Change is in the Air! The #FatChick is Movin' in Another Direction for 2016

Hi Ho, Guys and Dolls! Did you miss me? It's been a rough few months of crazy veterinarian schedules, writer's block, health scares and plain old exhaustion but now I'm ready to dive back into my blogs.

With all I've gone through, you would think I'd want to curl up in a ball and escape the world for a year or two, but Lady Fate has other plans for me. The scene where fictional cast of Seattle Grace works their butts off to save their friend is one I've had to deal with as a veterinarian far too often. In the show, they saved Callie. In real life, my colleagues and I weren't so lucky with a few of our critical patients. It's hard to accept there will be cases where no matter what you do, how hard you pray, how much Eastern and Western medicine you throw out there your patient will still lose it's battle.

The cute little Labradoodle puppy that damn near broke me this week lost his battle against Parvo. I had to be his advocate and say enough was enough. His pain was too great and his body too frail. He placed his little head in my hand and snuggled as I gave him one last injection. I wanted so badly to curl up in that cage with him and forget the world. 

Sometimes it's just too much. Then the next one comes through the door on the edge of death and somehow you gather yourself up and give it your all. This time it works. The 10 month old puppy who was left for dead in a ditch after a car slammed into him is coming around. Thankfully no broken bones but other injuries leave him in critical condition for the following 12 hours.

The little stinker rallies and is able to go home 48 hours later to his loving and very grateful family.

These are the reasons I continue to do what I do and not curl up in a ball and forget the rest of the world.

They're also the reason why I won't stop writing and publishing my stories. Both of my worlds are a part of me. I am not ME without either of them. As soon as I let that sink in, the writer's block crumbled and I'm itching to get back into the worlds of my characters. Of course that means my smart ass self is back to share my thoughts on all things in the veterinary world, publishing, authors helping (and hindering) other authors, and my other passions like food and crafts.

Not Enough Time in the Day was the very first blog I started after Siren Bookstrand agreed to publish my first novel For the Love of Quinn nearly five years ago. In a few short months, the rights to that book will be reverted back to me. I'm thrilled at the prospect as I have plans for that monster sized novel! I'm splitting it into two books and adding scenes back in that had to be cut the first go around. Next year, I'll get the rights back to  The Island (Now and Forever 2). At that point, all of my books will be under my control and I have to tell you it feels wonderful to say that. I'll be forever grateful to Siren for giving me a chance, but it's time I move out on my own with everything.

Speaking of moving on...

The last year I've been the regional relief veterinarian for a group of hospitals here in the Seattle area. They've decided to go in another direction and have offered me a fabulous contract to work full time between two hospitals instead of 13. March 1st is the start of that new venture and one that will give me a set schedule for writing again!

This is the final year I can say "forty something" for my age. It's opened up many hours of reflection for me and going through the posts I've done for my memoirs, I've decided to put it all together in one book to be released at the end of the year to celebrate. The Fat Chick posts will continue. I have too much to say on things to let that go. LOL!

If you've been here before, you may have noticed I've changed the side bars up to include some ad space and links to favorites. Starting this month, I will be offering ad space for sale at the top of each side bar. I'm working on the guidelines and pricing and will have a separate page for the information. You'll be able to find it in the menu tabs at the top when it's ready to go. Payments will be accepted ONLY through Paypal.

The Fat Chick posts, Writer's Words of Wisdom, and veterinary posts will have their own index pages also listed in the menu tabs at the top of the blog. This way you can find them in one spot. Of course, you can always use the new search this blog feature in the left side bar.

I'm off to help the hubby work on his new blog Pint For You And Me. He's featuring everything he knows and wants to know about brewing beer from the home, small breweries and others around the world. 

Until next time,

The Fat Chick (Tammy)

#FurbabyFridays: Dr. Tammy's Manic Mondays, Terrible Tuesdays, And Wild Cat Wednesdays

Welcome to Furbaby Fridays. I'm Dr. Tammy and today I thought I would share a post I did in October of last year. It was written right after a particularly stressful Monday at my veterinary hospital. Not that it was atypical for it to go down the way it did, but having so many patients with similar ailments was a bit odd.  

Mondays tend to be one of our busiest days in general because people don't feel like giving up their days off to take their sick pets into the vet and don't get me started about animals that get sick after hours!  I've discussed this numerous times before. It's an honor and a privilege to own a pet, not a RIGHT. Along with pet ownership comes huge responsibilities including but not limited to: keeping your pet healthy with routine checkups, vaccinations, flea control, and heart worm prevention; seeking medical attention when the pet is ill, providing clean and protected housing.  If you can't provide these things for yourself and your family, you really shouldn't be a guardian for a pet until you can.  I'm sorry if that sounds harsh, but it's a bit of advice that can save you a lot of heartache in the long run.  

Now to today's post...

I've worked over twenty years of Mondays as a veterinarian and to this day, it's my least favorite part of my work week. Not only is there always a rush first thing in the morning with client's who conveniently "forgot" we were open on the weekends, there usually is a literal flood of transfers of patients from the emergency clinics. The 8 am doctor is usually swamped and by the time I get in there at 10 am it's chaos at it's best. 

There are the usual dogs and cats that have been sick for at least the last three days and of course NOW it's an emergency to their owners. Each and every single one feels their pet is sicker than the rest and should be taken care of first. We have a basic triage system at our hospital. Each patient is given a stability check. If they are deemed stable to wait, they will wait their turn. If they are thought to be critical, they move up the list. Even appointments have to be delayed if an emergency walks in the door. Most folks understand that, but there are those chosen few...you all know the folks I'm talking about. The ones who come into the lobby crying and screaming "My BABY! My Baby is dying and I need a doctor NOW! Lawdy Jesus, save him. He's got the epilepsy and he's been having seizures for the last three days straight..." When asked why they waited to bring their precious in, our ears are assaulted once again. "We ain't got no money! You have to save him. You took an oath!"

Yeah, I do see those kind of clients more often than I care to admit, but today was a mixture of emotions I hadn't felt in a while. Two good Samaritans brought in a stray Chihuahua they found on the side of their street. This poor dog was in severe shock after being hit by a car. He had a broken back leg, broken pelvis, fractured ribs creating what is referred to as a flail chest, and major head trauma. These wonderful people took the time to carefully transport this older dog to us so we could end his suffering. He had no microchip, was not neutered, and had no collar or tags. He would have died along the side of the road, alone and afraid if it wasn't for these two men. From the bottom of my heart I thanked them for helping this animal die with dignity. 

I wade through the next several drop ins and appointments until I come across one where the owner wants to talk about a weight loss program for her cat. You see, he's just a little larger than your average cat. He tops the scales at just over TWENTY-FIVE POUNDS!!! Holy Guacamole!

This cat doesn't like to get very active at home and he feels he's run a marathon just getting from his litter box to the couch every day so he's not thrilled with the idea he has to earn his keep. After going through how many calories he is to get TOTAL per day and an exercise program for him, my staff took over to draw blood from him for his Senior Wellness panel. Well, let's just say the blood draw went very well, but not the collection of urine. He was much too big to even feel his bladder and the our needles weren't long enough to reach it through all of his body fat. Ugh!  (yes he could have been a twin to the one shown in the picture!)

Besides all the pets with major diarrhea issues over the weekend, multiple pets came in with broken nails. Not one of them broke them outright. No, they had to be partially broken so that we have to let them grow out some more in order to cut them back. At least they were all good spirits about it. Cookies go a long way with the bouncy Pitbull who keeps trying to lick your glasses off when you are placing the padded bandage on his front foot. And of course, let's not forget the wrestling job we have to go through to get the E-collar on! LOL

We didn't get any patients ingesting their owner's marijuana stashes today, but one energetic boxer decided to polish off half a chocolate cake around 8am. What time did his owner actually bring him in you ask? Well, 2:15 pm. That would be beyond the window we have to induce vomiting and he really should be admitted to the hospital for intravenous fluids and a seizure watch. What were we allowed to do? Subcutaneous fluids and activated charcoal. That's it. Hopefully that will be sufficient. I guess we will find out more by morning when the dog is transferring from one of the emergency clinics for convulsing all night long! 

Sometimes we get patients in because their owners are actually going through some medical issues of their own...the psychiatric kind. I had one of those today. This very nice woman insisted her cat was covered in bugs that were burrowing under her skin creating these horrible sores on her body. We went round and round about it and finally I got her whole story out. The owner had been off her own meds for too long and was actually self medicating with Goddess knows what. One thing she was doing was coating her body in Desitin. She thought she would put some on her cat and did, but luckily she thought better of it. Desitin has zinc in it and can cause serious life threatening anemia if it's ingested by a cat. Oy! 

Finally I got the woman to listen to me when I told her that her cat was healthy and only had a flea allergy. I also told her that her home was infested with fleas since they were also biting her and she was digging the shit out of herself. She agreed to call the exterminator again in the morning. 

Today was also the day of the "land shark." I'm sure you've heard the term from me from time to time. It's used in the veterinary field to describe the little dog that introduces itself to you with a snapping jaws. Wouldn't you know that all of my land sharks today were chihuahuas? One of them even lunged at me as I was leaving the room. Well, I went right back in and the dog backed up cowering behind the owner. I took the leash and walked him back out. Ha! He was more than okay to be my friend then. Stinker!  

I had one cat today that made it's way onto the land shark list. All claws and teeth this one. Of course he was on his "best" behavior with me, but as soon as my staff took over for testing, he turned into the Tasmanian Devil! What the hell? He even launched himself around our treatment room daring my technicians to catch him long enough to give him his tapeworm medication. Whew!

One last thing before I end for the day. I know many folks like to keep a bowl of fresh fruit out on their tables or counters. If you have pets, it's probably a good idea to be sure you don't include grapes in those bowls. Grapes and raisins can be very toxic to dogs and cats. If they eat enough for their body, they can end up with kidney failure. How much is too much? No one knows. The amount varies from pet to pet so it's best to just keep grapes and raisins safely locked in the refrigerator. 

For cats, make sure you keep any and all lilies out of their reach. Not all of them will cause kidney failure in cats, but many do. Two in particular, the Easter Lily and the Tiger Lily will cause kidney failure if any part of the plant or flower is eaten. Peace Lilies will cause horrible gastroenteritis...yeah tons of vomiting. So do yourselves and your inquisitive cats a favor and don't have these flowers/plants around.

Well, that's it for me. Another Manic Monday under my belt and I'm wiped out. Time to head to bed and rest up for Terrible Tuesday! LOL  

Until next time...
~Dr. Tammy

#FurbabyFridays: Reflections of Twenty Years As A Veterinarian And The Battle With #DrGoogle

This year marked my 20th anniversary as a full time veterinarian. I've had some amazing days and some that I don't care to experience ever again. As I enter my last year in this career, I've begun to reflect up on all that I've seen and heard over the years. Some of it will shock the hell out of you as it did me at the time I went through it and still does as the memories run through my brain. So much more of it will warm your heart and make you laugh until you beg for mercy! 

I'm going through my older posts here and updating them a bit to share again and then add more. Sharing my memories and experiences as a veterinarian and animal lover is my way of giving a bit back to a profession that helped create who I am today.  As I move on to pursuing my writing and publishing career, I'll continue to use what I've learned as a veterinarian and from those I've met along the way. Who knows? Maybe some of you will recognize bits and pieces of it in my books! LOL!  Here's a bit of one of my days a year ago...

I've got a lot of stories to tell having been a veterinarian for over a fifth of a century. Some will make you cry and others will make you laugh until you pee your pants. Still quite a bit more will have you shaking your head and saying WTF???? Today was one of those days for me.

Just when I think I've heard everything when it comes to my four-legged patients, in walked in an adorable and obviously very pregnant pit bull. Her owner was in complete denial. He told my receptionist that he already knew what was going on with his dog because he googled it.

Seriously. You read that right. This man actually asked GOOGLE to diagnose his dog.

According to Google, his precious "child" was going through a false pregnancy. Here is the conversation that followed after I picked my jaw up off the floor. Not only could I feel at least two puppies in her uterus, I heard their heartbeats with my stethoscope. Her mammary glands were full of milk and getting ready for the arrival of the pups. Her body temperature was a little low as well. This is another indicator that BIRTH IS COMING!!!

"So why do you think she's going through a false pregnancy?"

"Cuz it's only been a month since she was in heat. She's not been around any other dogs except at my friend's house." 

"When was that?"

"Two months ago, but that can't be it. She wasn't in heat then when they tied up."

Now I got him. "Dogs won't breed unless they are in heat and definitely won't be tied up unless the female is in heat and receptive to the male."

"I don't get it. I bred her twice last time and it didn't take. She was definitely in heat then and all she did was fight the other dog off."

Here's where I wanted to smack my head against the wall repeatedly but I refrained myself. I had a hell of a time keeping from laughing though. "Uh, hate to tell you this, but when she fought the male off, she wasn't in heat. THIS time she was, and at the right time to get pregnant. Your dog due any day now."

"But Google said—"

I held up my hand. "With all respect to Google, I disagree. If you want, we can take an x-ray and count the puppies to see how many and how big they are."

"Don't have any money for that, Doc. I just want you to fix her false pregnancy. That's what I came here for today."

"It's not a false pregnancy. She is going to give birth. Nothing false about that."

"Google said her symptoms go along with a false pregnancy so there ain't no pups in there. I used to work at the shelter and I learned a lot. What I didn't know, I looked up on Google. So far I've done right by all of my dogs, except for the two puppies that died last year."

"Oh, sorry to hear that. What happened to them?" I had a pretty good idea. The most likely cause of their death would have been parvovirus. It is a deadly virus that is highly contagious. Too many people in our area don't get their puppies vaccinated early enough, or for a long enough period of time. Because of that, these pups are unprotected when their owners take them to the local dog parks and beaches.

"Well, Google said they had worms so I gave them dewormers, but that didn't work."

"Did you give the puppies vaccines?"

"Naw. They weren't old enough yet. Everybody knows you don't start vaccines on pups until they are five or six months old."

"Where did you hear that?" Oh I regretted that as soon as I said it.

"My friend who's raised dogs all his life told me. He's raised tons of litters. Just to be sure though, I googled it."

"How about you take these handouts that explain everything you need to know about your dog giving birth. They also tell you what to look for while she's nursing them and how old they need to be when they have their first veterinary exam and vaccinations." 

"Thanks, Doc but you didn't need to go through all this trouble. If I have anymore questions I'll just hit up Google!"

Take home message:

Getting veterinary advice from Google or any other search engine on the Internet is a bad thing. Using Google to look up information your veterinarian has discussed with you can be a GOOD THING. Take the time and ask questions of your veterinarian while your pet is getting it's annual and semi annual exams. Just because someone has raised animals all of their lives doesn't make them experts. Please, please please be responsible pet owners and seek proper veterinary care for your new and current fur babies. 

 

Being a pet guardian is not a right. It's a privilege and an honor.  

Until next time
~Dr. Tammy

#FurbabyFridays: Dealing With Elderly Pets And Their I Know More Than You Vets Owners

Welcome to Furbaby Fridays with Dr. Tammy. This week has been filled with so many frustrating cases and clients. I thought I'd share an article I posted here 1 !/2 years ago and it sums up what my colleagues and I had to deal with working in our very busy veterinary hospital over the last month. For myself, it was nearly verbatim a conversation I had with a male owner concerning his very sick cat. He screamed at me when I couldn't just lay my hands on his cat and tell him for sure that the mass I felt in Miss Kitty's belly was in fact going to be terminal. Never mind he waited five days to bring her in this last time. She was in very big trouble and I had to try to get through to him. Ultimately he did go to the specialist as I recommended, but it took two more doctors to tell him the same things I did...at two different clinics...before he came to grips with the severity of his pet's illness.

Ever have one of those days where no matter what you do, or what you say you just can't seem to make a difference? Today was one of those days for me and a few of my fellow veterinary colleagues. Each patient chart that turns up in the rack is a potential puzzle to be solved. Sometimes we try to come up with ideas of what could be ailing the pet before we go in, just to see if our intuition is on target...or way off depending on what kind of information the pet owner is willing to divulge to our staff before we get in there.

It can be like pulling teeth getting an accurate history. I've had clients refuse to give any details about what is up with their furry companion until I get in there, and still they keep quiet, thinking that just by laying my hands on the animal I will miraculously know what is making "Fluffy" not want to eat for the last week. Starting with the usual questions about what foods they animal is being fed and it's "potty" habits can be the most challenging. 

"I don't know the name of the food, Doc. It's the one in the yellow bag."  

"I got four cats, how am I supposed to know who pissed or shit in the box?"  

"What does his food have to do with why Ranger is itching and keeping me up all night?" 

"Flea control? Naw, I never saw a flea on him so it ain't flea allergy."

Wanna make a bet?

Today I had one woman say to me that she knew the reason her cat was so ill was because she switched his food over to a raw food diet.  That was over five days ago and he still wouldn't eat ANY food. I told her that the diet switch may have been the final trigger that set the anorexia off, but probably not the cause. Do you know what she said to me? "Well, you're just guessing now. You have no proof of that."  

I stared at her for a half a beat and then let her have my sweetest smile.  "You are the one guessing here. It's time we do some blood work and figure out what the heck is wrong with Angus instead of guessing until we're both blue in the face."

"Well, I don't see the point in spending a lot of money to find out what's wrong if there's a chance the tests will come out normal."

I had to really restrain myself from rolling my eyes. "Well, you're obviously worried about Angus, otherwise you wouldn't have returned here three times for us to check him out. I think it's time you take our recommendation and see if we can at least find out what's NOT making him sick."

"If it turns out to be the food that's making him sick, do I have to still pay for the tests?"

"Yes. The costs are for running the tests and interpreting the results. If we don't do some sort of testing, we'll keep guessing and throwing treatments at him that may or may not work one bit."

"Can't you just tell me what's wrong by looking at him? Are you a newly graduated doctor? Why can't you just tell me right off what's wrong? My old vet who retired ten years ago could do that. I never had to pay for these expensive tests."

Now I am really biting my tongue and hoping that the blood from the wound doesn't seep out onto my lips. "I graduated over 20 years ago now, Mrs. Green and have been in practice ever since. We can get into why properly diagnosing pets often needs more than just the physical exam, or we can do the testing you came in for today. You agreed to come back if Angus didn't respond to the fluids so that we could do these tests."

"You vets just want all of my money. I've had cats all of my life and I never had to do this stuff before."

"Angus is nearly 17 years old now and there are a lot of things that could be going wrong with his kidneys, liver, or other organs. He could have a cancer somewhere that we can't feel on exam yet, or the start of diabetes or hyperthyroid disease. The only way to know is to do the blood tests."

"Well, I just don't want to spend any more money on him.  The treatments you all gave him didn't work. He's sick again.  Why won't he eat?"

We stare at each other a few more moments. This woman brought her cat into the hospital THREE times now and has refused to do anything for him other than subcutaneous fluids. She was told repeatedly that this was just to help with his dehydration and wouldn't tell us anything about his condition at all.  "What do you want from me, Mrs. Green?"

"I want you to fix my cat. Tell me what food to feed him so he'll eat again. Tell me what's wrong with my cat."

"We have to do these tests to figure out what is going on so we can treat him properly."

"I don't think the tests will tell us anything."

At this point I'm so tempted to tell her Angus has a terminal cancer, but know that's not what she wants to hear and I don't know that's what's wrong with him. "Why did you come back today, Mrs. Green?"

"I want you to tell me what is wrong with my cat and fix him."

"I'm trying to do that but we need the tests so we can do this the right way."

"Why can't you just look at him and the notes from the other doctors and figure it out that way? I know I'm right and it's because I changed his food."

At this point, I basically want to pull my hair out. Angus has lost another pound in the last week. That's over 10% of his body weight gone in less than 7 days.  His anorexia had been going on for the last two weeks, off and on. It was now five days since he ate anything at all. This wasn't good at all and until we figured out what was going on, he could continue to go downhill. I changed tactics a bit. "I know you love Angus and want what's best for him. I wouldn't recommend these tests if I didn't think it was the first steps we need to take in order to help him. That's exactly what the other doctors have recommended as well."

She bit her lip a few times. "Well, if really you think the tests would help find out what's going on, then let's do them.  If I would've known they were so important to his health, I would've done them sooner. You know, it's not a matter of the money. I'll do whatever I need to do to help him.  I just don't want to do any unnecessary tests if he can be fixed with just a shot."

Oy! Does anyone else feel like they're in the middle of an Abbott and Costello movie? I did at the time it all happened and still do reading through it again!
~Dr. Tammy

#FurbabyFridays Revisits Heat Stroke and Warm Weather Death Traps

I originally posted the following blog on May 9, 2012. In light of the death of a patient because it was left in a car at a BART station for nearly 7 HOURS while the owner went off for the day to Goddess knows what, I thought it was important to bring up the topic again. The day this Pit bull died? It was in the low 70's and clear blue skies. We weren't dealing with a heat wave, just a sunny day and a dog left in a car that quickly became an oven and an instrument of death.

Don't like the thought of a dog seizuring out of control for hours? Don't like the image in your head? Me either and neither did the Good Samaritans who called the police when they saw the dog seizuring in that car. Please, please, please! Don't leave your pets or your children in cars alone unattended while you "run a quick errand." Leaving them home or with supervision and the  air conditioner on could save their lives. 

Read on to learn more about heat stroke.
~Dr. Tammy



People don't often realize how dangerous warm weather can be for their pets. Not only are there the obvious dangers of being hit by cars, allergic reactions to insect bites, snake bites, and the ever "evil" pieces of weed seed called foxtails commonly found here in California, there is something else that ranks up pretty high in the danger list as the temperatures rise above 70 degrees.

Heatstroke is unfortunately a very common occurrence this time of year, and not just for dogs left in cars. Although rare in cats, it has been reported in cases were the feline was trapped in a clothes dryer, left in carriers in hot vehicles or indoors with little or no ventilation. Exotic pets can also be victims. Rabbits, chinchillas, rats and guinea pigs are frequently presented to emergency veterinarians near death because their hutches and cages are placed in areas with little or no shade and are provided with little to no water while their body temperatures soar.

For the purpose of this article, I will focus more on dogs, but honestly all the information discussed here can be applied to the other furry friends. There are many ways animals can become dangerously overheated. Dogs have sweat glands only on the pads of their feet and cool themselves primarily by panting. When the air is hot and humid, they cannot rid themselves of the excess heat efficiently. Heat exhaustion or heat stroke is more likely to occur during the first hot days of spring or summer when it's 70-75 degrees than on a 100 degree day in August.

Why? Because by the end of summer dogs are used to the heat and typically their owners know enough by then to take it easy with themselves and their pets. It's early on when dogs and people are simply not acclimated to the heat and can easily overexert themselves in the new warm temperatures.

Quite a few people travel with their pets when the days are warm, even running errands with their pets "riding shotgun." Unfortunately, unless you plan on leaving the engine running and the air conditioning on full blast, leaving your dog in the car while you run into that store for a "few seconds" is simply NOT an option. Whether or not you leave the windows down or up, park in the shade or not, it doesn't matter. Here's a chart demonstrating how hot the inside of the car can get at various outdoor temperatures.

Pretty frightening isn't it? Within 20 minutes your car can be 30 degrees warmer than the outside temperature! Being left inside a car isn't the only cause of heat stroke. Here are a few others.

1. Physical exertion during the heat of the day. This can include going for a run with their owner, playing outside, running along the backyard fence, etc. Heat stroke can even occur inside if the house is warm and the dog becomes excited.

2. Being outdoors in hot weather without access to cool water and shade. Dogs that are tied or kenneled outside can sometimes get trapped out of reach of shade or water.

3. Being a certain breed whose physical conformation makes them unable to cool themselves effectively. Bulldogs, Boxers, Pit bulls, Rottweilers, Boston Terriers, etc all have short noses, small airways and excess tissue at the back of their throats that can make it difficult to get rid of excess heat.

4. Confinement in a poorly ventilated cage or crate especially under a cage dryer such as when a dog is being groomed.

5. Being overweight

6. Having medical ailments such as heart or airway diseases that can impair breathing. Heart failure, arrhythmias, laryngeal paralysis, pulmonary hypertension, asthma, and bronchitis can all make dogs predisposed to heatstroke.

7. Being very old or very young

So what are some of the symptoms of heatstroke? Each patient is different, but if you see any of these with your dog on a hot day, it would be wise to seek help from a veterinarian earlier rather than later.

1. Heavy panting: rapid or labored breathing

2. Bright or brick red gums. These may also be dry to the touch

3. Weakness or collapse

4. Elevated rectal temperature. Normal is between 100-102.5 degrees Fahrenheit. Seek IMMEDIATE veterinary care if the temperature is 105 or higher. Once an animal's body temperature approaches 109 degrees, brain damage is highly likely.

5. Vomiting

6. Bloody diarrhea

7. Dark urine

8. Bleeding from the mouth

9. Seizure or coma

DEATH can occur within 20 minutes or in a couple of days from delayed complications such as kidney failure.

Now that you've scared the heck out of us, what do we do to prevent our pets from getting heatstroke?

It's all basic common sense. Don't leave your dog in the car when the outdoor temperatures are over 70 degrees and definitely not on bright sunny days. Restrict your pets activity during the heat of the day. Don't go jogging at high noon with your dog. It's way too hot for him and for you. 

Allow your pets to gradually acclimate to warm weather, especially if they are physically active. Always provide access to shade and cool water when dogs are outside Keep breeds at risk, very old, very young or dogs with health conditions indoors in cool, well ventilated areas. If there is a heat advisory issued, please keep all animals inside. If unable to do so, use misters, fans, or wading pools to provide extra cooling measures for outdoor pets.

What do we do if our pet does suffer from heat exhaustion or heat stroke?

First of all, try not to panic! Your pet needs swift and immediate intervention in order to give it the best chance of survival.

1. Immediately move the dog indoors or to a cool area. If in an enclosed crate, remove the dog from it immediately.

2. Wet the dog down with cool water. Do not use ice water as that will make internal cooling more difficult by constricting blood vessels.

3. Take the rectal temperature. If it's over 105 degrees, transport immediately for veterinary care. Know where the nearest emergency clinic is located. Call en route to let them now you are coming.

4. Do not cover your dog during transport, not even with a wet towel as that can prevent heat from escaping.

5. Offer water to drink during transport, though not to a vomiting patient. Only offer small amounts of water at a time and do not force it down your pet!

6. Transport in an air-conditioned car or lower windows so circulating air can help with evaporative cooling.

7. Stop cooling measures when the rectal temperature reaches 103 degrees so you don't over do it and result in hypothermia.

8. Even if your pet seems to respond to treatment, it is still best to have them evaluated by a veterinarian to check for internal problems. Complications from heat stroke can develop several hours to days later due to organ damage caused by high internal temperatures.

Still not convinced it could happen to you and your beloved pet? Click on the link below...

What happens to a dog in a hot car?

The above link is to a graphic that I found today discussing what actually happens to that dog left in a car on a nice day...even with the windows down! I see way too many cases of heat stroke during the nice days here in California. The biggest excuse I hear from people? "I was only gone a few seconds." Yeah, right! You try staying in a hot car with a fur coat for just a few seconds and you tell me how you feel. What you THINK is only a few seconds is actually a few seconds too long when it comes to the health and well being of your dog.

Not only is this dangerous for dogs, it's also a problem for cats, rabbits, other small rodents and birds. Why take the chance people! Leave you pets at home when you run errands, or have someone stay in the car with them with the air conditioner running.

Did you know that in most cities across the country it is ILLEGAL to leave a pet unattended in a car? Just because you haven't been caught doing it, doesn't mean that it's okay to keep doing it. So please, please, please be a responsible pet owner and keep them safe in ALL weather!

#FurbabyFridays: The Oath That Breaks Your Heart

This has been one hell of a week for me the veterinarian.  I’ve seen the best of pet owners and the very worst humanity has to offer. It’s the worst cases that weigh heavily on my heart today. I’m at a loss as to how to fix the overall ignorance of more and more of the people walking into our hospital doors. At every single turn we’re tossed road blocks and speed bumps that prevent us from upholding the oath we take when we become veterinarians.  Not only are we prevented from upholding it, we are constantly told we aren’t doing what we’re sworn to do by clueless individuals. These people have no idea what the oath states and most assuredly no understanding for what those words mean.  Here’s what the veterinarians before 2010 recited at their graduation ceremonies:

Being admitted to the profession of veterinary medicine, I solemnly swear to use my scientific knowledge and skills for the benefit of society through the protection of animal health, the relief of animal suffering, the conservation of livestock resources, the promotion of public health and the advancement of medical knowledge.

I will practice my profession conscientiously, with dignity and in keeping with the principles of veterinary medical ethics. I accept as a lifelong obligation the continual improvement of my professional knowledge and competence.

Now here’s the “revised oath” adopted by the AVMA since 2010 and recited by every graduate of a veterinary school in the United States.

Being admitted to the profession of veterinary medicine, I solemnly swear to use my scientific knowledge and skills for the benefit of society through the protection of animal health and welfare, the prevention and relief of animal suffering, the conservation of animal resources, the promotion of public health, and the advancement of medical knowledge.

I will practice my profession conscientiously, with dignity, and in keeping with the principles of veterinary medical ethics. I accept as a lifelong obligation the continual improvement of my professional knowledge and competence.

Read the words carefully. Where in there does it say that as veterinarians we are obligated by our oath to give away our services for free? Yes, we can and do eliminate suffering for animals presented to us by offering humane euthanasia at no cost. Yes, we do stabilize an animal that is in shock and pain until the owners can be found at no charge to the owner. Yes we do perform many services, nursing and supportive care to our four legged patients in need, often at a reduced or NO COST to the owner of the pet.   But nowhere in that oath does it say we have to vaccinate you pets for free, microchip your pets for free, give you free medications to treat your pet that’s been sick for months all for free.

Nowhere does it say we are responsible for your decision to NOT vaccinate your 10 month old puppy and then have to give you all the medications necessary to treat the same puppy because it contracted parvo due to YOUR negligence.

Nowhere does it say we have to perform the third C-section on your dog because you refuse to have her spayed after the first difficult pregnancy.  You didn’t think her “son” would breed with her since they were “related” even after we told you that doesn’t matter in the animal kingdom!

Nowhere does it say that we have to keep treating each and every new puppy you bring into our clinic with parvo FOR FREE because you didn’t listen to us when we told you the virus is deadly and can survive in the environment for at least six months to a year. We BEGGED you not to bring another puppy into your contaminated house and yard and yet you decided you and Dr. Google knew better than those of us who “took an oath.”

I take my oath very seriously that’s why I spend the time with you in the exam room and on the many phone calls you make to my hospital daily. I’m not trying to “rip you off” by recommending “unnecessary” tests. I’m trying to give the information you need to make informed decisions about the care and wellbeing of your pet.  Part of that oath I took implores me to “protect animal health and welfare.” I’m trying to do that by recommending the appropriate vaccinations for your pet’s lifestyle, the proper flea control methods and heartworm preventatives.  I’m “promoting public health” by discussing and recommending flea control for all of your pets, routine dewormings and fecal testing.  Many diseases can be spread to humans through parasites that infect animals. This is part of my job daily…and the bane of my life as a veterinarian.

Why?  Because so called experts online and those in the community who’ve “owned pets all their lives” claim to know more than I do and tell many of my clients to ignore all vets. “You don’t need that fancy flea control. Just feed your animals garlic.” “You don’t need no heartworm prevention. I’ve had dogs for over 30 years and not one of them have ever got it.”   “They’re all about money.”

Not in my hospital. Each and every one of my colleagues, nursing staff, and receptionists bust their butts daily for the health and wellbeing of our patients and their owners.  We work short-handed and hours after our scheduled shifts to make sure our patients get the care they need. We hold our patients in their last moments on this earth when their owners couldn’t bear to watch them die or just didn’t want to deal with them anymore.

At the beginning of the week, I had to step in and tell a pet owner enough was enough. No amount visits to my office or specialists were going to bring back their beloved Dalmatian to his glory. The poor thing was in full dementia, could no longer stand and refused to eat. He continued to yelp out in pain and at times for no apparent reason. This wasn’t the dog I first saw in my office many years ago. This was a shell of skin and bones the owner clung to. Both were suffering and I had to beg my client to please let me take away his best friend’s pain.

So the next time you think veterinarians are just out to get your money, think about that Dalmatian and his best friend and owner.  Think about YOUR responsibility as the owner and guardian of your own pets. Maybe if perspective pet owners had to take an oath such as the one I had to take, there wouldn’t be so many unwanted animals in the shelters. 

Maybe there still wouldn’t be so many unvaccinated puppies dying of distemper and parvovirus  annually.  Maybe there wouldn’t be owners just callously tossing their little Yorkie aside because they didn’t want to be bothered with the nursing care it would take to save her.  Instead, they tossed a hundred dollar bill down and walked out munching on their McMuffin as they went.

Maybe there would be more people setting up relief organizations that help pet owners with the cost of the care of their pets instead of pushing it off onto veterinarians and overcrowded shelters because we “took an oath.”

Maybe there would be more people spreading the CORRECT information about what it takes to keep pets healthy instead of perpetuating mistruths and Old Wives tales as facts. 

And maybe there wouldn’t be such a high rate of burn out in this profession.  Walk a few days in my shoes and you’ll learn a hell of a lot more than you ever wanted to know about the joys and the sorrows of being a veterinarian or veterinary technician.  The fuzzy kittens and chubby puppies will steal your heart while the injuries and diseases that attack them will shatter it into a million pieces.

~Dr. Tammy

#FurbabyFridays: Snail Bait Toxicity

Some parts of the United States see this toxicity more than others simply because of the climates in those specific areas. Southern US, Pacific Coast states and the Hawaiian Islands all have issues with the slippery, slimy garden creatures that are the reason for using this toxin.

A common ingredient in the baits used to kill off snails and slugs is metaldehyde. This is also found in some brands of solid fuel for camp stoves. If ingested, prompt veterinary intervention is needed to save these animals. The longer the delay in treatment, the worse the prognosis and the risk for death is ever so much higher.

Why is this attractive to domestic animals?

To make the baits appeal to the snails and slugs, bran and molasses are often added. These ingredients are very tasty and appeal to our furbabies as well as other wildlife. So if you live in an area where you have to battle the slippery creatures, it's best to find alternatives to the baits that are commonly used. If you rent, or are in a community that happens to hire a gardener/grounds keeper make sure you ask what they use to get rid of the pests. 

Why is it so toxic?

Metaldehyde is a neurotoxin, which means the primary symptoms tend to be associated with the nervous system such as tremors, hyperexcitability and seizures. Other symptoms include:

1. anxiety
2. vomiting
3. diarrhea
4. excessive drooling
5. uncoordinated walking
6. hyperthermia (increased body temperature)
7. tachypnea (increased respiratory rate)

How does it cause the neurotoxicity and why is it so deadly?

The exact mechanism of action is of course unknown, just like with many of the toxins we've discussed over the last few weeks. It's believed the acidity of the stomach enhances the affects but no studies have found this conclusively. Metaldehyde can cross the blood brain barrier easily, to it does interfere with the neurotransmitters norepinephrine and serotonin. When this occurs, the overall effect is to lower the seizure threshold making it easier for a seizure to occur.

The tremors induced by metaldehyde interference with the neurotransmitters will ultimately cause the animal's body temperature to rise. Temperatures over 107 degrees will cause all organ systems to experience damage at the cellular level.  Metaldehyde also interferes with electrolyte and acid/base balance in the body which leads to CNS depression and tachypnea. Liver failure can occur in within 2 or 3 days of ingestion.

How is it treated?

There is NO antidote! Treatment is early, aggressive supportive care with your veterinarian or at an emergency veterinary hospital. If the ingestion took place less than 30 minutes prior to presentation to the vet, they can induce vomiting. After that point, your pet may already be experiencing some symptoms that would make vomiting contraindicated. The stomach will need to be decontaminated by a different route..stomach tube and lavage. This is basically what they do in hospitals when a human has to have it's "stomach pumped."

The rest of the therapy includes many of the same elements as with the other toxins. Activated charcoal is used in multiple doses to help bind the toxin and prevent it from resorbing as it passes through the intestines. Intravenous fluids are used to help keep the liver and kidneys happy during the decontamination process. Medications are given to control tremors, seizures and correct any electrolyte imbalances that may be evident based on blood work results.  It's imperative that the liver and kidney function tests are monitored closely with repeated lab tests.

Recovery depends on how much of the bait was ingested and how quickly therapy was initiated. The general health of the patient BEFORE the ingestion also plays a big role in how fast they recover. As little as one teaspoon of the pellet form for a 10 pound animal can be deadly. For some pets, just licking it off their paws after walking through areas where the baits have been distributed is enough to make them quite ill.

Do yourself a favor. If you have a snail or slug problem, look for alternatives to get rid of them. A few examples include

1. pet and human hair
2. egg shells
3. salt
4. beer

Here's some links to articles that are great resources for you. Check them out. You won't be sorry you did!

How to Get Rid of Snails Naturally

Veterinary Partner article on Snail bait toxity

ASPCA Poison Control

Murdoch Unversity Snail Bait Article

#FurbabyFridays Warning About Easter Lily Toxicity in Cats

For those of you who have visited with me this entire month, you may have noticed a trend. I've been working my way through some of the common toxins that I've seen with my patients. Since this weekend many will celebrate the Easter holiday, I decided today's spotlight toxin should focus on one that can happen any time during the year and not just now.

Easter Lily

Lily toxicity is unfortunately a very common presentation to veterinary hospitals all over the country. People receive beautiful bouquets of flowers from loved ones and secret admirers all the time. Because lilies come in a variety of types and colors, they are a popular addition to these gifts. Unfortunately, these gifts of love and admiration can be deadly for our feline family members.

Star Gazer Lily

Easter lilies, tiger lily, Japanese Show lily, some species of day lily and certain other members of the Liliaceae family can cause kidney failure in cats. All parts of these lilies are considered toxic and consuming even tiny amounts can be life threatening. Many people are not aware of the dangers these kinds of lilies pose so if you're expecting a florist to warn you about the potential hazard, good luck with that. As more and more people learn about it and help to educate others, one day we will see a decline in cats admitted to emergency hospitals on death's door.

The exact toxin so far has not been identified. Just like with the grape and raisin, we are left stumped as to why it happens. We do know the toxin is water soluble and kidney damage occurs within 24 to 72 hours of ingestion of even just a few bits of a leaf or flower petal.

There are no known diagnostic tests to check for lily toxicity. The tests performed by your veterinarian center on checking the function of your pet's kidneys. Treatment must be done early on in order to be successful. Just like with most ingested toxins, the emptying of the stomach contents is recommended if it's within 2 to 4 hours of ingestion of the plant. Activated charcoal, IV fluids for at least 24 hours and other supportive care is needed to ensure the patient recovers. If left untreated, kidney failure usually begins within 2 to 4 days. By this point there are very few treatment options left and the death rate from lily toxicity is very high.

What are the common signs of lily poisoning?

These early signs often develop within the first 6 to 12 hours of exposure

• vomiting
• inappetance
• lethargy
• dehydration

Left untreated, the signs worsen as kidney failure develops

• not urinating at all or urinating too frequently
• not drinking at all or excessive thirst
• walking drunk
• diorientation
• tremors
• seizures
• death

Once again...THERE IS NO ANTIDOTE for lily poisoning. Prompt veterinary attention is necessary.

What about other types of lilies?

Peace Lily

Not all lilies cause kidney failure but there are some that are mildly poisonous. These kinds contain oxalate crystals that irritate the mouth, tongue, pharynx and esophagus. With these, you will see minor drooling. Even so, it's better to be safe than sorry with ingestion of lilies of any kind.  Examples of these less toxic lilies include

• Peace Lily
• Peruvian Lillies
• Calla lilies

Add Cala Lilies

The take home message here is to avoid having lilies of any kind around your cats. If you are planning on sending a flower arrangement to someone and you know they have cats, ask the florist to use alternatives to lilies. If you suspect your cats have been munching on any part of the lily that does make it into your home, consult with your veterinarian IMMEDIATELY.  If you see any of the signs discussed above, seek veterinary help ASAP. Time is your enemy in this situation. 

~Dr. Tammy

Additional resources that can be helpful

Lily Dangers for Cats: The Cat Fanciers Association

ASPCA Animal Poison Control Center

#FurbabyFridays: Chocolate Toxicity

Hello and welcome back to my weekly installment of Furbaby Fridays with Dr. Tammy. This week we are counting down to Easter and I thought today would be a great time to remind folks about the dangers of chocolate. This tasty treat comes in all shapes and sizes and formulations whether in cocoa products like candies, cakes , cookies and brownies, but also in cocoa beans and mulches.  The most accidental exposures of pets to chocolate of course occur more around the holidays and Easter is a big one.

Because dogs tend to be the pets that tend to eat just about anything, we don't usually see cats with this toxicity, but there are a few of those pesky felines who pretend they are dogs and ingest some odd things. So to be safe, keep chocolate away from all fur babies.  This includes some cocoa bean hull mulches. Not only do the mulches smell like chocolate Pop Tarts, they are readily available for pet for some pets because of their use in gardens and landscapes. Of course the makers of the mulches will say there has only been one documented death from the ingestion of these kind of mulches, this does not mean that animals are not sick from them. In fact, even Hershey one of the makers of these mulches admit that 50% of dogs who ingest their mulch can get sick from it.  Here's an article by snopes.com that talks a bit more about it.

What makes chocolate toxic to animals?

Methylxanthines are the culprits here, specifically theobromine and caffeine. That's right. There are TWO toxic components in chocolate and each will vary in concentration depending on the type of product. The rule of thumb is the darker the chocolate the higher the amounts of both of these compounds. White chocolate has 0.25mg theobromine per ounce and 0.85mg of caffeine per ounce. In contrast, dry cocoa powder has 737mg theobromine and 70mg of caffeine per ounce.  Now what does that mean? 

Animals can show mild signs after only ingesting 20mg/kg of either theobromine or caffeine. Severe signs are seen at 40mg/kg and seizures at 60mg/kg. So if you have a 20 pound dog (roughly 10 kg) it would have to eat 400 mg of the toxins to start showing some signs.  So only 1/3 of an ounce of the dry cocoa powder can be dangerous and only one ounce of the cocoa bean hulls in the mulches could do it as well. Less than 1 ounce of milk chocolate per pound of body weight is potentially lethal for dogs. Milk chocolate is nearly 100 times as toxic as white chocolate. Baker's chocolate is SIX TIMES more toxic than milk chocolate. 

A lot of figures, I know but I wanted you to see the comparisons. If your dog decides he likes your dark chocolate candy bar you've been saving in your purse, you very well may have an emergency on your hands. 

 For an article about chocolate intoxication and a chart that includes the amounts of the types of chocolates and caffeine sources click HERE. It's a page on the ASPCA website with articles aimed more for veterinarians. The article is a PDF that will download to your computer if you click on the link.

It's not only the actual amount of chocolate we have to worry about when our pets ingest these kinds of foods. More often than not, the ingestion takes the form of eating candy in wrappers. Those can be just as bad leading to obstructions in the stomach and bowel loops. Even if the mulches are of the variety that have been treated to remove the theobromine, the debris itself could cause an obstruction if enough is eaten.  

What are the clinical signs to look for?

Usually withing six to twelve hours of ingestion you will see the first clinical signs. These include polydipsia (drinking a lot of water), vomiting, diarrhea, bloating and restlessness. If enough of the chocolate has been ingested, the signs can progress to an animal that ends up extremely agitated/hyperactive, urinating a lot, tremors or even seizures.  Other symptoms include high heart rates, arrhythmias, elevated body temperatures, coma and even death.  It's the arrhythmias that can cause death in these patients so it's imperative that you seek immediate veterinary care if your pet gets a hold of any kind of chocolate. It's better to be safe than regret it later.

How is chocolate intoxication treated?

As soon the pet arrives, the veterinary staff will be in motion. Stabilization first involves decontamination of the stomach by inducing vomiting. This will be done only if the patient is stable enough for it to happen. If your dog is seizuring, the induction of vomit will NOT occur. Instead the seizures will be brought under control first. Once more stable then decontamination will occur using stomach tubes to remove as much of the chocolate that remains and to administer activated charcoal without sorbitol. (In the paint ball toxicosis article you will recall that sorbitol is one compound that can cause issues all on it's own. 

If it's been within a two hour period of ingesting the chocolate, emesis (vomiting) will be induced. Trust me, some of the dogs that have come into my clinic after eating chocolate have amazed me with the sheer amount of the stuff in their stomachs. One patient at a box of mint cookies covered in dark chocolate. My treatment room reeked of minty chocolate for hours after that pooch tossed his cookies...pun intended. ;)  

Intravenous fluids, close monitoring of vital signs to make sure elevations of temperature and heart rates don't occur. If the signs do progress, then medications are administered to control seizures and arrhythmias. Usually our patients present early enough that just 12 hours of IV fluids, and monitoring are all that's needed after the decontamination. Activated charcoal is sometimes split into three different doses in order to continue to absorb any chocolate that got into the intestinal tract.  The patients that have the longest recovery are those who are treated after the bad symptoms have already started or they've ingested chocolate that contains other "ingredients" such as marijuana, laxatives, "magic" mushrooms and other recreational drugs. 

So do yourself and your pets a huge favor and lock up all products containing chocolate and caffeine. Even if it's white chocolate containing very little toxin per ounce, it's best to just keep it out of reach. Don't leave any candies out in dishes, Christmas stockings, wrapped under the Christmas tree, in Easter baskets accessible to pets, boxed chocolates on Valentine's Day, or baked goods out where your pets have access.  I know that all seems like common sense, but you'd be surprised by the number of folks who say "my dog never jumps up on the counter. Why would I put the chocolate away?"  Here's another good one, "It's a dog. They don't eat chocolate."  

This is where I usually hear Bill Engvall's "Here's Your Sign" routine.  LOL