Them Bones, Them Bones

So, I was out for a long run on Monday. Actually, I didn't have access to a car, my daughter having absconded with it and I had no other way to go home. Now a more sane person might have called someone for a ride, or at least picked the most direct route home. But nooo, I mapped out a 12 mile route, including a little turn around the high school track for good measure and trotted off. The thing about long runs is that there is a period of time where there is nothing to do other than to let one's mind drift, and drift mine did. As various things started to ache, I focused on a bunch of things that I wanted to write about, most of which I have forgotton, but I'll try to stick with the free association that I went through over the two hours it took me to get home to dinner.

First, I was thinking how I should think of things to write about. Seems to make sense. Then I realized that no one, not even one person, ventured a guess about the film references. I'm not going to assume that there are no readers out there (my ego couldn't take it) so I'll assume there are no Italian film fans. The references were to Amarcord, a 1973 coming of age film with everything a guy could want in a movie with subtitles except there was no karate.

Then I realized that no one knew that in our practice, Bichons, are the master stone formers. They just pop back and forth between struvite and oxylate, frustrating the heck out of their owners and their doctors alike.

By the second mile, I was all warmed up and feeling pretty good. I looked down at my feet and realized that I will need new running shoes after this race in September. (I never race in new shoes) Then I was thinking about the shoe drive that we are running at our hospital, collecting used but wearable shoes to be distributed by souls4soles, a non profit outfit that is actually in Hati right now as we speak, delivering shoes to those who are bare foot.

That kept me distracted for a while, until I started thinking about my pace and heart rate and all of those mundane things that I need to keep track of if I am to finish this run in any kind of shape and still be able to get the rest of my work outs in over the week. I was trying to juggle my schedule so that I didn't have runs on back to back days because that is really hard on my legs. Which led me to think how lucky I am that my knees are good. My mind quickly did some trick to ward of the evil eye and then I thought I should talk about arthritis in pets. There was one brief digression as I ran on a bit of roadside path that made me worry about ticks and lyme disease, but that topic doesn't really fit the trend of nutritional posts I wanted to write and maybe I could put that off for a week or so, even though we are getting into the second peak season for deer ticks that spread the disease, even tho we don't have a lot of deer in my area and then I notiticed that I hadn't taken a breath and the run on thought had become a run on sentence and I was going to pass out if I didn't slow down.

So miles 4 - 8 were mostly on joint disease. Now, both dogs and cats are subject to degenerative joint disease. I am talking about the type of arthritis that is caused by wear and tear on the joints. There may be underlying instability in the joint as in hip dysplasia. Sometimes it is a genetic predisposition such as the abnormal looking joints in Basset Hounds. And sometimes, it is just part of the aging process. We think of dogs as being arthritic, but there was actually a retrospective study that looked at the x ray films of cats admitted to hospitals for other reasons. 22% of the cats over a year old in this study showed radiographic evidence of osteo arthritis.

So what are we to do? There are plenty of medications out there to treat arthritis in dogs, not so many in cats. Some are non-steroidal anti-inflamatory medications (not in cats please). There are nutriceuticals such as glucosamine, chondroitin, green lipped muscles (who knew they had lips). There are surgical treatments (not so good). New research shows promise using stem cells. And we have had some very good success using our laser to treat painful joints in both dogs and cats. But what if you could do one thing to prevent, or at least mitigate, the degenerative changes in the joints.

Well, if you are a regular reader, you know that weight control is very important in preventing arthritis in pets. Purina did a great study in labs showing a correlation between arthritis and increased (excessive) body weight. (Leaner dogs also lived longer) So, work with your veterinarian to get the weight off of your heavy furry friends. Or, better yet, don't let them get fat to begin with.

What if they are thin and have arthritis anyway? It does happen you know. There was a series of three articles published in the past year in the Journal of the American Veterinary Medical Association (JAVMA) showing that there was an excellent response to a diet made by the folks at Hills. Dogs fed J/D (Hills cleverly uses initials to make it easier for veterinarians to remember what the food is for. Joint Diet - get it?) had a good resolution of clinical signs related to arthritis. In fact, there were all sorts of things that were measured and showed improvement over the initial 30 day period that the food was fed. I know, these diets are expensive. Not really when you consider that one of the articles demonstrated that dogs could reduce the amount of NSAID that they took when they ate this food. Add that savings in (not to mention that there are no side effects to feeding J/D and there can be with medications) and then the food is not that expensive after all. Oh, what about cats you ask? Well, they just came out with a diet for cats (Feline J/D, so clever those folks at Hills) and it works great too.

Now stop your whining before you start. "My cat won't eat that food" I can hear it already. They have a money back guarantee, my rep told me so today. If your cat won't eat the stuff, you can return it to your vet and get your money back.

So, here it is, you can actually decrease your pet's chances of getting a debilitating disease by feeding it optimally to prevent obesity. And if your pet is unlucky enough to develop osteo arthritis, you can "treat" the condition with food. Hey we all have to eat anyway, why not feed something that will make your pet's legs get better.

I'm not going to go into what I ws thinking about for the last couple of miles of the run. It wasn't pretty, and the thoughts were not all that pleasant. Just leave it to I finished, I was happy with the time it took, my legs felt OK and I had a cold beer waiting for me. My idea of optimal, post workout re hydration and recovery.

Something's Amiss if a Dog ....

OK, so no one read the last blog post. It can't be that no one knows where the film quotes are coming from. But just in case there are hundreds of you out there and you are just to shy to let me know what movie I'm rambling on about, today's post title is another hint.

I also purposely skipped dogs in last week's post about lower urinary tract disease. No, not because I think dogs are second class pets. It's just that their disease is actually easier to write about and the photos that I have are better, or at least more dramatic.

Now, dogs with lower urinary tract disease often have infections. These respond well to antibiotics. The diagnosis is made by clinical signs, (frequent urination other than marking by unaltered males), +/- blood in the urine, a urinalysis indicating infection or inflammation, and sometimes a culture. Simple UTIs (urinary tract infections) are more common in females than males, an anatomical issue not a sexist one, and should respond to a short course of antibiotics. Cure should be confirmed with a follow up urinalysis. UTIs that do not respond to treatment usually fall into one of several categories. 1. The antibiotic chosen was not appropriate for this specific infection due to bacterial resistance, solution, culture to get correct antibiotic sensitivity. 2. Antibiotic was appropriate, but not given for a long enough time or at the correct dose. 3. There is some sort of underlying problem causing the infection or the clinical signs that are interpreted to be an infection. These can be any of the following; bladder failing to empty completely due to anatomical defect or neurological problem, obesity causing anatomy problems leading to ascending bacterial infections, bladder tumors, or (if you peaked ahead) bladder stones.

This radiograph is a much better illustration than the cat photo from last week. Need I point out the mass of minerals in this poor dog's bladder. I hope not because I still haven't gotten around to the use of arrows in my photographs. (any hints on this would be greatly appreciated.)

Bladder stones in dogs are similar to urinary stones in most mammals. They are mineral concretions that form in the urinary tract. We do see calcification of the kidneys as well, but clinical kidney stones are less common than bladder stones in dogs. The most common stones historically were struvite stones. These phosphate based stones need a nidus to form, usually a bacteria and are therefor associated with UTIs. An important factor when talking about prevention. Struvite stones are usually smooth, yellow to tan colored little rocks. They tend to form in alkaline (not acid) urine but I have seen them look like anything and form in all sorts of urine. The only way to tell what type of stone the dog has is to get one and send it off to the lab. Now, in male dogs, there is usually only one way to get one, surgery. I have been lucky in females and have been able to get them to pee out a small stone that we can have analysed. The other cool thing about struvite stones is that they can be dissolved by diet. While the SO diet by Royal Canin will do this, I find that S/D (could that be for stone diet?) made by Hills does a great job. Struvite stones can be dissolved in about 1 month in most dogs. There is a catch for the guys tho. I don't like to try to dissolve stones in a male dog. The thing is, that before a stone dissapears, it becomes small. Small stones can pass out of the bladder and get stuck in the urethra, just above the os penis (penis bone) This can cause an obstruction, a true surgical emergency.

So for all you guy dogs out there, and you know who you are, your choice is surgery. Here's what came out of the bladder above.

Pretty impressive collection, huh? Now once the stones are out, if they turn out to be struvite, we do put the dogs on S/D just to make sure that we are good to go and that nothing else is forming. Then we put the pet on a maintenance diet and monitor the urine every month. What are we looking for? Infection. Remember, these stones need a nidus of bacteria to form, so if we can catch the UTI early, we can prevent the struvite stones from forming. The thing we have to be careful about tho is the other end of the spectrum, stone wise. We used to try to promote an acid urine, either by diet manipulation or by adding acidifiers to the diet to prevent these stones from forming. That's when we started to see an increase in the number of oxylate stones in our canine patients. These stones cannot be dissolved by diet, do not need infection to form, and must be removed surgically in males and females. They are rough surfaced and can stick to the lining of the bladder. They can be difficult to remove and I can only assume that they are quite painful. Once out, we usually use the Royal Canin diet to prevent them from coming back. This diet maintains a neutral ph so as not to encourage struvite stone formation and works by decreasing the precursors for stone formation in the bladder. Another new improved option is Hills C/D multicare, it does the same thing. I won't put another set of links to the website, just follow the ones above.

So the take home message is, re occurring bladder symptoms in the dog are not usually just repeated infections. Additional testing needs to be done to find out why the dog is having the problem, what the problem is, and what can be done to cure this episode and prevent future ones. It is an on going problem that can be managed very well with diet and follow up.

Oh, and if anyone thinks they know their stones, here's a little trivia question. What breed do you think has the greatest incidence of bladder stones in our practice. I'll give you a hint, nah, no hint, but I will give you a prize. First person that doesn't work at my hospital to leave the right answer as a comment will get a $10 gift certificate for some really outstanding pet food. Check it out at www.TheVetsChoice.com.

To be Fit as a Fiddle, a Cat Has to ....

OK, there it is, right in the title, my homage to Fellini. Not that the oblique film reference has anything to do with today's topic, I'm just trying to show that I am a multi dimensional kind of guy. The first person to identify the reference and leave it in a comment will win ..... My undying respect for your film knowledge. I mean come on, I gave you the artist, you should be able to figure this one out.

But on to our first topic in nutritional therapy, feline lower urinary tract disease. (maybe we should have stayed with Italian films). Back in the dark ages, when I graduated from vet school, (go Penn class of '84), we used to see a lot of cats with signs of lower urinary tract disease. You know, increased frequency of urination, perhaps some blood or straining in the litter box with little urine produced. In male cats it would frequently get bad enough that they would block and be unable to urinate at all, necessitating surgical intervention of some sort. Ultra sound was not readily available, so we assumed that these cats had infections and gave them antibiotics and made some diet recommendations (at the time Hills Prescription Diet C/D was all that was really available) and lo and behold, most of these cats got better. Logic, incorrect as it might have been, dictated that there was an infection that the antibiotics cured. Current theory was that the ph of the urine (measure of acidity calculated by the inverse of the negative log in base 10 of the hydrogen ion concentration, but now I am just showing off) was too high so we added acidifiers to the diet as well.

Theories came and went over the next few years, but the antibiotics stayed. In that time we thought it was the ash content of the diet, the magnesium content of the diet, the ph of the urine, and people even thought that urinary disease in cats was related to the phase of the moon. What did change, is that we started to culture some of these cats' urine and we found, you guessed it, no infection. So what was going on? We had made the urine acid, we had given antibiotics, but then after really screwing up the urine of these felines, we started to do some imaging. First was x rays. It's hard to see in this photo, (and I don't know how to put arrows in these yet but hey, I'm an old dog learning new tricks.)

The bladder is to the left of the bones and to the right of the black gas. If you look carefully, you can see a line of small white stones. This is what we started to see on a certain percentage of our bladder x rays. Stones are made of minerals so they show up white. Most are struvite (phosphate) or calcium oxylate stones. It is hard to tell which are which on radio graphs, you need to take them out and send them off for analysis. The thing is, a lot of cats had urinary tract signs, negative cultures, and no stones on radio graphs. Enter the ultrasound machine. Now, some people can read ultrasounds with no problem. I on the other hand have difficulty. So, I have a doctor that does imaging come to our practice to do our studies. And what he finds in many cases, is simply a thickening of the bladder wall. No infection, no stones, no nothing.

These are cases of sterile interstitial cystitis. A potentially serious inflammation of the bladder that causes all of the signs that we see. Sometimes it is self limiting and usually episodic. That explains why so many cases get better after a week of antibiotics. They would have gotten better even without antibiotics. Some do not resolve so quickly and others are real bears to manage. They require constant dietary manipulation and medication just to keep the disease under control.

So what do we do to manage feline lower urinary tract disease? Well if we find an infection, antibiotics are still the answer. If we find stones, we take them out. Here are the stones from the cat in the above radiograph. Easier to see now that they aren't in the cat.
We will send these off to the lab and once we know what type of stones they are, then we will make long term management recommendations. The tough cats are the ones with the sterile cystitis (SC). These get a combination of pain medications, anti inflammatory medications and even some anti anxiety medications. But the only thing that seems to have any science behind it is dietary manipulation. Now, anicdotally, colleagues of mine in feline only practices have told me that they have significantly reduced the incidence of FLUTD (feline lower urinary tract disease) in their patients simply by having all of their clients feed canned food. It seems that the increased moisture may play a roll. Cats are notoriously poor drinkers so it does make sense that a more dilute urine brought on by increased water intake might help with irritants in the bladder. There are actually studies showing that feeding canned SO a diet made by Royal Canin actually has been demonstrated to decrease the signs of FLUTD in cats. It will also dissolve those pesky struvite stones and prevent new calcium oxylate stones from forming. It is our go to diet for most of our cats with FLUTD. There are some issues tho, it is high in salt which can be a problem if cats have marginal kidney function.

Another choice is a Diet made by Hills. Remember the C/D I mentioned earlier? Come on, pay attention. Well it has been reformulated. It is designed to dissolve struvite stones in the dry form, so it probably will in the canned form as well. The canned formulation is lower in salt than the Royal Canin diet and we are going to start using this a bit more for our cats with SC.

So we have come a long way from just popping our feline friends with antibiotics every time they strain to urinate. And, we have done far fewer urethrostomy surgeries on blocked male cats, which is a good thing. We can control and treat many cases of FLUTD in cats with diet and common sense. Talk to your veterinarian for dietary recommendations and don't forget to let me know if you figure out the reference at the beginning of this post.

I didn't forget about dogs, they are just entirely different beasts and I will post about them next time.

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You are what you eat, they are what we feed them

I have to say that I was pleasantly surprised by the feed back that I received for the last blog series. Maybe there is something to this whole series concept. People that are not related to me actually sent me suggestions for topics and I wrote about them. I whole new experience for me, positive feedback from the blogisphere.

Now I've made this mistake before. As rush chairman at Penn Iota chapter of Phi Kappa Psi fraternity in the late 70's I did sign off on a series of theme parties that went from the very successful Hawaiian themed rush kick off, to the disastrous "Come Get Mugged", beer mug give away, (those of you that were there will remember that we ended up with hundreds of leftover beer mugs), I'm still going to give this theme thing a go.

So, I would like to write a series of posts on nutrition and the treatment of disease. We use nutritional therapy as a stand alone for certain conditions and as a adjunct therapy along with medicine and surgery for others. Sometimes just diet changes, sometimes supplements. There is a whole lot of misinformation out there. People are making recommendations that are not based in science. Alot of these people want to sell you something. Some of them are just misinformed, Some are just parroting things that misinformed people from the previous sentence told them. Others are just silly.

I'm going to try to limit my discussions to things that the general scientific community knows to be true. I will offer my opinion when I feel it is appropriate, but will tell you when it is my opinion. I will try to provide references when I can to support my statements, and I will try to make them independent or at least independently corroborated when I can.

So what do I want from you dear readers? Well, I'd love you to keep reading. I would also like it if you could send me some subjects that interest you. Disease conditions your pet's have that are being managed with nutrition or that you would like to manage with nutrition; things that you have heard that you would like to know more about; things that have worked for your pets and things that have not worked. I'll do some research, see what I can find out, and then post. You are free to comment, but I'll cut you off at the knees if your comments are just sales pitches to my readers.

Now this may sound like an excuse, but some of these posts will take some serious thought. So, there may be a bit of a lag between them. No, I'm not getting lazy during the height of my triathlon training season, I just want to bring you quality information along with my entertaining wit.

So let me know what you want to read about and we'll get started. I announce my new posts on twitter , so feel free to follow. If the whole twitter thing is too much for you to deal with (I mean who likes to tweet anyway), become a fan on facebook, I announce my posts there as well. It is also a great source of information and cute pet pictures, if I do say so myself.

Keith Niesenbaum, VMD

www.CrawfordDogandCatHospital.com

Live Long and Prosper, the final chapter

OK, those of you that have been following along probably have some documentation indicating that this was going to be a 5 part series and if you've been counting, it's only 4. Too bad, my blog, my rules. I actually am quite surprised that I was able to focus long enough to string together 4 posts over a rather regular interval on a related subject. Fortunately, I just got back from vacation, so I should be able to avoid the rant that happened in a previous post. I'm feeling very mellow after spending some quality time with family and friends and their dog. That's right, a true busman's holiday, their dog Zeus was with us for the week. Just to make me feel at home, my host's fed their dog some table food (you all know how I feel about that) and he had a bout of an upset stomach that ruined a previously reviled and hideous, yet functional area rug in the living room. But I digress. Zeus is a really cool dog of the 60 lb mixed breed type. Not without his foibles like a bit of separation anxiety and a quirk that won't allow him to pee or poop unless he is taken for a walk at the most inopportune time. One thing I will say, he is well behaved. In fact most of the dog's we encountered on this trip to Martha's Vineyard were well behaved. Well, that one black dog did almost knock his owner over trying to get to Zeus on one of our previously alluded to walks and their was the dog aggressive Leonberger on the beach that barely looked like a Leonberger but we'll defer to his owner since the owner and the dog both were trying to behave.

Why am I prattling on like this you are probably asking at this point. Well, I would like to address an often overlooked reason for early death in both dogs and cats. Euthanasia for behavior issues. Cats are trickier so we can get them out of the way first. While I have seen cat's euthanized for behavior issues, these are often not training deficiencies, but rather behavior problems. The most common being failure to use the litter box, destruction by scratching and aggression towards people and other animals. These can be stress related, although looking at the lifestyle of most of the cats that I know I can't imagine a more stress free life.

However, the stereotype of the cat collector aside, cats are not pack animals like people. In the wild they are generally solitary hunters, coming together when necessary at common feeding areas and to seek the company of other cats to make kittens. (there, doesn't get anymore G rated than that does it?) We put a bunch of them together in one home and sit back and wait for behavior issues to develop. There are a number of good sources of information on reducing this stress, but my favorite is put out by The Ohio State University, School of Veterinary Medicine. Give it a look see.

To summarize, make sure everyone is neutered (cats not people, different topic and less G rated), have adequate, clean litter boxes with varied substrate, separate feeding and watering areas, and plenty of perches and scratching posts. This should take care of most of you issues. For those that are particularly troubling, consult your veterinarian, and take a look at the Ohio State link.

Dogs are both more complex and actually easier to deal with. They are pack animals and as such can and should be trained. That doesn't mean that all dogs will be neurosis free and never have a bad moment. I mean, my dog Cookie is generally well behaved unless you let your toddler put their face too close or it thunders out. Even Zeus had his moments this week. However, it is a rare dog that can't be made obedient in most, if not all situations. Dogs should listen to their owners, come when called, sit, stay, and go to the bathroom outside. Some can even be trained to pick up after themselves and friends although I think Piglet has way too much supervision in this video.

The point is, well trained dogs are easier to deal with and people will enjoy being around them and therefore, around you as well. So start as a puppy, socialize your pet, and get some basic obedience training. Oh, and you can't just go to some classes when your dog is 4 months old and expect that it will be trained for life, you have to keep working at it and working at it.

If I had read the manual for the digital camera that my wife purchased a couple of weeks ago, I would have a picture of Zeus behaving for you to see and it would make this blog more interesting. So, if you have photos of your dog doing tricks, why don't you post them on my Facebook Fan Page so everyone can see them. Or, if you know how, put them in a comment right here on the blog.

While we're talking about comments. I had to reject a couple in the past week. While I love to hear from you all, please don't submit comments for products or services. If you want to promote yourself, then write your own blog. It's not hard, any well trained dog or cat can do it. Heck, even a veterinarian that can't use a digital camera can do it.

Next week, we'll try to focus on nutrition and specific diseases. If you have any favorites that you would like me to touch on, let me know. These may end up being a little less rambling and a little more educational, but hey, you never know.

Keith Niesenbaum, VMD

www.CrawfordDogandCatHospital.com

Live Long and Prosper, Third in a Series

So here it is, a couple of days late due to a little techno hang up. (I couldn't find any pictures to use for this post even though I have saved many over the past couple of months in anticipation). I think the glitch has something to do with my abandonment of the Blackberry Storm that I have hated for two years and the acquisition of the yet to be mastered Droid Ally. However, I think that my technology foibles can be another whole series of posts for some future date. I'm not here to talk about phones or apps, or even my laptop computer which seems to spend more time at a certain apartment in Brooklyn than it does on my lap. I'm here to talk about one of the most important things you can do to help your pet live a long and healthy life. We've covered vaccines and Nutrition/weight control. Now it's on to oral health.

Now this doggie seems to have nice, shiny, white teeth. You might say, "Gee, the gums look a little red and maybe I detect some staining on that upper 4th premolar." (big tooth with two points). You might also wonder why this dog has a clear tube coming out of it's mouth, and why Kim's fingers are so close to the aforementioned pointy teeth. Well, as you might have guessed, this dog is sleeping and it's teeth didn't look like this a little while ago.

They looked like this. (Cue the horror movie dramatic music)

Yes, it's true, someone probably let this dog lick them on the face and couldn't imagine why it's breath smelled like 2 week old dead fish. But bad breath is not the only problem that we see with dental disease of this degree. As you can imagine, this dog's mouth must hurt. Go to your dog right now. I'll wait, bring him or her back to you computer. Now sniff his breath. Lift his lip carefully like Kim was doing in the first picture. If you smell rotten eggs or see any staining on the teeth, or worse, if you see tarter and red gums like this you call your veterinarian first thing in the morning, hang your head in shame and make an appointment to have your pet's mouth examined and the disease treated. That's right, disease. Oral disease is a painful condition that leads to tooth loss. Infections in the periodontal pocket can cause abscesses. Cat's (not pictured here due to the aforementioned tech issues) also get cavity like lesions that expose the nerves. Bacteria can get into the blood and cause kidney disease, heart valve disease, and liver abscesses. Toxins from these heinous bacteria make your pet feel like crap. This is serious stuff. Oh, I know, your pet is too old for anesthesia and dental treatment. Horse Hockey! (for all you Col. Potter fans). Old age is not a disease but rotting teeth are. Have your vet perform a complete physical examination, including the oral cavity. This, along with some basic blood work will determine the safest way to treat your pet's mouth.

See, here's another dog with horrendous teeth. This guy isn't going to be so lucky. Once the teeth were cleaned and radiographs were taken, it was determined that not all of the teeth could be saved. That's right, we had to make the phone call that owner's hate to hear, "Mrs (fill in your name if you haven't been taking care of your dog's teeth.) we have finished Fluffy's cleaning and radiographs and we have to extract several teeth" The owner always gasps and asks how the dog will eat. I tell them, "better than he is eating now because these teeth are loose and painful."

Notice how clean the teeth left behind are? Notice how many are missing? And this is only one side of the mouth. I assure you that the other side looks much the same. Do not let your pet's teeth get like this. Your veterinarian should be examining your pet's teeth at every wellness visit. You should ask your veterinarian if your pet's teeth are OK and if yes, what you should do to keep them that way. If no, what do you have to do to treat this disease. Once the mouth looks like the pre pictures above, no amount of brushing, or treats, or prayer will clean them. I have to clean them. Then you have to work out a home care program and do your part. Oh, yeah, when your veterinarian tells you the teeth are bad, don't answer with, we just had his teeth cleaned last year. Look in the mouth and have the doctor show you the problem. Then the two of you need to come up with a plan to treat the problem and then prevent the problem from coming back so soon.

You may have noted a bit of terseness in my tone for this post. You are correct, I am ranting again. Next to overfeeding your pet, not taking care of it's mouth may be one of the worst things you can do. It will decrease lifespan and will make for a horrible quality of life for both of you.

I'll calm down now. I hope no one got bitten looking in their pet's mouth. I should have warned you to be careful earlier. I also wanted to thank my associate Dr. Brian Spar for the photos. He has an I phone and he will be glad to tell you how much better it is than any technology I could ever posses. (wait until his I phone 4 starts dropping calls). Also, special thanks to Kim Green for helping to display the oral cavities. She is our Licensed Veterinary Technician and she does our dental cleanings and takes the oral x rays for our patients. She will also be the one calling you to tell you if we need to do extractions or additional work.

One more post in this series, then it's on to another topic. I think there is an over/under poll going on as to how many days it will take me to finish off the series. I was really good for the first two.

Keith Niesenbaum, VMd

www.CrawfordDogandCatHosptial.com

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Live long and prosper, #2

So this could be a first, but I'm actually blogging according to some pre-arranged schedule. Two weeks in a row, keeping to the topic of what you can do to help keep your pet healthy. Last week, I talked about regular vaccinations for your pets. I know everyone read and enjoyed it but in case you need to review, just check it out here.

This week is a topic that is near and dear to my heart and one that will cost you nothing and save you a bundle in veterinary bills over your pet's life. I'm talking about nutrition and fitness, or more specifically, controlling your pet's weight. I touched on this topic briefly in the past, but obviously no one was listening to me because I keep seeing overweight pets. Well it's time to take the gloves off and get down and dirty. If you have an overweight pet then this is for you.

This is a fat cat. It's not cute, (OK, maybe a little), it's fat. There are a whole slew of diseases that fat cats get more often than normal weight cats. First thing that comes to mind is diabetes. Yes diabetes as in your cat has a high blood sugar, will get severe complications and need insulin injections for the rest of it's life diabetes. Fat cats also are more prone to arthritis. Studies have shown that a large percentage of older cats have arthritic changes on radiographs. These cats may suffer in silence. Once can only imagine how carrying around this extra weight will make things worse. Overweight cats also have a higher incidence of respiratory disease, heart disease, and certain tumors. If that's not gross enough, they also have a higher incidence of constipation. You haven't lived until you've had to sedate a cat to pull obstipated poop out of it's butt. DO NOT LET YOUR CAT GET FAT!!! Talk to your vet about appropriate diets, especially after spay or neuter surgery as this will alter your cat's metabolism, lowering their caloric needs. I'll not get into details here, but try to avoid high carbohydrate diets, and stick with a large proportion of canned food that is higher in protein and fat. Think Catkins (Atkins) diet, as I cross over some copyright law line and walk all over Dr. Atkins' name. If there is interest, we can look deeper into this topic in the future. Some blogger guru said that I should keep my posts at around 800 words and those who know me know how hard that is, so lets move on.

OK, dog owners, you didn't think I was going to let you off the hook did you? Dogs get fat too. Actually, it was a run of fat, crippled, could not get up off the floor, dogs that made me decide to write this whole series of articles. I actually had to put a 135 lb Golden retriever to sleep because it was so fat that it had Pickwickian syndrome. Follow the link, I didn't make it up and it is a great SAT vocabulary word for my younger readers. Fat dogs have degenerative joint disease, increased risk of torn ACL ligaments, hip dysplasia, heart disease, and a total lack of vitality. Is it worth giving into that begging at the dinner table? Just say no!

Now I just got back from a half Ironman triathlon this weekend. I don't just throw this out because I want you to know that I can complete the 70.3 miles, even in the brutal heat, (1.2 mile swim, 56 mile bike ride, 13.1 mile run) but because I want you to know that I know what a battle this is (weight control that is). I spent a day getting passed by guys and gals that looked like this greyhound in the picture. We don't have to limit our pets diets until they look skeletal. A Labrador will never look like this guy, and the poor pugs will develop body image issues just looking at the photo. The point is, we all have an ideal body weight and we need to get there to stay healthy.

So, what's a pet owner to do? Feed a healthy diet. Feed to body condition, that is to say, if the amount you are feeding is leading to weight gain, cut it back. If your dog doesn't eat the food that you put down every time, in 3 seconds, but is maintaining weight, you do not have to top dress it with pan drippings (fat), or chicken breast, or hamburger, or anything. And exercise. This is tougher for cats than for dogs, but 20 minutes with a laser pointer every day will do wonders, if it doesn't make you crazy. And dogs need to walk, or run (breed dependent) every day, twice a day if possible. I go crazy when people tell me they exercise their dog every Saturday for 10 minutes if the weather is good. I look at them and realize that they are on the same type of exercise program. They should check with their doctors and veterianarians to make sure that they are starting out on a healthy, suitable program, then get off the couch people, and grab a leash, it's good for both of you. Take a spouse out with you and the dog, talk to each other meet your neighbors. (unless you live up at like 173rd street, then maybe you should leave your neighbors be and make sure you have a big dog and walk before dark.)

Some dogs (not most cats) like to swim. Great exercise. But I have to say, if they learn to ride a bike and pass me at my next triathlon, I'll have to find another athletic activity. My ego can only take so much. I can take being passed by the old men and women, but the first time a dog takes me down at an Ironman event, I'm done.

So, now I'm out of ideas for the next three posts on what you can do to keep your pet healthy. Give me some ideas. If I have any hope of keeping to this schedule, it will be up to you. This idea came for crazyboutdogs on twitter. Follow her at www.twitter.com/crazyboutdogs. Follow me at www.twitter.com/knvet and become a fan of our facebook page at Crawford Dog and Cat Hospital

Keith Niesenbaum, VMD

www.CrawfordDogandCatHopsital.com