The saddest part about Lucy’s story is we could tell no one cared about her before her arrival at M & J’s house.

No one cared enough to have her spayed.

No one cared enough to give her heartworm preventive.

No one cared enough to take her to a doctor and find out that she had hookworms and whipworms and get her appropriate treatment for those.

Lucy appeared to be a hunting dog, so we assume that she simply outlived her usefulness as a hunter and had to be disposed of. Or, maybe she no longer had the energy to hunt well because of heartworms, hookworms, whipworms and repeated pregnancies.

No one cared enough to take her to a pet doctor and have her humanely euthanized. Or even mercifully put a bullet in her head. No one even cared that much.

Maybe they thought it was caring to drop her off in an upscale neighborhood. Fat lot of good that did, as they left her on one of the busiest thoroughfares on the Mississippi Gulf Coast, and she got hit by a car before M & J could rescue her.

Sadly, her injuries were too severe to save her, and Lucy finally got the merciful relief she needed.

We can only hope that now, as she rests in peace, she has pleasant dreams of younger, happier, healthier times.

Please, if you can no longer care for your pet, take her to a humane shelter or animal adoption agency. Statistics show that over 90% of dumped pets die. Of starvation. And a substantial portion of the remaining 10% suffer injuries from automobiles, most of which prove to be fatal.

Dumping is simply not the answer.

Surrendering unwanted pets to pet adoption agencies is the answer.

A young girl and her mother brought me a puppy they had traveled across two states to purchase. The puppy had an entire list of birth defects none of which would allow him to live more than a few months without major surgeries. Yes, that’s surgeries, plural.

How do these things happen? There is fault to be found on both sides.

First, let’s talk about the things you can control.

When shopping for a puppy or kitten, I’d like for you to make your first consideration where the pet will come from. Keep in mind that when adopting from a humane shelter that you are saving the life of a pet who, if not adopted, will be euthanized, along with about six million animals nationwide this year. Granted, you aren’t likely to get a purebred pet at a shelter, but you can’t begin to put a value on the good feeling you will get. And, purebred pets tend to have more medical and maintenance problems than mixed-breed pets.

If you’re set on a purebreed, consider the many breed-specific rescue organizations across the country. Most of these can be accessed through the Internet, and most are reputable. One downside is that some of these rescued animals have been in abusive circumstances, and may have developmental or behavioral problems.

Suppose you’ve made the decision to purchase a pet from a local or nearby breeder. How do you tell if the breeder is reputable, and what demands do you have the right to make?

As to the latter question, it’s your money, and your 15 years of taking care of this new pet, so you make any demands that make you feel good about your purchase. However, the breeder doesn’t have to agree to all of your demands. Any breeder who rejects reasonable demands should be taken out of consideration.

While I don’t wish to take the romance out of the purchase of a pet, there are some practical considerations:

• is the facility clean, good-smelling and not overcrowded? Are all of the pets on the premises housed comfortably? If not, move on to the next facility on your list.
• don’t take your children with you on the first trip. The first trip is for you to pick a few good candidates. If you see puppies or kittens who are obviously unhealthy or malformed, this is the time to reject those. After you find a clean source for healthy pets, the children can accompany you on the second trip, and they can pick their favorite from a collection of a few healthy pets you’ve pre-chosen.
• insist to the breeder that you may have a full money-back guarantee if your pet’s doctor finds serious disease or defect within 24 hours. As an alternative, the breeder may be asked to pay for the diagnosis and treatment of health issues that are easily healed. And, ensure that you get this examination on schedule. If you put it off you may be so attached to the pet that regardless of what defects are found you are emotionally unable to extract the new pet from your heart. Though I’ve seen this happen countless times, without a doubt the saddest case was a tiny Cocker Spaniel puppy who had been with the new owners for less than 12 hours. Not far into the initial examination we discovered a congenital heart murmur. Though the defect is surgically repairable, it calls for a very expensive surgery. These owners were far too attached to even consider taking the puppy back. Fortunately, surgery was successful and the little guy lived a long and happy life.
• take a quick look over the new pet for yourself. If you see fleas (which you don’t want to take home with you), call your pet’s doctor about what to do. In fact, making an appointment for that first examination before even going home with the new pet is a great idea. In the case of the sad little puppy in the first parzgraph, he was infested with intestinal parasites that could have infected the child and the child’s mother. That’s a danger she wasn’t willing to risk.
• if your new puppy is a pure breed that has the potential to have an adult weight of 50 pounds or more, insist that you see certification from the Orthopaedic Foundation for Animals (OFA) that both parents are free from hip dysplasia. German Shepherds are the classic breed to be afflicted with this genetically-transmitted cause of arthritis. However, many other breeds such as Labrador Retrievers, Collies, Chow-Chows and Great Danes also can be affected. Having OFA certification that the parents have not passed on this trait is your only assurance of minimizing the risk of crippling joint problems later in life.

Your specific situation may call for other, unique requirements. Feel free to ask your pet’s doctor for advice before committing yourself to a new pet. He is trained and experienced to help you with this important family decision.

“Yes, ma’am, we can see you at 2:50 this afternoon and get Sprint all safe for the trip.”

Sprint arrived with some history. It turns out that he has had an abscess in this same place on his face before.

And, he has Cushing’s disease.

As you know, or just read, Cushing’s disease results in high levels of cortisol, a naturally-produced corticosteroid that comes from the adrenal gland. High levels of cortisol can suppress the immune system and result in wounds and infections that won’t heal.

Enter Sprint, whose Cushing’s disease is not yet fully regulated, having only recently been diagnosed back home in Iowa. The swelling he has today is in the same location as a previous lesion, indicating a strong likelihood that this is an unresolved, recurrent problem.

After thorough examination we discovered that Sport has moderate dental calculus, but that’s not exactly the source of today’s problem.

Sprint’s problem is, in fact, dental, but not visible from the outside. He has an infection of one of the roots of the right carnassial tooth, the fourth upper premolar. You can most easily recognize it as a big, obvious crushing tooth.

A three-rooted tooth, the carnassial possesses one root that terminates just under the facial bone, immediately in front of the eye. Pet owners commonly think that draining wounds in this area have been caused by the bite of another animal. Infection of the tooth root is a fairly common problem.

Treatment can be conservative or aggressive.

Conservative therapy includes dental scaling and polishing to remove dental calculus, which may harbor bacteria that are in the source for infection, along with long-term antibiotic therapy of at least four weeks duration. Six to eight week durations of antibiotic therapy are sometimes needed.

Even with extended antimicrobials pockets of infection often persist, necessitating more aggressive treatment.

Aggressive treatment usually translates to surgical extraction of the tooth. Having three roots, the tooth must be sectioned, dividing each crown and root from the others. Each portion is then removed individually and the resulting defect is sutured closed. Post-operative pain medication will be dispensed so that your pet will not be uncomfortable. He will soon be eating normally, even on the affected side, though hard food will have to be crushed on the opposite side.

If the tooth is to be saved, referral to a board-certified veterinary dentist can be scheduled for a root canal procedure.

We elected to treat Sprint with a Convenia injection, and made plans for him to have two more Convenia injections at two-week intervals after he gets home. These injections will be performed in conjunction with dental prophylaxis.

Sprint’s mom and I had an interesting conversation after we finished with his medical care. She said, “I can’t get over the devastation from Hurricane Katrina. According to the news reports we got, we didn’t even know the storm hit here. All we heard about was New Orleans this and New Orleans that.”

“Sadly, we were ignored by the press to a great extent. In fact, the eye of the storm went immediately west of our home. Another reason you didn’t hear much about us, though, is the nature of Mississippians. As Governor Barbour put it, ‘Our people hitched up their britches and went to work.’ We had tremendous help from church groups all over the country. We will never be able to thank people enough for all they did for us.

“Some people fretted over the lack of publicity, but many of us took the Conestoga wagon approach.”

Sport’s mom cast a questioning look at me.

“When people were crossing the plains in Conestoga wagons in the 1800s, if an axle broke, they didn’t wait for the government to come fix it for them, Pa just said to Ma, ‘Hon, when I pick up the wagon, you slide the wheel on.’ And she did. And they went on across the prairie. People took responsibility for their own welfare, and that’s what we did.

“August, 2010, will be our five-year point after Katrina. We’re very proud of how far we’ve come, but, thanks to the weak economy and the outrageous cost of insurance, many homes and businesses have not been rebuilt, and some never will be. Nagasaki wasn’t rebuilt in five years, and no one should be surprised that we aren’t.”

Sprint’s mom glowed. “We love it here, and we hope our bid is accepted on the house we like so that we can spend half of our year here.”

“Have a safe trip Saturday,” Stephanie and I said as Sprint and mom exited.

See you tomorrow, Dr. Randolph.

Oscar, the cat with special abilities.

Oscar is a cat who lives at the Steere House Nursing and Rehabilitation Center in Providence, RI. Oscar would be rather ordinary if not for his uncanny ability. He is a beautiful cat with a medium-length grey tabby coat and a long, bushy tail. He first came to live at Steere House when the staff adopted him because they feel pets make the Center more homey.

Oscar’s ability? Though he is usually aloof, he sometimes seeks out the rooms of certain patients. When he does, he curls up on the bed of one of the room’s occupants and stays with them until they expire. He arrives near their “final hours.” What makes him choose those patients? No one knows.

Dr. David Dosa is fascinated by Oscar. At first he was skeptical, but when he and his colleagues recorded fifty episodes of Oscar picking soon-to-be-deceased patients, their doubts vanished.

Now Dr. Dosa has written a book about Oscar and his ability: Making Rounds with Oscar: The Extraordinary Gift of an Ordinary Cat. Both the staff and families of patients find Oscar to be a great comfort, and he is frequently mentioned in obituaries.

As someone who teaches a Sunday School class in a nursing center, I can really relate to the importance of the comforting presence a pet brings to the residence. When a pet comes to visit, it matters not whom the owner is, for a time that pet belongs to everyone who sees him.

Losing residents becomes a part of nursing home work one must adjust to when one has been called to such a ministry. I can certainly see how an Oscar could bring tremendous comfort to the bereaved.

Our thanks to Ray Henry of the Associated Press and Stew Milne for the photograph of Oscar.

See you tomorrow, Dr. Randolph.

Could there be any better words for a veterinarian to hear about one of his patients?

Trouble, who is pictured below, and really is no trouble at all, has arthritis. It was June, 2009, when we first discovered pain and weakness secondary to arthritis. She was 12 years of age then and, as you can see, is a pretty large dog, so her human-age-equivalence was about 64.

Trouble, and her owner, are happy now that she is 80% free of arthritis pain.

As is routine, and recommended by the pharmaceutical companies that produce all canine antiinflammatory medications, we performed routine screening tests (CBC, Chemistry Profile and Urinalysis) prior to beginning Rimadyl for her. That way if there are subclinical metabolic problems, especially with the liver and/or kidneys, we can discover them prior to possible complications from non-steroidal antiinflammatories (NSAIDs).

Rimadyl and Metacam are our preferred NSAIDs, though there are other good ones. The job of an NSAID is to reduce the signs of inflammation, mainly pain, swelling, heat and loss of function. In doing so the canine arthritis patient obtains nearly-immediate pain relief.  Improvement of joint function allows him to perform in ways he hasn’t since he was young, before he was arthritic.

However, it is important to remember that NSAIDs don’t fix an arthritic joint, they only make it feel better. For the joint components to actually heal, they need healing ingredients.

Enter Dasuquin, an agent from the Cosequin people, Nutramax Laboratories, which contains glucosamine, chondroitin, and a host of other ingredients that work together to help a rough, arthritic joint become smoother. Now, please keep in mind that even Dasuquin cannot transform a 60-grit sandpaper joint into smooth-as-baby’s-skin again, but it can help to reduce the level of roughness.

In addition, Dasuquin can improve joint mobility by increasing lubrication of joints. More joint fluid of a high quality will provide for more stamina, more comfort, and greater range of motion when compared to a dry or under-lubricated joint.

While there are many, many sources for glucosamine, it is important to recognize that Nutramax Laboratories is the only company that submits its products for independent testing to verify that both the quantity and the quality of ingredients is as stated. In government testing some products claiming to be glucosamine showed to have less than stated amounts, all the way down to zero percent glucosamine.

For Trouble, a thirteen-year old dog, to be 80% better than before treatment is extremely gratifying for her owner, for us as caregivers, and, not the least, for Trouble.

See you tomorrow, Dr. Randolph.

Just as with dogs, cats get heartworms from mosquitoes, which act as an intermediate host of the parasite.

Many people are under the misconception that their cats can’t get heartworms because they never go outside. Actually, researchers have discovered that heartworms occur at about the same rate in indoor cats as outdoor cats. The reason is that the mosquito that transmits heartworms best likes the indoor environment. Therefore, indoor cats are getting “curb service” for their heartworm infestations.

Once a cat becomes a host for Dirofilaria immitis, the scientific name for heartworms, a cascade of events is begun. These are cardiopulmonary events, meaning both the heart and lungs are involved.

As you read, keep in mind that average cat heartworm infestation is one to three adult worms. Cats typically don’t have the massive heartworm burdens dogs do.

Here is what happens on the “cardio,” or heart side. As with dogs, the young adult heartworms try to make their way to the right ventricle of the heart, but are pushed into the pulmonary arteries by the high volume of “used” blood that is sent to the lungs. Instantly the cat’s body recognizes these intruders as foreign, and begins to react to them. The immune system is put on alert, producing both cells and protein complexes in an attempt to eradicate the parasite. The physical pounding of the worm against the wall of the artery causes it to react to protect itself: the artery wall swells, thickens, becomes scarred and becomes infiltrated by some of the products the immune system has made, all attempts at self-preservation. Radiographs and ultrasounds will show pulmonary artery thickening.

On the “pulmonary,” or lung side, the breathing system is not happy, either. Fluid immediately pours into the alveoli, tiny sacs in the lungs where gas exchange takes place. The volume of fluid determines whether the victim breathes with difficulty or proceeds to drown on his own fluids. The immune system mediates most of this reaction, and many immune system cells arrive in an attempt to deal with the foreign body reaction. These cells only make matters worse, exacerbating the buildup of fluid, and resulting in inflammation.

By now your kitty is coughing. In the earliest stages these patients may be treated symptomatically for respiratory tract infection or feline asthma. Symptomatic therapy may actually help, as antibiotics will control the abnormal bacteria growing in the fluid in the lungs, and antiinflammatories used for asthma will reduce the immune system response, resulting in temporary relief. When the medications end, however, the damage resumes, along with the clinical signs.

As the disease progresses your kitty is ill more and more often, and symptomatic medications help less and less. When your pet’s doctor begins to suspect there may be more going on than feline asthma alone, he takes a radiograph of your cat’s chest. He discovers pulmonary arteries that are several times their normal size. There is fluid in the lungs, which explains why he is having so much difficulty breathing. Scar tissue is beginning to replace the delicate tissue of the alveoli, preventing them from participating in gas exchange. Now, oxygen can’t get in, and carbon dioxide and other waste gasses can’t get out.

The only good thing about this feline heartworm disease scenario is that you, as pet owner, have an opportunity to prepare for what eventually will happen: death of the heartworm’s host, your kitty.

However, this is the less-commonly-seen scenario. More commonly in cats infested with heartworms, sudden death is seen. Here’s how it goes: Kitty is bitten by mosquito. Months later adult heartworms reach the heart and pulmonary arteries. Kitty tolerates the presence of the heartworms, unlike the kitty above, whose cardiopulmonary system overreacted to them. Kitty seems to be as fat and healthy as any cat could be, until, one day, you come home for lunch and find him dead in the middle of the living room. No sign of a struggle or bodily injury, just a little blood-tinged fluid coming from his mouth and nose.

You rush him to your veterinarian. “Please help Roscoe! I came home for lunch and he’s not breathing and he’s bleeding from his mouth and nose.”

Examination reveals the bad news: Roscoe, indeed, has no heartbeat and no breath sounds.

“Doctor, what killed Roscoe? Our doors were all locked and our alarm system was on. the house was secure from the time I left for work until I got home for lunch. Roscoe doesn’t have a cat door, so he’s been inside all morning.”

“I’m sorry, Mrs. Jones,” her veterinarian replies. “From the outside, there are no apparent injuries or abnormalities. A post-mortem examination, a necropsy, possibly with blood and urine test would be required to find the cause, and there are no guarantees that we would find the cause. Do you want us to proceed with the necropsy?”

“Yes, please. My husband and I just won’t be able to rest until we know what took him.”

Hours into the necropsy your pet’s doctor finds the culprit. In the outer reaches of the smallest branches of the pulmonary arteries he finds a single adult male heartworm.  The heartworm has been dead just a little bit longer than his host/victim.

How did one heartworm cause the death of a robust kitty?

Quite easily, actually. Some cats with heartworms are like the one in the first picture we painted, tolerating their heartworms poorly, constantly reacting to them and causing chronic illness until, eventually, the disease process overwhelms him.

In the second scenario, the cat’s body was very tolerant of his one heartworm, as long as it was alive. It was heartworm death that triggered a massive and sudden reaction from the body, filling the lungs with fluid, drowning the cat, and soon stopping the heart.

So, you see why we didn’t give a heartworm-killing treatment to the first kitty, as we would have done with a dog. It is the death of the adult heartworm that causes the intense reaction and takes its host with it.

Now you understand why we veterinarians are constantly after our clients to administer heartworm preventive to their cats every single month, year-round. Regardless of which one you use, and you can find a variety of choices by clicking this link, they are easy to use and quite affordable.

Think of feline heartworm preventive as inexpensive insurance against a disease that is nearly impossible to treat and is almost always fatal.

 To someone whose pet is not a family member, this line from “Mr. BoJangles” might just be attributed to a kooky old hobo drunk who just couldn’t cope with the realities of life.

But to those of us to whom pets are our lives, it seems reasonable and proper behaviour.

Your pet’s doctor can help. While veterinarians are not professional counselors, we all have experience and training in talking to pet owners about the loss of a beloved pet. Veterinarians also know how and when to recommend professionals who deal in grief counseling for pet owners.

There are five recognized stages of grieving, and they apply to the loss of anything dear. The first is denial. It is our natural human reaction not to be able to face the fact that the illness or injury afflicting our best friend could be fatal. This is a step that often starts prior to the actual death of a pet, and is the ideal time for counseling to start, before the “counselee” becomes critical.

Bargaining is the next step. “God, if You will just let Sam get well, I’ll never let his vaccinations be late again.” Realization that bargaining isn’t working leads to the next phase, anger.

Anger may be directed at others, irrationally, or at ones’ self. A university doctor to whom I had referred a difficult orthopaedic case once gave me an update on a client whose dog had an untreatable condition, “She ripped me up one side and down the other,” he related. “I `gave’ her dog a bad disease, and she just couldn’t cope with it.” Guilt may lead one to take the blame, “If only I had gotten that limp treated sooner”, or “If I had stayed home today instead of going fishing”. This stage may be very destructive to the mourner and his surroundings. It is a time in which help from a friend or professional can make a huge difference. It is a time that needs to be dealt with, and left behind quickly.

Then comes genuine grief, described as a period of emptiness. At this stage the mourner needs maximum support, sympathy, understanding and accompaniment. The last thing the bereaved pet owner should hear is, “You can get another one anywhere”, or “It was just a dog, get over it.” To us, it’s not “just a dog” or “just a cat”. People who understand that concept are the people who need to help the person suffering the loss. It is crucial that you realize that the ties to your loved one must be broken for progress to occur. Breaking these ties is the most painful part of the process. It does not mean leaving the memory behind, just the realization that you must get on with your life, when the time is right for you. Sarah Morris says, in her book Grief, and How To Live With It, “…don’t make loneliness a way of life”.

Goodbye is the final stage that forces us to accept the truth. Done properly, it can be an important part of healing. The rituals are important. The beauty of a memorial service provides the comfort of a lasting memory. You may wish to be present during euthanasia; verbally saying goodbye just at the moment of passing can be comforting to some pet owners. The most final rituals are important, too. Burial options may include home in the back yard under the pet’s favorite tree, pet cemetery burial, or individual cremation and saving or scattering the ashes.

May I suggest that you print this post and put it with your pets’ important papers for future reference. It is sad fact of pet ownership that we will all need it eventually. It is the nature of loving something with a life expectancy so much shorter than ours that we must be prepared to say farewell sooner than we would like.

Sally Randolph at Christmas

This column is dedicated to the memory of Sally Randolph and the joy she brought to our lives, a joy that remains today.

We performed the procedure and it went uneventfully. The only down side is that, after the procedure, when we were easily able to access the horizontal ear canal, we found it to also be swollen closed.

Below you can see Lucy’s and Joe’s ears for comparison. Note that Joe’s ear canal is wide open, having experienced Zepp surgery several years ago and since being mostly free from ear infections because his owner now can easily and effectively clean his ears.

Lucy's swollen left ear prepped, draped and ready for Zepp Surgery

Pencil tip denotes Lucy's swollen-closed horizontal ear canal

We expect Lucy to have a similar outcome soon, but it will take some work. Our plan is to maintain aggressive antibiotic therapy for her, both systemic (she is on Convenia now) and topical therapy, as well as weekly cleanings for prevention of relapses. In addition, after she has sufficient time to heal from surgery we will add oral corticosteroids to reduce her swelling further.

See you tomorrow, Dr. Randolph.

I have several feline patients who come to their owners at the appointed times to receive their twice-daily injections of insulin.

Of course, they do also get a treat when they get their injections, and the injection needle is very small, but I’m still amazed when I hear these stories.

Whether the cats really know that the insulin will make them feel better or they are keying on the treat, it’s still fascinating.

See you tomorrow, Dr. Randolph.