You know the dangers of smoking, chewing tobacco and dipping snuff.

Clean, smoke-free air improves your cat's chances of living longer, living cancer-free.

Did you know that tobacco is dangerous for your pet, too?

The damage that second-hand smoke does to both pets and people is well-documented. Cats subjected to second-hand cigarette smoke are more than twice as likely to develop a cancer of the white blood cells, lymphoma, than similar cats who live in smoke-free environments. Once thought to be exclusively caused by Feline Leukemia Virus, we now know that a significant percentage of these cats have cancer that could have been easily prevented by avoiding cigarette smoke.

When exposure increases to a pack or more of cigarettes per day, the risk of feline lymphoma rises to three times the risk of smoke-free cats.

Further, it is known that children may become exposed to particulate tobacco smoke contaminants by mouthing objects on which the particles have settled. Likewise, cats grooming themselves may ingest these particles, in addition to the ones they inhale.

There is strong evidence in people that cigarette smoke, primary or secondary, is associated with both Hodgkin and non-Hodgkin lymphoma.

In addition, feline oral cancers (squamous cell carcinoma) are seen at a higher rate in smoking households, along with increased incidence of lung and nasal cancers in dogs and birds. Interestingly, oligocephalic dogs, those with long noses such as Collies, are more likely to develop nasal tumors than brachycephalic (short-nosed) dogs such as Boston Terriers. A longer nose equates to more filtering surface area, thus carcinogens are more likely to lodge in the noses of Collies. Brachycephalic breeds in a smoky environment have a greater incidence of lung cancer because particulate matter flows all the way to the lung parenchyma.

For help in quitting smoking, click here to access the American Cancer Society.

See you next week, Dr. Randolph.

credit:  some information obtained from:  Oklahoma State University (2007, August 31). Secondhand Smoke Is A Health Threat To Pets. ScienceDaily.

Diamond Pet Foodis again in the news.

Catherine enjoys healthy and safe Hill's Healthy Advantage Puppy Food.

And that’s not a good thing.

Just before Christmas, 2005, Diamond Pet Food had to recall many of the brands it manufactures at its Gaston, South Carolina, plant because of contamination with aflatoxins.

Aflatoxins are poisons produced by certain molds and most commonly occur when grains are allowed to become warm and wet, producing good conditions for mold growth. Graingrown under stressful conditions, such as drought, are more likely to generate significant mold growth, which may or may not lead to aflatoxin production.  When incorporated in foods the mold carries the toxin with it.

Aflatoxin occurs naturally when Aspergillus flavus and Aspergillus parasiticus grow. Both fungi are widespread in nature, with Aspergillus flavus being the more common. At least 13 mycotoxins can be produced by these fungi, with aflatoxin B1 being the most toxic.

While the USDA checks for aflatoxins in samples of products, the testing is far from comprehensive, although several laws and many federal regulations specify the amount of testing to be performed.

At least 17 pet deaths and many more pet illnesses occurred as a result of the contamination. Diamond cooperated fully with government investigators and recalled five cat products and fourteen dog products.

Symptoms of aflatoxin toxicity are mainly related to the liver: jaundice (yellowing of the skin and whites of the eyes) and bleeding disorders, often accompanied by loss of appetite, vomiting and discolored urine.

The current pet food recall, however, is not aflatoxin-related, but results from a Salmonella contamination. Once again it is the Gaston, S.C. plant in the spotlight.

One major difference, however, is that people are becoming ill from handling pet food.

“Diamond Naturals Lamb and Rice Formula”, “Chicken Soup For The Pet Lover’s Soul Adult Light Formula” and “Diamond Puppy Formula.” In addition, Diamond produces pet foods for other labels and some of those brands are also affected. A complete list of affected foods may be accessed by clicking here.

Humans affected by salmonella may experience fever, chills, nausea, vomiting, diarrhea and cramps. Of course, those immunosuppressed by chemotherapy, organ transplant anti-rejection drugs and HIV are at the greatest risk.

Pets may display similar symptoms, or none at all.

Salmonella carrier state occurs in both pets and people. In this condition, outward signs may not appear, yet the individual can still spread salmonella bacteria.

See you next week, Dr. Randolph.

Uroretrohydropropulsion.

Any male dog can have urinary tract obstruction with stones.

Now, that’s a mouthful, even for someone who works with medical terms every day. Let’s break it down.

“Uro” refers to the urinary tract. “Retro” refers to something going backward. “Hydro” means water or another liquid will be used in the process. “Propulsion” refers to the movement of an object.

Uroretrohydropropulsion is a technique sometimes used in male dogs to relieve a blockage of the lower urinary tract caused by stones. The medical term for stones is calculi. The singular is calculus.

Dogs and cats usually form their stones in the urinary bladder, whereas people tend to form stones in their kidneys.

Male dogs have a bone in the penis called os penis or baculum. The os penis surrounds 80% of the circumference of the urethra, is two to three inches long, and sits at the end of the penis. From the bladder to the os penis, the urethra can expand dramatically to allow large volumes of urine and even large stones to pass. However, when calculi reach the portion of the urethra inside the bone, the urethra cannot expand, thus causing even small stones to become lodged.

If stones are of sufficient size, shape and number they can create a “logjam” effect, even stopping the flow of urine. That is a surgical emergency which, if not addressed quickly, can result in urinary bladder rupture.

Unlike female dogs, whose small stones can sometimes be removed by voiding urohydropropulsion, male dogs must have their stones removed surgically or by dissolution with diet.

The os penis bone in a dog's penis assists in reproduction. Credit Miller, Christenson and Evans, Anatomy of the dog.

When surgery is indicated it is preferable to remove the stones from the urinary bladder and not have to cut into the urethra. The urethra can be unforgiving after surgery. Scar tissue can form and restrict urine flow. Sutures in the urethra may fail, resulting in urine leakage under the skin as well as additional anesthesia and surgical time.

Thus, uroretrohydropropulsion was invented as a method of moving lodged stones back into the bladder, where they can be removed surgically with less risk of complications.

The procedure begins with catheterization of the urethra, passing the catheter only as far as the proximal (upstream) portion of the os penis. A large volume of balanced saline solution is injected into the catheter. Finger pressure is applied at the distal portion of the penis, thus preventing the solution from escaping and keeping flow in the proper direction. The goal is for the fluid to carry the stones back up the urethra, redepositing them in the bladder.

Multiple attempts may be required, and X-ray or ultrasound can be used to determine whether all of the stones have exited the urethra.

Uroretrohydropropulsionis not always successful. Some stones are too large to move and some may become embedded in the mucosa (lining) of the urethra. In such a case the surgeon has no choice but to make an incision into the penile urethra to remove the stones.

All stones will be chemically analyzed so that preventive measures can be taken to prevent future stones.

See you next week, Dr. Randolph.

Carol writes, “My daughter is taking her cat by car from New York City to Florida. What does she need to know to make this a smooth trip? Might a sedative be appropriate?”

Cat Travel can be safe and easy, it just requires some advance planning.

Great questions, Carol, and ones that are frequently asked.

You hit on an important point. Sedatives are indicated for any pet who exhibits anxiety during travel. 
Cat sedatives, like dog sedatives and people sedatives are prescription medications, so your daughter can get that from her veterinarian, or, if the kitty isn’t current with a doctor, an appointment can be made for an examination to be sure he’s healthy enough for the medicine, as well as the travel.

While there, he should be updated on a test for Feline Leukemia Virus (FeLV), and
Feline Immunodeficiency Virus (FIV) .

If those two results are negative he can have updated vaccines. It’s best to do this well before the trip so that full protection is achieved prior to departure. If these are his first vaccinations, boosters are needed. On the first visit he should also have a fecal flotation to test for intestinal parasites.

I have written a few pieces on my blog about travel. Here are the links: Pet Travel Safety Part 1 , Pet Travel Safety Part 2  , Pets Must Not Ride In Drivers’ Laps , Keeping Pet Travel Safe And Healthy .

Your daughter will want to be sure the kitty is in a secure cage or carrier and the cage should be firmly attached to the inside of the car with a seat belt and/or rope. Its door should be secured with easy-release wire ties to ensure its integrity in case of a crash while still making the door easy to open in case of emergency.

Acclimating him to car rides by taking short, then longer and longer rides prior to the trip will help make the trip easier, too. Start the trip on an empty stomach and feed him when she stops for the night. Water should be available at all times.

I think that will solve all of the problems!

See you next week, Dr. Randolph.

After searching all over for a new poodle puppy, we found Willie just miles from where our children live in Kentucky!

I’ve seen it again and again.

A new puppy comes in for its first examination, and it’s a train wreck.  A “train wreck” is defined as a patient with so many problems the doctor doesn’t know where to start.

Usually there are warning signs a potential new owner should have seen, but sometimes love clouds our vision.

One of the biggest red flags is hearing, “My house is hard to find. I’ll just meet you on the highway.” Such a breeder doesn’t want you to see the other train-wreck puppies, the train-wreck sire and dam, or the train-wreck facility he runs.

Flea markets are often a source of some of the sickest puppies I’ve seen in 32 years of practice. Like the above example, the “breeder” doesn’t want you to see what conditions are like at home. He can clean up a wire cage or two, shampoo a dozen puppies and hit the road easier than he can rehabilitate his entire venture.

Suppose you do get invited “home,” here are some danger signs:

• dirt.
• odor (we’re talking stench here, not just failure to clean up a recent accident).
• multiple breeds. The most reputable breeders focus on one or two breeds, three at the most.
• a good, healthy puppy will be well-adjusted, not fearful of strangers, ready to play.
• thin, sickly-looking puppies.
• no medical records. By the time a puppy is old enough to show to potential buyers, they should have had at least two visits to a veterinarian. If the person you’re considering doing business with is a do-it-yourselfer, run the other way.
• large-breed puppies whose parents are not certified free from hip dysplasia.
• no warranty. You should be allowed at least one business day to have a new puppy examined by your veterinarian, with the right to return the puppy if any serious problems are found. Warning: You need to plan in advance to stick with this plan before you fall in love with a new pup.
  Click here to read a horror story from a warranty examination.

There are some wonderful breeders who do everything in their power to improve the breeds they are involved in. It may require some work, but you can find a good, clean facility run by responsible breeders such as Cathy, 
where our Willie came from.

And, of course, always try to make a shelter pet your first choice.

See you next week, Dr. Randolph.

There is no known breed predisposition with vestibular syndrome.

Vestibular syndrome is a common occurrence in dogs and catsand can be terrifying for pet owners.

Many pet owners believe their dog or cat has suffered a stroke.  Stroke is  actually a less-common cause of vestibular disease in pets.

The vestibular system is the major sensory system that participates in the maintenance of balance. It has both central (brain and spinal cord) and peripheral (trunk and limb) components.

Peripheral lesions can include receptors (structures receiving nerve input) or ganglia in the inner ear or cranial nerve VIII, the Auditory Nerve.

Central lesions are located in the brain (medulla or vestibulocerebellar components).

Vestibular syndrome with a peripheral cause is usually easier to diagnose and carries a better prognosis than central lesions. Accurate diagnosis of central lesions may require advanced equipment, such as magnetic resonance imaging (MRI).

Three characteristics are common to both peripherally- and centrally-affected vestibular syndrome patients:

• Head tilt, which is usually toward the affected side.
• Ataxia (falling, rolling and circling), again usually in the direction of the affected side. Circling is often “tight” (small circles).
• Pathologic nystagmus and positional strabismus. Pathologic nystagmus is abnormal movement of the eye(s) that can occur side-to-side, up-and-down or rotatory (oscillating in an arc on the central axis of the eye). Positional strabismus is evidenced as a stationary movement of the eye to an abnormal angle when the head is moved.

Patients with peripheral vestibular disease may stagger, but they are not weak. They are aware of their position and surroundings, even though their reactions and responses may be abnormal. Horner’s syndrome, causing sagging in the face, can sometimes be seen because of effects on the facial nerve.

Patients with central vestibular disease will have head tilt, altered consciousness, paralysis in two or four legs, multiple cranial nerve deficits and be unaware of where their feet are (proprioception deficits). They may be weak and unable to stand.

Exceptions to the above “rules” also exist. Paradoxical vestibular disease is a central form of the syndrome that doesn’t fit the expected pattern.

Bilateral vestibular lesions, although causing abnormal gait and behavior, tend to balance each other out, resulting in a patient with little disturbance of equilibrium, but taking a low, crouching stance with feet spread wide apart. The head may sway back and forth. Bilateral vestibular disease occurs more commonly in cats.

Causes of peripheral vestibular syndrome include inflammation of the middle and inner ear, idiopathic, low thyroid function, toxic or cancerous.

Central vestibular disease can be a medical emergency, because its causes are often related to encephalitis, stroke or cancer inside the skull. Patients not quickly and correctly diagnosed and treated will often suffer irreversible brain damage. A notable exception is toxicity from metronidazole overdose, which carries a good prognosis and rapid resolution with medication.

See you next week, Dr. Randolph.

Our thanks to Dr. John Rossmeisl, Professor of Small Animal Internal Medicine and Neurology at the Virginia-Maryland Regional College of Veterinary Medicine, who presented this topic at a recent Louisiana Academy of Veterinary Practice meeting.

Voiding urohydropropulsion.

Sophie had successful urohydropropulsion this week, removing many small stones.

Wow! That’s a mouthful!

Let’s break it down: “Uro” is a Latin prefix referring to the urinary tract. “Hydro” refers to water, or, more broadly, any liquid. “Propulsion,” from the Latin propellere, meaning “to propel,” “the act of driving forward.”

Voiding urohydropropulsion, then, is the act of using a liquid to expel something from the urinary tract. More specifically, we are using a physiologic solution in the bladder to remove urinary bladder and urethral stones. This technique cannot help stones that are in the kidney(s) and/or ureters.  However, unlike people, dogs and cats form more stones in their bladders than in their kidneys.

The technique was developed by Dr. Jody Lulich at the University of Minnesota Urolith Center.

The steps are fairly straightforward. It can be practiced in the wide-awake, sedated or fully anesthetized patient. First, aseptically (using a sterile technique), introduce a urinary catheter. Second, instill physiologic saline or lactated Ringer’s solution into the bladder to distend it. Care must be taken not to overdistend and rupture the bladder. Third, place a finger onto the urethra to prohibit flow while removing the catheter. Fourth, orient the patient with the spine vertical (standing up like a human) and have an assistant squeeze the bladder, after which the finger inhibiting flow is removed. The result should be a rush of urine and solution from the bladder, the goal of which is to carry urinary bladder stones in the flow.

Of course, the size of stones that can pass is proportional to the size of the patient’s urethra, which is roughly proportional to the overall body size.  While the procedure can theoretically be used in female cats, it’s going to work on only on the largest queens with the smallest stones. Male cats’ urethras are much to small for VU to be practical.

A pet with a really large cystic calculus (bladder stone) is going to need cystotomy: opening the abdomen, incising the urinary bladder and removing the stone that way.

One of the giant advantages of voiding urohydropropulsion is the fact that tiny granules of stone material that might be missed or overlooked in an open surgical technique are more likely to be flushed out.

The procedure can be repeated as many times as necessary, although the practitioner must take into account that inflammation of the urethra and bladder lining occur with each passage of the catheter.

Still, it is much less invasive and less irritating than cystotomy.

We used the technique successfully on little Sophie (pictured above) this week. Observe the many stones visible on the preoperative radiograph (X-ray),

Sophie's pretreatment radiograph. Notice the many stones.

and the total absence of stones on the post-treatment film.

No stones can be seen after the procedure.

The stones have been sent to the University of Minnesota Urolith Center, where quantitative analysis will tell us whether Sophie has a recurrence of calcium oxalate calculi.

See you next week, Dr. Randolph.

Microchip use in dogs and cats is now widespread and growing every day.

An AVID microchip is easily inserted into any size pet.

It is our opinion at MyPetsDoctor.com that every dog and cat have a microchip, simply because we never know when that escape, natural disaster or man-made accident is going to result in our separation from them. Even people who say, “But my dog (or cat) never leaves my side” have experienced loss.

Ask the thousands of people who became separated from their pets in Hurricane Katrina.

Or people who have had their pets escape in automobile accidents.

MRI: Magnetic Resonance Imaging. It's not just for people anymore.

Now, new information is available about the durability of microchips, specifically their resistance to adverse effects during MRI (Magnetic Resonance Imaging). Just ten years ago MRI for pets was available only at teaching hospitals. Since then, MRI is becoming more and more accessible. Many referral centers now perform MRIs for many ailments.

With that in mind, a team at the College of Veterinary Medicine, Knoxville, TN, tested 53 patients with a variety of chip brands and numerous during MRI of multiple body parts. Chip numbers were scanned and recorded for each patient before and after MRI.

In every case, every chip responded appropriately.

Therefore, if your pet is in need of imaging using MR, one concern you will not have is damaging effect on his microchip.

See you next week, Dr. Randolph.

Veterinary techniciansare a very devoted group.

Sit 'n Stay Pet Cafe appears Thursdays in Winter Park, FL.

It is not unusual for them to work all day at a veterinary hospital, then spend more of their day volunteering to help animals.

Or, as in the case of Lauren Hicks, incorporating animal care into a second job.

Lauren’s dog has allergies, and rather than purchase hypoallergenic treats, she began to cook her own. That lead to joining with her sister to purchase a food truck and join a group in a food truck pod. Lauren was already a food blogger, so her finger was on the pulse of many foodies. She and her sister purchased a retired mail truck that was being used as an ice cream truck, and began the conversion.

However, putting gas and food into the truck and driving to the food truck pod was not Hicks’ next move. Rather, she contacted her sister and they formulated a business plan. Part of that plan was for sister Kathy Trimble to handle the accounting, as well as to prepare for marketing the new venture.

In 2011, $50.96 billion was spent on pets. It only makes sense that food is a big part of that figure. Since many visitors to food truck pods take their pets along, it only made sense to fill the void so that pets could eat while their owners were dining.

Lauren offers such delicacies as:

• Poochi Sushi: jerky twists wrapped in flour, coated with honey and rolled in sesame seeds
• Ruff-Ins: carrot-apple muffins
• Mutt-balls: meatballs made from locally-grown grass-fed beef and lamb, that are eight for $6
• Pup-sicles: ice cream bars
• Grrr-avy: in jars
• Mutt-worsts: sausages in potato pancakes

See you next week, Dr. Randolph.

Our thanks to Joseph Freeman of the Orlando Sentinel, and News Of The Weird for the foundation of this story.

Patients with certain cancers treated with Avastin (bevacizumab) know that their cancer is serious. They may not necessarily be expecting a cure, but they are certainly hoping for improvement, at least in the form of tumor shrinkage.

Your local veterinarian is someone you can trust. Obtaining your pets' medications from him is safe.

They hope the treatment will buy some time.

They also know the medicine is expensive, costing doctors approximately $2000.00 for a 400 mg. vial. Add to that the cost of administration, monitoring and treatment of side effects, the cost is substantial.

So, it’s hard to blame doctors when they were offered a source for the drug at a 25% discount, which they could pass on to their strapped and suffering patients.

Except that the bargain turned out to be no bargain at all, because there was no bevacizumab in the vials.

And, before you think this is a terrorist plot hatched in some Middle East country, think again. The mailing address for the supplier is in Belgrade, Montana.

USA.

Avastin is not used in animals, but there is still a lesson for pet owners in this story.

Be careful of the source of your pets’ medications.

Online pharmacies have sprung up all over the globe. The track record of Australian “pharmacies” is abominable. Some of the domestic online and catalogue pharmacies don’t do too well, either.

Obtaining heartworm preventive and other medications from your veterinarian may cost you more, mostly because his volume is minuscule, but the risk of getting “fake” or “no” medication from him is very small, too. Most of us purchase our heartworm preventives directly from manufacturers such as Pfizer Animal Health (Revolution), (see a fake Revolution box by clicking here) Elanco (Trifexis), Novartis Animal Health (Interceptor and Sentinel) and Merial (Heartgard).

Some medications are obtained through “distributors,” but even in those cases our practice utilizes huge companies such as Butler Schein Animal Health.

These deadly tricksters are motivated only by greed.

They don’t care who dies.

And, if they don’t care about your wife, child or grandmother, they sure won’t hesitate to allow your dog or cat to die from heartworms or some equally horrible disease.

See you next week, Dr. Randolph.