benefits

As time has progressed, I have become a fan of pet health insurance. More clients are asking about the benefits and limitations of policies and we have seen a number of clients’ pets receive care that the client would otherwise have not have been to provide without an insurance plan. It is not a panacea for health care, and there are limitations, but understanding the available programs may assist you in keeping you dog or cat healthy for years to come.

Nearly every insurance plan works in a reimbursement basis: the client receives a bill for the veterinary services and pays the bill on a credit card or via another means. The client then processes the claim with the insurance company, which then reimburses the client either through a deposit into their checking account or via mailing the client a check. In special cases, the insurance company may be able to reimburse a veterinary hospital directly, but such an arrangement must be made with the veterinarian and the insurance company in advance.

What’s covered? it depends upon the insurance carrier selected and the plans that they offer. Most plans cover accidents and illnesses that occur after the insurance is purchased and several have wellness components. When evaluating the plans, check to see if pre-existing conditions are covered, whether there are breed / hereditary condition restrictions, and age of enrollment maximums. Then assess if there are waiting periods. Several plans have a two week waiting period before coverage is effective, and most have a restriction on coverage for hip dysplasia or knee problems. Remember, this is insurance and the companies want you to enroll before there are problems.

There may be a maximum age in which you can enroll your pet. If over this age, they may not write a new policy, but if your pet was enrolled before said age, your pet may have the policy renewed for life. This helps keep the pool of healthier pets larger, pushing down overall costs of the insurance plans.

Reimbursement for accidents / illnesses will generally include the exam fee, necessary bloodwork, X-rays, medications, necessary treatments, hospitalization, and surgery. Many plans even include rehabilitation services and alternative medicine modalities, such as acupuncture, laser treatment, and others.

One must navigate pre-existing conditions carefully. Read your pet’s full medical chart carefully for any prior findings of abnormalities. If your pet has had a knee problem in the past or has had skin disease or upper respiratory infections, you may not be reimbursed for like problems in the future. Some companies will review your pet’s medical records in advance for you and detail any problems with coverage at no cost to you. I highly recommend such a service, especially if your pet is older or has had issues in the past.

Most plans have an annual deductible and possibly an annual or lifetime limit that is paid by the insurer. Ask what the deductibles are and if there is a per-incident or per-disease / condition deducible or reimbursement. It is usually best to avoid per-incident deductibles as these can limit the amount paid out to you, even if you meet your standard deductible. For example, the company may only pay $2000 for a condition, but the actual bill was $3000. You are left paying the difference. It is also important to be certain that, so long as you keep the policy in good standing, chronic conditions that develop while insured will continue to be covered every year.

Several companies offer wellness endorsements to their policies. There are detractors to wellness plans, but if you know how to navigate them, you can save yourself a few dollars. They pay up to a certain amount for routine vaccinations, heartworm testing, preventives and dental procedures. Wellness plans work similar to a health savings plan – you put money in and the payout when used is larger than that put in, usually by 20%.

Differences exist between plans – some are comprehensive and cover everything, others only illness. Although we don’t endorse a specific company or plan, we are happy to chat with you about insurance and you pet. Please research what plan is best for you and your friend and feel free to ask us anytime for help.

dt,dvm – (C) 2016