Moving A Veterinary Hospital

Fall of 2023 marked a new experience for the East Goshen Veterinary Center. The hospital and staff moved from 1506 Paoli Pike to 1560 Paoli Pike (it’s literally on the other side of the shopping center). 1560 is a former bank which has been converted into our new hospital and if you were ever in the TD bank that was formerly there you won’t recognize it. This blog post will let everyone see just what goes into building a new hospital and then the big move!

The Demolition

It’s safe to say there was no money inside.

Starting in March the old bank was dismantled from the inside. Walls, safes, bathrooms, teller stations, all of it was removed. The vault was emptied (no we didn’t find anyone’s long lost treasures) but the vault itself is remaining.

First week of demo.
Inside the vault. We hope you didn’t forget your safety deposit box.

The floor was dug up for new plumbing, the wiring was replaced, and everything was stripped down to the studs.

Future waiting room and reception.
Digging for buried treasure.
Not sure they found any treasure or oil buried underground.

Building In

Once the demolition was done it was time to put it all back together. The skeleton of the building started going up. Our staff had the plans in hand but even they couldn’t yet see the vision of the architect but everything started to slowly fill in.

Floors are all fixed up and ready to build. This will be surgery and treatment soon.

Once the walls started going up things became easier to see. The exam rooms wrap around the waiting room with the bulk of the hospital behind them. Our staff thought of our clients and recommended a second waiting area to help keep our patients and clients comfortable while they wait.

Exam rooms or cells? Hard to tell right now.
Can you believe this is the vault! No more safety deposit boxes.
Those wide open spaces are filling in.
Reception with their new windows.
The pharmacy and the magic behind the exam rooms.
Looking at the exam rooms, no longer looking likes cells now.

In the back will be our new state of the art surgery suite and treatment area. The kennel runs join our cages, so large dogs won’t have to be stuck in the cages during their stay.

Runs with the big dogs.

Radiology will be in the back, where the vault use to be.

Radiology is now in the vault!

The new office now has 4 exam rooms instead of just 2. That means we have one for smaller dogs, 1 for larger dogs, and 1 for cats, plus 1 extra for when we are too full.

Our new exam room one! For small dogs.

We want to thank our four legged patients who this is all for!

Nori who took the honor of being one of Dr Hitchens last patients as a puppy in 2019 and our last patient in the old office!

Thanks for being Elvis’ friend Nori!

And Baxter who had to be the first dog in the building to make sure we brought over his beloved scale (we did of course)!

Baxter, relieved that his favorite scale made it!

We can’t wait to see everyone in the new office!

Canine Infectious Respiratory Disease Complex and Kennel Cough

“He hasn’t been to a kennel so it can’t be kennel cough,” we hear this alot and we hate to break it to everyone but ‘kennel cough isn’t only found in kennels.  And these days it is also known as Canine Infectious Respiratory Disease Complex (CIRDC). It’s been very prevalent in our area since the summer so we thought it was about time to write about it.  Recent stories of canine influenza that have made the news are referring to this overall disease complex.

Bacteria, virus, inflammation, oh my…

CIRDC and kennel cough are not caused by a single pathogen but rather two or more that take hold at the same time.

Bordetella bronchiseptica is a bacteria that is one of the most common pathogens involved. Other viruses and bacteria that are involve include canine influenza, canine parainfluenza, canine coronavirus (not to be confused with Covid-19), canine distemper, canine adenovirus, streptococcus equi zooepidemicus, and Mycoplasma.  For this blog we are looking at the more common pathogens, mainly Bordetella, parainfluenza, and influenza.

Bordetella

Bordetella works by infiltrating the respiratory system.  This system normally removes pathogens with the help of cilia that line the cells and work in coordination to move things up through the mucus to the throat where they can be coughed up or swallowed.  Bordetella bacteria attack these cells that contain the cilia and prevent this mechanism from working. And it can start within 3 hours of exposure. It then works against the immune system by releasing toxins that attack the respiratory tissue as well as the immune system to prevent white blood cells from removing the bacteria.   This bacteria can also enter cells and become an intracellular pathogen.  If this occurs the bacteria can linger for months and cause flare ups as well as causing your dog to be a carrier, spreading the disease without showing symptoms.  This can explain why it can spread so much, dogs can be asymptomatic but contagious. 

Parainfluenza

An RNA virus, it has very similar aspects to Bordetella.  It causes a cough, has an incubation of about a week, and can lead to more severe infections if mixed with another pathogen.  It is not actually related to the influenza virus but has been around far longer.  There is a vaccine for it which you can read about further on (we want to make sure you keep reading after all).

Influenza

Yes, there is a dog flu!  Lucky for us it’s not the same flu that we get.  There are 2 current strains of the canine flu, H3N2 or H3N8, but neither are the same as human strains.  H3N2 is the more common strain but even that is only sporadically seen in the US.  Symptoms can include coughing, as well as decreased appetite, fever, and nasal discharge or sneezing.   Sounds alot like ‘kennel cough’ doesn’t it! And that is the problem.  Your veterinarian can run test after test, send samples to a lab to differentiate which pathogens are causing your pet’s illness, or just start treatment to help your pet feel better.  Most of our clients would prefer the latter which is why we can not tell you what pathogen is causing the illness.  Since treatment will typically be similar we don’t want to waste time on pinning the blame on a virus or bacteria.

Clinical Signs of the Times

  • “My dog sounds like he’s trying to cough something up,” “my dog was up all night coughing,” “It’s just a lingering cough,” all things we hear.  
  • Clinical signs often present 2-10 days (average of 6 days) from exposure.  
  • The most common sign is a coarse, honking cough which may or may not present along with gagging and what can look like an infected dog is trying to ‘bring something up’.  White foamy/frothy material can occasionally be brought up.
  • Many dogs recover from a simple case of kennel cough within a week, however, lately (2022) we have had cases lasting for over 2 months.  And pets can and do become reinfected.  In fact we have had dogs recover, go back to daycare or boarding and get reinfected.
  • While dealing with this cough in and of itself is frustrating, your veterinarian grows more concerned when your dog becomes lethargic, stops eating, or has a fever.  Kennel cough can turn into pneumonia which is much more severe and even life threatening.  
  • Because the severity of your dog’s case can affect the treatment, your veterinarian usually requests examining your dog in person.  Remember that our dogs are often more stoic than we are.  We have seen cases where the dog appears normal, goes out running and playing and then suddenly has trouble breathing.  These dogs can actually be very sick with pneumonia but haven’t shown any sign of weakness to make the owner suspect something is amiss until it’s quite serious.

Pneumonia and Bronchitis

Pneumonia occurs in deep lung tissue, tissue that is involved in oxygen and carbon dioxide exchange, that becomes inflamed with or without fluid (such as pus from bacteria) that interferes with this gas exchange.  Pneumonia typically occurs after the lungs have already been compromised due to another infection, like from a virus or bacteria.

Bronchitis on the other hand occurs when the bronchi, or airways that bring oxygen to the lungs, are affected by irritants.  When trying to heal themselves the bronchi will actually cause inflammation, which will cause more irritation, and then the cycle continues.  A consequence of all this inflammation is the increased mucus that is produced then causes coughing. And all that coughing? Leads to more irritation! (It’s the circle of…frustration?)

Pneumonia and bronchitis can occur separately or together. And both can be caused by kennel cough.

Don’t Smell the Roses

While kennel cough gets its moniker from one of the most common places to find the disease, the truth is it can be spread so easily that it is hard to avoid.  Besides kennels and daycare, groomers, trainers, shelter, vet hospitals, and dog parks can all harbor the bacteria and viruses that cause it.  

The Bordetella virus can survive in the air for up to 4 hours while on surfaces for up to 48 hours, and in soil for up to 45 days.  So if an infected dog coughs up respiratory drops on that lovely rose plant and your dog then comes by and takes a good sniff, it is possible to pick up the bacteria and whatever else might be with it.  Sharing water bowls, dog toys, and other objects can also expose your pet for up to 2 days.

For this reason you want to keep your sick dog away from any other dogs, avoid parks, homes, and even walking in areas where other dogs meet up.  

Prevention

  • Vaccination is key but we’ll leave that for its own section.  
  • If your pet is going to a kennel/groomer/trainer/day care there are some things you can ask about to see what your pet’s risk is.  
  • Ask about their vaccination requirements – if they are pretty lax about requiring Bordetella or other vaccines, this should be a red flag.
  • Ask about ventilation and air exchange.  Ideally the air exchange should be between 15-20 exchanges per hour.  Now your average receptionist may not know this answer, but you should be able to email a manager who can get you the answer.  
  • Ask how long recovered dogs are kept from the facility.  It should be at least 2 weeks since their last day of symptoms but we know some places do not abide by this.
  • Sanitation – the best cleaner to kill Bordetella bacteria is bleach.  It can be diluted in water and used on surfaces that may have been exposed.

Vaccinations

Vaccinations play a strong role in preventing kennel cough. 

Bordetella

There are multiple versions available but we recommend the oral mist which includes Bordetella and parainfluenza (one of the common combinations leading to kennel cough). However, not every dog loves the idea of us opening their mouth and sprays a mist in there so we also have a subcutaneous injection available to those dogs. 

DA2PP

(often referred to as the Distemper vaccine) is also quite important.  If you ever wondered why it is called DA2PP here’s the answer: it stands for Distemper, Adenovirus-2, Parvovirus and Parainfluenza.  Distemper, Adenovirus-2 and Parainfluenza are all players in the cause of kennel cough.   (We told you we’d mention that parainfluenza vaccine, remember?)

Influenza

not one of our core vaccines but it has recently come up a lot with this recent outbreak.  In fact while a few boarding/daycare facilities have required vaccination before, there has been an increase in facilities requiring this vaccine before pets can stay there.  You should know that if your pet has not had it before it is a series of 2 vaccines given 2-4 weeks apart.  And some kennels require vaccines be given up to 2 weeks in advance of their stay.  We also want to stress that this vaccine has been on backorder a lot recently so we have trouble getting it in.  Our staff works hard to keep some in stock but with the uptick of all local hospitals getting more, it has made it a hot item.  If your pet is getting the first of 2 boosters, rest assured that we have set up a system to make sure their booster is reserved just for your dog so you won’t risk not being able to get the necessary 2nd dose.

Who Else is at Risk

Besides dogs, cats can be infected with Bordetella too.  Its presence in cats is less documented, so it is likely harder to transmit across the species but it is possible.   However, it is a rarity.

And what about humans?  Yes, bordetella can affect humans but only in very rare cases and only in those that are severely immune compromised.  For this reason we do not worry about the spread to your family.  After all, our staff would pick Bordetella infections up like the common cold working here, and we promise they’re all fine!

Learn More

https://www.canada.ca/en/public-health/services/laboratory-biosafety-biosecurity/pathogen-safety-data-sheets-risk-assessment/bordetella-bronchiseptica.html

https://www.vet.cornell.edu/departments-centers-and-institutes/riney-canine-health-center/canine-health-information/respiratory-disease-outbreak-new-hampshire-and-neighboring-states-updated-nov-28-2022

https://www.avma.org/resources-tools/animal-health-and-welfare/canine-influenza

https://www.avma.org/resources-tools/pet-owners/petcare/canine-infectious-respiratory-disease-complex-kennel-cough

https://veterinarypartner.vin.com/default.aspx?pid=19239&catId=102899&id=4952113&ind=246&objTypeID=1007

https://veterinarypartner.vin.com/default.aspx?pid=19239&catId=102899&id=4951478&ind=171&objTypeID=1007

https://veterinarypartner.vin.com/default.aspx?pid=19239&id=5138343

https://www.aaha.org/aaha-guidelines/2022-aaha-canine-vaccination-guidelines/key-vaccination-considerations-by-antigen/bordetella-canine-parainfluenza-and-canine-influenza/

https://www.inquirer.com/news/canine-influenza-dog-flu-penn-veterinarian-cats-philadelphia-20230215.html

The Hardest Bridge To Cross

The hardest part of owning a pet is realizing how short their time with us really is.  One day they’re a goofy, energetic puppy and suddenly they’re having a tough time getting up or enjoying their favorite things in life.  And when those days come we often get asked by owners, how do we know it’s time?  While some may wish your veterinarian could be the one to tell you, the truth is you know your furry family member best, and you will know when it’s time.  Here are some things that our staff often ask owners to consider when the question first arises.

What’s changed to make you consider euthanasia?  Sometimes it’s something drastic, no longer eating or moving, or sometimes it’s a number of things adding up.  We’ve heard tales of family or friends who visit and notice something that because of it’s slow progression has gone unnoticed, like weight loss or a lackluster greeting of guests.  Whatever the reason, there is often something that causes your concern.

When was your pet’s last exam?  Sometimes dogs or cats come in with issues that seem so dire that their owners believe this is the end, perhaps they have trouble getting up and walking, or they won’t eat their food.  A good physical exam and some diagnostics could help prolong your pet’s quality of life.  An arthritic dog could find relief from pain medications or a cat who won’t eat may have chronic kidney disease and could feel better with a specialized kidney diet and increased fluids.  While there may not always be a treatment for your pet, sometimes we can help find ways to keep them happier and healthier longer.  

Are they enjoying life?  Have those long walks in the park become a thing of the past for your dog?  Has your cat given up his adventures of jumping on tables and cabinets for the safety of the ground? Does spending time with the family or enjoying their favorite foods seem to have lost its appeal? When the things your pet once loved, no longer seem to make a difference then it’s time to listen.  Maybe the walks need to be shorter, the meals more enticing, or steps need to be added to reduce the jump height.  No one wants their pet to suffer and eventually things will have to change for our aging pets, but by making their favorite things still within reach even if they have to be modified they can still enjoy their lives longer.

How is their quality of life?  This is the big question, the one that you will know better than the veterinarian because you see your pet everyday. We want pet owners to know that your pet’s life should be measured by the quality of their time rather than the quantity of it.  Just like their human counterparts suffering from ailments, they may have good days and bad days.  And you do your best to help them through those bad days hoping a great day is around the corner. But when you start to find that your buddy is suffering through more bad days then good days it may be time to assess the quality of those days.  A slew of rough days waiting for that one good day isn’t fair to you or your pet, because that good day may not come in the end.  We have been asked if it’s wrong to say goodbye on a good day, and the answer is no.  Wouldn’t we all love to spend our last day with a loved one, curled up in our favorite spot after our favorite meal or enjoying a walk in the park and a favorite treat?  Sometimes letting that be your pet’s last day can be a blessing for you both, a fond memory of a lifetime bond.

When that day finally comes, we want you and your family to be comfortable with your decision and to make the process as easy as possible.  We often wish that our pets could pass away comfortably in their sleep, free from any last minute pain or discomfort.  And our goal is to make that happen as best we can.  Our veterinarian will give them a sedative in the muscle to make them relax and drift to sleep, losing consciousness with their family around them. Our staff will give you the privacy to say goodbyes and cuddle with your family member as they drift to sleep during this time.  Once your pet is unconscious a second injection is given in the vein that will stop their heart.  This injection is quick and while painless, can be unsettling for some owners due to the finality of it. If you choose to leave once your pet is unconscious before the final injection, please know that one of our nurses and the veterinarian will be with your pet through the end of the process.  They will always give ear scratches and a belly rub and a final goodbye to your pet who will never be left alone even if you can’t be there.  

You will find that our staff will ask you what you would like to do with your pet’s remains when you first arrive that day.  Though we know this is a tough decision, and will give you time to decide, we ask ahead of time so that you do not have to think about it at the end.  Once you have said your final goodbyes our staff will take care of your pets body form then on, we don’t want you to have to dwell on the hard times but to try and remember better times as you leave.

In the end, our pets will give us signs that they’re ready to cross that final bridge alone, to waiting for us on the other side with our loved ones.  We just have to be brave enough to let them take that journey without us.  Our staff knows how hard that feeling is, and hope you can find strength in the memories you built up over those long years to hold on to during this hard time.  And when you find those tears coming and your heart about to burst remember that as Ernest Montague wrote, “dogs never die they are sleeping in your heart.”  And when your heart hurts the most it’s that tail wagging so hard, or your cat purring so loud, that brings those tears to your eyes.  One day we will find them waiting for us, healthy and happy, across that bridge.

https://www.rainbowsbridge.com/poem.htm

https://www.lapoflove.com/community/Pet-Loss-Support

https://www.akc.org/expert-advice/vets-corner/knowing-time-say-goodbye-pet/

https://www.veterinarypracticenews.com/how-to-help-clients-say-goodbye-to-dying-pets/

https://www.businessinsider.com/vet-reveals-what-happens-in-a-dying-pets-final-moments-2018-9

https://www.purina.co.uk/dogs/key-life-stages/saying-goodbye/coping-with-the-loss-of-your-pet

https://www.vetmed.wsu.edu/outreach/pet-loss-hotline/issues-to-explore/saying-goodbye

https://hopevs.com/resources/support-service-programs/

Show Us Your Pearly Whites

https://dogtime.com/assets/uploads/2017/10/periodontal-disease-dogs-1.jpg

Have you ever skipped your dentist visit (or several) because you dread being told about a cavity, or root canal, or that you have gingivitis?  Have you ever had to have a periodontal cleaning (trust me, this isn’t your regular cleaning)?  Well now imagine not only skipping those dental cleanings but bypassing brushing your teeth at all for say 5-10 years.  It would not be a pretty picture, but for our four legged family members that’s often the case for their teeth.  This is why over 80% of dogs and cats over the age of 2 have periodontal disease.  Yes, a disease. And once it passes the first stage of this disease it becomes irreversible, and can affect far more than just their teeth, but also their kidney, heart, and liver. 

You may be surprised to know that one of the biggest complaints of pet owners is their pet’s breath.  It can often take your veterinarian only a moment to diagnose the problem and all they have to do is lift up your pet’s lips to do so.  That smell isn’t from their food or whatever they’ve gotten into outside, but from the bacteria flourishing in the plaque buildup on the teeth.  The fastest way to freshen their breath is to schedule a full cleaning or, a complete oral health assessment and treatment (COHAT), where their teeth are scaled of plaque and tartar, including the surface under the gums which bacteria love to live in and no toothbrush can get to.  This would be a painful periodontal cleaning for us humans. Unfortunately, as wonderful as your pet may be, no dog (or cat) will gladly sit there and allow our nurses or doctors to use noisy, ultrasonic dental tools or drills in their mouth.  Nor would they open wide to allow their inner teeth be cleaned the same way.  So this means your pet will undergo general anesthesia for their safety and our employees safety. 

So let’s take a closer peak at what your pet’s mouth looks like when your veterinarian takes a look.

It’s a mouthful!

https://pictures-of-cats.org/wp-content/uploads/2018/04/Do-cats-have-more-teeth-than-dogs.jpg

Dogs have 42 permanent teeth while cats have 30.  So let’s give a quick break down of those teeth.

Incisors -the teeth in the front of the mouth, are used for scraping skin or meat off a bone (or fuzz off a tennis ball)

Canines – the ‘fang’ teeth are used to pierce and tear off large muscle tissue or meat (or grip a toy or leash)

Premolars – the next several teeth behind their canines, they shred and break down their food with these (usually why you find them chewing toys and bones on the side of their mouth)

Molars – far in the back, usually out of sight unless you can pull their lips all the way back, they’re used to crush and grind hard food.

A Healthy Mouth

A younger dog is likely to have a mouth like this, though we find that sometimes puppies coming in for their spay/neuter surgery can have tartar building up on their teeth already.  So how can your pet’s teeth look like this?  Well, they need constant care.  The gold standard is to brush them everyday.  Other options such as dental chews or food can help, but they will only prolong the time between visits to the vet for complete cleanings.  If you are a current client and have asked about dental care for your pet you may have heard about our one staff member who brushes her dog’s teeth every night!  At 11 years old, here’s a picture of his teeth which have never had to have a COHAT (aka dental cleaning).  You can still see small buildups of tartar on some teeth, and yes he’s worn those canines down (he is a chewer), but notice the nice, pink gums. No gingivitis here!

Now, let’s be realistic, most of us don’t have the time or ability to care for their pets teeth so well.  This means that a general anesthesia dental cleaning will be in your pets future.  So let’s take a closer look at what you want to look for.

The Start of Periodontal Disease

https://dogtime.com/assets/uploads/2017/09/dog-gingivitis-gum-disease-2.jpg

The first stage of this disease is gingivitis, an inflammation of the gums which is caused by irritation. That red line just above the teeth, that’s gingivitis. What causes this irritation?  The tartar, plaque, and bacteria build up on the teeth and gums.  The fix?  A COHAT cleaning.  

Why wouldn’t brushing do the trick?  The two biggest reasons are; brushing won’t remove the tartar already on the teeth and a toothbrush can’t get under the gum line to where there is plaque and bacteria.  At this stage of the disease if we can clean these teeth up and you follow up with more strident home care than we can actually reverse the disease and your pet’s teeth and mouth will enjoy a healthy smile.  

Perfect right?  If only this was what we typically see when we look in a pets mouth, but alas it is not.

So what happens when those teeth don’t get a COHAT?  Well then the disease will continue to progress.  The next stage of periodontal disease occurs when the constant presence of bacteria irritating the gums leads to the gums pulling away from the teeth, leaving large gaps for bacteria and plaque to spread and leave the root of the tooth more and more exposed.  Once this first begins, there is no reversing course.  The only option is to try and prevent the disease from continuing by keeping up with routine COHATs and home care.  Your pet can still lead a happy life with this care but unfortunately most dogs will find themselves continuing down the course of this disease.

The next stage of this disease will see the gums pulling away from the teeth to the point that their stability in the mouth can degrade.  This can cause them to move or lead to abscesses both of which are painful.  Imagine having a toothache (or more than one) for days and months and no one knew.  Unfortunately our pets are very stoic when it comes to pain, so we often don’t realize the pain they can suffer from.  But there’s something else that a recent study has shown, the constant inflammation of the gums as well as the constant signals of pain from the mouth can lead to a systemic response from the body.  Increased levels of inflammatory cells and their degradation over time can put a strain on the liver, kidney, and even heart.   In fact, it was discovered that dogs with mild kidney, liver, or heart disease could see improvement in these organs after a COHAT and increased home care of their teeth.  Getting your pet’s mouth in order could improve their overall health.

But if that COHAT doesn’t happen the final stage of periodontal disease will occur.  By now you probably guessed what was coming, the gums have left the teeth so exposed that they can fall out.  Extractions are very common during this stage and even the preceding stage.  And while many extractions can be very time consuming to get all the roots out and suture the gums up, others have been to known to literally fall out of the mouth when our nurses are removing tartar from them.  You can imagine how much pain these teeth must be causing your pet along with their inflamed gums.  Like the previous stage, a full cleaning can help their organ function as well as their comfort level.  Dogs at this stage may require a specialist to extract more teeth that can appear fine after cleaning but dental radiographs may show an abscess or a root that is rotting away.  Some dogs can lose all their teeth which is something no one wants to see.  Veterinary specialists are often far more expensive than your general practice’s COHAT so you really don’t want to end up there.

Now that we’ve taken a look at the mouth, let’s talk about how this COHAT is done.

These procedures typically start with bloodwork since your pet will be going under general anesthesia.  If there is an issue with the liver or kidney we prefer to know about it ahead of time and can change our sedation, monitoring, and recovery plans to best ease any strain on your pet’s body.

Cleaning the mouth starts by looking at the mouth, from the tongue, the gums, the roof of the mouth, and the tonsils.  Our nurse will make note of any abnormalities that are seen and notify the veterinarian if anything is unusual.  Then she’ll brush their teeth with an antiseptic, not because it removes any of the tartar but it helps reduce the bacteria in the mouth before we begin using the ultrasonic cleaner.   Otherwise all the bacteria ends up in the air and pretty much everywhere else as they clean.

Next we remove any large chunks of tartar which requires some care to protect the unseen enamel beneath it.  Then we must remove the remaining tartar and plaque on all the teeth with an ultrasonic cleaning tool.  Both that which you can see on the teeth and that which is underneath the gums.  The whole tooth must be cleaned this way, including the inside of the mouth, which can sometimes be worse than the outside of the teeth.  This is why having your pet sedated is so important, we could never clean inside the mouth with a loud, mechanical scaler spraying water.

Once all the teeth and gums have been cleaned, the veterinarian will be called in to check any suspicious teeth that may require extractions.  For some teeth, such as the large premolars, an oral surgeon may be needed for extraction.  Once any teeth have been extracted and their gum tissues sutured up, the remaining teeth will be polished to smooth their surface and help prevent buildup of plaque and bacteria.  

While your pet’s mouth may bleed some after their cleaning, which can cause foul breath, this will subside and your pet’s breath will greatly improve.

What About After the Cleaning?

If you didn’t brush your teeth after you went to the dentist, I’m sure you can imagine how quickly your teeth would degrade.  Your pet is no different.  The gold standard for home care is to brush your dog’s teeth.  You don’t have to spend several minutes brushing or use an electric brush.  Using a soft brush and some pet friendly toothpaste is enough.  Brush the outside of the teeth and allow your pet to use their tongue to clean the rest of their teeth with the toothpaste.  Daily cleaning is best but even every few days is great.  Studies have shown that it takes only 20 hours for substances on the teeth to form plaque to feed the bacteria in the mouth.

Alright, if we’re realistic, we know many of you won’t brush teeth, or maybe your pet won’t let you!  So what are some other options?  

There are dental diets, such as Hill’s T/D or Science Diet Oral Care for pets who may develop tartar very quickly.  These foods are designed to not break apart the moment a tooth pierces the kibble but rather stay intact long enough to brush against the teeth and remove plaque.

Dental treats such as OraVet Chews or Greenies can help as well, but only if your pet actually chews them, if they tend to swallow things whole it won’t work.  But remember to check the calories in the treats, some of them can have a lot more than you think.  It may require you to reduce your pets food intake to reduce the risk of your pet gaining weight.

One thing we don’t recommend are water additives.  If you add these to your pet’s water and they dislike the taste they will start drinking less.  That can lead to a whole other mess of problems.  

If you are interested in more information on dental care, please ask our staff.  We are here to help you and your pet so we’re always glad to answer your questions. Or check out these links below to learn more.

http://www.vohc.org/accepted_products_dogs.html

https://www.amcny.org/wp-content/uploads/2019/01/Five-stages-of-Peridontal-disease.pdf

https://dogtime.com/dog-health/dog-dental-care/57491-periodontal-disease-dogs-symptoms-causes-treatments

https://www.aphis.usda.gov/animal_welfare/downloads/breeders/dogs/AC-Aids-for-Dogs_Canine-Periodontal-Disease.pdf

https://www.hillspet.com/dog-care/routine-care/4-tips-for-cleaning-your-dogs-teeth?gclid=Cj0KCQjwyJn5BRDrARIsADZ9ykFVpHFgbkZzSQAkuOkXvc4yFe44Mf8IUjEOIeeCJ-jd52yYifrtgvgaAszcEALw_wcB&gclsrc=aw.ds

https://www.avma.org/resources-tools/pet-owners/petcare/pet-dental-care

http://www.pethealthnetwork.com/dog-health/dog-checkups-preventive-care/10-reasons-why-you-should-take-care-your-pets-teeth

https://www.purina.co.uk/dentalife/dental-advice/dog/article/canine-dental-anatomy

The ABCDs of CBDs

Cannabinoids, also referred to as CBDs, have been popping up almost everywhere.  The companies make claims that seem miraculous, so why aren’t veterinarians handing them out like treats?  Well for starters, it’s still considered illegal to market food products with CBDs in them. Veterinarians also aren’t swayed by marketing tactics, they look for cold, hard facts and there are very few available right now.  Testimonials and marketing jargon can exaggerate or mislead their audience who may be looking for any ray of hope to help their ailing pet. Veterinarians look to research, particularly peer-reviewed research before they start hailing new products as miraculous. The FDA has even recently expressed growing concerns over the safety and quality of these products.  So let’s break down the facts about CBDs and your pet.

All in a name – 

Cannabis sativa is a plant that contains tetrahydrocannabinol (THC), a psychoactive drug that causes the high associated with marijuana.  There are other cannabinoids within the plant that are believed to bind to the same receptors within the brain but without the same potency.  The levels of each of these chemicals will vary depending on the portion of the plant you look at. For instance, the flowering portion of the plant contains high levels of THC while the leafy portion contains very little.  Companies that produce CBD products use plants that grow quickly but with minimal flowering, decreasing the presence of THC. What is important to keep in mind, is that these products can still contain THC and that is toxic to our pets.

Beyond the Positives – 

It is also important to keep in mind that every drug you give to your pet can have side effects and CBDs are no exception.  Reported side effects so far include lethargy, urinary incontinence, vomiting, hypersensitivity, and muscle weakness. Research in humans has also brought up concerns about liver damage from CBDs.  If these products contain any trace of THC the side effects can be more severe and can lead to much more severe side effects such as vocalizing, agitation, trouble breathing, seizures and even death.  So while few testimonials mention side effects, it doesn’t mean that there aren’t any.  

Check the Purity 

Because these products risk having THC in them you would think that these products are tightly scrutinized but, they are not.  In fact, research into the products qualitative analysis has shown that over 96% of these products do not contain the amount of CBDs that they claim.  And if they are misleading the purity of their CBD products how can you feel confident that there are no traces of THC, pesticides or herbicides? Worse yet, these plants are believed to be very efficient at removing heavy metals from the soil (and into the plant).  These products are not currently monitored by the FDA, one of the strong reasons that your veterinarians remain leary of supporting these products. So how do you weed out the unreliable products from the trustworthy options? First, look for companies that can give you a certificate of analysis to prove that their product has been tested to confirm it’s contents.  Second, don’t go for the cheap stuff. While we don’t recommend you spend your entire paycheck on high quality CBD oil for your dogs it is also not an area where you want to go cheap because of the high risk for low quality or tainted product. Third, look for liquid tinctures so you can control the amount of chemicals you are giving more precisely.

Dig Past the Surface

As mentioned earlier, there is little research behind these products which is why veterinarians are waiting for the results first.  Currently there is research into CBDs use in epileptic dogs. So far the early indications are that dogs given a specific dose of CBDs and their anti-seizure medication have lower seizures breaks then dogs on a placebo and their anti-seizure medication.  Another research study has begun looking at their effects in helping treat arthritic dogs but it is still in its initial stage.

It’s also important to remember that there is no guideline for how to dose your pet.  Which makes it hard for you or your veterinarian to come to a conclusive starting point to medicate your pet.  And with their promise to ‘do no harm,’ your veterinarian does not want to risk your pet’s longtime health to a drug that also has no studies looking at their long-term side effects. 

Examine the Fine Print 

Finding reputable information on CBDs and where to find them requires some research.  And while we do not have any suggestions for you as to what brands to look for we can help you start your research.  Below are the websites we used with more information on CBDs and your pet. No matter whether you decide to take the risk or not, always make sure you look for well rounded information, look for the good and the bad people have to say on the products.

And if your pet ever ingests any marijuana laced products always keep the Pet Poison Helpline number close at hand: 800-213-6680.

https://www.fda.gov/consumers/consumer-updates/what-you-need-know-and-what-were-working-find-out-about-products-containing-cannabis-or-cannabis

https://www.fda.gov/news-events/press-announcements/fda-warns-15-companies-illegally-selling-various-products-containing-cannabidiol-agency-details

https://www.petpoisonhelpline.com/pet-safety-tips/marijuana-toxicity-pets/

https://moderndogmagazine.com/articles/cbd-canines/118556

https://www.akc.org/expert-advice/health/cbd-oil-dogs/

http://www.akcchf.org/news-events/news/clinical-trial-to-study.html

https://www.akc.org/expert-advice/health/cbd-oil-for-dog-seizures/

https://www.consumerreports.org/cbd/should-you-try-cbd-for-your-pet/

https://www.nbcnews.com/better/lifestyle/what-you-need-know-about-cbd-oil-your-pets-ncna968476

https://www.fda.gov/news-events/public-health-focus/warning-letters-and-test-results-cannabidiol-related-products

https://www.aspcapro.org/resource/cbd-hemp-pet-treat-dangers-overdose-treatments

The Grain of Truth in Dog Foods

We all want to feed our pets the best food out there but with so many brands to chose from it can be awfully hard to choose. And we have heard clients say they bought their pet’s food because; ‘it’s the most expensive food at the pet store’, they ‘looked at the ingredients on the back and they’d eat those things’, or simply they ‘saw an ad and it sounded great’. But the truth is that many of these pet owners are merely pulled in by some flashy marketing gimmicks, exactly what the companies want. Pet food has become a very competitive market and companies are only too eager to jump in on anything that sells. And lately there has been a big push for grain-free, exotic, and human grade ingredients. Your veterinarian get it, you see your pet as family and want only the best, but as the FDA continues to warn about certain pet foods we just ask owners to do more research first.

Last year the FDA first released a warning about grain-free foods and a link to dilated cardiomyopathy (DCM). In June of this year they released an update and included exotic ingredient and boutique brand pet foods as foods that owners should reconsider giving to their pets. While there is no answer yet to the link the fact still remains that dogs are suffering from DCM and the commonality has been these foods. So what are veterinary nutritionists thinking? Well we did some research to see what nutritionists at Tufts University, Cornell University, and Hill’s Pet Food have to say on the topic.

So what is DCM? DCM is a weakening of the walls of the heart decreasing its effectiveness at pumping blood through the body. As blood flow slows tissues are deprived of the necessary oxygen they need while the backing up of blood can cause it to back into the lungs. These conditions can leave dogs short of breath, unable to tolerate walking or playing, coughing, and fainting from lack of oxygen. If left untreated it can eventually cause death.

So why are these foods such a concern, aren’t they suppose to be good for them? Well it stems from companies wanting to make a quick buck from the increase in consumers’ desire to treat their four legged family like their two legged family members. We all want to feed our pets the best food and often times we make the mistake of thinking that what is best for us is best for our pet. But the truth is that dogs and cats did not descend from humans, and that means their GI systems and nutritional needs are not the same as ours. To put it another way, most people love to eat chocolate but even one piece could kill your dog. And it’s because they can’t metabolize chocolate like we can, we take a mere 2-3 hours while dogs take 18 hours to metabolize it. And while we’re not here to talk about chocolate we are merely trying to stress that our pets just don’t digest things like us. But that hasn’t stopped pet companies from offering up products that mimic people’s need for specific ingredients or lack of others.

Grain-free foods came from the trend of gluten-free options that became popular for people. Suddenly grains became the enemy of dog foods and it left veterinarians baffled. The truth is that dogs break down grains better than people and get many nutrients and vitamins from them. This includes wheat, barley, corn, and oats to name a few. Many marketing ads began saying that grains were linked to all sorts of health issues including GI upset and allergies. But according to nutritionists at Tufts University, it’s all a lie. Grains have not been linked to health problem in dogs and less than 1% of food allergies are linked to grains, and most of those are linked to one genetic line of Irish Setters in the UK. And yet people believe the marketing gimmicks.

Exotic Ingredients include proteins like salmon, kangaroo, and duck as well as other ingredients such as legumes, potatoes, and peas. Some people believe giving their pets different protein sources reduces the risk of food allergies while others simply want their pets to have more well rounded diets like they have. According to veterinary nutritionists, while proteins such as chicken, beef, dairy, and egg are the most common food allergies (though they stress that food allergies make up only 10% of the cause of allergy issues in pets) switching proteins may actually trigger allergies. And as for legumes and potatoes? Well research is looking into their link with DCM because it is believe that dogs do not digest these foods as well as grain which means they may not get the nutritional benefits of them.

And what about boutique foods that promise human grade or high quality ingredients? According to Hill’s Pet Food, there is no legal definition of human-grade food in pet foods. So in other words the term can be used for just about anything and pet food companies don’t have to prove anything. Now, I’ll admit I’ve been caught reading the ingredients of pet treats before considering buying them but I discovered in my research that nutritionists say that’s the wrong way to go when picking out foods. The ingredients list tells you what is in the food and you can usually assume that the first few ingredients make up the bulk of the food but nothing tells you how much is actually in the food. Instead they recommend you look for the nutritional adequacy label or AAFCO Statement (Association of American Feed Control Officials). This label means that the food is complete and balanced for your dog. And while it does not say anything about the quality control testing of the food it can help you rule out other foods.

So now let’s get to the FDA’s latest warning. There are several brands of food that offer grain-free foods that have been linked to DCM. These brands are: Acana, Zignature, Taste of the Wild, 4Health, Earthborn Holistic, Blue Buffalo, Nature’s Domain, Fromm, Merrick, California Natural, Natural Balance, Orijen, Nature’s Variety, Nutrisource, Nutro, Rachael Ray Nutrish. We recommend you avoid these brands, or at the very least stop feeding their grain-free options.

Now that we’ve talked about foods to avoid how do you decide what foods to choose? Tufts recommends you do your own research to pick your pets food, don’t listen to the company marketing. First consider a big name company that has been in the pet food industry for years. Then look at whether the companies have their own nutritionist on staff, if they don’t, big red flag. Ask about their factory, do they own it? How is their quality control testing done? Do they do research on their food? Can they give you specific amounts of product in their foods, not just quote what is on the label? If a company can’t give you this information then consider taking a big step back. Don’t let them try and divert your questions, if they can’t give upfront answers it likely means they know you won’t like the answers.

Pet food can be a lot to consider but if you truly want to do right by your pet, do the work. Don’t be sucked in by the shiny lights and special effects of marketing campaigns. Your pet is worth the effort aren’t they? If nothing else ask our staff about our recommendations.

Don’t take our word on all this, below is a list of the sites we used to do our research. If you do your own research make sure you look for reliable sources. Just like school teachers told you to avoid Wikipedia and social media we recommend you look for veterinary schools, veterinary journals, and peer-reviewed research. Avoid sites with testimonials or opinion sections, these sites can be full of false information and lead you astray.

Want to do some research of your own? Here are a few good places to start looking.